Massachusetts Hospitals Battle Poor Surgical Outcomes

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MASS-thumb1Outcomes, outcomes, outcomes.

This is the focus of modern healthcare, and as noble an endeavor as improving patient outcomes is, achieving these better outcomes is often harder than many hospitals realize, even after a decade of intensive scrutiny, something Massachusetts hospitals are finding out.

According to Liz Kowalczyk in The Boston Globe, “Massachusetts hospitals are reporting more errors during surgery and invasive procedures, even after an intensive, decade-long campaign to reduce these mistakes — called ‘never events’ because they’re preventable and, with reasonable precautions, simply shouldn’t happen.”

Kowalczyk lists several of these commonly reported mistakes, including “anesthesia injected into the wrong leg, a guidewire left inside a patient’s vein, and a catheter threaded into a patient who didn’t need one.”

But what is causing these errors to increase by 65 percent in 2012? According to the article, part of it has to do with care being increasingly sent to outpatient clinics, procedure rooms, and physicians’ offices, “where administrators and caregivers generally have been less vigilant about implementing safety protocols of the sort required in most hospital operating rooms.”

Kowalczyk adds, “The number of mistakes during surgery and invasive procedures is the highest since the state began collecting data five years ago, even as errors of all types, including preventable patient falls and bed sores, have declined.”

Hospital officials, such as Dr. Kenneth Sands, chief quality officer at Beth Israel Deaconess Medical Center, are quick to point out that these errors don’t necessarily bring harm to the patients. “They are uncomfortable and unnecessary for patients and should never happen, even though there is not permanent harm.”

But, he said, it’s important to remember that “people have become more sensitized and reporting is getting better for when these events occur.”

His point is incredibly valid. The fact that hospitals are more aware of errors and thus reporting more errors could be impacting the 2012 figures, Dr. Madeleine Biondolillo, director of Health Care Safety and Quality, said. Furthermore, the number of errors hospitals are expected to report has also ballooned.

“When safety becomes a serious central concern as it should, reporting does go up,’’ Dr. Donald Berwick, former director of CMS and Massachusetts gubernatorial candidate, explained. “Hospitals will look worse before they look better. That is good news because they are noticing things that previously went below the radar.’’

As healthcare executives, what are your thoughts on this news? Has your organization become more conscious of errors? Do you think your rates will increase, at least temporarily, as a result?

-by Pete Fernbaugh

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