Simple Changes to Correct Medical Errors
Ebola paranoia has nestled into the
collective conscious of the western world. This is especially
poignant when one begins to digest the rash of medical precautionary
measures which nudged Ebola into the 24 hour news cycle. Some of the
critique levied onto the medical facilities and their staff is
justified and not without merit. That notwithstanding, the medical
field as a business entity has addressed these types of procedural
pitfalls both preemptively and forensically. One of the ways they do
this is by way of certification through The Joint Commission.
ALERT: for those of you directly or
tangentially within the medical field you might want to jump ahead;
you're already mind-numbingly familiar with The Joint Commission. For
those of you who are not as well acquainted with The Joint
Commission, then it is prudent to go over what this accrediting
organization does.
The Joint Commission is a
not-for-profit and independent organization which accredits and
certifies over 20 thousand health care organizations and medical
programs throughout the United States. In order to receive and remain
a Joint Commission certified health care facility, a series of
guidelines, procedures, protocols, clinical pathways and best
practices, that the commission set forward, need to be followed and upheld. Far more
than just a nitpicking watchdog The Joint Commission also establishes
longterm goals which aid the health care facilities in committing to
a shared vision of business practice.
Central to The Joint Commission's
longterm goals and visions is the concept of safety. This is an
umbrella concept which entails things like, avoiding patients
falling, mental or physical injury and medication errors . Although
an emphasis is given to patient safety, the safety of the health care
workers is also enumerated. In light of the procedural and mechanical
errors made by health care workers treating Ebola patients, the
necessity of adhering to the standards and goals set forth by The
Joint Commission is of even greater importance.
What is often overlooked or simply
never given credence are the more basic ways in which medical errors
could be curtailed. Here follows a few straightforward suggestions
for tinkering with the medical field in order to reduce hospital and
medical errors.
Too many names for the
same thing
A convention which arose in
Europe was the adoption of universal names of medical terms based on
Latin and Greek. Undoubtedly, this was done in conclave to better
accommodate medical teaching in the handful of prestigious
Universities on the continent.
Employing colloquial
terminology was useful dealing with non-medical people but grossly
inadequate when discussing it with other medical people across
Europe. As is often the case, man's hubris deconstructed a
standardization which was meant to quell egos. The result is that a
whole jumbled medical lexicon has evolved which is unnecessarily
confusing and rife with synonyms. Here are a few examples.
When referring to kidneys
they are either renal(Latin) or nephritic(Greek). Kidney stones are
renal calculi (pebbles in Latin). If one has bladder stones then these
become cystoliths (stones in Latin).
One can run into a Sesame Street like word game when referring to the
head: skull, capit (Latin), cranium (Latin) or the cephalic (Greek)
region.
Convert to the metric
system already
The consistent use of standardized
measurements is one of the cornerstones of scientific research and
discovery. It allows for peer review of experiments by facilitating
another pillar of scientific research: replication. The vast majority
of scientific research conducting the US is done utilizing one
standardized set of measurement; the metric system.
The metric system was first established
in France around 1799, the same year Napoleon Bonaparte the reigns of
power that war torn country. Although not confirmed, this adoption
might have been hastened throughout the European continent because of
Napoleon's eagerness to codify and govern more efficiently. Despite
the official sanctioning of the metric system in the US by the end of
the American Civil War in 1866, an colloquial adoption of the metric
system still hasn't materialized.
One way to reduce medical errors would
be a formal transition within American medical treatment.
Calculations of weight, height, length, temperature, depth and volume
are routinely done in the US customary units which have to be
converted to be applied to metric calibrations.
Lab values and scales all
need a make over: 0-10
As anyone who is in the
medical field can attest to; lab values and scales are the bread and
butter of recognizing either a pathology or a return to normalcy.
Knowing your blood sugar level helps to prevent the adverse effects
of either hyper- or hypoglycemia or whether or not the fever with a
spike in white blood cells means an infection throughout the body.
Daily lab values are
essential in caring and treating patients; especially when
administering or adjusting medications. Sadly, there hasn't been a
push towards standardization of lab values and scales. Some are done
parts per million or parts per thousand. Others are based on
increments of decimals attached to single digits like 1.3-1.7. Still
others are based on an arbitrary finite set like 80-100 or 45-60.
An overdue simplification of
labs and scales based on sets of 10 could reduce the feral nature of
establishing an interval scale. Something like 0-10 or 0-100 would
bolster medical accuracy substantially.
