---
title: "Patient safety"
chunk: 1/10
source: "https://en.wikipedia.org/wiki/Patient_safety"
category: "reference"
tags: "science, encyclopedia"
date_saved: "2026-05-05T04:26:13.019610+00:00"
instance: "kb-cron"
---

Patient safety is a specialized field focused on enhancing healthcare quality through the systematic prevention, reduction, reporting, and analysis of medical errors and preventable harm that can lead to negative patient outcomes. Although healthcare risks have long existed, patient safety only gained formal recognition in the 1990s following reports of alarming rates of medical error-related injuries in many countries. The urgency of the issue was underscored when the World Health Organization (WHO) identified that 1 in 10 patients globally experience harm due to healthcare errors, declaring patient safety an "endemic concern" in modern medicine.
Today, patient safety is a distinct healthcare discipline, supported by an ever evolving scientific framework. It is underpinned by a robust transdisciplinary body of theoretical and empirical research, with emerging technologies, such as mobile health applications, playing a pivotal role in its advancement.

== Prevalence of adverse events ==

Millennia ago, Hippocrates recognized the potential for injuries that arise from the well-intentioned actions of healers. Greek healers in the 4th century BC drafted the Hippocratic Oath, pledging to "prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone." Since then, the directive primum non nocere ("first, do no harm") has become a central tenet for contemporary medicine. However, despite an increasing emphasis on the scientific basis of medical practice in Europe and the United States in the late 19th century, data on adverse outcomes were hard to come by; the various studies commissioned collected mostly anecdotal events.
In April 1982, the ABC television program 20/20 entitled The Deep Sleep presented a rising problem in American hospitals. Showing accounts of anesthetic accidents, the producers stated that, every year, 6,000 Americans die or experience brain damage related to these mishaps. In 1983, the British Royal Society of Medicine and the Harvard Medical School jointly sponsored a symposium on anesthesia deaths and injuries, resulting in an agreement to share statistics and conduct studies. Attention was brought to medical errors in 1999 when the Institute of Medicine reported that about 98,000 deaths occur every year due to medical errors made in hospitals.
By 1984, the American Society of Anesthesiologists (ASA) had established the Anesthesia Patient Safety Foundation (APSF). The APSF marked the first use of the term "patient safety" in the name of a professional reviewing organization. Although anesthesiologists comprise only about 5% of physicians in the United States, anesthesiology became the leading medical specialty addressing issues of patient safety.

=== To Err is Human ===

In the United States, the full magnitude and impact of errors in health care were not appreciated until the 1990s, when several reports brought attention to this issue. In 1999, the Institute of Medicine (IOM) of the National Academy of Sciences released a report, To Err Is Human: Building a Safer Health System.
The IOM called for a broad national initiative focused on several key actions: creating a Center for Patient Safety, expanding the reporting of adverse events, implementing safety programs within healthcare organizations, and increasing involvement from regulators, healthcare purchasers, and professional societies. The majority of media attention, however, focused on the statistics: from 44,000 to 98,000 preventable deaths annually due to medical errors in hospitals, with 7,000 preventable deaths related to medication errors alone. Within 2 weeks of the report's release, Congress began hearings, and President Clinton ordered a government-wide study of the feasibility of implementing the report's recommendations. Initial criticisms of the methodology in the IOM estimates focused on the statistical methods of amplifying low numbers of incidents in the pilot studies to the general population.
To this day, there are only a few comprehensive studies on medical errors. A bibliometric analysis in 2020 revealed a steady growth of publications in this area. In 2016, Michael Daniels and Martin A. Makary published a piece in The British Medical Journal that claimed medical error was the third leading cause of death in America at nearly half a million deaths per year. This number has since been debunked, citing flawed and improper methodology in the paper. More recent analysis using data from the 2016 Global Burden of Diseases, Injuries, and Risk Factors (GBD) study obtained an estimate of 123,603 deaths in the United States from 1990 to 2016 due to adverse effects of medical treatment (AEMT), with the mortality rate decreasing over time despite an overall increase in the number of deaths.
The experience has been similar in other countries.

In 1992, an Australian study revealed 18,000 annual deaths from medical errors. Professor Bill Runciman, one of the study's authors and president of the Australian Patient Safety Foundation since its inception in 1989, reported himself a victim of a medical dosing error.
In June 2000, the Department of Health Expert Group estimated that over 850,000 incidents harm National Health Service hospital patients in the United Kingdom each year. On average, forty incidents a year contribute to patient deaths in each NHS institution.
In 2004, the Canadian Adverse Events Study found that adverse events occurred in more than 7% of hospital admissions and estimated that 9,000 to 24,000 Canadians die annually after an avoidable medical error.
These and other reports from New Zealand, Denmark and developing countries have led the World Health Organization to estimate that one in ten persons receiving health care will suffer preventable harm.

== Psychological safety ==
Psychological safety aims to provide an environment where patients and medical professionals feel comfortable sharing concerns and mistakes without fear of embarrassment or retribution. This enables increased reporting, as well as the sharing of new ideas and honest feedback. A wider variety of information is thus shared throughout the organization, allowing for creativity, innovation, and learning. Psychological safety is believed to lead to better outcomes by providing basis for more informed decisions.
Psychological safety has been found to play an important role in both patient safety culture and in enabling quality improvement in the health care setting.