Vital Signs
New Zealand Listener|September 22-28 2018

Patients must not be afraid to speak out to avoid mistakes in our hard-pressed hospitals.

Donna Chisholm
Vital Signs
You’re heading into hospital. You’ve either packed an overnight bag with your pyjamas and toothbrush for that elective surgery that’s been scheduled for months or you’re in an ambulance en route to the accident and emergency department for urgent treatment.

Chances are you’ll be safely at home and on the mend again within days. Your stay will be uneventful. With luck, it will set you back on track to good health. If you’re unlucky, you might get much worse before you get better. If you’re very unlucky, you might never go home at all.

Last year, a Health Quality and Safety Commission (HQSC) report, “Learning from Adverse Events”, recommended putting patients at the centre when doctors and bureaucrats report, review and learn from adverse events. The HQSC analysed and categorised the 542 adverse events reported in 2016-17 and found, unsurprisingly, that more than half (282) were the result of clinical management issues. The next biggest category was falls (210), followed by medication errors and hospital-acquired infections (35).

The common denominator in many cases came down to one word – delays: delays in referral to a specialist; delays in finding the correct diagnosis; delays in recognising patient deterioration; delays caused by shortages of staff, equipment or clinic time to meet demand; and appointment delays.

The same trend is reflected in the more than 2000 complaints each year to the Health and Disability Commissioner. The two largest categories of complaint, making up nearly a quarter of the total, are of missed or delayed diagnosis and inadequate or inappropriate treatment. The number of complaints is steadily increasing – up 20% since 2012 – suggesting patients are becoming more aware of their rights, and of provider obligations.

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