Medical errors are responsible for 98,000 deaths per year in the United States. They increase disability, costs, and decrease trust in the U.S. healthcare system (Pham, Aswani, Rosen, Lee, Huddle, Weeks, & Pronovost, 2012). One of the main goals of quality and risk management is to minimize medical errors in order to improve the overall quality of medical care. Additionally, healthcare organizations have developed a risk management program to protect their financial resources from medical malpractice. Healthcare is a complex environment where people suffer due to system failure. According to James Reason (2000), effective risk management requires detailed analysis of mishaps, accidents and near misses, and free lessons to identify adverse events. Almost all adverse events involve a combination of 2 sets of factors: active failure and latent conditions. Active failures are unsafe acts committed by people who are in direct contact with the patient or system. They take a variety of forms: slips, errors, fumbles, errors and procedural violations. Active failures have a direct and usually short-lived effect on the integrity of defenses (Reason, 2000). On the other hand, latent failures include lack of teamwork and communication, poor design of working hours or the working environment, and variations in design equipment (Gabay, this means that effective defenses must be created to prevent or trap active failures and latent failures before they cause damage. Being a high-reliability organization can prevent active and latent failures. The characteristics of a high-reliability organization are concern for failure prevention, appreciation of the complexity of errors and the reluctance to simplify the causes or strategies to prevent them. errors, focus on system failures rather than individual performance, including non-punitive approaches to addressing errors, ability to learn from errors and continuously improve, and flat organizational hierarchy in which staff at all levels can effectively voice concerns and take action