Twenty years ago, in To Err Is Human, the Institute of Medicine estimated that 44 000 to 98 000 people die in hospitals each year from preventable errors. Fast forward to 2014 to 2017, the Agency for Healthcare Research and Quality’s national scorecard on hospital-acquired conditions revealed a dramatic decrease in avoidable patient harm that helped prevent 20 500 deaths. Every hospital-acquired condition had reductions—from adverse drug or obstetrical events; catheter-associated urinary tract, central catheter–associated bloodstream, or Clostridium difficile infections; falls; ventilator-associated pneumonia; to venous thromboembolism—except for hospital-acquired pressure injuries (HAPIs), which increased 6% during this time.

Nationally, the annual cost of treating HAPIs is $11 billion (with up to $70 000 for stage 4 HAPIs). A costly preventable condition, HAPIs have gained more attention as a quality indicator of high-reliability organizations. The Centers for Medicare and Medicaid Services...

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