More than 12 years have passed since a groundbreaking report on preventable patient deaths in hospitals alerted the nation to a crisis in patient safety. Galvanized into action, the federal government poured money into research and training, patients and families formed advocacy groups, private and government insurers began refusing to reimburse medical institutions for the most serious preventable injuries and hospitals developed systems to track patient harm at the insistence of accreditation agencies. Yet patients continue to suffer high levels of death and injury from medical errors, and the health care industry, government regulators, insurers and patient advocates are struggling to figure out how to tackle the problem. Bloodstream infections caused by contaminated catheters are among the most dangerous threats, and hospitals are taking strong steps to prevent them. Meanwhile, medical experts are debating the value of patient involvement in safety procedures.