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PSNet: Patient Safety Network
Journal Article

Doctors are more dangerous than gun owners: a rejoinder to error counting.

Dekker SWA. Human factors. 2007;49:177-84.

The author argues that approaches to improving patient safety that focus on measuring adverse events and limiting variability are inherently limited, as they only measure practitioners' behaviors. Such systems do not account for the "higher order" organizational characteristics that constitute the safety culture within an organization, such as willingness to refine and adapt approaches to safety. The author proposes that safety should be considered a dynamic and interactive process, and outlines a new framework for understanding safety in complex systems.