The patient's right to safety--improving the quality of care through litigation against hospitals.

It is the consensus of experts in the patient-safety field that little has changed to improve the safety of hospital care since the Institute of Medicine’s 1999 report, To Err Is Human.1-5 The report noted that in order to be successful, “safety must be an explicit organizational goal that is demonstrated by clear organizational leadership. . . . This process begins when boards of directors demonstrate their commitment to this objective by regular, close oversight of the safety of the institutions they shepherd.”1 Leape and Berwick agree, noting that safety cannot become an institutional priority “without more sustained and powerful pressure on hospital boards and leaders — pressure that must come from outside the health industry.” 2 In hospital care, the challenge is to reform corporate governance to make hospital boards take their responsibility for patient safety at least as seriously as they take the hospital’s financial condition. Most patient-safety experts continue to believe that the threat of liability is the primary barrier to the development of effective and comprehensive patient-safety programs in hospitals.1-7 I suggest, on the contrary (and no doubt controversially among physicians), that judicial recognition of an explicit “right to safety” for hospital patients, with a correlative duty of hospitals to implement patient-safety measures, can become the primary motivator for the development of systems to improve patient safety. Hospitals that do not take specific actions to improve safety should be viewed as negligent and be subject to malpractice lawsuits when a violation of the right to safety results in injury.