Where Does Safety Fit In?

Key points

  • Psychological safety is essential for learning.

  • Safety requires safe systems, not just individuals working safely.

  • Involving patients in their own safety improves quality of care.

John F Kennedy's quote describes our patient safety journey in the National Health Service (NHS) towards understanding and proactivity, from talking about harm to talking about safer systems that provide the right care, as intended, every time and learning from what works, not just what does not. It also speaks to the idea of doing that in a just culture where psychological safety means we will hear more, learn more, and can act more to improve care.

Since 2009 in the UK, with the publication of the World Health Organization (WHO) Guidelines for Safe Surgery and the launch of the framework for identifying and monitoring “never events,” there has been significant progress, review, and emphasis placed on safety within perioperative medicine. In 2015, this was further supported by the publication of the National Safety Standards for Invasive Procedures (NatSSIPs), which enabled organizations to standardize the key elements of procedural care that lay mostly outside the operating room environment.

National Health Service Patient Safety Strategy

Any health system that wants to become safer needs to move from an approach based on individual effort to a systems-based approach that understands and addresses major patient safety challenges such as healthcare-associated venous thromboembolism and eliminates rare but significant errors such as misconnection of gases. This requires insight from a range of sources, infrastructure, an approach to the involvement of staff and patients, a syllabus and training, and then the development of the improvement capability to bring about the required systematic changes ( Fig. 2.1 ).

Fig. 2.1, Summary of the National Health Service (NHS) Patient Safety Strategy

The first NHS patient safety strategy was launched in England in 2019 and seeks to continuously improve patient safety by building on the foundations of a patient safety culture and patient safety system.

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