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Our complex health care system will not be error free for the foreseeable future. Certain interventions must be put into place to manage that risk, and staffing effectiveness is a critical part of clinical risk management. Application of research and practice can create a basis for a proactive risk management plan, and will build in an essential feedback loop to leadership. Pay for performance initiatives by the Centers for Medicare & Medicaid Services and other payers are creating further incentive to get to zero errors faster. By implementing what we know about staffing and avoidable errors, we are in a very good position to meet the challenges to create a safe health care system.