Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety. | AHRQ Patient Safety Network

Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety. | AHRQ Patient Safety Network

• Commentary
 
• Published November 2018

Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.

Bates DW, Singh H. Health Aff (Milwood). 2018;37:1736-1743.

The release of the Institute of Medicine's To Err Is Human in 1999 represented a seminal moment in patient safety and is considered by many to have launched the modern patient safety movement. The report highlighted the incidence of medical errors and preventable deaths in the United States and catalyzed research to identify interventions for improvement. The authors reflect on progress since its publication and suggest that while many effective interventions have been developed for addressing safety challenges such as hospital-acquired infections and medication errors, successful implementation of these solutions remains difficult, and improvement in other areas has been less consistent. In addition, new safety challenges have emerged in the last 20 years including those related to ambulatory care and diagnostic error. The authors conclude that preventable harm remains significant and advocate for enhanced use of widely available electronic data to develop improved interventions for what they foresee may be a Golden Era of swift progress in patient safety. A PSNet perspectivereflected on patient safety progress in surgery.

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