4 Actions to Reduce Medical Errors in U.S. Hospitals

In American hospitals, medical errors are a significant problem that results in hundreds of preventable deaths annually. A Johns Hopkins study estimates that medical errors result in the deaths of over 250,000 individuals annually, ranking them as the third most common cause of mortality in the US. 

These errors—drug overdoses, poor communication, incorrect diagnoses, and healthcare-associated infections (HAIs)—illustrate how critical it is that hospitals prioritize patient safety from the start. In this blog article, we’ll discuss four crucial actions that online healthcare organizations, including hospitals, may take to improve patient safety and reduce medical errors.

What are medical errors?

We describe medical errors as inaccuracies or deficiencies in healthcare services that can harm patients, including causing death. Any step of the patient care process, including diagnosis, therapy, prescriptions, surgery, and other medical procedures, could result in these mistakes. 

Medical error, often preventable, is one of the leading causes of patient injury in professional healthcare systems worldwide, especially in complex settings like hospitals.

Types of medical errors

Here are the types of medical errors, along with descriptions for each:

1. Diagnostic Errors

When a doctor or nurse gives the wrong diagnosis, the patient may not get the proper treatment or may have to wait longer. We call this mistake a diagnostic error. This category also includes cases where healthcare providers miss diagnoses by not considering a disease.

Examples:

• Failure to Diagnose: When a health care provider misses a diagnosis, such as a cancer diagnosis.
• Delayed Diagnosis: Patient outcomes may worsen if healthcare providers do not promptly identify the correct ailment, even when it is eventually diagnosed.
• Misdiagnosis: Healthcare providers give the wrong diagnosis to a patient, such as diagnosing anxiety when the patient is having a heart attack.

Consequences: Among the repercussions are an exacerbation of the illness, inappropriate or delayed therapy, and needless interventions.

2. Medication Errors

Healthcare providers make medication errors during prescription, delivery, or medication administration. They can occur at any point during the drug process, from prescription to side effect tracking.

Examples:

• Inappropriate Medication: A patient must receive the correct prescription for their condition.
• Inappropriate Dosage: The patient receives more or less medication than is indicated.
• Medication Given to the Wrong Patient: Inadvertently, a patient is given medication.
• Neglected Drug Interaction: When recognized allergies or potentially harmful drug interactions are overlooked.

Consequences: Possible results include overdose, allergic responses, inadequate therapy, adverse pharmaceutical reactions, and even death.

3. Surgical Errors

Surgeons make surgical errors during procedures or therapies. They are often high-risk errors because surgery is invasive and can cause long-term damage.

Examples:

• “Wrong-site surgery”: This refers to surgery on the incorrect side or bodily portion (e.g., amputating the wrong limb). Giving a patient the wrong kind of surgery is an example of an inappropriate procedure.
• Apparatus Unintentionally Left Inside the Body: During surgery, surgical instruments like sponges can occasionally be unintentionally left inside patients.
• Inadequate post-surgical care: Failing to monitor or treat post-operative issues promptly.

Consequences: Mortality, excruciating pain, loss of function, infection, and recurrent surgeries are among the effects.

4. Communication Errors

Inadequate communication between patients and medical staff is one of the primary causes of preventable medical errors. This might include giving vague instructions, misinterpreting essential details, or giving out too few handoffs.

Examples:

• Incomplete Handoff: Not all the details regarding a patient’s condition or treatment plan are provided when a shift changes.
• Ignorance of Patient Concerns: The healthcare provider needs to pay more attention to the patient’s grievances and past medical records.
• Vague or illegible notes: Any vague notes recorded in the patient’s medical file may lead to inaccurate treatment. We call this kind of documentation vague.

Consequences: Possible effects include incorrect diagnosis, inappropriate therapy, delayed care, and medication mistakes.

5. Systemic Errors

Flaws in the healthcare system’s protocols or infrastructure cause these errors. We sometimes call them hidden mistakes because they result from systemic faults rather than individuals’ direct actions.

Examples:

• Inadequate Staffing: Departments that are understaffed or overworked increase the risk of errors and weariness.
• Defective medical equipment: It is defined as poorly maintained or needs the necessary training to operate it.
• Poorly Designed Processes: Outdated or inefficient methods, including manual data entry, make mistakes possible.

Consequences: Higher chance of mistakes, ineffective treatment, patient injury, and delayed care.

