Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Improve patient safety to improve healthcare quality

Pearl Korn
Policy
January 29, 2012
Share
Tweet
Share

It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that shocked our nation with its revelation that 98,000 people died yearly in hospitals due to doctors’ errors. For decades, and through one administration after another, the lack of safety in our healthcare system has gone un-addressed, placing us at greater and greater risk. Hospitals have disappeared, been downsized or have consolidated into vast medical complexes operating like big businesses, with overextended staff spending less and less time with patients due to the fee-for-service paradigm. Adding to this toxic environment are the insurers, who squeeze every dime they can out of the insured by increasing premiums and co-pays and denying coverage for certain procedures at will, while cutting doctors fees for services rendered.

A non-system of healthcare seemingly held together with scotch tape and a prayer. The millions who are uninsured are a testament to the failure of an overly costly delivery system that leaves too many without basic healthcare security and coverage. With this as a template for healthcare delivery, how could safety be a part of the package?

Not too long ago, we saw George W. Bush repeatedly diverting attention from the issue of safety in healthcare with fables of frivolous lawsuits and million-dollar pay outs. There is no doubt that this issue is dirty laundry that few in Congress have had the backbone to take on. For many years Public Citizen has issued annual reports honing in on the failures of the Office of Professional Medical Conduct (OPMC) in the states’ Health Departments to protect the public by taking minimal action — if any — against doctors who have been sanctioned by their hospitals — a failed agency model that is reactive instead of proactive.

At the beginning of the new year, there was a segment on ABC World News on the release of a new report by the Inspector General of Health and Human Services, which oversees Medicare and Medicaid, that found that only one in seven errors and accidents in hospitals are reported. This translates into more than 130,000 Medicare patients being estimated to have experienced one or more adverse episodes in a single month. These staggering numbers were also reported in an op-ed in the New York Daily News. If these are just the numbers reported for Medicare patients, what about those on Medicaid and with private insurance? Is any attempt being made to identify them?

The op-ed mentioned numerous and varied reasons for these adverse happenings, from ineptitude to medication errors to bedsores and infections. The suggestion was that doctors and support staff don’t know what is causing the problem, or they think someone else filed a report, or it was simply a routine occurrence. Basic definitions and code numbers are needed to identify adverse events in hospitals so that they can be charted and solutions found. Instead, they continue to go unreported or underreported, which is against the law. Clearly, little has changed since 1999. We all know a friend or family member who has a hospital-related horror story. Just last week, an echocardiogram technician told me she went to the hospital with kidney stones and developed a hospital-born infection, which left her hospitalized for a month. How much did that cost her and the system?

Some weeks before the Inspector General’s report was released, Centers For Medicare and Medicaid Services (CMS) announced its competitively selected 32 Accountable Care Organizations, created under the Affordable Care Act, to participate in a pilot program to provide high-quality, coordinated healthcare and to reduce costs, with new models of healthcare delivery and payment to be implemented in those 32 selected hospitals around the country. Quality standards will be based on patient outcomes and patient experiences, along with coordination of care. This is all part of the transformation in healthcare on the way, with a major focus on e-medical record keeping as the linchpin. Better health and a reduction in hospitalizations are the goals, with an emphasis on primary care. CMS will pay a lump sum for each patient to cover all medical needs. A percentage of the money saved over a three-year period through reduced illness and hospitalizations would then be shared with the hospitals, if quality and performance standards are met. Awarding payment for results is certainly a novel concept in healthcare.

I find it interesting that only one hospital was chosen in New York State to participate in the ACO program, in a state where the nation’s leading teaching hospitals and research medical centers are located. 24,000 traditional Medicare patients will be enrolled in this program in New York at Montefiore Medical Center and throughout the Montefiore system. To improve the quality of healthcare, this innovative program should certainly include improving safety among its primary goals. No patient should be fearful of entering a hospital or be at risk of injury or worse. It will be important to follow these pioneer efforts and see how improved healthcare delivery becomes a focus of these ACO’s, hopefully at the same time developing safeguards that will eventually be used nationwide. Is a new era in safe, high-quality healthcare delivery with lower costs finally upon us? At least the door now appears to be open.

This post is dedicated to Seth Speken, who died unexpectedly at the age of 23 in a hospital in 1993, and to Christina Zisa, who died at age 27 as a result of injuries sustained during her birth in a hospital. Her lifetime of disabilities ended in January 2011. These were children of personal friends.

This post was written with Jonathan Stone.

Pearl Korn is an advocate of improved Medicare for All.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

How will the Baby Boomers age and die?

January 28, 2012 Kevin 7
…
Next

New classes of devices to diet and exercise

January 29, 2012 Kevin 3
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
How will the Baby Boomers age and die?
Next Post >
New classes of devices to diet and exercise

ADVERTISEMENT

More by Pearl Korn

  • a desk with keyboard and ipad with the kevinmd logo

    Interviewing a primary care doctor to better understand her professional day

    Pearl Korn
  • a desk with keyboard and ipad with the kevinmd logo

    Health reform needs to end fee for service medicine

    Pearl Korn

More in Policy

  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Choosing between care and country: a dual citizen’s Independence Day reflection

    Kathleen Muldoon, PhD
  • How fragmented records and poor tracking degrade patient outcomes

    Michael R. McGuire
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Improve patient safety to improve healthcare quality
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...