Exactly ten years ago, the Institute of Medicine (IOM, a congressionally chartered non-governmental agency providing independent research and advice published a landmark report on patient safety. The report entitled “To Err is Human” estimated that between 44,000-98,000 people die in the U.S. each year due to medical errors. That is the equivalent of a 747 crashing every other day!

Medical errors are mistakes that are committed by physicians, nurses, pharmacists and other healthcare professionals which cause injury or death to patients. Examples of medical errors are errors in diagnosis, errors in administration of drugs and other medications, errors in surgery, errors in the interpretation of laboratory and imaging tests, and errors in the use of medical equipments.

There was a surprisingly rapid and strong response to the IOM report by the media, the public, key lawmakers, researchers, healthcare administrators and providers. Within weeks, Congress held hearings on patient safety, and then-President Clinton held a Rose garden ceremony to appoint a task force to discuss the issue. Patient safety became the buzzword in healthcare and in the media.

Ten years later, an important question to ask is how much progress have we made in reducing medical errors and how safe are our hospitals? There have been no recent studies that have assessed how many people are still dying every year due to medical errors. However, an important study that will be published in the journal Health Affairs next month suggests that while the healthcare system has made unmistakable progress, there are still some troubling gaps in our patient safety efforts.

In the study, the author examines nine different safety categories, and gives each one of them a grade on improvements made since 1999. The following are the various categories with their respective grades:

  • Regulation/accreditation (B+)
  • Error reporting systems (B+)
  • Health information technology (C+)
  • Malpractice system and accountability (C+)
  • Workforce and training issues (B-)
  • Research (B-)
  • Patient engagement and involvement (C+)
  • Provider organization leadership engagement (B)
  • National and international organizational interventions (A-)
  • Payment system interventions (C+)

Overall, efforts to improve patient received a grade of B-, a modest improvement from the grade of C+ given by the same author in 2004 (5 years after the IOM report). Areas that will likely constitute the key solutions in the next few years include a better implementation of information technology that will allow hospitals to prevent medication errors, better enforcement of error reporting systems by caregivers without fear of litigation, and better involvement of patients in their care processes.