The Institute of Medicine Report on Medical Errors: Misunderstanding Can Do Harm

Quality of Health Care in America Committee*

In This Article


In December 1999, the Institute of Medicine (IOM) released the report, "To Err is Human: Building a Safer Health System."[1] The response was immediate and far-reaching. The report received near-saturation coverage in the media, and a public opinion poll found that 51% of the American public closely followed the coverage of medical errors.[2] Within 2 weeks of the release of the report, Congressional hearings on the issue began and the President directed the Quality Interagency Coordination Task Force (QuIC) to evaluate the IOM recommendations and respond with a strategy for reducing medical errors.[3] In February, the President endorsed virtually all of the IOM recommendations and the comprehensive strategy for improving patient safety developed by the QuIC.

The ensuing debate around the findings and recommendations of the IOM report has been thoughtful and informative, and has stimulated additional thinking. Unfortunately, it has also led to some misunderstandings. Because of the urgency of moving ahead promptly with the substantial changes that are needed to make our healthcare system safe, it is important that those misunderstandings be cleared up as quickly as possible. The IOM report carried 4 core messages: first, the magnitude of harm that results from medical errors is great; second, errors result largely from systems failures, not people failures; third, voluntary and mandatory reporting programs are needed; and fourth, a concerted national effort is needed now to improve patient safety.