Military hospitals lack patient safety standards, unexpected deaths go unchecked

A New York Times in-depth investigation called into question patient protection policies at military hospitals across the country, completely separate from the Veterans Affairs hospital system, after it discovered the facilities failed to look into numerous unexpected patient deaths.

Internal documents revealed that military hospitals, made up of 56 domestic and overseas facilities which care for 1.6 million active-duty service members and their families, don't often complete mandatory safety investigations after unexpected patient deaths or severe patient injuries, a Defense Department requirement as of 2001, the Times reported.

Medical workers reported 239 unexpected deaths, but the Pentagon's patient safety center received only 100 inquiries from 2011 to 2013. The military system also had higher than expected rates of harm and complications to patients, specifically in maternity care and surgery, according to the article.

The more than 50,000 babies born at military hospitals were twice as likely to sustain an injury during delivery, while mothers were more likely to hemorrhage after childbirth, as compared to civilian hospitals nationwide, according to the Times. Eight of the largest 16 military hospitals had higher than expected complication rates over a recent 12-month period.

The issue stems from a lack of prioritizing patient safety, a compartmentalized leadership system and a culture of secrecy, the Times concluded. The military system does not measure quality of care through rates of death and readmission, adjusted for serious illness, like civilian hospitals do. The Army, Navy and Air Force have separate surgeons general and each one oversees a branch healthcare system.

"The patient safety system is broken," Mary Lopez, M.D., a former staff officer for health policy and services under the Army surgeon general, told the Times. "It has no teeth … Reports are submitted, but patient safety offices have no authority. People rarely talk to each other. It's 'I have my territory, and nobody is going to encroach on my territory.'"

The military system has also been under financial scrutiny lately. The Military Health System's healthcare cost the Pentagon $51.4 billion in fiscal 2012, which makes up 9.7 percent of military spending, compared to $19 billion, or 6 percent of spending, in 2001, FierceHealthcare previously reported. That number may reach $65 billion by fiscal 2017 and $92 billion by 2030, according to Congressional Budget Office projections. In 2013, Congress established the Defense Health Agency to align and standardize information technology, facility planning, contracting, budget management and medical logistics between the different branches' medical systems.

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