Wednesday, June 30, 2004

reducing medical error

neil versel has a great new blog on IT in healthcare, clinicalit. he posted about medical errors earlier this month, specifically in reference to this parade magazine article on the topic. here are some snips from the magazine article:

According to a groundbreaking 1999 study by the Institute of Medicine (IOM) of the National Academy of Sciences, as many as 98,000 patients die in the more than 5000 U.S. hospitals each year because of medical errors. Such mistakes are the eighth leading cause of death in America—ahead of car accidents, AIDS and breast cancer—according to the IOM’s most conservative estimates.
[...]
Reasons for preventable hospital errors include poor communication among staff, overworked or minimally trained workers and a faulty system of checks and balances. “Starbucks has more procedures in place for catching errors than many hospitals have,” contends Dr. Clancy.

Another important factor is the shortage of nurses. According to the American Nurses Association, there will be a shortage of 139,000 registered nurses this year and 275,000 by 2010.

There is a direct relationship between the number of nurses, patient care and hospital errors. One study by Linda Aiken and the University of Pennsylvania School of Nursing showed that the number of patients dying after common surgeries in hospitals jumps when there is more than the average 4:1 patient-nurse ratio. A 7% increase in deaths is tied to a 5:1 ratio, and a 31% increase results from an 8:1 ratio.
[...]
The type of hospital you’re in also matters. A study by Prof. Eric Thomas of the University of Texas revealed that patients in for-profit hospitals, government-owned minor teaching hospitals and all government-owned nonteaching hospitals are at least 1.6 times more likely to suffer “preventable adverse events” than those in nonprofit hospitals. This suggests that bottom-line concerns may affect the quality of patient care.
[...]
“Studies have demonstrated that as much as 40 minutes per shift can be gained by using electronic charting,” says Terri Price, a nurse in the hospital’s department of patient services. “That’s 40 minutes more that a nurse can spend with patients.” And more nursing care can lead to fewer errors.



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