The systems approach to medicine: controversy and misconceptions
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Updated: Apr 26, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Sidney W A Dekker1, Nancy G Leveson2
1Safety Science Innovation Lab, Griffith University, HUM, Nathan Campus, Queensland, Australia.
Abstract:
The 'systems approach' to patient safety in healthcare has recently led to questions about its ethics and practical utility. In this viewpoint, we clarify the systems approach by examining two popular misunderstandings of it: (1) the systematisation and standardisation of practice, which reduces actor autonomy; (2) an approach that seeks explanations for success and failure outside of individual people. We argue that both giving people a procedure to follow and blaming the system when things go wrong misconstrue the systems approach.
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