Intended for healthcare professionals


Clinical leadership in the provision of hospital care

BMJ 2005; 330 doi: (Published 26 May 2005) Cite this as: BMJ 2005;330:1219
  1. Sisse Olsen, research fellow (,
  2. Graham Neale, visiting professor
  1. Clinical Safety Research Unit, Academic Department of Surgery, Imperial College, St Mary's Hospital, London W2 1NY

    Must be improved to reduce basic errors in clinical care

    Throughout the developed world, direct observation and reviews of patients' records reveal basic errors in the care of patients. A recent study from France showed that the oft quoted figure of 10% of adverse events arising from health care in hospitals is probably an underestimate.1 How can clinical leaders help to solve these problems?

    The first task for clinical leaders must be to make doctors and nurses aware of such errors and to teach them to understand the contributory factors. In the United Kingdom's NHS, all too often there is insufficient contribution to acute care from experienced and fully trained staff. This is exemplified by a study that showed a fourfold difference in mortality from major general surgical procedures undertaken in a British hospital compared with surgical mortality in a US counterpart,2 and by another study that found that shortfalls in medical care contributed to 25 of 200 deaths occurring from illnesses requiring emergency medical admission to hospital.3

    The fact that junior doctors are often stretched beyond their capabilities is underlined by the recent report …

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