If you’re going to undergo an inpatient operation in the hospital any time soon, then you might want to listen to Geena Davis’ advice from The Fly, and “be afraid…be very afraid.” Serious errors are taking place in hospitals everywhere because charts are misread and the medical staff you expect to take care of you isn’t always paying attention. And some of the mistakes were made because of pre-surgical errors in the physician’s office.
Although there are procedural guidelines that surgical teams are supposed to follow, horror stories still abound. The wrong patient receives an operation, a healthy kidney is removed while the diseased one remains, and surgery is performed on the wrong area of the brain. Practically any body part that’s a pair — hands, feet, knees, eyes, etc. — seems to be fair game for a screw up in which the surgeon operates on the opposite side. In another case, a chest tube was inserted into a healthy lung, causing it to collapse and kill the patient.
A recent study, conducted through the University of Colorado in Denver, examined a compilation of insurance information from Colorado. More than 27,000 incidents were reported by 6,000 doctors between 2002 and 2008. These occurrences were documented because the physicians that use this insurance plan are provided with incentives for early notification of potential problems. In the sample, there were 25 surgeries performed on the wrong patient altogether, and another 107 operations took place on the correct patient, but on an incorrect body part.
It had been previously assumed (at least by the medical community) that these kinds of mix-ups were relatively rare, perhaps one in every 110,000 surgeries. This research, however, is proof positive that these preventable mistakes are not nearly so rare. It’s possible that underreporting previously caused low estimates or that these instances of error have increased in recent years. In either case, they happen much more often than previously estimated.
A study that took place in 2008 by the Department of Health & Human Services’ Agency for Healthcare Research and Quality found that these types of surgical mistakes cost employers close to $1.5 billion each year. By these researchers’ estimates, 10%–one out of every 10 patients — who died within three months of surgery did so because of errors by the medical team. The study looked at the records of more than 160,000 patients across the United States between the ages of 18 and 64 who underwent a surgical procedure in 2001 or 2002.
Other recent research scrutinized the surgical records of various highly-rated hospitals throughout the world. Scientists with the Safe Surgery Saves Lives Study Group based at Harvard University found that hospitals could reduce surgical complications by approximately 30% and the deaths they cause by 40% if the medical staff would follow a safety checklist of rules — just like airline pilots do before taking off. Developed by the World Health Organization in 2008 in response to increased reports of surgical errors, the checklist provides 19 items for medical teams to cover before, during, and after any procedure. It includes such seemingly basic steps as ensuring that the right patient is in the operating room, double checking that the site at which the incision is to be made is correct, and that the appropriate procedure is about to take place.
The researchers studied compiled information on surgical complications and deaths in nearly 7,700 patients at eight hospitals in different countries. None of the hospitals were implementing the WHO checklist initially, but it was put into use during the time of the study.
There were 3,733 patients who underwent surgery before the checklist was adopted. Eleven percent, or 411, of them experienced complications and 14% of those 411 (56) died. After the implementation of the checklist, there were 3,955 patients who had surgical procedures. A much-improved 7%, or 277, people experienced complications, with 32, of those patients dying.
With approximately 234 million operations taking place annually around the globe, there is obviously a lot of surgical error, along with the resulting complications and deaths, taking place. Even one mistake is one too many when it’s your life that’s at stake. But if something as simple as a procedural checklist can dramatically shift the odds in your favor, then clearly it’s a no-brainer, at least from your POV, to start enforcing its use.
Or to put it another way. You wouldn’t want to fly in a plane in which the pilot hadn’t run through his safety checklist, would you? Well then why would you want a surgeon cutting deep into your body to do any less?