Headlines highlight need for improvements

Published 12:00 am Thursday, May 19, 2005

There they are stacked two deep on the front page of our hometown paper. Scary headlines tell of suits involving doctors who left surgical towels inside the patient, resulting in infection and pain instead of relief and recovery.

What a shame!

The people who came to the hospital for surgery were seeking help and placed their trust in staff to keep them safe and aid them on the road to health.

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The doctors, nurses and staff who tried to help these unfortunate patients were dedicated to meeting that expectation and honoring that trust.

I bet not one of them reported to work thinking &uot;Let’s leave a foreign object behind in some unsuspecting person’s body today.&uot;

So, what happened?

Hospitals spend millions of dollars each year implementing safeguards and systems to maintain patient safety.

There are computerized monitors on sensitive equipment, screening mechanisms for staff, organized systems and double checks for safe surgical procedures,

ongoing education for every imaginable occurrence, and still the unthinkable happens. Systems fail, someone makes a mistake and a patient suffers harm.

This is not the outcome anyone wants.

In her book Wall of Silence, Rosemary Gibson explores the human face of suffering caused by medical error.

She presents cases of people from all walks of life whose medical treatment had disastrous results.

In most of these cases, the patient, injured and feeling betrayed, seeks legal help in obtaining compensation for the injury and punishing the doctors and institutions who failed to keep him safe. The doctors and hospitals, concerned about cost of liability, have limited contact with the patient and family. A &uot;wall of silence&uot; is maintained between the patient and medical personnel that benefits no one.

Gibson asked these injured individuals and the families of those who did not survive what they would like to happen in an ideal system of health care when a clinical mistake is made.

Their answers were golden wisdom honed by their personal suffering. They wanted four things. The first was full disclosure of exactly what happened by a medical professional who would take the time to help them understand and apologize if a mistake was made. They wanted patients and families not to be abandoned in their pain and confusion, but to be supported and comforted by representatives of the facility.

They wanted the clinicians who were involved in the care not to be abandoned.

One patient said, &uot;I feel sorry for those doctors.

You have to know they must feel bad about what happened.

I know they didn’t mean to do it.&uot; Another said &uot;I want to see physicians and nurses heal.&uot;

The last thing they requested was taking steps to see that the mistake did not happen again.

These are reasonable requests of caregivers, but the punitive and litigious environment that pervades our culture makes it difficult for health care entities to enthusiastically implement the recommendations.

The challenge is to develop mechanisms for fairly compensating the injured

while establishing a non-punitive method for physicians and hospital staff

to disclose mistakes and support the patient and each other.

There are a few model programs in the United States which have made inroads in moving toward the ideal.

In 1999, the 407-bed Veterans Affairs Medical Center in Lexington, Kentucky implemented a program that features proactive compensation for patients injured by negligence or error and improvements in clinical process to track and prevent medical errors.

Diane Artemis, the Virginia delegate to the grass roots patient safety organization PULSE (Persons United Limiting Substandards and Errors) calls the program a &uot;groundbreaking alternative to the traditional system of ‘blame,deny and sue.’&uot; Hospitals in California and Florida are incorporating into their regular procedures full disclosure and mediation for settlement of cases involving injury.

These initiatives are beacons of hope for a system where patients and doctors can maintain a dialogue that improves patient care-even when mistakes are made.

Beverly Outlaw is a Suffolk resident and occasionally writes a column for the News-Herald.