Two Decades Since To Err Is Human: An Assessment Of Progress And Emerging Priorities In Patient Safety
Two Decades Since To Err Is Human: An Assessment Of Progress And Emerging Priorities In Patient Safety
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DOI：
10.1377/hlthaff.2018.0738
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发表时间：
2018-11-01
期刊：
影响因子：
9.7
通讯作者：
Singh, Hardeep
中科院分区：
文献类型：
--
作者：
Bates, David W.;Singh, Hardeep
1999年出版的《医学研究所的错误是人类》代表了美国医疗保健系统的一个分水岭时刻。该报告极大地提高了患者安全的形象，并刺激了对患者护理这一基本方面的专门研究资金。自那以后，针对医院获得性感染和用药安全制定和采用了高效的干预措施，尽管这些干预措施的影响因其执行和实践不一致而有所不同。在解决其他医院获得性不良事件方面的进展一直是可变的。在过去的二十年里，已经确定了更多的安全风险领域，并将其作为干预的目标，例如门诊护理、诊断错误和卫生信息技术的使用。总而言之，可预防的伤害的频率仍然很高，必须采取新的科学和政策方法来处理先前和正在出现的风险领域。随着电子数据的日益普及，现在必须在开发和测试方法方面进行投资，以常规和持续地测量患者伤害的频率和类型，甚至预测特定患者的伤害风险。这一进展可能会将我们从初级工具开发的青铜时代引领到患者安全得到极大改善的黄金时代。
The Institute of Medicine's To Err Is Human, published in 1999, represented a watershed moment for the US health care system. The report dramatically raised the profile of patient safety and stimulated dedicated research funding to this essential aspect of patient care. Highly effective interventions have since been developed and adopted for hospital-acquired infections and medication safety, although the impact of these interventions varies because of their inconsistent implementation and practice. Progress in addressing other hospital-acquired adverse events has been variable. In the past two decades additional areas of safety risk have been identified and targeted for intervention, such as outpatient care, diagnostic errors, and the use of health information technology. In sum, the frequency of preventable harm remains high, and new scientific and policy approaches to address both prior and emerging risk areas are imperative. With the increasing availability of electronic data, investments must now be made in developing and testing methods to routinely and continuously measure the frequency and types of patient harm and even predict risk of harm for specific patients. This progress could lead us from a Bronze Age of rudimentary tool development to a Golden Era of vast improvement in patient safety.