In the past year, some staggering facts on issues related to patient safety have come to light.
One of the most disappointing pieces of news in 2016 was the study by researchers at John Hopkins Medicine saying medical errors rank as the third leading cause of death in the United States. These medical errors are defined as anything from surgical complications that go unrecognized, to mix-ups with doses or types of medications that patients receive.
Based on an analysis of prior research, the study estimated that more than 250,000 Americans die each year from medical errors.
Most of these deaths are preventable, and there are factors surrounding medical mistakes that we can modify and improve to minimize the chance for medical errors.
We spoke to Kaustubh Dabhadkar, a Cardiology fellow at Brown University, about his experiences with patient safety.
“Every day, we see many instances where patient safety could be improved,” he began. “Unfortunately, most of them relate to provider communication.
Last week I cared for a young female who switched her care to me from a different healthcare system. She had surgery on her heart as a kid. Due to the nature of her job, she has lived in three states over last two years. Every time she switches a cardiologist, she has to make sure her records are sent over, and unfortunately this time, the records were not transmitted over. In the clinic, she complained of episodic shortness of breath and palpitations over the last month. The cardiologist who had treated her before could not be reached during the clinic visit. So I had to start her workup and treatment without knowing details of her heart surgery. Eventually, I received a 95-page fax three days after requesting her records. After digging through that, I found the four pages that I cared most about.
Very often, and this is the case more so with specialists, patients show up without any records. We are left to make our study and examinations without basic knowledge of the patient’s medical history.
Quite often this is urgent. We spend a lot of time in the emergency room, and when a patient comes in with a heart attack, we need to look at their prior records. A lot of hospitals don’t have their own catheterization labs, and when patients get transferred, all their records are pulled, and we are on the phone on the other side, faxing things, forwarding to hospitals, etc. This is an everyday thing, and some of those records don’t make it back to us soon enough. They’re faxed to someone in the office, who then tries to reach me, and I end up with no access to records.”
In moments of emergency, provider communication and technology success is vital. However, it is also critically important in non-emergency situations. Misinformation and lack of information, especially in regards to patient records, can start workflows that lead to endangering patient safety.
“It still baffles all physicians that in this day and age of connectivity, it is difficult to communicate efficiently with another healthcare system or physician,” Dabhadkar remarked.
“Despite the tremendous progress in the procedural field, the medical community is resistant to communication technology. As an example, most physicians still carry a pager and trust it more than a smartphone. Some of us still prefer paper charts to electronic health records. Part of the reason is - the technology is sometimes developed without considering physician workflow.”
In order to take steps toward improving miscommunication and other medical errors, some hospitals are working with organizations like the Patient Safety Movement Foundation.
“Hospitals that attain zero preventable deaths in areas like healthcare-associated infections plan for it for it by implementing processes like our Actionable Patient Safety Solutions (APSS),” said Joe Kiani, Founder of the Patient Safety Movement Foundation.
“80% of serious medical errors involve miscommunication during hand-off between clinicians. The implementation plan and solutions we note are key for accurate, complete, and effective handoff communication” said Kiani.
Medical errors are a leading cause of death in America, and both the catalyst and the solution seem to revolve around communication.
“After all,” Dabhadkar expresses, “we are all working towards a shared goal of patient safety.”
Doximity is proud to be supporting one of the strongest advocates of ending medical errors, the Patient Safety Movement Foundation, whose mission is to achieve “zero preventable deaths by 2020.” Toward that goal, they are kicking off 2017 with the fifth annual World Patient Safety, Science & Technology Summit.
The Summit will bring together international leaders from hospitals, medical and information technology companies, the patient advocacy community, public policy makers and government officials to discuss solutions to the leading challenges that cause preventable patient death in hospitals. Their keynote speaker is President Bill Clinton. For the agenda, click here, and for a link to live steam, click here.
To learn more about the Patient Safety Movement, click here.