In 2004, a HealthGrades Patient Safety in American Hospitals Study put the number of patients who died because of medical error annually at 195,000. The study more than doubled the number of deaths the Institute of Medicine’s 1999 report, confirming that patient safety in the U.S. was a national epidemic.
More than a decade later, with a Johns Hopkins study that puts medical errors as the third-leading cause of death in the U.S., “Insights and Outcomes” asked Dr. Robert Wachter, Chair of Department of Medicine at University of California San Francisco and New York Times bestselling author of The Digital Doctor and author of Understanding Patient Safety, what are the biggest challenge facing patient safety today—and what’s our best chance of making improvements?
In this podcast Q&A, Dr. Wachter explains how complexity in hospital organizations and rigid hierarchical environments pose some of the leading threats to care and safety for the patient. And while the rise of electronic medical records and technology in hospitals have made patients safer, those solutions have come with unintended side effects. Twelve years after the HealthGrades study, it comes down to how we are shaping future generations of doctors as team players and team leaders. “I think team-based care is fundamental to patient safety. We have learned from study after study that communications failures are probably the most common cause of medical mistakes…. Recognizing that has been really important. We have gotten better about teaching people at team-based care, but it is still a work in progress.”
“For today’s medical students the notion that you are a member of a team, and you are not god and you are not up on a pedestal… the quality of the care you deliver will in part be determined by how well that team functions, for today’s medical students that is a very comfortable, familiar way of thinking. For physicians in my generation, less so. We were trained in a much more rigidly hierarchical environment, the doctor was god, and thank goodness most medical students today that’s not the profession they expect to see and when they see it… they find it off putting and they are very comfortable acting as members of teams and understanding that this is a team sport.”
Physicians of Dr. Wachter’s generation were taught “precisely nothing” about safety, quality, systems thinking and teamwork. Safety today is getting much more attention in medical schools which represents a generational shift in understanding that the role of the clinician. In assessing the state of medical education today, Dr. Wachter observes that “Students today – not just medical students but nursing students, pharmacy students and other health professional students – need to be deeply comfortable with the science of safety and quality and improvement, and need to truly understand that the role of the clinician…that the role of a doctor is not simply, you do the best job you can taking care of the patient in front of you. It must have a component of, I am also a leader in the system in which I work… It’s a recognition that for us to deliver high quality, safe, satisfying care to patients, it is essentially as much about the quality of the system as about the quality of the individual.”
Listen to the full podcast here.
To learn more about patient safety in medicine, download this free eBook, Patient Safety: The Past, the Present, and Future, or visit AccessMedicine to read selections from Dr. Wachter’s book Understanding Patient Safety.Tags: patient safety in hospitals, patient safety awareness, patient safety and quality healthcare, patient safety in medicine, Dr. Bob Wachter