A Run for Safety

Seeing the Forest

And kill them we do. Now, you may not like the word “kill,” and certainly it makes me uncomfortable, but what other word better characterizes the situation? Medical errors result in up to 200,000 preventable deaths per year, according to the recent HealthGrades patient safety report.¹ This study reviewed Medicare data from all 50 states and found a mortality rate that was nearly double that reported in the seminal 1999 Institute of Medicine report (44,000-98,000; extrapolated from data in three states).²

And these are just deaths in hospitals; no mention is made of community or residential deaths from medical error. These data also don’t account for the pain and suffering left in the wake of the estimated 15 million annual episodes of harm (that’s 40,000 per day!).

In the end, the World Health Organization (WHO) estimates that 10% of hospital stays involve a serious, preventable, adverse event. Which of the 10 patients you’ll see tomorrow will suffer that serious, PREVENTABLE harm?

Using a conservative average of the two reports, roughly 100,000 people die annually from hospital-based medical errors. This slots medical error as the sixth-most-common cause of death in the U.S., trailing only heart disease (616,067), cancer (562,875), stroke (135,952), chronic lower respiratory disease (127,924), and accidents (123,706). If we use the 200,000 estimate, then error trails only the heart and cancer as a cause of death. And, in terms of individual cancers, only the lung (156,940) kills as many Americans as medical errors. Colorectal (49,380), breast (39,970), and prostate (33,660) don’t even come close.

Yet these data appear to be lost on the legions of race organizers. A Web search uncovered not a single organized race event trying to counter the perils of medical error. No Lance Armstrong, no Katie Couric, no Jerry Lewis. Nothing.

Thankfully, these data are not lost on the ones who bear the brunt of these errors. A Commonwealth survey reported that 22% of respondents were aware of a medical error in care provided to them or their family. Another paper following the release of the IOM report put the number at 42%.^3,4

Still, nary a race “K” has been devoted to reducing medical errors.

Harriers Against Harm

As the finish line draws near, I note that the overhead scoreboard has taken on the appearance of the national debt clock in Manhattan—a large number rapidly getting larger. The replenishment table is littered with crumpled Dixie cups, the music has drifted, and the crowd has dwindled to a handful of volunteers, many of whom tap their toes awaiting my finish.

I wonder what it’ll take. If 12,000 people with spinal muscular atrophy is enough to convene a race, what of the millions of people harmed annually by medical errors? How many more have to die before patient safety becomes an issue, becomes it’s own cause, gets it own fun run?

Dr. Glasheen is associate professor of medicine at the University of Colorado at Denver,where he serves as director of the Hospital Medicine Program and the Hospitalist Training Program, and as associate program director of the Internal Medicine Residency Program.

References

1. HealthGrades Eighth Annual Report on Patient Safety in American Hospitals Study. Available at: www.healthgrades.com. Published March 2011. Accessed Aug. 31, 2011.
2. Kohn LT, Corrigan JM, Donaldson MS, et al. To Err Is Human: Building a Safer Health System. Washington, D.C.: National Academies Press, 2000.
3. The Commonwealth Fund 2002 Annual Report. The Commonwealth Fund website. Available at: http://www.commonwealthfund.org/Content/Annual-Reports/2002-Annual-Report.aspx. Accessed Sept. 9, 2011.
4. Blendon RJ, DesRoches CM, Brodie M, et al. Views of practicing physicians and the public on medical errors. N Engl J Med. 2002;347:1933-1940.