It’s been 24 years since the Institute of Medicine’s 2000 study “To Err is Human” report was published, drawing broad attention to medical mistakes that kill up to 98,000 Americans annually. More people die annually from medication errors than from workplace injuries, motor vehicle accidents, breast cancer, or AIDS.
To Err Is Human broke the silence that has surrounded medical errors and their consequence – but not by pointing fingers at caring health care professionals who make honest mistakes. Instead, its book sets forth a national agenda–with state and local implications–for reducing medical errors and improving patient safety through the design of a safer health system.
16 years later, a 2016 study published in the British Medical Journal found about 250,000 deaths annually are due to medical error, making it the third leading cause of death in the United States, where it’s more problematic than other developed countries.
A great deal of research shows that patients who are told about mistakes are more likely to follow medical advice, and continue with care while being less likely to seek malpractice lawsuits, according to “Patient Safety and Quality: An Evidence-Based Handbook for Nurses.“
According to a recent series on What You Need to Know About Surgery – Part 7 – published by the Epoc Times, many states have “apology laws,” which are designed to allow for honest communication between physicians and injured patients.
However, the American Medical Association Journal of Ethics said they don’t go far enough. For instance, few states have laws protecting expressions both of sympathy and of fault from being entered into medical malpractice lawsuit evidence. This puts an unofficial gag on doctors, it said.
As of 2023 only 17 states, including California, require physicians to disclose an error to the patient. Some doctors hide behind the fact that the definition of “medical error” is vague. More than two-thirds of states have adopted laws that preclude some or all information contained in a practitioner’s apology from being used in a malpractice lawsuit.
The California law that requires physicians to disclose medical errors to patients is the Patient’s Right to Know Act of 2018 (Senate Bill (SB) 1448). This law took effect on July 1, 2019, and requires physicians to disclose all harmful medical errors to their patients, regardless of whether the error resulted in serious injury or death.
In 1996, The Joint Commission created a Sentinel Event Policy to help healthcare organizations that experience serious adverse events improve safety. Since that time, The Joint Commission has maintained an associated Sentinel Event Database with de-identified and aggregate data.
The Joint Commission has released its Sentinel Event Data 2022 Annual Review on serious adverse events from Jan. 1 through Dec. 31, 2022. A sentinel event is a patient safety event that results in death, permanent harm or severe temporary harm.
Between January 1 and December 31, 2022, The Joint Commission received 1,441 reports of sentinel events; the majority -90% (1,299) – were voluntarily self-reported to The Joint Commission by an accredited or certified entity. The number of reported sentinel events increased by 19% compared to 2021. The majority of reported sentinel events occurred in the hospital setting (88%). 20% of reported sentinel events were associated with patient death.