But as she investigated ways to address the medication error crisis, Pape didn’t rack her brain for an innovative fix. Instead she sought to imitate a solution that had been successfully applied in another industry. That industry was aviation—an enterprise, like health care, in which people’s lives depend on professionals’ precision and accuracy. While reading up on aviation safety, Pape learned that the moments of highest risk occurred during takeoffs and landings—periods when the plane was under ten thousand feet. She spotted a correspondence in her own field: for hospital patients who are
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