Medical mistakes in Maryland hospitals rose by 5% in fiscal 2023, according to the state health department's annual report on the Hospital Patient Safety Program released Sept. 12. The report, which covers data from fiscal 2023, documents 808 serious level 1 incidents, including 49 patient deaths. Most serious injuries resulted from falls and pressure injuries such as bedsores. The report attributes some of the increase to the after-effects of the COVID-19 pandemic and staffing shortages.
However, one potential cause not mentioned in the report is language barriers among healthcare workers. Approximately 50,000 foreign nationals are employed in Maryland's healthcare system, representing about 26% of the state's 190,000 healthcare workers, according to AI estimates based on U.S. Census Bureau and Bureau of Labor Statistics data. At Johns Hopkins Hospital in Baltimore, where the author spent 51 days recovering from open heart surgery, a similar proportion of staff may speak English as a second language.
The author recounts multiple instances where medical instructions were misinterpreted by staff due to unclear communication. "On more than one occasion I heard the doctor issue medical instructions that were misinterpreted by attending staff," the author writes, noting that follow-up checks with the doctor prevented potential errors. While the overall care was excellent, the author emphasizes the need for clear communication to avoid mistakes.
"The need to fill the voids in the health care system in Maryland is clearly understood," the author states. "However, there is a need to ensure that those foreign workers who are filling the void are able to communicate clearly regarding patient needs." The author suggests that Maryland's health department investigators should consider the impact of communication issues among foreign-born staff when seeking root causes for medical mistakes.
