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Two opposite forces often determine whether a bad result occurs during medical care. These forces (or poles) are the concepts of patient safety and medical errors. As many as 44,000 to 98,000 persons die in US hospitals each year as a result of medical errors.

Two opposite forces often determine whether a bad result occurs during medical care. These forces (or poles) are the concepts of patient safety and medical errors.

How successful medical providers are in reducing or eliminating medical errors determines the level of patient safety. Success requires reconition of problem areas within medical practice and a serious effort to identify the underlying reasons for the recurring medical errors. Ranting against the legal system which permits patients to seek fair compensation for injuries caused by medical errors does absolutely nothing to improve patient safety. Limited rights to fair compensation merely assures the continuation of low levels of patient safety.

Patient safety is the freedom from accidental or preventable injuries produced by medical care. According to the Agency for Healthcare Research and Quality there are categories of events that can lead to a breach of patient safety, including the following:

1. device-related complications (eg, indwelling catheters, infusion pumps);
2. diagnostic errors (eg, clinical misdiagnosis, diagnostic test interpretation error);
3. discontinuities, gaps, and hands-off problems;
4. fatigue and sleep deprivation;
5. identification errors (eg, wrong patient, wrong-site surgery);
6. medical complications (eg, nosocomial infections, patient falls);
7. medication safety (eg, medication errors, adverse events);
8. nonsurgical procedure complications (eg, occurrences in bedside procedures and interventional radiology);
9. psychologic and social complications (eg, privacy violations);
10.surgical complications (eg, intraoperative and postoperative complications); and
11.transfusion complications.

Medical errors, usually defined as breaches of the accepted professional standard of care, are one of the nation’s leading causes of death and injury.

The Institute of Medicine has estimated that as many as 44,000 to 98,000 persons die in US hospitals each year as a result of medical errors. Rates of medication errors and adverse drug events for hospitalized children were comparable with rates for hospitalized adults in a 2001 study published in The Journal of the American Medical Association. However, the rate for potential adverse drug events was 3 times higher in children, and it was substantially higher still for infants in neonatal intensive care units.

According to a February 2002 report from the US Food and Drug Administration, adverse events associated with mediations are the single leading contributor to preventable patient injury, and they may cost the lives of up to 100,000 Americans each year. They also account for more than 3 million hospital admissions, and they increase the nation’s hospitalization bill by up to $17 billion each year. Drug-linked injuries outside of the hospital are estimated to inflate the annual health care bill by an additional $76.6 billion.

This article draws upon materials published by the Agency for Healthcare Research and Quality, the US Food and Drug Administration, the Centers for Medicare and Medicaid Services and MDConsult.com.

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