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[Excerpt] Health care needs to become a high-reliability industry in more than name. It needs a radical cultural transformation, like the one that has taken place in aviation over the past thirty years.

To help promote that transformation, we decided to write this book: a description and analysis of a major cultural shift that has made one complex and safety-critical industry—never previously known for concern for interpersonal or inter-professional relations—into an exemplary teamwork culture that is arguably now one of the safest in the world.

If aviation could do it, health care can too.

The lessons of aviation and other safety-critical, high-reliability industries are receiving more attention in health care than ever before. In spite of great resistance, some of these initiatives are producing positive models that offer great promise, as described in subsequent chapters. Nevertheless, we write this book out of concern that that there is much more lip service than real systemic change when it comes to making health care a truly high-reliability industry—one in which genuine interprofessional and occupational practice is the norm. This is why it is so important for health care to recognize how much it can learn and adapt from the aviation model of safety and teamwork. Moving beyond the checklist will help advance the efforts of all of those who are working so hard to make health care safer for both patients and those who work in health care settings.


The abstract, table of contents, and first twenty-five pages are published with permission from the Cornell University Press. For ordering information, please visit the Cornell University Press.