Patient safety ethics and human error management in ED contexts. Part I: Development of the global patient safety movement

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end patient safety has become the focus of a world-wide endeavour aimed at reducing the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments. In this article (the first of a two-part discussion on the subject) an overview of the incidence and impact of preventable adverse events in ED contexts is explored. The development of a [`]culture of safety' in other hazardous industries and the [`]lessons learned' and applied to the health care industry are also briefly examined. In a second article (to be presented as Part II), some of the ethical tensions that have arisen in the context of implementing patient safety processes and their possible implications for ED contexts are explored.