• decision support
• adverse events
• error
• patient safety
• iatrogenic illness

Steel et al raised a red flag for the medical community in 1981 when they articulated the serious risks associated with hospitalization.¹ They identified a lack of progress in the 15 years that followed a previous report of the same problem. The many advances in diagnostic and therapeutic interventions that had appeared during those 15 years were not matched by a reduction in iatrogenic illness suffered by patients in hospital. They identified the types and magnitudes of several risks without assigning blame or claiming that the iatrogenic illnesses were preventable; 36% had at least one iatrogenic illness, 9% had a major iatrogenic illness, and 2% sustained an iatrogenic illness that contributed to death.

Interestingly, iatrogenic illness occurred in several different clinical settings within the medical service they studied. One of the strengths of their study lies in the inclusion of all new patients admitted to medical and metabolic wards and to both an intensive care unit and a coronary care unit. Iatrogenic illness was encountered in all of these settings. As expected, the intensive care settings accounted for more …