Five years after the Institute of Medicine's landmark report on medical errors, there are "pockets of progress," but significant clinical and policy changes await, industry experts said. "There is no national commitment to studying safety as a property of our system," said Donald Berwick, president and chief executive officer of the Institute for Healthcare Improvement, which hosted a telephone conference on progress since the 1998 IOM report, "To Err Is Human." Payments from Medicare and private insurance must be tied more closely to quality, rewarding providers of the best care and supporting investments in information technology, said Janet Corrigan, an IOM healthcare official. "Payers are going to end up paying for IT," said Lucian Leape, adjunct professor of health policy at the Harvard School of Public Health and an IOM board member.
At a hospital level, boards "lack windows on the safety of their own organizations," an impediment to change, Berwick said. Individuals' lack of knowledge about the continuum of care as a whole can be alleviated with job swapping, said Peter Pronovost, medical director of the Center for Innovations in Quality Patient Care at Johns Hopkins University. For example, residents and nurses at Johns Hopkins hospital do another person's job for two hours to get a better view of the continuum of care and how it can be improved, Pronovost said. A recent Modern Healthcare cover story focused on industry progress on patient safety. Read the story. -- by Jeff Tieman