Still Not Safe

The term patient safety rose to popularity in the late nineties as the medical community -- in particular physicians working in nonmedical and administrative capacities -- sought to raise awareness of the tens of thousands of deaths in the US attributed to medical errors each year. But<br>what was causing these medical errors? And what made these accidents to rise to epidemic levels seemingly overnight? <p/><em>Still Not Safe</em> is the story of the rise of the patient-safety movement -- and how an epidemic of medical errors was derived from a reality that didn't support such a characterization. Physician Robert Wears and organizational theorist Kathleen Sutcliffe trace the origins of patient safety to the<br>emergence of market trends that challenged the place of doctors in the larger medical ecosystem: the rise in medical litigation and physicians' aversion to risk; institutional changes in the organization and control of healthcare; and a bureaucratic movement to rationalize medical practice -- to<br>make a hospital run like a factory. <p/>If these social factors challenged the place of practitioners then the patient-safety movement provided a means for readjustment. In spite of relatively constant rates of medical errors in the preceding decades the epidemic was announced in 1999 with the publication of the Institute of Medicine<br>report To Err Is Human; the reforms that followed came to be dominated by the very professions it set out to reform. <p/>Weaving together narratives from medicine psychology philosophy and human performance <em>Still Not Safe</em> offers a counterpoint to the presiding doctor-centric narrative of contemporary American medicine. It is certain to raise difficult important questions around the state of our healthcare system<br>-- and provide an opening note for other challenging conversations.<br>