First and Always, Do No Harm

From Carmela Coyle & Robert Imhoff

This post has been archived and contains information that may be out of date.

CHA acknowledges the 20th anniversary of To Err Is Human: Building a Safer Health System – the clarion call for patient safety – with an op-ed recognizing all California hospitals have done to respond over the last two decades, and their continued commitment to quality improvement.



We have witnessed miracles.
We have seen premature babies who decades ago wouldn’t have a chance at life go home, with smiling parents, after a couple of months in the NICU.
We have seen terminally ill cancer patients make a one-in-a-million recovery thanks to breakthrough therapies.
We have seen car crash victims literally brought back from the dead.
This is the best that hospitals can be, and it is everything they strive for – every day, every hour, every minute.
But they aren’t perfect. Because ultimately, these miracles are performed by people. And all people make mistakes. Sadly, when you work in a hospital, those mistakes can have tragic consequences.
In 1999, the Institute of Medicine released a landmark report that served as a call to action for nurses, doctors, and hospital leaders. To Err Is Human: Building a Safer Health System estimated that as many as 98,000 people died each year in U.S. hospitals because of preventable medical harm.
California’s hospitals readily responded, adopting a variety of tactics to make patients safer, including:
Establishment of a central clearinghouse –the Hospital Quality Institute – to develop leadership, research, tools and protocols to enhance knowledge about safety
Identifying and learning from errors through immediate and strong mandatory reporting efforts, as well as the encouragement of voluntary efforts
Raising standards and expectations for improvements in safety through the actions of oversight organizations, group purchasers, and professional groups
Creating safety systems inside health care organizations through the implementation of safe practices at the delivery level
This has meant fewer errors, fewer infections, fewer deaths. All told, patient safety efforts in the past year alone have led to more than 103,000 harms avoided, more than 19,000 lives saved, and more than $1.1 billion in reduced costs for California’s health care system.
But even a single case of avoidable patient harm is one too many. And while California has shown nation-leading progress in some areas – like maternal and neonatal health – there are challenges elsewhere.
That’s why California’s hospital leaders continue to do all they can – every day — to improve the quality and safety of patient care. Because while they know that human beings –in the course of caring for their families, their friends, their neighbors – will never be fully free of mistakes, they also believe that every mistake they avoid means a life has been changed for the better.
We’re proud to stand alongside hospitals on this journey of continuous quality improvement – on the 20th anniversary of the clarion call for improved patient safety — as we dedicate ourselves to the eternal struggle to do no harm – first, and always.
Carmela Coyle                                                 Robert Imhoff
President & CEO,                                            President,
California Hospital Association                    President, Hospital Quality Institute