Boeing takes action to reduce MEDICAL MISTAKES

As a Leapfrog Group member, Boeing is helping make health care safer by opening doors to valuable information

BY STEPHEN SZEHNER

Why focus first on mistakes in hospitals? Although a visit to the doctor may be more common, your health can be more significantly affected by the care you receive while hospitalized.

Preventable medical mistakes are the fifth-leading cause of death in the United States, taking more lives annually than car accidents, breast cancer or AIDS, according to the Institute of Medicine, a national health care advocacy group.

Medical mistakes happen daily. A 1999 Institute of Medicine report found that preventable medical mistakes kill up to 98,000 patients in U.S. hospitals each year.

In an effort to make medical treatment safer, Boeing joined The Leapfrog Group, a coalition of more than 100 private and public organizations working together to reduce preventable medical mistakes in the health care industry.

"We can't control every health care situation, but we can improve the availability of useful, value-added information," said Greg Marchand, Boeing Health and Welfare Operations senior manager and Leapfrog representative. "Our active role in Leapfrog illustrates the company's concern about the well-being of our employees, retirees and their families."

Three patient safety practices

Based on scientific evidence from Dartmouth School of Medicine, Leapfrog has identified three safety practices likely to reduce the number of preventable medical mistakes occurring in America's hospitals.

The group encourages health care consumers to consider these three safety practices when choosing a hospital:

• Computerized physician order entry: Database or software applications that help eliminate confusion over paper prescription orders and alert doctors to negative drug interactions or other possible problems.

• Evidence-based hospital referrals: Data that helps identify hospitals with the most experience in performing specific, complex procedures.

• Intensive care unit staffing: Use of intensivists (specialized critical care physicians) in hospitals to manage intensive care patients for at least eight hours a day.

Researchers at the Dartmouth School of Medicine estimate these three safety practices combined could prevent 60,000 hospital deaths related to medical mistakes.

Preventing Rx mistakes

More than one million mistakes involving prescription medication occur each year in U.S. hospitals. Many of these mistakes are due to handwritten prescriptions, which are hard to read and can lead to dispensing the wrong drug. Incorrectly filled prescriptions also are responsible for dangerous overdoses and interactions.

Research indicates that computerized physician order entry systems could reduce --serious medication mistakes by up to 86 percent each year. When prescriptions are computerized, your physician enters orders into a computer rather than writing them down on paper, and the prescription is automatically checked against your current information for potential mistakes or problems. This helps your doctor by supplying the background needed to select the best drug treatment for your condition.

Evidence-based referrals

When you need specialized medical care, your doctor may refer you to another professional with expertise in your particular ailment. With evidence-based hospital referrals, the same principle is applied to certain medical procedures requiring hospitalization.

It's a simple truth: Patients who go to hospitals with a history of good results in performing certain procedures have the best chance of surviving and successfully recovering. For example, more than 100 studies published in leading medical publications such as the New England Journal of Medicine and the Journal of the American Medical Association have shown that patients usually get better results at hospitals that perform a high volume of certain types of surgery.

By tracking hospital data on six complex medical procedures and posting this comparative data on the Internet, Leapfrog lets you and your physician evaluate hospitals on the basis of frequency of procedures performed annually. When faced with the need for one of these procedures, you may then identify which of your local hospitals most frequently treats your condition.

Focus on intensivists

Your health is most vulnerable during an intensive care unit stay. Having access to the right experts during this period could mean the difference between life and death. Studies indicate that at least 10 percent of patients who die every year in ICUs could have lived if care were managed for at least eight hours a day by "intensivists." These are physicians specially trained to care for critically ill or injured patients, whose primary focus is treating ICU patients. As a result, intensivists are more familiar with the complications that can occur in an ICU and are better prepared to provide that care, thus minimizing errors.

Your health at stake

Medical mistakes not only have serious physical and emotional implications, but they also contribute to the increasing cost of health care. Boeing spends more than $1.7 billion a year on health and welfare costs for employees and those retirees and dependents who are covered under the company's benefits programs. Current estimates project that Boeing medical costs will increase by more than 15 percent annually during the next few years.

Medical mistakes are preventable. But employees can make a difference by researching whether their local facilities follow the three Leapfrog recommendations at these times:

• Before scheduled hospitalizations, when you have the time to be thorough.

• During annual enrollment. Hospital networks vary by medical plan. If you have a choice of medical plans, investigate the hospitals and see how they rate against the Leapfrog safety practices. If your hospital has completed a recent Leapfrog survey (which assesses its progress with these practices), you can find this information on Leapfrog's web site at www.leapfroggroup.org

• When considering a new doctor. Check the safety practices in place at the doctor's affiliate hospitals.

• When helping family and friends choose health plans, doctors and hospitals.

For more details on The Leapfrog Group or how you can put its research to work for you, visit www.leapfroggroup.org

And look for more information in the coming months about what you can do to help prevent medical mistakes.