Atul Gawande used to think that the hospitals delivered the best health care were those that did the most to minimize risk - the places that “did a better job of preventing things from going wrong” - until he read a new study out of the University of Michigan:

Some places still have far higher death rates than others. And an interesting line of research has opened up asking why.

Researchers at the University of Michigan discovered the answer recently, and it has a twist I didn’t expect. I thought that the best places simply did a better job at controlling and minimizing risks—that they did a better job of preventing things from going wrong. But, to my surprise, they didn’t. Their complication rates after surgery were almost the same as others. Instead, what they proved to be really great at was rescuing people when they had a complication, preventing failures from becoming a catastrophe.

Scientists have given a new name to the deaths that occur in surgery after something goes wrong—whether it is an infection or some bizarre twist of the stomach. They call them a “failure to rescue.” More than anything, this is what distinguished the great from the mediocre. They didn’t fail less. They rescued more.

Gawande, in a commencement address delivered earlier this week at Williams College, goes on to talk about the practice of “risk management” in health care. Read the full speech here.