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Fatal Admissions: Are Patients Safe?

by Rick Blizzard

According to a 2000 Institute of Medicine (IOM) report, medical errors kill up to 98,000 people annually -- more than those who die from traffic accidents, breast cancer or diabetes. Release of this report sent paroxysms of panic throughout the American healthcare community. On June 15, 2000, the same day the study was released, Sens. and Health, Education, Labor and Pensions Committee members Jim Jeffords, I-Vt., (then a Republican) and Edward M. Kennedy, D-Mass., unveiled legislation on patient safety, and the American Medical Association (AMA) delegates began refining the AMA stance on safety issues.

Effective July 1, 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) implemented new patient safety standards. According to these standards, preventing medical errors requires "an environment in which patients, their families, and organization staff and leaders can identify and manage actual and potential risks to patient safety." JCAHO also issued a safety guide aimed at patients, titled "Speak Up."

Healthcare Organization Performance in 2001

Responding to JCAHO initiatives, Gallup introduced patient safety questions to its patient loyalty survey core questions in 2001, by asking patients how safe and secure hospital staff made them feel. The graph below depicts the percentage of patients who said they were "very satisfied" with the staff making them feel safe and secure, and compared it to the percentage of patients who were very satisfied with the hospital's services overall.

Clearly, patients are most satisfied (71% "very satisfied") and feel most safe (68% "very satisfied") in outpatient surgery. Only one in two patients in inpatient (50%) and emergency department (47%) settings were "very satisfied" with how safe and secure the staff made them feel. Concern with safety in the emergency department correlates strongly with overall satisfaction in the emergency department. On the other hand, patients tend to be much less satisfied with their feelings of safety and security in the inpatient environment than they are with overall patient service. This suggests that staff members must work harder to cultivate feelings of security among those in the inpatient environment.

Key Points

JCAHO notes that patients, their families, and organizational staff and leaders must work together to identify and manage actual and potential risks to patient safety. While this seems to go without saying, based on the number of lethal medical errors that occur every year, perhaps more overt discussion of this issue is necessary. Clearly, based on Gallup's 2001 patient loyalty survey results, in which 47% of patients in the emergency department and 50% in inpatient settings were "very satisfied" with staff making them feel safe and secure, this aspect of patient care has much room for improvement.

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