Developing and maintaining a culture of quality is essential to effective health care. In fact, it can quite literally mean the difference between life and death. Back in May, Johns Hopkins Medicine released a study in the British Medical Journal suggesting that medical errors actually account for 10% of deaths in the U.S., making it the third leading cause of death after heart disease and cancer. Yet, errors are currently not being reported this way. In fact, NPR writes that according to the study, "no one knows the exact toll taken by medical errors." Why is this?
The Johns Hopkins study argues that the way in which the Centers for Disease Control and Prevention (CDC) collect "national health statistics fails to classify medical errors separately on the death certificate." As a result, the study argues, the data "doesn't capture things like communication breakdowns, diagnostic errors, and poor judgment that cost lives." According to Martin Makary, M.D., M.P.H., professor of surgery at the Johns Hopkins University School of Medicine and an authority on health reform,
“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics. The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.”
In keeping with this, the study argues that clearer and more accurate reporting on medical errors is a matter of public health, one that could result in better funding and public awareness. Dr. Tejal Gandhi, president of the National Patient Safety Foundation, tells NPR that, "if you ask the public about patient safety most people don't really know about it. If you ask them the top causes of death, most people wouldn't say 'preventable harm.'"
What can be done to improve these stark findings? Many leading experts believe that nurses can play a significant role in quality improvement. As such, this year's National Nurses Week theme was "Culture of Safety. It Starts with You." Additionally, in the May issue of the American Journal of Nursing, Maureen Shawn Kennedy, MA, RN, FAAN, argues that,
"Nurses have always been the sentinels, the around-the-clock watchers, detecting the changes that might herald a patient's deterioration. Nurses are the ones that the system looks to—and often blames—when there's a failure to rescue. Such constant vigilance requires that nurses be present in adequate numbers and with full attention."
The upcoming Quality Improvement: A Guide for Integration in Nursing by Anita Finkelman continues this quest to improve patient care and reduce errors through quality improvement. A comprehensive resource, it focuses on the practical aspects of quality improvement and the nurse’s role in the process, while acknowledging the importance of an inter-professional approach. It also examines the current state of healthcare quality in the U.S., critical trends, data, and how to plan and implement change to reach improvement. What’s more, the author connects quality improvement to technology and the role of the patient while emphasizing the importance of engagement and nursing leadership. To learn more about this text, visit our website.