Indiana hospitals report ‘preventable errors’

Only one of 28 types of preventable errors was reported by both the Bloomington Hospital and the Monroe Hospital this year.

“It’s a patient safety initiative,” LeAnne Horn, director of Quality Improvement and Patient Safety for Bloomington Hospital, said. “I’m very proud that we are working as a state.”

In 2006, Governor Mitch Daniels required the Indiana State Department of Health to employ a medical error reporting system. Medical facilities are required to report the occurrences of what the health department defines as “preventable errors.”

The 2009 report was released by the department on Aug. 30. The report described the efforts medical facilities took to reduce preventable errors.

Bloomington Hospital reported they allowed a patient to develop severe pressure ulcers — also known as bed sores — after admittance to the facility, she said.

The development of pressure ulcers was the most common error reported to the health department in previous years. Because of this, Horn said, teams have been implemented to focus on prevention methods.

“Despite our best efforts, human error can and does occur,” she said.

Compared to previous years, Bloomington Hospital showed improvement with only one error in 2009. One error was reported in 2006, two in 2007 and four in 2008.

This is the first year Monroe Hospital reported a preventable error to the health department. Monroe Hospital reported an operation-related death in an otherwise healthy patient. The Monroe Hospital quality improvement staff was unavailable
for comment.

The 28 errors also include surgery on the wrong body part, surgery on the wrong patient and infant discharge to the wrong parent, among others.

Horn said Indiana is the second state to require medical facilities to report preventable errors to the state and the public.

Medical facilities in Indiana have ­— according to the report — improved their prevention methods in the past two years since the system was implemented.

The total medication errors that caused death or disability in the state also decreased to its lowest level in four years.

“One event is too many,” Horn said. “We continue to improve, and we’re dedicated to
patient safety.”