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Hospitals Must Become “Safety First” Environments

When discussing Illinois birth injuries, our focus is usually on the inadequate conduct of the medical providers involved. Each individual case is, in the end, about the mistakes made by a single set of actors. Sometimes a doctor does not act quickly enough to respond to an emergency situation. At other times a medical provider may apply too much force, unnecessarily leading to nerve damage. Still other situation result from nurses’ inaction or failure to properly report changes in condition to physicians.

When it comes to actually going into a Chicago birth injury trial, all that matters are the actions (or lack of actions) of the individuals and companies involved in that particular case. However, when discussing birth injuries generally and the need to limit their prevalence, the discussion must be about system-wide changes. Individual mistakes directly results from human errors, but systematic problems within our healthcare system can often be thought of as part and parcel of each individual error, because those systematic problems often create environments where those mistakes become more likely.

This was the point of a recent Huffington Post story about the need for hospitals to be “safety first” environments. The article was written by a Medicare advocate who dedicated the article to the child of a personal friend whose daughter was born with debilitating injuries due to medical malpractice during her birth. The child had severe disabilities throughout her entire life and died recently at twenty seven years old.

The author reminded readers that these preventable injuries occur much more often than the public assumes. Ever since the landmark 1999 federal study (To Err is Human), however, those involved in the industry have known that tens of thousands of patients die each and every year because of mistakes made by their medical providers-including mothers and children during childbirth. The report suggested that just shy of 100,000 people died each year that otherwise would have survived had the medical care they received been up to the basic levels. Unfortunately, as the author notes, in the thirteen years since that study, few major changes have been made to actually address the underlying problems that were revealed. Instead of focusing on improvements with safety as the first priority, the healthcare industry has in some ways changed such that errors are more likely.

For example, many hospitals have been downsized and consolidated into vast complexes. In this way they are run like businesses, with profit maximization as the goal. It should not be too difficult to see how hospitals and businesses have wildly different goals. Businesses are always driven to cut costs, balancing inferior products with the market demand for cheap goods. Conversely, when hospitals act in this way-by cutting services and overextending staff members-patients ultimately receive worse care than they otherwise would. This doesn’t mean that the involved individuals ever intend to commit mistakes, but the pressures faced upon them increase the risk that potentially deadly errors actually occur. When insurance pressures are added to the mix, the risks of mistake increases even more. These companies increase co-pays, deny coverage, and then cut payments to doctors for services provided.

All discussions about preventing medical mistakes must take these system-wide problems into account.

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