Although it is inevitable that errors will occur in patient care, a recent article in New England Journal of Medicine showed that there has been no significant change in the number of patients harmed in our hospitals (“Temporal Trends in Rates of Patient Harm Resulting from Medical Care”, NEJM 2010;363:2124-34). Landrigan and colleagues studied the medical records of patients hospitalized in North Carolina between 2002 to 2007. Approximately 25 harms per 100 admissions were seen, with at least half being potentially preventable. Why has little change occurred despite a report titled “To Err is Human” released in 1999 by the Institute of Medicine which called for a movement to prevent errors?
Although there will always be errors, there are ways to minimize them from both the physician as well as the patient/family side. For the physician, treating everyone the way you would like your family cared for, is a mantra that helps reinforce commitment to better care and communication. It is a privilege to have the trust of a patient and their family. Thinking through the alternative diagnoses and what serious issues may be missed is essential – this is taught when you are a medical student and is referred to as “Critical Thinking”. This prevents going down the wrong pathway and opens up transparency of our complicated medical system to the patient/family as to the uncertainties in medicine. For the patient, “Dare to Ask”. You need to be an active informed partner in your care. You should ask questions if you don’t understand and relay your questions or concerns to your doctor. It is this bilateral partnership forming a trusting relationship that can enhance your care and avoid mistakes.
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- No Significant Change in the Number of Patients Harmed