Expectations of perfectionism VS standards of high quality

I saw this article (actually one like it) in my own local paper. My personal belief is that hospitals must strive toward perfectionism at all times, but on an average day, a nurse may administer what?--35 to 50 meds--and errors are inevitable. Many of the errors are relatively benign. I don't think nurses or hospitals can be shamed into perfection and we all recognize the effect of understaffing on error rates, but I only see this "shame factor" as making the hospital an ever more punitive and hostile environment in which to work. Any thoughts?

New Rules on Hospitals' Mistakes

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Story Filed: Wednesday, June 27, 2001 8:04 PM EDT


CHICAGO (AP) -- Hospitals will be required to tell patients when they've been victims of medical errors under safety standards that take effect Sunday.

The rule is the first of its kind from the Joint Commission on Accreditation of Healthcare Organizations, a nonprofit group that monitors nearly 5,000 hospitals nationwide.

The commission acted partly in response to a 1999 Institute of Medicine report estimating that medical errors kill 44,000 to 98,000 hospital patients each year.

Under the guidelines, hospitals that don't discuss harmful mistakes with patients and fail to prove to commission investigators that they're doing so will risk losing their accreditation.

``We need to create a culture of safety in hospitals and other health care organizations, in which errors are openly discussed and studied so that solutions can be found and put in place,'' said Dr. Dennis O'Leary, the commission's president.

Some hospitals, including the nation's Veterans Affairs facilities, already tell patients when errors occur. Others may keep quiet to avoid potential lawsuits, said Dr. Sidney Wolfe, co-founder of Public Citizen Health Research Group, a consumer-oriented advocacy group.

He said research showed that hospitals that were honest with patients about mistakes faced fewer lawsuits.

``People don't like to get jerked around,'' Wolfe said. ``Part of the understandable anger that accompanies a lawsuit is the idea that something bad happened to me and they didn't tell me.''

Rick Hendrick, a Chicago contractor who was given the wrong medicine in a hospital emergency room, agrees.

Hendrick, 47, said the hospital should have ``come to me and said, 'This is what happened. I'm sorry, we made a terrible mistake' and had warned him of the side effects.

Instead, he says, hospital staff never admitted that they'd given him a big dose of an antibiotic destined for another patient. Hendrick, who had sought treatment for a bad case of hives, said he had severe heart palpitations, nearly passed out and was weak for several days from the drug.

Dr. Don Nielsen of the American Hospital Association said the new standards echo AHA policy for its members -- about 5,000 hospitals and health care systems nationwide.

AHA policy even goes further, advising hospitals to tell patients about mistakes that don't cause any harm, Nielsen said.

In Congress some legislators are calling for nearly $1 billion to help hospitals and technology companies invest in devices to avoid more deaths and injuries. Congressional figures show medication errors -- missed dosages, double dosages, and dangerous mixes -- are believed to kill or injure 777,000 people each year.



On the Net:

Joint Commission: http://www/jcaho.org



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