Medical errors are the 3rd leading cause of death in the US. Scary, right? Why are medical errors so common? It turns out, hospital culture contributes to medical errors. So, what can you do to reduce your risk of harm from errors?
The good news is that hospitals work hard to reduce errors. The bad news is these errors can cause serious harm and even death. So, why is it taking so long for hospitals to significantly reduce their error rates?
Hospital culture contributes to medical errors.
Safety experts identified 8 cultural barriers that can impede hospital efforts to reduce errors, as summarized below.
Acceptance of errors as system complexity grows
It is stressful to be responsible for the health, and life, of patients. There is pressure on healthcare professionals to provide the best care possible with the resources available, which can lead to doctor’s taking dangerous shortcuts. When staff are overwhelmed and/or required to do unusual tasks, errors are more likely.
Dysfunctional external accountability
Hospitals have several agencies that regulate their service and care, each with different rules to follow and results to measure. Following mandates from different agencies can cause hospitals to focus on the short-term goal of following requirements instead of focusing on the long-term goal of eliminating errors.
Lack of comprehensive internal oversight
Hospital risk management departments are usually reactive, instead of proactive. Hospital management must proactively create new initiatives that will improve safety and reduce errors.
Slow introduction of high-reliability principles
Healthcare organizations should look at other industries for operational solutions to reliability. Hospitals should establish proven best practices to help in decision-making. Furthermore, hospitals should create a culture of a shared focus on safety, focusing on behaviors, not outcomes.
Fear of retribution
Hospitals must create cultures where staff can feel safe reporting errors, and near-misses, without concern for punishments.
Personal failure is unacceptable
Perfectionist personalities and professional pride can lead to doctors and others thinking that only “bad doctors and nurses make mistakes”. As a result, medical staff may not admit to errors and near-misses, which can impede efforts to identify problem areas and/or activities.
Overly developed sense of urgency
Healthcare professionals often escalate a potential issue into an urgent issue. When staff are inpatient, have too little time, and/or are uncertain of next steps, they can move too quickly which can lead to errors. This is more likely to occur when there are intense patient demands.
Standardization is perceived as a burden
Some healthcare professionals feel that process controls undermine their expertise. Therefore, hospitals must work collaboratively with their staff to get past those barriers and focus on providing safe, high-quality, patient-centered care.
What can patients and family caregivers do to reduce the risk of errors?
I suggest you consider the following:
- Ask as many questions as you need to be sure you understand the diagnosis and treatment options.
- Don’t be shy about repeating yourself if your doctor seems to misunderstand your story.
- If something doesn’t seem right, speak up.
- If your complaint is being ignored, be persistent to get the attention of your doctor or nurse.
- Take careful notes while in the hospital and at all medical appointments and keep detailed records of test results, lab work, etc.
- Ask for and read a copy of the doctor’s notes in your Electronic Health Record. Notify the doctor if you see errors.
Additionally, for hospitalized patients:
- Be sure staff is dispensing the correct medication every time!
- If possible, family member or other attentive adult stay with a patient in the hospital at all times, particularly if the patient is critically ill.
- To reduce the risk of missed bedside alarms, family members or friends should familiarize themselves with the bedside equipment. Learn the purpose of each monitor and which ones are urgent. Additionally, learn the sound of each equipment alarm. If an urgent alarm sounds and help does not arrive, a family caregiver or friend should seek help immediately.
- Realize that in hospitals, times of shift change and patient transfers are highly susceptible to communication errors. The patient and/or a family member should pay close attention during those times and participate in conversations whenever possible.
Since hospital culture contributes to medical errors, it’s critical for patients and families to actively participate to reduce the risk of errors. Therefore, I suggest you read these posts for more information:
- 10 Tips to Communicate Better with Doctors.
- Why is Sepsis so Dangerous?
- Is C. Diff Dangerous for Patients?
- The Dangers of Missed Bedside Alarms.
- The Benefits of Participating in Hospital Rounds.
- How to Avoid Medication Errors in the Hospital and at Home.
- Tips for Hospital Discharges.
- What’s Your Hospital’s Safety Record? Is Your Hospital Safe?
- Is Your Hospital Safe? Are Programs in Place to Avoid Dangerous “Never Events”?