Operational Risk Management is one of the most important attributes of High Reliability Organisations in the industrial sector. In this article it is questioned whether the Health Care Sector is a high reliability organisation. The application of safety models, widespread in the industrial sector is absolutely feasible in the medical sector. One should move from a shame-and-blame policy to a just culture. Pro-active search and reporting of unexpected events, incidents and accidents, coupled with root cause analysis and Deming’s principle of continuous plan-do-check-act is the only way to improve system safety and reduce errors. These industrial methodologies have been implemented with success in our radiotherapy department since 2009. From reporting of incidents we were able to move to steering continuous education and process management. Facing the high human and economical societal burden linked to lack of a robust operational risk management in the health care sector, it is an ethical duty for leaders to define new values and behaviours, both defining a new culture!
(BELG J MED ONCOL 2013;7(5):137–41)