CAIRO: A new study published by the British Medical Journal suggests hospital patients in developing countries are harmed most often by the mistakes of the hospital's clinical staff and by the failure to follow protocols and policies. All data was collected from medical records in Egypt, Tunisia, Morocco, Jordan, Yemen, Sudan, Kenya and South Africa. Over 15,500 case records from 2007 were reviewed from 26 hospitals to evaluate patient safety in the Middle East and Africa. The study found that 8.2 percent of all cases resulted in an unintended injury related to healthcare management and not the original ailment being treated. For the sake of the study, the unintended injury included “temporary or permanent disability or death (including increased length of stay or readmission).” Thirty percent of the patients who suffered from these “adverse events” died. The study determined 83 percent of unintended injuries that occurred in the hospitals were preventable. The figure of cases which resulted in an unintended injury includes records from patients who were treated and discharged in one day. The study found that for any patients who were admitted in these eight countries for more than one day, the chance of sustaining an unintended injury increased to 8.8 percent. For a patient staying for 30 days in a hospital, that risk increased to 25 percent. As the number of days admitted to a hospital in one of these eight developing countries correlates to increased risk of unintentional injury, the same is true of age. The study found the older a person was, the higher the likelihood that they would suffer an event that resulted in death or serious injury. The most common type of unintentional injury was due to a “therapeutic error”—when a diagnosis was made, but the treatment was not delivered or was not ordered in the first place. This “therapeutic error” attributed to about 34 percent of all cases. The second most common hospital error was diagnostic (either untimely, incorrect or no diagnosis) and the third most common was an operative error. More “adverse events” occurred when the patient suffered from a chronic illness, like malaria than from someone who was taking a regular drug treatment. The study concluded that the cause for the number of unintended injures in these eight countries were most often due to insufficient protocol and treatment guidelines. Insufficient education was also blamed for many of the cases. Coming in third, was poor communication at the hospitals in these eight countries. Over 150 of the events related to a patient's permanent disability or death were accredited to inadequate supervision or training of the hospital's clinical staff. The British Medical Journal's study found that their data suggested a higher risk of mortality for a patient in these countries than previous studies found. The report concluded that increased resources to these hospitals will not solve the problems related to patient's safety. The study was conducted by authors from the New York City Health and Hospital Corporation and initiated by the World Health Organization.
