Docs Told To Be More Vigilant

Hospitals should use computers to order drugs for patients, work harder at coordinating treatment and educate patients to help care for themselves, physicians groups said Tuesday in an effort to reduce medical errors.

Doctors who treat disorders of the hormone systems — such as diabetes — issued the proposals after a two-day conference.

Five years after the Institute of Medicine reported that medical errors kill between 44,000 and 98,000 Americans annually, fear of medical mistakes remains a major concern for the public, Dr. Richard Hellman of the American College of Endocrinology said at a briefing.

Hellman said that an estimated 50 percent of people with a chronic condition at some time experience a medical error in their care or that of a family member.

"We need to collectively value safety," Hellman said, calling for better information, education and more coherent care.

Management of diabetic hospital patients is a particular problem, Hellman said, and he urged that doctors and nurses not rely on standard sliding scale doses of insulin, which he said may be inaccurate for hospitalized people.

Errors are also easy to make with hospitalized diabetics, he said. A common problem is to give a patient a dose of insulin and then have him taken for a test before getting the needed food to balance the drug. In other cases, because of errors food may be late or not delivered at all after insulin is given.

Hellman said his group and the American Association of Clinical Endocrinologists are working with state patient safety organizations in an effort to get their recommendations into use in local hospitals.

The recommendations from the conference included:

• Create a culture of safety in which people work together, communicate, do backup checks and share information.
• Implement electronic patient records and information-sharing systems.
• Reduce medication errors through use of computerized physician order entry.
• Improve coordination of care, focusing on teamwork among health professionals and other caregivers.
• Improve patient self-care through information and education.