title: We have a perfect storm - let's use it.
abstract: The lead paper, "Responsibility for Canada's Healthcare Quality Agenda: Interviews with Canadian Health Leaders," is a valuable contribution to the quality and safety improvement conversations taking place across the country. My commentary suggests a dramatic convergence of social, economic, demographic and technological forces has brought healthcare to a threshold of a perfect storm. To brace ourselves against this storm, I have suggested that we need to understand the system not as a structure but as relationships. I argue that alignment is not a concept that is particularly well understood - and we tend to focus almost exclusively on the component of structure.
authors.affiliation: Canadian Patient Safety Institute.
authors.forename: Hugh
authors.initials: H
authors.lastname: Macleod
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D009313:National Health Programs / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*