Medical Errors and Quality of Care: From Control to Commitment

Abstract

Ongoing efforts to reduce medical errors and enhance quality of patient care focus primarily on technological innovations. However, important management issues that underlie about two-thirds of adverse events have commanded insufficient attention. This article examines two alternative management philosophies—control-based and commitment-based—premised on opposite sets of assumptions about human motivation, and it develops a model linking the overall management philosophy with medical errors and quality of care. The current control-based culture and management systems in health care organizations are inherently inadequate in delivering high quality of patient care and safety. Consequently, there is a need to transform them for bringing further improvements in clinical outcomes. Implementing commitment-based management will foster collaboration, communication, coordination, and teamwork, the essential mechanisms for reducing medical errors and rendering high-quality health care.