I think I like this guy.

An excerpt from one of my favorite sources: "The Wrong Stuff" on Slate Magazine. This is James Bagian (hey, do you think that's an Armenian name? It's kind of short; I'll look into that next*), who is a safety expert holding the position of director of Veteran Administration's National Center for Patient Safety. Take a look at what he has to say about how the healthcare industry deals with human error and tell me if it reminds you of anyting else.

How does the healthcare industry compare to engineering and aeronautics when it comes to dealing with human error?

Not favorably. Much of my background is in what's called high-reliability industries—the ones that operate under conditions of high hazard yet seldom have a bad event—and people in those fields tend to have a systems perspective. We're not terribly interested in what some individual did. We want to know what led up to a bad event and what changes we need to make to reduce the likelihood of that event ever happening again.

When I got into healthcare, I felt like I'd stepped into an entirely different world. It was all about, "Let's figure out who screwed up and blame them and punish them and explain to them why they're stupid." To me, it's almost like whistling past the grave. When we demonize the person associated with a bad event, it makes us feel better. It's like saying, "We're not stupid so it won't happen to us." Whereas in fact it could happen to us tomorrow.

Sounds an awful lot like the way our society deals with human error in just about any business environment. His focus is (and evidently always has been) safety, but I think you could take a broader view of his philosophy and apply it across industries.

"When we demonize the person associated with a bad event, it makes us feel better."

Sums it up nicely, don't you think?

 * Yep! Armenian. Thank you, Wikipedia: James Philip Bagian (Armenian: Ջեյմս Ֆիլիպի Բաղյան)