No End to Hospital Errors

Three Years After a Landmark Report Found Pervasive Medical Mistakes in American Hospitals, Little has Been Done to Reduce Death and Injury

December 3, 2002
By Sandra G. Boodman, Washington Post Staff Writer

When the august Institute of Medicine (IOM) issued its blunt assessment of medical errors three years ago, Lucian L. Leape, the pioneering Harvard physician researcher who helped write the report figured it would meet a fate common to such documents: The initial flurry of media accounts would be followed by a swift descent into obscurity.

Instead, the report's conclusion that as many as 98,000 hospitalized Americans die every year and 1 million more are injured as a result of preventable medical errors that cost the nation an estimated $29 billion commanded attention in a way Leape and his co-authors never imagined.

Shortly after its release, Congress held hearings and promptly earmarked $50 million for research into the causes and prevention of medical mistakes. President Clinton announced his support for a key recommendation -- mandatory reporting of serious errors -- an idea borrowed from aviation.

Four bills that would establish error reporting systems have been introduced on Capitol Hill. A consortium of Fortune 500 companies launched a year after the report's release is pressing hospitals to make specific changes in clinical practice known to reduce mistakes. "Patient safety" has become a mantra of the nation's hospitals. Beginning in January hospitals will be required by accreditors to show they meet six basic standards that reduce errors, which the IOM said kill more Americans than breast cancer, traffic accidents or AIDS.

"Frankly we were all very surprised," recalled Leape, a former pediatric surgeon and the author of several earlier groundbreaking studies of medical errors. "Before the IOM report, nobody was doing diddly squat. Now there are a lot of good people involved and a tremendous amount of activity," he said. "Of course, activity is not the same as progress."

The distinction drawn by Leape underscores the reality of the nascent movement to reduce medical mistakes: There's a lot of talk, but no significant progress. The reasons, observers say, include fierce resistance by doctors and hospitals to mandatory reporting and other IOM recommendations, a lack of oversight by the federal government and the absence of an effective consumer lobby.

As a result, experts contend, it's doubtful that patients checking into most of America's 5,200 hospitals today are any less likely to be killed or injured than they were on November 29, 1999, when the report was issued. With the conspicuous exception of the Department of Veterans Affairs (VA) medical system, whose hospitals have embraced the ethic and many of the methods that have made aviation and other industries safer, most hospitals have taken few new steps to protect patients from errors.


© 2002 The Washington Post Company
for full article see
http://www.washingtonpost.com/wp-dyn/articles/A58443-2002Nov30.html