PT - JOURNAL ARTICLE AU - E Coiera AU - J Braithwaite TI - Market-based control mechanisms for patient safety AID - 10.1136/qshc.2007.025833 DP - 2009 Apr 01 TA - Quality and Safety in Health Care PG - 99--103 VI - 18 IP - 2 4099 - http://qualitysafety.bmj.com/content/18/2/99.short 4100 - http://qualitysafety.bmj.com/content/18/2/99.full SO - Qual Saf Health Care2009 Apr 01; 18 AB - A new model is proposed for enhancing patient safety using market-based control (MBC), inspired by successful approaches to environmental governance. Emissions trading, enshrined in the Kyoto protocol, set a carbon price and created a carbon market—is it possible to set a patient safety price and let the marketplace find ways of reducing clinically adverse events? To “cap and trade,” a regulator would need to establish system-wide and organisation-specific targets, based on the cost of adverse events, create a safety market for trading safety credits and then police the market. Organisations are given a clear policy signal to reduce adverse event rates, are told by how much, but are free to find mechanisms best suited to their local needs. The market would inevitably generate novel ways of creating safety credits, and accountability becomes hard to evade when adverse events are explicitly measured and accounted for in an organisation’s bottom line.