Few publications in recent memory have received as much notice or stimulated
as swift a response among policy makers as the Institute of Medicine (IOM)
report on medical errors.1 Within 2 weeks of
the report's release last November, Congress began hearings and the president
ordered a government-wide study of the feasibility of implementing the report's
recommendations. The IOM called for a broad national effort to include establishment
of a Center for Patient Safety within the Agency for Healthcare Research and
Quality, expanded reporting of adverse events and errors, development of safety
programs in health care organizations, and intensified efforts by regulators,
health care purchasers, and professional societies. However, while the objective
of the IOM report, and the thrust of its recommendations, was to stimulate
a national effort to improve patient safety, what initially grabbed public
attention was the declaration that between 44,000 and 98,000 people die in
US hospitals annually as a result of medical errors. These estimates represent
current national extrapolations from the results of 2 large population-based
studies carried out to assess the impact of medical injury.2,3