According to two landmark studies from the 1980s and 1990s, injuries caused by medical management occurred in 3.7 percent of patients with 69 percent of cases attributed to error. Errors fell into four groups.
First, diagnostic errors include the failure to use relevant tests, using outdated tests, mistaken or delayed diagnosis, and failing to appropriately act on test results.
Next, treatment errors involve mistakes when performing tests, treatment, or procedures. Errors in drug dosage or administration and avoidable delay in providing treatment are also in this group.
The third group are preventative errors. This involves inadequate monitoring or follow-up care or failure to provide preventative treatment.
Finally, there are general errors. Equipment failure, communication errors and system failures fall within this group.
Identifying the areas and patients with the greatest risk, such as surgery, is important. Surgery is a complicated and dynamic specialty requiring technical skills, teamwork, and complex equipment for treating a high number of patients.
Surgical injuries accounted for almost half of all reported adverse medical events, according to the study. Development and implementation of strong protocols, performing skills assessments of surgeons and support staff and providing training that allows mistakes in a controlled environment can help lower risks.
Older patients and patients with more complex ailments face greater risk of serious disability or death from errors. Safety training, checklists and feedback resources should be directed to treatments and procedures involving these patients.
Injuries can be prevented by staff teamwork such as the TeamSTEPPS which is used in approximately 70 percent of hospitals in this country and may have reduced errors by 20 percent. It has curriculum addressing competencies in team structure, monitoring situations, communication, leadership and providing support.
Errors are also prevalent in handoffs where patient care is transferred from one provider to another. Good protocols and training stressing face-to-face communication can reduce these errors.
Hospital also need to deal with technology such as electronic records. These were designed to reduce errors by creating one easily shareable record that is accessible by many practitioners to assure oversight of medication allergies or concurrent medications. But mistakes are made because of inaccurate data entry.
Electronic monitoring can help track the frequency and impact of data errors to prevent their reoccurrence. Intervention can correct mistakes and highlight the errors that cause the most harm.
Attorneys can help injured patients or their families seek compensation from negligent hospitals. They can help protect this right in lawsuits and negotiations.