Openness and safety

Sunday, Dec. 26, 2010 | 2 a.m.

Over the last several months, the Las Vegas Sun has published the results of its investigation into hospital care in the valley, finding that in 2008 and 2009 thousands of patients were sickened or injured due to mistakes.

Sun reporters Marshall Allen and Alex Richards found that hospitals regularly fail to acknowledge those mistakes and unsafe conditions, and when patients are harmed due to a mistake, the hospitals often neglect to tell them.

In fact, most hospital officials don’t want to publicly address patient care issues. As Allen reports in today’s newspaper, the chief executives of all but two of Las Vegas’ hospitals have refused multiple requests for interviews.

Larry Matheis, executive director of the Nevada State Medical Association, summed it up well, saying, “There’s an awful lot of denial.”

Denying the problem isn’t helping anyone. It’s harming patients and adding to the cost of medicine through repeated errors. It’s not just a Las Vegas problem. The federal government estimates that 15,000 Medicare patients nationwide die every month due to harm incurred in hospitals.

Mistakes happen, but many could be avoided if hospital officials would quit denying them and find ways to prevent them.

The denial of the problem largely seems to stem from a fear of medical malpractice lawsuits. Doctors often believe “it’s a mistake to admit a mistake,” but as it turns out, honesty really is the best policy. Research indicates that malpractice lawsuits decrease when hospitals and doctors are honest about their mistakes and apologetic.

The University of Illinois Medical Center in Chicago is a good example of what can happen with openness. In 2004, it created a policy to combat medial errors. The staff is encouraged to report errors, which are investigated within 72 hours.

Patients who are harmed by a mistake are fully informed and staff members apologize for errors. The hospital works with patients to resolve the problem. The investigation’s findings are used to educate staff and change procedures as necessary. From 2006 to 2008, there were more than 200 improvements to patient safety at the Chicago hospital, and officials can point to instances where harm was avoided due to the changes.

Hospital officials say the result has been a

30 percent drop in medical malpractice claims. Costs related to those cases have dropped by

$3 million.

“I’ve always felt badly that our motivation had to be financial,” said Dr. William Chamberlin, the medical center’s chief medical director. “But now I would argue that full disclosure will help improve safety.”

Several hospitals across the country are studying what the University of Illinois is doing, and Nevada’s hospitals should take a good look as well. It shows impressive results. Of course, it takes a willingness to openly address problems, and that’s something not enough hospitals in Nevada have been eager to do.

We are encouraged that state lawmakers appear ready to force the discussion with proposed bills that would increase transparency in health care and bring more accountability to hospitals.

Hospital officials and doctors may cringe, seeing this as a blame game, but it shouldn’t be. Mistakes happen, and because those mistakes can be fatal, the medical community should be doing everything it can to prevent them. To really address the problem, hospital officials and doctors need to open up and stop denying the problem.

As the University of Illinois Medical Center in Chicago has shown, openness and transparency can improve patient safety and cut malpractice costs. We should follow their lead.