What You Need to Know About Patient Safety

By Ken Suggs*

Five years ago, the Institute of Medicine (IOM) issued a startling report ("To Err is Human") that acted as a wake-up call to hospitals, health care providers, and patients: as many as 98,000 people die each year in hospitals from infections, drug mix-ups, and other mistakes—mistakes that could have been prevented.

Two of the authors of that report, Lucian Leape, adjunct professor of health policy and management at the Harvard School of Public Health in Boston, and Donald Berwick, CEO of the Institute for HealthCare Improvement in Cambridge, Mass., recently published a follow-up article in the Journal of the American Medical Association (JAMA).

They noted that the IOM report "stimulated...stakeholders to engage in patient safety, and motivated hospitals to adopt new safe practices." But, they also concluded that progress since the initial IOM report, "has been slow."

They suggested that the pace of change in patient safety will likely increase in the areas of "implementation of electronic health records, diffusion of safe practices, team training, and full disclosure to patients following injury."

Further, Leape and Berwick called upon the Agency for Healthcare Research and Quality (the lead federal agency for patient safety) to bring together "all stakeholders" in the patient safety arena "to agree on a set of explicit and ambitious goals for patient safety to be reached by 2010."

While we wait five more years for those advances, we can arm ourselves, now, with knowledge. There has been a proliferation of online information so that people can be smart consumers when it comes to finding top doctors and safe hospitals.

For a broad overview, try the federal Agency for Healthcare Research and Quality (www.AHRQ.gov). It has an extensive section on medical errors, including fact sheets on how family members and individuals can prevent medical errors in children and adults. AHRQ also has a link to the Patient Safety Network. Here you can view abstracts and some full texts of medical journal and news articles pertaining to patient safety, as well as find out about meetings pertaining to patient safety. There is also a link to an AHRQ journal that features actual cases of medical errors.

If you are looking for top hospitals, most of us have seen the U.S. News and World Report article that comes out annually ranking the best hospitals in 17 specialties. At the website (www.usnews.com) there is a link to the "best hospitals" site. Be sure to click on the "methodology" section to read about how U.S. News and World Report evaluates each hospital.

Not all hospital-rating websites use the same methodology in their evaluations, and they offer slightly different products. For example, at HeathGrades (www.healthgrades.com), you can obtain a report (for a small fee) on a physician's training, certification and any state or federal disciplinary actions against them (not including malpractice information).

For more detailed information about individual doctors, the best place to go is the clerk's office of your county courthouse. This office holds the key to finding important facts such as whether a doctor has been sued, and if so, how many times, and the outcome of each case.

The health care data company Solucient (www.100tophospitals.com) offers many lists pertaining to what it determines are the "100 Top Hospitals" in the nation. Click on "Media," then "Press Releases" to get easy-to-read synopses of study information. Part of Solucient's methodology includes assessing a hospital's profitability, cash-to-debt ratio, and tangible assets.

While it may seem strange to assess finances as a factor in patient safety, the AHRQ recently did just that, focusing on elderly patients in acute-care Florida hospitals. It determined that patients treated at "financially distressed" hospitals are 13.7 percent more likely to have a surgery-related patient safety event, and 24 percent more likely to die during hospitalization, than those patients treated at "highly profitable hospitals."

You can also learn to be the best advocate you can be for yourself, a friend, or your family. Not speaking up for more tests or an extra day in the hospital, or asking to see the label on an IV bag could make the difference between quality care and a patient safety failure.

The National Family Caregivers Association website advises, "Being an advocate means recognizing that the squeaky wheel is often the only one that gets attention in a too busy system."

*Ken Suggs, president of the Association of Trial Lawyers of America, is a partner in the Columbia, SC, law firm of Janet, Jenner & Suggs.

Used with permission from The Association of the American Trial Lawyers of America.  All rights reserved.