RT Journal Article SR Electronic T1 Market-based control mechanisms for patient safety JF Quality and Safety in Health Care JO Qual Saf Health Care FD BMJ Publishing Group Ltd SP 99 OP 103 DO 10.1136/qshc.2007.025833 VO 18 IS 2 A1 E Coiera A1 J Braithwaite YR 2009 UL http://qualitysafety.bmj.com/content/18/2/99.abstract 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.