Summary
The Drive podcast episode hosted by Peter Etia focuses on patient safety in medicine with Marty McCary, a professor of surgery and public health researcher at Johns Hopkins. The episode discusses the evolution of patient safety in medicine, starting with a commission set up in New York state in the 1990s to address medical errors resulting in preventable adverse events. In 1999, the Institute of Medicine released a groundbreaking report estimating that up to 98,000 people die each year in the United States due to preventable medical mistakes. The report put into stone the idea that dying from medical mistakes, if it were a disease, would rank as the eighth leading cause of death. The episode also discusses the importance of creating a culture of speaking up and standardizing procedures to reduce complications, as well as the tragic case of a heart transplant failure due to a missed cross match that highlights the need for standardized procedures.
The episode also discusses the prevalence of medical errors in the US, with a survey finding that 10.5% of US doctors reported making a major medical mistake in the last three months. The opioid epidemic has emerged as the number one cause of death in the US among people under 50, with opioid deaths being a form of medical error. The movement towards "sorry works" and being honest with patients about mistakes has been beneficial in reducing malpractice claims. The episode shares two stories related to patient safety in medicine, one about a doctor who made a mistake and informed the patient about it honestly, which led to the patient developing trust in the doctor, and another about a nurse who accidentally gave a patient a paralyzing agent instead of a sedative, causing the patient's death.
The episode also discusses the case of Redonda Vaught, a nurse who was arrested and charged with negligent homicide and abuse of an impaired adult after making a medication error that resulted in a patient's death. The case caused controversy among healthcare professionals and nurses across the country who felt that the charges were unjust and undermined the fundamental doctrine of just culture in patient safety. Despite admitting to the mistake and raising funds for her legal defense, Voigt was found guilty and sentenced to three years of probation. The episode raises questions about the legal and political implications of medical errors and the need for a more supportive and just culture in healthcare.
The episode concludes with a discussion on the need for payment reform to incentivize hospitals to prioritize patient safety. The adoption of AI technology in healthcare to identify discrepancies in medical reports and scans is also discussed, with the current payment model needing to change to encourage the adoption of patient safety innovations. The movement for patient safety is formalized into a group called the Institute for Healthcare Improvement, and while hospitals are investing in safer technology, more attention needs to be paid to patient safety innovations. Overall, the episode highlights the importance of creating a culture of speaking up and standardizing procedures to reduce complications, as well as the need for payment reform to prioritize patient safety in healthcare.
