According to research published in the New England Journal of Medicine and reported by NBC News, nearly one-quarter of hospital patients in the United States may be damaged. The findings are dismal, and experts believe that, after decades of work, hospitals in the United States still have the opportunity to enhance patient safety.
“These findings are disheartening but not startling,” said Dr. David Bates, the study’s primary author and Brigham and Women’s Hospital’s chief of general medicine. “They demonstrate how much work remains to be done.”
In 2018, an estimated 2,809 people were admitted to one of the eleven hospitals in the Boston area. The participant’s medical records were examined. The study excluded those who received observational, hospice, rehabilitation, addiction therapy, or psychiatric care.
According to the hospital, 663 patients, or 24%, had an unfortunate health incident. Due to preventable consequences, 222 people were affected. This equates to just 7% of researchers being truthful. Twenty-nine patients, or 1% of all inpatients, had significant, avoidable complications that resulted in substantial injury. Nonetheless, the vast majority of bad events were unavoidable. Two examples are unfavorable drug effects and surgical risks.
Medication was responsible for about 40% of all adverse events in hospitals. Surgical operations accounted for 30% of total costs, with “patient-care events” accounting for 15%. Falls and bedsores are two examples of this. Experts noted that infections obtained while in the hospital now account for around 12% of adverse events, a significant drop from a 1991 research that found infections to be the second-most prevalent adverse event.
Harvard Medical School researchers conducted an extensive study in the form of the Harvard Medical Practice Study I in 1991. Using 1984 New York state hospitalization statistics, it was concluded that just 4% of patients were harmed. However, the scope of the study was less than that of the present analysis, and hospitals have been better at reporting injuries since then.
“At the very least, the rate is not decreasing, and injury remains a major issue,” Bates said. Dr. Albert Wu, director of the Center for Health Services and Research Outcomes at the Johns Hopkins Bloomberg School of Public Health, noted in an email that while medicine has evolved, new threats have developed.
While “some types of harm have been removed,” according to Wu, others have been generated due to the advent of new solid therapies and procedures. Even though the pharmaceutical industry has made significant advances in the three decades since the previous study, more medications imply more prescription errors.
According to Dr. Donald Berwick, president emeritus and senior fellow at the Institute for Healthcare Improvement in Boston, more medications are available now than in 1991. Still, the therapeutic margin (the difference between the effective dose and the potentially harmful dose) for some of these drugs is smaller. Both the new study and Berwick’s interpretation were made public on Wednesday.
Unfortunately, measures to prevent drug mistakes can sometimes exacerbate the situation. New technologies frequently have unforeseen impacts and must be closely monitored. “You need to anticipate what can go wrong and build dykes around the threats,” Berwick added. Only California has regulated staffing levels in hospitals to protect patient safety. A nurse can only adequately care for up to five patients simultaneously.
Aiken believes that if such a guideline is implemented, it will enhance patient safety and save many lives. These are avoidable, but more nurses should be striving to prevent them. Even experts agree that avoiding the unavoidable must be a top goal.
Bloodstream infections were formerly thought to be “inevitable rather than preventable,” but Dr. Peter Pronovost of University Hospitals Cleveland discovered a means to prevent them. He said in an email that the death rate from these infections, which was previously more significant than that of breast and prostate cancer, has been reduced by 80%.
