53. Patient Safety

Summary

Safely providing the most effective care has always been a priority in medicine. However, increasing consumer and provider interest coupled with recent progress in the patient safety movement has now made this a primary concern. The past 50 years have witnessed an evolution in healthcare into a complex environment, requiring integration of advanced technologies and diverse and specialized teams. Thus, opportunities for failure have become more prominent and the costs of errors never greater. In 1999 the Institute of Medicine estimated that approximately 44,000–98,000 patients die each year due to medical errors, with a majority of these incidents due to preventable errors and correctable faults. Realizing that this would make medical errors the eighth leading cause of death in the United States, greater than those from motor vehicle accidents, breast cancer, and AIDS, puts the burden of this reality into perspective. The foundation of the patient safety movement is that fallible individuals and teams working in an increasingly complicated system create substantial and substantive opportunities for inadvertent adverse outcomes. Healthcare leaders have responded with improving safety and quality standards, developing better communication and teamwork techniques, and building more robust fail-safes. Today, the science of medicine has renewed a commitment to its ancient credo of “first, do no harm.” This chapter discusses the major concepts in patient safety as applied to obstetrics.