Thursday, March 14, 2019

Leading Causes of Death and Medical Errors

The leading diseases that cause death account for almost 75% of all deaths; and, the top 3 diseases account for over 50% of all deaths in the United States. During the past 10 years, the main culprits have remained relatively the same.
Leading Causes of Death in U.S. Bar Chart

As shown in the bar chart above, the diseases that are the leading causes of death are:
-- Heart Disease
-- Cancer
-- Stroke
-- COPD/Respiratory Diseases
-- Diabetes
Other top diseases include:
-- Influenza/Pneumonia
-- Alzheimer's
-- Kidney Disease

However, medical errors (e.g. surgeries, adverse drug reactions, prescription errors, infections, lab errors, defective medical devices, misdiagnoses, etc.) have become the Number 3 leading cause of death, accounting for at least 250,000 deaths each year!

Other studies report much higher figures, claiming the number of deaths from medical error to be as high as 440,000. The reason for the discrepancy is that physicians, funeral directors, coroners and medical examiners rarely note on death certificates the human errors and system failures involved. Yet death certificates are what the Centers for Disease Control and Prevention rely on to post statistics for deaths nationwide.
FYI: Every year, about 35 million people visit the hospital (average 4.8 days stay) in the U.S. That's about 96,000 people a day. Every year, about 2.5 million people die in the U.S. (56 million worldwide). In the U.S., that's roughly 6800 people that die each day (153,000 worldwide).
Note: Globally, the top 3 diseases are the same around the world as they are in the United States.

FYI: In addition to the increase in heart disease, cancer and diabetes, recently, autoimmune diseases have begun to skyrocket, primarily affecting women and young children.
Good News!
Although many of these disease are increasing each year, there are still strategies and activities that we can implement to prevent these diseases and, in some cases, even reverse the effects of these diseases.
The most important thing that you can do right now is to educate yourself about disease and nutrition, and learn why prescription drugs are not the answer, especially long term.
Unfortunately, most people ignore these numbers because most people don't expect this is going to happen to them (to die in the hospital or after surgery due to a medical error) -- until it does ... but, then, it's too late ... 
So, be proactive and begin to educate yourself and gradually change your diet over time. If you don't like the idea of changing your diet all at once, then, keep some of your favorite foods or comfort foods as part of your diet and make just small changes over time.

By taking it slow, you'll have a better chance of sticking with the diet. Also, the really nice thing about this kind of proactive strategy is that if you should develop one of these diseases, then, it will take you a lot less time to implement the complete diet and go "all in".

In addition, it is key that you learn how to protect yourself from medical errors if you should ever end up in the hospital.  Almost 68% of the deaths due to medical errors can be prevented if the hospitals/doctors implement some improved processes and procedures; and, if the public is more aware and takes the necessary precautionary actions.

Here are some things that you can do to protect yourself:

Finding the right doctor – Even though poorly trained doctors are not a direct cause of faulty medical treatment, knowing how to choose the right doctor is still paramount to receiving an efficient, safe and tested treatment. You should never choose to go to a physician with more bad reviews than good ones and should always verify his or her reputation from multiple sources.

Checking in the most adequate hospital – Secondly, checking the hospital you wish to get treatment or surgery in is mandatory. There are plenty of sites that rate hospitals based on mortality rate, success in treating certain types of diseases, specialized equipments, safety score. You can’t foresee all the issues that may appear, but being prepared and informed before choosing the hospital will take you a long way in receiving the treatment you need.

Choosing the right insurance – Last but not least, your medical insurance should cover the adequate treatment for your condition. If, for example, your doctor recommends a certain type of surgery that is not covered by your insurance, you should not bend your treatment to fit the insurance’s limitations, but rather try to expand it as to cover the recommended treatment. If not, try as much as possible to contract another insurance that is going to support the treatment you need.

