Delivering safe health care

Abstract

See advertisement in clinical research edition (facing p 610), general practice edition (facing p 623), and other editions (facing p 583) One fundamental guarantee that we cannot give our patients is that faults and errors in the healthcare system won't harm them. Of course, health care is by its nature risky. Not everyone undergoing surgery for an aortic aneurysm survives. Many interventions carry risks. But these risks are mostly small and usually quantifiable. Ideally, patients understand the possible risks and benefits before choosing to undergo a procedure. For some patients these are difficult decisions. Though doctors may discuss risks of treatment, they do not speak about risks of harm from the system—or even about such harm when it occurs. Recent studies in the United States, Australia, and the United Kingdom and reports from the US Institute of Medicine and the UK Department of Health have drawn attention to the chronic “unsafeness” of health systems worldwide.1-7 This attention is not new. What is new is that preventable, iatrogenic injuries are being quantified and …