RUNNING HEAD: MEDICAL ERRORS IN HEALTH CARE Medical Errors in Health Care Susan Franks HCS/545 Health Law and Ethics November 6, 2015 Richard Nordahl
MEDICAL ERRORS IN HEALTH CARE Medical Errors in Health Care In 1999, the Institute of Medicine (IOM) surprised the healthcare industry with its landmark study on patient safety. In it, Kohn, Corrigan, and Donaldson estimated that medical errors contributed to the death of up to 98,000 patients annually. Many questioned this number, citing that problems with data collection and research methods had probably inflated the estimate; there had to be a mistake. Since the IOM report, there have many attempts to get a more accurate picture of the harm caused by preventable errors. Some have suggested that a more precise estimate may be ten times higher than what the IOM reported (Andel, Davidow, Hollander, & Moreno, 2012). A literature review by James (2013) estimated that there are over 400,000 premature deaths related to preventable medical errors each year, which is more than 1,000 people a day. Assessing the economic impact of medical mistakes is even more challenging because there are so many factors to consider, but it is easily in the hundreds of billions of dollars annually (Andel et al., 2012). There will always be some question about the actual number of deaths associated with preventable medical errors, but most will agree that any of the estimates reported deserve a stronger response than has been observed. The following is an examination of the roles that organizational structure, governance, culture, and regard for social responsibility play in the persistence of medical errors. The ethics of allocating resources to affect this reduction will be discussed. Finally, evidence-based suggestions on how organizational systems should be redefined will be explored. 2
MEDICAL ERRORS IN HEALTH CARE Organizational Structure, Governance, Culture, and Social Responsibility Hospitals inherently have organizational structures that make procedures complicated and at risk for error. A patient’s journey through the hospital depends on the joint efforts of different departments, professions, and hierarchal levels. It is difficult to monitor behavior and make significant changes with so many moving parts and different people, who answer to various supervisors- if any, and who have different educational backgrounds ( Rivard, Rosen, & Carroll, 2006) . Quality improvement and risk management have traditionally been separate departments, rarely joining forces in addressing medical errors. Until 2005, essentially the only regulatory influence on preventable medical errors was via tort liability. The IOM report, released in 1999, contributed to the introduction of federal legislation regarding patient safety. The Patient Safety and Quality Improvement Act of 2005 (PSQIA) established a system of patient safety organizations and a national patient safety database. Many providers feared voluntary reporting of safety issues because of the risk of malpractice or disciplinary action. The
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