[The image of patient safety in Sweden might seem contradictory].

There is a multiplicity of signals and evidence of avoidable harm and lack of quality in health care. In parallel the medical results often are excellent. Better understanding and knowledge is needed regarding how different factors interact in a complex way resulting in both good and bad outcomes. That would improve the possibilities for better patient safety as well as even better medical results. Evaluation and follow-up of safety and results always in itself influences the processes. Evaluation has to be done in a balanced and well elaborated way to provide a basis for wise governance and improvement. There is need of a leadership that keeps focus on safety and quality even when there is a competition with economy and other challenges.