November 18, 2024 — A new study published in The BMJ has raised alarm over the persistent high rate of complications faced by surgical patients in hospitals, with more than a third of patients experiencing adverse events, and nearly 1 in 5 of those complications linked to medical errors. Despite decades of focus on improving patient safety, the findings suggest that hospitals are still grappling with serious gaps in care that continue to harm patients.
The research, led by a team at Harvard University, reviewed the outcomes of over 1,000 surgical patients across 11 hospitals in Massachusetts in 2018. It found that 38% of patients suffered at least one adverse event during their hospitalization, with many of these incidents deemed preventable. Among the 383 patients who experienced complications, half faced serious or life-threatening outcomes, and approximately 25% of the incidents were categorized as potentially preventable. Importantly, 10% of the adverse events were identified as definitively preventable — many of them stemming from medical errors.
This study, which follows the groundbreaking 1980s Harvard Medical Practice Study, aimed to assess whether the state of patient safety has improved over the past several decades. The results paint a sobering picture, suggesting that while some safety measures have been implemented, including electronic medical records and presurgery checklists, they have not been enough to significantly reduce harm to patients.
Medical Errors and Preventable Complications Remain a Major Issue
The study highlights several key areas of concern, including surgical complications, medication errors, and healthcare-associated infections. The most common adverse events occurred not in the operating room, but after patients were transferred back to their hospital rooms. These included falls, pressure ulcers, and infections, which are often preventable with proper care and monitoring.
For patients undergoing more complex procedures, such as heart and lung surgeries, the rate of complications was notably higher. The research also found that the risk of adverse events increased with the patient’s age, suggesting that older adults may be particularly vulnerable during surgeries.
Dr. David Bates, one of the lead researchers, expressed disappointment that the rate of complications remained largely unchanged from previous studies, despite advancements in medical technology and patient safety protocols. “It’s clear that the problem has not gone away. If anything, it’s even bigger than it was,” Bates said. “Hospitals are doing a better job of identifying issues, but we need to do much more to prevent them from occurring in the first place.”
A Personal Call for Action on Patient Safety
The study’s publication coincides with the release of a powerful editorial by Helen Haskell, a patient safety advocate whose son, Lewis Blackman, died in 2004 after complications from a routine surgery. Haskell, whose son’s death was caused by a medication error that led to a perforated ulcer, has been a vocal advocate for improved hospital safety standards. She founded the group Mothers Against Medical Error after her son’s death, and her work has focused on raising awareness about the devastating impact of medical errors.
Haskell expressed her frustration with the ongoing prevalence of preventable harm in hospitals, noting that many of the issues identified in the study, such as poor communication and lack of adequate monitoring, are long-standing problems that have not been adequately addressed by the healthcare system. “These are longstanding issues that are not being properly addressed, because I think they’re not as high in the consciousness of either patients or healthcare providers as they should be,” she said.
Moving Forward: Calls for Improved Accountability
Despite the sobering findings, there are signs of progress in patient safety. The study found that the introduction of electronic health records, which can alert healthcare providers to potential medication conflicts, has had a positive impact in some cases. However, Dr. Kedar Mate, president of the Institute for Healthcare Improvement, cautioned that the overall problem of medical errors is still far too widespread.
“While there have been improvements, the reality is that the rate of harm remains unacceptably high,” said Mate. “We need a more concerted effort to reduce errors, especially in complex procedures, and make patient safety a central focus of all healthcare organizations.”
Advocates are also calling for hospitals to implement better systems for regularly reviewing adverse events, as the study found that most hospitals review only a small fraction of cases where patients are harmed. Dr. Bates noted that standard approaches to identifying adverse events typically miss about 95% of cases, meaning that the true scale of the problem may be even larger than reported.
What Can Be Done?
While the responsibility for preventing medical errors ultimately lies with hospitals and healthcare providers, there are steps patients can take to reduce their risk. Dr. Bates suggests that patients ensure they are aware of the medications they are taking and their dosages, and advises having a trusted friend or family member present during hospital stays to help advocate for their care.
“Patients who are in pain or under heavy sedation may not be fully aware of what’s happening around them,” Bates said. “Having someone there to ask questions and ensure proper care can make a huge difference.”
The Path Forward
The study’s findings underscore the need for greater attention to patient safety in hospitals and renewed efforts to address longstanding issues that continue to result in harm to surgical patients. While there have been incremental improvements over the past few decades, the evidence suggests that much more work remains to be done to ensure that patients receive the highest quality of care and that preventable errors are reduced to a minimum.
As experts and patient advocates continue to call for better safety practices, the study serves as a critical reminder that, despite technological advancements and increased awareness, the fight to reduce medical errors and surgical complications is far from over.