Mistakes run the gamut. The surgeon nicks a healthy blood vessel; a nurse mistakenly administers a toxic dose of medicine; the staff fails to adequately disinfect a room, and a patient contracts a dangerous "superbug."
The number of patients who die each year from preventable hospital errors is equal to four full jumbo jets crashing each week. If airline tragedies of that magnitude were occurring with such frequency, no one would tolerate the loss.
"At its deepest level, what we're now having trouble with is the enormous complexity of medicine," says Atul Gawande, a surgeon, Harvard associate professor and author who promotes the use of medical checklists to save lives. "We now have 13,600 diagnoses, 6,000 drugs, 4,000 medical and surgical procedures," he says. And yet "we have not paid attention to the nuts and bolts of what's required to manage complexity." Experts like Gawande say one reason medical errors continue at such high rates is that hospitals have only recently begun to copy aviation's decades-long effort to create safety procedures that take into account human fallibility — often using only simple checklists.
There has been some progress, to be sure. Around the country, safety innovators have introduced promising ways to minimize slipups — from using checklists to reporting hospital infection rates on state websites. Last spring the Obama administration announced it would spend $1 billion to fund safety measures by hospitals, with the ambitious goal of reducing preventable patient injuries by 40 percent by the end of next year.
Still, the question of how close hospitals can ever come to being error-free is controversial. It seems fair to expect them to reduce the number of times — as many as 40 per week — that U.S. surgeons operate on the wrong person or body part. But what about other procedures?
Patient safety advocates have been able to raise the bar on hospitals in some key areas, showing that they can prevent harm to even the most vulnerable patients. A case in point: bloodstream infections that result from inserting a tube into a large vein near the heart to deliver medication. For years, these infections, which resulted in some 30,000 deaths annually, were viewed as largely unavoidable.