What Exactly Is Patient Safety?

Abstract

We articulate an intellectual history and a definition, description and model of patient safety. We define patient safety as a discipline in the health care professions that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery. We also define patient safety as an attribute of health care systems that minimizes the incidence and impact of adverse events and maximizes recovery from such events. Our description includes: why the field of patient safety exists (the high prevalence of avoidable adverse events); its nature; its essential focus of action (the microsystem); how patient safety works (e.g., high-reliability design, use of safety sciences, methods for causing change, including cultural change); and who its practitioners are (i.e., all health care workers, patients and advocates). Our simple and overarching model identifies four domains of patient safety (recipients of care, providers, therapeutics and methods) and the elements that fall within the domains. Eleven of these elements are described in this paper.

Defining attributes of patient safety through a concept analysis

“…Adverse events occur as a result of a breakdown in the system, not simply as a result of an individual's failure; therefore, it is essential that all components of healthcare delivery (institutions, healthcare provider teams, other individuals and technologies) be integrated into a high‐reliability systems design that minimizes the incidence and impact of and maximizes recovery from adverse events (Emanuel et al . ). Inevitably, all the authors described patient safety as an attribute of care delivery systems.…”

“…World Health Organization () described that ‘the discipline of patient safety is the coordinated effort to prevent harm, caused by the process of health care itself, from occurring to patients.’ Similarly, articles by Emanuel et al . (), Gluck (), Montoya and Kimball () also describe that the main goal of patient safety discipline is to minimize adverse events and eliminate preventable harm in health care. In the article by Emanuel et al .…”

“…In the article by Emanuel et al . (), the authors described that patient safety is a ‘discipline in the healthcare sector that applies safety science methods towards the goal of achieving a trustworthy system of healthcare delivery’ (Emanuel et al . , p. 5).…”

Is team‐based perception of safety in the operating room associated with self‐reported wrong‐site surgery? An exploratory cross‐sectional survey among physicians

“…Safety culture is one important dimension of patient safety and reflects values, attitudes, and behaviors that health care professionals have in common when administering care to patients and includes their perception of safety as an individual and/or team‐based responsibility. Health care professionals are trained to be diligent in their care of patients and to follow the guiding principle “first do no harm.” Over the past decades, the development of a safety culture in health care—and, specifically, in the operating rooms (ORs)—has become a significant issue, and efforts have been made to enhance the importance of safety as a collective, rather than an individual, process . Yet changing attitudes towards safety perceptions has been difficult, mostly because of cultural reasons .…”

Missed Nursing Care: A Symptom of Missing Evidence

“…Jones, Hamilton, and Murry (, p. 1122) posit that given nurses’ roles as gatekeepers, planners, coordinators and evaluators of care, “few care processes reach patients without first passing through the hands of nurses.” Melnyk and Newhouse () asserts that patients trust nurses to plan and deliver care that is based on the best available evidence, their clinical expertise and the patients’ own preferences. In the light of such close involvement with patients and members of the wider multidisciplinary team, nurses should be key drivers of evidence‐based patient safety and play an integral role in realising a trustworthy organisation of healthcare provision (Emanuel et al., ). To this end, it is imperative in the first instance to scrutinise our own practice in order to ascertain our limitations in the areas of patient safety, and evidence‐based practice, and to consider ways in which we might minimise our contribution to patient harm, while optimising patient outcomes.…”