From the local stage viewpoint, designs for safety and
quality emerge from professional specialization, expertise,
and experience which foster the skills to support withindomain
improvisation and innovation in the face of safety
challenges. From an HRO perspective, healthcare professionals
have superb resources on which to draw in their
willingness to make decisions under pressure, to improvise
fluidly, to appreciate new knowledge, and to place their
patients’ well being even above their own. These practices are
based on deeply held assumptions developed over centuries
when individual doctors had to be responsible for their
patients under extreme and uncertain conditions.