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Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
Every year roughly 100,000 fatal and injury crashes occur in the United States involving large trucks and buses. The Federal Motor Carrier Safety Administration (FMCSA) in the U.S. Department of Transportation works to reduce crashes, injuries, and fatalities involving large trucks and buses. FMCSA uses information that is collected on the frequency of approximately 900 different violations of safety regulations discovered during (mainly) roadside inspections to assess motor carriers' compliance with Federal Motor Carrier Safety Regulations, as well as to evaluate their compliance in comparison with their peers. Through use of this information, FMCSA's Safety Measurement System (SMS) identifies carriers to receive its available interventions in order to reduce the risk of crashes across all carriers. Improving Motor Carrier Safety Measurement examines the effectiveness of the use of the percentile ranks produced by SMS for identifying high-risk carriers, and if not, what alternatives might be preferred. In addition, this report evaluates the accuracy and sufficiency of the data used by SMS, to assess whether other approaches to identifying unsafe carriers would identify high-risk carriers more effectively, and to reflect on how members of the public use the SMS and what effect making the SMS information public has had on reducing crashes.