We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Controversies |

Patient Safety Efforts Should Focus on Medical Errors

Robert A. McNutt, MD; Richard Abrams, MD; David C. Aron, MD, MS; for the Patient Safety Committee
JAMA. 2002;287(15):1997-2001. doi:10.1001/jama.287.15.1997.
Text Size: A A A
Published online


Physicians and other members of the health care team encounter many problems in trying to make medical care safe. Two reports by the Institute of Medicine (IOM) claim that the medical profession is not organized to deliver high-quality care.1,2 While we do not dispute the conclusions in these reports, we believe the reports may underestimate the magnitude of the problem as well as the character. Also, if not carefully considered, the report may lead to taking aim at isolated injuries rather than error. In doing this, the perception may be that medical care is being fixed; instead, the stage is being set for worse errors to come.3 The following case report highlights this issue.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Figure 1. Classification Scheme for Medical Error
Graphic Jump Location
The sequence of boxes is shown in order of detection, not in order of occurrence.
Figure 2. Model of Constraint in a Health Care Process
Graphic Jump Location
Components within a health care process may occur in an interdependent, nonlinear manner. Each component contributes an amount of output toward achieving safe health care, indicated as units per hour. The overall success of the process is limited by the constraint.



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

45 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Inserting epidural patient controlled analgesia into a peripheral venous line. Rev Esp Anestesiol Reanim Published online Apr 6, 2016;
Impact of clinical pharmacist in an Indian Intensive Care Unit. Indian J Crit Care Med 2016;20(2):78-83.

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Effect of Opiates on Potential Management Errors

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Reference Standards for Management Errors