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Medical mistakes under the microscope

New book explores causes, effects, prevention of medical errors

Now, a new book picks up where the IOM left off, diagnosing the persistent causes of medical errors and offering new ways to think about errors from top experts. Titled "Medical Error: What Do We Know? What Do We Do?" (Jossey-Bass/Wiley), it offers a timely, comprehensive and constructive discussion on a crucial issue in medicine.

University of Michigan medical sociologist Marilynn M. Rosenthal, Ph.D., and Kathleen M. Sutcliffe, Ph.D., an associate professor of organizational behavior and human resource management at the U-M Business School, co-edited the volume, which collects essays from doctors, nurses, health care administrators, researchers and organizational experts involved in the effort to make American health care safer. Rosenthal and Sutcliffe co-wrote introduction and discussion sections.

"Coincidentally, we had scheduled a symposium on medical errors at the U-M for October, 1999, to bring together some of the key players in the field," says Rosenthal, who runs the U-M Forum on Health Policy.

"With the momentum from that event, and from the IOM report, we were able to compile this book, which we hope will be a resource for anyone involved in health care," she continues. "In particular, we have a cutting-edge discussion of systems theories and their applications to health care."

Rosenthal, whose past books include "Medical Mishaps: Pieces of the Puzzle", notes that the new book includes critiques of the IOM report, as well as calls for transparency, accountability and action based on thoughtful and accurate understanding. It addresses ways in which health care is mired in outdated approaches, instances where data on medical errors have been misinterpreted, sources of new insights, and opportunities for innovation.

The book's contributors are:

• Harvard University professors Troyan Brennan, M.D., J.D., MPH and David Studdert, Sc.D., who conducted the first major studies of medical errors in the early 1990s, on which the IOM report was based;
• Darrell Campbell, M.D., chief of staff and transplant surgeon at the U-M Health System, who has led patient safety innovation at U-M hospitals and co-wrote an essay on stress and burnout with medical writer Patricia Cornett;
• prominent systems theory researchers Robert Helmreich, Ph.D. and Eric J. Thomas, M.D., MPH, of the University of Texas at Austin;
• world-renowned social psychologist Karl Weick, Ph.D., the Rensis Likert Distinguished University Professor of Organizational Behavior and Psychology at the U-M Business School;
• systems analysis expert Paul R. Schulman, Ph.D., the Robert and Ann Wert Professor of Government at Mills College in Oakland, CA and a prominent ;
• Derek van Amerongen, M.D., the chief medical officer for the Humana/Choice Care managed care insurance company;
• Michael Millenson, a former Chicago Tribune reporter and author of several books on health care accountability;
• Michael Fetters, M.D., a U-M family medicine physician who specializes in medical errors in primary care;
• Beverly Jones, MPH, chief nursing officer at Henry Ford Health System in Detroit, and former chief of nursing affairs at the U-M Health System, whose essay focuses on the "code of silence" about medical errors;
• a team of current and former U-M Health System risk management leaders, including Margaret Dawson, Ann Munro, Kenneth Appleby and Susan Anderson; and
• Evidence-based medicine advocates Susan D. Horn, Ph.D. of the Institute for Clinical Outcomes Research, Anne-Claire France, Ph.D. of the Memorial Hermann Healthcare System in Houston, and Joanne Hickey, Ph.D., and Theresa Carroll, Ph.D. of the University of Texas Health Science Center.

Gilbert S. Omenn, M.D., Ph.D., U-M executive vice president for medical affairs, wrote the book's foreword. Omenn chairs the IOM's Committee on Enhancing Federal Health Care Quality Programs, which is currently preparing an independent external review of the quality oversight, quality improvement and quality research programs under federal system. The committee was commissioned by Congress in the wake of the IOM medical errors report.

"We feel we've pulled together a good variety of perspectives, to answer questions that get to the heart of understanding and preventing errors," says Rosenthal, whose past books also include "Dealing with Medical Malpractice" and "The Incompetent Doctor". Sutcliffe is the co-author, with Weick, of a 2001 book, "Managing the Unexpected: Assuring High Performance in an Age of Complexity".

"Medical Error: What Do We Know? What Do We Do?" by Marilynn M Rosenthal and Kathleen M. Sutcliffe. Jossey-Bass/Wiley, July 2002, $45.00, cloth, 325 pages, ISBN: 0-7879-6395-X. Available by special order in bookstores nationwide, via all major online booksellers and at www.josseybass.com or by calling 800-956-7739.

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