medical errors essay conclusion

Medical Errors and Patient Care Quality Essay

The reliability of healthcare organizations is measured by the capacity to maintain a high quality of care over the years. Therefore, as much as several attributes can contribute to a safe and high-reliability culture, the most vital is preoccupation with errors. Every fault or near miss is an opportunity to learn and make amends. Therefore, healthcare organizations should be characterized by continuous education for quality enhancement.

The main reason for selecting the preoccupation with error attribute is due to its ability to promote the relentless pursuit of perfection and standardization of practice. According to Gaw et al. (2018), high-reliability organizations are always looking for what might go wrong to mitigate the effects. Moreover, errors during intake, assessment, diagnosis, and treatment have dire consequences and may be fatal. For instance, there are 254000 deaths in the United States every year resulting from human error (Guttman et al., 2019). The authors add that such errors are the third leading cause of mortality. The statistics show that it is time for healthcare providers to consider moving beyond the current safety and quality approaches and learn from human mistakes, regardless of how small.

As a leader, the first step for reinforcing the attribute is to set up high standards, guidelines and policies for practice. The aim is to ensure that medical professionals have a reference point for every step they take in the health continuum. The second step is to ensure that there is proper record keeping of every step from the time of intake to the discharge of patients. The rationale is to ensure there is that in case of an error, it is easy to identify. Finally, continuous research and professional collaboration are integrated I the strategy to have evidence-based solutions for mistakes and implement positive change. To reinforce the steps, it is vital to ensure that the errors are solved immediately, focusing more on learning instead of criticizing the person who made a mistake. The organizational environment should be enabled to ensure that people feel safe to share their errors and expect assistance from colleagues.

Gaw, M., Rosinia, F., & Diller, T. (2018). Quality and the health system: Becoming a high reliability organization . Anesthesiology Clinics , 36 (2), 217-226. Web.

Guttman, O., Keebler, J. R., Lazzara, E. H., Daniel, W., & Reed, G. (2019). Rethinking high reliability in healthcare: The role of error management theory towards advancing high reliability organizing . Journal of Patient Safety and Risk Management , 24 (3), 127-133. Web.

The cost of healthcare is continually increasing, and the cause is often attributed to several causes, including politics and insurance. However, the ineffectiveness and inefficiency are increasing due to the complexity of science in the medical field (Gawande, 2012). When healthcare started, autonomy was the most valuable attribute. Not anymore, since there are now at least four thousand medical procedures, 6000 prescription drugs, and other solutions that the medics are trying to deploy town by town and to each patient. However, it is becoming more apparent that doctors cannot know everything. The development of specialists handling a single patient does more harm than good.

Therefore, the solution is to adopt systems of healthcare in which all the components of healthcare are combined as a whole. The implication is that it is possible to recognize mistakes and successes and errors instead of data (Gawande, 2012). Once the failures are identified in a system, they look for solutions to improve health. They can use technology and other devices to make it possible to get a working solution (Gawande, 2012). It is vital to ensure that the medics have a checklist for the entire process to understand the process and reduce complications. The last solution is the capacity to implement the process, which is hard given that people resist change that critiques their practices.

Implementing the system requires a leader to first talk to the healthcare team in an organization to explain its relevance and agree that there is a valid reason for the change. Next, I will prepare a checklist for all the health procedures a multi-professional team should adhere to when managing a patient. It is vital that teamwork in cooperation and know each other by name to make communication and sharing of information easier. The process will ensure that people work as a system rather than as individual specialists.

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Medical Errors: Overview

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• First Online: 28 November 2023
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• Yaser Mohammed Al-Worafi   ORCID: orcid.org/0000-0002-5752-2913 2 , 3  

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Medical errors are a global concern, and their impact is particularly significant in developing countries. This chapter describes the prevalence, causes, prevention, management, challenges, and recommendations related to medical errors in developing countries. Medical errors arise from various factors, including communication breakdowns, diagnostic errors, medication-related issues, surgical errors, and systemic challenges. Preventive strategies encompass effective communication, standardized protocols, patient engagement, and a culture of safety. Managing medical errors necessitates prompt response, thorough investigation, learning from mistakes, and implementation of preventive measures. Challenges in developing countries, such as limited resources and infrastructure, pose unique obstacles. Recommendations include enhancing healthcare infrastructure, promoting patient safety policies, strengthening workforce capacity, improving access to technology, and fostering collaborations. These efforts can contribute to reducing medical errors and improving patient safety in developing countries.

