It is worth noting that healthcare is a busy and highly sensitive sector in any society. There are several activities implemented in the healthcare organizations, hence increasing the number of mistakes (Shaffer, 2006). The Institute of Medicice (IOM) reported that an average between 44,000 and 98,000 medical errors occur in the United States on a yearly basis leading to patients deaths (Agency for Healthcare Research and Quality (AHRQ, 2000). It is unfortunate to note that the deaths, which happen due to the adverse events, can be curbed account to the higher percentage in the USA as compared to deaths that result from cases of breast cancer, motor vehicle accidents, or AIDS (AHRQ, 2000). Dr. J. Lyle conducted a study for thee IOM and derived a conclusion that the patients in a hospital have to experience a medical error every day. The study shows the adverse effects of medical mistakes as it indicates that they negatively impact around 1.5 million patients every year (Tasker, 2007). Moreover, one main study conducted on the subject of medical errors indicated that from the total number of mistakes that were examined in the sample, 70 percent were preventable (AHRQ, 2000).
In addition, the National Patient Safety Foundation conducted a nationwide poll that demonstrated shocking facts about the prevalence of medical errors. In the given poll, forty two percent of the sample stated that their relatives, friend or them personally had suffered the effects of medical mistakes at one moment. Reviewing the extent of the errors effects, 32 percent of the studied population indicated that they caused irreversible negative impacts on the health of the victims (AHRQ, 2000).
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Moreover, the number of medical errors occurring in a given year causes a negative impact on the hospitals bottom line. It is disturbing to note that the costs of healthcare are escalating at a rate that is faster than that of the national inflation. The IOM indicated that the medical mistakes that occur in the in-patient settings amount to an estimated cost of about $37.6 billion dollars on a yearly basis (AHRQ, 2000). The challenges associated with occurrence of the medical errors in the healthcare as well as the consequent implications to the general society is helpful in understanding the reason for the increased concern regarding the possible remedies to the situation. Stichler (2007) states that the goal of enhancing patients safety is achievable only if the required measures are taken to instill a relative culture, which reflects transformational leadership ensuring that the healthcare providers perceive safety as a priority.
Literature Review
Kohn, Carrigan and Donaldson (2000), state that medical errors are common in the hospitals while fulfilling the tasks involved in the medication process. They argue that there is possibility of medical errors occurrence during drug procurement, prescription, medication administering and in the process of monitoring the impacts of a prescription. However, they consider that medical mistakes are expected to happen at the drug prescription and administering stages. Considering all the types of errors, a patient is exposed to more than one medication mistake on a given day.
Despite availability of records justifying that medical errors occur in all hospitals, Stichler (2007) notes that there are significant variations in their rates in different health facilities. The ADEs that result from medical errors are preventable, but it is not easy to measure accurately the frequency of preventable ADEs occurrence. A study that was conducted by the Agency for Healthcare Research and Quality (AHRQ, 2000) estimated the number of preventable ADEs in the hospitals to be 3380,000 yearly. Dekker (2007) provides a higher estimation of around 450, 000 preventable ADEs per year. However, the Agency for Healthcare Research indicates that the demonstrated assessments are understatement. The reason is that the reports showing that the number of errors, which occur among outpatient Medicare patients, amount to 530,000 per year are considered to be underestimated. The corresponding studies, which have highlighted the number of medical errors, do not take into account the errors of omission, where the healthcare providers fail to give prescriptions in cases when they should prescribe drugs. In compliance with these considerations, it is possible to arrive at a conclusion that there is certain generalization proving that the number of preventable ADEs is not less than 1.5 million per year in the United States (AHRQ, 2000).
It is worth noting that the medication errors are rather costly to the patients, their families, insurance companies, employers, and the general public. Regarding the patients, the cost is evidently high as several errors have resulted in the loss of life. The families are forced to incur numerous problems in the attempt to counter the negative implications of the medical errors. In addition, many children have remained orphans, hence increasing the dependency ratio, which is not beneficial to any society. Despite the fact that it is impossible to establish the exact cost associated with the medical errors, there are some reliable estimates calculated by different studies. In compliance with one study, it is argued that every ADE, which occurred in a hospital, resulted in the additional $8,750 to the cost of the hospital stay (AHRQ, 2000). If it is assumed that around 400,000 of such occurrences are reported every year, the total annual cost would reach the amount of $3.5 billion in a given group.
