Like many important issues, healthcare often gets caricatured during elections – complex ideas are cramped into tweet-able slogans – and the political conversation skirts around what’s really important. Such was the case in the 2018 midterm elections, where candidates from both parties avoided talking about the third-leading cause of death in America: medical errors.
This week, The Leapfrog Group, a non-profit research organization which tracks hospital safety, released their biannual Hospital Safety Grades, and it shows that medical errors continue to harm patients across the country. Some hospitals and states were safer than others, but the correlation has seemingly nothing to do with party colors. Republican or Democrat, elected officials need to come together to solve this issue in order to prevent hundreds of needless deaths that occur in hospitals every single day.
Why Are Hospital Safety Grades Important?
Patients should be able to see which hospitals have the best track records for keeping patients safe. Unfortunately, the healthcare industry is far from transparent and the Center for Disease Control and Prevention (CDC) does not make all of their information public or accessible. Often, when something catastrophic happens at a hospital, families settle and sign non-disclosure agreements, preventing mistakes from coming to light.
Leapfrog collects and analyzes data about medical errors that individual Americans cannot do alone, and distills their findings into Hospital Safety Grades. These give patients an idea of past performance and encourage underperforming hospitals to make concrete changes.
Grades range from “A” to “F,” and are assigned twice a year to over 2,600 general acute-care hospitals in the U.S. For the first time this year, Leapfrog assessed how well hospitals handled Bar Code Medication Administration (BCMA). BCMA helps ensure that the right patient gets the right medication, which is crucial, because medication administration errors happen all the time. Some of the key findings from Leapfrog’s latest assessment of hospital safety:
- Out of all hospitals graded, 32 percent earned an “A,” 24 percent earned a “B,” 37 percent a “C,” 6 percent a “D” and just under 1 percent an “F”
- The 5 states with the lowest percentage of “A” hospitals are Connecticut, Nebraska, Washington, D.C., Delaware, and North Dakota.
- Hospitals with “F” grades are located in California, Florida, Illinois, Indiana, Louisiana, Mississippi, New York, New Jersey, New Mexico, and South Carolina.
- There are no “A” hospitals in Washington, D.C., Delaware, or North Dakota.
Letter grades provide a clear-cut and sterile assessment, but it should never be forgotten that these letters are linked to real lives – patients continue to be hurt or killed by preventable mistakes in American hospitals. Researchers from Johns Hopkins estimated that 33,000 lives would be saved if every hospital were as safe as an “A” graded hospital. The destruction caused cannot be overstated.
In Washington, any progress in healthcare only comes after a giant political fight. Isn’t preventing thousands of needless deaths something politicians can agree on? They are quick to spend vast sums of money protecting American lives with military might, and yet seem incapable of organizing resources to prevent needless hospital deaths on American soil.
Poor Letter Grades Reflect Lives Lost
The 2018 Leapfrog Hospital Safety Grades reveal that both red and blue states both have a long way to go when it comes to patient safety. In traditionally blue states, 33 percent of hospitals received “A’s.” In traditionally red states, 32 percent of hospitals received “A’s.” What does this mean? That close to 70 percent of hospitals across the country consistently expose their patients to needless risk.
This is an extensive problem, and one that is not being sufficiently addressed. Leah Binder, president and CEO of The Leapfrog Group, urged lawmakers to re-focus their attention on hospital safety before more people die:
"Healthcare was an important issue in the 2018 mid-term elections, yet both parties are still neglecting the third leading cause of death in America – errors and infections in hospitals . . . Every elected official, from city councilors to senators, to the president, should hold hospitals accountable and support efforts to improve patient safety."
Red and blue need to come together to stop this epidemic. This is a problem that affects everyone, and it is going to take sound leadership on both sides avoid a gridlock in Washington while patients continue to be harmed.
To Err Is Human
The documentary film, To Err Is Human, is holding screenings across the country and looks at how to bring about a new culture of safety in medicine. It takes its title from the famous 1999 Institute of Medicine (IOM) report on the prevalence of medical error that rocked the medical community and first drew public attention to the horror that hospitals were hushing up. The film’s director, Mike Eisenberg, made the film “to ensure Americans are not just informed of the hazards of medicine, but empowered to become a part of their own care.”
To Err Is Human follows the story of the Sheridans and the medical errors that left 1 child with cerebral palsy and cost the father his life. Interspersed with the family’s story are experts who weigh in on how to stop tragedies like the Sheridan’s. In response to viewing the documentary, famed surgeon and writer Atul Gawande reflected on the mixed-up priorities of healthcare funding:
“We invest tens of billions to find cures for disease but barely a fraction of that to find cures for one of the world’s biggest killers – medical errors. This important documentary conveys just how big a mistake that is. It also shows how we can do better. For the problem isn’t bad clinicians. It is the complexity that good clinicians deal with every day.”
The epidemic of medical errors will not be stopped by blaming doctors or nurses – the system they work within is what has to be fixed. And fixing that system is going to take significant resources. Gawande hits the nail on the head by pointing out the irony: Why spend so much on a cure that might be given to the wrong person as a result of a system that needs more funding?
It’s been almost 20 years since the original IOM report broke the silence about the widespread damage caused by medical errors. The authors of that report knew that they were outlining a task that would not be easy to solve. Even so, they closed the report on a note of optimism, writing:
“With adequate leadership, attention and resources, improvements can be made. It may be part of human nature to err, but it is also part of human nature to create solutions, find better alternatives and meet the challenges ahead.”
While some adjustments have been made, adequate leadership, attention and resources have not been committed, and so, sadly, the improvements in patient safety have not been realized. Not by a long shot. Medical errors result in as many as 440,000 preventable deaths a year.
By not talking about this issue during the midterm elections, leaders on all sides are dismissing their duty to look out for public health. Continued silence on this issue will only lead to more pain and suffering. The time to act is now – and it has been for a long time.