Hospitals neglecting safety, doctors claim

By MARTIN JOHNSTON

New Zealand public hospitals are investing too little in safety systems, say two leading health-quality experts.

One of them, Green Lane Hospital director of anaesthesia Professor Alan Merry, said last night that the spending might even be declining as health boards struggle with deficits.

Research figures in today's New Zealand Medical Journal - and previously reported in the Herald - show 10.4 per cent of public hospital patients suffer "adverse events".

The study defines "adverse events" as unintended, disabling injuries caused by healthcare.

They can include prescribing penicillin to someone who is allergic to it, or failing to diagnose cancer because standard tests were not used.

Thirty-five per cent of the adverse events were "highly preventable".

Nearly 15 per cent of patients who experienced an adverse event suffered permanent disability or died, the researchers, led by Professor Peter Davis of the Christchurch Medical School, found.



In a journal editorial, Professor Merry and Dr Mary Seddon, of Middlemore Hospital, say drug prescribing and administration are known to be high-risk areas.

"Dramatic" reductions of up to 90 per cent in adverse drug events had been achieved with initiatives such as employing clinical pharmacists on hospital ward rounds, computerised prescribing systems, hand-held electronic drug guides, and use of computer bar-codes.

But very few New Zealand hospitals had enough clinical pharmacists to attend ward rounds, none had electronic prescribing systems and only a few had tested a limited system of electronic drug administration.

"Instead, we rely on exhorting hospital staff to try harder not to make mistakes," say the authors.



The Ministry of Health says computerised drug prescribing and administering systems are expensive and hard to maintain, so their introduction has to be carefully considered.


Herald feature: Our sick hospitals