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Leape (2006) also demonstrates a study, which shows that the preventable ADEs occurring among Medicare enrollees who are aged between 65 years and older required a yearly treatment cost of about $887 million. This amount may be obviously higher as compared to the estimates presented in the various studies since the most authors narrowed their focus to the specific mistakes as well as certain errors costs. The estimates do not cater for the earnings that people lose due to medication errors or the amount of compensations, which the hospitals must reimburse the victims for pain and suffering. It is particularly worrying to observe the figures of the related high costs due to the fact that most of the medical errors are preventable. The hospitals need to operationalize the preventive approaches that have been already tested and proved to be effective in avoiding medication errors in order to reduce the costs associated with them (Stichler,2007). The current situation is worrying, and there is a need for a joint effort in attempting to curb a continued occurrence of the medication errors.
The aim of the healthcare workers is to reduce the number of medical mistakes that occur every year. Most of the errors are blamed on the faulty systems or some breakdowns that are faced in the process of providing healthcare. It is worth noting that the individuals were traditionally responsible for the medical failures. However, this accusation is changing as the stakeholder are trying to justify these people, especially in cases when medical interventions result in adverse events. Currently, there is a collective responsibility trying to initiate measures aimed at boosting patients safety. It happens when many healthcare providers are also being prosecuted for the medical errors that occurred when the patients were under their care (Dekker, 2007). Dekker (2007) suggests that one of the main facts to note is that the mistakes can only be reduced if people stop apportioning blames on other individuals and focus on finding the ways to provide proper healthcare while advocating for systems improvement.
The most important stakeholders who should play a pivotal role in improving healthcare are the medical staff and hospital administrators. The medical staff members include surgeons, physicians, nurses, and other healthcare workers. The issue is of great concern to the hospital administrators due to several reasons. The administrators daily management decisions have the potential to either ensure safety in the hospitals or create a healthcare environment that is highly prone to the occurrence of errors. Due to the costs associated with the medical errors, it is expected that the insurance companies will begin reimbursing the hospitals through a pay-for-performance system (Brooks, 2007). Such reimbursements can help to motivate the hospitals and the medical staff to initiate the measures of limiting errors occurrence in order to reduce the cost of insurance companies. In the related plan, the hospitals, which focus on the patients safety as one of their main priorities, are highly rewarded.
It is an evident fact that the medical staffs are not interested in medical errors occurring under their care. They seek to reduce the mistakes because their obligation as the healthcare providers is aimed at treating diseases and curing their patients. They focus on the patients safety and reduction of the medical errors, which is one of the possibilities to achieve their objective. The patients are also concerned with a decrease of the medical errors. They apply to the hospitals after suffering injuries or when they are burdened with illnesses expecting to receive adequate treatment and recover. When the patients choose the health facility, they rely on trust that the hospital is capable of helping them regain their healthy status. Tasker (2007) states that a corresponding clinic, which faces medical errors, decreases patients trust, hence making them suffer from negative implications of the error or completely lose confidence that the given facility is competent in providing safe care. Tasker (2007) further states that a reduction in the medical errors improves patients conviction, due to which he applies to the given healthcare facility without any fear of being harmed.
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Proposal for Change
It is necessary to implement some changes in the healthcare sector in order to help limit the occurrence of medication errors hence improving the hospitals and boost patients safety. The possible changes include initiating a shift in the patient-provider relationships, application of information technologies to reduce medication errors, improved labeling and packaging of medications, and a number of policy changes (Leape, 2006).
A Shift in Patient-Provider Relationship
First, Leape (2006) suggests that it is important to provide the patients with opportunity to assume more active roles in their medical care. There is a need for changing the tradition where the health care system has been famous for highly provider-centric and paternalistic behavior hence denying patients possibility to be involved in their own health care process. The research shows that one of the most effective changes that should be implemented to remedy the situation with regards to occurrence of the medication errors is to facilitate partnership between health care providers and the patients (Leape, 2006). Moreover, it is important that the patients seeking medical assistance have more understanding about their medications. It is also necessary to be more responsible in monitoring their medications. The partnership is vital in improving providers willingness to educate the patients and listen to them.
In order to operationalize the patients provider partnership, the providers need to improve their communication with the patients and ensure that they reach mutual understanding (Brooks, 2007). As the providers devote themselves to listen to the patients, they are required to inform them about possible contraindications, risks, and side effects of the given prescriptions as well as provide recommendations how to respond in case they witness such side effects. In case of medication mistakes, the health care providers should be forthcoming in order to provide explanations on the possible causes of such errors and the necessary response. The patients and their surrogates should be more responsible and participate in the entire process. They can assist in recording the medications and monitor them through cross checking their prescriptions as well as giving timely report when they experience any negative response to the drugs (Brooks, 2007).
