Improving quality and patient safety has long been a major focus in healthcare, but it has become especially prominent since the publication,in 1999, of To Err Is Human: Building a Safer Health System, the seminal report from the Institute of Medicine. Decreasing the amount of preventable adverse events that occur in U.S. hospitals and promoting higher patient safety standards have been common goals, yet they are diffi cult to achieve. Some commentators, for example, wonder whether efforts to evaluate physicians and hospitals to determine the quality of care are even asking the right questions. Measuring preventable harm from medical errors is an “immature science” at this point, and healthcare has often focused on the data that can be measured, some of which may not be valid or reliable (Pronovost et al.). In light of the many factors to consider when undertaking the broad task of improving patient safety, finding a focus can be overwhelming.

RMRep1211.pdf