The Hippocratic Oath pledges to "First, do no harm". But is Zero Harm in healthcare a realistic destination, or is it an unachievable stretch goal that might actually do more harm than good? In this episode, we explore whether healthcare systems can truly eliminate preventable medical errors or if Zero Harm is an aspirational vision. We trace the evolution of patient safety from individual blame to the Swiss Cheese Model and High-Reliability Organizations. The episode covers just culture, systems safety, proactive risk management, and how healthcare teams balance perfection with everyday reality.
References:
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- Gandhi TK, Feeley D, Schummers D. Zero harm in health care. NEJM Catal Innov Care Deliv. 2020;1(2).
- Gandhi TK, Hemmelgarn C. To achieve zero harm, we must address financial harm. J Patient Exp. 2025;12:1-4.
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- Sculli GL, Pendley-Louis R, Neily J, Anderson TM, Isaacks DB, Knowles R, et al. A high-reliability organization framework for health care: a multiyear implementation strategy and associated outcomes. J Patient Saf. 2022;18(1):64-70.
- Stockmeier CA, Thomas E, Lee M, Mossburg SE. Zero harm: striving to reduce preventable harms – point, counterpoint, and areas of agreement. PSNet. September 2024.
- Thomas EJ. The harms of promoting ‘Zero Harm’. BMJ Qual Saf. 2020;29(1):4-6.
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