Intended for healthcare professionals


The Tokyo Declaration on patient safety

BMJ 2018; 362 doi: (Published 08 August 2018) Cite this as: BMJ 2018;362:k3424
  1. Kelsey Flott, centre manager,
  2. Mike Durkin, senior adviser on patient safety and leadership,
  3. Ara Darzi, director
  1. Imperial College London, UK
  1. k.flott14{at}

A new partnership between health workers and patients to promote safer care.

The 3rd Ministerial Summit for Patient Safety was held in Tokyo in April this year, with delegations from over 40 countries. The summit coincided with the publication of an Organisation for Economic Co-operation and Development (OECD) report, Flying Blind, which made an economic case for extending the patient safety movement to primary and ambulatory care, and further compelled international political interest in safety.1

We can no longer afford to ignore the burden of poor safety, given the harm and cost to patients and healthcare systems it causes. The OECD has previously estimated that 15% of all hospital care is as a direct consequence of patient harm. The broader social and economic costs run to trillions of US dollars globally. Many of these harms are preventable and the costs of prevention strategies are dwarfed by the costs of harm. Improving patient safety in US Medicare hospitals saved an estimated $28bn (£22bn; €24bn) between 2010 and 2015.2

At this year’s summit, patient harm in primary and ambulatory care settings was brought to the attention of many of the world’s leaders in healthcare policy and …

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