Medical mishaps clogging up health care

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Canadian Press

Toronto - Patients who've experienced medical errors are clogging up a huge number of available hospital beds in Canada, potentially absorbing as many hospital bed resources as all women experiencing pregnancy and childbirth, a new report suggests.

As many as 1.1 million hospital days may be attributable to correcting the problems caused by so-called adverse events, the Canadian Institute for Health Information said in its annual report.

The report builds on a recently released landmark study which sought to establish for the first time the rate at which things go wrong in Canadian hospitals and what impact that has on the patients receiving care. That study, by Prof. Ross Baker of the University of Toronto and Dr. Peter Norton of the University of Calgary, found that one in 13 people experienced an adverse event while in hospital and that preventable errors may be contributing to between 9,200 and 24,000 deaths a year. The chairman of the Health Council of Canada said those numbers startled even system insiders.

Michael Decter, who was chair of the institute of health information when it agreed to co-fund the Baker-Norton study, said he'd initially hoped the study would show the long-accepted estimate of 10,000 preventable deaths was on the high side.

Instead, it suggested it was at the low end of the range. "So this is a massive problem which is only going to be dealt with by very thoughtful effort," Mr. Decter said at a news conference. "Not by blaming people but by finding a way of bringing the errors out into the open so that we can find better ways of doing things." The institute helped shed more light on the scale of the problem by analyzing some of their own data, gathered from hospitals across the country, as well as the released Baker-Norton data and information from other sources.

It suggests:

- One in nine adults contract an infection while in an acute care hospital. The number among children is one in 11. Urinary tract infections, wound infections and pneumonia are the most common of these.

- One in 20 women experience third or fourth degree tears during childbirth.

- Birth trauma occurs in one in every 81 births. Trauma can range from a dislocated shoulder to much more serious problems.

- One in 1,100 seniors break a hip during a fall while in hospital.

- One in 6,700 people who have surgery have a foreign object, things like a sponge or a surgical instrument, left in them during surgery.

The report noted that a recent survey of Canadian health-care professionals found that nearly 70 per cent felt the under-reporting of adverse events was a serious or somewhat serious problem in this country. But another showed that many doctors feel the need to cover up medical errors; 42 per cent said in a survey in 2000 that they felt pressure not to reveal mistakes. Meanwhile a survey of the public, also cited in the report, showed that three-quarters of people believe that the threat of lawsuit is a powerful motivator for reform of the health-care system to improve patient safety. Effecting change in the culture of hospitals is key to reducing the rate of adverse events, all the experts say. But they say it reconciling the need to expose where the problems lie with the risk of litigation remains a challenge.

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