It's almost enough to make patients stay away from hospitals altogether.
Classen's numbers are even worse than those released last November by the U.S. Office of Inspector General, which said 13.5% of hospitalized Medicare beneficiaries experienced one or more adverse events during their stay, according to a sample of all Medicare discharges in October, 2008. "An estimated 1.5% experienced an event that contributed to their deaths, which projects to 15,000 patients in a single month," the report said.
Classen tells me that the GTT isn't used in part because hospitals don't know about it, – it's still very new – but also because it's expensive. To use the GTT tool meaningfully requires at least one senior clinical, highly trained professional (at a cost of about $100 an hour) to spend about 150 hours going through a representative sample of about 10% of a typical hospital's 3,000 discharge charts each month.
Also, he says, many hospitals think that the way they're currently tracking adverse events does the job quite adequately.
"It's a learning curve that a lot of places still have to go through," he says.
What's even more worrisome is that Classen says the hospitals selected for this study are already ahead of the curve. They already had extensive patient safety programs and are much further along in their patient safety and adverse event detection journey than other hospitals.
So there are 10 times more harmful medical errors than we knew about, even at the best hospitals.
As if that paper isn't enough to make you worry anew about the quality chasm, another article in the April edition of Health Affairs, by Jill Van Den Bos and colleagues at Milliman's Denver Health practice, estimates the number of hospital adverse events or medical errors resulting in death, is really double what was estimated by the Institute of Medicine's 1999 report, "To Err Is Human" or 44,000 to 98,000 a year.