9.14.2009

Learn From Mistakes; Don’t Try to Hide Them

Hospitals are beginning to realize that admitting and learning from mistakes is better than trying to cover them up, according to an article in The Wall Street Journal.


Some hospitals like Baptist Children's are taking steps to admit grievous mistakes and to learn from them in order to overhaul flawed procedures. That represents a sharp departure from hospitals' traditional response when something goes terribly wrong—retreating behind a wall of silence to guard against potential lawsuits.

Now, some hospitals are hoping to stem the tide of lawsuits by being more open with aggrieved patients and their families. While some experts warn that disclosure will lead to an increase in litigation and costs, there are some indications that patients are less likely to sue if they receive full disclosure and an apology, along with an offer of compensation. But longer term, some administrators say the solution is to improve hospital safety records.

"Sorry alone doesn't work unless we learn from our mistakes," says Timothy McDonald, a pediatric anesthesiologist and chief safety officer at the University of Illinois Medical Center in Chicago. "We have to also make promises that this won't happen again and get patients and families engaged in the effort to improve our performance."


One example cited in the article is the University of Illinois.


The University of Illinois center set up a specialized service in 2004 to help staff communicate with patients and families after harm occurs. Since 2006, the center has had a policy of fully disclosing medical errors, apologizing when they occur, and swiftly offering a financial settlement. And patient-family members sit alongside staff on a board charged with overseeing plans to prevent errors.

Dr. McDonald says that over the past four years, the number of lawsuits against the center is down 40% compared to the period between 1999 and 2004, even though the number of procedures increased 23%. While it can't say for certain that the disclosure program was responsible for the decreases, "we can certainly say that it has not caused an increase in lawsuits or payouts," he says.


While I’m sure the hospital is pleased by having fewer lawsuits, I am more interested in whether its efforts resulted in fewer medical mistakes – and there were actions taken to reduce mistakes. The result:


Despite such efforts, the federal Agency for Healthcare Research and Quality reported in May that the rate of adverse events—a key measure of patient safety defined as unintended harm during medical care—has risen by about 1% in each of the past six years, in part because of a rise in hospital infections. The old and the young are especially vulnerable: One in seven hospitalized Medicare patients experience one or more adverse events, and one in 15 hospitalized children are harmed by medication errors, other studies show.


The focus should now be on reducing the infection rate.

This trend away from covering up mistakes is healthy, and I applaud those hospitals taking the lead.

How does your company deal with mistakes?

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