Understanding patient safety performance and educational needs using the ‘Safety-II’ approach for complex systems

McNab, D., Bowie, P., Morrison, J. and Ross, A. (2016) Understanding patient safety performance and educational needs using the ‘Safety-II’ approach for complex systems. Education for Primary Care, 27(6), pp. 443-450. (doi: 10.1080/14739879.2016.1246068) (PMID:27800711)

131620.pdf - Accepted Version



Participation in projects to improve patient safety is a key component of general practice (GP) specialty training, appraisal and revalidation. Patient safety training priorities for GPs at all career stages are described in the Royal College of General Practitioners’ curriculum. Current methods that are taught and employed to improve safety often use a ‘find-and-fix’ approach to identify components of a system (including humans) where performance could be improved. However, the complex interactions and inter-dependence between components in healthcare systems mean that cause and effect are not always linked in a predictable manner. The Safety-II approach has been proposed as a new way to understand how safety is achieved in complex systems that may improve quality and safety initiatives and enhance GP and trainee curriculum coverage. Safety-II aims to maximise the number of events with a successful outcome by exploring everyday work. Work-as-done often differs from work-as-imagined in protocols and guidelines and various ways to achieve success, dependent on work conditions, may be possible. Traditional approaches to improve the quality and safety of care often aim to constrain variability but understanding and managing variability may be a more beneficial approach. The application of a Safety-II approach to incident investigation, quality improvement projects, prospective analysis of risk in systems and performance indicators may offer improved insight into system performance leading to more effective change. The way forward may be to combine the Safety-II approach with ‘traditional’ methods to enhance patient safety training, outcomes and curriculum coverage.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Morrison, Professor Jill and Bowie, Dr Paul and McNab, Duncan and Ross, Dr Alastair
Authors: McNab, D., Bowie, P., Morrison, J., and Ross, A.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Journal Name:Education for Primary Care
Publisher:Taylor & Francis
ISSN (Online):1475-990X
Published Online:01 November 2016
Copyright Holders:Copyright © 2016 Informa UK Limited, trading as Taylor and Francis Group
First Published:First published in Education for Primary Care 27(6):443-450
Publisher Policy:Reproduced in accordance with the publisher copyright policy

University Staff: Request a correction | Enlighten Editors: Update this record