How to Avoid a Bad Outcome in a Hospital--Don't Get Sick

June 29, 2012

As impractical as that suggestion is, it remains the one sure method of avoiding problems in the average U.S. Hospital.

One Death Is a Tragedy, A Thousand, a Statistic

While many claim the United States has the gold standard of medical care, for 30,000 patients a year, it provides a death sentence.

The AARP has published a story on hospital safety and they used this image to describe the magnitude of the problem:

"The number of patients who die each year from preventable hospital errors is equal to four full jumbo jets crashing each week."

Not in a year, but each week. They go on to point out that airline passengers would stop flying if air travel were that fraught with peril. Most hospital patients do not have that option.

Necessary Complexity

As one doctor laments, part of the problem of patient safety is due to the level of complexity present in modern medicine. We can do so much, but all that complexity means there are many moving parts, and that means many parts to break.

Checklists

To further analogize to aviation, some problems in hospitals are due to a lack of sufficiently sophisticated checklists. Pilots, before they takeoff, must go through exhaustive checklists, where they verify the operational fitness of the aircraft. They cannot rely on one person's thinking that they may have done something; they check every step.

Of course, the analogy has limits, as the pilots have a compelling interest in the performance of the aircraft, as their lives, like those of their passengers, are at stake. Surgeons, doctors and nurses, while certainly concerned for the well-being of the patients, do not face such a draconian, irreversible sanction for mistakes and errors.

Can Anything Be Done?

Yes, procedures can be made safer. The AARP story notes the example of bloodstream infections that occurred when catheters were used near the heart to provide medication. The conventional wisdom was that these infections were "unavoidable."

Michigan intensive care units created a checklist and worked to change the culture of the ICU, and managed to cut these infections 60 percent and saved 1,500 lives in 18 months.

Your Health is at Stake

Nonetheless, be insistent--this is not an abstract argument--it could be your life you are arguing about. It also helps to have a family member or friend as an advocate, to help keep an eye on the process.

If something goes wrong and there are complications, don't delay in speaking with an attorney. Securing evidence and obtaining recent recollections of potential witnesses may be critical to uncovering what went wrong.

Keep it Clean

Last, but not least, be very persistent in demanding that doctors, nurses and any other staff clean their hands whenever they are present. The simple sanitizing of hands has shown itself to be among the most intractable "culture" changes to make in a hospital.

Article provided by Snyder & Wenner
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