Patient safety lapses in U.S. hospitals increased by 3% overall from 2003 to 2005, and top-performing hospitals had a 40% lower rate of medical errors compared with the worst-performing hospitals, according to an annual patient safety study released Monday by HealthGrades, HealthDay/Washington Post reports (HealthDay/Washington Post, 4/2). For the study, researchers examined the records of Medicare beneficiaries treated at nearly 5,000 hospitals between 2003 and 2005. According to the study, about 1.16 million preventable patient safety lapses occurred in 40.6 million hospitalizations of Medicare beneficiaries from 2003 through 2005, compared with 1.24 million safety lapses in nearly 40 million hospitalizations from 2002 through 2004. However, the report found that patient safety problems worsened between 2003 and 2005 by 2.03 incidents per 1,000 hospitalizations. According to the report, 247,662 deaths could have been prevented during those years if hospitals had made fewer medical mistakes. In addition, the study found that 10 of 16 indicators of safety at hospitals showed an increase in patient safety problems by an average of more than 11.5%. The indicators included accidental lacerations, infections caused by medical care, post-operative respiratory failure and foreign objects left inside patients' bodies. The greatest increases in patient safety lapses were reported in post-operative sepsis, up 34.3%; post-operative respiratory failure, up 18.7%; and infections caused by medical care, up 12.3% (Karash, Kansas City Star, 4/2). Six other indicators improved by an average of 8% (Black, Seattle Post-Intelligencer, 4/3). HealthGrades found that the number of deaths caused by "failure to rescue" patients whose health suddenly deteriorated declined by 6%, and the number of hip fractures that occurred following surgery declined by 9% (Campanile, New York Post, 4/2). According to the report, patient safety issues have cost Medicare an additional $8.6 billion between 2003 and 2005. Had all hospitals performed at the level of those in the top 5%, more than 34,000 deaths could have been prevented and $1.74 billion could have been saved, according to the report.

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Gregg Laiben, medical director of Primaris consulting firm, said that better tracking of medical errors likely contributed to higher reporting of patient safety problems. He said further reporting will improve patient safety in all hospitals, even those that are listed as the worst performers. "More hospitals are paying attention to these patient safety issues," Laiben said, adding, "It will take several years of diligent efforts to bring all of these numbers back down" (Kansas City Star, 4/2). Samantha Collier, HealthGrades' chief medical officer and the report's lead author, said, "The cost of medical errors at American hospitals in both mortality and dollar terms continues to be significant, and the 'chasm in quality' between the nation's top and bottom hospitals, which HealthGrades has documented in this and other studies, remains." She added, "But the nation's best-performing hospitals are providing benchmarks for the hospital industry, exercising a vigilance that resulted in far fewer in-hospital incidents among the Medicare patients studied" (HealthDay/Washington Post, 4/2).

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