More emphasis on safety needed: The patient advocate’s perspective

The U.S. health care system boasts some of the world’s most sophisticated medical treatment, superior medical education and training, and hundreds of thousands of conscientious and committed health care professionals. Nonetheless, patient safety in the U.S. has been the source of concern for many years now. Patient injury is widespread, and there is little evidence of consistent improvement.1 The Centers for Disease Control and Prevention (CDC) estimates that up to 10 percent of hospitalized patients develop a hospital-acquired infection (HAI), and that 1.6 to 3.8 million infections occur annually in long-term care facilities.2 The annual direct costs of these infections may be as great as $45 billion.3 Shockingly, in 2011, 13 wrong site operations and three wrong person procedures were performed in Connecticut alone.4

Behind each of these statistics is a name, a family, and a story of sorrow. Some patients and families suffer medical bankruptcy or unemployment, others loss of life or limb. For patients harmed while receiving health care services  there is also physical and emotional pain, broken trust, and disbelief.

The Connecticut Center for Patient Safety (CTCPS), a not-for-profit patient advocacy group, was established in response to the medical mistakes and preventable harms that patients and health care consumers all too regularly endure.5 CTCPS’ mission is to promote patient safety, improve the quality of health care, and protect the rights of patients through public media, patient education, and legislative action.

Initially, CTCPS’ advocacy efforts focused on HAIs given the magnitude and severity of the HAI problem and the common belief that many providers had taken the issue for granted. Indeed, stakeholders ranging from hospital executives to the CDC have argued that nosocomial infections may be “expected”—a statement that illustrates a dramatic rift in the expectations of patients and the health care community. No patient expects to visit a licensed medical facility and receive a deadly infection along with their treatment.

The CTCPS is part of a growing patient safety and advocacy movement, including the Consumer’s Union. There is evidence that the health care system is starting to respond to this movement and the voices it represents. The newly established Patient-Centered Outcomes Research Institute represents a focus on patient well-being, and the Agency for Healthcare Research and Quality has plans to pilot test a patient harm complaint system.4 The CDC and the American College of Surgeons are collaborating to monitor surgical site infections.6

These developments are encouraging, but much work remains to be done to protect health care consumers. In tackling these challenges, the CTCPS looks forward to working with and not against the health care sector. By collaborating to improve patient safety, patient advocates and providers can honor the needs and rights of patients, acknowledge the harm that has previously been done, and help ensure that such harm does not occur in the future.

Authors’ note
For further inquiries, Ms. Rexford can be reached via e-mail at


  1. Landrigan CP, Parry GJ, Bones CB, Hackbarth AD, Goldmann DA, Sharek PJ. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med. 2010;363(22):2124-2134.
  2. Preventing Central Line-Associated Bloodstream Infections: A Global Challenge, A Global Perspective. Oakbrook, IL: The Joint Commission; 2012.
  3. Scott RD. The Direct Medical Costs of Healthcare-Associated Infections In U.S. Hospitals and the Benefits of Prevention. Atlanta, GA: Centers for Disease Control and Prevention; 2009.
  4. Connecticut Center for Patient Safety. Medical harm complaint system could be quality data goldmine. CTCSP Newsletter. 2012. Available at: Accessed January 16, 2013.
  5. Connecticut Center for Patient Safety. Patient safety. Available at: Accessed January 16, 2013.
  6. American College of Surgeons. ACS announces surgical patient safety collaboration with Centers for Disease Control and Prevention to prevent surgical site infections and other adverse outcomes. Press release. 2012. Available at: Accessed January 16, 2013.

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