[Safety-II in daily clinical practice]

Area of Science:

• Healthcare safety sciences
• Organizational psychology
• Clinical practice improvement

Background:

• Patient safety is paramount in healthcare, with adverse events being frequent.
• Safety-I minimizes errors, while Safety-II analyzes the entire system for both desired and adverse events.
• The Critical Incident Report System (CIRS) reflects a Safety-I approach in many hospitals.

Purpose of the Study:

• To determine if the Safety-II approach is utilized in clinical practice.
• To identify measurements supporting the integration of Safety-II into daily hospital operations.
• To explore the potential of daily feedback meetings (huddles) for Safety-II implementation.

Main Methods:

• Observation of daily feedback meetings (huddles) in six hospital departments.
• Expert interviews (n=7) using the Resilient Assessment Grid (RAG) to assess Safety-II potentials.
• Focus group discussions on integrating Safety-II into clinical practice.

Main Results:

• Department teams partially implement Safety-II, exchanging positive experiences during huddles.
• Resilient Assessment Grid potentials (respond, learn, anticipate) are satisfactory; 'monitor' needs improvement.
• The Safety-II approach is viewed as a cultural shift rather than a paradigm change.

Conclusions:

• Integrating Safety-II necessitates focusing on desired occurrences alongside errors to improve patient safety.
• Systematic reflection on desired outcomes fosters organizational culture development.
• Understanding daily clinical practice enhances proactive counteraction of adverse events and patient harm.