Patients with eventually fatal chronic illness: their importance within a national research agenda on improving patient safety and reducing medical errors.

In September 2000, the Quality Interagency Coordination (QuIC) Task Force invited the RAND Center to Improve Care of the Dying and Americans for Better Care of the Dying to testify at its National Summit on Medical Errors and Patient Safety Research. In their testimony, the organizations urged the QuIC to consider the special vulnerability and needs of individuals at the end of life in crafting their research agenda. Patients at the end of life are particularly vulnerable to medical errors and other lapses in patient safety for three reasons: (1) substantially increased exposure to medical errors; (2) more serious effects from errors because they cannot protect themselves from risks and have less reserve with which to overcome the effects; and (3) pervasive patterns of care that run counter to well-substantiated evidence-based practices. A national research agenda on preventing medical errors and increasing patient safety must include a focus on how to improve shortcomings affecting these vulnerable patients. The QuIC's preliminary research agenda, released in October 2000, included patients coming to the end of life. The Agency for Healthcare Research and Quality, the lead federal agency for researching patient safety and medical errors, released between November 2000 and April 2001 six Requests for Applications for research into medical errors.