The conversation around tracking medical errors highlights a lack of safety cultures.
By Megan Headley
Why are medical errors the third leading cause of death?
It was a question asked frequently by the consumer press back in May 2016, in response to an article in BMJ (Makary & Daniel, 2016) that analyzed medical literature on such errors to better understand their contribution to deaths.
However, there’s a more pressing question that the article by John Hopkins researchers Martin Makary, professor, and Michael Daniel, research fellow, sought to address: Why aren’t we doing more research into strategies that can reduce medical errors?
Getting data on the problem
The goal of the BMJ analysis was to encourage strong research into and better reporting on preventing medical errors. Makary’s chief concern is that medical errors are not cited as a cause of death, which limits research into effective solutions.
As the John Hopkins researchers point out, causes of death are reported using codes from the International Classification of Diseases (ICD). Those causes not associated with an ICD code—namely, medical errors—are not captured. One result of this is that medical errors will never be listed on the Centers for Disease Control and Prevention’s annual list of the most common causes of death in the United States, which guides national research priorities for the year.
When ICD codes were first adopted nearly 70 years ago, medical mistakes weren’t broadly recognized as a cause of death. And in a culture where the emphasis is placed on assigning blame for problems rather than seeking solutions for improvement, there has been seemingly little interest in a broad, high-level investigation of strategies for reducing systemic medical errors and their impact on patient mortality. But by not capturing this data, healthcare organizations are losing out on a strong opportunity for improvement.
Makary and Daniel emphasize in their article that medical errors can’t solely be attributed to bad doctors. Most are the result of systemic problems stemming from challenges such as poorly coordinated care, fragmented insurance networks, or the lack or underuse of safety nets, as well as variation across physician practice patterns that lack accountability.