Should Zero Harm Be Our Goal?

How many of your hospitals have a program aiming at Zero? Zero Infections, Zero Never Events, Zero Harm?

These terms and initiatives are currently so ubiquitous that their impact on the vast majority of us is certain. Some of you may say, “Why is this even a question? Is it not obvious that we need to aim at Zero?”

Certainly, our patients believe that the answer to the question of our commitment to Zero harm as a goal should universally and emphatically be “Yes!”. But, what if aiming at Zero actually had a downside? And if so, how might we negotiate with our patients the concept that Zero may not be the optimal goal in surgery? The purpose of this Surgical Perspectives is to explore the conflicts associated with “Aiming at Zero,” and to propose an alternative paradigm.