Leading Safety Indicators: Towards Determining the Enhancement or Degradation of the Level of Patient Safety in Healthcare

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Maria Mikela CHATZIMICHAILIDOU, University of Cambridge

A leading safety indicator is “a warning sign that can be used in monitoring a safety-critical process to detect when a safety-related assumption is broken or dangerously weak and that action is required to prevent an accident. Alternatively, a leading indicator is a warning signal that the validity or vulnerability of an assumption is changing” (Leveson 2015). The NHS defines a “patient safety incident” as “any unintended or unexpected incident which could have or did lead to harm for one or more patients receiving NHS care”. The Health Foundation (2013) notes that fifteen years after the establishment of the National Patient Safety Agency, it is still difficult to know whether patients are safer in the NHS than they were. Thus, the question is: can leading safety indicators monitor and assess the level of patient safety?

To shed some light on the above question, this proposal introduces a methodology for developing leading safety indicators in healthcare. The healthcare setting is suggested due to its complex, risk prone procedures and socio-technical nature (NHS 2010). Healthcare incorporates human factors that carry mental models, control and feedback loops between human operators and technology, warning and reporting systems, formal and informal policies, operational and safety regulations etc. These are elements that comprise a system (e.g. pathways, services, processes) and ideally are oriented towards creating (The Health Foundation 2013) and enhancing safety. Given the plethora of reporting and investigation data, as well as the rapidly growing number of reports (The Health Foundation 2013), the elements of a healthcare system are potentially tangible in a sense that they are feasible to detect and record (Chatzimichailidou, Stanton, and Dokas 2015).

Date & time

7-8 June 2016

NCTL Learning and Conference Centre, Nottingham

What is a Complex System?

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