Ninety-five Percent of Physicians Have Seen a Serious Medical Mistake, Survey Finds

In a survey of more than 1,000 health care providers, 58% said that health care in the United States "isn't very good" and 72% said that "fundamental changes are needed" (Robert Wood Johnson Foundation survey, March/April 2001). The survey of 600 physicians, 400 nurses and 200 senior-level hospital executives was released yesterday by the Robert Wood Johnson Foundation. "Underscoring how entrenched the problems are," 61% of survey participants reported that they "accept common [medical] errors as routine practice," USA Today reports. Further, the survey found that 95% of doctors had witnessed a "serious" medical error (Appleby, USA Today, 5/9). More specifically, 4% of doctors said they had seen serious quality of care or medical mistakes frequently, 27% said occasionally and 64% said infrequently, although the study did not define what a "serious" mistake was. As for nurses, 89% said they had witnessed a major mistake, with 71% saying they had seen mistakes infrequently, 15% occasionally and 3% frequently (Washington Post, 5/9). According to Dr. Donald Berwick, co-chair of the foundation's grant program, the survey defined a medical error as "the failure to carry out a task in medicine the way we intended it -- giving the wrong drug or doing the surgery in a way we didn't plan" (Levy, Spokane Spokesman-Review, 5/9). Twenty-nine percent of respondents indicated that they "believe they can provide leadership to change" the U.S. health system.

To "jump-start a solution," Berwick and Lewis Sandy, the foundation's executive vice president, yesterday announced the Pursuing Perfection initiative, a $20.9 million, three-year campaign that will give hospitals and doctor groups money to "improve health care." So far, the initiative has received more than 220 applications. Twelve groups will receive money to develop business plans, and six will receive up to $3.5 million to implement system-wide changes. Robert Wood Johnson officials said they "want to see a tenfold improvement in quality of care and a similar drop in errors" (USA Today, 5/9). Sandy said that "pursuing perfection" means care providers are "striving" to deliver services accurately and on time, to avoid services that are not helpful or cost-effective, to prevent safety hazards and errors and to respect patients' "unique needs." He added, "Compared with other industries, the expectation for health care quality is very low. We have intentionally set the bar high for this initiative. Pursuing Perfection may sound idealistic, but we believe it is possible to make dramatic and momentous improvements on a system-wide basis." Berwick said, "While the bad news is that errors are common and quality is doubted, the good news is that there is a strong cadre of providers out there who believe we can raise the bar for health care performance" (RWJF
release, 5/8). For more information on Pursuing Perfection, click
here. To view results from the RWJF survey, click here.