Our leaders in Congress experience medical harm, too. On Monday, Politico reported that Pennsylvania U.S. Congressman John Murtha had died as a result of complications from recent gallbladder removal surgery at Bethesda Naval Hospital. A few days later, we heard that Murtha’s “complications” were followed by a surgical cut to his intestines which caused infection and further complications, according to Murtha’s close friend and colleague Representative Robert Brady (PA). The first Vietnam combat veteran to serve in Congress, Murtha died at age 77 at Virginia Hospital Center, where he entered three days after his surgery.
Representative Murtha was not the only Congressperson harmed by our health care system. Last summer, Senator Robert Byrd (WV) battled a staph infection he acquired in the hospital which extended his hospital stay longer than expected. Even Congress is not immune to the errors and infections that too many of us are familiar with.
Murtha’s medical error story reveals several ways hospitals should improve their care. First, hospitals should strive to prevent all errors and infection and implement basic practices that can improve surgical team communication and safety. According to surgeon Dr. Atul Gawande, a simple two-minute checklist can reduce complication rates by 36 percent and death rates by half, yet only 20 percent of American hospitals have adopted these lifesaving checklists. That’s a shame.
Second, hospitals should do more to provide higher quality discharge planning so that we can avoid costly readmissions. According to the New England Journal of Medicine, one in five hospitalized Medicare patients are readmitted within a month of discharge from the hospital and a third are readmitted within 90 days. Hospital readmissions cost us $15 billion annually, with 80% of those costs potentially preventable, according to the Medicare Payment Advisory Commission.
“Poor care transition is a major reason for preventable readmissions. Leaving the hospital is only the beginning of a process of recovery,” says Arthur Levin of Center for Medical Consumers. “People are discharged quickly after these minimally invasive procedures, typically without adequate instructions about what to be on lookout for in terms of symptoms of problems and what to do about them. In addition, a critical failing occurs when surgeons and hospitals don’t follow-up with the patient or family. A safety check, such as home visit follow ups, means that someone on the medical team has to arrange for that to happen.”
Aware of this problem, the federal Centers for Medicare and Medicaid (CMS) made some hospital readmission rates publicly available in July 2009. You can visit CMS’s Hospital Compare site to find out readmission rate data on 30-day readmission for heart attack, heart failure, and pneumonia.
In Congressman Murtha’s case, so much about what exactly happened is unknown by the public, but typically patients and their families are also in the dark. We hear from many people who were harmed and don’t know exactly what went wrong during their medical procedure, and it’s not because they lack medical expertise, it’s because they aren’t told. Surgeons and doctors don’t necessarily share that information, and patients are left to speculate and suffer.