MEDICAL ERRORS: Series Provokes Defense, Calls for Change
Last week's four-part Philadelphia Inquirer series on medical errors has unleashed a torrent of reaction from the Philadelphia community. Sunday's Inquirer published 10 letters from physicians, who either dispute or applaud the piece. Most noteworthy: Two senior officials at Medical College of Pennsylvania, the hospital singled out in the series for hundreds of medical errors made public in court filings by owner Tenet Healthcare, defend their operations to their peers and the public, observing, "We go to great lengths and exercise great care as we strive for perfection in an imperfect world." CEO Richard Freeman and Medical Staff Chief Dr. Oksana Korzeniowski object to one local hospital official's claim, published in the series, that risk-management reports are routinely ignored. Rather, they argue, Tenet's hospital network uses "patient-focused risk management ... [that] concentrates on the entire cycle of care," fostering a "code of openness" which, combined with other safety measures detailed in the piece, has increased awareness of medical errors at MCP (9/19).
Room for Improvement
The Inquirer argues in an editorial that the problem "is all too typical nationwide" and offers up several strategies for improving safety in America's hospitals. Among them: better disclosure of errors to patients and mobilization among employers to "press ... patient-safety standards as part of medical insurance agreements." Recommending a "systemic approach to safety," editors call for the adoption of the "industrial medicine approach," implementing limits on the number of hours worked by interns and residents, running simulation trials and implementing computerized drug and medical records (Inquirer, 9/19). In an op/ed piece, Andrew Wigglesworth, President and John Combes, Senior Medical Advisor of the Delaware Valley Healthcare Council of the Hospital & Healthsystem Association of Pennsylvania also call for a more effective mechanism for tracking errors. They recommend implementation of a model like that used in the aviation industry, in which all safety concerns are reported to NASA as opposed to the regulatory Federal Aviation Authority. Such a model would allow "near-misses and system failure" to be "analyzed without fear or blame." Conceding that "error is one of the greatest challenges facing hospitals and their medical staffs," Wigglesworth and Combes highlight the lengths health care providers go to reduce errors but promise that the state hospital body "can and will do more" to foster quality improvement (Inquirer, 9/19). In a letter to the editor, Dr. David Behar of Philadelphia offers a more hard-nosed solution: "Medical liability should be outlawed and replaced by mandatory reporting" subject to criminal penalty for failure to do so, and "immunity for honestly reporting mistakes" (Inquirer, 9/19).