ABSTRACT
The Institute of Medicine’s classic study To Err Is Human: Building a Safer Health System (Kohn et al., 2000) set off a chain reaction across the U.S. healthcare system (this study is available free on the web; we recommend that you at least scan it). The study concluded that avoidable medical errors occurring in U.S. hospitals cause 44,000-98,000 deaths annually. The follow-up report 10 years later, To Err Is Human-To Delay Is Deadly (Jewell and McGiffert, 2009), found little had changed in improving patient safety, and that preventable medical errors were still causing significant numbers of deaths each year. The report concluded that systemic change would be necessary to improve a healthcare system that is plagued with quality issues, while we spend more on healthcare per capita than any other industrialized nation (Committee on Quality of Health Care in America and Institute of Medicine, 2001).
