RT Book, Section A1 Wachter, Robert M. SR Print(0) ID 56250094 T1 Chapter 2. Basic Principles of Patient Safety T2 Understanding Patient Safety, 2e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176578-7 LK accessmedicine.mhmedical.com/content.aspx?aid=56250094 RD 2024/10/10 AB The traditional approach to medical errors has been to blame the provider who delivers care directly to the patient, acting at what is sometimes called the “sharp end” of care: the doctor performing the transplant operation or diagnosing the patient's chest pain, the nurse hanging the intravenous medication bag, or the pharmacist preparing the chemotherapy. Over the last decade, we have recognized that this approach overlooks the fact that most errors are committed by hardworking, well-trained individuals, and such errors are unlikely to be prevented by admonishing people to be more careful, or by shaming, firing, or suing them.