Improving Value

Reduce Medical Errors

A critically important area of excess spending and patient suffering is connected to care that is not only unnecessary but actually harms patients. Among other things, medical harm includes:

  • Serious Reportable Event—more commonly called “Never Events”1
  • Healthcare-acquired conditions,
  • hospital-acquired infection,
  • medication errors, and
  • Diagnostic errors.

The strategies that help reduce patient harm are fairly well understood but unevenly implemented. In part, this stems for a lack of public reporting of harm. Hence, key strategies to measure and reduce medical harm include:

  • Improving the accuracy, breadth and standardization of publicly reported medical harm across all settings.
  • Funding training and education of healthcare providers to understand the most effective strategies for reducing medical harm.
  • Aligning financial incentives to harm reduction, such as no payment for serious reportable events, reducing payments to the lowest performers and bundling payments in patient-centered integrated health delivery systems.
  • Make the National Practitioner Data Bank—a database of all state and federal actions against US physicians, including malpractice settlements—available to the public. Currently the data is available but the names of doctors are confidential.
  • Establish a National Patient Safety Board—similar to the National Transportation Safety Board ‚Äčor the Consumer Finance Protection Agency ‚Äčto represent the interests of patients/consumers by monitoring, investigating and promoting healthcare system changes that will lead to the elimination of medical errors.

 Related Reports and Advocacy Resources:


1.These errors are defined as "adverse events that are serious, largely preventable.” A list of “never events” is maintained by the National Quality Forum.