We have brought quality to the forefront of medicine since 1999, when the Institute of Medicine showed that medical errors caused almost 100,000 deaths a year, before the turn of the millennium.

Quality!  Quality came to the forefront!  We have been championing Quality Metrics for over fifteen years.  We thought.

The Washington Post offers us the headline:

Researchers: Medical errors now third leading cause of death in United States

Their analysis, published in the BMJ on Tuesday, shows that “medical errors” in hospitals and other health care facilities are incredibly common and may now be the third leading cause of death in the United States — claiming 251,000 lives every year, more than respiratory disease, accidents, stroke and Alzheimer’s.

It’s time to forget about Quality, and focus on Quality – wait, what? The killer medical establishment has increased unnecessary deaths by 250% over the last fifteen years? How’d that happen?  Just imagine how bad it would have been if we DIDN’T keep our eye on the quality 8-Ball, eh?

Am I finagling the numbers?

The IOM, based on one study, estimated deaths because of medical errors as high as 98,000 a year. Makary’s research involves a more comprehensive analysis of four large studies, including ones by the Health and Human Services Department’s Office of the Inspector General and the Agency for Healthcare Research and Quality that took place between 2000 to 2008. His calculation of 251,000 deaths equates to nearly 700 deaths a day — about 9.5 percent of all deaths annually in the United States.

Kenneth Sands, who directs health care quality at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School, said that the surprising thing about medical errors is the limited change that has taken place since the IOM report came out. Only hospital-acquired infections have shown improvement. “The overall numbers haven’t changed, and that’s discouraging and alarming,” he said.

At a top U.S. hospital, almost 50 percent of surgeries have drug-related errors. Could we be underestimating the actual death rate?

“Some estimates would put this number at 40 times the death rate,” van Pelt said. “Again this gets buried in the daily exposure that care providers have around patients who are suffering or in pain that is to be expected following procedures.”

Deaths from medical errors could be as high as 40 x 250 = 10,000,000 per year in the United States. Ten Million Deaths a year. That is over TEN TIMES heart-disease-plus-cancer-plus-diabetes.

What do you think? Should we have a Night of the Broken Glass against the hospitals and doctors?

And how is this happening?  Insufficient standardization, insufficient regulation, that’s how!

(Kenneth Sands), who was not involved in the study published in the BMJ, the former British Medical Journal, said that one of the main barriers is the tremendous diversity and complexity in the way health care is delivered. Consumer Reports recently investigated California licensing records and found that many doctors who were still practicing were on probation for serious violations of patient safety.

“There has just been a higher degree of tolerance for variability in practice than you would see in other industries,” he explained. When passengers get on a plane, there’s a standard way attendants move around, talk to them and prepare them for flight, Sands said, yet such standardization isn’t seen at hospitals. That makes it tricky to figure out where errors are occurring and how to fix them. The government should work with institutions to try to find ways improve on this situation, he said. “Measuring the problem is the absolute first step,” he said. “Hospitals are currently investigating deaths where medical error could have been a cause, but they are under-resourced. What we need to do is study patterns nationally.”

Yeah. We should do that sometime.

Some of the me-too yahoos agree in the comments:

The problem is secrecy! No one — not even the insurance companies or employing hospitals effectively monitor physicians. Every patient should have a patient advocate at every examination — a professional one, a friend, or a family member. This would immediately reduce questionable treatment and errors. Medical malfeasance far outnumbers the “partner abuse” identified by the secrecy.

and

It’s almost impossible to be a “good consumer” of health services in this country. Information to make informed decisions is hard, if not impossible to come by. Good luck facing a major health intervention and being able to know the success rate, infection rate, mortality rate, etc. of the providers, the information is not available. Add to that the inability of the providers to quote you a price for the products and services they are about to provide. After that 98,000 deaths per year study was publicized, the Journal of Patient Safety evaluated the data and came up with a “true number” of over 400,000. When you are facing a major health intervention, you are provided what they called “folklore” about the doctor or surgeon, things like “this famous athlete went to Dr. X for their knee surgery”, no hard facts.

IF only we could put lapel cameras on all the doctors and surgeons…hey, what an idea!

 

 

Advertisements