Back Button
Menu Button

Research on ‘Medical Errors’ Published in Journal of Patient Safety

NOTE:  Our peer-reviewed article concerning the prevalence of medical errors experienced by Iowans has been published in the September 2020 issue of the international publication, Journal of Patient Safety (JPS).  The article summarizes the experiences and opinions of a statistically representative sample of 1,010 Iowans, and provides new insights on approaches Iowa can take to determine the extent of the problem and develop solutions to obtain safer care for patients. 

The article, “Medical Errors in Iowa: Prevalence and Patients’ Perspectives,” was co-authored by myself and two others: David R. Andresen, PhD and Andrew Williams, MA. The article reports that medical errors, also known as preventable adverse events, are seldom voluntarily reported by healthcare providers in Iowa and the U.S.

Quantifying the magnitude of the medical error problem is an essential first-step toward solving these safety issues. The hope is that vulnerabilities in the healthcare delivery process will be exposed so that solutions can be found. However, the U.S. does not have a bona fide national strategy to assess medical errors, and, as a result, hospitals and clinicians around the country do not report medical errors accurately and consistently.

The JPS article suggests there is no single method for healthcare providers to promote full, transparent reporting of medical errors. However, the approaches described can serve as a counter-balance to lax provider reporting that includes the patient experience and perspective:

  • Implement mandatory provider reporting and appropriate compliance enforcement. From this, reported errors can help medical organizations more clearly understand exactly what happened, regardless of the outcome of the error, and identify the combination of factors that caused the error or near-miss to occur.
  • Create a central state repository for patients to report medical errors, making sure the reporting process is uncomplicated.
  • Develop an on-going, independent, random-sampling process to survey patients (and family members) who recently received care to document the prevalence and nature of medical errors. This is the most disruptive approach. From this collection process, state authorities, medical providers and the public will gain critical insight on the prevalence of medical errors, allowing for improvements. When errors are not reported and discussed, providers miss crucial feedback and learning opportunities.

The survey process can originate from claims data available through Medicare, Medicaid and private insurance companies. Patient experiences with medical errors can be collected and monitored for each medical provider, who would then receive systematic feedback about these errors to facilitate improvement processes. Through this data collection, results of medical errors would eventually be publicly reported for each institutional provider (e.g. hospital, surgery center, etc.).

A vast majority of Iowans have positive experiences with the healthcare system in Iowa. However, nearly one-in-five Iowa adults (18.8 percent) report having experienced a medical error either personally or with someone close to them during the past five years. Of those, 60 percent say they were not told by the responsible healthcare provider that an error had occurred. The survey found that hospitals were the most frequent site of medical errors (59 percent), while 30 percent of errors occurred in a doctor’s office or clinic, four percent in nursing homes and seven percent at some other location.

Among many important findings, the Iowa survey found that nearly 90 percent of Iowans “strongly agree” that healthcare providers should be required to tell patients about any medical errors. Additionally, 93 percent of Iowans “somewhat agree” (30 percent) or “strongly agree” (63 percent) the public should have access to medical-error information for each hospital and doctor.

Iowans feel strongly that medical errors must not be hidden from the public and should be reported, both to the patient and to an appropriate regulatory agency. Quality of healthcare will only improve when leadership, organizational culture and patient engagement are fully aligned. When seeking healthcare, patients deserve truthful, timely and transparent information about medical errors. Additionally, insurance companies can also contribute by embracing the safety of care their members receive from the medical providers included within their networks.

To stay abreast of employee benefits, we invite you to subscribe to our blog.

The Iowa Employer Benefit Study© – An Iowa ‘Natural Resource’?

This week, Data Point Research (DPR), the research organization that I have partnered with for over 20 years, will send out the first invitations to Iowa employers to participate in this years’ Iowa Employer Benefits Study©. I’m looking forward to learning what this year’s findings will reveal to us – especially after taking a one-year sabbatical in 2017.

This study has become a two-decade ‘project’ for DPR and myself. In 1999, the first year of this study, I contacted Andrew Williams, president of DPR, to learn how we could conduct a randomized survey that would provide the necessary methodologies to reflect results of the entire employer community in Iowa. Taking this approach, we felt, was the safest and most efficient method to survey enough Iowa employers WITHOUT having to survey them all. DPR has proven to be a trusted partner to extract the benefits information. And, from this work, Iowa employers have come to depend on our annual results to benchmark their benefits with other similar employers.

Benchmarking our survey results continues to serve as a top tool used by leadership in Iowa organizations. It supports informed decision-making when identifying cost-effective employee benefits. Benchmarking helps:

  • Human Resource and finance leaders make benefit choices with confidence, and track progress over time based on using empirical evidence, rather than ‘gut feel’ or opinion.
  • Provide clear evidence of opportunities for employers to improve on cost-effective employee benefits, given the size and industry in which employers operate.
  • Place employers ahead of the pack on trends that develop in the Iowa marketplace.

The industries we track for employers are varied. Depending on the number of survey responses, the industries may include:

  • Overall – All industries combined
  • Finance, Insurance and Real Estate
  • Government and Public Education
  • Healthcare and Social Services
  • Manufacturing
  • Retail
  • Other Services
  • For-Profit only
  • Not-For-Profit
  • Government Only – Bargained
  • Non-Public – Bargained
  • Public Schools – Bargained
  • Trucking

We also distinguish results by employer-size (based on number of employees), because, after all, size does matter a great deal when it comes to breadth and scope of employee benefits.

The Iowa Study has been particularly relevant to Sue Bennett, compensation and benefits manager at Kirkwood Community College. Sue recently commented:

The Iowa Employer Benefits Study© has been extremely valuable over the years in reviewing the competitiveness of our employee benefits package. Other benefits studies provide data on a nationwide basis, but having data specific to Iowa is more useful. The most beneficial aspect of the survey is the ability to extract data based on industry type and size.

I have always believed in the importance of having empirical evidence to share with benefits consultants and their employer clients. Most recently, I received another ‘testimonial’ from John Monaghan, partner at PDCM Insurance, a Waterloo benefits consulting organization. Over the past decade, John has loyally applied our study results with his clients by using our benchmarking data to successfully guide them through the benefits decision-making strategies he employs.

If you are a benefits consultant or Human Resource professional, the Iowa Employer Benefits Study© should be considered one of Iowa’s best natural resources. For over 10 years, my clients have used the data in the study to develop benefit programs without guesswork. So often, benefit decisions that cost millions of dollars are made with a gut feel. This study provides the data to take the guesswork out and make sure every invested dollar counts. It provides the information to build a True benefits strategy.

John finished his comments with this:

My clients have made the adjustments to better attract and retain employees through the data provided by this study.

I am truly humbled by Sue and John’s comments. To me, ‘natural resources’ are items that people can use which come from the natural environment, such as oil, natural gas, other minerals, soil, forests and timber, etc.

When people, who are unfamiliar with my work, ask what I “do for a living,” I will sometimes jokingly tell them that I am both an “archaeologist and inventor.” They will then quizzically look at me and ask, “How so?” My response is simply, “I’m similar to an archaeologist because I dig for items that are not readily available for the public to find, and I’m like an inventor, because once this treasure has been found and exposed, I convert it into something usable for others.”

A natural resource for Iowa? I’m unsure about that, but my gloves are now back on my hands and I have begun the digging process to unearth the next treasures buried below the surface. Stay tuned as to what we may find!

To learn more, we invite you to subscribe to our blog.