A recent analysis published in BMJ by Dr. Martin Markary and Michael Daniel highlight the fact that medical error is not reported on death certificates or in rankings for cause of death. Their estimate of patient deaths associated with medical error place it as the third most common cause of death in the US after heart disease and cancer, based on comparisons to causes of death compiled by the CDC. They urge systems to move towards collecting better data for research and prevention efforts.
They summarize definitions of medical error by broadly, defining it as “an unintended act […] or one that does not achieve its intended outcome, […] an error of execution, […] an error of planning, or a deviation from the process of care that may or may not cause harm to the patient” either at the individual or system level. Here at ASCENT, we echo the importance of designing and developing patient safety solutions at the system level to improve patient safety.
Several reports have estimated the annual deaths from medical error in the US in the past, though the authors find these rates to be underreported or outdated. Makary and Daniel extrapolate a medical error mean rate of 251,454 deaths per year, using several studies published since the 1999 Institute of Medicine (IOM) report on medical error. This updated estimate was calculated using the total number of US hospital admissions in 2013.
Their suggestions include collecting better data, as currently, deaths caused by errors go unmeasured based on the format of death certificates in the US used to compile national statistics. When errors more visible, conversations can begin around the science of improving safety. Markary and Daniel note that more appropriate recognition of the role of medical error in patient death could “heighten awareness and guide both collaborations and capital investments in research and prevention.”
Makary Martin A, Daniel Michael. Medical error—the third leading cause of death in the US BMJ 2016; 353 :i2139. http://www.bmj.com/content/353/bmj.i2139
Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. National Academies Press, 1999. http://www.ncbi.nlm.nih.gov/pubmed/25077248