Safety-II and resilience

Staender, Sven

doi:10.1097/aco.0000000000000252

Cited by 23 publications

(11 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whereas Safety I has its focus on the avoidance of negative deviations from expected performance, Safety II concentrates on systematically understanding how good performance is produced and how adaptive mechanisms help in recognizing perturbations in the system and in reacting appropriately to them. There is a growing recognition of Safety II in healthcare [ 26 , 27 ] as well as in healthcare simulation [ 28 ]. The team in the vignette could discuss and analyze in detail the “normal” and good parts of their performance.…”

Section: Theoretical Perspectives Of the Learning From Success (Lfs) mentioning

confidence: 99%

Variation and adaptation: learning from success in patient safety-oriented simulation training

et al. 2017

View full text Add to dashboard Cite

Simulation is traditionally used to reduce errors and their negative consequences. But according to modern safety theories, this focus overlooks the learning potential of the positive performance, which is much more common than errors. Therefore, a supplementary approach to simulation is needed to unfold its full potential. In our commentary, we describe the learning from success (LFS) approach to simulation and debriefing. Drawing on several theoretical frameworks, we suggest supplementing the widespread deficit-oriented, corrective approach to simulation with an approach that focusses on systematically understanding how good performance is produced in frequent (mundane) simulation scenarios. We advocate to investigate and optimize human activity based on the connected layers of any setting: the embodied competences of the healthcare professionals, the social and organizational rules that guide their actions, and the material aspects of the setting. We discuss implications of these theoretical perspectives for the design and conduct of simulation scenarios, post-simulation debriefings, and faculty development programs.

show abstract

Section: Theoretical Perspectives Of the Learning From Success (Lfs) mentioning

confidence: 99%

Variation and adaptation: learning from success in patient safety-oriented simulation training

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The latest step in this transition of safety culture is the shift towards learning from excellence, also known as Safety-II [12,20,21]. Safety is often perceived as the absence (or rarity) of incidents, with the focus on analysing things that go 'wrong.'…”

Section: Key Pointsmentioning

confidence: 99%

Broadening the scope and rising to the occasion, an opportunity for anaesthesiologists to take the lead in healthcare quality & patient safety (again)

Buhre,

Maas

2024

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of review The landscape of healthcare is characterized by high demands and scarce human and financial resources. This calls for action in improving healthcare quality. This review shows how anaesthesiologists are the designated medical specialist to share their affinity and knowledge in quality and safety, throughout the hospital and across the care continuum. Recent findings Recent studies show excellent frameworks and examples of anaesthesiologist leading the way in patient safety and quality of care. Summary Anaesthesiologist are early adapters of patient safety. In the last decades anaesthesia has become linked with patient safety and the quality of care. With the recent transition from peroperative to perioperative care; new opportunities are emerging, expanding our professional scope. Unfortunately, the anaesthesiologist is not often positioned in a leading role in quality of care and patient safety. After a brief rise during the COVID-19 pandemic, in which anaesthesiologists were visible in the frontline in many countries, we have unfortunately disappeared from the spotlight. This review shows numerous ideas, examples, and a framework how a leading position can be realized.

show abstract

“…Clinicians who are on the front lines of healthcare can work with systems engineers and human factors experts to develop a more accurate understanding of how clinical work is actually accomplished [24 & ]. This updated view of safety in complex systems has been proposed as an important step towards reducing patient harm [25]. The surgical time-out is not viewed only as a checklist addressing issues known to cause harm (such as insufficient sterile prep dry time) but also as an opportunity for the team to collectively discuss multidisciplinary goals, expected risks, and available resources, thus enhancing resilient performance [26].…”

Section: Lessons Learned From Air Traffic Controlmentioning

confidence: 99%

In control or along for the ride? Lessons for anesthesiologists from air traffic control

Ruskin

Dutton

Ruskin

2023

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of review Anesthesia professionals work in an unpredictable, rapidly changing environment in which they are quickly diagnose and manage uncommon and life-threatening critical events. The perioperative environment has traditionally been viewed as a deterministic system in which outcomes can be predicted, but recent studies suggest that the operating room behaves more like a complex adaptive system, in which events can interact and connect with each other in unpredictable and unplanned ways. Recent findings The increasing complexity of the healthcare environment suggests that the complete elimination of human error is not possible. Complex clinical situations predispose to errors that are the result of high workload, decision making under stress, and poor team coordination. The theory behind complex adaptive systems differs from medicine's traditional approach to safety and highlights the importance of an institutional safety culture that encourages flexibility, adaptability, reporting and learning from errors. Instead of focusing on standardization and strict adherence to procedures, clinicians can improve safety by recognizing that unpredictable changes routinely occur in the work environment and learning how resilience can prevent adverse events. Summary A better understanding of automation, complexity, and resilience in a changing environment are essential steps toward the safe practice of anesthesia.

show abstract

Safety-II and resilience

Abstract: We are well advised to consider adapting these modern concepts of 'resilience' and 'safety-II' thinking when we want to substantially improve patient safety in anaesthesiology.

Cited by 23 publications

References 21 publications

Variation and adaptation: learning from success in patient safety-oriented simulation training

Variation and adaptation: learning from success in patient safety-oriented simulation training

Broadening the scope and rising to the occasion, an opportunity for anaesthesiologists to take the lead in healthcare quality & patient safety (again)

In control or along for the ride? Lessons for anesthesiologists from air traffic control

Contact Info

Product

Resources

About