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March 25, 2026
Patient Safety Concerns: #3 – Adverse Events

Patient Safety Concerns: #3 – Adverse Events

“Do no harm” is a precept long accepted in the medical community throughout the world. While not part of the original Hippocratic oath, Hippocrates did use this exact phrase in another one of his written works, which he entitled Of the Epidemics. Here is the quote in question:

Patient Safety Concerns: #3 – Adverse Events

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The physician must . . . have two special objects in view with regard to disease, namely, to do good or to do no harm.

The Latin phrase, primum non nocere, which translates to “first, do no harm,” cannot be directly attributed to Hippocrates because he didn’t speak Latin but rather Greek. The insertion of “first” must be a later interpolation by a Latin-speaking reader of Hippocrates, and that is what has come down to us through history.

Oh, the Irony

How ironic it is, then, that harm to patients within the surgery or hospital stay context is on the rise. In fact, according to a Johns Hopkins study, adverse events associated with patient care amount to the third leading cause of death in the United States. And it’s not just here in the U.S. where Hippocrates’ maxim seems to be in peril. According to the World Health Organization, patient harm is one of the top causes of morbidity and mortality worldwide.

But here’s another problem. Healthcare systems are not recognizing or reporting many of these adverse events. This makes it extremely difficult to evaluate or mitigate the risk of such events. In July 2025, the Office of Inspector General, an agency under the aegis of the U.S. Department of Health and Human Services, conducted a survey among several participating hospitals. The results indicated that these hospitals captured only 51% of the adverse events that actually occurred.

According to a report conducted by ECRI concerning their “Top 10 Patient Safety Concerns 2026,” the lack of event recognition or internal reporting can be attributed to various factors: events were not considered unexpected in the course of care or were indistinguishable from the patient’s condition; organization reporting requirements were too narrow to capture all events; or the event occurred post discharge.

Obviously, better reporting will lead to better management of adverse events; but, first, they have to identified! “When organizations accurately identify and report events, risks can be addressed more effectively,” according the ECRI report. Once identified, the facility can implement policies and procedures, education and training, in order to decrease the likelihood of the identified adverse events going forward. “An adverse event or unanticipated harm can cost an organization anywhere from approximately $5,000 to $17,0003,” according to ECRI; conversely, one health system’s implementation of harm reduction strategies saved a total of more than $100 million. On that note, let’s now take a look at just a few of the items found in the ECRI report from a solutions standpoint.

Recommendations

Here is a quick-hit list of strategies that hospitals and health systems can utilize to mitigate or even eliminate many adverse care events: 

  • Assess the organization’s definition of harm. Ensure that it is sufficient to allow recognition and capture of all events and that it is standardized across the organization.
  • Ensure the organization’s culture is conducive to reporting adverse events.
  • Create reporting pathways for patients and caregivers to voice concerns during the course of care.
  • Ensure that policies and procedures guide providers in communicating how issues were resolved with patients and families after harmful or potentially harmful events.
  • Encourage reporting of all harm events by ensuring that reporting is easy, quick and minimally disruptive to staff member routines. Make sure that staff have the time and resources necessary to submit a report and that supervisors are able to promptly follow up to obtain necessary information and manage the aftermath of the event.
  • Provide patient and family feedback to healthcare staff—not as a punitive measure but as part of a reasonable approach to learning and improvement. Consider options such as a monthly “good catch” award to encourage reporting. In addition, sharing lessons learned from an event report can promote further reporting.
  • Reporting systems should be able to protect reporters’ privacy, receive reports from a range of staff, share summaries as needed and support action plans.
  • Obtain leadership and staff buy-in before training on reporting systems, as it will require collaboration among risk, quality, information technology, training, and other staff.
  • Develop and assess the efficacy of communication systems to convey event definitions, identification strategies and lessons learned as a result of event reports. 

All health facilities want to be known for excellence in care. Doing no harm is a good place to start in the pursuit of patient satisfaction. Hospitals and health systems would do well, then, to implement strategies that increase adverse event identification and reporting, as well as methods to reverse patterns of harm. Hippocrates would be pleased.