System performance is the real problem.

Abstract

Baker and Norton are right in calling for a study of medical error in Canada, and they have provided some very reasonable recommendations for reducing the problem. Medical error, however, is just part of a broader problem of performance quality in healthcare. The healthcare system itself is now being identified as a major cause of illness, death and added costs because of errors, infections, the adverse effects of medications, the underuse of effective interventions and the provision of unnecessary or inappropriate care. For the healthcare system to aspire to the safety level of other modern industries (e.g., airlines) there will be a need for: leadership and vision; better data systems and information on performance; commitment and skills development among providers; and better accountability.