For years, hospitals used terms such as "quality " and "safety" as reassuring buzzwords that could be dropped in a marketing brochure or mission statement as easily as "hospitality" or "convenience."
But there were always hints that all wasn't right with the quality of care.
A group of surgeons in the early part of the century discovered an astounding degree of nonconformity among American hospitals in their approaches to medical care. By the 1970s, researchers began to detect that much of the care being delivered was inappropriate.
With few exceptions, delivery system managers and the public bounced along thinking all was fine with the quality of their healthcare.
Then came news that as many 98,000 Americans were dying annually as a result of medical errors in hospitals. "Kaboom," says Donald Berwick, M.D., co-author of the Institute of Medicine's 1999 To Err is Human report. "The public at large got the message."
Berwick, president of the not-for-profit Institute for Healthcare Leadership in Boston, which has helped healthcare adopt new methods for ensuring quality, says the first IOM report merely brought to light research that had been going on for years.