title: The systems approach to medicine: controversy and misconceptions.
abstract: The 'systems approach' to patient safety in healthcare has recently led to questions about its ethics and practical utility. In this viewpoint, we clarify the systems approach by examining two popular misunderstandings of it: (1) the systematisation and standardisation of practice, which reduces actor autonomy; (2) an approach that seeks explanations for success and failure outside of individual people. We argue that both giving people a procedure to follow and blaming the system when things go wrong misconstrue the systems approach.
authors.affiliation: Safety Science Innovation Lab, Griffith University, HUM, Nathan Campus, Queensland, Australia.
authors.forename: Sidney W A
authors.initials: SW
authors.lastname: Dekker
authors.affiliation: Aeronautics and Astronautics and Engineering Systems Division, Massachusetts Institute of Technology, Aeronautics and Astronautics, Cambridge, Massachusetts, USA.
authors.forename: Nancy G
authors.initials: NG
authors.lastname: Leveson
mesh_terms: D002985:Clinical Protocols; D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D061214:Patient Safety / Q000592:standards*; D017410:Practice Guidelines as Topic; D013597:Systems Analysis
keywords: Complexity; Human error; Human factors; Patient safety; Quality improvement