Could a new approach lower the number of surgical errors?

A shift in hospital and physician protocols could lower the number of surgical errors.

Many approaches have been adopted by facilities across the country in an attempt to lower the number of preventable surgical errors that take place each year. Among these have been:

  • The introduction of pre-surgery checklists
  • Training doctors, nurses and surgical techs on "worst case scenarios" to prevent errors that could happen in a high-stress emergency situation
  • Marking the surgical area and reviewing several times with the patient beforehand what type of surgery he or she is going to have
  • Implanting RFID tags into surgical instruments and implements (like scalpels, forceps, clamps, sponges, towels and retractors) to prevent them from being accidentally left in a patient
  • Ensuring adequate rest for surgeons and other operating room staff to prevent fatigue-induced mistakes
  • Making sure that accurate counts are performed of sponges and other items easily lost in a bloody surgical field prior to patients being closed up

While these various techniques have helped individual hospitals, surgery centers and other facilities lower their particular error rates, none of them has shown a definitive systemic impact across the medical industry. A relatively new approach - from a medical and legal standpoint, anyway - has championed by the federal Agency for Healthcare Research and Quality (AHRQ) and is gaining support across the country to reduce the number of potentially surgery errors suffered by patients.

Current culture

The current prevailing culture in the medical industry seems to be one of defiant silence in the face of any potential wrongdoing. Patients who suffer following a hospital-acquired infection, prescription drug error, birth injury, surgical error, misdiagnosis or other form of medical malpractice tend to generally be met with stony silence or evasiveness when they ask questions and seek answers about what went wrong. Time and again, we read in news stories about medical malpractice that patients or their surviving loved ones eventually filed a lawsuit because they "wanted answers."

The reason for this is two-fold: the first is likely that hospital administrators don't want to admit wrongdoing from a legal perspective, and the second has to do with the mindset of surgeons and other physicians themselves. Facilities might be hesitant to discuss the details of malpractice allegations because they fear that admissions could be used against them in a lawsuit.

Sometimes the unwillingness to discuss the matter stems from another source, however. Many doctors, surgeons in particular, find it necessary to maintain a certain high level of confidence (some might even call it arrogance) in their abilities in order to effectively do their jobs. Questioning that ability, even if the concern is warranted, can make it nearly impossible for a surgeon to function in the operating room. They are human, but some of them need to think of themselves as almost infallible in order to overcome the inherent anxiety resulting from literally taking other peoples' lives in their hands.

A new approach

The proposed approach supported by the AHRQ is known as CANDOR, which stands for "Communication and Optimal Resolution." Its main tenets are:

  • Tell patients and their families almost immediately once instances of "patient harm" have been identified
  • Reach out to caregivers to begin investigating the incident
  • Remain open to patient and family questions throughout the entirety of the investigation
  • Pause the billing process so that patients aren't receiving an influx of bills (or even collection notices) while they are dealing with a medical error
  • Wrap up investigations as soon as possible
  • Apologize for the harm done to patients and their families as a result of the facility/physician/nurse's actions
  • Negotiate financial settlements when instances of preventable harm, negligence or malpractice are discovered

This approach may seem basic to some, but it's a complete departure from the way medical malpractice allegations are currently handled. The hope is that transparency in the process of investigating and handling medical errors will help improve the way that patients are treated, thus lowering the overall rate of such mistakes. The corollary to reducing the number of errors is cutting the rate of malpractice filings, which could lower the cost of malpractice insurance and have a positive impact on healthcare expenses overall.

This new approach hasn't yet been widely adopted around the country. In the places it has been piloted, however, there are clear signs of success. Tragically, in the meantime, preventable medical errors are still harming or killing tens of thousands of patients each year.

If you or someone you love has suffered from the effects of medical negligence, you have legal rights. For more information about possible legal options at your disposal, contact the Des Moines law firm of Galligan Reid. Call them toll free at 800-217-9312, locally at 515-282-3333, or send them an email.