The Institute of Medicine's report on medical error - Implications for pathology

Context.-During the past several years, more attention has been focused on the topics of medical error and patient safety than in the past. At the end of 1999, the Institute of Medicine (IOM) published a seminal report concer ning medical error in the United States; this report will have sweeping imp lications for all disciplines of medicine, including pathology. Objective.-To review the major findings of the IOM report on medical error and to discuss their implications for the field of pathology. Methods.-Review of the IOM report on medical error and discussion of other relevant literature on medical error. Results.-The IOM report on medical error highlights an unacceptable rate of medical error in the United States and mandates a 50% reduction in medical error during the next 5 years. It recommends regulatory solutions to this problem, as well as organizational approaches to error reduction. It propos es both mandatory and voluntary systems for reporting of medical error. The report suggests that systems should be examined for latent flaws and that individual culpability for error should not be overemphasized. The report r ecommends that error-reduction strategies that have been applied to other i ndustries should be studied and that known concepts of error reduction shou ld be applied to medicine. Strategies that the IOM suggests can be applied to pathology. Conclusions.-Medical error occurs at an unacceptably high rate. Recommendat ions made in the IOM report on medical error and patient safety should be a pplied to the practice of pathology.