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The health care system should improve the provision of education to the patients and establish measures to enable the patients educate themselves. This can be achieved by creating avenues to facilitate consultation between the patients and their care providers. In addition, government agencies, the National Library of Medicine and FDA should collaborate in standardizing and improving medication information leaflets provided by the pharmacies (Brooks, 2007). They should also facilitate provision of more available drug information over the Internet as well as put much effort to achieve success in the development of a 24 hour national telephone helpline in order to provide an easier access of the consumers to drug information (Leape, 2006).
Reducing Medication Errors by use of Information Technologies
The second approach to the reduction of medication errors is to adopt the use of information technologies in the prescriptions and drug dispensing. According to Leape (2006), it is impossible for the health care providers to keep record of all the prescriptions, which can be solved due to the advanced information technologies. Prescribers are capable of obtaining the entire information about drugs that they need to prescribe, when they use point-of-care reference information. Electronic prescriptions are also useful in preventing occurrence of medication errors. Several errors that are associated with handwritten prescriptions can be avoided due to the electronically written recipes. The reason is that the software used in providing e-prescriptions helps to ensure that the vital information is filled out legibly. E-prescriptions should also be tied to the patients medical history in order to ensure automatic checking of inconsistencies such as drug allergies, high dosages, and drug-drug interactions. When e-prescriptions are installed in the system, the prescriptions will help to reduce occurrence of the handwritten errors (Leape, 2006).
Reducing Medication Errors through Improved Packaging of Medications
In addition to improving partnerships and using modern technology in the health care, it is necessary to ensure that the drug information is clearly and effectively communicated to the patients and providers through improved packaging. Leape (2006) argues that there are cases when medication errors result from two drugs that have similar names or sound similar. To correct the confusing situation, the drug industry and the relevant federal agency should cooperate to initiate the improvement of drug nomenclature. Such changes should not only target the names of drugs but include the improvement of abbreviations and acronyms. Moreover, there is a need to redesign the information sheet that accompanies drugs with a close consideration of the recommended methods of communicating instruction about medications (Shaffer & Christopher, 2006).
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Policy Recommendations
It is necessary that all the stakeholders involved in the healthcare are attentive and actively involved in implementing the recommended measures in order to reduce the occurrence of preventable ADEs. The federal government should assist in facilitating such involvement. For example, it can sponsor and coordinate an extensive research that is aimed at improving knowledge regarding prevention of the medication errors. Regulatory agencies should also be in the forefront while encouraging application of technology and practices that can help to reduce medication mistakes. Moreover, the accreditation agencies should assist in improvement of training on medication management practices (Kohn, Carrigan, & Donaldson, M.S., eds, 2000).
Cost/ Benefit Analysis
The suggested solutions to the problem of medication errors may be involving and expensive. In fact, the necessity of advanced patient-provider partnership may appear simple and easy to attain, but is requires training in order to be successful. Moreover, it is expensive to adopt modern technologies such as e-prescriptions in the healthcare systems. Such changes present the need to train both health care providers and patients in order to facilitate realization of success (Atkinson & Royle, 2007). The recommendations also include suggestions for more research regarding the aspects such as drug packaging and how to provide effectively drug information of the accompanying sheets. All these interventions have both financial and time value attached to them. However, despite the expected financial strain in the process of implementing the recommendations, the expected outcome highly outweighs the cost involved.
The main aim of the health care providers is to reduce the number of medication errors that occur every year. A high percentage of these mistakes results from faulty systems or breakdown in the process of providing health care. It is worth noting that successful implementation of the given recommendations can decrease the strain and costs of medication errors. Moreover, it can help reduce the cost of the errors faced by the patients, employers, patients relatives, health care providers, the government, and the general society. Consequently, it is obvious that the benefits of the interventions largely outweigh the expected cost.
Conclusion
The health care system is drastically growing and becoming more complex. More people seek medical attention every day, and they cause considerable pressure on the health care providers. It is critical to ensure that diagnostic tests are not performed for the benefit of its implementation, but they help to ensure that the patients receive adequate prescriptions with a view of improving their health conditions. There is a necessity to eliminate the tradition of apportioning blame on the individuals for medication errors. All the stakeholders in the health care should collaborate to initiate measures aimed at preventing occurrence of medication errors as has been suggested by the AHRQ. The problem of medication mistakes should be of great concern for the hospital management as well as for the care providers. The reason is that the occurrence of such errors erodes patients trust on the ability of the health facilities involved to provide quality care. Moreover, medication errors are expensive, and the involved costs are faced by the patients, care providers, hospital management, the government, and employers, etc. Consequently, there is need for a collective effort regarding the policy formulation and adoption of more effective health care provision approaches. The suggested solutions include improving patient-provider relationship, adoption of technology in the health care, improving drug packaging and some vital policy changes aimed at reducing the errors.
