In this case it may be OK to kill the messenger, but have mercy on the message.
A study in the July 5 issue of the Journal of the American Medical Association supports what some skeptics have quietly believed since the Institute of Medicine released its 1999 bombshell report on medical errors. While the IOM's "To Err is Human" study claimed 44,000 to 98,000 preventable deaths occur each year in U.S. hospitals, cynics among us said those numbers just didn't seem right.
And finally those naysayers can cite some science. Three Indiana University Medical School researchers say the IOM's "hot and shrill" numbers were exaggerated, although the team of Hoosiers offers no estimates of preventable deaths.
Harvard researcher Lucian Leape, M.D., a lead player in the IOM study, realizes the death numbers helped grab the headlines. He also acknowledges limitations and methodological weaknesses in the research cited by the IOM report; yet Leape believes the numbers are perhaps even underestimated.
Whatever the case, the medical-errors genie is out of the bottle. Initially, the IOM statistics touched off a firestorm of negative reaction from politicians and patient advocates, many of whom questioned the very safety of hospital care.
But the hoopla also sparked a much-needed industry debate on how hospitals can reduce medical errors and preventable deaths. Rather than operating out of fear and in denial, providers have started seriously discussing how to learn from mistakes so they can avoid them in the future.
For too long, patient errors have been ignored or buried in internal committee reports. The IOM study provided the impetus for change, and, despite concerns about the methodology, the momentum for frank debate must continue.
Someday it could lead to the creation of a mandatory reporting system for medical errors. The notion is dandy, but only if it meets certain requirements and provides necessary safeguards. Most importantly, any mandatory system should guarantee providers legal protections and exclude identifiable information about providers and patients.
In the meantime, hospital and health system managers should set an
so that caregivers within their organizations aren't afraid to report or admit mistakes. After all, to err is human.