Mapping the patient safety footprint: The RADICAL framework

Numerous interventions to promote patient safety have been proposed. For these to produce demonstrable and positive change, appropriate metrics should be available. Measurements must, however, be comprehensive enough to cover all domains of patient safety. In this paper, I introduce the term 'patient safety footprint' to encapsulate the totality of attributes and domains that define or describe the degree of protection accorded to patient safety by a healthcare provider (individual or organisation). A framework, identified by the acronym RADICAL, is presented. It specifies and captures all domains required for mapping the patient safety footprint: (R)aise (A)wareness, (D)esign for safety, (I)nvolve users, (C)ollect and (A)nalyse patient safety data, and (L)earn from patient safety incidents. In addition to providing a schema, the RADICAL framework describes a worldview of the concept of patient safety. Examples are given of its application in obstetrics and gynaecology.