title: [Burden of medical errors in Italy: an analysis of the literature].
abstract: BACKGROUND
  Medical malpractice and litigation have a significant impact on the Italian National Health Service. The aim of this study was to analyze the state of the art of medical errors in Italy, in particular, assessing which specialties are most affected.
  
  
  METHODS
  We performed a literature search in PubMed, Google Scholar; institutional websites (Ministry of Health, Higher Institute of Health, National Agency for Regional Health Services, National Institute of Statistics, National Research Council, Court of Auditors), gray literature and specialized magazines.
  
  
  RESULTS
  Results show that data regarding the frequency of medical errors and the effectiveness of prevention measures in Italy are scarce. Most papers published on this topic refer to a few specialties, including Surgery, Radiology, Cardiology, and Laboratory medicine. Surgery is the specialty most affected.
  
  
  CONCLUSIONS
  Despite a growing attention towards patient safety and quality of healthcare, medical errors continue to occur in clinical practice. Most errors are not due to individual incompetence or negligence but they are rooted in system breakdowns. A systematic approach is therefore required, based on: an analysis of critical aspects in the system; the selection and implementation, at different levels of the system, of appropriate and evidence-based risk management interventions involving all stakeholders; a context analysis to identify barriers and facilitators for change; a performance assessment to verify results and identify actions for improvement.
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Specchia
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cadeddu
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Lovato
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Silvio
authors.initials: S
authors.lastname: Capizzi
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ferriero
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Marina
authors.initials: M
authors.lastname: Veneziano
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Agostino
authors.initials: A
authors.lastname: Mancuso
authors.affiliation: Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
mesh_terms: D002309:Cardiology / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D013502:General Surgery / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007755:Laboratories, Hospital / Q000706:statistics & numerical data; D008318:Malpractice / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000706:statistics & numerical data*; D061214:Patient Safety; D011787:Quality of Health Care / Q000706:statistics & numerical data; D011871:Radiology / Q000706:statistics & numerical data