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Al-Worafi, Y.M. (2024). Medical Errors: Overview. In: Al-Worafi, Y.M. (eds) Handbook of Medical and Health Sciences in Developing Countries . Springer, Cham. https://doi.org/10.1007/978-3-030-74786-2_276-1

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DOI : https://doi.org/10.1007/978-3-030-74786-2_276-1

Received : 17 May 2023

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Medical students' experiences with medical errors: an analysis of medical student essays.

Martinez W, Lo B. Medical students' experiences with medical errors: an analysis of medical student essays. Med Educ. 2008;42(7):733-41. doi:10.1111/j.1365-2923.2008.03109.x.

Medical students reported witnessing errors frequently, and felt that housestaff and attending physicians were reluctant to appropriately disclose errors to patients or provide support to those who committed an error. A prior AHRQ WebM&M commentary discusses the authority gradient that prevents students from openly discussing errors.

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Suffering in Silence: Medical Error and its Impact on Health Care Providers

Affiliations.

• 1 Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia.
• 2 San Antonio Military Medical Center, Fort Sam Houston, Texas.
• PMID: 29366616
• DOI: 10.1016/j.jemermed.2017.12.001

Background: All humans are fallible. Because physicians are human, unintentional errors unfortunately occur. While unintentional medical errors have an impact on patients and their families, they may also contribute to adverse mental and emotional effects on the involved provider(s). These may include burnout, lack of concentration, poor work performance, posttraumatic stress disorder, depression, and even suicidality.

Objectives: The objectives of this article are to 1) discuss the impact medical error has on involved provider(s), 2) provide potential reasons why medical error can have a negative impact on provider mental health, and 3) suggest solutions for providers and health care organizations to recognize and mitigate the adverse effects medical error has on providers.

Discussion: Physicians and other providers may feel a variety of adverse emotions after medical error, including guilt, shame, anxiety, fear, and depression. It is thought that the pervasive culture of perfectionism and individual blame in medicine plays a considerable role toward these negative effects. In addition, studies have found that despite physicians' desire for support after medical error, many physicians feel a lack of personal and administrative support. This may further contribute to poor emotional well-being. Potential solutions in the literature are proposed, including provider counseling, learning from mistakes without fear of punishment, discussing mistakes with others, focusing on the system versus the individual, and emphasizing provider wellness. Much of the reviewed literature is limited in terms of an emergency medicine focus or even regarding physicians in general. In addition, most studies are survey- or interview-based, which limits objectivity. While additional, more objective research is needed in terms of mitigating the effects of error on physicians, this review may help provide insight and support for those who feel alone in their attempt to heal after being involved in an adverse medical event.

Conclusions: Unintentional medical error will likely always be a part of the medical system. However, by focusing on provider as well as patient health, we may be able to foster resilience in providers and improve care for patients in healthy, safe, and constructive environments.

Keywords: medical error; resiliency; second victim; wellness.

Copyright © 2017 Elsevier Inc. All rights reserved.

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Medical Errors, Essay Example

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The literature that has been published on the topic of medical errors in health care present evidence indicating that there is a low level of awareness concerning this problem. Typically, medical errors are handled internally and it often becomes the responsibility of health care professionals to determine how these will be resolved and prevented. While national and local laws that are put in place to guide medical practice provide information that helps health care institutions understand the level of quality that is required, there is little support from these agencies in terms of actual implementation. As a consequence, medical errors are seen to be the responsibility of individual hospitals and employees and they are therefore silenced in the public domain.

There are many medical errors because practice standards have not evolved in a manner that is conducive to prevention. Many modern hospitals are dealing with budgetary crises that forces the administration to focus on determining how to work with limited resources rather than heightening safety standards. Furthermore, even when quality improvement initiatives are put in place, it is often challenging to establish suitable training programs that will ensure full compliance from staff due to a lack of time and resources available. Health care systems can report, monitor, and prevent medical errors from happening more substantially if health records are recorded on electronic health record systems and regularly accessed by each employee working with the same patient. This will allow them to gain a greater understanding of the initial interview and which medications have been prescribed, along with a wealth of other related information. Furthermore, this provides employees with the potential to communicate with one another more significantly, which makes a big difference to prevent medical errors that occur as a consequence of shift changes. Ultimately, switching records to a digital means will allow protocol to be checked which will help prevent against commonly made mistakes.

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How to Deal With Medical School Rejection

Students who don't get accepted to med school can develop a growth mindset to improve and overcome the setback.

