Reducing Medical Errors and Increasing Patient Safety: TRM and 5 Q's Approaches for Better Quality of Life

Introduction

The unaided human mind is incapable of performing consistently at the necessary level to provide optimal healthcare (Weed, 1997). Thus, human error is inevitable even for the best trained and qualified physician and other healthcare providers. Using information and communication technology (ICT) can also be inevitable factor to reduce medical and medication errors. ICT can be used to assure that the clinical decision support system actually catches errors that injure patients, to develop systems that coordinate different care activities and communicate with each other and to evaluate, measure and prevent adverse consequences. It can also be utilized to digitalize prescriptions, to implement bar-coding for medications, blood, devices, and patients; and to utilize modern electronic systems to communicate key pieces of asynchronous data such as markedly abnormal laboratory values (Bates et al., 2001). This chapter is based on Zineldin, et al. (2014) and will describe the interrelationship between ICT, total relationship medicine approach, 5 Q and reducing medical errors and increasing patient safety.

The Harvard and Australian studies into medical error remain the only studies that provide population level data on the rates of injuries to patients in hospitals and they identified a substantial amount of medical error. Medical errors are one of the Nation’s leading causes of death and injury. A report published in 2000 by the Institute of Medicine (IOM) estimates that as many as 44,000 to 98,000 people die in U.S. hospitals each year as the result of medical errors. By 2004 the result was, 195,000 dies and 1,000,000 excess injures by the medical errors. This means that more people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS (Sexton et al., 2000; Thomas et al., 1999; Weingart et al., 2000).

23% of Europeans argue that they have been directly affected by a medical error personally or in the family. 18% indicate that they or their family members have experienced a serious medical error in a hospital whereas 11% announces having been prescribed wrong medication (European Commission, 2006).

In Sweden, over 3000 people die each year as a result of medical errors (MEs) and adverse events (AEs) (SAS Health and Life Sciences blog, 2009). Mixed up test results, injuries suffered during childbirth, infections following surgery, and incorrect drug dosages are just a few of the medical errors that reveal it can be harmful to a patient’s health to end up at a Swedish hospital (The Local, 2011). In Canada (2004) 185,000 were associated with an adverse event, 70,000 were potentially preventable. 11% of total deaths in Australia are caused by medical errors.

An investigation of a sample of 36 medical and health care institutions shows that medication errors were 19% of the doses (605/3216) in the typical hospital and skilled nursing facility. The major frequent errors were due to wrong time (43%), omission (30%), wrong dose (17%) and unauthorized drug (4%). 7% of the errors were considered potential adverse drug events (Barker et al., 2002).

Healthcare sector and its providers face many pressures. One of those pressures is that modern patients are demanding steady and broader access to their medical information and online (passive or active) and e-mail access to their providers. Medical errors are adding more pressures.

One approach to reduce and minimize medical errors is effective utilization of the ICT. Here too, the healthcare institutions are struggling with how to efficiently incorporate technology into their practices. Technology has the potential to drastically change healthcare and save lives by increasing access to patient and medical information, increasing the efficiency of providers, reducing medical errors, tracking outcomes, identifying areas for providers to improve, and facilitating outcomes-based research (Sokol and Molzen, 2002).