MedicalResearch.com Interview with:
The Johns Hopkins University School of Medicine
M.D. Candidate 2016
Michael G. Daniel is a graduating medical student at the Johns Hopkins School of Medicine. He will be attending the Osler Internal Medicine Residency Training Program next year at the Johns Hopkins Hospital. His research focus is on Patient Safety, Quality, and Outcomes improvement.
Medical error ranks as the third leading cause of death in the United States, but is not recognized in national vital statistics because of a flawed reporting process. Using recent studies on preventable medical error and extrapolating the results to the 2013 U.S. hospital admissions we calculated a mortality rate or 251,454 deaths per year.
MedicalResearch.com: What made you want to research this topic?
Response: I decided to study medicine because I wanted to improve patient health. However, I realized that improving patient health is not only about curing a disease but is sometimes about fixing the way we deliver healthcare.
MedicalResearch.com: Is this news surprising to you?
Response: Yes, because all previous estimates of medical error were much lower and when I started the research I couldn’t use the CDC statistics to get current data.
MedicalResearch.com: What can hospitals do to ensure their patients are receiving the proper care?
Response: 15 years ago Johns Hopkins started a major effort to get control of medical errors. Hopkins started a new Armstrong institute for patient safety and has a number of ongoing efforts to reduce medical errors. A description of the proactive steps that hospitals can implement to increase patient safety can be found on the Armstrong Institute website http://www.hopkinsmedicine.org/armstrong_institute/
MedicalResearch.com: With this news, do you think that there will be an updated criteria for classifying death on death certificates?
Response: We are hopeful that increased attention to this problem will result in changes that will help us better track and prevent medical errors.
MedicalResearch.com: Why aren’t deaths being reported accurately? What can be done to change this?
Response: Unfortunately, death statistics are recorded using death certificates. Death certificates have a major limitation in that they are tabulated using the ICD (International Classification of Disease) billing code system. As a result causes of death not associated with the ICD coding system, such as human and system factors are not captured. One potential solution is to add a section on the death certificate that inquires whether a medical error occurred.
MedicalResearch.com: How can doctors themselves use this data to solve the growing problem of deaths-related to medical errors?
Response: I think the major focus of this data is on improvements at the system level so that the largest number of patients can benefit from what we learn. However, individual physicians can continue to be vigilant and when an error occurs recognize it and advise their hospitals on ways the system could be improved in the future to limit such an error occurring again.
MedicalResearch.com: What do the findings of this study mean for patients?
Response: I think this data reminds patients and informs them that errors do occur and that patients need to continue to be advocates in their care and the care of their loved ones. Including asking questions, making sure they understand all of the doctor’s orders and prescriptions, and if they see something and are concerned be sure to speak up.
MedicalResearch.com: What further research is needed?
Response: A lot of research needs to be done on improving the science of safety specifically focused on reducing communication breakdowns, diagnostic errors, poor judgment, inadequate skill and other forms of preventable error which can directly result in patient harm and death.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation: Medical error—the third leading cause of death in the US
BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2139 (Published 03 May 2016)Cite this as: BMJ 2016;353:i2139
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