There is a problem in health care that has been hiding in plain sight: medical errors.
These errors are numerous and varied – from misdiagnoses to medication mishaps – and their causes are equally diverse. In its report Improving Diagnosis in Health Care, the National Academy of Medicine estimates that “nearly every American will experience a diagnostic error in their lifetime, sometimes with devastating consequences.”
A new film, To Err is Human, takes an in-depth look at this silent epidemic and those working to fix it. Filmmaker, Mike Eisenberg, writes in a Health Affairs article that “documentary film is one of the most powerful and influential mediums for increasing awareness on any issue.” Eisenberg credits his father, Dr. John Eisenberg, who once led the Agency for Healthcare Research and Quality, as inspiration for making the film. He also writes about the Moore Foundation as one of the funders of the project.
Our support for this documentary was one project in a broader portfolio of patient safety work that has spanned nearly two decades. This work was inspired by our co-founder, Betty Irene Moore, who became a champion for improving the quality of care after a medical error nearly cost her life. In response, the foundation launched the Betty Irene Moore Nursing Initiative (2003-2015) which measurably improved the safety of health care delivery in hospitals across the San Francisco Bay Area and greater Sacramento.
You can’t improve what you can’t measure
More recently, our work has focused its attention on the historically underappreciated topic of diagnostic errors and their resulting harm. In November 2018, the foundation launched a six-year, $85 million initiative in diagnostic excellence. Achieving excellence in diagnosis goes beyond avoiding errors and also includes consideration of cost, timeliness and patient convenience.
As we embark on this new initiative, our primary strategy is to strengthen accountability for diagnostic excellence by helping to develop and validate new measures for diagnostic performance. We start with this infrastructure because our health care systems are unable to systemically measure diagnostic performance in real time, which limits the ability to quantify performance and guide improvements. As the adage goes, “you can’t improve what you can’t measure.”
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