Inpatient Safety Hasn’t Improved Since 1984, Study Finds

In 1984, the Harvard Medical Practice Study (HMPS) examined the medical records of hospitals throughout New York State for signs of adverse medical events, especially concerning adverse events that should have been preventable. When the study was published in 1991, it determined that nearly 4% of hospital admissions involved some sort of adverse event, with a quarter of those events being caused directly by preventable negligence.

To try to see if anything has changed for the better, in 2018, a group of doctors examined a random sample of 2,809 admissions from 11 Massachusetts hospitals. According to their findings, which were only recently published, inpatient safety only got worse as time has gone on.

Based on the recent study:

• Nearly 24% of hospital admissions involve some form of adverse event.
• About 23% of adverse events were caused by preventable negligence.
• Almost 33% of adverse events caused serious or fatal consequences for the patient.
• 39% of the adverse events involved a medication or drug error.
• More than 30% of the adverse events involved a surgical or procedural error.
• 15% of the adverse events involved falls, bedsores, and other nursing care failures.
• Close to 12% of the adverse events involved a hospital-caused infection.

When compared to the 1984 study, this information shows that the rate of adverse medical events at hospitals has increased by more than 600% across the decades. However, the rate of adverse events deemed “preventable” has stayed about the same. This seemingly contradictory conclusion could suggest that the definition of a “nonpreventable adverse event” is too lenient by today’s standards, so that percentage hasn’t increased as the rate of total adverse events has. Or it could show that medical recordkeeping has improved throughout the years, so it has become easier to identify adverse events.

Due to the uncertain meaning behind the result comparison, further research is warranted. However, no matter how the data is interpreted, it seems that inpatient safety has not improved despite the advancements in medical science and technology.

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