Medical error
Medical error refers to mistakes made by healthcare professionals in the course of patient care, which may include doing something that should not be done, failing to perform necessary actions, or incorrectly executing procedures. While some medical errors are minor and may not result in serious harm, they often lead to adverse outcomes for patients, with estimates suggesting that they can be a leading cause of death in the United States. Errors can occur at various points within the healthcare system, including during diagnosis, treatment, prevention, and medication administration. The complexity of medical care, involving numerous professionals and intricate procedures, increases the likelihood of these errors.
Common types of medical errors include diagnostic mistakes, improper treatment decisions, failure to administer necessary preventive measures, and medication errors made by both healthcare providers and pharmacists. Factors contributing to these errors range from human oversight and systemic failures to inadequate communication among caregivers. Recognizing the significant impact of medical errors on patient well-being, healthcare professionals strive to implement safety measures and improve communication to minimize risks. Patients can also play an active role in reducing medical errors by staying informed about their treatments and medications, ensuring clear communication with their healthcare providers, and advocating for their care.
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Subject Terms
Medical error
A medical error is the result of a medical professional doing something that should not be done, failing to do something that should be done, or incorrectly performing a procedure while caring for a patient. While medical errors can happen without causing any serious problems for the patient, the term generally implies that the patient has experienced some adverse effect from the error. In common usage, a medical error can be either wholly accidental or the result of some deliberate or reckless act on the part of the medical professional. While exact numbers are difficult to determine because there is no standard way to report medical errors, the results of a 2016 study indicated that medical errors are the third leading cause of death in America.
Background
Medical errors can happen in different parts of the health care system. A staff member in a physician's office, clinic, laboratory, nursing home, ambulatory care center, hospital, pharmacy, or other clinical setting can make an error in treating a patient. The complex nature of medical care and the number of people involved in treating a person for even a common illness makes it relatively easy for errors to occur. There are four main types of medical errors: diagnosis errors, treatment errors, prevention errors, and other errors.
Errors can occur during diagnosis. A physician can order the wrong test or fail to order a necessary test. The test results can be interpreted incorrectly, or the physician can fail to follow up after receiving the results. This can lead to the patient receiving no treatment or the incorrect treatment.
Many errors can occur during a patient's treatment. Such errors might include mistakes in prescribing or administering medications, errors in performing a procedure or failing to perform a necessary procedure, and ordering treatment not indicated for the condition. Caregivers can also err by not reading or interpreting a test result correctly or by failing to order a drug or treatment that could help the patient improve. Errors can also occur with prescription drugs. Pharmacists can fill the prescription incorrectly or list the wrong instructions on the label. Home caregivers can give too much or not enough of the medication or give it at the wrong time.
Some errors are related to preventing illnesses, such as failing to offer immunizations or neglecting to follow up on treatments. Errors in which medical professionals do not take necessary precautions against spreading diseases, such as failing to wash their hands or wear a mask when warranted, would also fall into this classification. Many hospital-acquired infections are the result of this type of error.
There are numerous miscellaneous ways errors can occur as well. A piece of equipment might fail during a procedure due to poor maintenance or missed safety checks. There might also be communication errors among caregivers. For instance, two physicians may both think the other one is taking care of the patient, when, in fact, no one is with the patient.
Medical errors can be attributed to simple human mistakes, to system failures, to professionals who disregard safety procedures, or to clinical environments that create conditions that encourage or necessitate cutting corners. Regardless of the cause, thousands of people are affected by medical errors each year. These patients may undergo additional procedures, spend more time in the hospital, incur additional expenses, and suffer emotional and physical discomfort due to medical errors. Many will also die as a result of incorrect or inadequate treatment.
Overview
It is difficult to determine just how many people are affected by medical errors each year because there is no standard way to report them. Many researchers analyze data based on diagnosis codes for conditions known to be related to hospital error. Each illness or condition for which a person is treated has an assigned numeric code known as an International Classification of Disease (ICD) code. However, there is no code specifically for medical errors, so researchers have to either analyze thousands of patient charts or examine smaller samples and estimate how many errors would occur in a larger population.
