Medical errors are a common occurrence in healthcare practice. It is a modern concern of both healthcare practitioners and patients in part due to the spotlight generated by publicized incident of mishaps at the hands of practitioners.
Medical errors have various causes and consequences. Causes include, and primarily are, of the technical nature (skill-based) – errors that occur as a result lapses in the performance of procedures such as surgical procedures and medicine administration. However, cognitive-based errors, while less frequent, are responsible for more permanent disabilities.Cases, Causes and Consequences of Medical Errors Medical errors and the injuries and deaths that occur as a consequence of such errors are part of the modern concerns of both healthcare practitioners and patients. This is in part due to the spotlight generated by publicized incidents of “catastrophic injuries occurring at the hands of physicians” (Weingart, et al. , 2000, p.
774). These documentations, however, provide little insight into the nature and extent of the problem that it has underestimated the magnitude of the risks and the extent of the harm associated with medical errors.In the journal article Epidemiology of Medical Error, Weingart and his associates (2000) discuss the epidemiology behind medical errors, concentrating on the “prevalence and consequences” of these medical errors. The authors tackled several factors that contributed to the occurrence of medical errors such as type of clinicians, “risk factors that increase the likelihood of injury from an error” and discussed which type of medical errors are most common (Weingart, et al. , 2000, p. 774).
In terms of prevalence, in the hospital setting alone, review of the Harvard study (1984) and a similar model in Australia (1995) by the authors revealed that “medical error is ubiquitous and the costs are substantial” (Weingart, et al. , 2000, p. 774). Findings from the reviewed studies showed that in Australia, medical errors resulted in 18,000 unnecessary deaths and that more than 50,000 patients were disabled as a result of these errors. In the United States, medical errors were responsible for 44,000 (even as many as 98,000) unnecessary deaths and 1,000,000 incidences of excess injuries.Reports on the prevalence of medical errors in terms of outpatient care however are few and there is little known about such occurrences.
“In both the Harvard and the Australian study 89% of adverse events occurred in a doctor’s office, 23% at home, and 12% in nursing homes” (Weingart, et al. , 2000, p. 774). However, these figures underestimate the extent of outpatient care-related medical errors since the values only reflect errors serious enough to warrant hospital admission.
In another reviewed literature from Gandhi and co-authors about a study conducted in Boston, it was found that 18% of patients reported drug related complications that included gastrointestinal symptoms, fatigue, and sleep disturbances (Weingart, et al. , 2000). In terms of error types, findings from both studies (Harvard and Australia) revealed that among in-patients, adverse events are due to surgeries and that these account for about half of the cases, while the remaining instances are of non-operative causes.These include “drug treatment, therapeutic mishaps, and diagnostic errors” (Weingart, et al. , 2000, p. 775).
The former example (surgery) is a skill-based error, and skill-based errors are easily addressed due to the fact these errors bring focus to inadequacies existing in procedures and practices especially if it is determined that the error occurred despite following protocol and procedures. Knowing these problem areas allows for practitioners to address these areas and eventually develop solutions to solve or minimize the problem.This is proven in practice through the continuous decline in the risks surgical operations carry (e. g. , craniotomies for brain tumors in 1913 had an 80% mortality rate, 20 years later the rate has gone down to 13% and as of now, ;1% (cited in Brennan, 2000)). Another common skill-based error is in the area of adverse drug events, specifically during ordering (56%) and administration (24%), revealing that 40% of the 245 near-miss cases in the two Boston teaching hospitals mentioned in Bates et.al. ’s study were a result of this prevalent and preventable medical error (cited in Weingart 2000).
Lastly, the Australian study also revealed that cognitive errors (such as incorrect diagnosis, missed diagnosis and erroneous medicine prescriptions) could have been preventable and that such errors are “more likely to result in permanent disability” compared to technical (skill-based) errors (Weingart, et al. , 2000, p. 775).The review also mentions that “malevolent providers” are rare and that evidence of such “bad apples” are little and that “no specialty is immune to error” (Brennan, 2000, p. 1123).
References Brennan, T. A. (2000). The institute of medicine meport on medical errors — could it do harm?. The New England Journal of Medicine 342 (15), 1123-1125. Weingart, S.
N. , Wilson, R. McL. , Gibbert, R.
W. , ; Harrison, B. (2000). Epidemiology of medical error.
British Medical Joural, 320, 774-777.