What Exactly Is Patient Safety?

TLDR

Patient safety exists to reduce the high prevalence of avoidable adverse events, focusing on microsystems and employing high‑reliability design, safety science methods, and cultural change, with all health care workers, patients, and advocates as practitioners. This paper articulates an intellectual history, definition, and model of patient safety, describing it as a discipline that applies safety science to build trustworthy health care systems and as an attribute that minimizes adverse events and maximizes recovery, and outlines eleven key elements. The authors present a simple overarching model comprising four domains—recipients of care, providers, therapeutics, and methods—and the elements within each domain.

Abstract

ABSTRACT We articulate an intellectual history and a definition, description and model of patient safety. We define patient safety as a discipline in the health care professions that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery. We also define patient safety as an attribute of health care systems that minimizes the incidence and impact of adverse events and maximizes recovery from such events. Our description includes: why the field of patient safety exists (the high prevalence of avoidable adverse events); its nature; its essential focus of action (the microsystem); how patient safety works (e.g., high-reliability design, use of safety sciences, methods for causing change, including cultural change); and who its practitioners are (i.e., all health care workers, patients and advocates). Our simple and overarching model identifies four domains of patient safety (recipients of care, providers, therapeutics and methods) and the elements that fall within the domains. Eleven of these elements are described in this paper.