Avoiding harm in the hospital

I spoke recently at a summit organized by Consumers Union’s Safe Patient Project, and learned in detail about the persistence and prevalence of hospital-acquired infections and other safety risks. Hospitals are not as safe as they should and could be, and hospital safety advocates are working hard to turn that around. Joe and Terry Graedon of People’s Pharmacy, who are cofounders of the Society of Participatory Medicine, write about “Avoiding Harm in the hospital,” noting a report just issued by the Inspector General of Health and Human Services showing that a projected 15,000 Medicare patients die monthly as a result of hospital care, and 44% of the adverse events could have been prevented. They go on to advise what caregivers and patients can do in the interest of safety and survival: always have a caregiver/advocate with the patient, ask about medications and drug interactions, and get detailed discharge instructions when leaving the hospital.


Posted in: hc's problem list | policy issues | pt/doc co-care





7 Responses to “Avoiding harm in the hospital”

  1. Annie Stith, e-Patient says:

    Hey, Jon Lebkowsky!

    I was appalled when I saw and retweeted Dave on this topic this morning. Being a Medicare patient, it hit me pretty hard.

    I had a problem myself when I had my gallbladder removed and ended up with MRSA. Because I can’t take many of the more recently marketed antibiotics (in this case, Cipro), I was put on Bactrim for six months, along with an antimicrobial soap. It was expensive, the Bactrim totally screwed up the good bacteria in my digestive system, and my sensitive skin didn’t like the soap. I had to throw out all my lotions, cosmetics, and personal care items, “just in case” the staph was in them. After, I had to sanitize as much of my apartment as possible. Regardless, I lost part of a breast because some of my milk ducts became infected.

    The worst part? Being told that what I was going through was common after hospitalization for surgery. Chances are I got the infection from a nurse who either didn’t wear gloves, or didn’t sanitize her/his hands before tending my wound. Here in St. Louis, we’ve had at least two emergency rooms completely overrun with MRSA and closed by the Health Department. They had to build all new ER’s in a different location before they could reopen, while the old ones were torn down.

    Personally, I’d like to know what I’m supposed to do if/when I have to go inpatient again. I have no family nearby, and most of my friends are long distance or online. There’s no one I know who can advocate for me.

    Maybe some of the unemployed could be retrained as paid advocates. ;)


    • e-patient dave says:

      Annie, I’m pretty sure Medicare isn’t the issue – it’s just that the only data *available for analysis* is Medicare, because private insurers won’t participate in this kind of study. This is just one of the reasons I believe it’s important for patients too stand up and say “Gimme my damn data” – retrospective analysis like this is impossible otherwise.

      I know of no evidence that Medicare outcomes are any worse than private insurance patients.

      You should probably read the new second edition of Best Care Anywhere, about the VA Healthcare system. They’ve been doing this kind of analysis for many years, which is part of why their costs, outcomes AND safety are better than outside.

      The previous administration, for some stupid reason, set out to kick patients out of the VA
      system (or disqualify them), supposedly to
      reduce government costs, thus forcing them into the MORE expensive Medicare system. Mind you, the author is no lefty – he’ s a free market guy.

      The IOM’s famous report on errors ten years ago can’t be literally repeated today because HIPAA won’t allow combing through patient records, but this analysis was done by looking at Medicare records, which the government obviously can see. I’m glad this was done. Our families’ lives depends on improving it.

      • Apologies to email subscribers, my previous reply was cut short. Please come online to read the whole thing.

      • Concur on the point that Medicare data just happens to be the data that’s available. One thing I got from the Safe Patient summit: when hospitals are measured, they improve.

      • Annie Stith, e-Patient says:

        Hey, Dave!

        I understood that the only data available is for Medicare patients. And while there may not be evidence that rates are higher for Medicare patients, I’d bet good money they are.

        I’m not sure how the “official” process works. I do know that there are only so many doctors who accept Medicare, so our access to physicians are limited to start with. Then there are only so many hospitals who give these doctors privileges, which again limits our care. (The exception being for life-saving procedures, after which we’re transferred to another hospital.) It seems as though Medicare is becoming the equivalent of Medicaid, where physicians and hospitals don’t want to get paid the “approved” amount allowed by Medicare and, paying attention to my EOB’s, I can’t say I blame them.

        You’re right, though, thay there is no evidence. I just know what I’ve experienced.


  2. Stitch says:

    One of the biggest obstacles to safe patient care is nurse to patient ratios. The greater the number of patients, the more nurses are pressed for time, the more short cuts they are taking to get what their administrators want done.

    The number one thing that increases patient safety and improves patient outcomes is good quality nursing care.

  3. […] Inspector General reported that 15,000 Medicare patients a month die from accidental causes. (See Jon Lebkowsky’s post about it, from a Consumers Union Safe Patient Project meeting where he […]

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