Patient Safety

History

The timeline below represents historical events that relate to patient safety, going the whole way back to the 1850s. We have also included key events related to our work here at the Patient Safety Movement Foundation. 

  1. 1850's

    Florence Nightingale is the first to use charts and graphs to show the relationship between hygiene and patient outcomes during the Crimean War.

  2. 1900-1949

    The American College of Surgeons (ACS) developed the first set of hospital standards, which was one page long, and began on-site inspections.

  3. 1950-1989

    1950
    The American College of Surgery and several other physician groups joined to become the Joint Commission for Accreditation of Hospitals (JCAH). The name changed later to JCAHO as the focus became on outpatient settings and is now known as TJC, or The Joint Commission.

    1965-1966
    The US government institutes the Medicare program to insure those over 65 or with chronic conditions. Medicaid, a similar program run by states for low-income populations, begins a year later.

    1970’s
    The Institute of Medicine (IoM) was founded under the National Academy of Sciences to address the concerns of medicine and healthcare. The IoM has now been renamed the National Academy of Medicine (NAM).

    1980’s
    The concept of Quality Improvement is more widely introduced in healthcare by Donabedian and others. Diagnostic-Related Groups (DRGs) are instituted in the U.S., which reduces payment to hospitals from Medicare.

    1989
    Walt Bogdanich in his Great White Lie book exposed many of the failings of our healthcare system that lead to preventable deaths, even care providers’.

  4. November 1999

    Institute of Medicine releases report, To Err is Human: Building a Safer Health System, claims that as many as 98,000 people are dying in hospitals due to medical errors each year. Over the next decade, Founder Joe Kiani becomes passionate about how to significantly reduce this number.

  5. 2001

    2001
    Josie King passes away due to Sepsis at world-renowned The Johns Hopkins Hospital.

    In response to Josie King’s passing, John Hopkins intensive care specialist, Dr. Peter Pronovost, who cared for Josie King, developed a 5-item checklist to reduce central line infections and the infection rate within Johns Hopkins decreased from 11% to 0%.

  6. 2003

    The U.S. government introduces “Core Measures” requirements for U.S. hospitals: the first publicly reported patient outcome data.

    The Joint Commission introduced the “National Patient Safety Goals” program which articulates steps for reducing medical error and is updated on an annual basis.

  7. 2004

    Institute for Healthcare Improvement (IHI) launched its campaign, titled 100,000 Lives Campaign, to significantly reduced preventable deaths over 18 months. From this initiative, IHI reported 122,000 fewer preventable deaths.

  8. 2006

    The HCAHPS survey (Hospital Consumer Assessment of Healthcare Providers and Systems) for American hospitals was introduced as the relationship between patient satisfaction and patient safety became evident.

  9. 2007

    World Health Organization (WHO) launches its first patient safety campaign entitled “Safe Surgery Saves Lives”, aiming to bring together surgical leaders around the world to focus on key topics such as Surgical Site Infection (SSIs), safe anesthesia, and surgical metrics. During this time, the WHO and a team of Harvard scientists developed the “Safe Surgery Checklist” which was broadly distributed and implemented worldwide.

    Department of Veteran Affairs (VA) spearheaded a project aimed at reducing MRSA infections, specifically aimed at prevention and contact with patients. The Centers for Disease Control and Prevention (CDC) noted a ⅔ decrease in the amount of MRSA infections in VA hospitals from 2005-2017.

  10. 2008

    The Association of American Medical Colleges (AAMC) created the Integrating Quality Initiative which focused on emphasizing patient safety in its medical schools and teaching hospitals’ curriculum.

  11. 2010

    Boston Children’s Hospital launched the I-PASS project to mitigate hand-off communication errors.

    Partnership for Patients, a subgroup in the Affordable Care Act (ACA), was created with the mission to reduce Healthcare-associated Infections (HAIs), adverse drug events, and pressure ulcers.

    The Office of the Inspector General (OIG) publishes a report revealing the number of Medicare beneficiaries who experience preventable deaths reaches 180,000.

  12. 2011

    AHRQ created “National Scorecards for Hospital-acquired Conditions”.

    The Joint Commission’s Center for Transforming Healthcare conducted an interdisciplinary, 18-month effort to reduce falls and saw a 62% reduction in fall-related injuries in hospitals.

  13. 2012

    Joe Kiani decides that he has to do something to help with the patient safety problem. He decides to create and hold the Patient Safety, Science & Technology Summit in hopes to unify the healthcare ecosystem and come up with an action and commitment-oriented approach to eliminate preventable deaths. Joe Kiani and President Bill Clinton travel to Africa and discuss the problem in June 2012 during their travel.  President Clinton commits to helping Joe in the mission to achieve ZERO preventable deaths. A series of brainstorms with luminaries like Dr. Peter Pronovost helps determine which patient safety challenges to address first. These become our Actionable Patient Safety Solutions (APSS). The Masimo Foundation for Ethics, Innovation, and Competition in Healthcare become the Founding Sponsor of the Patient Safety Movement Foundation.

  14. 2013

    Ten-year anniversary of the National Health Service’s (NHS’s) National Reporting and Learning System, which was established to aggregate incident data.

