The vast majority of people have no idea how often medical malpractice happens. In fact, if medical malpractice was ranked by the Center for Disease Control (CDC), it would be the third leading cause of death in America, right behind heart disease and cancer. How is it that something this dangerous has stayed largely hidden from discussion?
Actually, it is easier than one might expect. First and foremost, the information about when an act of malpractice occurs originates by the all-too-frequently negligent medical providers. Reporting of malpractice causing patients harm is near nonexistent. Many facilities do not encourage reporting safety concerns, because it could harm their reputation, as well as the providers who work there.
If steps were taken and an investment in risk management procedures, we could hope to have less medical malpractice claims and less patient harm. In a recent journal article, Responding to patient safety incidents: the “seven pillars,” there is a discussion on how to resolve the issue of reporting concerns and provide a full disclosure process created by the University of Illinois Medical Center at Chicago (UIMCC). The article focuses on “the ‘seven pillars’ that constitute a comprehensive process for responding to patient safety incidents, including full disclosure of harm-causing unreasonable care.”
The first pillar focuses on reporting the initial incident. The UIMCC gives recognition to staff who report incidents in there safety newsletter, Safe-Times. The next pillar is investigation. Obviously, it is important to find out if there was actually patient harm. If there was, then additional steps must be taken to investigate the matter. This includes an investigation by a team of staff called a root-cause analysis (RCA), which occurs within 72 hours of the report being filed, to find out the actual cause of the incident and who should be held accountable.
The third pillar is communication and disclosure. This is essential and continuous throughout the entire process. There should be clear lines of communication with the patient and their families through every step. The fourth pillar is apology and remediation. This happens when patient harm did occur. There should be a formal apology, as well as additional steps including no payment for the treatment they received and potentially offering compensation. The fifth pillar is system improvement; the data is analyzed and then evaluated for improvements. The sixth pillar includes data tracking and performance. The seventh and final pillar is education and training. All staff is involved in this process to grow from experiences and improve the system as a whole.
Implementing this system could help improve the way patient safety incidents are handled in medical facilities. With time it could also help prevent patients from being harmed, causing less malpractice cases. We need to start holding providers and facilities accountable for their actions. Patient safety should always be the number one priority.
Mcdonald, T. B., L. A. Helmchen, K. M. Smith, N. Centomani, A. Gunderson, D. Mayer, and W. H. Chamberlin. “Responding to Patient Safety Incidents: The “seven Pillars”” BMJ Quality & Safety 19.6 (2010). Web.