Is reducing medical errors similar to improving transportation safety?

According to a recent op-ed, Jim Hall, former chairman of the National Transportation Safety Board, says, “Because American medicine accepts error as an inevitable consequence of treatment, our hospitals, insurers and government do little to respond to unnecessary deaths. If we are to address the problem in a serious manner, we must first change this culture.”

But a simple solution to reduce medical errors may be elusive, says emergency physician Graham Walker. He comments that the human body is significantly more complex than the transportation industry, writing, “I feel like there’s many more that can go wrong with humans–not just the patient, but also the multiple humans taking care of the patient.”

He also points out the unintended consequences of striving for zero medical errors, such as some of Medicare’s “never” events, like the goal of zero thrombotic events after orthopedic procedures: “So the hypercoaguable patients just won’t get orthopedic procedures, because orthopods just won’t touch them anymore, for risk of triggering a ‘never event,’ which the hospital won’t pay for.”

Although there’s no question we need to do better to reduce medical errors, poorly thought-out initiatives can potentially make things worse. And indeed, I wrote previously that, when it comes to some Medicare never events, “Penalizing hospitals for events that cannot be prevented is counterproductive and leads to unintended consequences, including driving up the cost of care by exposing patients to more testing, thereby decreasing access to medical care.”

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