Resources

In Australian health services, roles that support consumer safety are a mix of trained specialists, people who evolve on the job and those who struggle through the basics with little opportunity for development. In the UK,  the NHS has created a new role of ‘patient safety specialist’, introduced to bring a more structured, professional approach to patient safety. This evaluation article seeks to understand the professionalisation of patient safety, with implications for the further development of patient safety specialists in the UK and other countries. 

Over the past three decades, many health systems have sought to enhance care delivery. Despite various approaches such as quality improvement and lean management these efforts can fall short. Failures are often attributed to leaders and workers not doing the right things. This article argues that the real quality problems lie in the underlying systems staff work with. It says that human service organisations will be more successful if they focus on designing systems that support the delivery of high-quality care, rather than trying to fix the people working within them.

Spreading, scaling up, and sustaining improvements in human services is a complex challenge that many countries, including the UK, USA, and Australia, have been tackling. Despite significant efforts, the sustainability of scaling up local improvements remains low. One reason for this is the traditional, linear approach to spreading improvements, which often overlooks the complexity and evolving nature of healthcare systems.

We spend a lot of time on root cause analysis (RCA) – and have done it for 20 years or so. But key clinical risks remain stubbornly consistent.

SystemsThinking - A New Direction in Healthcare Incident Investigation.

The Managing Clinical Risk in Primary Health Care document is designed as a resource for staff in primary health care services. The document has been developed after consultation with practitioners, managers, risk specialists and with reference to the conceptual framework provided by the Victorian Quality Council.

Dignity of risk is another way of saying you have the right to live the life you choose, even if your choices involve some risk.

This 'Dignity of Risk' research project aims to determine policy and decision-makers perceptions of ‘Dignity of Risk’ as it applies to vulnerable older persons living in residential aged care services.

In this No Harm Done podcast, Dr Cathy Balding and Cathy Jones delve into the clinical risk management depths.

This guide is a resource to help support individual and organisational learning and to drive quality improvement, in response to patient safety incidents. Organisations may also choose to use the guide to support quality assurance processes.