First large study in a decade finds little progress on patient safety in hospitals

Researchers from Brigham and Women’s Hospital undertook the largest study on patient safety since 1999. The results showed little progress on patient safety in hospitals. The study looked at cases of medical harm at ten hospitals in the State of North Carolina - a state that has shown a high level of engagement to improve patient safety relative to other states, as measured by the hospitals’ enrollment rates in national patient safety initiatives.


The study found 588 cases of medical harm for 10,415 patient-days or 25.1 injuries per 100 admissions. The top three causes of medical harm were procedures (186), medications (162), and hospital acquired infections (87). Patients in 42.7% of the cases required extra time in the hospital, 2.9% of the cases resulted in permanent injury, and 2.4% of the cases contributed to patient death.

One interpretation of the study results is that, in spite of years of efforts to improve patient safety, evidence-based safety practices are still rare in practice. Some hospitals have made significant strides in certain areas of care, such as in the adoption of electronic medical records and computerized physician ordering systems, but these improvements are often made independently of other areas, usually lacking coordination and an overarching strategy.

The last large scale study on patient safety was conducted in 1999 by the Institute of Medicine. The results of that study brought patient safety into the national spotlight. Results from this new study will hopefully lead to more concerted efforts to reduce medical harm through better utilization of resources, collaboration, and adoption of evidence-based practices.

Full text of the study in the New England Journal of Medicine