In the lead paper, Zimmerman et al. explore the role of problem and solution ownership in solution adoption by front-line healthcare staff. The front-line ownership (FLO) approach suggested by the authors proposes a shift in leadership style such that managers act as enablers of patient safety improvement efforts by front-line staff (i.e., a bottom-up management style). From a systems perspective, it would be necessary to examine contributing factors to patient safety problems, including process, workflow, task requirements etc., in order to effectively utilize a solution-oriented approach such as FLO. These factors would be difficult to identify by clinical staff alone. There is a need for a multidisciplinary approach to patient safety management in healthcare.