An intensive care unit is a high-risk environment where the complexity of care contributes to significant patient safety concerns; however, focusing on a systems-based approach can decrease errors. An article punlished this month in

Current Opinion in Critical Care reviews these safety strategies. Medication delivery is a key component of patient care in the ICU; the role of CPOE, standardized concentrations and smart pumps is discussed. Handoffs and teamwork are also reviewed. Perhaps the best strategies for improving safety involve multifaceted programs such as care bundles and improving the culture of safety. Attention should be turned from reviewing what went wrong to imagining what could go wrong. This preoccupation with failure is a component of high reliability organizations.