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  • Book
  • Open Access
  • © 2021

Making Healthcare Safe

The Story of the Patient Safety Movement


  • This book is open access, which means that you have free and unlimited access to the electronic version

  • Provides an insider’s first-hand record of how patient safety became recognized as an important problem, the underlying science, and the efforts to implement changes

  • Comprehensively covers systems theory and how to change processes, working conditions, patient-doctor/nurse communications, patient support, teamwork, creating a just culture, and creating a culture of respect

Buying options

Softcover Book USD 49.99
Price excludes VAT (USA)
Hardcover Book USD 59.99
Price excludes VAT (USA)

Table of contents (24 chapters)

  1. Front Matter

    Pages i-xxviii
  2. In the Beginning

    1. Front Matter

      Pages 1-1
    2. The Hidden Epidemic: The Harvard Medical Practice Study

      • Lucian L. Leape
      Pages 3-16Open Access
    3. It’s Not Bad People: Error in Medicine

      • Lucian L. Leape
      Pages 17-30Open Access
    4. Changing the System: The Adverse Drug Events Study

      • Lucian L. Leape
      Pages 31-44Open Access
    5. Coming Together: The Annenberg Conference

      • Lucian L. Leape
      Pages 45-52Open Access
    6. A Home of Our Own: The National Patient Safety Foundation

      • Lucian L. Leape
      Pages 53-65Open Access
  3. Institutional Responses

    1. Front Matter

      Pages 67-67
    2. Who Will Lead? The Executive Session

      • Lucian L. Leape
      Pages 89-104Open Access
    3. When the IOM Speaks: IOM Quality of Care Committee and Report

      • Lucian L. Leape
      Pages 127-142Open Access
    4. Setting Standards: The National Quality Forum

      • Lucian L. Leape
      Pages 159-184Open Access
    5. Enforcing Standards : The Joint Commission

      • Lucian L. Leape
      Pages 185-202Open Access
    6. Partners in Progress: Patient Safety in the UK

      • Lucian L. Leape
      Pages 203-213Open Access
    7. Going Global: The World Health Organization

      • Lucian L. Leape
      Pages 215-229Open Access
    8. Just Do It: The Surgical Checklist

      • Lucian L. Leape
      Pages 231-241Open Access
    9. Spreading the Word: The Salzburg Seminar

      • Lucian L. Leape
      Pages 243-251Open Access

About this book

This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD.  Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span.  In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design.  Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US.  


Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it.  II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality.   Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve.  


Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.


  • patient safety
  • high-risk industries
  • system design
  • silent epidemic
  • workplace safety
  • open access

Authors and Affiliations

  • Harvard T. H. Chan School of Public Health, Boston, USA

    Lucian L. Leape

About the author

Lucian L. Leape, MD

Immediate Past Chair, Lucian Leape Institute for Healthcare Improvement

Adjunct Professor of Health Policy

Harvard T.H. Chan School of Public Health

Boston, MA 


Lucian Leape, MD is a physician and professor at Harvard School of Public Health, who has been active in trying to improve the medical system to reduce medical error. In 1994 he had an article, "Error in Medicine," published in JAMA. In 1997, he testified before a subcommittee of the US Senate with his recommendations for improving medical safety.

Leape is known as the father of the patient safety movement has spent the last 30 years of his working life campaigning for change in the American healthcare system. He travels the world to give talks and lectures, influencing many of the world's brightest medics.

Leape is the Chair of the Lucian Leape Institute at the National Patient Safety Foundation. The Institute, founded in 2007, is charged with defining strategic paths and calls to action for the field of patient safety, offering vision and context for the many efforts underway within health care, and providing the leverage necessary for change at the system level. Its members comprise national thought leaders with a common interest in patient safety whose expertise and influence are brought to bear as the Institute calls for the innovation necessary to expedite the work and create significant, sustainable improvements in culture, process, and outcomes critical to safer health care.​

Bibliographic Information

  • Book Title: Making Healthcare Safe

  • Book Subtitle: The Story of the Patient Safety Movement

  • Authors: Lucian L. Leape

  • DOI:

  • Publisher: Springer Cham

  • eBook Packages: Medicine, Medicine (R0)

  • Copyright Information: The Editor(s) (if applicable) and The Author(s) 2021

  • License: CC BY

  • Hardcover ISBN: 978-3-030-71122-1Published: 29 May 2021

  • Softcover ISBN: 978-3-030-71125-2Published: 29 May 2021

  • eBook ISBN: 978-3-030-71123-8Published: 28 May 2021

  • Edition Number: 1

  • Number of Pages: XXVIII, 450

  • Number of Illustrations: 1 b/w illustrations

  • Topics: Internal Medicine, Surgery

Buying options

Softcover Book USD 49.99
Price excludes VAT (USA)
Hardcover Book USD 59.99
Price excludes VAT (USA)