Medication errors and diagnostic mistakes are
among the areas of concern that will be discussed at the First Asean Patient
Safety Congress to be held on June 25 at the Sofitel Manila.
Organized
by the team of Dr. Agnes Mejia, dean of the University of the Philippines
College of Medicine, the conference will highlight the safety perspective in
Asean, to be presented by Dr. Shin Young-soo, regional director of the World
Health Organization. Health Secretary Janette Garin will talk about the
national state of medical safety.
The human
factors in patient safety will be discussed by Dr. Vic Malabonga, deputy chief
of staff of Central Texas Veterans Health Care System, and the ergonomics
perspective by Rosemary Seva, dean of De La Salle University’s Gokongwei College
of Engineering. I will talk about the safety perspective in pediatrics.
Some of
the other topics to be discussed are: error reduction in healthcare, effective
teamwork, minimizing infection through improved infection control, patient safety
in surgery, multiprofessional approach to antibiotic stewardship, and
integration of patient safety in the health science curriculum.
Significant problem
Worldwide,
patient safety is now recognized as a significant problem. Ten percent of
hospitalized patients in the United States suffer from harm and injury as a
result of processes involved in medical care. The harm to patients results in
high healthcare costs and loss of productivity amounting to about $17 billion
every year in the United States. Unfortunately, there is no study in our
country in this regard.
Ten years
ago, the Society to Improve Diagnosis in Medicine was founded by Dr. Mark
Graber in the United States. In 2005, the Dalhousie workshop on diagnostic
error was hosted by Dr. Pat Croskerry; it was attended by 40 international
experts on safety and human error. This gathering snowballed into yearly
meetings of researchers and experts on safety and reduction of diagnostic
errors in the United States and Canada.
The
Patient Safety Congress on June 25 will hopefully start a new era in medical
practice in the Asean countries, from diagnosis and treatment focus to reducing
and preventing harm and injury in hospitals, medical offices, and at home. All
of us will benefit from this shift in medical thinking.
Kids at higher risk
In 1972,
I was accepted as a member of the medical staff of a medical center in Maine in
the United States. Within a year, a mother at the obstetric ward developed
kidney failure because she was given the wrong medication. A nurse had misread
the physician’s order because the handwriting was not clear. A few years before
I retired, a pediatrician in another hospital gave intravenous medication to an
infant without reading the label. It turned out to be a dangerous drug, and the
baby died.
Children
are at higher risk than adults when medication errors occur. Several studies in
hospitalized children found the rate of medication errors ranging from 4.5 to
5.7 errors per 100 medication orders.
Medication
errors are more common in children under 2 years old, those in intensive care
especially the newborn, those in the emergency room from 4 to 8 a.m., those
receiving chemotherapy, those getting intravenous medications, and those whose
weight is not documented.
To reduce
the chance of medication errors, prescriptions should be printed, preferably
using a computer.
Bigger concern
The
bigger safety concern in medicine is diagnostic errors. In a review of more
than 350,000 paid claims from 1986 to 2010 included in the US National
Practitioner Data Bank, errors in diagnosis were shown to be the cause of more
deaths, disabilities and medical liability payment than any other kind of
medical error.
Of more
than 100,000 medical liability cases, errors in diagnosis make up 30 percent of
the total, compared to treatment mistakes (27 percent) and surgical errors (24
percent).
Dr. Leonardo L. Leonidas
(nonieleonidas68@gmail.com) retired in 2008 as assistant clinical professor in
pediatrics from Boston’s Tufts University School of Medicine, where he was
recognized with a Distinguished Career in Teaching Award in 2009. He is a 1968
graduate of the UP College of Medicine and now spends some of his time in the
province of Aklan.
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