In November of 1999, the Institute of Medicine released a clear commentary citing the need for a systems based approach to reduction of medical errors.  Modern tools evolved by giants in the field of quality like Deming & Shingo, further refined by organizations like Motorola, Westinghouse, and GE, exist and are routinely used by other industries like aviation and manufacturing; yet, these same tools are more rarely employed in healthcare as our field says "healthcare is different".  Healthcare colleagues:  will we learn the tools that already exist and are well-known to affect system-level improvements?  Here, for example, is a tool to highlight patient risk for a given outcome in your system.