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Dr. Nina Radcliff / Medicine must address errors the way aviation does

Dr. Nina Radcliff / Medicine must address errors the way aviation does

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My job responsibilities have changed dramatically. My first job at age 16 was as a hostess. On a good day, I would commit at least one mistake an hour. No harm done, but I was still fired after only three weeks.

Two decades later, as a physician anesthesiologist, a mistake can mean the difference between life and death. And it can occur over a matter of seconds. A new study in the current issue of the Journal of Patient Safety claims that between 210,000 and 440,000 patients die each year in hospitals due to medical mistakes. That would make medical errors the third leading cause of death after cardiovascular disease and cancer. The number is greater than the number of people who die from homicide, HIV, stroke and diabetes combined.

The number of deaths from preventable mistakes should be zero. Instead, with approximately 34 million hospital admissions a year, there is a 0.6 percent to a 1.3 percent incidence of mortality due to medical errors. Also, 1.3 million Americans a year incur injuries due to "medication errors." Every day, approximately seven wrong-site surgeries occur.

Numerous comparisons have been made between aviation and medicine - in both, peoples' lives are at stake, and highly skilled and trained professionals must work together to achieve safe results. Safety in the airline industry came painstakingly and was literally "bought in blood." Where the health-care field needs to emulate the aviation industry is to learn from its painful mistakes.

The airline industry has developed a nonpunitive reporting system that also aims to shift the blame from the individual to the environment or system. Similarly, most medical errors appear to be secondary to faulty systems rather than individuals. Unfortunately, less than one-third of hospital systems allow for anonymous reporting of mistakes, allowing the possibility of backlash or retribution. A health-care worker should never be placed in the position of choosing between political correctness or doing the right thing for the patient.

After the Asiana Airline crash, the aviation industry quickly identified the root cause and implemented system changes to prevent it from happening again. Accidental patient deaths often go without notice or media attention.

However, following the airing of a "20/20" news segment in 1982, titled "The Deep Sleep: 6,000 Will Die or Suffer Brain Damage," the American Society of Anesthesiologists responded with a program to standardize anesthesia care and monitoring. Within two years, the new standards decreased the number of deaths due to inadvertent insertion of breathing tubes into the esophagus instead of the trachea from 0.01 percent to 0.0005 percent. In this instance, media coverage stimulated change and has helped save human lives.

It would be absurd to have an airplane fly to the wrong destination because the pilot misread the destination. Doctors are notorious for their terrible handwriting. It would be laughable, except that bad writing can be deadly. With more than 3.2 billion prescriptions written in the United States annually, sloppy penmanship contributes to 7,000 deaths a year. Many errors result from illegible writing, ambiguous abbreviations and dosage indications.

To address this problem, electronic prescribing programs have been developed. But many doctors have not embraced this system due to the cost. The goal is to do away with the prescription pad, a weapon of mass destruction, and start providing incentives to physicians who embrace electronic prescribing.

Lost baggage during traveling is inconvenient and a nuisance. However, leaving behind instruments, sponges or needles in a patient following a surgery or procedure can result in significant suffering, harm and death. This should be a "never event," but unfortunately it is estimated to occur between 4,500 to 6,000 times a year. At the end of a procedure, counts are conducted. However, the lack of standardization creates opportunities for errors. Manufacturers now make sponges that can be tracked. These tracking systems can cost between $8-$12 an operation, but many hospitals have not adopted the system due to the overall cost of thousands of surgeries.

Analyzing mistakes can change standards of care. The common goal should be to save lives, decrease harm and, as an added benefit, lower costs and liability.

Dr. Nina Radcliff, of Galloway Township, is a member of the American Society of Anesthesiologists and a medical contributor for Fox News Channel.

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