In 1999, Americans learned that 98,000 people were dying every year from preventable errors in hospitals. That came from a widely touted analysis by the Institute of Medicine (IOM) called To Err Is Human. This was the "Silent Spring" of the health care world, grabbing headlines for revealing a serious and deadly problem that required policy and action.
As it turns out, those were the good old days.
According to a new study just out from the prestigious Journal of Patient Safety, four times as many people die from preventable medical errors than we thought, as many as 440,000 a year.
Back in the old days, the IOM experts had very little concrete information to use in estimating the extent of killer errors in hospitals. But with innovations in research techniques led by Dr. David Classen, the Institute for Healthcare Improvement and others, we now have more tools to tell us where the bodies are buried.
With these latest revelations, medical errors now claim the spot as the third leading cause of death in the United States, dwarfing auto accidents, diabetes and everything else besides Cancer and heart disease. Harvard's Dr. Lucian Leape, the father of the patient safety movement and one of the experts behind the original IOM report, says the numbers in this new study should supplant the IOM estimates from 1999. That means hospitals are killing off the equivalent of the entire population of Atlanta one year, Miami the next, then moving to Oakland, and on and on.
These people are not dying from the illnesses that caused them to seek hospital care in the first place. They are dying from mishaps that hospitals could have prevented. What do these errors look like? The sponge left inside the surgical patient, prompting weeks of mysterious, agonizing abdominal pain before the infection overcomes bodily functions. The medication injected into a baby's IV at a dose calculated for a 200 pound man. The excruciating infection from contaminated equipment used at the bedside. Sadly, over a thousand people a day are dying from these kinds of mistakes.
If you aren't alarmed enough that our country is burying a population the size of Oakland every year, try this: you are paying for it. Hospitals shift the extra cost of errors onto the patient, the taxpayer and/or the business that buys health benefits for the infected patient. My nonprofit, which provides a calculator of the hidden surcharge Americans pay for hospital errors, finds most companies are paying millions or even billions of extra dollars for the cost of harming their employees.
And our estimates are likely conservative. A study a few months ago in the Journal of the American Medical Association found that employers paid $39,000 extra every time an employee suffered a surgical site infection. That's enough money to create a good job. Instead, it's rewarding a hospital for creating an infection.
Hospital industry leaders will tell us that reducing errors is extremely difficult because hospitals are complex places with very sick clientele. To prevent errors every person who works in the hospital has to follow rules precisely, and systems have to function properly.
These leaders are correct; it is hard for hospitals to be safe. But there's little excuse for this record of abject failure, and the misery and death of millions. In the dozen years since the IOM report, a plethora of research and case studies have emerged with proven strategies for improving hospital safety. The hospitals that put a priority on safety and use these proven techniques show results, and their patients are safer. Those that minimize the importance of patient safety kill more of their patients. As a result, in our Hospital Safety Sore program grading hospitals on the extent of their errors, we see enormous variation, with some hospitals showing real progress while others -- often in the same region or neighborhood -- riddled with errors, many of them deadly.
The reason many hospital leaders fail to put a priority on safety is that we as a country haven't forced them to do so. On the contrary, we haplessly pay them for these errors. We tolerate hospital lobbyists insisting on hiding their error rates. We fail to insist on safety when we choose where to seek care or when we put together our business' health benefits. When we don't demand safety, they don't supply it.
It's time for Americans to make clear to hospitals that they must earn our business, and our trust, and we will not pay with our lives for their failure to act.
The piece first appeared on Forbes.com