How Prevalent Are Medical Errors?

Contributing Lab Leader: Michael Laposata, MD, PhD

Operational

Article highlights:

Learn how DMTs may help your organization reduce medical mistakes

It’s not an exaggeration — medical errors happen every day in the United States. Just how serious are the consequences, and what do they mean for your organization?

A 2016 Johns Hopkins study¹ estimates 10 percent of all deaths in the U.S. each year happen because of medical errors, totaling more than 250,000 fatalities annually. After an eight-year analysis period, the study ranked medical errors as the third highest cause of death in the country and indicates that their incidence is still likely underrecognized.

It goes without saying that lives lost are the most significant impact of medical errors, but there’s also financial loss to consider. According to a study commissioned by the Society of Actuaries and completed by Milliman, Inc.², measurable medical errors cost the U.S. economy $19.5 billion in 2008, accounting for approximately 25 percent of the estimated $80 billion associated with overall medical injuries that year.

Why do medical errors happen?

Medical errors can stem from several different factors and are not automatically the fault of individual doctors or subjective mistakes. Systemic problems across organizations can lead to communication breakdowns resulting in errors that prevent patients from being correctly diagnosed and treated. In the same vein, a lack of standardized protocols between departments may slow down processing of lab tests and create the opportunity for errors to occur.

It’s also important to note that medical errors may go unreported due to fears of retribution, making it difficult to gage an accurate assessment of just how common they really are and how often they’re occurring.

The role of diagnostics

For many families who suffer loss as a result of a medical error, the desire to find out who’s at fault to blame them is a natural reaction. While medical mistakes can occur at any point in a healthcare transaction, a 2015 report by the National Academy of Medicine³ indicates that diagnostic errors contribute to approximately 10 percent of all patient deaths, and 6 to 17 percent of adverse events that occur in the hospital setting.

“When a diagnosis is not made accurately and rapidly, what ensues are therapies that don’t work, as well as possible complications of an untreated disease,” said Dr. Michael Laposata, Professor and Chairman of the Department of Pathology at the University of Texas Medical Branch in Galveston. “The associated costs in both circumstances are enormous and put a significant strain on the fiscal management of healthcare systems.”

To help prevent medical errors, laboratory leaders must take a pro-active role in assuring the correct tests are being performed at the correct time, following up to make sure the test results procured are accurate, and communicating those results clearly and quickly to other medical professionals.

“Laboratory leaders can provide effective consultation for physicians and other healthcare providers who order laboratory tests,” Dr. Laposata noted. “They have the ability to offer advice on the appropriate selection of laboratory tests and on the clinical meaning of the test results.”

However, Dr. Laposata points out that existing barriers within most U.S. healthcare systems often hinder collaboration between laboratorians and doctors.

“The small reimbursement paid for this consultative service is provided only to medical doctors with M.D. or D.O. degrees, and that’s just one example,” he explains. “Other factors include the prospect of lawsuits associated with misdiagnoses, and the unwillingness of many hospital leaders who know little about their value to provide support for diagnostic teams.”

How DMTs can help

Realizing just how big a problem medical errors truly are in the United States, some doctors, lab managers and other healthcare professionals have been teaming up in recent years, taking a new collective approach to decrease the possibility of medical mistakes and improve overall patient care.

The Diagnostic Management Team (DMT) concept convenes a multi-disciplinary group of healthcare professionals to meet on a regular basis. After evaluating individual patient histories and interpreting clinical data, the DMT generates an expert-driven narrative that’s communicated with treating physicians to help guide and inform patient treatment. DMTs can be conducted remotely, giving highly qualified professionals in specific fields the chance to participate and contribute their expertise, even from a distance.

“There are two primary missions of the DMT — to provide advice on the appropriate selection of laboratory tests, and to provide expert input on the diagnostic test results that can lead to rapid and accurate diagnoses,” said Dr. Laposata, a strong proponent of the DMT initiative. “Expert teams that help healthcare providers reach the correct diagnosis are obviously beneficial to patients, and to the organizations in which they work.”

The interpretation streamlines patient recordkeeping by providing all relevant diagnostic and treatment comments and information in one readily accessible document, saving users time spent having to search multiple records in different locations to find the info they need. The interpretations are written in clear language that’s easy for all healthcare providers to understand, quickly getting everyone involved in the case on the same page about what’s happening with each individual patient. The end goals? Decreased episodic cost of care, fewer preventable readmissions, and a means for data-tracking to justify the cost of organizing the DMT to C-suites and insurance companies. Ultimately, DMTs aim to achieve a significant reduction in medical errors and to improve patient care and medical outcomes.

Challenges for DMTs

Launching and maintaining an effective DMT isn’t without challenges. For starters, it can sometimes be hard to accurately predict and definitively quantify cost savings generated by the DMT, which can make it difficult to convince C-suites to support the concept alongside other programs with more clear-cut means of measuring results.

“The C-suite has to recognize that expertise in operations management and finance is not equivalent to clinical expertise,” he described. “A conclusion that a minor increase of maybe one cent per dollar in the laboratory budget, which is currently 3 to 5 percent of the healthcare dollar, isn’t worth offsetting much larger expenses in the hospital’s general budget reflects an incomplete understanding of the patient experience, from presentation through successful treatment.”

“Concern about one budget in isolation prevents one budget from providing major savings in another budget,” Dr. Laposata continued. “In most cases, once a correct diagnosis has been established, treatment is provided expeditiously and often successfully. The process of obtaining a diagnosis can drag on for days and sometimes weeks, or it can fail completely.”

The future of the DMT

While the future of DMTs on the whole remains to be seen, support for the concept seems to be growing. If you’re interested in learning more about creating a DMT in your organization, you’ll find links to a series of DMT-related articles on LabLeaders.com.

The LabLeaders DMT series... Get More Here

References:

Contributing Lab Leader

Michael Laposata, MD, PhD

Professor and Chairman of the Department of Pathology

University of Texas Medical Branch in Galveston

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