Bad apples’: time to redefine as a type of systems problem?
What is perhaps clear is that identifying the problem clinician will likely involve multiple sources of intelligence, and taking very seriously warning signs that do appear from any source. A research agenda in this field must be pursued vigorously. The field of patient safety (and quality improvement more generally) probably could not have achieved the traction it has without first focusing on identifying and correcting systems problems. But the time has now come to design and evaluate systems that identify problematic individuals.
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