Everyone wants safe medicine. The traditional approach to adverse events has developed within a culture of blaming the individual practitioner. Such an approach is likely to be damaging to individuals and possibly counterproductive by creating an atmosphere of defensiveness and denial. Industries such as airlines have developed an alternative culture using a systems approach. This approach concentrates on assessing and improving the systems of working rather than blaming an individual's performance. Frameworks have been developed for applying this approach to investigating and avoiding medical accidents. These form the basis of a check-list for acupuncture practice that is presented here, and may be useful for individuals and organisations who are concerned to reduce the risk of adverse events.
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