http://www.usatoday.com/usatonline/20010628/3440087s.htm
Hospital mistakes must be disclosed Accreditation at risk if patients aren't
told
By Robert Davis
USA TODAYHospitals must now tell patients and their families when they have
been hurt by a medical error, according to nationwide standards that take
effect Sunday.The standards by the nation's leading health care accrediting
agency are the first to hold hospitals accountable for a higher level of
patient safety. As many as 98,000 people die each year from medical errors,
according to the Institute of Medicine. The medical community is scrambling
to try to make health care safer, but the effort has been hampered partly
because of the way that errors are handled.When a mistake is made today,
there is no legal requirement that a patient be told. The result is that
those close to the error know of the mistake, but the event is kept secret.
Left hidden, common medical mistakes -- such as administering a drug
incorrectly -- are rarely identified quickly and studied for ways to make the
health care system safer, researchers say.''These standards are meant to
create a culture of safety,'' says Dennis O'Leary, president of the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO), a non-profit
group that accredits 80% of the nation's hospitals. He announces the
standards today. ''Errors are not reported inside organizations because
caregivers are fearful they will be punished.''The new standards are designed
to promote open discussion and review of errors so that fixes can be found
and applied, O'Leary says. A hospital could get in more trouble for not
looking for errors than by committing them. ''If we can save a lot of lives
by making some basic changes in patient care processes, it will be a
wonderful benefit,'' he says.The new standards, available at http://www.jcaho.org,
do not require new hospital bureaucracies. JCAHO simply demands that hospital
leaders tackle medical errors and patient safety -- or risk losing
accreditation.During regular hospital inspections, the commission now will
look for patient safety compliance from hospital CEOs to patients. Each
hospital in the USA must: Actively work to prevent errors; design patient
safety systems, such as systems that double-check a drug order before a
prescription is filled; and encourage and act on internal reports of
errors.The JCAHO calls a medical error ''an unintended act, either of
omission or commission, or an act that does not achieve its intended
outcome.''The American Medical Association, which has an ethical standard
that says doctors should always tell patients about medical errors, applauds
the commission's new standards.''Safety has to start with the leadership of
an organization,'' says the AMA's Donald Palmisano, a surgeon in New Orleans.
''That is what JCAHO is doing here.''The American Hospital Association
agrees. ''We are very supportive,'' the association's Don Nielsen says.The
new standards should not cost hospitals anything to implement, he
says.O'Leary says that ''to create a culture of safety, caregivers must feel
safe that they are not going to be punished and that the system is designed
to protect them when they do make a human error.''