Researchers from Johns Hopkins University published a study in The British Medical Journal in 2016 that indicated that as many as a quarter of a million Americans might die each year due to medical errors. The Centers for Disease Control and Prevention's published numbers for deaths by medical condition for 2013 listed heart disease as the number-one cause of death (611,105 deaths), cancer as the second leading cause (584,881 deaths), and chronic respiratory diseases as the third overall cause of death (149,205 deaths). The figures from the Johns Hopkins study would make medical error the third leading cause of death, after heart disease and cancer.
Some have disputed these numbers, however. They point out that the researchers were using the usual flawed system of combining and averaging numbers for medical errors without looking to see whether the error really played a role in the death. Consider the following example: Surgery is indicated for a patient's condition. The physician delays scheduling surgery, and the patient dies before surgery can take place. Was the death due to the delay in surgery, or was it likely the patient would have died anyway?
Medical professionals at all levels work to minimize errors, which are costly to all concerned, cause patients and families to lose faith in the medical industry, and demoralize practitioners. Additional safety procedures, increased monitoring, automation (eg, automated prescription filling), and increased education for medical professionals can help. Patients can also help minimize the possibility of medical error by taking some steps when receiving care.
Sharing information about any medications—including over-the-counter drugs, supplements, and herbal treatments—with every physician is important to avoid duplication and drug interactions. It is also important to understand what a drug is for and how it should be taken, especially when starting a new medication. For inpatient care, watching that all staff observe hand-washing rules can help limit infections, and discussing care with the physician can help identify potential errors. If a patient is too ill to do this, another caregiver or family member can assist. Following up to get the results of tests is important and having one physician coordinate care can help reduce the chance of medical error.
Bibliography
Grober, Ethan D., and John M.A. Bohnen. "Defining Medical Error." Canadian Journal of Surgery, vol. 48, no. 1, Feb. 2005, pp. 39–44, www.ncbi.nlm.nih.gov/pmc/articles/PMC3211566/. Accessed 19 Dec. 2016.
Jha, Ashish. "The Real Cause of Deadly Medical Errors." Scientific American, 2 June 2016, blogs.scientificamerican.com/guest-blog/the-real-cause-of-deadly-medical-errors/. Accessed 19 Dec. 2016.
Makery, Martin A., and Michael Daniel. "Medical Error—The Third Leading Cause of Death in the US." The British Medical Journal, 3 May 2016, www.bmj.com/content/353/bmj.i2139. Accessed 19 Dec. 2016.
Murphy, Michael. "Medical Error: Causes and Solutions." Medical Scribe, 26 Aug. 2014, scribeamerica.com/blog/medical-errors-causes-solutions/. Accessed 19 Dec. 2016.
Prasad, Viney. "Don't Believe What You Read on New Report of Medical Error Deaths." Stat News, 9 May 2016, www.statnews.com/2016/05/09/medical-errors-deaths-bmj/. Accessed 19 Dec. 2016.
"Study Suggests Medical Errors Now the Third Leading Cause of Death in the U.S." Johns Hopkins Medicine, 3 May 2016, www.hopkinsmedicine.org/news/media/releases/study‗suggests‗medical‗errors‗now‗third‗leading‗cause‗of‗death‗in‗the‗us. Accessed 19 Dec. 2016.
"To Err Is Human: Building a Safer Health System." Institute of Medicine, Nov. 1999, www.nationalacademies.org/hmd/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf. Accessed 19 Dec. 2016.
"20 Tips to Help Prevent Medical Errors: Patient Fact Sheet." Agency for Healthcare Research and Quality, US Department of Health & Human Services, Dec. 2014, archive.ahrq.gov/patients-consumers/care-planning/errors/20tips/. Accessed 19 Dec. 2016.