Dealing With Medical School Rejection

Getty Images | iStockphoto

If you did not get into your top pick for medical school, wait to see what opportunities come your way.

Spring is when medical schools wind down their interview season and send letters of rejection to students who were not placed on an alternate list. This is distressing to good students who are used to achieving their goals and don’t understand why they were not accepted.

There are many ways unaccepted students can deal with this disappointing news. Some give up when they should not, but simply feel too discouraged. What they should do is look for the keys to improvement. 

Check Your Mindset

There is a great TED Talk by Carol Dweck, a psychologist and college professor who speaks about the two ways students react to failure. The first way is disastrous and ruinous, having what Dweck calls a “fixed mindset.” Typically, these are students for whom success has become an expectation. 

The other type of students have what Dweck calls a “growth mindset.” They know that they’re on a learning curve and have confidence that they can develop their abilities – they just don’t have the abilities now. 

This “not yet” attitude, as Dweck calls it, is part of the growth mindset. If students with this attitude fail a test, for example, they wouldn’t describe themselves as a failure and run from future challenges. Rather they would say they are not yet successful and embrace the opportunity to try again. 

We can all understand the difficulty people with a fixed mindset face when they perform poorly on an exam or fail at mastering a second language. But unless they can transform their fixed mindset into a growth mindset, they will be devastated by rejection, and that includes rejection from medical schools.

The good news is that they can change. 

If you feel you have a fixed mindset, you can work toward developing a growth mindset. First, know that every time you tackle a difficult challenge, as Dweck pointed out, you’re creating newer, stronger neurons, which will boost your intellect and abilities. Second, be honest with yourself in terms of getting into medical school. Take an honest look at your application and any interviews you had. 

Check Your Essays

If you didn’t get any interviews, why did that happen? Was it grades , MCAT , little volunteering, lack of shadowing or essays that were not helpful? Remember, fewer than half of applicants get into medical school. You need to have all the important ducks in a row. Yes, screeners very carefully read your essays.

Recently, a student approached me for advice to consider why he might not have received an interview at his dream school. Although there is no certainty, I suggested we look at his essays since everything else seemed to be excellent.

When we looked at his essays, he picked out the secondary essay that was likely a concern. It sounded overconfident and a little elitist. He looked at it and said, "It doesn’t sound very humble, does it?” Perhaps if he had read it with a scrutinizing eye before the submission, he might have seen a different outcome.

Since most secondary essays are written for a specific school, oversight in one may not affect other applications. 

Think about how well your essays and activity descriptions are written . Have advisers and colleagues critique them, and not with kid gloves. If you didn’t do well in a particular class or on the MCAT, is there enough to indicate how you have improved since then? Does the humility and willingness to learn from others come out in your essays?

Seek Feedback and Examine Yourself

If you were fortunate to have interviews but still didn’t get in medical school, scrutinize what might have gone wrong. After looking at the process, ask others for their input. This might include your premed adviser, staff in the medical admissions office and others who might be able to comment on your interpersonal and communication skills.

Last month, I was asked to help some students who had not matched. I asked them separately to write down as many questions as they could recall from their interviews. Each student wrote how they answered the questions and then individually reviewed them with me.

The exercise was very revealing. One student had a way of turning conversations toward his gym workouts, where he was passionate. His answers about people came across as matter of fact or rather flat. It is not that he is a bad candidate, but he really needs a lot of coaching and practice interviews before the next round. 

The other student began to see his mistakes as soon as he began writing down what he had answered.  He could even see through the progression of interviews that he had not learned from his mistakes in earlier ones and could have prepared much better than he did. This exercise alone seemed to help him, and I would recommend it for anyone whose interviews did not bring them success. 

Examine everything about yourself, from how well you interact verbally with others to how well you show interest in everyone you meet. 

There are many applicants who request advice and many have used it. Examples include a student who actively began a course in public speaking, others who sought treatment for anxiety, some who studied and retook the MCAT , some who practiced interviews with various faculty and some who took a gap year to allow for more science courses, volunteering or shadowing. 

I once spoke with a prospective student who demonstrated a fixed mindset. He wanted to talk with me about why he wasn’t admitted to multiple medical schools . In reviewing his application and interview notes, I identified multiple points where I believed he had opportunity to improve his chances for the next year. 

He argued on each point, and that was when I realized he wasn’t really asking for help. He was attempting to prove that the admissions committees were wrong about him. He simply could not accept that he was not yet ready for medical school. 

