To Err is Human . . . To Improve Elusive?
Peggy McDaniel, BSN, RN, is an infusion practice manager and occasional blogger
As a nurse working in the quality improvement and patient safety arena, I’m not surprised that the title of a recent article at Fierce Healthcare got my attention: “Hospitals Are Bad for Your Health.” The article highlights a recently released report from the Department of Health and Human Services Office of Inspector General based on a study of Medicare patients discharged in 2008. Among other things, it revealed that “44% of adverse or temporary harm events were clearly or likely preventable.” The usual culprits were to blame:
- infections
- medication errors
- surgery-related errors
- patient care issues
Most of these have been previously labeled as “never events” by the Centers for Medicaid and Medicare Services (CMS), and currently hospitals are not being reimbursed for the costs incurred if one or more of these happen to a patient while in the hospital. CMS was the first to implement such a pay-for-performance model—and major insurance companies have followed their lead.
In recently published NEJM study, 63% of the adverse events reported in the hospitals studied were deemed preventable. This study was disheartening because we recently passed the 10-year anniversary of the release of the
