The evolution of the patient safety perspectives, the technological age, the human factor age and the safety management age, have no clear cut and coexist. The current edition of the Current Opinion in Anesthesiology Technology, Education and Safety section presents an eclectic compendium of articles addressing these views from the technological improvements, human factor developments and organizational safety management impacting patient safety. Every solution, every patch to fill the cheese hole, holding the domino piece to fall, opens a new disruption elsewhere that needs to be addressed following the zero-preventable harm path.