Hospitalization per se is now the third-leading cause of death in the U.S. How did this happen? As analyses of in-patient care and hospital spending moves forward, it has become clear that patients too often become sick from the very act of being a patient. In 1999, the U.S. Institute of Medicine published, “To Err is Human: Building a Safer Health System,” a landmark article that revealed the huge burden of harm to hospitalized patients. This article presented the number of patients injured or killed from errors in hospitals: errors such as wrong site surgery, patient falls, incorrect medication administration, and exposure to microorganisms causing serious infections — infections that were not present before the person donned a johnnie and became a patient. Each year, these medical errors and healthcare-associated infections (HAIs) kill hundreds of thousands of patients and costs healthcare millions of dollars.
The components of this epidemic of harm in hospitals are multifold. More people survive from successful medical intervention to become vulnerable patients, often with impaired immune defenses. The select microorganisms that are not killed by powerful antibiotics used in hospitalized patients survive because of genetic or physical resistance. These resistant organisms subsequently reproduce, thriving in patients, on surfaces, and in hospital mechanical systems. In this way, the hospital unwittingly becomes a reservoir and vector for virulent, treatment resistant pathogens. That is the bad news.