What can go wrong in a hospital?

What can go wrong in a hospital? The answer is anything. From Emergency Room provider doesn’t give treatment to a patient with potassium value of 6.5 thinking it is from a hemolyzed blood sample then patient coded on the floor (see here), to misinterpreted radiology reports, missing lab reports not reviewed by primary care physician, to a million things that could happen.

If you are a physician/medical student, you will benefit from reading horror stories happened in a hospital as 99% of our daily practice usually has some safety margin built-in, but that 1% of not-so-textbook clinical presentations/rare situations may sink you and you need to develop some sensitivity to that rarity.

There is a tendency among healthcare environment of underestimating the risks because those horror stories do have a low incidence rate. Nurses called you multiple times for false alarms on that telemetry patient and asked you to turn it off/discontinue the telemetry order, at that time can you imagine that specific patient was found a few hours later deadly cold and pulseless? You may brush it off as in your mind this event is so rare that it is almost impossible (see here).

Some good advice – stick to clinical routines, develop a wide differential diagnosis, build redundancy and double-check mechanism in your practice and be careful about those high-risk life-threatening potential diagnosis.

Reading stories on WebM&M provided by AHRQ.

Attend M&M conferences in your hospital.

Read books about medical mistakes such as

Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes“,

Your Patient Safety Survival Guide: How to Protect Yourself and Others From Medical Errors“,

and “Bitter Medicine: What I’ve Learned and Teach about Malpractice Lawsuits (And How to Avoid Them)” (recommended for surgical specialities as the author is a surgeon and mostly talked about mistakes in the surgical world in the book).