6. Documentation Errors

These mistakes happen when information in patient records is erroneous, lacking, or deceptive. Documentation errors in healthcare may result in poor choices or unsuitable interventions.

Examples:

• Inaccurate Patient Information: Make sure the medical record has the correct diagnosis, course of therapy, and patient history.
• Inaccurate Medication Lists: Medication lists are not updated when new prescriptions are added or removed.
• Vital patient information: Information, such as allergies or previous procedures, is omitted from the medical record.

Consequences: This include incorrect diagnosis, drug mistakes, ineffective or delayed therapy, and legal ramifications.

7. Infection-Related Errors (Healthcare-Associated Infections, HAIs)

These mistakes include avoidable illnesses that patients get while in the hospital, frequently resulting from ineffective infection control procedures.

Examples:

• Infections brought on by inadequate sterilization or extended catheter use are known as catheter-associated urinary tract infections or CAUTIs.
• Surgical site infections (SSI) are infections that develop at the surgical site as a result of inadequate post-operative care or inadequate sterilization.
• Lung infections brought on by inappropriate ventilator use are known as ventilator-associated pneumonia (VAP).

Consequences: There might be severe illness, infection, extended hospital stays, or even death.

8. Diagnostic Testing Errors

These errors occur when there is a mistake in ordering, interpreting, or following up on diagnostic tests.

Examples:

• Misinterpretation of Test Results: Reading blood tests, radiology scans, or other diagnostic equipment incorrectly.
• Not placing the necessary test orders: Not placing the necessary test orders that could result in an accurate diagnosis.
• Delayed Follow-Up on Abnormal Results: Not promptly notifying the patient or taking appropriate action in response to abnormal test results.

Consequences: Incorrect or delayed diagnosis, inappropriate course of therapy, and avoidable consequences.

9. Patient Identification Errors

This occurs when a patient is misidentified, leading to diagnosis, treatment, or medication administration errors.

Examples:

• Surgical Error: When a procedure is carried out on the incorrect patient.
• Medication Given to the Wrong Patient: Giving a patient medication meant for someone else.
• Switching Medical Records: Mixing up samples or patient files.

Consequences: Serious mistakes in medicine, surgery, or therapy that may have fatal results.

10. Preventive Care Errors

These errors occur when preventive care—such as vaccinations, screenings, or follow-up appointments—is overlooked or put off.

Examples:

• Missed Screenings: When regular screenings for diseases like cancer or cardiovascular disease are not recommended or offered.
• Immunizations given after the fact put people at risk for diseases that may have been avoided.
• Inadequate Follow-Up: Neglecting ensures patients receive the essential post-treatment or post-operative care.

Consequences: These include advancing diseases that may have been prevented, worse patient outcomes, or needless complications.

4 Actions to Reduce Medical Errors in US Hospitals

Here are four actions that can help reduce medical errors in US hospitals – 

1. Strengthening Communication Across Healthcare Teams

Inadequate communication is among the leading causes of medical errors in the healthcare sector. This might result in the wrong patient receiving the wrong therapy, delayed diagnosis, inappropriate medication doses, or even misdiagnosed illnesses. Communication errors in the healthcare industry are often classified as hidden errors, implying that errors are caused by systemic issues in the communication flow.

Hospitals should prioritize implementing clear, standardized communication procedures such as SBAR (Situation, Background, Assessment, Recommendation) to overcome this. This method ensures healthcare personnel share important information appropriately and concisely, particularly during handoffs or shift changes. Another solution is to adopt electronic health record (EHR) systems, which make it easier for departments to share patient data.

In addition, healthcare teams must foster an environment of accountability and openness where every team member feels free to voice concerns or provide explanations as needed. The Joint Commission, a nonprofit organization that accredits healthcare facilities, has included improving communication to reduce medical mistakes in the healthcare system as one of its National Patient Safety Goals (NPSGs) 2024.

Practical Strategies for Improving Communication:

• Hold daily briefings or team meetings to ensure everyone agrees on patient care plans.
• Make use of instruments for standardized communication, such as SBAR.
• Provide all healthcare personnel with frequent training on effective communication strategies.
• Promote a non-punitive environment where team members can voice issues or ask questions without fear of repercussions.

2. Utilizing Clinical Decision Support Systems (CDSS) to Reduce Diagnostic Errors

Diagnosis errors account for around 10% of patient fatalities in the medical industry, severely harming victims. These errors arise from medical practitioners misdiagnosing patients, which may lead to improper treatment planning or postponement. Conversely, advanced medical technology, such as Clinical Decision-Support Systems (CDSS), may help prevent many diagnostic errors.

