Patient safety is a top priority in U.S. hospitals and healthcare systems. Decades of effort have led to notable improvements: Never events – errors so egregious that they should never happen to a patient under any circumstance – significantly decreased. Patient falls and trauma decreased by approximately 25%. And between 2010 and 2019, adverse event rates fell 36% for heart attack patients, 31% for heart failure patients, 39% for pneumonia patients, 36% for major surgery patients, and 18% for patients hospitalized with all other conditions, according to a 2020 JAMA article.
Some of these gains were erased by the COVID-19 pandemic. Healthcare-associated infections (HAIs), for instance, were down pre-pandemic, but increased from 2019 to 2020 and 2020 to 2021. Now, HAIs are above pre-COVID levels.
Progress toward improving patient safety is often hampered by a few stubbornly persistent patient safety myths. During Patient Safety Week this month (March 13-19), tackle these myths head on to help your hospital reach new levels of patient safety.
Myth #1: Serious mistakes and medical errors are rare in U.S. hospitals
Many people believe that U.S. hospitals are safer than hospitals elsewhere in the world, and while that sentiment is true in some cases, it is not universally true. Post-operative complications, including pulmonary embolisms and deep vein thrombosis, are more common in the U.S. than most peer countries, according to the Peterson-KFF Health System Tracker. The United States also has higher rates of reported medication and treatment errors than most comparable countries.
At least one in ten patients are harmed by care provided in U.S. hospitals and clinics. Each day, more than 1000 Americans die because of a preventable hospital error. And though that number might not seem particularly large, given the number of people hospitalized at any given time, medical error remains a leading cause of death and disability in the United States.
Myth #2: Patient safety is completely dependent on the actions of healthcare professionals
Healthcare providers have major roles to play in protecting patient safety. But patients, family members, and caregivers play an important role as well. Empowering patients and others to speak up when they notice safety infractions and care concerns can prevent harm and save lives.
One reason why bedside shift reporting leads to a decrease in medical errors is because patients and families have the opportunity to clarify and correct miscommunication. Many patients and caregivers need explicit encouragement and guidance to speak up regarding patient safety concerns, as some fear possible retribution from healthcare providers. Others worry that their concerns will be brushed aside or ignored.
Efforts to involve patients and families in patient safety initiatives can be quite effective, though, as patients and their loved ones are highly motivated – and, often, acutely aware of patients’ baseline functioning, so they can detect subtle deviations. That’s why the University of Pittsburgh Medical Center established Condition Help, a safety hotline that patients and families can call when they notice a change in condition and can’t get the attention of a healthcare provider. Every Condition Help call brings a rapid response team to the patient’s bedside, and the hospital believes that “Condition H has averted significant patient harm over the years.”
Myth #3: All patients are equally vulnerable to harm
Age, sex, gender, race, diagnosis and culture all influence patients’ vulnerability to harm in healthcare settings. According to Leapfrog, Medicare patients (who are all age 65 or older) have a 1 in 4 chance of experiencing injury, harm or death when admitted to a hospital, compared to a 1 in 10 chance for patients of all ages. Women are 50% more likely than men to be misdiagnosed when having a heart attack, and 25% more likely to be misdiagnosed after a stroke. Black, Latinx, Asian, and Indigenous people experience higher rates of healthcare-associated infections (HAIs) than white people in the United States.
The mental and physical state of patients’ healthcare providers also affects patient safety. According to the Agency for Healthcare Research & Quality, clinicians who are experiencing high levels of burnout are more likely to make mistakes and practice unsafely.
Disaggregating adverse event data can help hospitals identify inequities and create targeted patient safety interventions.
Bust these persistent patient safety myths to significantly improve patient safety.