How U.S. Health Care Got Safer by Focusing on the Patient Experience

Before 1999, the assumption was that quality in health care was basically pretty good – and, in any case, was difficult, if not impossible, to measure. The financial health of an organization was the most important metric for management and governance to follow. But 1999 was the year the Institute of Medicine released To Err is Human, the first line of which was “Health care in the United States is not as safe as it should be …” The second sentence estimated that as many as 98,000 people die in hospitals each year as a result of preventable errors. Two years later, the follow-up IOM report, Crossing the Quality Chasm, reviewed other types of disappointing quality, including gaps in efficiency, effectiveness, timeliness and patient-centeredness. Some IOM reports are quickly forgotten; these two changed the world. There are still plenty of opportunities for improvement in health care today, but the fact is that care is better and safer and more efficient than it used to be. But some organizations are clearly leading the charge, and research shows that organizations with better patient experience also have better safety records and report better financial margins.