On important goal in any country should be to deliver safe and  high-quality health care to patients in all clinical settings. Despite the best intentions, however, a high rate of largely preventable adverse events and medical errors occur that cause harm to patients.

Medical errors are one of many Nations´ leading causes of death and injury. In USA, between 50,000 to 100,000 people die in U.S. hospitals each year and 1 000 000 excess injures as the result of medical errors (MEs) and adverse events (AEs). 23% of Europeans argue that they have been directly affected by a medical errors personally or in the family. over 3000 people die in Sweden, 185,000 case are associated with an adverse event in Canada and almost 11% of total deaths in Australia are caused by medical errors. Mixed up test results, injuries suffered during childbirth, infections following surgery, and incorrect drug dosages are just a few of the harmful errors.

This means that more people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS. One question is How many patients need to die before the media, government, county councils and care planners start to take serious actions to prevent such lose of people because of the medical errors?

Total relationship medical management (TRMM) emphasizes the totality and the holistic nature of a relationship which includes internal and external factors, functions and resources inside and outside any health care organization/institution. TRMM includes 5 generic quality dimensions (5 Qs) and measurements.  5Qs will be used in this study to identify the shortcoming of a health care institution to reduce the medical errors which lead to the increase of physicians and patients relationship.