The number of medical errors and unavoidable mistakes, termed patient harms, have not gone down over a six-year period in the USA, despite serious efforts to improve things, researchers from Harvard Medical School reported in NEJM (New England Journal of Medicine) after examining six-years' worth of medical records at 10 North Carolina Hospitals.
Teams of nurse reviewers looked at the medical records of over 2,341 hospital admissions spanning from the start of 2002 through to the end of 2007, they were all selected randomly. 588 examples of patient harm were found, including surgical errors, dosage mistakes, and hospital-acquired infections - that is a patient injury rate of 25.1 per 100 admissions.
The authors wrote:
- "Though disappointing, the absence of apparent improvement is not entirely surprising."
The investigators said they had chosen North Carolina because of its excellent history and commitment to patient safety. They added that their findings most probably reflect what has been occurring around the country.
The Institute of Medicine (IoM) published a critical report on error rates in 1999, prompting hospitals to try to do something about it. Dr. Christopher Landrigan, study author, wrote that no standardized guidelines that might help clinics and medical centers approach safety improvements exist.
The researchers found that the penetration of evidence-based safety practices has been fairly modest - apparently, only 1.5% of American hospitals have implemented a comprehensive system of electronic medical records.
- "What has been done right is that regulatory agencies have begun prioritizing patient safety. But these efforts have largely been a patchwork of unconnected efforts and so far have not been as strong as they can be."
- Result of a procedure - 186 injuries
- Medication errors - 162 cases
- Nosocomial (acquired in hospital) infections - 87 cases
- Other therapies - 59 cases
- Diagnostic evaluations - 7 cases
- Falls - 5 cases
- "In a study of 10 North Carolina hospitals, we found that harms remain common, with little evidence of widespread improvement. Further efforts are needed to translate effective safety interventions into routine practice and to monitor health care safety over time."
Christopher P. Landrigan, M.D., M.P.H., Gareth J. Parry, Ph.D., Catherine B. Bones, M.S.W., Andrew D. Hackbarth, M.Phil., Donald A. Goldmann, M.D., and Paul J. Sharek, M.D., M.P.H.
N Engl J Med 2010; 363:2124-2134November 25, 2010
Written by Christian Nordqvist