By analyzing patient data, CDSS interfaces with EHRs to help healthcare providers make better decisions by proposing potential diagnoses or courses of treatment. CDSS helps lower the possibility of errors in clinical judgments by providing evidence-based suggestions, highlighting possible pharmaceutical errors, and reminding physicians of preventative care principles.

Furthermore, by providing real-time notifications for possible harmful drug interactions or dose errors, CDSS can operate as an additional line of defense for physicians. It can cross-check vital signs, allergies, and lab findings to ensure that treatments and medications are safe and suitable for the patient.

Practical Strategies for Implementing CDSS:

• Ensure the hospital’s EHR and CDSS are connected for smooth data sharing.
• Update CDSS software frequently to reflect current best practices and medical guidelines.
• Teach medical staff members how to integrate CDSS into their clinical workflow efficiently.
• Track and analyze CDSS alerts to assess and modify clinical decision-making procedures.

3. Enhancing Medication Safety to Prevent Errors

One of the most prevalent categories of medical errors in healthcare, medication errors annually impact millions of people. Any step of the drug process, including prescribing, transcribing, dispensing, administering, and monitoring, is susceptible to these mistakes. An Institute of Medicine report states that healthcare providers in the United States make at least 1.5 million avoidable drug errors annually.

Healthcare institutions must implement complete healthcare solutions prioritizing technology and human aspects to reduce prescription mistakes. One workable solution is to use Barcoded Medicine Administration (BCMA) systems, which require medical staff to scan a patient’s wristband and medicine before giving it to them. This considerably lowers errors by guaranteeing that the right patient receives the proper medication at the right time in the right amount.

Another crucial instrument is automated dispensing cabinets (ADCs). This helps store pharmaceuticals and dispense them according to a patient’s prescription. When combined with EHRs and CDSS, these solutions reduce human error in pharmaceutical preparation and administration.

Practical Strategies for Reducing Medication Errors:

• To guarantee precise patient identification and drug administration, use BCMA systems.
• Use ADCs to increase the accuracy of medicine dispensing.
• Promote the practice of “medication reconciliation,” in which healthcare professionals review a patient’s whole drug history when changing a patient’s care.
• Regular training on medication safety procedures and error-reporting techniques is provided to nurses and other healthcare staff.

4. Promoting a Culture of Safety and Error Reporting

Reducing medical mistakes in the healthcare industry requires fostering a culture of safety. An essential component is fostering an environment where healthcare personnel feel free to report errors, near misses, and other safety hazards without fear of consequences. This kind of culture actively prevents mistakes from occurring again and encourages growth.

Implementing an error reporting system in the medical industry may highlight areas for improvement and provide valuable data on the patterns of medical mistakes. In support of this, the Patient Safety Act (2005) created the Patient Safety and Quality Improvement Act (PSQIA), which encourages voluntary and private reporting of adverse events, medical mistakes, and near misses.

Leaders in the healthcare sector need to prioritize continuous education and training programs emphasizing the significance of mistake prevention and patient safety. Regular simulation training, for instance, may help medical professionals safely respond to complex medical events. The National Patient Safety Goals 2024 highly value leadership’s responsibility in promoting a safety culture, addressing healthcare mistakes, and ensuring the consistent implementation of best practices.

Practical Strategies for Promoting a Safety Culture:

• Establish mechanisms for anonymous error reporting to promote openness.
• Examine mistake reports regularly to spot patterns and potential improvement areas.
• Provide all employees with regular training on patient safety and preventing medical errors.
• Activate leadership to support patient safety programs and provide funding for safety enhancements.

Conclusion

A concerted, system-wide effort incorporating pharmaceutical safety, technology, enhanced communication, and a strong safety culture is needed to reduce medical errors in US hospitals. Healthcare organizations may significantly enhance patient outcomes and minimize avoidable harm by addressing the underlying causes of medical errors, whether medication-related, diagnostic, or communication-based. The steps covered in this blog are not stand-alone remedies; they need to be part of an all-encompassing patient safety plan that aligns with the 2024 National Patient Safety Goals.

All healthcare workers, including nurses, doctors, and hospital managers, must prioritize patient safety by adopting mistake-avoidance procedures and creating an environment where providing exceptional care is a constant goal. By implementing these suggestions, the US healthcare system may make great strides in reducing medical mistakes, improving patient trust, and saving lives.