Recommendations from "To Err is Human": Where are We Now?

The Institute of Medicine (IOM) released its “To Err is Human” report in 2000. Now that we're nearing the end of 2009, safety experts are examining the extent to which the IOM's recommendations have been implemented. Unfortunately, progress over the past ten years has been slow to negligible in several key areas.

The IOM recommended mandated medical error reporting at the state level. To date, just 20 states (40%) have mandatory reporting requirements. The IOM also recommended transparency and clarity in reporting. In nearly all of our states (45), hospitals are not named and/or hospital-specific data is not available. These hospitals either don't collect data or don't allow access to their collected data.

The IOM recommended improving the overall safety of healthcare facilities. While many hospitals complied and in many cases developed new and innovative safety initiatives, there are still a number of hospitals where the safety status quo continues. And most importantly, there is no evidence that healthcare facilities are safer today. In fact, according to some sources, they may be worse now in terms of safety than they were before the release of the IOM report. The Hearst report, named "Dead by Mistake," estimates that people are twice as likely to die from a preventable medical error or injury then die from injuries sustained in a motor vehicle accident.

The Hearst reporters contacted 20 of the 21 living authors of the IOM "To Err is Human" report and were told by 16 that they believed that the IOM goal of reducing medical errors by 50% had not been achieved. The IOM’s goals and recommendations were not lofty or pie-in-the -sky; they were realistic and potentially achievable. The question now is why so few healthcare facilities implemented the recommendations and instead, kept their heads in the sand.