If an applicant isn’t ready to learn from what didn’t work and try a new approach, they might not be ready to become a physician. I will never be as good as I can be, but I will continue to learn from my mistakes. If applicants choose not to do this, it might be a time to reflect on other career options.

In medicine, we are always trying to improve individually and as a group. Lifelong learning is a true joy once you embrace it.

Another student was advised to take a course to improve his interpersonal communication . He knew he had to learn to be a better listener, how to explain his ideas clearly and how to demonstrate passion for what truly mattered to him. 

He was accepted to medical school the following year. But more important than that was his determination to get better in this area. He realized his patients didn’t just want a diagnosis and treatment, but also sincere communication. This is a great example of growth mindset. As he continued to improve his skills, he became a chief resident and later a faculty leader.

Keep in mind that opportunity abounds, even for those who get rejected by one, two or even three or more medical schools. If I were applying to medical school, I would approach rewriting an application and interviewing in the next cycle, being grateful for the opportunity to try again. 

As an aside, "What will you do if you don’t get into medical school this year?” is a frequently asked question. I was asked that many years ago, and some still use it today. Classic questions about your strengths and weaknesses are ways to show your resilience . Be thoughtful, humble – not fake humility – hopeful and enthusiastic during interviews. 

People with a growth mindset are able to see opportunities, while those with a fixed mindset see defeat. Those with a growth mindset are eager to try again and will try even harder. To them, a missed opportunity isn’t a reflection on their ability or intelligence. Rather, it’s an invitation to embrace effort, hard work and perseverance.

Medical School Application Mistakes

Tags: medical school , graduate schools , education , students

About Medical School Admissions Doctor

Need a guide through the murky medical school admissions process? Medical School Admissions Doctor offers a roundup of expert and student voices in the field to guide prospective students in their pursuit of a medical education. The blog is currently authored by Dr. Ali Loftizadeh, Dr. Azadeh Salek and Zach Grimmett at Admissions Helpers , a provider of medical school application services; Dr. Renee Marinelli at MedSchoolCoach , a premed and med school admissions consultancy; Dr. Rachel Rizal, co-founder and CEO of the Cracking Med School Admissions consultancy; Dr. Cassie Kosarec at Varsity Tutors , an advertiser with U.S. News & World Report; Dr. Kathleen Franco, a med school emeritus professor and psychiatrist; and Liana Meffert, a fourth-year medical student at the University of Iowa's Carver College of Medicine and a writer for Admissions Helpers. Got a question? Email [email protected] .

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Guest Essay

In Medicine, the Morally Unthinkable Too Easily Comes to Seem Normal

By Carl Elliott

Dr. Elliott teaches medical ethics at the University of Minnesota. He is the author of the forthcoming book “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,” from which this essay is adapted.

Here is the way I remember it: The year is 1985, and a few medical students are gathered around an operating table where an anesthetized woman has been prepared for surgery. The attending physician, a gynecologist, asks the group: “Has everyone felt a cervix? Here’s your chance.” One after another, we take turns inserting two gloved fingers into the unconscious woman’s vagina.

Had the woman consented to a pelvic exam? Did she understand that when the lights went dim she would be treated like a clinical practice dummy, her genitalia palpated by a succession of untrained hands? I don’t know. Like most medical students, I just did as I was told.

Last month the Department of Health and Human Services issued new guidance requiring written informed consent for pelvic exams and other intimate procedures performed under anesthesia. Much of the force behind the new requirement came from distressed medical students who saw these pelvic exams as wrong and summoned the courage to speak out.

Whether the guidance will actually change clinical practice I don’t know. Medical traditions are notoriously difficult to uproot, and academic medicine does not easily tolerate ethical dissent. I doubt the medical profession can be trusted to reform itself.

What is it that leads a rare individual to say no to practices that are deceptive, exploitative or harmful when everyone else thinks they are fine? For a long time I assumed that saying no was mainly an issue of moral courage. The relevant question was: If you are a witness to wrongdoing, will you be brave enough to speak out?

But then I started talking to insiders who had blown the whistle on abusive medical research. Soon I realized that I had overlooked the importance of moral perception. Before you decide to speak out about wrongdoing, you have to recognize it for what it is.

This is not as simple as it seems. Part of what makes medical training so unsettling is how often you are thrust into situations in which you don’t really know how to behave. Nothing in your life up to that point has prepared you to dissect a cadaver, perform a rectal exam or deliver a baby. Never before have you seen a psychotic patient involuntarily sedated and strapped to a bed or a brain-dead body wheeled out of a hospital room to have its organs harvested for transplantation. Your initial reaction is often a combination of revulsion, anxiety and self-consciousness.

