Electronic Health Reporter

By Tim Dubes, vice president of marketing, Ocrolus.

Human error at healthcare organizations is often associated with physicians unintentionally harming patients. While this scenario is common and serious, it’s not the only form of human error that takes place. Human error also happens in administrative roles. And sometimes, the mistakes can be just as damaging as those made in a clinical setting.

To improve patient care, healthcare organizations must root out human error in all its forms, whether it takes place on the operating table or in the back-office.

Medical Error: 5 Ways to Combat Mistakes Made by Clinicians 

There’s a reason most people associate human error in healthcare organizations with medical error. In 2016, the CDC estimated that 251,454 deaths were caused by medical error, making it the third leading cause of death in the US, behind only cancer and heart disease.

James Lieber, author of Killer Care: How Medical Error Became America’s Third Largest Cause of Death and What Can Be Done About It, has identified five treatment reforms that can reduce medical errors across healthcare organizations:

Integrate pharmacists into patient areas — Erroneous pharmaceutical orders and doses cause thousands of deaths every year. Research shows that embedding a pharmacist in patient areas can cut medical errors leading to death or severe harm by 94%.

Loop multiple healthcare experts into key decision making — Misdiagnosis, delayed diagnosis, and other diagnostic errors often result from a physician’s blind spots. Lieber suggests looping other doctors and healthcare professionals into diagnostic decisions to combat bias and limitations.

Adopt structured handoffs — Two thirds of all deaths related to medical error are caused by miscommunication during care transitions. Adopting structured handoffs that combine input between the patient, the new team, and the retiring team can eliminate confusion about the patient’s condition.

Enforce CDC guidelines for disinfection — 75,000 patients die every year from hospital infections. The CDC has explicit guidelines for cleaning medical tools, patient rooms, and other items in healthcare facilities. Lieber believes these guidelines should be mandatory.

Share patient data across healthcare organizations — Only 14% of clinicians share data with healthcare professionals beyond their organizations. Healthcare facilities must make sharing patient data a mutual priority to ensure quick and effective care.

As Lieber’s research shows, healthcare institutions can make concrete treatment adjustments to reduce medical error. But a less talked about form of human error also lurks within the medical bureaucracy. Human error in the back office, though less visible, can sometimes produce results that are no less damaging than medical error.

The Invisible Threat: Human Error in the Back Office

Administrative tasks, particularly processing paperwork, have always been an issue for healthcare organizations. Doctors in clinics perform nearly two hours of desk work for every one hour with patients. That’s why human error is often more likely to occur in the back office, as opposed to in a clinical setting.

Take, for instance, human errors that are made while determining Medicaid claims and eligibility. Medicaid eligibility errors, such as misapprising a patient’s income, can result in the rejection of qualified applicants and acceptable expenses. Since many Medicaid recipients are low-income patients that require intensive and complex care, any delay in coverage is potentially devastating.

Most healthcare organizations use human review to manually classify and extract data from Medicaid documentation, such as hospital bills, tax forms, and bank statements. This is a costly and time-consuming process, with error rates for data entry as high as 4%. That comes out to 400 errors per 10,000 data points, a significant number that could jeopardize care for a significant number of Medicaid applicants.

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