The Top 10 Medical Errors that Can Kill You

The 10 most common errors that can occur during your hospital stay include the following:
#1. Misdiagnosis. The most common type of medical error is error in diagnosis. This is not surprising, since the right diagnosis is the key to your entire medical error. A wrong diagnosis can result in delay in treatment, sometimes with deadly consequences. Not receiving a diagnosis can be dangerous too; this is why it’s so important to aim to figure out what you have, not just a list of things that you don’t have.
#2. Unnecessary treatment. Patient advocate Patty Skolnik founded Citizens for Patient Safety after her then-healthy, 22-year old son underwent brain surgery that left him partially paralyzed and unable to speak. He fought for his life for two years before succumbing to multiple infections. His story is incredibly tragic—especially since his surgery was never needed in the first place. Like Michael, thousands of people receive unnecessary treatment that cost them their lives.
#3. Unnecessary tests and deadly procedures. Studies show that $700 billion is spent every year on unnecessary tests and treatments. Not only is this costly, it can also be deadly. CT scans increase your lifetime risk of cancer, and dyes from CTs and MRIs can cause kidney failure. Even a simple blood draw can result in infection. This is not to say that you should never have a test done; only to be aware that there are risks involved, and to always ask why a test or procedure is needed.
#4. Medication mistakes. Over 60% of hospitalized patients miss their regular medication while they are in the hospital. On average, 6.8 medications are left out per patient. Wrong medications are given to patients; a 2006 Institute of Medicine report estimated that medication error injure 1.5 million Americans every year at a cost of $3.5 billion.
#5. “Never events”. Virtually everyone has heard the story of operating on wrong limb or the wrong patient. There are more horror stories. Food meant to go into stomach tubes go into chest tubes, resulting in severe infections. Air bubbles go into IV catheters, resulting in strokes. Sponges, wipes, and even scissors are left in people’s bodies after surgery. These are all “never events”, meaning that they should never happen, but they do, often with deadly consequences.
#6. Uncoordinated care. In our changing healthcare system, the idea of having “your” doctor is becoming a relic of the past. If you’re going to the hospital, chances that you won’t be taken care of by your regular doctor, but by the doctor on call. You’ll probably see several specialists, who scribble notes in charts but rarely coordinate with each other. You may end up with two of the same tests, or medications that interfere with each other. There could be lack of coordination between your doctor and your nurse, which can also results in confusion and medical error.
#7. Infections, from the hospital to you. According to the Centers for Disease Control, hospital-acquired infections affect 1.7 million people every year. These include pneumonia, infections around the site of surgery, urinary infections from catheters, and bloodstream infections from IVs. Such infections often involve bacteria that are resistant to many antibiotics, and can be deadly (the CDC estimates nearly 100,000 deaths due to them every year), especially to those with weakened immune systems.
#8. Not-so-accidental “accidents”. Every year, 500,000 patients fall while in the hospital. As many “accidents” occur due to malfunctioning medical devices. Defibrillators don’t shock; hip implants stop working; pacemaker wires break. There are supposed to be safeguards to prevent these problems from happening, but even if they happen for 1 in 100 people, do you want to be that one person who experiences the “accident”?
#9. Missed warning signs. When patients get worse, there is usually a period of minutes to hours where there are warning signs. You may feel worse, and there are often changes in your heart rate, blood pressure, and other measurements. Unfortunately, these warning signs are frequently missed, so that by the time they are finally noticed, there could have been irreversible damage. 
#10. Going home—not so fast. Studies show that 1 in 5 Medicare patients return to the hospital within 30 days of discharge from the hospital. This could be due to patients being discharged before they are ready, without understanding their discharge information, without adequate follow-up, or if there are complications with their care. The transition from hospital to home is one of the most vulnerable times, and miscommunication and misunderstanding can kill you after you get home from the hospital too.
Hospitals recognize these medical errors as a significant problem, and they are taking steps to make care safer. But if you or your loved one needs medical care now, what you can do to ensure that your hospital doesn’t kill you? 

How to Prevent Medical Errors from Killing You or a Loved One

Unfortunately, more and more people are dying from non-life-threatening problems such as weight loss surgery, knee surgery, hip-replacement surgery, post op care, adverse drug reactions, prescription errors, infections, lab errors, defective medical devices, misdiagnoses, etc.

