Advancing Patient Safety

Patient safety was brought to the national forefront when an Institute of Medicine report estimated that as many as 98,000 patients die every year in U.S. hospitals as a result of preventable medical mistakes. The report brought quality and safety to the forefront of pressing industry issues. The Duke Endowment has awarded nearly $40 million in 11 multi-year grants to help hospitals create a culture of safety in North Carolina and South Carolina and reduce mistakes that might harm patients.


Quality initiatives have existed for years, but the 1999 Institute of Medicine report, "To Err is Human: Building a Safer Health System" triggered major shifts in the health care landscape. The report outlined a strategy for reducing medical mistakes and set a five-year goal.


The Duke Endowment began a special focus on patient safety in 2000. Through discussions with health care leaders, educational conferences and grants, the Endowment hoped to encourage hospitals to create opportunities for open dialogue and develop an environment where people can learn from mistakes. The Endowment also hoped to encourage hospitals to find best practice models for monitoring systems and error reduction strategies.

Milestones included:

  • 2001: Four organizations—Duke Medical Center in Durham, N.C., Northeast Medical Center in Concord, N.C., Iredell Memorial Hospital in Statesville, N.C., Wayne Memorial Hospital in Goldsboro, N.C.—received grants to purchase and implement new technologies aimed at reducing medical errors. The technologies included bar coding systems, physician order entry systems and electronic medical records.
  • 2003: A collaborative of seven hospitals and health systems in South Carolina received an Endowment grant to improve patient and worker safety through a multi-year effort.
  • 2003 and 2004: The Endowment sponsored representatives from the Carolinas to complete a year-long intensive learning experience with the American Hospital Association's Health Forum Patient Safety Leadership Fellowship Program.
  • 2003: Leaders in South Carolina approached the Endowment to discuss their vision for a partnership between health systems and universities. In 2004, Health Sciences South Carolina was founded.
  • 2004: The North Carolina Hospital Association established a Center for Hospital Quality and Patient Safety using a $5 million, multi-year Endowment grant.
  • 2004: The South Carolina Hospital Association convened a committee on patient safety to review issues and help with statewide activities.
  • 2006: The Endowment initiated a special grant program focused on health information technology.
  • 2006: The South Carolina Hospital Association formalized patient safety efforts using a $3 million, multi-year grant from the Endowment. With Endowment funds, the Association hired a medical director to create the framework for shifting South Carolina's hospital culture from competition to collaboration.
  • 2006: A $21 million, multi-year Endowment grant to Health Sciences South Carolina helped establish infrastructure to advance education and research. Health Sciences South Carolina is the only statewide collaborative of its kind in the United States to pool the resources of research universities and health systems.

Participating Sites

  • North Carolina Hospital Association
  • South Carolina Hospital Association
  • Health Sciences South Carolina


Area of Work

  • Quality and safety of health care

Program Area

  • Health Care

Grantmaking Status

The Endowment is continuing to work through current grantees and is not accepting new applications.

Areas of Work

  • Prevention and early intervention for at-risk children

    To equip children and families with skills to ensure that children reach developmental milestones to lead successful lives.

  • Out-of-home care for youth

    To drive child welfare systems toward greater accountability for child well-being.

  • Quality and safety of health care

    Improving the quality and safety of health care delivery

  • Access to health care

    Improving health by increasing access to comprehensive care

  • Prevention

    Expanding programs to promote health and prevent disease

  • Academic excellence

    Enhancing academic excellence through program and campus development

  • Educational access and success

    Increasing educational access and supporting a learning environment that promotes achievement

  • Campus and community engagement

    Promoting a culture of service, collaboration and engagement among schools and communities

  • Rural church development

    Building the infrastructure and capacity of United Methodist churches to enhance ministry and mission

  • Clergy leadership

    Strengthening United Methodist churches by improving the quality and effectiveness of church leadership

  • Congregational outreach

    Engaging United Methodist congregations in programs that serve their communities