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Health Aff (Millwood). 2018 Nov;37(11):1736-1743. doi: 10.1377/hlthaff.2018.0738.

Two Decades Since To Err Is Human: An Assessment Of Progress And Emerging Priorities In Patient Safety.

Author information

1
David W. Bates ( dbates@partners.org ) is chief of the Division of General Internal medicine at Brigham and Women's Hospital, in Boston, Massachusetts.
2
Hardeep Singh is chief of the Health Policy, Quality, and Informatics Program, Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and a professor of medicine at the Baylor College of Medicine, both in Houston, Texas.

Abstract

The Institute of Medicine's To Err Is Human, published in 1999, represented a watershed moment for the US health care system. The report dramatically raised the profile of patient safety and stimulated dedicated research funding to this essential aspect of patient care. Highly effective interventions have since been developed and adopted for hospital-acquired infections and medication safety, although the impact of these interventions varies because of their inconsistent implementation and practice. Progress in addressing other hospital-acquired adverse events has been variable. In the past two decades additional areas of safety risk have been identified and targeted for intervention, such as outpatient care, diagnostic errors, and the use of health information technology. In sum, the frequency of preventable harm remains high, and new scientific and policy approaches to address both prior and emerging risk areas are imperative. With the increasing availability of electronic data, investments must now be made in developing and testing methods to routinely and continuously measure the frequency and types of patient harm and even predict risk of harm for specific patients. This progress could lead us from a Bronze Age of rudimentary tool development to a Golden Era of vast improvement in patient safety.

KEYWORDS:

Diagnostic error; Health Information Technology; Health policy; Quality Of Care; medical error

PMID:
30395508
DOI:
10.1377/hlthaff.2018.0738

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