Hospitals Look At Ways to Curb Errors, Help Staff That Make Mistakes

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Posted on 18th March 2010 by gjohnson in Uncategorized

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Hospitals Look At Ways to Curb Errors, Help Staff That Make Mistakes

The Wall Street Journal Tuesday offered an intriguing take on how hospitals are trying to deal with errors by staff – including consoling physicians and doctors who make mistakes. http://online.wsj.com/article/SB10001424052748704588404575123500096433436.html

The story, headlined “New Focus on Averting Errors: Hospital Culture,” leads off by noting that errors by medical staffs lead to the deaths of an estimated 44,000 to 98,000 people a year.

The piece by one of the Journal’s star reporters, Laura Landro, says that hospitals are not only addressing the problem of staff errors but are also “coming up with procedures for handling – and even consoling – staffers who make inadvertent mistakes.”

A government advisory board, the National Quality Forum, has crafted a Care of the Caregiver guide, which has hospitals treating “traumatized staffers” who made errors with patients as if they are patients, too. Those guides even suggest that such staffers take part in the investigation of the error as long as they are not believed to acted recklessly or intentionally.

Noting that sometimes hard to assign blame for an error, the story cites a case that happened at St. Mary’s Hospital in Madison, Wis., four years ago. A nurse, Julie Thao, mistakenly gave a 16-year-old teen, Jasmine Gant, about to give birth an IV with an filled with an epidural pain killer.

The baby was delivered through a Caesarian section, but the mother Gant died. Thao lost her job, and was prosecuted for criminal negligence.

St. Mary’s paid a $1.9 million settlement to dispose of the malpractice suit brought by Gant’s family.

A study on that case that will be published in the April issue of the Joint Commission Journal on Quality and Patient Safety. That study found that although Thao skirted some safety procedures, there were weak links in the safety guidelines that contributed to her error. That study was also critical of the way St. Mary’s fired Thao.

Eventually, Thao plead guilty to reduced charges of two misdemeanors, and her nursing license was suspended. But Thao, who once considered suicide, got work as a researcher with an official of the National Quality Forum.