The Need for Quality Control (part2)

The fractured nature of patient care has increased dramatically. A cancer patient may well have over four specialists who rarely meet to discuss the individual. Computerized patient entry would assure that each physician has access to the complete patient file.

Drug toxicity is the single most common threat, hitting 6.5% of hospitalized patients. Information technology can help prevent errors and catch drug interactions before they do much damage. OSF Healthcare in Peoria, IL, has reduced drug-related injuries by almost 75% since 2001 using available technology.

There are many more examples - wrong site surgery, provision of evidence-based care, the benefits of setting up rapid response teams, to name a few. Adding to the problem:

• The CT Department of Public Health has ranked 40th in the elimination of bad doctors. Their investigations have gone on for years and often ended with an inappropriate slap on the wrist. An anesthesiologist who turned off monitors resulting in the death of a healthy three year old was fine $5,000. A pill-pushing physician in New Haven faced criminal charges and was convicted before the Medical Examining Board dealt with the problem.

• The National Practitioner Data Bank is available to only healthcare professionals and because it is under funded it is out of date and full of inaccuracies. An anesthesiologist, who was fired from St. Raphael Hospital, went to Massachusetts and practiced there. After a few years, he returned and worked at Norwalk Hospital. Today, two women are in a permanent vegetative state due to his injuries. Even after the first incident, the hospital took no action nor did the Medical Examining Board. His record, as well as that of others who have injured, maimed or killed their patients, should be readily available to the public and healthcare institutions.

A Casualty Count

• 3% or more of hospital patients are hurt by medical error
• 1 in 300 patients die from such mistakes
• 24% of people say they or a family member have been harmed by medical error
• 90,000 people die of hospital-acquired infections annually. More than half of these may be preventable. Healthgrades puts the number of preventable deaths at 200,000 annually.
• 55% of recommended care actually gets administered.
• $2,000 Annual cost to employers per insured worker due to poor-quality care
• 61% of doctors wash their hands before examining a patient if they know someone is watching. Only 44% wash their hands if they think no one is watching.

Sources: Lucian Leaper; New England Journal of Medicine; Forbes Magazine; The Institute of Medicine; Quality and safety in Health Care; Rand.

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