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The State of Patient Safety and Quality Improvement

An Interview with Dr. Pierre Barker

As the Chief Scientific Officer of the Institute for Healthcare Improvement (IHI), Dr. Pierre Barker is at the forefront of efforts to improve health and healthcare, worldwide via rigorous scientific research.



More personally, Dr. Barker draws upon his extensive experience in designing effective health improvement interventions across a diverse range of both health systems and economies. A career that spans over 30 years across several continents as well as hospital and academic institutions.

Such a background gives a unique perspective on various topics discussed on the One Million Lives podcast including:

  • Current state of patient safety and quality improvement, both in the United States and globally.
  • Ongoing challenges and emerging trends in the field.
  • Potential role of artificial intelligence (AI) in transforming healthcare practices.

Background Context

Since its release over 20 years ago, the Institute of Medicine’s landmark report, To err is Human, has been a driver of change through the healthcare industry. This seminal piece of research established the connection between medical errors, ranging from erroneous diagnoses to surgical mistakes, resulting in significant patient harm, including death. The report went as far as suggesting that, at a minimum, tens of thousands of lives are lost annually to preventable errors.

As a result of its publication, there was a total paradigm shift still evident today. A widespread awareness with a focus on improving patient safety standards and practices. The influence has extended far beyond its initial release, sparking change at both institutional and policy levels. 

More recently, a follow-up report was published. Authored by David Bates and Hardeep Singh, Two Decades Since To Err is Human: An Assessment of Progress and Emerging Priorities in Patient Safety examines the progress in reducing medical error over the lapsed time. It served a dual purpose to both highlight reduction in medical errors leading to improved healthcare as well as identifying persistent issues and emerging priorities.

Even further, an editorial in the New England Journal of Medicine by Professor Don Berwick, the founder of the IHI, included findings suggesting that such advances had stalled.

Current State of Patient Safety

In reflecting on the current state of patient safety, Dr. Barker acknowledged that while some progress has been made, significant challenges remain. He highlighted the vital need for continued efforts to improve patient safety, singling out the need for systemic changes to enable meaningful progress to occur.

The Promise of Artificial Intelligence

Looking ahead to the future, Dr. Barker expressed optimism regarding the potential impact of artificial intelligence on healthcare. He remarked that emerging AI technology presented an opportunity to alleviate the documentation burden on clinicians. With time returned to them, they were more available to care for their patients. Additionally, there is a potentiality for AI to be refined to function as an assistant and guide for clinical care, providing valuable support leading up to and during decision-making processes.

Regarding a role in managerial capacity, Dr. Barker noted that AI could provide succinct and clear information to staff, particularly in handover meetings. Such an advent would provide further awareness about alerts and high-risk patients helping healthcare teams to be more proactive and anticipatory for potential issues before they arise.

Looking Forward

In brief and retrospect, it is essential that dedicated organizations continue to help drive progress in patient safety. While challenges persist, there are both current and future opportunities that allow for innovation and improvement. The integration of future technologies like AI provides optimism of transforming healthcare practices, improving patient outcomes.