Prescription errors associated with sloppy writing lead to many unnecessary injuries and deaths. Even in an increasingly digital age, they remain a common form of medical malpractice.

Research studies are showing, however, that doctors and hospitals can reduce errors by implementing electronic prescriptions. Studies have shown, for example, that the chances of getting the prescription right increase if the doctor is able to chose the medication from a menu of options on a computer screen - and then transmit the choice electronically to a pharmacy.

But only a little more than one third of all prescriptions nationally are delivered electronically. In 2011, the rate was 36 percent, according to an e-prescription provider called Surescripts.

The cost of failing to fill prescriptions properly is huge. The Institute of Medicine estimates that the cost of adverse events caused by prescription errors is $2 billion a year.

Obviously, when so much at stake, the need to do more data entry should not be used as an excuse for failure to implement a safer way of delivering prescriptions to patients.

Even in hospitals that do convert to the capability for electronic prescriptions, some medical providers still dispense prescriptions the old-fashioned way. That way is generally a more dangerous way and is hardly the stuff of nostalgia.

To be sure, sometimes the old ways are best. But not with paper prescriptions.

Source: "Chicken Scratches vs. Electronic Prescriptions," Randall Stross, New York Times, 4-28-12

It is not surprising that there are also issues with measuring the quality of treatment. New research shows techniques that hospitals are using to game the system and make their medical outcome statistics look better than they actually are.

For example, a report from the Journal of the American Medical Association stated that pneumonia rates dropped 27 percent over a six-year period. Researchers dug further, however, and published a new report showing that the rates dropped only because hospitals changed their diagnostic coding system to classify pneumonia as a secondary diagnosis.

One possible reason for this change is that diagnostic codes enable hospitals to bill patients at higher rates. Critics argue that this presents a conflict of interest, because medical professionals who study and propose changes to billing and coding systems stand to personally gain from changes.

Hospitals, like any other for-profit business, are managed with the principle goal of maximizing profit. Maximizing compensation through billing practices presents a shortcut to achieving this goal.

Some argue that the problem lies with measurement. For instance, hospitals are penalized based on readmission rates, but only a small percentage of those are truly preventable. Many hospitals focus on these areas that are largely out of their control, rather than care issues in greater need of improvement.

When the quality of any organization is measured, the organization naturally seeks a way to improve its numbers. Patients considering health care data before making hospital choices should be aware of questionable practices by some hospitals.

Source: "Why the fragility of health outcomes research may be a good outcome for health," David Shaywitz, Forbes, 4-5-12

Chicago medical malpractice attorneys are therefore concerned about medical mistakes that can result from the lack of interpreters in hospitals. After all, Chicago is a cosmopolitan city, home to many people who do not speak English as their first language.

The problem is particularly serious in emergency rooms, where there is such an urgent need to make quick decisions. This was documented recently in a research study that was conducted at two pediatric emergency rooms in Massachusetts. It was based on families who were primarily Spanish-speaking.

The research found that medical mistakes that could have "clinical consequences" were about twice as likely to occur for non-English-speaking patients if there were no interpreters present or if the translation was done by an amateur.

The lead researcher for the study was Glenn Flores of the University of Texas Southwestern Medical Center. In his report, Flores emphasized the need for proper training of interpreters. The evidence indicates that the best chance of preventing translation errors comes when interpreters have at least 100 hours of training.

Hospitals often like to invest in expensive high-tech equipment. They would do well to consider the value of investing in basic language skills, so that doctors and patients can communicate clearly.

Source: "Interpreters in ER may limit medical errors: study," Reuters, 4-17-12

Nursing home abuse or neglect can take many forms, of course. One is failing to properly monitor residents so that they fall - and break bones or suffer even worse damage.

Another is failing to administer needed medication properly, sometimes because of prescription errors. These errors can do grievous harm or even bring about premature death.

In terms of the sheer terror it causes nursing home residents, however, assault is in a class by itself. When a nursing home allows assaults on residents to occur - either by staff members or by other residents - it needs to be held accountable.

But in a current Chicago case, state regulators are finding that accountability can be difficult to achieve.

Two years ago, allegations surfaced of a disturbing pattern of patient-on-patient violence at the Rainbow Beach Care Center, a 200-bed facility on the South Side. It offers housing and treatment for indigent adults with mental health and disability issues.

The facility's problem with assault came to light through police reports and inspections by the state health department. Chicago police statistics indicate that there have been seven allegations involving criminal sexual assault or sexual abuse since 2008. That is more than for any other Chicago nursing home.

Rainbow Beach contested the presence of the monitors and recently obtained a court order to have them temporarily removed.

The health department says it is not giving up, despite the temporary setback. A spokeswoman said the department is committed to stopping unsafe nursing homes from operating.

Source: "Beleaguered nursing home manages to expel 2 state monitors," David Jackson and Gary Marx, Chicago Tribune, 4-16-12

So why do hospitals still have almost complete discretion on whether or not to repot infections that result from surgery? After all, such infections cost more than 8,000 people their lives in the U.S. every year.

A reporting requirement could reduce the frequency of medical malpractice and cut down on needless deaths.

It could also save the U.S. healthcare system as much as $10 billion a year.

These figures come from a new report from researchers at Johns Hopkins University School of Medicine. The report found that fewer than half the states (21 in all) have laws that mandate monitoring of infections that follow surgery.

Of those 21 states, only eight require public disclosure of the data. And only a fraction of the types of available surgeries are included in the reporting - 10 out of a possible 250.

The collection and distribution of data on surgical infections acquired in hospitals remains highly fragmented and inconsistent across the country.

More transparency is urgently needed. The lead author of the Johns Hopkins report, Dr. Mark Makary, is himself a surgeon. "Is it right," he asks, that hospitals can be well aware of an alarmingly high infection rate or other bad outcome at their hospital relative to neighboring hospitals and not disclose that information, continuing to provide more dangerous services unbeknownst to the consumer?"

The answer to Dr. Makary's question is clear: No!

Source: "Lack of National Reporting Mandate for Hospital Infections Hurts Consumers," Gergana Koleva, Forbes, 4-5-12

Chicago medical malpractice attorneys are aware that more and more evidence shows the effectiveness of checklists in preventing medical mistakes, such as surgical errors, and enhancing patient welfare.

The most recent evidence comes from a study presented last week at the annual meeting of the American College of Cardiology in Chicago. The study involved 96 patients who were admitted to the hospital for heart problems.

At the time of discharge, researchers randomly divided the patients into two groups. The first group was given a 27-point checklist of steps to follow before they left the hospital. The other group got the normal discharge instructions.

The research found that the rates of readmission of the two groups varied greatly. After one month, only two percent of the patients whose doctors used the checklist had been readmitted. This compared to 20 percent of the other patients.

For both doctors and patients, checklists are a reminder to do things that they should be doing. In the case of heart patients, the checklist provides a prompt to follow a low-salt diet. It also prompts doctors to schedule an appointment for the patient with a nutritionist to help make a low-salt diet a reality.

Source: "Checklist keeps heart failure patients out of hospital," USA Today, 3-25-12