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Make Patients Responsible for Reporting Medical Errors? Really?

by Mark Graban on October 23, 2012 · 6 comments

really 300x179 Make Patients Responsible for Reporting Medical Errors? Really? lean

Karen Wolk Feinstein, president and CEO and the Pittsburgh Regional Health Initiative, channeled the Saturday Night Live Weekend Update segment “Really!?!” in this recent op-ed titled “Don’t put this on patients: Sick people are supposed to monitor medical errors? Really??

I’m all for patient engagement and I certainly believe that patients should be aware of risks and dangers in the hospital, but I think the hospital is abdicating its responsibility, and it’s setting unrealistic expectations, if they are expecting patients to report (or even know about) medical errors or unsafe practices.

Karen writes:

Why is it voluntary in most settings for doctors to mark a surgical site before cutting, for staff to wash their hands, for hospital and examining rooms to be thoroughly cleaned, for safety checklists to be employed? Why do whistleblowers get marginalized? Why are interns and residents afraid to report mistakes they witness? Why are clinicians who often over-treat with unnecessary interventions and tests or who routinely under-treat and fail to perform evidence-based best practices allowed to continue doing these things? What if a patient isn’t even aware that medical mistakes are occurring? How could they tattle on their docs?

“Really??”

Read more:  http://www.post-gazette.com/stories/opinion/perspectives/dont-put-this-on-patients-sick-people-are-supposed-to-monitor-medical-errors-really-657941/#ixzz2A7nh0Ugf

She draws parallels to restaurants, asking why a person would eat at a restaurant that gives them a 25% chance of getting food poisoning. Do we rely on restaurant customers to report unsafe conditions in the kitchen or refrigerators?

I’ve made a parallel argument before, pointing out that airline passengers aren’t expected to double check the work of the pilots and, when you buy a new car, you aren’t expected to double check if the lugnuts on the wheels are tightened properly. My graphic that’s indicative of campaigns that encourage patients to ask doctors and nurses if they’ve washed their hands:

lug nuts 500x366 Make Patients Responsible for Reporting Medical Errors? Really? lean

I think the primary responsibility needs to be taken by hospital leaders and physicians… not the patients. Let the patients focus on their own health and recovery and comfort, not policing the system that is supposed to take care of them.


Mark Graban 2011 Smaller Make Patients Responsible for Reporting Medical Errors? Really? leanAbout LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the VP of Innovation and Improvement Services for KaiNexus.


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1 Brian Knoblauch October 23, 2012 at 8:50 am

Unfortunately, after many years of car ownership, I now check everything (that I can see and reach) that the mechanics touch while doing a job. I’ve had panels improperly installed, clips left off of replacement axles, dipsticks not pushed all the way in, among other things…

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2 Mark Graban
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October 23, 2012 at 8:51 am

You’re much more knowledgable than the average car owner, then!
Mark Graban recently posted..Just Call it “5S Six Sigma” Instead of “Lean Sigma,” PleaseMy Profile

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3 Al Norval October 23, 2012 at 9:58 am

Agree entirely Mark. The average patient doesn’t have the depth of knowledge to be able to detect a medical error. In addition to that, standards for medical practices aren’t visible. Without job conent knowledge or visible standards, it’s virtually impossible for people to be able to do anything but report the grossest and most obvious medical errors.
Sounds like defection rather than really trying to work to improve the system.

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4 Dean Bliss October 23, 2012 at 11:28 am

Great article. I agree with all that the average patient doesn’t know when an unsafe condition is created, so it’s ridiculous to suggest they should be responsible for their own safety. There are a few things (asking questions, waiting for the nurse to avoid a fall, etc.), but for the most part, the hospital and the providers need to ba accountable.

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5 Robert Drescher October 23, 2012 at 3:10 pm

Hi Mark

You got this one right, yes if we know a medical professional is doing something wrong we should naturally complain and point it out. But there are very few of us that have enough knowledge of medical practises to be able to tell if they are doing most of their job right or not. It falls upon those in any profession to protect their clients by treating them in a proper way and by policing their own members.

It is unfortunate that we have developed a society were bending the rules is common place and in fact is required because of dumb laws. Yet it makes it hard to get anyone to enforce rules in virtually any organization. Hence why people that blow whistles usually pay a price for it, which they shouldn’t, in fact they should be rewarded.

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