Doctors are not pilots and patients are not airplanes: Quality improvement in medicine

Abstract

The Institute of Medicine of the National Academy of Science issued a report in 1999 entitled “To Err Is Human.” It described errors in hospitals which led to between 44,000 and 99,000 deaths per year. This was the “tipping point” toward self-evaluation and quality improvement. Medicine has slowly developed quality improvement methodologies that seem to work. Surgery leads the way. This article will go through some of the history of quality improvement with the difficulty comparing patients and defining outcomes, along with the difficulties changing physician behavior. The challenges of implementing quality improvement across an entire hospital will be demonstrated.

Keywords:

• quality
• surgical quality
• medical quality improvement