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Barriers to the implementation of patient safety initiatives

      In 1999 the Institute of Medicine (IOM) [
      • Institute of Medicine
      To err is human: building a safer health system.
      ] issued a report on medical errors, “To Err is Human: Building a Safer Health System,” which presented data supporting the fact that preventable adverse events are currently a leading cause of death in United States hospitals. Since the publication of this report, a huge effort has been expended at both national and local levels on error-related clinically applied research and on the implementation of new standards and practices related to quality improvement and patient safety. Despite a seeming consensus by all stakeholder groups in our health care system on the priorities of providing high quality care and “doing no harm” to patients, in many cases implementation of quality improvement plans, including plans aimed at decreasing medical errors, has achieved minimal to modest success. Although these plans are grounded in sound theory and strong scientific evidence, they have had less than the expected impact on practice and care [
      • Oxman A.D.
      • Thomson M.A.
      • Davis D.A.
      • Haynes R.B.
      No magic bullets: a systematic review of 102 trials of interventions to improve professional practice.
      ].
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