title: Culture of safety: A foundation for patient care.
abstract: The 1999 IOM report on patient safety identified the house of medicine as a culture that tolerated injury at a frightening level. Identifying other industries that had cultures that would not tolerate such levels of error has begun to change the culture of healthcare to a more "high-reliability" culture. Various organizational and standardized communication tools have been imported from the military, airline, and energy industries to flatten the hierarchy and improve the reliability of communication and handoffs in healthcare. Reporting structures that focus on the effectiveness of the team and the system, more than blaming the individual, have demonstrated noticeable improvements in safety and changed culture. Further sustained efforts in developing a culture focused on safety as a priority is needed for sustainable reduction of harm, and improve the reliability of care.
authors.affiliation: Department of Pediatric Surgery, University of Texas Medical School at Houston, 6431 Fannin St, Suite 5.256 Houston, TX 77030. Electronic address: Kuojen.Tsao@uth.tmc.edu.
authors.forename: KuoJen
authors.initials: K
authors.lastname: Tsao
authors.affiliation: Division of Pediatric Surgery and Urology, Children׳s Hospital of the Lehigh Valley Health Network, Allentown, PA.
authors.forename: Marybeth
authors.initials: M
authors.lastname: Browne
mesh_terms: D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D061214:Patient Safety / Q000592:standards*; D058996:Quality Improvement / Q000592:standards*; D014481:United States
keywords: Crew resource management; High-reliability organization; Medical error; Patient safety culture