Preventable Hospital Deaths: Why is this accepted and what can we do about it?  A Call for Action
Last night I had a chat about preventable hospital deaths and preventable deaths in general.  The conversation was triggered by a phone call from one of our VHC members and his knowledge of a recent preventable death associated with a treatment error.  We were wondering why there is no uproar about preventable deaths in general and why adverse outcomes in hospitals; specifically preventable deaths and injuries  seem to go … unnoticed.  The silence surrounding this issue is hard for me to comprehend?  Is it denial?  Is it “learned hopelessness”?  Is it part of “unconditional surrender” to The Business of Medicine?  Do people really believe they have no choice?  What is this inaction about?  Are people saying, “That can’t happen to me” in silence?   What can we do about it?
The words outrageous and atrocity come to my mind when considering the fact that the most vulnerable of the vulnerable are dying at an alarming rate  as a result of substandard care delivered in hospitals.  The estimated and reported preventable death rates in the US hospitals are variable but the conservative estimates range around 100,000 preventable hospital deaths per year (may be much higher — between 210,000 and 440,000 patients each year).
 What can we do to fix it?  Put adverse outcomes and money flow on display.  Huh?  Yes, if we put the numbers up there and encourage people to walk away from the “bad actors” and elective surgeries the problem will be fixed rapidly.
As I recall, NY State began displaying outcomes for cardiac surgery while I was at SUNY in Syracuse.  That was a brilliant move and it triggered quite a bit of commotion and motion toward better care.  Patients took themselves to the hospitals with better outcomes and hospitals made an effort to improve their outcomes.  Sure, there were games played with the numbers and screams claiming “my patients are sicker than your patients” … that points to another problem.
Now, we have the technology to expand that New York effort.  We need larger real time displays that cover outcomes from all the nations hospitals.  Money flow (with names) and outcomes should be on real time display.   I call it the “Greedometer”.
How about a campaign to follow the flow of money and the outcomes for every hospital in the nation?  Zero Profit & Zero Bonus UNTIL Zero Preventable Deaths and Zero Preventable Injuries.  Patients can be encouraged to hold off on any and all elective surgery unless or until the problem is resolved in their hospital.  That get’s administrative attention, because $$$ elective “bread and butter” surgery is “the thing” that funds the profit and bonus pot.
Hospitals can be put on color coded state and national maps (global for that matter) … and updated on a regular basis … preferably on a daily basis … all shades of RED (stop) YELLOW (caution) GREEN (go)
When 84 people die and 157 people are seriously injured due to a faulty ignition switch, GM gets appropriately hammered, it is all over the press and people can choose to walk away from GM vehicles, or not, depending upon their personal assessment of the situation.

“GM had argued it was protected from claims on vehicles pre-dating its 2009 exit from Chapter 11 bankruptcy. Plaintiffs in the lawsuits said the company had mislead the bankruptcy court by not disclosing the faulty ignition-switch issue, which it knew about in 2005. The ignition switch issue has now been linked to 84 deaths and 157 serious injuries.”

I expect some criminal charges will eventually come from this.  What do you think?

Preventable adverse outcomes, deaths and injuries that result from substandard care of the most vulnerable needs discussion (a page) and a concerted action plan.  We have the civil rights to address the issue.  Why are we avoiding this issue?  Let’s put preventable death on the map …

Thanks for your help.

Dr. Mike