The measurement and monitoring of safety

The measurement and monitoring of safety

Author: The Health Foundation

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Over the past 10 years there has been a deluge of statistics on medical error and harm to patients, many tragic cases of healthcare failure and a growing number of major government and professional reports on the need to make healthcare safer.

There is now widespread acceptance and awareness of the problem of medical harm, and considerable efforts have been made to improve the safety of healthcare. But if we ask whether patients are any safer than they were 10 years ago, the answer is curiously elusive.

The Health Foundation commissioned Professor Charles Vincent and his colleagues from Imperial College London to bring together evidence from a range of sources (published research, public data, case studies and interviews), both from within healthcare settings and from other safety critical industries. The authors have synthesised this evidence and have proposed a single framework that brings together a number of conceptual and technical facets of safety.

A report summary is also available.

Five dimensions: a proposed framework

This framework highlights the following five dimensions, which the authors believe should be included in any safety and monitoring approach in order to give a comprehensive and rounded picture of an organisation’s safety:

  • Past harm: this encompasses both psychological and physical measures.
  • Reliability: this is defined as ‘failure free operation over time’ and applies to measures of behaviour, processes and systems.
  • Sensitivity to operations: the information and capacity to monitor safety on an hourly or daily basis.
  • Anticipation and preparedness: the ability to anticipate, and be prepared for, problems.
  • Integration and learning: the ability to respond to, and improve from, safety information.

This framework provides a starting point for discussions about what ‘safety’ means and how it can be actively managed. A diagram of the framework is available.

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You can order a hard copy of The measurement and monitoring of safety from the Health Foundation website.

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