The Institute of Medicine's landmark 1999 report, To Err is Human,1 set the stage for progress in quality and safety in health care. Yet 15 years later, recent findings still suggest that potentially up to 400,000 preventable deaths occur yearly.2 Part of the challenge in addressing this gap in health care is that systems for accountability are underdeveloped and standardization is lacking in the way quality and safety data are presented to health system leaders and boards. Creating a robust performance management system in health care to provide standardization and accountability similar to that found in financial accounting has been suggested3; however, this represents a transformational step that is still incipient and requires broad health care stakeholder involvement. In the interim, it is possible to adapt financial concepts to quality and safety at a local level, with individual hospitals and health systems leading the way for greater progress.
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