BMJ  2007;334 (13 January), doi:10.1136/bmj.39092.694572.3A

Editor's Choice

US editor's choice

Safety at what cost?

The first 150 words of the full text of this article appear below.

Improving patient safety is a complicated business. Sometimes we don't know exactly what to do. Other times we must balance increased safety with decreased patient autonomy or slowed availability of possibly life-saving medications. We have examples of all of these in this week's BMJ.

In response to patient safety concerns many hospitals have set up routine incident reporting systems. Ali Sari and colleagues reviewed the results of such a system in a large hospital and compared them to a structured review of case notes for the same 1000 admissions. Their study (doi: 10.1136/bmj.39031.507153.AE) found that the incident reporting system missed almost half of the important patients safety incidents—those that actually resulted in patients being harmed. In an accompanying editorial (doi: 10.1136/bmj.39071.441609.80), Charles Vincent agrees that reporting systems are not an effective way to improve patient safety. He argues that only active measurement and improvement programs focused on . . . [Full text of this article]

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