Safety-I focuses on identifying factors that contribute to incidents or errors. Safety-II seeks to understand and learn from the many cases where things go right, including ordinary events, and emphasizes adjustments and adaptations to achieve safe outcomes. This commentary describes Safety-II and complementary positive strategies of patient safety, such as exnovation, appreciative inquiry, learning from excellence, and positive deviance.

Learning in health care can be motivated by seeing and building on the success of others. This commentary describes a program based on the concepts of Safety-II and positive deviance which led to improvements in prescribing practice in a pediatric intensive care unit.