Understanding and Preventing Medical Errors: What You Need to Know

Medical errors are unfortunately very common in healthcare. A study published in the British Medical Journal estimated that communication breakdowns, diagnostic errors, poor judgment, inadequate skill, and systems failures in clinical care result in 200,000 to 400,000 lives lost per year in the United States alone. This would make medical error the third leading cause of death if it was classified as a disease.

Why Medical Errors Often Go Unreported

The study authors point out that medical errors are vastly underreported for several reasons:

• Death certificates usually list the physiologic cause of death, not the error that led to it. For example, "heart attack" may be listed instead of the missed diagnosis that could have prevented it.

• There has been a culture of silence around medical mistakes, with lack of disclosure to patients due to fear of litigation or retaliation.

• There is no national database to compile information on medical errors for quality improvement and prevention research.

The Importance of Identifying and Analyzing Medical Errors

To develop safer healthcare, it's critical to identify and analyze medical errors when they occur. Many healthcare institutions now have systems in place to encourage open reporting of errors and near-misses. This allows the information to be used to improve processes and prevent future mistakes.

An example is an online safety reporting tool that allows doctors and staff to easily log issues ranging from mislabeled lab specimens to incorrect medications to patient falls. While it may seem like more reports means more mistakes are happening, the reality is that the vast majority of errors go unreported. Increased reporting allows issues to be examined and addressed.

Learning from Mistakes: A Doctor's Personal Experience

One doctor shares a personal example of missing a diagnosis of hyperparathyroidism in a patient complaining of fatigue, depression and body aches. Slight elevations in the patient's calcium level were initially dismissed. After a delay of two years, further testing confirmed the condition. Surgery to remove the overactive parathyroid gland resolved the patient's symptoms within a day.

The doctor apologized to the patient for the delayed diagnosis and shared the error with colleagues and in the reporting system. This allowed others to learn from the example and be more diligent about investigating abnormal lab results. The patient appreciated the doctor's honesty and willingness to use the mistake as a valuable lesson.

As one medical school instructor advised, "Cultivate the attitude that allows you to own your mistakes, and then, not repeat them." In healthcare, openly identifying and analyzing errors is essential for improving patient safety and preventing harm. Systems that foster honest reporting and shared learning are key to reducing medical errors and advancing the quality of care.