The Evidence on Medical Mistakes and How to Avoid Them

As scary as it is to think about, we know that all people make mistakes, including the health care professionals who work in hospitals and doctors’ offices. Furthermore, our health care system is complicated, leading to glitches that can harm patients. As a result, patients sometimes experience injuries, complications and even death as a result of the care they receive.

A systematic review published this summer in the British Medical Journal takes a careful look at what we know about preventable patient harm – that is, injury to a patient that could have been avoided.

The review looks at studies published since January 2000 that quantify preventable harm and describe what we know about medical mistakes. The review includes a total of 66 studies which included more than 337,000 participants. Here is what the researchers found:

About 6 percent of participants experienced preventable harm as a result of their medical care, according to the pooled results from the review. Of all the patients affected by preventable harm, the effects were considered mild for 49 percent and moderate for 36 percent. Twelve percent experienced a serious harm, which caused permanent disability or death.

Patients in intensive care units of hospitals were the most likely to experience a medical mistake; 18 percent were affected. Obstetrics patients were the least likely to experience a medical mistake; 2 percent were affected.

The review also classified different types of medical mistakes. Three main types of problems accounted for the majority of medical mistakes: problems managing drugs, problems managing other medical therapies and mistakes made during surgical procedures. After that, the next most prevalent problems were infections contracted from the health care system and problems with diagnoses.

While it’s impossible to eliminate all medical mistakes, the review authors address the question of how to reduce the incidence of preventable harm. They concluded that our health care system needs a combination of solutions. This includes interventions on an individual level, such as training sessions for health care providers; changes at the facility level, such as better designed work environments and computer systems; and changes at the organizational level, such as quality monitoring systems.

The truth is, it will take some time for health care leaders to make broader changes to reduce the likelihood of medical mistakes. In the meantime, the U.S. Agency for Healthcare Research and Quality offers some evidence-based steps that you can take to avoid becoming the victim of a medical mistake. They include:

  • Bring a list of all of your medicines and supplements to every doctor’s appointment.
  • Ask for information about any new prescription so that you understand what it is for, what the side effects are and whether it will interact with any other medicines or foods.
  • While staying in the hospital, ask health care workers if they have washed their hands before providing care.
  • If you are having surgery and you can choose the location, pick a hospital where many patients have had the surgery or procedure that you need.
  • Make sure that health care providers, such as your primary care doctor, coordinate your care.

The take-home message: Medical mistakes happen. Understanding where and how medical mistakes are most likely to occur can help you anticipate problems and take steps to avoid preventable harm.

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