Medical error has reached epidemic proportions, and researchers have developed insufficiently sophisticated models of safety culture to match the complexity of the challenge of safety in health care. This has left providers and researchers with an inadequate conceptual toolkit for improving...

The factors that compel individuals to exert the extraordinary effort needed to create high reliability — consistent error-free performance under trying conditions — remain unspecified. Here, we propose that when individuals experience emotional ambivalence and prosocial motivation, it...