If hospitals don’t disclose all errors, how can they ever stop them?
Every year, the state of Minnesota releases its Adverse Event Report. Last year, the results were about the same. About 300 people died in Minnesota due to adverse events, but nurses and doctors know this isn’t the whole story. Mistakes and “near misses” in hospitals happen all the time. While some improvements have come in hospital transparency, the New England Journal of Medicine wants more.
In a commentary by Dr. Allen Kachalia, M.D., J.D., the NEJM argues that hospitals must disclose mistakes if they ever hope to prevent them. Kachalia pushes for more use of Disclosure, Apology, and Offer programs (DAOs) that disclose errors to patients and let the chips fall where they may. Despite some hospital concerns, DAOs have shown to limit liability losses not increase them.
He cautions that hospital’s incentives to keep mistakes quiet are huge: liability, reputation, loss in patient population, but those can’t be considered compared to treating the systemic failures that cause medical mistakes to happen. Even a lapse in judgment or an error in diagnosis due to fatigue can be considered systemic. Patients have a right to know about medical mistakes, patient outcome results, staffing plans, and procedure costs. Hospital administrators should want to know about those too if they’re going to keep patients safe.
New England Journal of Medicine article here: http://www.nejm.org/doi/full/10.1056/NEJMp1303960?query=TOC