    Chairman Tom Harkin holds the first Senate Hearing on patient safety at the behest of Patient Safety Movement Foundation. The Patient Safety Movement’s goal of zero preventable deaths is announced at the Clinton Global Initiative by Founder and Chairman, Joe Kiani.

    Inaugural Patient Safety, Science & Technology Summit is sold out and draws in over 300 attendees. Nine Healthcare Technology Companies sign the Open Data Pledge, at the Summit. Several hospitals make a commitment to zero. Seven Guiding Principles are established and announced at the Summit. The first 9 healthcare technology companies sign the Open Data Pledge: Cercacor, Cerner, Dräger, GE Healthcare, Masimo, Philips, Surgicount, Smiths Medical, ZOLL. Intermountain Healthcare becomes the first hospital to make a commitment to ZERO preventable deaths at the evening break.

  15. 2014

    One plus 601 lives saved by committed hospitals. Hospitals in Canada and Lithuania make committments, becoming as first international organizations to join.

    John James publishes a new report based upon data from 2008 – 2011, which, unlike the 1999 IOM study, included errors related to missed care and poor communication. This new report estimates that between 250,000 and 400,000 people die each year due to medical error.

    In August 2014 the Patient Safety Collaboratives program was established in the NHS.

    In September, The Patient Safety Movement Foundation becomes a 501(c)(3) not-for-profit organization.

  16. 2015

    Foundation announces one plus 6,411 lives saved through commitments made by healthcare organizations and hospitals across the world.

    Former President Jimmy Carter and wife Rosalynn Carter demonstrate their support for the Foundation’s mission of ZERO preventable hospital deaths. The top three institutions that saved the most lives went on a once-in-a-lifetime fishing trip with President Carter and his wife.

  17. 2016

    Formerly known as the Patient Safety, Science & Technology Summit is renamed the World Patient Safety, Science & Technology Summit due to global traction by committed organizations. Foundation announces one plus 24,642 lives saved.

    After witnessing the potential for numerous alignments across associations, professional societies and non-profits the Foundation forms an opportunity to affiliate, calling these groups Committed Partners.

    Medtronic signs the Open Data Pledge and also becomes a Benefactor, granting the Foundation $1M per year, through 2020.  At this point, over 70 companies have signed PSMF data share pledge and over 50 have signed the CMS data share pledge that PSMF helped CMS create.

  18. 2017

    President, Bill Clinton, appointed Global Chair at the 5th Annual World Patient Safety, Science & Technology Summit. Foundation announces one plus 69,518 lives saved.

  19. 2018

    The World Patient Safety, Science & Technology’s 6th Annual event is held for the first time outside of California, in London, United Kingdom and brings together stakeholders from 25 countries. The Foundation announces 81,533 lives saved by committed hospitals operating in 44 countries worldwide.

    We release an update to PatientAider® a mobile app that was donated to us by Mari Miceli, a former RN who wanted to help make information available to help keep patients safe in the hospital.

    In September 2018, the Secretary of State for Health and Social Care announced there would be a new patient safety strategy, stating that “every patient – whether in hospital, at home, in a General Practitioner (GP) surgery – expects compassionate, effective and safe care.”

  20. 2019

    The 7th Annual World Patient Safety, Science & Technology Summit was held in Huntington Beach, California. The Foundation announced that 90,146 lives were saved by committed hospitals across 46 countries in 2018. In total, since 2012, 273,077 lives have been saved since the Foundation started.

    In May of 2019 the World Health Assembly votes and establishes World Patient Safety Day which will be celebrated each year on September 17th.

  21. 2020

    The Patient Safety Movement Foundation announced 93,276 lives saved by 4,793 hospitals across 48 countries. Cumulatively since 2012, hospitals in our network saved 366,353 lives – an incredible feat.

    The Patient Safety Movement Foundation officially launched the #uniteforsafecare campaign in June of 2020.

    On World Patient Safety Day, September 17, the Patient Safety Movement Foundation hosted a virtual event to honor the 200,000+ lives lost every year due to medical harm. Over 50 speakers shared their heart-wrenching and heroic stories of survival and loss as well as their professional and personal experiences that will help educate and inspire you to #uniteforsafecare

    We sunsetted our first commitment-based initiative and shared that over 366,353 lives were saved by hospitals and healthcare organizations in our Network between 2012 and 2020. A fantastic feat that we were happy to shout from the rooftops as their “megaphone” to help others emulate their successes.

    We also launched a new commitment-based model encouraging the 4,793 hospitals and healthcare organizations across the world to commit to ZERO. This new commitment encourages them to go back to the basics, committing to establishing safe and reliable healthcare. We’re excited to see where this will lead us on our goal to ZERO preventable harm and death across the world by 2030.

  22. 2021

    15 passionate patient safety advocates – patients, families, and health workers – gathered at Freedom Plaza in Washington, DC just before 10 am local time to walk down Pennsylvania Avenue to the Capitol building to bring awareness to patient safety. We kept the gathering small due to the pandemic and practiced safe distancing and masking along the way.

    #uniteforsafecare virtual event

    The 2nd annual event brought the world together again to unite for safe care, bringing fresh perspectives and new topics to light about how we can exit this pandemic ready to unite for safe care!