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Medical Mistakes Are 'Leading Cause' of Death and Disability


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Nov. 30, 1999 (Minneapolis) -- The news is in, and it's bad but not hopeless. There is an epidemic of medical errors, and the etiology is multifactorial: scrawled prescriptions, lookalike drug names, and an exploding knowledge base, according to a report from the Institute of Medicine (IOM).

The report, entitled "To err is human," cites two studies showing that between 44,000 and 98,000 hospitalized Americans die each year due to medical mistakes. As the title suggests, there is no way to eliminate errors, but the IOM says there are ways to prevent them, and save lives.

Medical errors are not due to individuals, but to poorly designed systems, says Linda Kohn, PhD, co-director for the IOM's Quality of Health Care in America Project, which issued the report. Therefore, the means for improving safety will be system-oriented, rather than involve the targeting of individuals.

"We need to redesign processes to make care safer," Kohn tells WebMD. For example, the report recommends a patient safety agency under the auspices of the Department of Health and Human Services. However, just because the necessary improvements transcend individual physicians doesn't mean that physicians should take the Project's findings lightly.

"This is a very serious issue. Patients are being harmed by errors in the health care system," she says. In the IOM's press release, medical errors were referred to as a "leading cause" of disability and death, killing more people annually than highway accidents, breast cancer, or AIDS. "We can make the system safer by designing safety into the system," Kohn tells WebMD.

"The [IOM] has been looking at the infrastructure of the health care delivery system for years. The notion of looking for medical errors is not new," says Rick Wade, senior vice president of the American Hospital Association. He tells WebMD that one reason for these recommendations coming after public concerns about medical malpractice has been a database lag. "There's a lack of uniformity among states in the reporting of errors," he says. "The systematic safeguards aren't sophisticated from a technologic standpoint, and manual checks are subject to human error."

Because the fear of litigation or other repercussions impedes an open discussion, the report calls for minor errors to be treated in confidence. "If errors cause no harm or little harm, the information about these errors should be protected [so that we can put] corrections into the system. On the other hand, serious errors need to be reported externally so we can learn," Kohn says. "The committee distinguished between these two types of errors.

"Health care organizations need to make patient safety a priority and devote resources to designing safer systems. Medical errors ... can occur in all issues related to the process of providing care. We know the system can be designed to improve safety, because several industries have better safety records," Kohn says.

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