Errors Today and Errors Tomorrow

If the Institute of Medicine is right, then at the very least, 100 patients will die in hospitals in the United States today because of injuries from their care, not from their diseases. How many will die tomorrow?Tom Nolan, one of the leading quality-improvement scholars of our time, identifies three essential preconditions for improvement: will, ideas, and execution.1 Improvement requires will, because durable improvement is not an accident; it takes effort. Left alone, systems tend to deteriorate. Roads decay until someone decides to repair them. Patients will suffer injuries from care until someone decides otherwise.Improvement requires ideas, because . . .