Using foresight in safe nursing care

This paper describes the importance of prospective risk analysis in healthcare, the development of the foresight training package and its underlying theory.

Many high-reliability industries formally train staff in prospective risk analysis. Although there are tools to retrospectively analyse incidents in healthcare and although many staff are error aware there is no training to formalize this learning.

Staff already use error awareness and often intervene to prevent patient harm resulting in many 'no harm' incidents. The National Patient Safety Agency has developed the foresight training package to broaden healthcare professionals' understanding of the many factors that can combine to contribute to an incident occurring, and to encourage shared learning. For management teams, this broader understanding will assist them in prospective risk assessment of the staff they manage enabling them to be proactive in minimizing risk. The training tool is based on Reason's 'three bucket' model.

Throughout every stage in the development of the foresight training package the concept and materials were tested with front-line staff. Formal evaluation of the published package is due to be completed by May 2009.