In this months BMJ Quality & Safety, Gordan Schiff and Kaveh Shojania have written a thoughtful article which holds at it’s centre the recent publication by Lucean Leape “Making Healthcare Safe; The Story of the Patient Safety Movement”.
The authors summarise and critique Leapes’ ‘history from within’ and share their own reflections on this “enduring field” of healthcare deliver. A highlight includes Leapes’ candid confession that in his years of practising surgery, it never occurred to him that “teamwork was the key to better outcomes”, instead he had assumed that surgeons constitute the captains of the ship whose skill and authority were what mattered most.
The authors’ summary of the patient safety history is viewed from qualitative and quantitative perspectives. The former perspective suggests that “given all the positive changes, one could characterise patient safety as a successful social movement with healthcare”. However, from the latter “few if any safety interventions possess the key characteristics of robust supporting evidence and widespread adoption”.
As such, the authors set out a list of key challenges and opportunities to improve patient safety. Central to this list is the differentiation between ‘systems and process’ changes (including technology) – the focus for the last 20 plus years, and ‘cultural and behavioural’ changes – the focus for the future? It is clear the authors feel the ‘enduring field’ of patient safety is yet to fully yield a satisfactory harvest, however, their ideas and optimism provide useful inspiration.
NB: The topic of ‘patient safety systems’ will be covered in more detail at a workshop led by Professor Henning Bøje Andersen at the Patientsikkerhedskonference 25.-26. April:
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