A strategy to maintain safety in clinical incidents

NHS team leaders are often in a position where they have to not only manage and control a clinical situation but also become actively involved in delivering patient care because of low staffing levels or inappropriate skill mixes. This increases the potential for loss of situational awareness and risk to patient and staff safety. "Inner and outer circles" offers a strategy that could reduce risks and increase patient safety. It is used in pre-hospital and industrial environments and could easily be adapted to inpatient and other settings.