This month marks the fifteenth anniversary of the landmark report from the Institute of Medicine of the National Academy of Sciences that estimated up to 98,000 Americans die from preventable mistakes in hospitals every year. It is time to know if health care is safer now.
Many hospitals are working diligently to reduce medication errors, hospital-acquired infections and other causes of harm. Progress has been made.
A wake-up call in 2013 raised the stakes. The Journal of Patient Safety published new estimates that up to 440,000 lives may be lost annually in hospitals due to errors, making health care the third leading cause of preventable mortality in the United States. This is equivalent to the combined populations of Cedar Rapids, Des Moines and Ames. Many more people are injured during their hospital stay.
Stresses and strains are making health care unsafe. Physicians, nurses, pharmacists and other health care professionals are forced to meet demands for higher productivity. They see more patients and do more, leaving little time to talk with patients and each other. Communication breakdowns ensue and patients fall through the cracks.
The performance of any system with unsafe conditions that is forced to operate at a faster pace has only one way to go, and that’s down.
On top of that, health care has become more complex with a steady stream of new equipment, devices, medications, and electronic health records entering the sacred space of patient care. Human ability to safely use this bounty is strained beyond capacity.
The time has come to stop relying on estimates of health care harm. The public should know the unvarnished truth. Are we better off than we were 15 years ago?
The federal government counts the number of deaths from all causes — including cancer, heart disease, vehicular accidents, and smoking — except medical harm. Counting the causes of mortality shows that society cares about every life cut short.
The numbers, and the human stories behind them, motivate people to act to reduce the burden caused when lives end too soon. Decades of sustained work to prevent and treat disease, design safer cars, and reduce smoking has extended life for countless numbers of people. Objective progress is reported to the public that is deeply satisfying. The lesson is that when a problem is measured and reported, it is more likely to be fixed.
A public commitment to transparency and zero patient harm from hospital governing boards and senior leadership would strengthen the public’s trust. The public will know that someone is in charge, is counting, and is accountable.
Right now, the public sees only a black box behind a wall of silence. Another 15 years will pass with the same result. We are obliged to do better.
Progress in reducing patient harm would give well-deserved attention to the highly skilled health care professionals who go to work every day to make health care better and safer for us all. That would be a good thing.
• Rosemary Gibson is Senior Advisor to The Hastings Center and has authored four books, including Wall of Silence, and numerous articles on health care issues. David P. Lind is founder of David P. Lind Benchmark, an employee benefits and health care research organization in Clive. Comments: firstname.lastname@example.org