It is no surprise in this day and age to read about hospital bills gone awry. Millions upon millions of dollars mistakenly included on a medical bill. That is what Part I will address, human error.

Mistakes happen, that is part of life. And sometimes when we try the hardest we make the most. The same applies to entering orders. A wrong test is ordered, or wrong date or not in proper time sequence. It could happen and it does happen.

From personal experience I can tell you I have been called by lab, radiology, pharmacy and even dietary questioning about an order in the computer. Fortunately not all in the same day on the same patient. Just recently lab called about an order, a magnesium was scheduled to be drawn even though one had been done earlier in the morning. Since there was no order, I canceled the new one.

I have been in situations where a lab or x-ray was needed immediately. In those cases the department will render the service and will ask you to put in the order later. Even a reminder if it is forgotten. Patient safety is not at risk just because an order is not in the computer.

Once the situation has passed is an order placed? That is the goal yes, but like other things sometimes it is missed.

Other safe guards are in place also, for instance hospitals may require doctors to enter their own orders into the computer. This eliminates several steps and presumably would cut down errors. Nurses routinely do chart checks to make sure the orders are noted and correct.

And remember those stickers and supplies? I can give you a personal example, this happened a few nights ago. I had two sick patients and I was very busy running from room to room giving care. At the end of the shift I had sticker all over my uniform top from the supplies I had used.

When it was time to affix the stickers to the "charge cards" I had to remember which sticker and corresponding supply I used for which patient. I am sure I did just that, but with the acuity of patients nowadays and the hectic work load stickers can be misplaced.

Even well intentioned actions intended for comfort of the patients can lead to unforeseen consequences. As I have said I have worked in a variety of care setting. This example took place in the Neonatal ICU. There we routinely put small fleece squares in the bottom of the isolette to prevent skin breakdown.

Little did we know that these fleece squares also at times made the x-rays appear patchy, with more white than there otherwise would have been. So what started as a well meaning comfort measure actually was counter productive. The reason for the patchy x-ray was quickly discovered by a bright physician and fixed.

Billing errors are common on hospital and medical bills. And as I have described above some of these overcharges are the result human error inputing the charges. Part II however deals with a different sort of problem.