Harvard Practice Study

Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 1991 324(6) 377-84. 

Brennan T, Leape L, Laird N, Hebert L, LocaUo A, Lawthers A, et al. Incidence of adverse events and negligence in hospitalized patients results of the Harvard Medical Practice Study. Qual Saf Health Care. 2004 13 145-52. 

The classic, pioneering study in this area is the Harvard Medical Practice Study, still hugely influential and much debated 20 years after it was carried out (Box 4.2). Similar studies have been conducted in Australia (Wilson et al, 1995), Utah and Colorado (Gawande et al 1999), United Kingdom (Vincent, Neale and Woloshynowych, 2001), Denmark (Schioler ria/., 2001), New Zealand (Davis et al., 2002), Canada (Baker et ah, 2004) France (Michel et al., 2007) and other countries. The results of these studies are summarized in Table 4.3 and constitute, as Peter Davis expresses it, a new public health risk ... 

The Harvard Medical Practice Study reviewed patient records of 30, 121 randomly chosen hospitalizations from 51 randomly chosen acute care, non-psychiatric hospitals in New York State in 1984. The goal was to better understand the epidemiology of patient injury and to inform efforts to reform systems of patient compensation. The focus was therefore on injuries that might eventually lead to legal action. Minor errors and those causing only minor discomfort or inconvenience were not addressed. 

Harvard Medical Practice Study (HMPS) Brennan etai, 1991 Leape et al., 1991 1984 30195 3.7... 

It appears that the modern patient safety movement started in 1991 with the publication of the results of the Harvard Medical Practice Study in the New England Journal of Medicine [2-4], In the study, the medical records of 30,000 patients hospitalized in acute care hospitals in New York State in 1984 were examined. In 1996, the American Medical Association announced the formation of the National Patient Safety Foundation [2], In 1999, the National Academy of Sciences Institute of Medicine released its report entitled "To Err Is Human Building a Safer Health System" [5]. The report stated that medical errors are causing 44,000-98,000 preventable deaths annually in the United States. In 2001, the United States Congress appropriated 50 million per year for patient safety research to the Agency for Healthcare Research and Quality (AHRQ) [2],... 

Brennan, T. A., Leape, L. L., Laird, N. M., et al., Incidence of Adverse Events and Negligence in Hospitalized Patients Results from the Harvard Medical Practice Study I, New England Journal of Medicine, Vol. 324, No. 6,1991, pp. 370-376. 

Harvard Medical Practice Study (HMPS) (2) A 1991 study of medical records from fifty-one hospitals in New York State. The study found that almost 4 percent of all patients whose records were studied had suffered adverse events as a result of their medical care (Brennan and others, 1991). 

Brennan TA, Leape LL. Adverse events, neghgence in hospitalized patients results from the Harvard Medical Practice Study. Perspect Healthcare Risk Manage 1991 11 (2) 2—8. Spring. 

How big is the problem of medical error The US Institute of Medicine has estimated that up to 98,000 people die annually as a result of medical error in the USA (Kohn, Corrigan and Donaldson, 2000). This figure has been put at 180,000/ year in other studies. Medical error has been cited as the eighth most coimnon cause of death. According to Zhan and Miller (2003), medical error is one of the 10 most cotmnon causes of death in the USA. The Harvard Medical Practice Study in 1991 found that 4 per cent of hospital patients had additional injuries as a result of medical... 

Butterfield, Fox. Study Finds Unsafe Practices by People Trained in Firearms. The New York Times, January 20, 1995, p. A12. Reports that although many people on both sides of the gun debate advocate firearms safety training, a study by the Harvard School of Public Health found that people who had taken safety courses are actually more likely to keep a gun loaded and unlocked at home. 

For a study of the role of ancient texts in the practice of Renaissance astrologer Girolamo Cardano, see Anthony Grafton, Cardano s Cosmos The Worlds and Works of a Renaissance Astrologer (Cambridge, Mass. Harvard University Press, 1999). 

Out of this work developed a third area of inquiry the resemblance of mystical experience induced by psilocybin to mystical states brought about by spontaneous rapture or by religious practice. This eventually became a "double-blind study, described by Leary as a "tested, controlled, scientifically up-to-date kosher experiment on the production of the objectively defined, bona-fide mystic experience as described by Christian visionaries and to be brought about by our ministrations. It was conducted by Walter Pahnke as part of his Ph.D. dissertation for the Harvard Divinity School. 

---