RT Journal
A1 Starr LM, Braslow A, Bircher N
T1 PRevention of patient harm
JF JAMA
JO JAMA
YR 2012
FD December 19
VO 308
IS 23
SP 2458
OP 2459
DO 10.1001/jama.2012.68799
UL http://dx.doi.org/10.1001/jama.2012.68799
AB 
To the Editor: The Viewpoint by Drs Pronovost and Bo-Linn1 on reducing patient harm “in the same way that engineers manage dynamic complexity: as a systems problem that requires an interdisciplinary systems solution” made 2 linked arguments. The first is that thinking analytically (ie, treating parts as both separate and independent) is “challenging, if not impossible” when faced with a systems problem. Analysis can usually quantify what is wrong but is frequently not useful to explain why. The better approach to a complex systems problem, including hospital-based medical harms, requires one to think systemically. The second argument is that thinking systemically means using systems-based methods that focus on interactions and integration.