Preventable harm:getting the measure right

Patient perspectives are essential to reliable detection of harm, including near missesHealthcare is not as safe as it should be. Twenty years since the publication of the seminal report To Err is Human,1 Panagioti and colleagues (doi:10.1136/bmj.l4185) estimate that about 12% of patients still experience some form of harm associated with healthcare, around half of which is preventable.2 This study raises serious concerns about the safety of health systems. How should health system leaders, doctors, and patients interpret these findings?Separating harm into outcomes that are deemed either preventable or inevitable is a necessary step to advance efforts toward patient safety. Yet no consensus exists as to what constitutes preventable harm, and even experienced clinicians vary in the extent to which they agree on whether an error is preventable.3 Panagioti and colleagues define preventable harm as the result of an identifiable modifiable cause and an event the recurrence …