Somewhat beating a dead horse, five years and one day after To Err is Human, UCSF patient safety expert (and by definition rebel physician) Robert Wachter has a paper in Health Affairs in which he (using a survey of 400 hospitalists) grades the US health care system’s efforts on the patient safety issue. The press release notes that he "gives the U.S. health system an overall grade of C+ on patient safety, noting some improvement but considerable deficiencies in key categories." Especially as the only category that patient safety gets an A grade (albeit it an A minus) is in the regulatory sphere. I don’t think that THCB’s commentator of earlier this week Michael Millenson would be so generous with his grading. As he said in his piece in THCB on Monday, "As the horror stories fade, Congress can barely summon the energy to mandate voluntary error reporting." Wachter is impressed only by JCAHOs regs on checking orders and the impact of the emerging role of hospitalists.

Here’s the full paper, and it doesn’t really make for encouraging reading.