The culture of safety.

A new paradigm is emerging as a result of the Institute of Medicine reports on medical errors. The Joint Commission on Accreditation of Healthcare Organizations, state licensing boards, academic institutions, and health care businesses are considering their missions and goals vis-à-vis a culture of patient safety. The author presents three examples that converge to indicate that the culture of safety represents a paradigm shift for the education, delivery, funding, and evaluation of health and medical care. The system, not the individual, must be recognized as the problem; reprimanding the person who committed an error is not a solution. Health care delivery systems that reduce this potential for error must be created.