Balancing Systems and Individual Accountability in a Safety Culture

Patient Complaints• “Dr. __ told us he was very busy and could not bespread any thinner, and that we did not appreciate thedepth of his expertise.”• “Dr. ___ is either too busy or scatterbrained to read myfiles or is dangerously neglectful.... I fear for my safetyand for her other patients....”• “Dr. __ inserted a drain and walked out of the room.After a while another MD removed the drain andexplained it wasn’t even in the cyst.”29NPSF Professional Learning Series