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. health care 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 assets against medical malpractice. Healthcare is a complex environment in which people suffer from system failures. According to James Reason (2000), effective risk management requires detailed analysis of accidents, incidents and near misses, as well as free courses to identify adverse events. Almost all adverse events involve a combination of 2 sets of factors: active failure and latent conditions. Active failures are dangerous acts committed by people in direct contact with the patient or system. They take various forms: slips, lapses, fumbles, errors and procedural violations. Active failures have a direct and generally short-lived effect on the integrity of defenses (Reason, 2000). On the other hand, latent failures include lack of teamwork and communication, poorly designed work schedules or work environment, and variations in design equipment (Gabay, This means they must create effective defenses to prevent or trap active failures and latent failures before they cause damage Being a high reliability organization can prevent active and latent failures. concern for error prevention, appreciation of the complexity of errors and reluctance to simplify the causes or strategies to prevent errors, focusing on system failures rather than individual performance, including non-error approaches. punitive measures to remedy errors, the ability to learn from mistakes and continually improve, and a flat organizational hierarchy in which staff at any level can effectively voice concerns and make decisions.