"Freedom from accidental injury" – a more than reasonable expectation for those accessing the health care system. This is how the Institute of Medicine defines patient safety in its landmark 1999 publication, To Err Is Human. In 1999, estimated deaths from medical errors in US hospitals was 98,000 per year and, while many successful improvement initiatives have been implemented since then, there is little evidence that a major decrease in patient harm has occurred. Patient safety initiatives in other countries identify similar issues and opportunities for improvement.
Many innovative health care organizations have made important breakthroughs in the design and performance of safer systems by focusing on lessons learned in other industries that have longer traditions of using quality methods and have achieved high levels of reliability. Examples include standardizing approaches, decreasing complexity, and incorporating human factors design. Redesign of processes combined with a shift to a culture of safety are essential for health care organizations to reduce harm to patients from medical errors.