Stuck Between Two Lives: The Paradox of Eliminating and Welcoming Errors:

Medical errors are a recurring fact in health care organizations. The importance of mitigating and learning from these errors is incontrovertible. Prevailing practices in health care organizations convincingly argue for a “both-and” approach to this goal, meaning that, in a perfect world, heath care professionals may simultaneously eliminate and welcome (and thus learn from) errors. Yet health care organizations that do well on both accounts are extraordinarily rare. Some health care policymakers, administrators, caregivers, and researchers believe that this problem stems from a lack of commitment to patient safety or insufficient implementation of such “both-and” practices. We challenge this reasoning and suggest that both organizational goodwill and implementation difficulties constitute simplistic explanations. In our opinion, health care challenges are strongly grounded in the current state of the error literature that promotes a “both-and” approach.