Hospital pioneers prize to prevent medical blunders

Thousands of mistakes are committed in hospitals every year swissinfo C Helmle

Swiss hospitals are competing for a new award, worth SFr25,000 ($19,000), by admitting their errors.

The Anna Seiler prize, launched by Bern University Hospital, is aimed at destroying the culture of secrecy which surrounds medical blunders.

The launch of the prize comes three years after two newborn babies died at the hospital after they were given the wrong medication.

“These incidents are unacceptable but doctors are human and make mistakes like everyone else,” hospital spokesman Charly Einstein told swissinfo.

“The important thing is that any kind of mistake is openly talked about so that it doesn’t happen again.”

Based on studies in the United States, the Federal Social Insurance Office has estimated that treatment errors could cause up to 3,000 deaths a year in Switzerland.

Anonymity

The prize is designed to encourage medical teams and hospital staff from around the country to report situations where patients have been placed at risk.

Each entry or incident will be judged on the effectiveness of the measures put in place to prevent a repeat.

Anonymity is assured to persuade whistleblowers to come forward, though the winner will be announced publicly in March.

“Staff need to be able to report incidents confidentially,” said Einstein. “We’re trying to change the whole working culture among doctors and other health professionals, and we have to go step by step.

“The tendency at the moment is to keep quiet: your career is in danger if you openly admit you made a mistake.”

Fatal consequences

Some 1.4 million patients were treated in Switzerland’s 364 hospitals in 2001.

Health experts say that errors and accidents occur in 1.5 per cent of all cases. Some have trivial consequences; others end in the death of patients.

In January 2001 a surgeon in Lugano amputated the healthy leg of an 80-year-old patient with an arterial blockage. He subsequently removed the bad leg as well. The man died shortly afterwards.

In a mix-up in Lucerne in 1998, a patient died after mistakenly being given a lethal injection.

In 1997 eye specialists in both Basel and Zurich operated on the wrong eye.

In another case near Zurich, a surgeon began cutting into a patient to perform a Caesarean before his team had administered an anaesthetic. The woman’s cries alerted them to their oversight.

Global problem

In Britain, studies suggest that there are hundreds of thousands of “adverse incidents” affecting patients every year – a figure broadly in line with other countries.

So could the publicity generated by the prize create alarm?

“People imagine that doctors don’t make mistakes, but they are human and they do,” said Einstein.

“With this prize, we are also trying to close the gap between expectation and reality.”

Most mistakes are related to drugs – giving the wrong dose or medication – and most are made by trainee doctors, who traditionally work long hours.

While it is impossible to eliminate such incidents altogether, many things can be done to minimise them.

Reducing the number of drugs with similar names in similar packaging is one obvious way to avoid mix-ups.

Near miss

Many hospitals are already taking steps to comply with new laws, which come into effect in 2005, limiting junior doctors to a 50-hour working week.

“It is a question of looking at every process of treating the patient from something as basic as the way bottles are labelled and stored,” said Einstein.

“We have to think about where mistakes are possible and how we can prevent them.”

Lessons learned from reporting mistakes rather than pushing them under the carpet also save money for hospitals in litigation and other costs associated with medical errors.

“We’re convinced that it is going to take years, maybe generations of medical service people [to change habits] but the intention is to take the first step in the right direction,” said Einstein.

Bern University Hospital celebrates its 650th anniversary next year. The prize, named after Anna Seiler who founded the hospital in 1354, will be awarded in March.

It will be awarded for a different theme every two years.

swissinfo, Vincent Landon

Key facts

Bern University Hospital celebrates its 650th anniversary next year.
To celebrate its founding, the hospital is awarding a SFr25,000 prize.
The prize encourages medical staff around Switzerland to expose hospital blunders.
In the current climate, most doctors don’t own up to errors.
Organisers hope that hospitals will learn from their mistakes to prevent such incidents happening again.