Blogs About U.S. Senate Subcommittee's Hearing On "More Than 1,000 Preventable Deaths a Day Is Too Many: The Need to Improve Patient Safety"

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On July 17, 2014, the U.S. Senate’s Committee on Health, Education, Labor & Pensions Subcommittee on Primary Health and Aging held a hearing on the subject entitled, “More Than 1,000 Preventable Deaths a Day Is Too Many: The Need to Improve Patient Safety”

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Preventable medical errors in hospitals is the third leading cause of death in the United States

On July 17, 2014, the U.S. Senate’s Committee on Health, Education, Labor & Pensions Subcommittee on Primary Health and Aging held a hearing on the subject entitled, “More Than 1,000 Preventable Deaths a Day Is Too Many: The Need to Improve Patient Safety.”

The Subcommittee Chairman opened the hearing by stating that preventable medical errors in hospitals is the third leading cause of death in the United States. He also referred to a recent study that estimates that as many as 440,000 people die from preventable medical errors in hospitals every year in the United States, and additional tens of thousands die from preventable medical errors outside of hospitals, from errors such as misdiagnoses and injuries from medications. And as many as 180,000 Medicare patients die from adverse medical events in hospitals each year in the United States.

The Subcommittee Chairman further noted that one in twenty-five patients acquire an infection while in the hospital, which led to 700,000 people getting sick and 75,000 people dying in 2011. Medical errors cost the U.S. health care system more than $17 billion in 2008. If you include indirect costs, medical errors may cost in excess of $1 trillion per year in the United States.

The Subcommittee Chairman stated, “Medical harm in this country is a major cause of suffering, disability and death as well as a huge financial cost to our nation. This is a problem that has not received anywhere near the attention that it deserves.”


In today's blog posting, we discuss the testimony of the six individuals who testified before the Subcommittee on July 17, 2014. Some of their suggestions for improving patient safety include:

  • Providing patients with an enforced bill of rights that would include the rights to legally defined and enforced right to give genuinely-informed consent; to know the safety record of their physician, outpatient clinic, nursing home, and hospital; to know costs for tests and elective procedures before hand; to transparent accountability in the case of an adverse event; to evidence-based care; to know when drugs are prescribed off-label; to be warned about bad lifestyle choices; to have an advocate present while hospitalized; and, to care by teams of professionals that build individual and team excellence through 360-degree performance reviews, which are anonymous reviews by patients, subordinates, colleagues, and leaders;
  • Focusing on three main areas: metrics, accountability, and incentives along with greater transparency, more accountability and the right set of incentives;
  • Requiring better systems to help minimize cognitive errors (missed and delayed diagnosis is the most common type of outpatient malpractice claim, often caused by breakdowns in the diagnostic process);
  • Better engaging with patients to ensure that patients understand and agree with their care plan so they understand why the medication or test that is ordered is important for their care and they understand what the plan is after leaving the hospital;
  • Designing better health information technology (HIT) systems to maximize patient safety benefits while minimizing new risks that can be introduced from these technologies;
  • Pay for quality: charge the Centers for Disease Control with developing, monitoring, and transparently reporting the incidence rates of the top causes of preventable harm; invest more in career development awards for patient safety improvement; support AHRQ to coordinate collaborative implementation science efforts to reduce harm; create standards for the reporting of health care quality and cost measures by creating the equivalent of the Securities and Exchange Commission and Federal Accounting Standards Board for health care;
  • Assure an adequate and appropriately educated supply of registered nurses at the bedside;
  • Actively engage patients and families as partners in their care;
  • Move hospitals and other health care settings to embrace a safety culture and become high reliability organizations;
  • Provide transparency in order to end medical errors. When patients are harmed, they often are subjected to additional harm when caregivers fail to disclose or explain what happened. Medical records are withheld or altered or never documented accurately. Many families have to file lawsuits just to get information about how their loved ones’ died. This is the underbelly of medical errors – the cover-ups and the insults to injury;
  • Create a more just and fair system that encourages discussions without requiring patients’ rights in exchange, that compensates patients for their losses and that treats them with dignity and respect;
  • Support the creation of a National Patient Safety Board, modeled after the National Transportation Safety Board;
  • Support the infrastructures needed for public reporting and tracking of infections and errors;
  • Expand hospital infection reporting so that infections are being documented throughout the hospital and consumers have a clear picture of a hospital’s overall infection rate;
  • Provide mandates for antibiotic stewardship;
  • Require hospitals to report on antibiotic usage and resistant infections using CDC-NHSN’s new modules;
  • Require medical error reporting: electronic billing records could be used as a resource for documenting these events by improving their accuracy. Create a rigorous validation process that includes fines for hospitals that fail to accurately document patient stays;
  • Require death certificates to indicate when infections or errors are the cause of death and document the presence of these events preceding or at the time of death;
  • Disclose hospital infection outbreaks to the public, the patients in the hospital, and patients being admitted;
  • Make the National Practitioner Data Bank public so patients can refer to it to check on physicians that have licenses in multiple states;
  • Continue adding measures to Medicare pay for performance programs and consider standardizing how incentives and penalties are calculated.


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