Lawyer shares 5 reforms that could make hospitals safer, less deadly

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James Lieber, an attorney and author of the book Killer Care: How Medical Error Became America's Third Largest Cause of Death and What Can Be Done About It, recently wrote an opinion piece in The Wall Street Journal, sharing five reforms that could make hospitals less deadly.

1. Structure handoffs. Mr. Lieber cited a 2014 study in the New England Journal of Medicine showing that structured handoffs — categorizing illness severity, medical actions and crisis contingency planning — can decrease adverse event rates by 30 percent.

2. Involve pharmacists. Pharmacists can help decrease medication errors when they are placed in patient areas, according to Mr. Lieber and a 2001 study.

3. Focus on infection. "The CDC promulgates evidence-based guidelines for disinfecting surgical tools, autoclaves, air and water sources, patient rooms and labs…Hospitals and nursing homes should promise continual adherence to CDC guidelines, and hospital graders should include compliance as part of their ratings," Mr. Lieber wrote.

4. Focus on diagnostic errors. Misdiagnosis, delayed diagnosis, partial diagnosis and overdiagnosis could be combated if physicians didn't have to make diagnostic decisions on their own, according to Mr. Lieber. "Physicians should be able to bring pathologists and radiologists into the loop to make sure the correct test is ordered and the right diagnosis is offered," he wrote.

5. Fight for EHR interoperability. Provider organizations and advocates should work to promote interoperability and sharing electronic health records "as soon as possible," according to Mr. Lieber.

"Embracing these reforms will help ensure that doctors first do no harm," he concluded. "Thousands of lives are on the line."

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