Occurrence Across Patient Care Process
Common Types of Medical Errors
Underlying Causes of Medical Errors
Introduction
Medical errors, which are deviations from a planned action or a wrong action in a healthcare setting, are a significant concern in healthcare, leading to consequences such as preventable harm and even death (Rodziewicz et al., 2024). With over 200,000 deaths annually in the United States caused by these errors, they are one of the leading causes of death in the country (Rodziewicz et al., 2024). Despite advances in medical science and technology, medical errors continue to have a profound impact on patient safety, healthcare costs, and public trust in the medical system.
Occurrence Across Patient Care Process
Medical errors can occur at multiple points in the patient care process, not just during diagnosis. As Dr. Pooya Beigi, founder of the Misdiagnosis Association and Research Institute (MARI) explains, mistakes may arise during paperwork, data entry, prescription handling, or even during the patient’s self-administration of medication at home (Blissy, 2024). Some of the most common types include surgical errors, diagnostic errors, medication errors, device and equipment errors, hospital-acquired infections, falls, and communication failures (Rodziewicz et al., 2024).
Common Types of Medical Errors
Surgical errors are among the most severe and can often result in permanent harm or death and are responsible for about 75% of malpractice cases involving surgeons (Rodziewicz et al., 2024). Common causes of these errors include miscommunication, clinical factors, and improper staffing measures of organizational procedures. Implementing preventative strategies such as surgical checklists and instrument counting are very important in ensuring patient safety and reducing these types of errors (Rodziewicz et al., 2024).
Surgical Errors
Surgical errors are among the most severe and can often result in permanent harm or death and are responsible for about 75% of malpractice cases involving surgeons (Rodziewicz et al., 2024). Common causes of these errors include miscommunication, clinical factors, and improper staffing measures of organizational procedures. Implementing preventative strategies such as surgical checklists and instrument counting are very important in ensuring patient safety and reducing these types of errors (Rodziewicz et al., 2024).
Diagnostic Errors
Diagnostic errors are another common type of medical error which occur when the correct diagnosis is not made in a timely manner or is miscommunicated to the patient (Rodziewicz et al., 2024). These errors can have consequences such as death or prolonged suffering of the patient (Rodziewicz et al., 2024). According to one study, around 12 million people in the U.S. are affected by diagnostic errors, and roughly one in three of those individuals suffer some form of injury as a result. (Rodziewicz et al., 2024). While misdiagnosis can happen for any disease or illness, conditions such as cancers, neurological disorders, cardiac, urological, or surgical complications, are the most common to be misdiagnosed (Rodziewicz et al., 2024). To reduce these errors, it is recommended for providers to use cognitive aids, such as algorithms, and to have interdisciplinary case discussions to make sure that the accurate diagnosis is given to the patient (Rodziewicz et al., 2024).
Medication Errors
Medication errors are another major type of medical error that are largely preventable. In acute care hospitals, medication errors occur at an estimated rate of 6.5 cases for every 100 patient admissions (Tariq et al., 2024). These errors can occur at any point in the medication process, from prescribing and dispensing to administering. Common medication errors include administering the wrong medication, incorrect dosages, or using expired medication (Rodziewicz et al., 2024). Preventative strategies such as computerized provider order entry, barcoding, and involving pharmacists in medication management can help reduce these errors (Tariq et al., 2024). Additionally, making sure that clinicians check medication names and dosages before administration can also reduce the number of medication errors (Tariq et al., 2024).
Device and Equipment Errors
Another type of medical error involves errors of medical devices. This error is typically due to design flaws, user errors, or device malfunctions (Rodziewicz et al., 2024). In order to reduce these types of errors, there should be strict protocols for device maintenance, increased staff training, and safety checks before devices are used in clinical settings (Rodziewicz et al., 2024).
Hospital-Acquired Infections
Additionally, hospital-acquired infections (HAIs) are another result of medical errors, which may lead to prolonged hospital stays, increased healthcare costs, and sometimes death (Rodziewicz et al., 2024). These infections are usually caused by improper hand hygiene, poor catheter care, or improper use of antibiotics (Rodziewicz et al., 2024). Preventive strategies to minimize the risk of this type of error may include strict hygiene protocols, antibiotic stewardship programs, and regular patient skin assessments.
Underlying Causes of Medical Errors
The underlying causes of medical errors can be categorized into active and latent errors, human factors, systemic issues, and technology failures (Rodziewicz et al., 2024). Active errors are those that directly cause harm to the patient, such as operating on the wrong organ or administering the wrong medication (Rodziewicz et al., 2024). Latent errors, on the other hand, are deeper system flaws that may not be immediately noticeable but can lead to active errors later (Rodziewicz et al., 2024).
Prevention Strategies
In order to reduce medical errors, preventative strategies must be implemented, some of which have been mentioned earlier. Tools like Situation-Background-Assessment-Recommendation (SBAR) have been shown to reduce communication related errors by up to 30% (Rodziewicz et al., 2024). By standardizing communication protocols, providers can ensure that vital information is conveyed clearly and accurately. Additionally, ongoing education and simulation-based training are another important strategy in improving decision making and teamwork (Rodziewicz et al., 2024). Healthcare providers who undergo regular training are less likely to make errors, as they are better equipped to handle complex situations (Rodziewicz et al., 2024).
Conclusion
Overall, medical errors are a serious and ongoing issue in healthcare that cause significant patient harm and financial costs. Surgical, diagnostic, medication, and communication errors are the most common, and their causes range from human factors and systemic issues to equipment failures. However, by implementing strategies such as improved communication, training, and systematic changes, medical errors can be significantly reduced.
References
Blissy. (2024, August 9). Why your skin issue might be misdiagnosed! Dr. Beigi’s Insights | The Blissy Experience Ep. 10 [Video]. YouTube.
https://www.youtube.com/watch?v=yA7PpiNM600
Rodziewicz, T. L., Houseman, B., Vaqar, S., & Hipskind, J. E. (2024, February 12). Medical error reduction and Prevention. StatPearls – NCBI Bookshelf.
https://www.ncbi.nlm.nih.gov/books/NBK499956/
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2024, February 12). Medication dispensing Errors and prevention. StatPearls – NCBI Bookshelf.
https://www.ncbi.nlm.nih.gov/books/NBK519065/
Provided and edited by the members of MARI Research, Error in Medicine Foundation, and MISMEDICINE Research Institute, including Kisha Patel, Bukky Alausa, and Dr. Pooya Beigi, MD. MSc.
