Solution for LeadersMeasurement as a Performance Driver: The Case for a National Measurement System to Improve Patient SafetyKrause, Thomas R. PhD∗; Bell, Kristen J. MA, MBA∗; Pronovost, Peter MD, PhD, FCCM†; Etchegaray, Jason M. PhD‡Author Information From the ∗Krause Bell Group, Ojai †Armstrong Institute for Patient Safety and Quality, John Hopkins Hospital ‡RAND Corporation, Santa Monica, California. Correspondence: Kristen J. Bell, MA, MBA, Krause Bell Group, 417 Bryant Circle, Ojai, CA 93023 (e-mail: [email protected]). The authors disclose no conflict of interest. Journal of Patient Safety: April 2021 - Volume 17 - Issue 3 - p e128-e134 doi: 10.1097/PTS.0000000000000315 Buy Metrics Abstract Safety metrics in healthcare settings stand apart from those in all other industries. Despite improvements in the measurement and prevention of adverse health outcomes following the 1999 Institute of Medicine report, no fully operational national-level program for monitoring patient harm exists. Here, we review the annual rate of fatal adverse events in healthcare settings in the United States on the basis of previous research, assess the current state of measurements of patient harm, propose a national standard to both quantify harm and act as a performance driver for improved safety, and discuss additional considerations such as accountability and implications for tort reform under this standard. On the basis of experiences in other sectors, we propose a federally mandated, nonpunitive national system that relies on accurate measurement as a driver of performance. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.