Heuristic thinking: interdisciplinary perspectives on medical error.

Abstract

Approximately 43 million adverse events occur across the globe each year at a cost of at least 23 million disability-adjusted life years and $132 billion in excess health care spending, ranking this safety burden among the top 10 medical causes of disability in the world.1 These findings are likely to be an understatement of the actual severity of the problem, given that the numbers merely reflect seven types of adverse events and completely neglect ambulatory care, and of course they only cover reported incidents. Furthermore, they do not include statistics on children and incidents from India and China, which host more than a third of the world’s population. Best estimates imply that about two thirds of these incidents are preventable. Thus, from a public health perspective, medical errors are a seri- ous global health burden, in fact ahead of high-profile health problems like AIDS and cancer. Interventions to date have not reduced medical errors to satisfactory rates. Even today, far too often, hand hygiene is not practiced properly (even in developed countries), surgical procedures take place in underequipped operating theaters, and checklists are missing or remain uncompleted. The healthcare system seems to be failing in managing its errors − it is costing too much, and the complexity of care causes severe safety hazards that too often harm rather than help patients. In response to this evolving discussion, the International Society for Quality in Healthcare recently nominated an Innovations Team that is now developing new strategies. One of the emerging themes is that the medical field cannot resolve this problem on its own. Instead, interdisciplinary collaborations are needed to advance effective, evidence-based interventions that will eventually result in competent changes. In March 2013, the Institute of Communication and Health at the University of Lugano organized a conference on <em>Communicating Medical Error</em> (COME 2013) in Switzerland to stimulate such interdisciplinary dialogue. International scholars from eight disciplines and 17 countries attended the congress to discuss interdisciplinary ideas and perspectives for advancing safer care. The team of invited COME experts collaborated in compiling this issue of the <em>Journal of Public Health Research</em> entitled <em>Interdisciplinary perspectives on medical error</em>. This particular issue introduces relevant North American and European theorizing and research on preventable adverse events. The caliber of scientists who have contributed to this issue is humbling. But rather than naming their affiliations and summarizing their individual manuscripts here, it is more important to reflect on the contribution of this special issue as a whole. Particularly, I would like to raise two important take-home messages that the articles yield: i) What new insights can be derived from the papers collected in this issue? ii) What are the central challenges implied for future research on medical error?