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What is the main cause of avoidable harm to patients?

BMJ 2010; 341 doi: (Published 09 September 2010) Cite this as: BMJ 2010;341:c4593
  1. Gordon Caldwell, consultant physician, Worthing Hospital, Western Sussex Hospitals NHS Trust
  1. Gordon.Caldwell{at}

    As a hospital consultant I lead a team that helps patients to recover from illnesses such as myocardial infarction, pulmonary embolism, and gastrointestinal haemorrhage. I do not want to harm patients, make their illnesses worse, or unnecessarily prolong their stays in hospital.

    Since attending the International Forum on Quality and Safety in Healthcare in Berlin in March 2009 I have been thinking and working hard to improve the care that my team of doctors and nurses give to inpatients. We have used a “considerative checklist” to ensure that we do everything we can to reduce the chances of pulmonary embolism, septicaemia from meticillin resistant Staphylococcus aureus, and diarrhoea from Clostridium difficile, among several other types of avoidable harm. We have greatly improved our attention to detail and safety in writing prescription charts. All this has helped us to be more careful to avoid harming patients during treatment.

    However, I …

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