Safety of Inpatient Healthcare

In their article on the safety of inpatient health care, Bates and colleagues describe events that should not surprise anyone for three key reasons.

First, the focus on "human error" has delayed progress in safety, as error-related literature supports rejecting human error as the primary cause of accidents and adverse events. Instead, complex socio-technical systems should be considered as the cause of preventable harm.

Second, there is a lack of research on how clinical care is provided. Billions of dollars have been spent on understanding the human body and developing treatments, but little investment has been made in understanding care delivery.

Third, the drivers of the patient-safety movement have excluded investigators trained in safety science, resulting in a reliance on safety practitioners with limited formal training in the broader science of safety.

Bates et al.'s study follows two other recent studies that reported disappointing progress in reducing medical errors. The authors argue that the lack of readily available, reliable, and automated measurements of medical errors and adverse medical events has hindered progress. In the era of electronic health records, automated measures can be created using audit log data, allowing for daily updates on patient safety in every hospital.