Are patients safe now? Reviews mixed on progress

There's been a lot of talk and even some action. But safety advocates say people are still dying and much more remains to be done.

By Andis Robeznieks, AMNews staff. Oct. 13, 2003.

Patient safety experts, used to toiling away in near obscurity, were both blessed and cursed by the Institute of Medicine report, "To Err is Human," claiming that up to 98,000 people die each year because of medical errors.

The resulting publicity from that 1999 report brought new faces to the movement, and an infusion of cash as business groups and the government pitched in to study the problem. But it also brought heightened scrutiny and a push for quick change in institutions used to moving slowly.

How successful medicine has been at instituting changes that increase patient safety is heavily debated. Experts agree more can be done. But when they discuss progress to date, they take divergent paths, with some celebrating incremental steps and others wanting measurable results sooner rather than later.

Donald Berwick, MD, president of the Boston-based Institute for Healthcare Improvement and a member of the IOM committee that wrote "To Err is Human," is disappointed by what he sees as a lack of progress.

"Studies continue to show problem rates nearly as high as those that started our concerns," he said.

Dr. Berwick recently stirred the pot by making it known he has seen no evidence that health care is safer. Despite the harshness of his message, the feedback, he said, has mostly been positive.

"I received an e-mail from the chief medical officer at a hospital who said, 'We want to take this more seriously. What can we do to be more aggressive?' A lot of people have suggested to me that we [in the medical profession] have not made enough progress."