Positive approaches to safety: Learning from what we do well

Area of Science:

• Healthcare Management
• Patient Safety Research
• Systems Engineering

Background:

• Traditional patient safety models are deficit-based, defining safety as the absence of harm.
• This approach, while effective, shows signs of plateauing progress in healthcare outcomes.
• Limitations exist in solely focusing on failures and negative outcomes.

Purpose of the Study:

• To discuss theoretical limitations of the current deficit-based patient safety model.
• To introduce emerging, complementary approaches to patient safety.
• To advocate for a balanced and holistic view of patient safety.

Main Methods:

• Review of theoretical limitations of deficit-based safety models.
• Introduction of Safety-II and resilience engineering paradigms.
• Exploration of positive approaches: exnovation, appreciative inquiry, learning from excellence, and positive deviance.

Main Results:

• Identified theoretical limitations in deficit-based patient safety approaches.
• Presented Safety-II and resilience engineering as system-wide safety paradigms.
• Highlighted positive approaches focusing on success (outstanding and everyday).

Conclusions:

• Emerging approaches like Safety-II and resilience engineering complement traditional methods.
• Focusing on system-wide work and success offers a more holistic view of patient safety.
• These new methods are not replacements but valuable additions for a balanced safety perspective.