BMJ  2005;330:553-554 (12 March), doi:10.1136/bmj.330.7491.553

Editorial

Patients' safety

Progress is elusive because culture in health care has not changed

The first 150 words of the full text of this article appear below.

Since 2000, when "To Err Is Human" stimulated action to eliminate errors and mitigate the resultant harm in the United States¹ and "An Organisation with a Memory" initiated similar efforts in the United Kingdom,² healthcare systems worldwide have devoted considerable attention to the safety of patients. Yet despite attempts to reduce adverse events through multilevel interventions and information technology, widespread change in the culture of health care remains elusive.

The numbers of affected patients are astounding. In the United Kingdom, adverse events with resultant harm were estimated to occur in some 10% of hospital admissions, equating to more than 850 000 events annually. In the United States, extrapolations based on medical record reviews imply that 44 000-98 000 lives were lost because of medical errors each year. Although some posit that these numbers were inflated, ongoing work indicates that these estimates may be conservative. For example, Davis et al . . . [Full text of this article]

Center for Quality Improvement and Patient Safety, US Agency for Healthcare Research and Quality, Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850

Center for Quality Improvement and Patient Safety, US Agency for Healthcare Research and Quality, Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850 (cclancy@ahrq.gov)

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This article has been cited by other articles:

• Wasson, J. H, MacKenzie, T. A, Hall, M. (2007). Patients use an internet technology to report when things go wrong. Qual Saf Health Care 16: 213-215 [Abstract] [Full text]  
• McDonald, R, Waring, J, Harrison, S, Walshe, K, Boaden, R (2005). Rules and guidelines in clinical practice: a qualitative study in operating theatres of doctors' and nurses' views. Qual Saf Health Care 14: 290-294 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Conscience

Lakshmipathy Ananthakrishnan
bmj.com, 13 Mar 2005 [Full text]

Progress in introducing a safety culture will remain elusive while individual doctors are being prosecuted for the effects of systems failures

Nigel Dudley
bmj.com, 14 Mar 2005 [Full text]

Patient Safety Culture Tools

Dr Nicola J Gilbert
bmj.com, 15 Mar 2005 [Full text]

Cultural change is easy in trainees using PDA technology

Stephen N Bolsin, et al.
bmj.com, 18 Mar 2005 [Full text]

Medical errors and culture of safety

Ediriweera B.R., Desapriya, et al.
bmj.com, 22 Mar 2005 [Full text]

Patient safety should be an important election issue

Nigel Dudley
bmj.com, 6 Apr 2005 [Full text]

Change in attitude needs to begin in medical school

Oliver T Mytton, et al.
bmj.com, 7 Apr 2005 [Full text]