How Many Die from Medical Mistakes in U.S. Hospitals? (2013)

As a Doctor, the potential for improvement begins from very basics. For instance - a radiologist sees a funny looking line on an xray and reports "this is probably nothing, but we should repeat the xray in 6 weeks to make sure." Sometimes these requests slip through the cracks and in a fraction of cases the patient presents 2 years later with terminal cancer from their metastatic lung Ca.

Ensuring blood thinners are prescribed post coronary bypass surgery or stenting is another one. It should happen every time, but sometimes by human error it may not.

A good startup idea would be to make a hotlist of the top ~1000 of these obvious, preventable errors, combine IT data sources to predict when they might be occuring, and have checking systems in place to prevent them. If it worked even adequately, hospitals would be seen as negligent for not using such a system.

The problem, and the root cause of many medical mistakes, is medical staff not getting enough sleep.

I know of nurses who could barely keep their eyes open while driving to work. And that's because they just finished a shift at a different hospital.

At a time, a friend of mine had to be picking up his wife from work, because he was afraid of what might happen if she drove herself.

So let's fix the sleep deprivation problem.

If I'm not mistaken, in Kaiser hospitals, each time a drug is administered to an in-hospital patient, the patient's wristband is electronically scanned with a handheld gun to re-verify that this is in fact Patient X with condition Y who needs treatment Z.

I have a few comments:

My main experience as a patient tells me that one major area of improvement comes from the utter lack of coordination there in on the part of hospitals, insurance companies, and pharmacies to get me the meds I've been prescribed. How many hours do I need to be on the phone? This is "just" at home, though.

In the hospital, I often have just as hard a time to get all my meds because some of my meds are so specialized that the in hospital pharmacy doesn't have them, and I have to bring them from home. If I come in due to an emergency, I am likely to forget them. Thus, additional problems can come about from not having these meds.

Those aren't what most would consider mistakes on the parts on doctors or health care professionals, though, that's institutional blockers to my health care. Do they get counted in this?

As for mistakes on the part of human workers, I wonder just how much is from workers not washing their hands. Anecdotally, a lot of people I know complain that doctors are loathe to do that and other cross-infection control procedures that are simple, but repetitive.

Another barrier I see (although not exactly a "mistake" from one person) to good care is how much effort this can all take, and that it often necessarily means taking time off work. Taking too much time off means you may get fired, etc. Is this taken into account?

I suppose many of my concerns are not direct causes--not getting your meds or getting to the doctor to figure out a problem early on means you miss the opportunity to prevent or fix an easier problem. Then have to deal with it as a full-blown disaster, which means more complicated care, and more opportunities for mistakes in the OR.

At a CU medical shool lecture I just saw a paper cited when the infection rate was reduced from 3% to no incidents (two quarters) after the teams used checklists for a certain complicated procedure. That is one of many improvement tools being adopted.

I'm working on a startup to help with this problem. My belief is doctors don't have enough opportunity to practice the complex tasks of diagnostics and treatment planning. Right now best-practice for medical training involves expensive life-size manikins and dedicated simulation rooms with real staff. My goal is a realistic software simulation of the emergency room with a wide variety of patient scenarios to let students and docs easily practice in a setting where failure is okay.