“The chances that we will kill you are higher in hospitals than in doctors’ offices,” notes Robert M. Wachter, MD, professor and associate chairman of the department of medicine at the University of California, San Francisco, and author of Understanding Patient Safety. You’re particularly vulnerable in the emergency room (ER) and intensive care unit (ICU), where odds are you’re already seriously ill and require multiple procedures from time-stressed providers, explains Janet Corrigan, PhD, of the National Quality Forum in Washington, D.C. “You’re also at risk on the hospital’s pediatric floors because of the challenges of caring for children.”
In some ways, this is nothing new. “Hospitals have always been dangerous places,” says Kaveh G. Shojania, MD, associate professor at the University of Toronto. But there’s now a perfect storm of factors that is putting too many patients at risk.
Hospital-acquired infections are on the rise
The rise of antibiotic-resistant bacteria like methicillin-resistant Staphylococcus aureus (MRSA) has transformed hospital-acquired infections from manageable risks to major killers, says Martin J. Hatlie, JD, president and founder of the Chicago-based nonprofit Partnership for Patient Safety. Hospital-acquired infections (HAIs) affect more than 1.7 million patients, killing more than 99,000 of them a year—and many of these deaths are not reflected in the official “hospital errors” death count.
Nurses are spread too thin
High turnover and vacancy rates in nursing mean you’re more likely than ever to have an overstretched nurse at the other end of that call button, according to an April 2008 statement from the American Association of Colleges of Nursing. “We know people are more likely to make mistakes when they’re multitasking, distracted, and tired,” Hatlie says. “Nurses today are always in that situation.”
Residents are working shorter shifts
Regulations now limit the number of hours residents can work, to 30 hours straight (compared with the 48 in a row many logged before 2003). Sending sleep-deprived young doctors home to get some rest sounds like a smart strategy, but it has created an unexpected problem: It increases the number of handoffs, which contributes to additional mess-ups. “The single highest risk time is when there’s a transition in care because so many little pieces of information can get lost in translation,” Dr. Shojania says.
One study found that patients were five times as likely to have an “adverse event”—any injury caused by medical care—when covered by a doctor who didn’t know them, which happens when a shift changes, explains David Bates, MD, chief of the division of general internal medicine at Brigham and Women’s Hospital in Boston.
Modern medicine is saving more people
“We’re giving life where we couldn’t five years ago,” Hatlie says. The problem: “Every new procedure brings a new risk.” Patients today are more likely to be “really sick people,” he says. “When you’re sicker, you’re weaker and less likely to survive an error.”
By Lorie A. Parch
Additional reporting by Kimberly Holland and Brittani Tingle
Related Links:
Comments (3)
If you really want to know why hospitals are so dangerous and our healthcare system is so dysfunctional, I highly recommend Maggie Mahar’s book “Money Driven Medicine.” I disagree with Martie, it’s not that we’re “giving life” where we didn’t 5 years ago, we’re giving a lot of expensive treatment (medicine, tests, procudures) to people who aren’t going to be helped or cured by it, and excessive and overuse of healthcare increases your chances of being the victim of an error, in other words, expensive care you didn’t need to begin with can kill you.
It’s not just hospitals…it’s every industry and darn near every person…people can flap their lips as much as they want but the bottom line is poeple and corporations only care about money…money is the bottom line to our problems…almost all of them!
As a nurse who worked on a medical/surgical floor for 20 years and now work in a large teaching hospital, I can tell you it is not just money. There is a huge shortage of medical staff and it is only going to get worse. Few people are willing to work under the stressful situation that most medical personnel work under and those that do are mostly highly dedicated people. They do not want to make mistakes. In this day of everyone suing every one, the guidelines that doctors have to work under require them to order certain batteries of tests for certain symptoms and conditions. If they miss a diagnosis, fingers are quickly pointing at malpractice. A stomach ache, fever and vomiting can be anything from mild food poisoning to any number of deadly conditions. The worst have to be ruled out first or someone could die. The bottom line is – know your body and conditions; don’t expect the medical staff to be with you every minute you are in the hospital(don’t leave your family member alone); don’t use the emergency room for routine care; and do everything you can to stay healthy.