In late 1999, the U.S. Institute of Medicine published To Err is Human:
Building a Safer Health Care System.
1
Although the IOM has published
more than 300 reports since To Err, none have been nearly as influential.
The reason: extrapolating from data from the Harvard Medical Practice
Study,
2,3
performed a decade earlier, the authors came up with the estimate that 44,000–98,000 Americans die each year from medical errors.
More shockingly, they translated these numbers into the now-famous
“jumbo jet units,” pointing out that this death toll would be the equivalent
of a jumbo jet crashing each and every day in the United States.
Although some critiqued the jumbo jet analogy as hyperbolic, I like it
for several reasons. First, it provides a vivid and tangible icon for the
magnitude of the problem (obviously, if extended to the rest of the world,
the toll would be many times higher). Secondly, if in fact a jumbo jet was
crashing every day, who among us would even consider flying electively!
Third, and most importantly, consider for a moment what our society
would be doing and spending to fix the problem if there were a jumbo jet
(or even merely a regional commuter plane) crashing every day. The
answer, of course, is that there would be no limit to what we would do to
fix  that problem. Yet prior to the IOM Report, we were doing next to
nothing to make patients safer.