April 2, 2012

Most Adverse Events in Hospitals Go Unreported

I am not sure how to react to this report. Yes, I believe the study and I am surprised it is not more of a horror story. Having experienced a few incidents first hand which I doubt were reported, anything is possible. Some hospitals are indeed better than others are, but I believe this comes from the top down. If the head of the hospital is conscientious and concerned, generally he will employ physicians and nursing staff that are concerned. Anyone can hire a bad apple, but it is the hospital administrator that sets the tone. In some cases, it is the hospital board of directors that establishes the standards.

The study reports that about 86 percent of patient mishaps in hospitals go unreported and are not entered into any incident database. Whether better reporting will improve the quality of care or patient safety remains to be seen. A big surprise in a way is that 62 percent of adverse and “temporary harm” events that were not reported were believed not reportable by hospital staff.

The Office of Inspector General (OIG) in the US Department of Health and Human Services (HHS) recommends that the Centers for Medicare and Medicaid Services (CMS) collaborate with the federal Agency for Healthcare Research and Quality and develop a master list of potentially reportable events. Then hospitals and other healthcare providers could use this list to eliminate any confusion. Presently, the three organizations that accredit hospitals - the Joint Commission, the American Osteopathic Association, and Det Norske Veritas Healthcare — do not have standardized lists of reportable patient incidents.

I seriously wonder if there will be any changes made, as you have to think that hospitals will continue on the present path. If nothing more than to minimize lawsuits, they will resist reporting adverse events. With hospitals now employing many doctors, they will continue to be profit motivated to a fault and to avoid legal problems. Nurses will continue to be dismissed when they do their job and counsel patients to the detriment of potential profits.

You may read the study here and the situation about the nurse here.

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