Let me tell you a little secret. I’m not very fond of air travel. In fact, when I am preparing for a flight like the one that I took recently to speak in Sacramento, I had to distract myself from picturing all kinds of plane disasters. But, really, what were the chances that my plane would be hit by lightning or have engine malfunction and crash over the Rocky Mountains? Pretty slim, right? In fact, the most fatalities from air travel were clocked in the year 1972 when 2,429 people died in air crashes around the world. Most years are well below 1000; and this is worldwide. Much can be said for the safety mechanisms hardwired into high-risk airline industry.
How do you think that compares to deaths from medical errors? A 2013 study in published in the Journal of Patient Safety found there are as many as 440,000 deaths from hospital errors each year; and that is just in the United States! This is equivalent to 1000 jumbo jet crashes a year or wiping out the entire city of Colorado Spring…every year.
This calculation of deaths from clinical errors is based on traditional hospital care information. Unfortunately, we have no nation-wide data collection process for correctional health care. What do you think, though? Is our patient care likely to be safer than that provided in hospitals? Possibly. However, there are indications that our delivery systems may be even more risky given the nature of our patient population and environment.
Keeping our patients safe from clinical error, then, is an important part of our professional practice. Patient safety emerged as a concern in the early 1990’s. The Harvard Medical Practice Study published in 1991 is credited with starting the movement when it identified higher than expected rates of preventable medical errors. Over the last two decades, the patient safety movement has developed into a primary focus in traditional settings but is only now gaining interest in correctional health care. Yet organizing health care processes around patient safety can be particularly helpful in a setting such as correctional health care where the fragmented nature of care delivery, the transient nature of the patient population, and the added application of security structures can overwhelm and overshadow patient care.
As health care clinicians, focusing on the best for our patients through a patient safety perspective is a satisfying way to view our role, our values, and our professional goals. In addition, a patient safety perspective allows us as clinicians to fully address the ethical basis of our profession – beneficence (doing good) and nonmalfeasance (not harming).
I made it to Sacramento unharmed; in large part due to the many safety mechanisms in place to be sure the flight was safe. Regrettably, I review many an incident in correctional health care that indicate missing or omitted safety procedures. How can we make correctional health care practice more like the airline industry? Any thoughts?