The improvement of healthcare quality and patient safety is at its heart a social act. I am particularly aware of this each year when I attend the International Forum on Quality and Safety in Health Care. In March 2009 in Berlin, I spent one of the most pleasurable evenings I can remember in a restaurant with colleagues from the UK, Sweden, Spain, Australia, Netherlands, Italy and the USA—a group with whom I meet annually at the International Forum. We enjoyed a similar evening in Paris last year, and in Prague the year before that. I am inevitably the beneficiary of the learning that comes from such a diverse and expert international group. As I reflect on these gatherings, I am reminded that I am the beneficiary of many Socially Transmitted Discoveries (STDs) that are highlights of the annual Forum.

STDS CAN BE PASSED INFORMALLY ACROSS NATIONAL BORDERS

I live in the USA. We Americans have a reputation for being quick to give advice. Fortunately, the USA now has national political leadership that counsels listening. The US healthcare system is a troubled enterprise,1 so we have a lot of listening to do. Granted, American medicine generally provides complex and valuable healthcare. Yet US healthcare per capita costs are about twice that of the next most costly system in developed countries, and its health outcomes …