A review of patient safety literature reveals clear documentation of significant patient safety concerns in many countries going back over two decades. However, it was not until the publication of the Institute of Medicine's To Err Is Human about four years ago that widespread attention was at last drawn to this issue. Even with this attention, there has been a very limited response in Canada to the well-documented need for action to address preventable errors. After some reflection, it is clear that a whole series of factors may be conspiring to slow or blunt our response to this issue. This commentary explores these factors and endorses strategies for moving forward.

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