Exploring Systems Safety: Increasing Awareness of Work Design beyond Acute Care

June 19, 2023 | Aging Services Risk Management


Improving patient, resident, worker, and visitor safety within the US healthcare system has been a national priority for over two decades. Despite years of varied approaches—including targeted initiatives and funding for research, education, public reporting, and more—the risk of harm is still prevalent across all care settings. This has prompted an industry-wide effort to implement a systems safety approach to continuous improvement.

Systems safety essentially acknowledges system complexity and the importance of system design. It provides a framework for analyzing how the design dictates system behaviors and how those behaviors affect outcomes to inform improvement efforts. Though systems safety has evolved since its inception in other high-risk industries like manufacturing, aviation, and the military, this core concept has remained unchanged and can be applied to any industry. Within the context of healthcare, systems safety considers how factors such as staffing and scheduling, workload, workflow, supplies and equipment, physical environment, and technology affect care delivery and safety outcomes. When we think of a care and service delivery system as a multidimensional environment, we begin to see how a change in the environment—such as a staff call-out, a...

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