This was published 7 years ago
Patient safety expert Sir Liam Donaldson wants to get rid of the 'patronising attitude' in health care
By Andrew Taylor
Professor Sir Liam Donaldson has first-hand experience of how medical errors can affect patients.
"When I was a medical student I broke my nose playing football," he said. "I actually scored a goal, but the goalkeeper broke my nose and I had to have it straightened."
International patient safety expert Professor Sir Liam Donaldson said medical errors account for about one in 10 hospital admissions.Credit: Peter Rae
Professor Donaldson, the World Health Organisation envoy for patient safety and former UK chief medical adviser, said he woke up during the procedure.
"It was absolutely terrifying," he said. "I was conscious of all the cutting and drilling and things going on."
Professor Donaldson with Australian patient safety researcher Professor Jeffrey Braithwaite.Credit: Peter Rae
Years later, Professor Donaldson, who addressed a seminar on patient safety at The Sax Institute in Sydney on Tuesday, was about to have another operation when he mentioned the experience to his anaesthetist, saying, "last time I had an operation I woke up. I don't want that to happen again".
"He said, 'We put a little electrode on here and we can tell what's happening in your brain so there's no chance of us missing that'."
Professor Donaldson said anaesthetics was the "star performer" when it came to improving safety. "More people used to die from a general anaesthetic two or three decades ago than today. Other fields of medicine have not been so successful."
But his experience is hardly unique. Professor Donaldson said medical errors accounted for about one in 10 hospital admissions.
European data suggests medical errors and health-care related adverse events account for up to 12 per cent of hospitalisations.
A study published in the British Medical Journal in 2016, calculated that more than 250,000 deaths a year in the United States were due to medical error, making it the third leading cause of death.
Jeffrey Braithwaite, a professor at Macquarie University's Australian Institute of Health Innovation, said it was "astonishing" that 90 per cent of people receive good care, given the complexities of the health system.
Professor Donaldson said medical mistakes included avoidable infections, errors involving medicines, accidents in hospitals – such as elderly patients falling over – and performing operations on the wrong patient.
He said the mishap he suffered as a medical student was a shock but not a surprise.
"My expectations were that would be the sort of thing that could happen," he said. "That's one of the problems in safety in health care. People's expectations are low."
Health care compares poorly to other high-risk industries such as the airline industry, in which the likelihood of death is about one in 10 million.
"A lot of doctors will say, 'Well, health care is more complex than flying'," Professor Donaldson said. "Patients are much sicker. And that is true – but not to account for that scale of difference."
He said there was wide variability in practice in health care compared with other industries, with up to 50 per cent of health guidelines not followed.
Professor Donaldson suggested blaming and punishing individuals for medical errors, rather than attributing fault to the system, led to cover-ups and a culture of fear.
He said Australia should aim to eliminate cases of "wrong-site" surgery as well as sign up to the WHO's latest patient safety initiative, launched in March, which aims to reduce severe, avoidable harm caused by medication errors by 50 per cent over the next five years.
Professor Donaldson said he would like to see patients on an equal footing to their doctor and not deferential and passive.
He said the patient was the expert in some cases involving chronic diseases, who could be assisted with technical help by medical professionals.
"When I was a young doctor, I remember sitting in a diabetic clinic and when the patient had left the consultant said to me, 'The patient knows more about their condition than we do because they're living with it every day'.
"We've got to get rid of this patronising attitude in health care that patients are the passive recipients."