How do you deal with human error/mistakes and improve accountability?   In any event, but especially when safety is involved?

James Bagian—NASA astronaut turned VA patient safety expert—suggests in this article to set a “blameworthy” criteria for mishaps.  His criteria is 3-fold: resulting from intentionally unsafe actions, intoxication, or criminal action (assault, rape or larceny).   I might add carelessness to that list, although from a systems perspective, carelessness can be the result of productivity standards set too high.

Bagian says that safety practices in our health care system are shameful compared with the fields of aeronautics and engineering.

Interesting series about wrongology on Slate.

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