To embark on a career in medicine is like moving to a foreign country where you do not understand the customs, rituals, manners or language. Your main concern on arrival is how to fit in and avoid causing offense. This is true even if the local customs seem backward or cruel. What’s more, this particular country has an authoritarian government and a rigid status hierarchy where dissent is not just discouraged but also punished. Living happily in this country requires convincing yourself that whatever discomfort you feel comes from your own ignorance and lack of experience. Over time, you learn how to assimilate. You may even come to laugh at how naïve you were when you first arrived.

A rare few people hang onto that discomfort and learn from it. When Michael Wilkins and William Bronston started working at the Willowbrook State School in Staten Island as young doctors in the early 1970s, they found thousands of mentally disabled children condemned to the most horrific conditions imaginable: naked children rocking and moaning on concrete floors in puddles of their own urine; an overpowering stench of illness and filth; a research unit where children were deliberately infected with hepatitis A and B.

“It was truly an American concentration camp,” Dr. Bronston told me. Yet when he and Dr. Wilkins tried to enlist Willowbrook doctors and nurses to reform the institution, they were met with indifference or hostility. It seemed as if no one else on the medical staff could see what they saw. It was only when Dr. Wilkins went to a reporter and showed the world what was happening behind the Willowbrook walls that anything began to change.

When I asked Dr. Bronston how it was possible for doctors and nurses to work at Willowbrook without seeing it as a crime scene, he told me it began with the way the institution was structured and organized. “Medically secured, medically managed, doctor-validated,” he said. Medical professionals just accommodated themselves to the status quo. “You get with the program because that’s what you’re being hired to do,” he said.

One of the great mysteries of human behavior is how institutions create social worlds where unthinkable practices come to seem normal. This is as true of academic medical centers as it is of prisons and military units. When we are told about a horrific medical research scandal, we assume that we would see it just as the whistle-blower Peter Buxtun saw the Tuskegee syphilis study : an abuse so shocking that only a sociopath could fail to perceive it.

Yet it rarely happens this way. It took Mr. Buxtun seven years to convince others to see the abuses for what they were. It has taken other whistle-blowers even longer. Even when the outside world condemns a practice, medical institutions typically insist that the outsiders don’t really understand.

According to Irving Janis, a Yale psychologist who popularized the notion of groupthink, the forces of social conformity are especially powerful in organizations that are driven by a deep sense of moral purpose. If the aims of the organization are righteous, its members feel, it is wrong to put barriers in the way.

This observation helps explain why academic medicine not only defends researchers accused of wrongdoing but also sometimes rewards them. Many of the researchers responsible for the most notorious abuses in recent medical history — the Tuskegee syphilis study, the Willowbrook hepatitis studies, the Cincinnati radiation studies , the Holmesburg prison studies — were celebrated with professional accolades even after the abuses were first called out.

The culture of medicine is notoriously resistant to change. During the 1970s, it was thought that the solution to medical misconduct was formal education in ethics. Major academic medical centers began establishing bioethics centers and programs throughout the 1980s and ’90s, and today virtually every medical school in the country requires ethics training.

Yet it is debatable whether that training has had any effect. Many of the most egregious ethical abuses in recent decades have taken place in medical centers with prominent bioethics programs, such as the University of Pennsylvania , Duke University , Columbia University and Johns Hopkins University , as well as my own institution, the University of Minnesota .

One could be forgiven for concluding that the only way the culture of medicine will change is if changes are forced on it from the outside — by oversight bodies, legislators or litigators. For example, many states have responded to the controversy over pelvic exams by passing laws banning the practice unless the patient has explicitly given consent.

You may find it hard to understand how pelvic exams on unconscious women without their consent could seem like anything but a terrible invasion. Yet a central aim of medical training is to transform your sensibility. You are taught to steel yourself against your natural emotional reactions to death and disfigurement; to set aside your customary views about privacy and shame; to see the human body as a thing to be examined, tested and studied.

One danger of this transformation is that you will see your colleagues and superiors do horrible things and be afraid to speak up. But the more subtle danger is that you will no longer see what they are doing as horrible. You will just think: This is the way it is done.

Carl Elliott ( @FearLoathingBTX ) teaches medical ethics at the University of Minnesota. He is the author of the forthcoming book “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,” from which this essay is adapted.

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