Dr. Gary Brandeland’s article, “The Day Joy Died,” which appeared in the Oct. 20, 2006, edition of Modern Medicine, underscores the primitive nature of quality thinking—and more specifically, safety thinking—in hospitals. Although I’m not going to give formal engineering advice about medical devices I’ve not actually seen, it’s clear from the narrative that the death of this patient along with serious injury to her unborn child could have easily been prevented by rudimentary quality and safety thinking. I refer specifically to Henry Ford’s “Can’t Rather Than Don’t” safety principle, which is also useful to any organization working with OSHAS 18001.

“Can’t Rather Than Don’t” refers to a kind of error-proofing that prevents rather than warns. For example, instead of warning signs and instructions that tell workers, “Don’t put your hand in the mechanical press while it closes,” the press itself is designed so the worker can’t put his hand into it when it closes.

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