It has been more than a decade since the publication of the Institute of Medicine’s “To Err is Human,” a report highlighting the fact that medical errors cause up to 98,000 deaths and more than one million injuries each year in the United States. In response to the report, widespread programs and initiatives were launched to improve patient safety.

But have these programs made a significant difference? The answer is no, according to researchers who published the results of a study in the New England Journal of Medicine. The retrospective study looked at a random sample of 10 hospitals in North Carolina during the period from 2002 to 2007.

One hundred admissions per quarter were reviewed by both internal and external reviewers. Results indicated that errors remain common and there has been little evidence of improvement. Whatever improvement was seen was not enough to be statistically significant.

The study, by Christopher P. Landrigran, MD, MPH, of Brigham and Women’s Hospital in Boston, looked at 2,341 hospital admission records, and identified a total of 588 harms to patients (25.1 per 100 admissions). Of those harms, 245 (41.7%) were temporary and required intervention, and 251 (42.7%) required initial or prolonged hospitalization. An additional 17 harms (2.9%) were permanent, and 14 (2.4%) resulted or contributed to a patient’s death.


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“Our findings validate concern raised by patient-safety experts in the United States and Europe that harm resulting from medical care remains very common,” the authors wrote. “Though disappointing, the absence of apparent improvement is not entirely surprising.” The authors added that only 1.9% of U.S. hospitals have comprehensive electronic medical records, only 9.1% have even basic electronic record keeping, and only 17% have computerized prescription ordering.

Other factors, such as overwork and sleep deprivation may also be contributing factors to medical errors. The authors state that “achieving transformational improvements in the safety of health care will require further study of which patient-safety efforts are truly effective across settings and a refocusing of resources, regulation, and improvement initiatives to successfully implement proven interventions.”