In November 2003, senior managers of Sunnybrook and Women's College Healthcare Centre in Toronto announced that lapses in the disinfection of equipment used for prostate biopsies had put more than 800 men at risk of blood-borne diseases (Woods 2003). In the next two months, nine other hospitals in Ontario reported infection control problems with similar diagnostic equipment and the Minister of Health ordered an audit (Greenburg 2004; Woods and Greenburg 2003). Earlier that year, a study of a patient-controlled analgesia (PCA) pump suggested that difficulties in programming such pumps may have contributed to patient deaths (Scully 2003). Stories like these in the past year have created growing attention to adverse events in Canadian healthcare and prompted questions about whether healthcare in Canada is safe and what is being done to improve it. While individual hospitals and regions are mounting patient safety efforts, these problems are systemic and require policy and organizational responses from governments and health regions, not just individual organizations. How are governments and other organizations responding to the calls to improve healthcare safety? This article provides an overview and examples of current initiatives based on reviews of documents and websites, interviews with key informants in several provinces and attendance at patient safety meetings in several cities. As we shall see, although several provinces are beginning to address the patient safety issues, there remain important challenges of leadership, coordination and learning that are essential in gaining public confidence in the safety of our healthcare system.

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