People, systems and safety: resilience and excellence in healthcare practice.

Smith, A F and Plunkett, E (2019) People, systems and safety: resilience and excellence in healthcare practice. Anaesthesia, 74 (4). pp. 508-517. ISSN 1365-2044. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://onlinelibrary.wiley.com/toc/13652044/2019/...

Abstract

This article outlines recent developments in safety science. It describes the progression of three 'ages' of safety, namely the 'age of technology', the 'age of human factors' and the 'age of safety management'. Safety science outside healthcare is moving from an approach focused on the analysis and management of error ('Safety-1') to one which also aims to understand the inherent properties of safety systems that usually prevent accidents from occurring ('Safety-2'). A key factor in the understanding of safety within organisations relates to the distinction between 'work as imagined' and 'work as done'. 'Work as imagined' assumes that if the correct standard procedures are followed, safety will follow as a matter of course. However, staff at the 'sharp end' of organisations know that to create safety in their work, variability is not only desirable but essential. This positive adaptability within systems that allows good outcomes in the presence of both favourable and adverse conditions is termed resilience. We argue that clinical and organisational work can be made safer, not only by addressing negative outcomes, but also by fostering excellence and promoting resilience. We outline conceptual and investigative approaches for achieving this that include 'appreciative inquiry', 'positive deviance' and excellence reporting.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WA Patients. Primary care. Medical profession. Forensic medicine
WX Health services
Divisions: Clinical Support > Anaesthetics
Related URLs:
Depositing User: Beth Connors
Date Deposited: 22 Mar 2019 16:12
Last Modified: 22 Mar 2019 16:12
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1963

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