October 13, 1996 — The nation’s largest-ever conference on preventing health care errors opened here today with the announcement of a National Patient Safety Foundation to be established by the American Medical Association (AMA), news that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will be launching immediate reviews of errors it considers to be sentinel events to determine root causes, and a listing of the top ten ways to prevent medication errors from keynoter Dr. Lucian Leape, a nationally recognized health care quality scholar.

“Even with the best training, resources and facilities, our nation’s health care system can still use improvement when it comes to preventing errors,” said Nancy Dickey, noting that establishment of the National Patient Safety Foundations is consistent with physicians’ traditional responsiblity for patients for patients under their care.

“In today’s health care environment, we’re all accountable and we all must work together to prevent errors,” explained Dickey, “which is why the National Patient Safety Foundation will be a collaborative initiative involving all members of the health care community aimed at stimulating leadership, fostering awareness, and enhancing patient safety knowledge creation, dissemination and implementation.”

In his keynote address opening the conference, Leape used his list of medication error prevention steps to illustrate that much is already known about how to decrease errors but that error prevention knowledge is not sufficiently disseminated and practiced.

“There have been many advances in recent years in our ability to reduce errors in health care, particularly in anesthesia and medication usage, and in industries such as aviation and nuclear power,” observed Leape, “and the purpose of this conference is to get these people to talk to one another and to get people to go home and implement proven remedies.”

Organized by the American Association for the Advancement of Science, the American Medical Association, the Anneberg Center for Health Sciences at Eisenhower and the Joint Commission on Accreditation of Healthcare Organizations, the conference includes, among its more than 300 participants and presenters, researchers, health care leaders and error prevention experts representing a broad range of perspectives, disciplines, specialties and even non-health care related industries.