Improving healthcare-system safety through near misses: learning from transport industries

The aim of this study was to understand how the transport industries of aviation, rail and maritime have implemented near-miss management systems, and the impact of their learning from near misses. Grounded Theory, augmented by a scoping review, was used to generate the theory and principles behind how the industries manage near misses. The paper summarises the key findings from the scoping review and the themes identified through interviews with safety/human factors leads across various transport organisations. The findings provide insights into how healthcare might better manage near misses. However, the findings also challenge healthcare perceptions that other industries have perfected safety, and the specific value of near misses if used in isolation. The paper finishes by recommending safety management systems in healthcare.