Updated medical errors report shows progress

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Sen. Barbara Boxer (D-Calif.) released an updated report on the most common and expensive medical errors in American hospitals and how healthcare leaders can prevent them.

"We have the opportunity to save not just one life, but to save hundreds of thousands of lives," Senator Boxer said during a visit to UCSF Medical Center last week, according to a statement from her office, noting that medical errors are one of the leading causes of death in the U.S. "These deaths are all the more heartbreaking for families because they are preventable."

Boxer's initial report, released in April, found that although medical errors caused an average of 325,000 patient deaths a year, slightly more than half of California hospitals said they were taking steps to reduce the most common errors. According to the updated report, all of the hospitals that responded said they have taken some steps to reduce errors. Many error-reduction strategies have gained widespread adoption, such as elevating the heads of patients on ventilators' 30-45 degrees.

Newer strategies include a program at Kaiser Permanente that requires nurses to wear colored sashes or vests while dispensing medication to patients to warn other staff members not to distract them. Desert Valley Hospital in Victorville awards prizes to incentivize hand-washing and prevent surgical-site infections, according to the report.

Many hospitals are also working on broader cultural changes to reduce errors, according to the report, including forming peer review committees for individual errors, daily safety huddles and weekly "harm reports." The report breaks down both common and hospital-specific approaches for the nine most common errors listed in the initial report: Fall and immobility-related injuries; obstetrical adverse events; pressure ulcers (bedsores); central line-associated bloodstream infections; catheter-associated urinary tract infectionsadverse drug events; venous thromboembolism; surgical site infections; and ventilator-associated pneumonia.

To learn more:
- read the report (.pdf)
- here's the statement

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