In the first chapter we read about a hospital with a conventional culture. I mentioned that within that hospital there were many people trying to make improvements. The Chair of Surgery was one of the people who wanted a more positive culture.

Working with leaders of the department, we designed a change program, and then I taught the first day of the educational effort. The entire program went well, so the second year they decided to take more surgeons through the process. I was again invited to lead the first day.

In the introduction, the chair of surgery did something that impressed me deeply. He began by reviewing what had happened the previous year. He shared a number of qualitative incidents that were attributable ...

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