Fri January 24, 2014
Hospitals Aren't As Safe As You Might Think
Many who work in the hospital industry claim the “aura” of modern medicine has lulled many Americans into a false sense of security. Errors and accidents continue to harm or even kill patients at an alarming rate. KLCC’s Tiffany Eckert reports on the current state of hospital safety and what every potential patient should know.
Right up there with the leading causes of death in the U.S.- diseases and accidents that can land us in hospital—there is this sinister statistic: medical mistakes and hospital-acquired-infections are the 8th leading cause of death. That's right. The very act of being hospitalized can put you at risk.
This has Dr. Patrick Luedtke worried. He's the Public Health Officer for Lane County. One of his charges is making sure his message of patient responsibility is heard.
Luedtke: "When you go into the hospital this is complex care. You need to tell your physician, surgeon every single thing you're taking. You need to be part of your care, actively engaged. We're not very good at that."
Luedtke says too many Americans think when we come out of the hospital, we'll be all fixed.
Luedtke: "In reality a hospitalization means you're body failed. It plain old failed. We need to change the view that a hospitalization is 'I'm going in to get a little bit of a tune-up and I'll come out exactly the same. Because frequently, you don't come out exactly the same."
Luedtke says being pro-active and engaged gives patients a leg up. Because doctors and nurses are people and people make mistakes. Sometimes, devastating ones.
Luedtke: “You need to say, “Oh by the way, this is the knee you’re operating on. Put a note on there saying ‘this knee’ and put an X on the other knee—‘Not that one.’”
Luedtke says before entering a hospital, know the score. One way to do that is by checking out their safety record.
Leapfrog is an independent hospital watchdog group based in Washington DC. Leah Binder is CEO.
Binder: “The overall rate of people going into the hospital and coming out with an injury or illness that they didn't have when they went in-- that is so common, it’s almost frightening to give you the statistic. 1 in 4 people suffer some form of accident, some form of harm. From minor harm to something that might kill them. One in four!”
As a public service, Leapfrog publishes the “hospital safety score,” which gives facilities around the country a letter grade from A to F. When it comes to hospital safety, Binder says Oregon has a long way to go.
Binder: “In Oregon there’s 31 hospitals that we rate and 7 of them have earned A’s. That does not give Oregon a particularly high ranking among all the states. It’s 26th in the country for its number of A hospitals.”
The safety scores are based on analysis of publicly available data using 28 evidence-based, measures of hospital safety. Including: catheter removal, hand hygiene and foreign object retention –that's leaving an implement inside the body after surgery.
Sound impossible? Just ask Donald Church. The 49-year old Seattle man checked into University of Washington Medical Center to have a tumor removed. He left with a 13-inch retractor still in his abdomen. Doctors had to admit the error.
Not all hospitals readily acknowledge mistakes. Leapfrog's Binder says always talk to *your doctor beforehand—because they probably have better access to hospital stats or the procedure in question. And she urges asking hospital administration the hard questions.
Binder: “What’s your error rate? How’re you doing on infections?”
It won’t be easy, says Binder. It’s taken Leapfrog Group 10 years to get even the most basic forms of transparency from hospitals and governments. In Oregon, infection rates are tracked but surgeon’s rates of complications, hospital mistakes or avoidable deaths are not required to be reported.
Binder:" If they're not willing to be transparent there's just a lot of information that the public in Oregon doesn't have about that hospital."
Hospital errors in the U.S. cost between 17 and 30 billion dollars annually. On the other hand-- “Safety is not expensive. It’s free to wash your hands. And to put in place the protocols to prevent all the errors and infections that happen.”
Both Binder and Dr. Luedtke agree the most important thing a patient can do to stay safe is speak up. If going in for surgery, confirm the surgical staff uses a pre-op check list or "time-out." Be clear about any allergies or previous conditions. Bring an advocate to look out for your interests the entire stay. And, make it a mantra. And, Luedtke says before anyone touches the patient…
Luedtke: You need to make sure that your providers are washing their hands."
The federal government has shown a commitment to increased safety measures in America's hospitals. The Affordable Care Act are has budgeted $75 million a year to improve patient safety.
While reforms in practices and patient care may be on the horizon, the fact remains-- when in hospital, you've got to advocate for yourself. Like your life depends on it.
Leapfrog Group's Hospital Safety Score