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Safety-II and the study of healthcare safety routines : Two paths forward for research

Rydenfält, Christofer LU (2022) In Journal of Patient Safety and Risk Management 27(3). p.124-128
Abstract

Safety routines such as the WHO surgical safety checklist and SBAR have gained widespread attention and implementation in healthcare. However, there has also been criticism. With the ongoing Covid-19 pandemic, the need for knowledge about how safety routines work in practice is larger than ever. In light of these obstacles, I suggest two approaches to the study of healthcare safety routines, based on a human factors perspective and a safety II mind-set that so far has gained little attention. The WHO surgical safety checklist, is used as an example. However, the suggestions presented here applies to other safety routines as well. The first approach is that instead of being preoccupied with what people do not do, investigate what they... (More)

Safety routines such as the WHO surgical safety checklist and SBAR have gained widespread attention and implementation in healthcare. However, there has also been criticism. With the ongoing Covid-19 pandemic, the need for knowledge about how safety routines work in practice is larger than ever. In light of these obstacles, I suggest two approaches to the study of healthcare safety routines, based on a human factors perspective and a safety II mind-set that so far has gained little attention. The WHO surgical safety checklist, is used as an example. However, the suggestions presented here applies to other safety routines as well. The first approach is that instead of being preoccupied with what people do not do, investigate what they value with the routine. The perceived importance of different parts of the routine can expose the rationality behind the personnel's choice of actions when using the routine. Knowledge that could be used both to investigate the dynamics of everyday performance and for redesign and adjustment of the routine. The second approach is that instead of looking for failure, investigate and highlight when the routine works. Examples of when the routine works, i.e. avert adverse events, can be used both as positive reinforcement, and as an opportunity for learning with regards to everyday performance variability. Since a safety-II perspective is largely missing in the literature on healthcare safety routines, the two approaches suggested here comes with a huge potential for learning about how to improve safety.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
checklist, complex adaptive system, Patient safety, resilience
in
Journal of Patient Safety and Risk Management
volume
27
issue
3
pages
5 pages
publisher
SAGE Publications
external identifiers
  • scopus:85130361869
ISSN
2516-0435
DOI
10.1177/25160435221102129
language
English
LU publication?
yes
id
a982f16d-e3bf-4e0d-8fbd-d1f1aef2d281
date added to LUP
2022-07-12 10:08:56
date last changed
2022-07-12 10:08:56
@article{a982f16d-e3bf-4e0d-8fbd-d1f1aef2d281,
  abstract     = {{<p>Safety routines such as the WHO surgical safety checklist and SBAR have gained widespread attention and implementation in healthcare. However, there has also been criticism. With the ongoing Covid-19 pandemic, the need for knowledge about how safety routines work in practice is larger than ever. In light of these obstacles, I suggest two approaches to the study of healthcare safety routines, based on a human factors perspective and a safety II mind-set that so far has gained little attention. The WHO surgical safety checklist, is used as an example. However, the suggestions presented here applies to other safety routines as well. The first approach is that instead of being preoccupied with what people do not do, investigate what they value with the routine. The perceived importance of different parts of the routine can expose the rationality behind the personnel's choice of actions when using the routine. Knowledge that could be used both to investigate the dynamics of everyday performance and for redesign and adjustment of the routine. The second approach is that instead of looking for failure, investigate and highlight when the routine works. Examples of when the routine works, i.e. avert adverse events, can be used both as positive reinforcement, and as an opportunity for learning with regards to everyday performance variability. Since a safety-II perspective is largely missing in the literature on healthcare safety routines, the two approaches suggested here comes with a huge potential for learning about how to improve safety.</p>}},
  author       = {{Rydenfält, Christofer}},
  issn         = {{2516-0435}},
  keywords     = {{checklist; complex adaptive system; Patient safety; resilience}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{124--128}},
  publisher    = {{SAGE Publications}},
  series       = {{Journal of Patient Safety and Risk Management}},
  title        = {{Safety-II and the study of healthcare safety routines : Two paths forward for research}},
  url          = {{http://dx.doi.org/10.1177/25160435221102129}},
  doi          = {{10.1177/25160435221102129}},
  volume       = {{27}},
  year         = {{2022}},
}