The Patient Safety Collaborative

Making a difference - Prevention Systems for Patient Safety

What is Patient Safety

A medical error can clearly compromise Patient Safety, and the cause andeffect is obvious, but by concentrating on Patient Safety also means instilling an improvement culture whereas the former propogates the blame culture.The term “Patient Safety” is a relatively recent phenomenon and some say the term was coined as a friendlier alternative to “medical error”. A medical error can clearly compromise Patient Safety, and the cause and effect is obvious, but by concentrating on Patient Safety also means instilling an improvement culture whereas the former propogates the blame culture.

However, the meaning of the phrase has developed since its inception and is now recognised as having a far greater depth of meaning. Despite the plethora of reports and articles on the subject, no universally accepted definition of Patient Safety exists as of today.

A useful working definition, as used by The Quality Interagency Coordination Task Force (QuIC) (USA), is as follows:

“The term “patient safety” …… applies to initiatives designed to prevent adverse outcomes from medical errors. “

For Patient Safety to be viewed as a pro-active approach to reducing the possibility of patients being unintentionally harmed by their exposure to healthcare requires:

1. Knowledge of what type of errors occur, and how often they occur, in particular healthcare settings (Reporting);
2. An understanding as to why they occurred (Root cause analysis);
3. The ability to act upon the results (Active Learning); and
4. The ability of changing systems and procedures to reflect the lessons learnt (systems design)