September 19th, 2013 UPDATE: An article published in the September issue of the Journal of Patient Safety estimates that there are between 210,000 and 400,000 deaths per year associated with medical errors in hospitals. That would make medical errors the third-leading cause of death in the United States, behind heart disease and cancer.
The new estimates were developed by John T. James, a NASA toxicologist who runs a patient advocacy organization called Patient Safety America. He dedicates the Patient Safety America website to his 19-year old son, John Alexander James, who died as a result of preventable adverse events in the summer of 2002.
Estimates of the number of deaths attributed to medical errors each year have been varied, but this article concludes that in a sense, the actual number of deaths attributed to medical errors each year doesn’t matter. James claims that, “Any of the estimates demands assertive action on the part of providers, legislators, and people who will one day become patients.”
Medical Errors in the U.S.
According to statistics provided by the AMA, an estimated 40,000 to 80,000 U.S. hospital deaths result from medical error annually. Some research suggests that these figures are higher. The total costs involved in preventable medical errors that result in injury or death (adverse events) each year are unknown, but are estimated at somewhere between $17 billion and $30 billion.
Considering the large number of fatalities due to these issues (as well as the financial costs to patients, hospitals, and insurance companies), medical errors and patient safety should be topics on the front page of every newspaper, yet the public is woefully unaware of the severity of this problem in the US health care system.
Medical errors may be diet or dosage related, or may be the result of misdiagnosis, incorrect record-keeping, malfunctioning equipment, or human error or forgetfulness during surgical or other medical procedures. Whether these errors involve the performance of procedures or administration of medications, they do not only occur in hospital settings. All too often, these deadly mistakes occur across all areas of medicine, in clinics, general practitioners’ offices, urgent care centers, surgery centers, pharmacies and nursing homes.
Health Care Industry Problems
The complexity of the US health care system is a large part of the problem. Thousands of patients receive care in outpatient surgical centers, urgent care, and independent doctors’ offices every day. Patients routinely rely on retail pharmacies to provide the correct prescription medication, the correct dosage, and patient education about the medicines they are taking. Home care requires patients, families, and home health professionals to use complicated medical equipment and administer medications correctly. Ineffective or insufficient communication between doctors, patients, pharmacists, and other health care personnel in this huge, decentralized and fragmented health care “system” is one primary cause of the high rate of medical error. The US health care system consists of a vast assortment of loosely affiliated medical providers, which makes clear lines of communication and accountability difficult to maintain.
The other primary cause of medical errors is “failed systems and procedures” in the actual practice of medicine. As an increased emphasis on patient safety and its relationship to human performance and the work environment becomes more prominent in medical training, hospitals and medical schools are looking toward team healthcare training and the use of medical simulation as the most effective methods of reducing the risk of preventable harm due to medical error.
Correcting Medical Error with Simulation
Interest in medical training software has increased with recent technological improvements in simulation training. Advanced simulation training has been utilized in flight instruction and military training exercises for many years, because simulation is most valuable in practicing risky, expensive and dynamic behaviors such as combat. Now, similar technology in digital imaging and medical training software has brought about highly realistic simulations of patients and entire medical environments that make simulation as a method of training and evaluation highly effective in the high-risk and dynamic medical field as well.
Medical simulators used in healthcare training range from low fidelity (lowest cost) computer-assisted instruction programs that represent work environments on-screen (best used with entry-level students), to virtual, computer-generated representations of full scale intensive care units with multiple sensory feedback components. There are also physical simulations such as task trainers (mechanical parts of human anatomy on which students can practice individual skills), entire simulated human patients with vital-sign feedback mechanisms, and even comprehensive simulated operating suites for surgical team trainings.
Simulation is key to meeting the challenges of patient safety. Medical training software with computer controlled simulation technology makes it possible for medical students to learn, practice and repeat complicated procedures as many times as needed. When practicing with medical simulators, students and providers can fine-tune skills and correct mistakes that could cause injury if they occurred when working with real patients. Simulation as a method of training is greatly improving the education of students and providers, and ensuring patient safety at the same time.
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Virtual Patient Simulation: The Evolution of Continuing Medical Education