Where should patient safety be installed?

The structure of an organization is important, and structure has a profound influence on the way people work and what gets done. Where work units and individuals in an organization are placed, to whom they report, and with whom they are grouped signals power, prestige, and privilege. It also divides workers into groups with common interests and motivations. The question is, where should patient safety be placed in a health care organization? Such a question can be answered only within a framework of understanding that gives a clear definition to patient safety. We define safety, as do safety professionals from other industries, as the reduction of risk. This definition is also in concert with the risk management model that identifies claims management, risk financing, and loss control as its foundational triad.