How to Prevent Errors in the Hospital
  • If you can, choose a hospital at which many patients have the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a lot of practice with their condition.
  • Make sure all health care workers who have direct contact with you wash their hands. Hand washing is an important way to prevent the spread of infections.
  • Before surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done. This can prevent errors and confusion during and after surgery. For example, surgery at the wrong site, such as left knee instead of right knee, is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopedic Surgeons urges surgeons to sign their initials directly on the site to operate on before the surgery.
  • When you get discharged from the hospital, ask your doctor to explain the treatment plan you will use at home. This includes learning about your medicines and knowing when you can return to normal life. Research shows that at discharge time, doctors think their patients understand more than they really do.
Take charge of your health care.
  • Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.
  • Make sure that someone, such as your primary doctor, is in charge of your care. This is especially important if you have several, ongoing health problems.
  • Ask a family member or friend to support your health. They can help keep track of things and speak up for you if you can’t. Even if you think you don’t need help now, you might need it later.
Learn more about your conditions, tests, and treatments.
  • Gather as much information as you can from your doctor. In some cases, you may want to get a second opinion. You can do research on your own as well to make sure you understand your problems and options.
  • Know that “more” is not always better. Find out why you need a test or treatment and how it can help you. You could be better off without it.
  • If you have a test, don’t assume that no news is good news. Follow up to get the results.
  • Ask your doctor if your treatment is based on the latest evidence. Treatment recommendations are available from the National Guidelines Clearinghouse. You also can ask your doctor about new trials or studies.
FYI: A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88% of medical errors involve the wrong drug or the wrong dose. This is one more reason why you should be a part of your health care. For prescriptions, know what medicine and dose you take. Check this when you pick up refills at the pharmacy. In the hospital, have in writing the medicine and dose you need. Keep track of this each time the doctor or nurse gives you drugs.

Next Steps to Wellness

If you're ready to begin reversing your diabetes naturally, then, get the ex-diabetic engineer's book Death to Diabetes.
If you're a health coach, then, also, get the Health Coaching bookScience of Diabetes book and/or the Health Coaching Program.

What Hospitals Can Do to Reduce Medical Errors and Deaths

There are many things that hospitals, doctors and pharmacies can do to help reduce medical errors and unnecessary deaths.
Simplify the process; reduce hand-offs
Many errors come from simple slips in transfers of materials, information, people, instructions or supplies. Therefore, anything that can simplify processes that are easier for people to understand and errors are easier to recognized will help reduce errors.
If a task is done the same way ever time – by everyone – there is less chance for error.
Reduce reliance on memoryDespite its incredible potential, human memory can fail us. As a result, any system that can help reduce errors caused by memory overload is a welcome addition to any system.
Improve information access
Good decisions require good information. Thus, people must have ready access to relevant and complete information or faulty decisions can and will occur.
Use constraints and forcing functions
The prompt after hitting the delete key — “Are you sure” —  is an example of a constraint that makes it more difficult to commit errors. Meanwhile, forcing functions, which are a “form of physical constraint in which the actions are constrained so that failure at one stage prevents the next step from happening” is another way to prevent errors.
Design for errors
Design systems that encourage error detection and correction before an accident occurs are invaluable to hospitals. Independent double checks are also a way to add a fresh perspective by having one practitioner cross-check the work of another. Research has shown that people find approximately 95% of mistakes when check the work of others.
Adjust work schedules
Practices such as failing to provide a sufficient number of staff members for the job (increasing workload) and frequently altering work shifts of employees (increasing fatigue) may ultimately lead to errors in human performance. Researchers, for example, found that nurses who work overtime were three times as likely to make an error if they worked shifts lasting 12.5 hours or more.
Adjust the environment
Human factors engineers have long recognized the error-producing factors in work environments, such as noise, poor lighting, heat, and clutter. Anything that can improve a working environment will help reduce errors.
Improve communication
To reduce mistakes, avoid indirect communication among the work team and cut down on the number of communications per task. For example, when discussing patients with same name or last name, a nurse and physician may be talking about care for two different people. Anything that mitigates that scenario, such patient assignment automation, will reduce potentially life-threatening errors.
Decrease reliance on vigilance
Relying on caregiver vigilance as the primary strategy for preventing mishaps is problematic. For example, when people are expected to devote too much of their attention to a problem or situation, they are apt to devote too much of their attention to a problem or situation, they are apt to become forgetful or complacent in their vigilance.
Provide adequate safety training
If faced with an unsafe situation, staff members need to know what steps they need to take and they must be given the power to act. For example, staff at Virginia Mason Medical Center are taught to “stop the line” and make an immediate report to a patient safety specialist when faced with a situation like to cause patient harm.
Choose the right staff for the jobFor any job or task, it is important to identify people the abilities necessary to perform the job safely. Staff members should be adequately trained in the competencies that are necessary for their job and have both the skill and knowledge to recognize a potentially medical error.
Engage patients and family members
Training patients to be more assertive and involved in the medical encounter has shown to be effective in increasing patient involvement in their own care and producing better health outcomes. Patients can be one more safeguard against untoward events by paying attention to the care being provided to them.

Medical errors are a fixable problem in healthcare, but to do so requires a dedication and commitment towards finding workable, viable solutions. Looking at medical errors from a systems perspective is a good first step.

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