Need for transparency with health care errors
The Philadelphia Inquirer wrote an article about how many errors in health care settings do not get reported. These errors or mistakes, whatever you want to call them, need to be disclosed so we can figure out how to prevent them in the future. These health care businesses are more worried about getting caught then preventing them.
The article describes several incidents where patients were not given proper care but the hospitals failed to report the problems such as two patients at Fox Chase Cancer Center in Philadelphia required additional surgery after objects were negligently left inside their bodies or three patients at Mercy Fitzgerald Hospital had to be sent back to the OR last year to stop excessive postoperative bleeding or At Abington Memorial Hospital, an elderly woman recovering from surgery for a broken hip in 2005 was left on a bedpan for at least 41/2 hours. She developed two open bedsores as a result.
For several years now, hospitals in Pennsylvania and New Jersey have been required to report medical mistakes and serious complications to state agencies charged with reducing medical errors. But most hospitals aren't complying, undermining efforts to improve patient safety. In New Jersey, five of the state's 80 hospitals failed to report a single preventable mistake last year. In Pennsylvania, some facilities didn't report any serious events or even the near misses that might have harmed patients.
James Bagian, head of the Department of Veterans Affairs' National Center for Patient Safety, said: "Anybody that is supposed to report close calls and has zero reports is clueless; Management is asleep at the switch and just waiting until they kill someone." The public can only learn that a hospital isn't reporting mistakes in those rare instances when the health department cites it for failing to comply with the law.
"There is still some underreporting, and we are working directly with the hospitals to understand why," said Eliot Fishman, policy director of the New Jersey Department of Health and Senior Services. Consumer advocates want more transparency so patients can make better health-care decisions.
The numbers suggest underreporting is more than just a passing problem. Calvin Johnson, the Pennsylvania secretary of health, said only people with their "head in the sand" would fail to see the problem of uneven reporting by hospitals. But he noted that with about 200 hospitals and millions of patient visits each year, it is impossible for the state to check every chart.
While it's important to study each of those reports, it is at least as crucial to identify hospitals that are not participating at all, said Conway, of the health-care improvement institute. "We cannot improve care unless we understand the problems," Conway said. "There can't be safety without transparency."
