Who killed patient safety?

Abstract

The medical community’s commitment to patient safety has withered to over the past 10–15 years after the original call to action in 2000 with the release of the IOM report, To Err is Human. The tragedy of this decline in action around safety lies in the lives of the families like ours, who have lost loved ones, been harmed, and often permanently injured by medical error. What was once a motivating call to action, safety in hospitals and oversight by our government has been deprioritized, defunded, and devalued leaving patients like us to wonder: What happened to Patient Safety? When the To Err is Human (IOM) report was released in 2000 it estimated that 44,000–98,000 people lose their lives every year from medical errors in U.S. hospitals. The medical community was appalled by the estimate of preventable death and injury from medical errors to patients as identified in the seminal report. More recent research published by John James, in 2013, and Marty Makary, in 2016, suggested the original estimates underrepresented the amount of harm to patients caused by medical care which amounted to 400,000 or more lives a year. In To Err is Human, the IOM called for a public-private partnership to reduce medical errors by ninety percent in 10 years. And as a follow up in its 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, the IOM positioned patient safety as fundamental to healthcare transformation. Twenty years later, other than infection control to anesthesia, the American hospitals have not progressed in systemically meeting patient safety goals, and the medical community seems to have lost its commitment to safety. Unsafe healthcare now vies with Covid-19 as the third largest cause of preventable death in the United States, and many of those who used to be champions for safety have moved on to other issues. Yet, we the patients and families, know safety is fundamental, not something that can ever fall off the list of priorities since it is a critical part of safe care every patient deserves. Earlier this year a peer review committee of the National Academy of Sciences (NAS), which now houses the IOM, published a discouraging report on the current strategies to improve patient safety finding: