# 180,000 preventable deaths we could stop today > We know exactly how to cut hospital deaths by 90%. The only thing stopping us is choosing not to. - Title: 180,000 preventable deaths we could stop today · Fortune - Summary: We know exactly how to cut hospital deaths by 90%. The only thing stopping us is choosing not to. Hospitals have access to evidence-based practices that… - Keywords: patient safety, preventable medical errors, hospital deaths, evidence-based practices, healthcare policy, medical harm, joe kiani, reimbursement reform, children's hospital of orange county, cms, healthcare regulation, institutional change - Source: Fortune — https://fortune.com/2026/09/17/how-to-end-preventable-medical-harm-joe-kiani - Author: Joe Kiani - Read time: 3 min - Topics: patient safety, preventable medical errors, hospital deaths, evidence-based practices, healthcare policy, medical harm, joe kiani, reimbursement reform, children's hospital of orange county, cms, healthcare regulation, institutional change ## A kidney donor's preventable death Anders Pederson donated his kidney to save his sister Kelly. Hours after surgery, warning signs went unnoticed. He died nine days later from a cascade of preventable failures in medication management and monitoring. > a cascade of preventable failures, inadequate monitoring and medication management, had taken the life of a healthy young man ## Medical errors kill like two planes daily Medical errors contribute to roughly 250,000 deaths annually in the U.S., ranking behind only heart disease and cancer. Globally, the toll may reach 3 million deaths per year. ## We could cut deaths by 90 percent If every hospital implemented all known evidence-based practices, preventable deaths could drop from 200,000 annually to just 20,000. This requires no new drugs or breakthroughs, only existing protocols. > if every hospital in this country implemented all of the evidence-based practices that researchers and clinicians have already identified and validated, we could reduce that death toll from approximately 200,000 a year to as few as 20,000 ## 25 years of ignored warnings The 1999 Institute of Medicine report warned of 44,000 to 98,000 preventable deaths yearly. By 2011, that number had jumped to 200,000. A quarter-century later, nothing has fundamentally changed. ## Why aviation's safety lesson fails Plane crashes dominate news and kill pilots too, creating urgency and accountability. Medical errors kill the equivalent of two full planes daily but barely register, and healthcare workers face no personal consequences. > Medical errors kill the equivalent of two fully-loaded passenger jets every single day in America, and it barely registers. ## Patients can't choose their hospital Unlike airline passengers, hospital patients have no choice. They come because they must, so hospitals face no consumer penalty for unsafe outcomes. This removes a key market pressure that drove aviation safety. ## Healthcare needs external accountability Aviation had built-in self-correcting mechanisms. Healthcare lacks these, so they must be deliberately constructed from outside through policy and incentives, not voluntary adoption. ## One hospital achieved zero deaths Children's Hospital of Orange County implemented 20 evidence-based practices covering medication errors, infections, communication failures, and diagnostic errors. Result: zero preventable deaths for over six years. ## The governance change that worked The hospital tied one-third of faculty bonuses to achieving zero preventable harm. Staff then color-coded their compliance with protocols and built mitigation plans. They stopped hoping for zero and started planning for it. > Instead of hoping for zero, the hospital started planning for zero. ## The formula for institutional change Board-level attention, incentives aligned with the goal, and a clear evidence-based roadmap. When these three elements combine, patient safety becomes a self-governing system, not just a values statement. ## Only five hospitals do it all Fewer than five hospitals in the U.S. have implemented all 20 evidence-based practices. Most implement only three or four, despite having access to the same protocols and knowledge. ## A policy moment that passed Between 2021 and 2024, a presidential advisory report outlined how the federal government could drive adoption of evidence-based practices without new legislation. Released in September 2023, it lost momentum after October 7th and was never implemented. ## Hospital lobbyists block reform Congressional leaders express alarm about preventable deaths, but hospital industry lobbyists warn of financial burdens and regulatory overreach until political will evaporates. The American Hospital Association effectively blocks change. ## The reimbursement fix with teeth Hospitals currently collect full payment even when preventable errors kill patients. The proposal: hospitals implementing all evidence-based practices get paid fully regardless of outcome. Those that don't lose reimbursement for both the original procedure and harm-related care. > just dress for the game. We will worry about the scoreboard later. ## Implementation would be rapid If reimbursement incentives were changed, hospitals would quickly adopt evidence-based practices. Those claiming implementation is too costly would discover that non-implementation is far more expensive. ## Even 90 percent reduction matters Critics argue evidence-based practices won't reach zero deaths. But reducing preventable deaths from 200,000 to 20,000 would be one of the greatest public health achievements in American history. ## The choice is ours to make Preventable medical harm is the third leading cause of death in America. It is not inevitable. We have known how to stop it for 25 years. The only question is whether we finally intend to act. > The third leading cause of death in America is not inevitable. It is preventable. ## Key takeaway Hospitals have access to evidence-based practices that could reduce preventable deaths from 200,000 to 20,000 annually, but lack financial incentives and governance structures to implement them.