suddenly thrust upon an already overburdened and overcrowded medical care system. It becomes more important than ever to TAKE CONTROL OF YOUR HEALTH!
With this in mind, and in view of the above impending changes, I decided to take four of my Slim Book of Health Pearls series and incorporate them into one book, all with the goal of assisting the patient in the daunting task of navigating through the coming healthcare changes and taking appropriate steps to control risk. The four steps are:
1.The Prevention of Medical Errors…Step 1
2.The Complete Medical Examination…Step 2
3.Risk Factor Analysis and Health Screening…Step 3
4.Symptoms Never to Ignore…Step 4
As a patient, your role in navigating through these four headings is crucial because.
•Medical errors are pervasive and dangerous and can injure or kill. You need to know what they are in order to take preventive measures.
•The complete medical examination in today’s medical environment is often incomplete and the source of many failure to diagnose malpractice law suits. You need to know what the complete exam entails and insist on its implementation.
•Risk factor analysis and health screening is a crucial part of an initial patient evaluation, but is often incomplete or ignored. Patients can perform this important risk factor analysis on their own and learn the proper timing of health screenings.
•Patient delay in evaluating symptoms is a dangerous procrastination that you must avoid.
The book will amplify each section in detail.
I would be remiss if I did not add one personal warning about the coming healthcare system. Tort reform, in the new healthcare changes to be, is conspicuous by its absence. As the thousands of pages of changes come into effect, and as more and more physicians abandon private practice to take on salaried roles, and as the medical system in the United States approaches the more socialized system of other countries, which I firmly believe is inevitable, the absence of tort reform, similar to the system of other countries poses the risk of collapsing the system, both medically and financially.
STEP 1: THE PREVENTION OF MEDICAL ERRORS
“Es Irrt Der Mensch, So Lang Er Strebt”
(As long as human beings strive, they will make errors)
Johann Wolfgang von Goethe
(1749-1832)
Introduction
A medical error has occurred anytime a healthcare provider plans a medical action and it does not succeed as intended, or the wrong plan is used. These errors can include problems in medical practice, failure to diagnose, procedural problems, system failures, or product deficiencies.
Ninety-eight thousand people per year die from medical errors, a number that represents more deaths than occur from automobile accidents or breast cancer. This statistic, published by the Institute of Medicine in 1999, has prompted efforts by the Joint Commission on Accreditation of Healthcare Organizations to focus the accreditation process on operational systems critical to the safety and quality of patient care.
What is the Institute of Medicine? Who are its members? Are they a governmental organization? What is the funding source?
The federal government created the National Academy of Sciences to serve as an advisor on scientific matters. However, the Academy and its associated organization (e.g. the Institute of Medicine) is a private, non-governmental organization that does not receive direct federal appropriations for their work. The Institute of Medicine’s charter establishes it as an independent body. They use unpaid volunteer experts who author their reports, each of which undergoes a rigorous and formal peer review process that must be evidence-based where possible, or noted as an expert opinion where not possible. Many meetings of the Institute of Medicine are open to the public, or the committee may deliberate amongst themselves until they reach consensus. Any potential conflict of interest could disqualify a committee member.
One cannot dispute this committee’s findings—the best minds are at work. In addition, the Joint Commission considered it serious as well, for they have launched a nationwide effort to minimize medical errors in healthcare organizations.
Let us define what medical errors are. The Joint Commission has categorized a long list of hospital errors that have resulted in death or injury, the so-called sentinel events. This is necessary so that the Joint Commission can investigate and make sure that hospitals have put systems in place to prevent the error from reoccurring. These sentinel events are:
Anesthesia related: Death or injury may result from anesthesia.
•Delay in treatment: Failure to diagnose in time, treatment delays resulting in disability or death and wrong diagnoses are all medical errors. An incomplete medical examination is often the reason.
•Elopement: Serious injury or death could result when patients leave facilities of their own accord before diagnosis.
•Infection-related: Lapses in sterile technique may result in an infection.
•Maternal deaths: Obstetrical deliveries may result in injury or death.
•Medical equipment: Medical equipment failures may result in disability or death.
•Medication error: Physician, pharmacist, or patient error may result in injury or death due to improper or wrong medication use.
•Operative/post-operative: Complications may result from surgical or post-surgical care.
•Patient abduction: Infant abduction from newborn nurseries have occurred.
•Patient falls: The failure to identify the fall-risk patient, and/or the failure to safeguard the patient may have serious consequences.
•Perinatal deaths/injury: Injuries or death may occur around the time of birth.
•Potassium Chloride: The accidental direct intravenous injection of potassium chloride can result in cardiac arrest.
•Restraint deaths: Restraints are a last resort to protect patients from themselves and staff from patients. Restraint use is only for the shortest time necessary and includes frequent monitoring. Failure to monitor these patients may result in medical complications or death.
•Suicide: Guidelines must be in place to identify and monitor the suicidal patient.
•Transfusion: An improper matching of a blood transfusion can cause injury or death.
•Ventilator: Mechanical ventilation is often necessary to breathe for patients who are unable to breathe for themselves. Improper ventilator settings, machine failure and incomplete monitoring may result in death.
•Wrong site surgery: Wrong-site surgery can result from failure to identify the precise surgical site.
•Wrong test performed: Improper orders or failure of interpretation of orders will result in the wrong test.
Medical
