RT Journal
A1 Pronovost PJ, Bo-Linn GW
T1 PRevention of patient harm—reply
JF JAMA
JO JAMA
YR 2012
FD December 19
VO 308
IS 23
SP 2458
OP 2459
DO 10.1001/jama.2012.68802
UL http://dx.doi.org/10.1001/jama.2012.68802
AB 
In Reply: We agree with Dr Starr and colleagues that health care must take a systems approach that also includes organizational social systems to reduce harm. Health care occurs within organizations delivered by diverse people and teams who are influenced by powerful social norms, incentives, and culture. Our work draws upon these important theories and methods.1- 2 Yet health care is not a pure organizational social system. It is a sociotechnical system in which patients, families, and staff interact and use an ever-expanding number of technologies, many of which are poorly designed and do not serve patients or clinicians well.