High Reliability Helps Connecticut Hospital Reduce Safety Errors by 80 Percent
by Jane Weber Brubaker
In October, a nurse who had extensive contact with Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas became infected with Ebola. Although the worker had worn protective gear, the Centers for Disease Control confirmed the infection was caused by a “breach in safety protocol.” (AP) Shortly thereafter, a second nurse at the hospital tested positive for Ebola.
According to a statement subsequently released by the hospital’s nurses via National Nurses United, the country’s largest union and professional association of registered nurses, protocols were inadequate at best: “Were protocols breached? The nurses say there were no protocols.”
A watershed moment in health care came in 1999, when a report from the Institute of Medicine sent a wake-up call to health care organizations. To Err Is Human: Building a Safer Health System stated, “At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented.”
Unfortunately, the current number of premature deaths associated with preventable harm to patients is closer to 400,000, making hospital errors the third leading cause of death in the United States, based on estimates from a 2013 study by the Journal of Patient Safety.