1. Profit motive: The Journal of General Internal Medicine published a study in March 2000, titled "Hospital Ownership and Preventable Events." It showed that patients in for-profit hospitals are 2 to 4 times more likely than patients at not-for-profit hospitals to suffer adverse events such as post surgical complications, delays in diagnosis and treatment of an ailment.
2. Staffing: Ratios are not at acceptable levels. Only California and Washington have regulations calling for a ratio guideline. Patients in a hospital with a 1:8 nurse-to-patient ratio, have a 31 percent greater risk of dying than patients in hospitals with a 1:4 ratios.
3. Shift work: Longer shifts translate into more errors. Physicians who are scheduled to work long hours make 36 percent more errors with five times as many serious diagnostic errors.
4. Injury to workers: Injury contributes systemically to medical error and compromises patient safety.
5. working conditions: Poor working conditions, such as ergonomics, patient developmental flows, staffing, workload, scheduling and autonomy contribute directly to medical errors. In 115 studies included in a 2003 review, working conditions affect patient safety, the rate of medication errors and the rate of recognition of such errors after they occur.
6. Behavior: A study of 1,700 nurses, physicians, clinical care staff and administrators found fewer than 10 percent address behavior by colleagues that routinely includes trouble following directions, poor clinical judgment or taking dangerous shortcuts. Specifically, 84 percent of MDs and 62 percent of RNs and other clinical care-providers had seen coworkers taking shortcuts that could be dangerous to patients ... fewer than 10 percent said they directly confront their colleagues.
7. Non and Under Reporting: There are 27 states in the U.S. with reporting regulations and none in Canada.
8. Accountability: Studies have shown even getting healthcare workers to wash hands between patients or after leaving bathrooms is not enforced and there are low compliance rates.
9. Technology: Smart technologies in health care are being designed to intervene in administration errors. But according to a recent study, 98,000 people end up in emergency rooms every year (mostly elderly) due to medication error.
10. Cost-Benefit Analysis: The Society of Actuaries has stated that medical errors are costing $20 billion a year. Bedsores alone account for a cost of $3.9 billion annually. The cost per patient of medical error can be as high as $20,000 per bed (using the American Hospital Association's data of 1 million hospital beds in the U.S.).