Resilient health care: turning patient safety on its head
Top Cited Papers
- 20 August 2015
- journal article
- research article
- Published by Oxford University Press (OUP) in International Journal for Quality in Health Care
- Vol. 27 (5), 418-420
- https://doi.org/10.1093/intqhc/mzv063
Abstract
The current approach to patient safety, labelled Safety I, is predicated on a ‘find and fix’ model. It identifies things going wrong, after the event, and aims to stamp them out, in order to ensure that the number of errors is as low as possible. Healthcare is much more complex than such a linear model suggests. We need to switch the focus to what we have come to call Safety II: a concerted effort to enable things to go right more often. The key is to appreciate that healthcare is resilient to a large extent, and everyday performance succeeds much more often than it fails. Clinicians constantly adjust what they do to match the conditions. Facilitating work flexibility, and actively trying to increase the capacity of clinicians to deliver more care more effectively, is key to this new paradigm. At its heart, proactive safety management focuses on how everyday performance usually succeeds rather than on why it occasionally fails, and actively strives to improve the former rather than simply preventing the latter.Keywords
This publication has 4 references indexed in Scilit:
- A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global PopulationNew England Journal of Medicine, 2009
- An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICUNew England Journal of Medicine, 2006
- Human ErrorPublished by Cambridge University Press (CUP) ,1990
- The Hazards of HospitalizationAnnals of Internal Medicine, 1964