Analysis: Hospitals face heat to cut error

WASHINGTON, May 18 (UPI) -- Medical errors cause thousands of deaths in the United States each year, but an alliance of health systems this week proposed a set of tougher guidelines for hospitals to make patient stays a less dangerous proposition.

As the eighth-leading cause of death in the country, medical-treatment mistakes kill 98,000 people each year, and hospitals currently average between 10 and 30 mistakes for every 100 procedures. Although many errors are minor, the ratio is discomforting.

But in an effort to curb those statistics, the Safest Hospital Alliance plan, sponsored by three health systems, proposes to implement 172 safety measures at participating hospitals with the goal of cutting overall process errors by 30 percent in two years.

"In other industries, they have more like five errors per million," said Richard Salluzzo, president of Wellmont Health System, one of the three health systems in the Safest Hospital Alliance.

The idea of increasing hospital safety is not a new one. In fact, lists of good practices abound, created by a variety of healthcare organizations, including the Agency for Healthcare Research and Quality and the Institute for Healthcare Improvement. But while all of these contain good ideas, the Safest Hospital creators say they are only causing confusion among medical practitioners.

"One of the real hurdles from the inside is, people are just taking a sip from the fire hose of recommendations people are throwing down," Salluzzo told United Press International.

Previous good practice lists failed to bring about change because, as proposals produced by voluntary organizations, they lacked the muscle to monitor or enforce compliance, Salluzzo said.

The implementation of this new plan, however, will be closely watched by its developers: Adventist Health System, Novant Health and Wellmont. Together, the three healthcare providers oversee 56 hospitals that treat 1.5 percent of all hospital patients in the nation. Because the program will be monitored, it will be easy to determine success, Salluzzo said, and convince others to adopt the measures.

"If 1.5 percent of the nation's (hospital) admissions are getting distinctly better treatment than the other (98.5 percent), how long will it be before our system is adopted?" he said.

The Safest Hospital program is also more of a "how-to" guide for hospitals in avoiding specific errors. Previous plans contained general recommendations with no explicit directions on how to achieve those positive outcomes.

"It's easy to say, 'Don't puncture a lung,'" Salluzzo told UPI. "But what are you going to do in terms of processes to prevent it?"

As a result, each of the 172 safety measures has about three to five critical steps that, if followed, should eliminate the error. For instance, in order to reduce the number of falls in hospitals, the plan requires nurses to assess each patient's risk of falling upon entry to the hospital.

If they have a high risk, the nurse orders a bed alarm, checks on the patient hourly, places a sign on the door and puts a star on the patient's chart.

Some of the hospitals involved have already seen success by aggressively promoting and monitoring specific safety measures. Tennessee-based Novant Health has significantly decreased improper hand hygiene -- a leading cause of hospital-acquired infections. Nationally, it is estimated that healthcare workers comply with all hand-hygiene requirements only 25 percent to 40 percent of the time.

"We've taken our compliance from the national average and now we're up in the 90 to 95 percent range of compliance," said Jim Tobalski, senior vice president of Novant.

By reducing incidences of error, even those as simple as inadequate hand-washing, the plan's creators also hope to reduce medical costs by 10 percent in two years. Medical mistakes not only cost lives, they strain patients' bank accounts -- to the order of $37.6 billion annually.

The health systems project all levels of the plan will be implemented by July 1.

If the plan succeeds, national safety measurements may be affected.

"The benchmarks that are used out there for patient safety indicators are really kind of average performance," Anthony Oliva, chief medical officer for Wellmont Health System, told UPI. "Our goal is to reset those benchmarks to be a better target for people to shoot for. We believe we can make that performance much better than the empirical data tell you."