Commentary: Shared learning from national to international contexts: a research and innovation collaborative to enhance education for patient safety.

Abstract

According to Hippocrates, the first principle for healthcare professionals is to take care that they suffer no hurt or damage (Edelstein, 1943) and yet education for most of the professions historically has included nothing on safety and safety science. There is often a simplistic view that patient harm is synonymous with individual negligence at worst, or lack of individual awareness at best. There is an increasing understanding of the complexity of health and the confluence of many different factors that, when combined, to use Reason’s (2000) analogy, align the holes in the Swiss cheese and allow inadvertent harm to occur. The authors of the reviewed study propose a pedagogical approach to educating healthcare students that draws on the empirical evidence and situates it within the students’ unique, contextual experiences of healthcare services. Using Rasmussen and Amalberti’s work on how everyday workarounds can move practice away from evidencebased standards, SLIPPS illuminates how good people can work in environments that threaten patient safety. By exploring the complexity, the student can begin to move away from a blame culture and towards prospective solutions that create the conditions where things go right more often. This reflects the ethos of High Reliability Organisations, where professionals must expect the unexpected (Weick et al., 2008) rather than assume they can be certain that their processes and protocols will ensure safety. This will present students with major challenges; in the UK at least, the top-down approach to safety leads to standardised processes but variable outcomes. Students who seek to achieve standardised outcomes but with variable processes may fall foul of the compliance culture that dominates healthcare systems.