Safety management healthcare organisation

Organisations still frequently rely on retrospective techniques such as incident reporting and complaints to drive safety management [21] and healthcare has been slow and sporadic in adopting predictive safety assessment techniques to detect medical error [22]. Twenty two percent of people in the UK believe, when asked, that they have been the victim of medical error [23]. Nevertheless continually striving to protect patients at vulnerable points in their lives is stiU clearly the right thing to do and a move from reactive to proactive risk reduction wiU surely pay dividends in the future. 

Bayuk [7] points out that Employees must fully trust that they will have management support for decisions made in the interest of safety, while also recognising that intentional breaches of safety wiU not be tolerated. The result is a non-punitive environment that encourages the identification, reporting, and correction of safety issues. Developing such a non-punitive culture is a challenge which both healthcare organisations and manufacturers need to embrace. 

Elina Pietikfiinen works as senior research scientist at the VTT Technical Research Centre in Finland. Her background is in psychology. Her research interests include safety culture evaluation and development, safety management, safety expertise, organisational evaluation and organisational learning. She works in research and development projects in several safety critical industries, such as social and healthcare and the nuclear industry. 

The NHS published standards DSCN 14 and DSCN18 require more formality and governance for safety management. The production of safety cases from suppliers or manufacturers and from the healthcare organisation (i.e. the Trust) is mandated. To support the safety cases a safety management lifecycle is defined. The intended dates for implementation were a challenge. In practice, there needed to be a process in place by the time of the implementation dates to derive safety cases. 

Safety and risk management research in healthcare has adopted as its dominant trend the systems oriented approach, modelled largely on previous research in safely critical industries such as aviation and nuclear power. The systems view entails that the focus is not primarily on the mechanisms of individual human error but on the factors that shape human performance (Rasmussen 1986 Reason 1993,1997). In an organisational context, such factors are, of course, those that are within the control of the organisation. For instance, it has been suggested that quahty and safety are affected not only by operators professional and technical competence and skills, but also by their attitudes to and perceptions of their job roles, their organisation and management (Helmreich and Merritt 1998). Such employee attitudes and views are important elements which shape safety cirlture - and its related notion safety climate . Indeed, survey studies have shown that staff attitudes are important indices of safety performance not only in human-machine system domains such as railway operations and constmction (e.g. Itoh and Andersen 1999 Itoh et al. 2004 Silva et al. 2004) but also in healthcare (e.g. Colla et al. 2005 Itoh and Andersen 2010). 

---