Beware of the patient safety juggernauts

Patient safety and medical error have become prominent issues following publication of Institute of Medicine reports in the USA. The USA, Australia, and now Canada have followed a national “medical error” studies path that uses language rejected by the interdisciplinary group of experts described previously in this column, and continues using methods considered seriously flawed as well as incomplete by noteworthy hospital epidemiologists. Preliminary review of British hospitals by similar methods also has been published. Proven and more cost‐effective surveillance methods are pertinent methods developed over the past several decades by hospital epidemiology and infection control professionals who have more experience, but this heritage has been ignored in recent patient safety juggernauts. It is time to question why retrospective physician chart review approaches remain in vogue with national bodies to enumerate adverse patient outcomes and attribute them with “medical error” when better alternatives exist.