As a Houston, Texas medical malpractice attorney, I commonly hear from patients that they feel that their doctors and nurses were just too busy to pay close attention to their condition and treatment.
When reviewing medical records in our lawsuits, I frequently encounter medication errors, which I believe are caused by healthcare providers speeding through their work without taking safety precautions.
In addition to experienced medical malpractice lawyers, accrediting organizations, like the Joint Commission, have unique insight into frequently-encountered medical errors. In 2017, the Joint Commission announced its Hospital National Patient Safety Goals, one of which targeted improving the safety of using medications.
The Joint Commission, by the way, periodically inspects and surveys hospitals, to ensure their compliance with mandatory policies and procedures designed to promote quality of care and patient safety. If hospitals meet the standards, they are accredited. If not, they are placed on probation or may not be accredited.
As a former hospital administrator, I know that hospitals take the accreditation process very seriously. Thus, I am pleased and encouraged that the Joint Commission has imposed new requirements that will help hospitals improve the safety of using medications.
Proper labeling of medications
New National Patient Safety Goal 03.04.01 requires hospitals to label all medications, medication containers, and other solutions on and off the sterile field in perioperative and other procedural settings.
From conducting on-site inspections, Joint Commission personnel observed that some hospitals had medications or other solutions stored in unlabeled containers that made it impossible to identify, with certainty, what they contained. In its rationale for this new requirement, the Joint Commission noted, “Errors, sometimes tragic, have resulted from medications and other solutions removed from their original containers and placed into unlabeled containers. This unsafe practice neglect basic principles of safe medication management, yet it is routine in many organizations.”
The standard of care requires nursing and other hospital personnel to safely handle medications, and to only administer medications that are ordered by a physician. In the rush and urgency of a surgery or operation, it is easy to see how there could be a mistake if the medications are not even labeled.
Reconciling home and hospital medications
Any time a patient is admitted to a hospital, nursing home, or rehabilitation facility, the standard of care requires the nursing personnel to perform a detailed task called medication reconciliation. This involves obtaining a complete list of all medications that the patient was taking at home, including names, doses, and frequency. This information is important because it allows hospital pharmacists and physicians to make sure that any new drugs that are ordered do not counteract or cause problems with medications that are already in your system.
The standard care also requires doctors to collect and document this information, as well, even for outpatient treatment.
From my experience in handling many medical negligence cases I know that there are, quite often, problems with the medication reconciliation process. Sometimes the nursing staff puts minimal effort into it. Other times, patients are unable to provide sufficiently-detailed information about the medications that they were taking at home.
This is why I recommend that patients keep a health journal, including the complete names of medications, doses, frequencies, who prescribed them, and on what date each prescription was filled. By taking your health journal to physician and hospital encounters, you can help to minimize the chance of medication problems.
The Joint Commission’s Hospital National Patient Safety Goal 03.06.01 imposes new standards for hospitals to meet concerning maintaining and communicating accurate patient medication information. Its rationale for these new rules includes the fact that, “Medication reconciliation is intended to identify and resolve discrepancies—it is a process of comparing the medications a patient is taking (and should be taking) with newly ordered medications. The comparison addresses duplications, omissions, and interactions, and the need to continue current medications.”
Of course, the standard of care requires hospitals to provide adequate training and guidance to its nursing staff on how to collect and reconcile current and newly-ordered medications, to allow safe prescription of medications in the future.
The Joint Commission now requires hospitals to follow new performance standards.
First, obtain information on the medications a patient is currently taking, upon admission to the hospital or being seen in an outpatient setting.
Second, the hospital administrators need to define the types of medication information to be collected in inpatient and outpatient settings. The requirements could be different for a patient that is being hospitalized, for example, as opposed to a patient who is just coming into the hospital for an outpatient radiology study.
Third, hospital staff must compare the medication information provided by the patient with medications ordered at the hospital, in order to identify and resolve discrepancies.
Fourth, hospital personnel must provide the patient or family members with written information on the medications the patient should be taking after discharge, or the end of an outpatient encounter.
Finally, the fifth performance standard requires hospitals to ensure that their personnel explain the importance of managing medication information to the patient, upon discharge.
We are here to help
While it is encouraging to see the Joint Commission efforts to raise the bar when it comes to patient safety and hospitals, medical errors remain common and rampant. Recent studies, in fact, have shown that medical errors are the third-leading cause of death in the United States.
If you or someone you care for has been seriously injured as a result of medical errors or malpractice, call 281-580-8800, for a free consultation with Painter Law Firm, in Houston, Texas.
__________
Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who focuses his practice on medical malpractice and wrongful death lawsuits against hospitals, doctors, surgeons, anesthesiologists, and other healthcare providers.
