Patient safety 2.0: slaying dragons, not just investigating them.
Card AJ. Patient safety 2.0: slaying dragons, not just investigating them. J Patient Saf. 2023;19(6):394-395. doi:10.1097/pts.0000000000001140.
A full cycle of examination, planning, and strategic implementation is required to improve safety through system change. This commentary explores reasons for the persistent overemphasis on patient safety incident tabulation and analysis in lieu of the employment of actions that serve to reduce the potential for accident occurrence.