With Nursing Week upon us, it comes as a shock that while we continue to make a focused effort on safer nursing practices, medical errors remain a leading cause of death in the United States. In an open letter to the Centers for Disease Control and Prevention, Martin Makary and Michael Daniel, the authors of a recent analysis of previous studies of medical errors, call for better reporting to capture more accurate statistics.
“Dear Dr. Frieden, We are writing this letter to respectfully ask the Centers for Disease Control and Prevention (CDC) to change the way it collects our country’s national vital health statistics each year. The list of most common causes of death published is very important – it informs our country’s research and public health priorities each year. The current methodology used to generate the list as what we believe to be a serious limitation,” Dr. Makary stated. “As a result, the list has neglected to identify the third leading cause of death in the U.S.—medical error.”
Medical errors have been an ongoing problem for multiple reasons, not the least of which is how to accurately identify and report medical errors. Since 1984 there have been studies reporting the number of estimated deaths annually due to preventable medical errors ranging from as low as 44,000 to as high as 440,000. Even with all of the education and safety measures implemented over the last several years, it is reported that 6 out of every 7 hospital errors, accidents and other adverse events go unreported. Dr. Makary is not alone in calling for action in how medical errors are reported. In 2012 the OIG recommended “AHRQ and CMS collaborate to create and promote a list of potentially reportable events for hospitals to use. We further recommend that CMS provide guidance to accreditors regarding their assessments of hospital efforts to track and analyze events. CMS should also suggest that surveyors evaluate the information collected by hospitals using AHRQ’s Common Formats. Additionally, CMS should scrutinize survey standards for assessing hospital compliance with the requirement to track and analyze events and reinforce assessment of incident reporting systems as a key tool to improve event tracking.” While the CDC disputes that such information is not adequately captured under current reporting protocols, it seems clear that this remains a serious problem in health care.
1999 – 44,000 – 98,000 deaths annually Committee on Quality of Health care in America, To Err is Human.
2004 – 195,000 deaths annually Health Grades, Patient Safety in American Hospitals, July 2004.
2011 – 400,000 deaths annually Health Affairs, Global Trigger Tool that Shows that the Adverse Events In Hospitals May Be Ten Times Greater Than Previously Measured.
2013 – 400,000 deaths annually Journal of Patient Safety, A new, evidence-based estimate of patient harms associated with hospital care.
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