By Dr. Devidas Bhalerao
The health care community is a trusted brotherhood, calling on them to be extra careful when following a treatment regimen. The slightest mistake can lead to the death of the patient, so among all the parameters during patient care, medical errors stand out in terms of avoidable occurrence. A medical error basically refers to; a patient’s extended hospital stay or any additional cost/therapy beyond the required treatment. This makes medical errors a significant source of adverse health care outcomes.
Medical errors, the incidence of which is high, cause thousands of deaths in hospitals each year. Medical errors endanger the quality of health care, increase health care costs and exacerbate the medical malpractice crisis. According to a recent Harvard study, 5.2 million medical errors occur in India every year and worldwide it is 138 million patients (according to WHO). More than one in 10 patients are injured during their medical care, and half of these injuries are preventable. Of preventable errors, 12% resulted in permanent disability or death of a patient.
Investigate medical errors
Medical errors are one of the dominant and determining factors in the quality of care. Therefore, taking it lightly can not only lead to poor quality of care, but also lead to an increase in the cost of treatment. Generally, medical errors are only frequent because of a lack of safety culture. This includes a robust workplace error reporting system and an internal quality control/audit team. Also, lack of knowledge and training, short attention span while administering medications/treatments to patients, poor time management, poor supervision and confusion regarding dosage could be some of the why these medical errors occur.
Understanding gaps in patient care
- Reducing medical errors requires an environment of continuous discovery and analysis. Further, to understand, the majority of medical errors can be categorized into (a) prescribing medication (b) inappropriate ordering of lab tests for the wrong patient at the wrong time (c) error in the filing system (d) giving the wrong medication (e) not reacting quickly to abnormal laboratory test results. A common point between the situations of medical errors mentioned above is that they can be avoided if they are approached with the objective of quality care. In addition, effective training of all staff involved in this ecosystem (clinicians, nurses and pharmacists) as well as improving staff skills can be extremely beneficial. Therefore, reducing medical errors and contributing to better patient outcomes is the collective responsibility of all hospital management. This includes a cultural shift of using new era digital tools to bring efficiency. For example, tools like the EMR help streamline the treatment process. It allows the clinician to access patient medical records while eliminating the culture of pen and paper. This helps improve the coordination of healthcare services, reduce wastage and control redundant testing.
Role of Clinical Decision Support System (CDSS)Improving patient safety involves three complementary activities: error prevention, error detection, and error mitigation. It may also include the use of information technology (IT) as a key first step in transforming and changing the healthcare environment to achieve better and safer patient outcomes. Digital technology helps clinicians store, retrieve, share and use clinical information, data and knowledge for effective communication. Digital tools like CDSS help physicians by highlighting errors and improving error prevention. CDSS provides a variety of decision aids, such as alerts, reminders, tips, reviews, and suggestions for better treatment. CDSS can reduce inaccuracy rates by influencing physician behavior, improving clinical care, and increasing patient outcomes (survival rates, patient length of stay, and cost). CDSS tools aid in automated decision support, clinical research, data mining, and patient disease management. The integration of CDSS in the EMR is very useful and necessary, especially for research and to improve the quality of care, because it makes the documentation process simple and accessible in just a few clicks. CDSS accuracy has proven to be superior to human accuracy in many cases. CDSS focuses on leveraging knowledge management to provide clinical advice based on a variety of patient-related data elements.
Dr. Devidas Bhalerao,Director of Studies and Clinical Research, Ruby Hall Clinic, Pune.
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