Modern safety science owes much of its current theories and practical approaches to the critical analysis of socio-technological disasters in the nuclear, chemical, maritime, and aviation industries at the end of the 1970 s and in the 1980 s. The medical field by contrast, was not challenged by a single high profile event, but by the release of a single report by the Institute of Medicine in 1999: To Err is Human – Building a Safer Health System. The report expanded the level of conversation and concern about patient injuries in health care and led to an unprecedented provision of research grants in patient safety research, essentially launching the academic base for that work. Twenty years later, it is a good time to analyze how this seminal work was received in the academic literature, which authors and institutions had the greatest research activity, which national and international collaborations ensued, and how the ideas presented in To Err Is Human might have affected the academic discourse in the two decades to follow.

To meet this aim, a bibliometric analysis was performed on all publications from 2000 to 2019 where the authors referenced To Err Is Human as part of their scientific argument. 20.494 documents were retrieved. The majority of patient safety related research was carried out by researchers from North America, with little international collaboration. Over the years, the thematic scope of the research diversified from the IOM report’s initial focus in many directions. Contrary to what might be expected from the IOM report’s central objectives, research on a systems approach to patient safety and on incident reporting were underrepresented. From a safety science perspective, the report narrowed the diversity of the patient safety discourse rather than enlarging it by favoring the theoretical framework proposed by James Reason over other, equally valid ones.

现代安全科学的大部分当前理论和实践方法都归功于对 1970 年代末和 1980 年代核、化学、海事和航空工业中的社会技术灾难的批判性分析。相比之下，医学领域受到的挑战不是单一的高调事件，而是医学研究所在 1999 年发布的一份报告：犯错是人类——建立更安全的卫生系统. 该报告扩大了对医疗保健中患者伤害的对话和关注的水平，并导致了对患者安全研究的前所未有的研究资助，从根本上启动了该工作的学术基础。二十年后，现在是分析学术文献中如何接受这项开创性工作的好时机，哪些作者和机构进行了最大的研究活动，随后进行了哪些国家和国际合作，以及To Err Is Human 中提出的想法如何可能影响了随后二十年的学术话语。

为了实现这一目标，对 2000 年至 2019 年期间作者引用To Err Is Human 的所有出版物进行了文献计量分析作为他们科学论证的一部分。检索到 20.494 份文件。大多数与患者安全相关的研究是由北美研究人员进行的，几乎没有国际合作。多年来，研究的主题范围从 IOM 报告最初的重点转向了许多方向。与 IOM 报告的中心目标所预期的相反，对患者安全的系统方法和事件报告的研究代表性不足。从安全科学的角度来看，该报告缩小了患者安全论述的多样性，而不是通过支持 James Reason 提出的理论框架而不是其他同样有效的理论框架来扩大它。