The Future of Regulation to Improve the Safety and Quality of Health Care: The individual Dimension of Successful Regulatory Interventions to Improve Safety

Abstract

The publication in 1999 of To Err is Human unleashed the potential for systems of regulatory governance to improve the safety and quality of health care services for patients (Institute of Medicine, 2000). In addition, it marked a point at which patients, health care professionals and health care organizations came to recognize the potential for regulation to change the pathways for the delivery of health care services. The mobilization of individual, organizational and governmental resources to reduce the occurrence of preventable harm in health care is a manifestation of what John Braithwaite has called ‘regulatory capitalism’. Over the last three decades or more ‘states have become rather more preoccupied with the regulation part of governance and less with providing’ (Braithwaite, 2008, p 1). But as David Levi-Faur has argued there has also been an expansion of the ‘regulation society and global regulations’. Levi-Faur argues that the ‘co-expansion of voluntary as well as coercive regulation’ is part of the phenomenon of ‘regulatory capitalism’ and that this phenomenon is transforming both civil society and the state (Levi-Faur, 2008, p viii). This article investigates both the potential of regulation to improve the safety and quality of health care and its potential to modify processes, organizations and practices that support the delivery of health care services. It follows work in other areas of public concern such as the problem of improving the safety of imported goods (Zaring and Coglianese, 2009).