Hospitals can be dangerous places. That is especially true now with health care workers stretched to their limits because of COVID-19. Headlines in papers across the country proclaim that hospitals are overwhelmed. There aren’t enough doctors, nurses, respiratory therapists, food service personnel or staff to clean dirty rooms. Elective surgeries are being postponed. Even in the best of times, you have to be careful to avoid being harmed in the hospital. When everyone is exhausted and overextended, the danger becomes far greater.
Mistakes Are More Common Than Patients Realize:
A surprising number of people are harmed in the hospital. A poll from Massachusetts revealed that one in four adults questioned reported observing or experiencing some kind of mistake within the past five years.
A novel approach to detect errors utilized something called a Global Trigger Tool.
Here is what the researchers uncovered using this strategy (Health Affairs):
“We found that the adverse event detection methods commonly used to track patient safety in the United States today-voluntary reporting and the Agency for Healthcare Research and Quality’s Patient Safety Indicators-fared very poorly compared to other methods and missed 90 percent of the adverse events. The Institute for Healthcare Improvement’s Global Trigger Tool found at least ten times more confirmed, serious events than these other methods. Overall, adverse events occurred in one-third of hospital admissions.”
Stop! Pause and reflect on that stat:
“adverse events occurred in one-third of hospital admissions.”
That is during “quiet” times. No pandemic. Imagine what has been happening the last few years.
Our Ancestors Feared Being Harmed in the Hospital:
There was a time when people tried to avoid going to the hospital. It was seen as a place to die. Hygiene was poor and treatment was limited.
Over the course of the 20th century, that attitude changed. Antibiotics, sterilization and improved surgical technique all contributed to making hospitals safer. Today, many people don’t think twice about a hospital stay. They expect excellent care and quick recovery.
Bad Health Care: A Leading Cause of Death:
A study published in BMJ (May 3, 2016) concluded that medical error is the third leading cause of death in the US. The authors calculate that at least 251,454 people die every year from medical mistakes in hospitals. Not surprisingly, the medical profession responded defensively to this analysis. Many physicians called for the BMJ to retract the article. The editors did not cave in to the pressure.
People Are Still Being Harmed in the Hospital:
A report from the Office of Inspector General (OIG) in the Department of Health and Human Services reveals that 29 percent of Medicare beneficiaries are harmed in rehab hospitals. This compares to 33 percent in skilled nursing facilities and 27 percent in hospitals. The range of problems patients encountered went from temporary harm to events that necessitated life-sustaining intervention or that resulted in death.
Perhaps the most damning aspect of the OIG report was the finding that 46 percent of the harm that occurred could have been prevented. In other words, many mistakes are happening in rehab facilities and hospitals, but little has been done to stop these preventable errors.
Stories from Readers Who Were Harmed in the Hospital:
Such statistics are impersonal. But readers have shared their own stories.
One person wrote:
“While I was in the hospital awaiting surgery for a broken leg, two young women came to change my sheets. I told them No, my leg was broken. They ignored me and ‘log-rolled’ me up on my broken leg and changed the sheets. I could hear and feel the leg bone crunching and crackling.
“After surgery the doctor said it was worse than he’d thought; I told him it was probably because of the log-rolling. I am now crippled for life and on a cane, though I was previously an active exerciser and line dancer.”
Another reader wrote about a family member’s experience:
“We dealt with plenty of issues, especially medication errors and overdosing, when my father was in rehab. They medicated him without his consent. Then they told us that he was not recovering and that he should be transferred to the long-term residence section.
“At first we believed they were right, until one morning when he was incoherent. I asked why he was like this when the night before he was talking normally and seemed to be recovering.
“I got the medication list and found that, number one, they put him on antidepressants without our knowledge. There were several other new medications on top of that. I took the list to the pharmacist and he was so helpful. He pointed out three interactions and dosing problems. Once we got that straightened out, my father recovered enough to go home a few days later.”
Medication Errors Lead the List:
Mistakes like this are all too common. The report points out that medication errors are a leading cause of harm. It is not uncommon for patients to receive the wrong medication, the wrong dose or a dangerous combination when they are in a health care facility.
“I bought and read your “Top Screwups” book. Even though I am very aware of problems in health care, having worked in that sector here in New Zealand, I learned a lot from your book. It was especially helpful about how to avoid medical mistakes and misdiagnoses.
“I have a short list of safety strategies I give to friends and family who need hospitalization:
1. Don’t go to hospital unless you really have to. 2. While in hospital question everything. If you can’t do that yourself, have someone with you who can. 3. Get out as fast as possible.
Thanks for your succinct advice. Of course if someone has COVID and is having trouble breathing they must get to the hospital pronto! Too many people have already died from the coronavirus. And we must have compassion for everyone working in the hospital, from the front line staff to the doctors, nurses, therapists and cleaning crew. This is a challenging time for everyone.
We’re glad you found our book, Top Screwups, helpful even in New Zealand. In it, we try to give people the tools they need to avoid health care harm. Those who are interested may find it in their public library or in the Books section of the store.
Linda in Lakeland, FL:
“Great book. Will refer to it many times and won’t go to the hospital without it! Thank you for this invaluable information.”
Virginia in GA:
“This should be required reading for all. I am a retired RN. Everything in this book is right on! I am going to give one to my PCP [primary care physician] because he really tries to keep up, but as stated in the book, it is not possible for him to read everything that’s out there. We patients need to be more astute about ourselves.”
Vivian in Jerseyville, IL:
“The book, ‘Top Screw-ups The Doctors Make,’ is indispensable! It is truly a work of love, art, pain, truth, and insight as to what a lot of dirty bastards are doing out there in this world we call America. I can’t thank you enough for putting into print what a great deal of it has been suspected by me all along. You have my undying respect. I am so very glad I spent my money on this wonderful informative piece of literature.”
Hospitals save lives and help us heal, but they also hold many unsuspected hazards. We hope you can avoid being harmed in the hospital by taking some precautions before you walk in the door.
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” Read Joe's Full Bio.
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