"Hospitals are very dangerous places. I don't know how to explain this to the public in a way that doesn't create too much fear. But they need to be realistic, and the technologies that help you can also hurt you — and they do it every single day," Berwick says.
Berwick estimates that for every 100 patients admitted to hospitals, there are 40 to 50 incidents in which patients are harmed — ranging from bruises and bed sores to much more life-threatening situations.
"Between 44,000 and 98,000 Americans die in hospitals each year, killed by their care, not by their disease," Berwick says.
The doctor says he hear from family members all the time who say my husband or wife or sister died and it didn't have to be.
"My e-mail is full of the most poignant stories that are surfacing from families, loved ones, patients themselves, saying this happened to me, why did it happen? It didn't need to happen," Berwick says.Josie King who came to the hospital to be treated for burns and died from dehydration. And 27-year-old Joshua Nahum, who came in with broken bones and died from an infection.
"We need to build a hospital like you build an airplane, so that everything works right and there's a kind of automatic excellence in the system instead of relying on human effort," Berwick says.
Berwick runs the Institute for Healthcare Improvement, and two years ago, he launched the 100,000 Lives Campaign. That's the number of lives he hoped to save by getting hospitals to have standard operating procedures for the way they care for patients. This includes hooking up a ventilator properly to eliminate the risk of pneumonia and ensuring that a patient's medication is monitored from the ICU to the hospital room to home.
Berwick says even something as simple as uniform hand-washing requirements would cut hospital infections in half.
"We have a campaign team that makes field visits all the time," he says.
New York's Beth Israel Hospital is one of the more than 3,000 hospitals that have signed on to his campaign. Dr. Brian Koll is the hospital's director of infection control.
"The belief was, 'they're at risk and this was something to be expected,'" Koll says, explaining hospitals' attitudes prior to the campaign.
Catherine De Santis would once have been at risk for a life-threatening infection because of the tube she needs for feeding. But new procedures, championed by Berwick, have greatly reduced this danger.
"We standardized practices so that the line is placed in a sterile manner," Koll says. Following the guidelines has saved untold lives, he adds.
"I feel — even though I don't want to be in the hospital — a lot more comfortable bring here," De Santis says.
The campaign does more than save lives — it saves hospitals money.
"A lot of people ask 'how can you afford to improve?' The answer is, 'you can't afford not to,'" Berwick notes.
Now his organization is making even more recommendations to ensure hospitals are safe.
"If I'm not fighting uphill battles against unreliability and dropped balls and things that go wrong, well, now I have time to sit with you and hold your hand and look at your face and answer your questions and do all the other things that only a caring, committed human being can do," Berwick says.
He's emotional about it because, he says, "it's in reach. It's just a matter of will and leadership."
The will to adopt small, simple steps that could greatly reduce complications and ensure that many more people live to leave the hospital.