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The patient safety story

BMJ 2005; 331 doi: (Published 04 August 2005) Cite this as: BMJ 2005;331:302
  1. Glyn Elwyn, clinician editor of saferhealthcare (,
  2. Janet M Corrigan, president and chief executive officer
  1. Centre for Health Sciences Research, School of Medicine, Cardiff University, Cardiff CF10 3AT
  2. National Committee for Quality Health Care, 1701 K St NW, Washington DC 20006, USA

    Has been told; now it is time to make practice safer

    Investigating and improving patient safety in health care is now an international phenomenon. The establishment of the National Patient Safety Agency in the United Kingdom1 and of the Center for Quality Improvement and Patient Safety in the United States2 are prime examples of the prominence given to safety within the wider concept of healthcare quality. No longer can there be any doubt that the most fundamental ethical principle in medicine—first, do no harm—is being taken seriously by a wide constituency. The next step is to embed safe practice into everyday clinical behaviour.

    Why is there so much interest in patient safety? Why now? Data have been available on error rates in medicine for at least a decade. Although there had been earlier work in the 1970s, the landmark Harvard Medical Practice study of hospital inpatients was published in 1991.3 Additional studies followed from Australia and other contexts.4 This research points to an adverse event rate in secondary care close to 10%. The error rate in primary care is less well studied.

    What we know

    The catalyst came from the United States. By 1998 some opinion leaders in health care were frustrated by …

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