Preventable in-hospital errors are the third leading cause of death in the United States after heart disease and cancer. An estimated 250,000 lives are claimed each year by medical errors which cost the nation $1 trillion in added healthcare costs. The statistics are chilling, no doubt. Would we tolerate two 747’s crashing every day? Or 9/11 occurring twice a week?
Childbirth is particularly prone to medical negligence. Obstetricians are one of the most highly sued specialties in malpractice lawsuits. Medical errors result in more than 25,000 infants being born with birth injuries each year. Some of these injuries are severe and permanent and some are not.
Yet, hospitals can make childbirth safer by stressing on a comprehensive obstetrics patient safety program. A study conducted by researchers at the Yale School of Medicine and published in the American Journal of Obstetrics and Gynecology showed that malpractice claims fell by 50 percent when the Yale-New Haven Hospital in Connecticut standardized obstetric care, improved communication and teamwork, and optimized quality review. Malpractice payments at the hospital fell from approximately $50 million to approximately $3 million in the 5 years after the program was implemented.
Similar findings were reported by the New York Weill Cornell Medical Center. An obstetrics safety program at this institution resulted in fewer adverse events and lower compensation payments. The results were a 99% drop in average claim payments and no obstetric malpractice lawsuits at the end of the 6-year period.
Here are some of the things hospitals can do to make childbirth safer:
Electronic health records (EHRs) may enhance patient safety and lower the possibility of medical errors. EHRs help physicians adhere to standard medical practice, for instance, by choosing the correct laboratory test. Specific features in the program can alert a physician about a possible medication error.
Dedicated attending obstetrician:
A dedicated on-call attending obstetrician at a hospital means that a doctor attending to one patient is not pulled away to consult on another patient. On a busy labor and delivery floor, having a senior obstetrician overseeing the department can have a considerable positive impact on patient safety.
Hospitals that have standardized protocols for the most commonly encountered clinical and surgical scenarios have a better safety record. For instance, oxytocin (Pitocin) is a drug given to induce women who are full-term and have not gone into spontaneous labor. Hospitals that have a standard protocol for Pitocin administration and a checklist for patient safety have a better chance of identifying situations that could be potentially harmful to the mother or the baby.
Color-coded safety labeling:
During childbirth, many different drugs are given to the mother, many of which can cause significant harm if given incorrectly or outside safe dosages. Color-coded safety labeling on pre-mixed drugs and solutions can help avoid inadvertent or accidental overdoses. Color coding helps lower the chance of confusion between similar looking medications, mislabelling, misreading a physician’s order, and communication errors. When hospitals follow color coding of IV lines and pre-mixed infusion bags, the incidence of drug errors is reduced.
Electronic fetal heart monitoring:
During labor, the baby’s heartbeat is often monitored electronically. This tells the obstetrician how well the infant is coping. If an obstetrician or nurses fail to note signs of distress on the fetal heart rate monitor, it could result in an adverse event. Hospitals that employ obstetrical nurses with an added qualification in the interpretation of electronic fetal heart rate monitoring have better safety records.