Hospitals Required to Report Errors

C H I C A G O, June 28, 2001 -- U.S. hospitals will be required to tell patientswhen they've been subjected to medical errors under new patientsafety standards that take effect Sunday.

The new rule is the first of its kind from the Joint Commissionon Accreditation of Healthcare Organizations, the nonprofit qualityevaluator of nearly 5,000 hospitals nationwide.

The commission acted partly in response to a 1999 Institute ofMedicine Report estimating that medical errors kill 44,000 to98,000 hospital patients annually.

Under the new guidelines, hospitals that don't discuss harmfulmistakes with patients and prove to commission investigators thatthey're doing so will risk losing their accreditation.

"We need to create a culture of safety in hospitals and otherhealth care organizations, in which errors are openly discussed andstudied so that solutions can be found and put in place," said Dr.Dennis O'Leary, president of the Oakbrook Terrace-based commission.

"We've got a lot of people I think to persuade that it is OK todo this," O'Leary said in a telephone interview Wednesday.

Some hospitals, including the nation's Veterans Affairsfacilities, already tell patients when errors occur. Others maykeep quiet to avoid potential lawsuits, said Dr. Sidney Wolfe,co-founder of Public Citizen Health Research Group, aconsumer-oriented advocacy group. But he noted that recent researchshowed hospitals that were up front with patients aboutmistakes faced fewer lawsuits.

"People don't like to get jerked around," Wolfe said. "Partof the understandable anger that accompanies a lawsuit is the ideathat something bad happened to me and they didn't tell me."

Saying 'I'm Sorry'

Rick Hendrick, a Chicago contractor who was given the wrongmedicine in a hospital emergency room, agrees.

Hendrick, 47, said he would have felt a lot better about hisordeal "if they'd come to me and said, 'This is what happened. I'msorry, we made a terrible mistake'" and had warned him of the sideeffects.

Instead, he says, hospital staff never admitted they'dgiven him a big dose of an antibiotic destined for another patient.Hendrick, who had sought treatment for a bad case of hives, said hehad severe heart palpitations, nearly passed out and was weak forseveral days from the drug.

"To make hospitals have to reveal these things … gives thepatient a choice in the future to determine whether or not toreturn to a hospital where they've had a bad experience," Hendricksaid. It also "will make a lot of hospitals police themselves alittle better" and be more accountable to patients, he said.

Dr. Don Nielsen of the American Hospital Association said thenew standards echo AHA policy for its members — about 5,000hospitals and health-care systems nationwide.

AHA policy even goes further, advising hospitals to tellpatients about mistakes that don't cause any harm, Nielsen said.

At the University of Chicago, the Center for Patient Safetyopened this year and urges medical staff to disclose errors topatients, said Dr. Paul Barach, the center's co-director.

"It's a challenge to some of the norms," he said, which "havebeen more of a paternalistic mindset where if it doesn'tnecessarily make any difference to the patient and they don't ask,then they don't need to know."

Patients and doctors need to know that "humans are humans" andhealth care is no different, Barach said.

"The goal is to reduce errors, but it's impossible to preventthem," he said.