Patient safety management: Available models and systems

This report is a part of a Finnish research and development project in which a model for patient safety management and related innovative services are developed. The report aims to clarify basic concepts related to patient safety management and to describe available safety management approaches from health care and other safety critical industries. Management and improvement of safety in health care, as in any other safety critical organisation, are strongly determined by certain concepts and how they are understood in the organisation. These concepts are patient safety, safety model, safety management model and safety management system. On the basis of the review, the following conclusions and recommendations were drawn: Patient safety should be seen as an organisation's ability that emerges from the social and technological factors interacting in an organisation. Safety is improved by creating good pre-requisites for work, not only by constraining performance. Some degree of flexibility is required. Safety model should describe the emerging safety as a systemic phenomenon meaning that both successes and failures are inevitable events in organisational behaviour. Systemic approach emphasises non-linear interactions. Safety management model should be in line with both the definition of patient safety and the safety model. It identifies the elements necessary for the management and improvement of patient safety. Safety should be considered together with the overall management of the organisation. Safety management system has to be integrated in the management system of the organisation. It aims at both assessing and eliminating risks and ensuring appropriate prerequisites for safety throughout the lifetime of the organisation. It takes into account the specific characteristics of the organisation and it is documented.