Reducing hospital errors would save lives, money: advocates

 The number of people affected by mistakes in Canada’s hospitals every week could fill three passenger jet planes, says the president of the Ontario Council of Hospital unions.

“And if three jumbo jets were crashing every week, would the government act to stop it?” Michael Hurley asked. “We think they would.”

Hurley was joined at a news conference this week by William Charney, a public-health activist who put together a book entitled Epidemic of Medical Errors and Hospital-Acquired Infections in the U.S. and Canada: The Systemic Causes. The pair are touring Ontario to promote not only the issue, but a June 4 conference on medical errors in Toronto.

Charney says errors and the infections people pick up while in hospital are the second-leading cause of all deaths in Canada.

While there are no official statistics detailing how many people are affected, Charney says he estimates that between 30,000 and 60,000 people are affected each year in Canada. Many other countries -- the U.K., the Netherlands, the U.S. -- keep those statistics, and Charney says the Canadian figure is extrapolated from those figures, and other data from Canadian hospitals.

Quebec is the only province that requires hospitals to report information on medical mistakes, he said. And even with several hospitals failing to file statistics, he said 179,000 mistakes were reported last year.

He cites a lack of handwashing by staff, bed sores caused by lack of care for seriously ill patients and improperly cleaning and disinfection by janitorial staff as the major causes of hospital errors and infections that are killing people. And the cause of many of those problems is tight hospital budgets, where the value of cleaning services and one-on-one time with patients is critically undervalued.

However, saving a few dollars in the cleaning budget ends up costing hospital much more in the long run, he said. Curing someone’s bed sores, for example, costs at least $10,000; a patient who contracts C. difficile, a potentially deadly infection, has to stay in hospital an average of 17 extra days, at a cost of $1,000 a day; battling an outbreak of MRSA costs about $14,000 a patient.

“Not only are bed sores expensive to treat, they’re very painful for patients,” Charney said. “And they can be prevented by turning patients over every few hours.”

Because of budget austerity, however, he said staffing levels don’t allow for that level of care. But it’s false economy, because it ends up costing hospitals more in the long run.

And infectious diseases are spread not only through the lack of handwashing, but by inadequate cleaning and disinfection of hospital floors, beds, etc. Charney cited a British study that found a direct link between cutting cleaning budgets and higher hospital infection rates.

Unlike medical errors, infection rates are tracked by Canadian hospitals. The rate for Sudbury`s Health Sciences North can be found at http://www.cihi.ca/CIHI-ext-portal/internet/en/documentfull/health+system+performance/indicators/performance/indicator_ent. The statistics for March reported no cases of hospital infections such as VRE or MRSA, but there were five cases of C. difficile, with no reported deaths. And overall, the infection rate in Sudbury is lower than the Canadian average.

However, since these are statistics the hospitals report themselves, Charney questions their value. While he has no knowledge of what’s going on in Sudbury specifically, he says the process itself is flawed and the rates are inaccurate.
“We don’t believe the numbers, because they’re self-reporting,” he said. “And self-reporting is junk science. We know the infection rates are higher.”

Other countries have found that a ratio of one nurse for every four patients results in significantly lower medical mistakes. But in Canada, nurses are typically overworked and suffer from fatigue and burnout. Plus cleaning budgets in Canada have been cut by 25 per cent since 1999.

“And that’s what can kill (patients),” he said.

Charney estimates that medical mistakes costs Canada’s health-care system at least $7 billion a year. He wants the provinces to do a rigorous cost-benefit analysis of what it would cost to make a significant investment in hiring more nurses and cleaning staff, versus the money that would be saved by reducing mistakes and infections.

“The Netherlands and Scotland have invested billions and significantly reduced their rates of medical mistakes,” he said. “We know beyond a shadow of a doubt the benefits of having more nursing and cleaning staff.”

He’s also calling for mandatory reporting of mistakes for all of Canada’s hospitals, more hospital beds overall and an improved patient-to-nurse ratio to ensure patients get the individual care they need to recover and leave hospital as quickly as possible.

For more information, go to www.ochu.on.ca.

 

Posted by Darren MacDonald