Takeaways from a new study in the New England Journal of Medicine.
When we are admitted to a hospital for medical treatment, we rightfully expect a certain level of care that is timely, safe, and appropriate for our condition. But what if that medical treatment presents its own risks to our health and safety?
A recent Harvard study published in The New England Journal of Medicine revealed that nearly one in four hospitalized patients experienced an adverse event, making these types of events a major cause of patient harm. And, while adverse events ranged from mild to grave (even causing death), over 32% were graded as “serious” or higher, i.e., causing harm that required significant intervention or led to prolonged recovery.
What were these adverse events? Most common were negative reactions to administered drugs at 39% followed by surgical or other procedural events at 30.4%. Another 15% were so-called “patient-care events” which were directly related to day-to-day nursing care (falls, pressure ulcers, e.g.), while infections made up nearly 12%.
To arrive at these findings, the study examined a random sample of 2,809 admissions from 11 different Massachusetts hospitals during the 2018 calendar year. Reviewers relied on certain “trigger” entries that indicated a likely association with a negative event as well as an overall review of medical records.
This study was a follow-up to a previous study published in 1991, the Harvard Medical Practice Study II, which found that 3.7% of hospitalized patients suffered disabling injuries caused by medical treatment. The scope of the 1991 study was narrower than the study published in January of this year; however, after decades of focus on the quality and safety of patient care, the results of this most recent study are far from encouraging.
Not all adverse events are categorized by the medical industry as “preventable.” In this most recent study of 2018 admissions, about 25% of all adverse events were deemed preventable. Preventable adverse events are those that are “…a direct result of failure(s) to follow recognized, evidence-based best practices or guidelines at the individual and/or system level.” In other words, these are events that likely would not have happened if providers and healthcare workers were acting in accordance with established procedures and protocols.
Behind the numbers and percentages reported in this study are real human lives. A 2000 report by the Institute of Medicine (now the national Academy of Medicine) titled “To Err is Human: Building a Safer Health System,” estimated the number of lives lost in hospitals (not just impacted) due to health care errors was between 44,000 to 98,000 a year, making patient safety a public health threat rivaling motor vehicle accidents and breast cancer.
The fact is the medical community, despite touting the improvement of patient safety as a priority, appears to be making little headway, if any. With the further erosion of healthcare capability after 2018 in the wake of the extended COVID-19 crisis, these percentages have likely only worsened. As one physician put it in a response to this recent study, “Senior executives and boards of directors in health care systems today may feel overwhelmed by an onslaught of urgent priorities….Nevertheless, “first do no harm” remains a sacred obligation for all in health care…Without renewed board and executive leadership and accountability for safety….a summary study 34 years from now may again look all too familiar, with millions upon millions of patients, families, and health care staff paying the price for inaction.”
Have you or a loved one suffered because of an adverse event while hospitalized? Contact us for a free consultation to explore possible next steps.