A Victory for Justice in the Congo In a stunning victory for justice, a Congolese court has convicted 11 men of crimes against humanity and sentenced them to life in prison for the rapes of dozens of little girls over a three-year period in the village of Kavumu, Democratic Republic of the Congo. To date, more than 2, children have been separated from their parents. This ruling deals a hard blow to the families of the victims of the brutal campaign of sexual violence in the Central African Republic CAR in and
Page xiii Acknowledgments The Committee on the Quality of Health Care America first foremost acknowledges the tremendous contribution by the members of two subcommittees.
Both subcommittees spent many hours working through a set of exceedingly complex issues, ranging from topics related to expectations from the health care delivery system to the details of how reporting systems work. Although individual subcommittee members raised different perspectives on a variety of issues, there was no disagreement on the ultimate goal of making care safer for patients.
Without the efforts of the two subcommittees, this report would not have happened. We take this opportunity to thank each and every subcommittee member for their contribution.
Page xiv Share Cite Suggested Citation: To Err Is Human: Building a Safer Health System.
The National Academies Press. Reinertsen, CareGroup; Joseph E.
A number of people willingly and generously gave their time and expertise as the committee and both subcommittees conducted their deliberations. Their contributions are acknowledged here. Participants in the Roundtable on the Role of the Health Professions in Improving Patient Safety provided many useful insights reflected in the final report.
Page xv Share Cite Suggested Citation: A number of people at the state health departments generously provided information about the adverse event reporting program in their state.
The committee thanks the following people for their time and help: At the Veterans Health Administration, Kenneth Kizer, former Undersecretary for Health and Ronald Goldman, Office of Performance and Quality shared their views on how to create a culture of safety inside large health care organizations.
A special thanks is offered to Randall R. Bovbjerg and David W.
Shapiro for preparing a paper on the legal discovery of data reported to adverse event reporting systems. Their paper significantly contributed to Chapter 6 of this report, although the conclusions and findings are the full responsibility of the committee readers should not interpret their input as legal advice nor representing the views of their employing organizations.
A special thanks is also provided to colleagues at the IOM.Welcome to ashio-midori.com, a free educational resource for learning about human anatomy and physiology.
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