To Err is Human, the influential Institute of Medicine report that spurred the patient safety movement, turned ten years old on December 1, 2009. How far have we come?

Writing in the journal Health Affairs, patient safety expert Robert Wachter gives a grade of B- (an improvement over the C+ grade he awarded at the five-year mark) and doubles the number of evaluation dimensions from five to ten.

It’s a mixed bag of progress, with the “most striking improvements in reporting and leadership.” He opines that “in a field as complex and massive as health care, a decade is a relatively short time, and incremental progress is probably the best we can hope for.”

Here’s hoping that someone develops the equivalent of Moore’s Law for health quality improvement. Something along the lines of “for every 500,000 patients with electronic health records, costs will be reduced by X% and errors reduced by Y%. Medicine could benefit from more aggressive expectations at the system improvement level.