American healthcare will not get better or be safer until issues related to overuse of health services, process improvement tools, and organizational culture are addressed, according to a viewpoint published by Joint Commission President and CEO Mark R. Chassin, MD, FACP, MPP, MPH.

“Harm-free healthcare does not exist today, but that should not prevent us from aspiring to achieve that goal,” Chassin wrote in the article, “Improving the Quality of Health Care: What’s Taking So Long?” He acknowledged that the lack of more rapid progress in fixing known problems is frustrating, and suggests that the task requires new approaches.

He also notes that, nearly 14 years after the Institute of Medicine published its report “To Err Is Human: Building a Safer Health System,” quality and safety problems in healthcare continue to routinely result in harm to patients.

Chassin proposes three strategies to address the problem: eliminating overuse of health services, recognizing that one size does not fit all, and creating a culture of safety.

“The organizational culture of most American hospitals and other healthcare organizations must change. To create a culture of safety, leaders must eliminate intimidating behaviors that suppress the reporting of errors and unsafe conditions. Leaders must also hold everyone accountable for adherence to safe practices,” wrote Chassin.