Florence Nightingale, Dr. Ernest Codman, American College of Surgeons Hospital Standardization Committee, and The Joint Commission: Four Pillars in the Foundation of Patient Safety

The foundation of patient safety was started by Florence Nightingale in 1854 and was enhanced in 1910 by Dr. Ernest Codman and his “end result system of standardization.” In 1951, the Joint Commission on Accreditation of Hospitals (now the Joint Commission) was established. The decades since then have seen further enhancements in the scope of the commission's activities and an increase in the number of organizations under its wings. During the twenty-first century, the Joint Commission has continued to evolve, with the establishment of the sentinel event policy and the development of a standards improvement initiative. Only with continued outcomes management and evidence-based medicine will health care continue to move toward improved patient safety and optimal patient care.