title: Health systems' accountability for patient safety.
abstract: Patient safety experts, including the Institute of Medicine Committee on Quality of Health Care in America, have emphasized the need to focus on systems failure as the source of most error in health care. This requires an emphasis on prevention and on health systems' accountability for error. This article discusses traditional and evolving approaches to systems' accountability for error. While there are some significant recent developments, such as the JCAHO new Patient Safety Goals, many issues remain about how to determine and enforce systems' accountability for error. These include identifying what systems will be held accountable for and how accountability will be enforced. While reporting of errors is one route toward accountability, many questions remain regarding the most effective approach toward error reporting. Research on and evaluation of reporting systems and other approaches toward systems' accountability will be important in moving forward in this area.
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, School of Nursing at the University of Washington in Seattle, USA. keepnews@u.washington.edu
authors.forename: David
authors.initials: D
authors.lastname: Keepnews
authors.forename: Pamela H
authors.initials: PH
authors.lastname: Mitchell
mesh_terms: D000068:Accreditation / Q000592:standards; D004868:Equipment Failure; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence; D019300:Medical Errors / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D010355:Patient Identification Systems / Q000379:methods / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration / Q000592:standards; D017751:Safety Management / Q000458:organization & administration*; D012637:Security Measures; D018571:Sentinel Surveillance; D012941:Social Responsibility; D014481:United States