• July 2011

17 Big Strategies to Reduce Medical Errors

By Robin Strongin
Creator, Chief Blogger
Disruptive Women in Health Care

We all agree that medical errors are unacceptable. But in medical settings, where the staff is overworked, often underpaid, and almost always sleep-deprived, mistakes are bound to happen.

The following is a post by two prominent nurses. Anna Gawlinski, RN, DNSc, FAAN (pictured below), is director of Research and Evidence-Based Practice and an adjunct professor at Ronald Reagan UCLA Medical Center. Elizabeth Henneman, RN, PhD, CCNS, of the UCLA School of Nursing, is also an assistant professor at the School of Nursing at the University of Massachusetts-Amherst. Gawlinski and Henneman—along with several others—recently published a paper in the American Journal of Critical Care, entitled, “Strategies Used by Critical Care Nurses to Identify, Interrupt, and Correct Medical Errors.”

Here is their take on reducing medical errors.

It’s easy to criticize the current state of our health care system.

All over the place, even outside of Washington, DC, people are talking left and right (politically, that is) when they should be talking right and wrong (care, that is).

But one important talking point that’s almost always left out of the equation is our role, the role of the nurse. Or more specifically, the critical care nurse whose job it is to save your life or your family members’ lives if hospitalized in the intensive care unit (ICU).

With its latest effort to reduce medical errors through the National Patient Safety Initiative, the government is putting dollars behind this effort. Hospital ICUs not only house a hospital’s sickest patients, but they also account for up to 30 percent of a hospital’s costs.

As many as one in five patients die in the ICU and this is partially attributed to the severity of medical conditions and the high rate of health care-associated infections (HAIs).

However, we all know that medical errors also play a huge role.

Medical errors occur in the ICU. In the past, many have been of the mindset that they are inevitable. However, our study recently published in the American Journal of Critical Care illustrates that nurses can play a significant role in reducing medical errors.

It is commonly known and discussed that medical errors can be caused by both human and system error. While it is important to address the system problems, nurses are uniquely positioned to serve as a key player in the human “error recovery” process.

The results of our study indicate 17 strategies nurses can use to identify, interrupt, and correct common medical errors:

  • 8 strategies to identify errors: knowing the patient, knowing the “players,” knowing the plan of care, surveillance, knowing policy/procedure, double-checking, using systematic processes, and questioning
  • 3 strategies to interrupt errors: offering assistance, clarifying, and verbally interrupting
  • 6 strategies to correct errors: persevering, being physically present, reviewing or confirming the plan of care, offering options, referencing standards or experts, and involving another nurse or physician

These strategies show the nurse’s pivotal role in reducing medical errors.

But let’s also not forget the advancements that have been made with health care technology.

The Affordable Care Act and the Meaningful Use requirements are guiding where the industry is headed with respect to patient care. In the ICU, clinical decision support—an expanding requirement in phase two of Meaningful Use can help nurses make a difference in spotting and responding to medical errors.

Take sepsis, for example. This life-threatening illness is caused by bacteria that overwhelms a patient’s bloodstream. However, sepsis is also the number one most-preventable cause of death in hospitals.

If nurses have the ability to combine the strategies identified above with clinical-decision support tools, we can detect the subtle signs of sepsis before it becomes a crisis. As for the left and right, that battle may never come to an end. But as for right and wrong, these strategies are putting us on the right path.

About Robin Strongin and her blog, Disruptive Women in Health Care

Robin Strongin is an accomplished public affairs expert, with more than 25 years of experience working in Washington, DC. Her areas of specialization include health care, science, technology, and innovation. Strongin has worked with and for federal and state governments, regulatory agencies, Congress, think tanks, nonprofit organizations, corporations, coalitions, and trade associations.

She founded Disruptive Women in Health Care in 2008 to serve as a platform for provocative ideas, thoughts, and solutions in the health sphere. “We recognize that to accomplish this, we need to call on experts outside of the health industry,” she asserts.

She is also the president of Amplify Public Affairs, the next generation in public affairs, leading the way in the integration of new media and traditional communications strategies.

Contact Strongin by email, rstrongin@amplifypublicaffairs.net. Sign up to receive daily blog postings at www.disruptivewomen.net.