Journal Article

Scandal as a sentinel event—recognizing hidden cost–quality trade-offs.

Bloche G. The New England journal of medicine. 2016;374:1001-3.

Latent factors are known to contribute to system-level failures. This commentary discusses the Mid Staffordshire NHS Foundation Trust inquiry and the Veterans Affairs health system investigation as examples of how executive expectations to meet performance targets and insufficient safety culture led to unintended consequences and system failures.