Patient-safety advocates Lucian Leape and Donald Berwick called on the CMS, the National Quality Forum and other major healthcare groups to establish explicit and ambitious goals for improving patient safety over the next five years. Leape and Berwick said a good starting point would be a list developed by the Commonwealth Fund and the Institute of Medicine that included eliminating 50% of current medication errors, 90% of nosocomial infections and all of the NQF's "never events." Writing in the Journal of the American Medical Association, Leape, an adjunct professor at Harvard School of Public Health, and Berwick, chief executive officer at the Institute for Healthcare Improvement, described the progress five years after a landmark IOM report on patient safety as "frustratingly slow" and difficult to measure. They lamented the continued lack of a national monitoring system for medical errors and the persistence of organizational cultures and reimbursement structures that inhibited safety improvements.
On the positive side, they said the industry had fully bought into the concept of medical errors as system failures rather than chiefly the responsibility of individuals, while providers were rapidly expanding use of electronic medical records and proven safe practices. "Resistance is already fading as more and more evidence comes on board that creating a nonpunitive environment and changing systems really does work," Leape said in an e-mail interview. Read the JAMA abstract. -- by Andis Robeznieks