One in five adults have personally experienced a medical error, and that mistake often has a lasting impact on the patient’s physical and emotional health, relationships and financial well-being, according to a new national survey.
Twenty-one percent of those surveyed reported they personally experienced a medical error, and 31% knew someone who had experienced an error. The survey didn’t ask how long ago the error occurred so it’s unclear whether these were recent experiences or happened at some point in the last 50 years.
But the findings do show that patient safety is a public health issue, Tejal Gandhi, M.D., chief clinical and safety officer at IHI, told FierceHealthcare during an interview prior to the release of the survey. The most common error described was a diagnostic error, a mistake not even addressed when the landmark report, "To Err is Human: Building a Safer Health System," was released in 1999. But misdiagnosis has emerged as a serious patient safety issue in recent years, and Gandhi says the survey finding validates that this is a topic that needs more attention.
“Another notable finding is that the majority of people reported that errors occurred in the ambulatory setting, doctor’s office or ER or urgent care settings. Only a third of the errors occurred in a hospital setting. Traditionally people looked at patient safety as a hospital issue but this gives attention to the fact that patient safety is an issue across the entire care continuum, not just an inpatient issue,” she said.
Other highlights from the survey:
- Nearly half of those who perceived that an error had occurred brought it to the attention of medical personnel or other staff at the healthcare facility.
- Most respondents believe that, while healthcare providers are chiefly responsible for patient safety, patients and their families also have a role to play.
- When asked what caused the medical error they experienced, people identified, on average, at least seven different factors.
The majority of survey respondents said that contributing factors that led to the error included the healthcare provider’s lack of attention to detail (69%); a poorly trained provider (58%); overworked, tired and stressed healthcare providers (50%); and lack of communication between multiple providers (47%).
One in four attributed the medical error to their healthcare provider spending too much time with computers and digital records. Other contribution factors that led to the error: patient was not able to see or review his or her own medical records (22%); healthcare providers were not aware of the medical care the patient received elsewhere (17%); healthcare provider didn’t spend enough time with them (15%); out-of date or incorrect medical records (12%) and healthcare providers failing to wash their hands or weak masks (7%).
When patients do report errors, most of them do so in an effort to prevent it from happening to someone else. Gandhi said this finding echoes what the industry has learned in malpractice cases. Money is typically not the motivating factor, she said. There is a real desire to prevent the error from occurring again.
Gandhi said she was also heartened to see that patients understand they have a role to play in patient safety and must partner with providers to ensure the safest care possible.
The findings, she said, will help the IHI/NPSF Lucian Leape Institute set a patient safety strategy, develop best practices to prevent diagnostic errors and drive forward the call to action (PDF) recommendations issued earlier this year to consider patient safety a public health issue.