Evaluation of system mapping approaches in identifying patient safety risks

Objective: While many system mapping approaches (SMAs) have been broadly used in safety‐critical industries, few have so far been employed in the healthcare field to assist in the identification of patient safety risks. In this study, we evaluated a set of system modelling approaches to assess their potential contribution to the identification of risks affecting patient safety. The aim was to gain a greater understanding of the practical application of system modelling approaches with the help of the risk categorization framework developed in this study. Setting: We conducted this study in a newly established Adult Attention Deficit Hyperactivity Disorder (ADHD) service at Cambridge and Peterborough Foundation Trust. Study participants: Eight key stakeholders of the chosen service, including clinicians, managers and administrative staff, were individually asked to evaluate a set of pre‐defined six SMAs according to their usefulness in identifying patient safety risks through interview‐based questionnaires. Results: It was found that each SMA could be useful in the chosen healthcare service in different ways. Further, specific types of diagrams were selected by stakeholders as more useful than others in identifying different sources of risks within the given system. Conclusions: The results of the evaluation showed that the system diagram is the most useful SMA in risk identification within the given system, while limited time, resources and experience of stakeholders with SMAs may present possible obstacles for their potential use in the healthcare field in future.

[1]  Felix Redmill,et al.  System Safety: HAZOP and Software HAZOP , 1999 .

[2]  P. John Clarkson,et al.  A comparison of the methods used to support risk identification for patient safety in one UK NHS foundation trust , 2015 .

[3]  D. Classen,et al.  'Global trigger tool' shows that adverse events in hospitals may be ten times greater than previously measured. , 2011, Health affairs.

[4]  R J Lilford,et al.  Organizing patient safety research to identify risks and hazards , 2003, Quality & safety in health care.

[5]  C. Landrigan,et al.  Temporal trends in rates of patient harm resulting from medical care. , 2010, The New England journal of medicine.

[6]  Clifton A. Ericson,et al.  Hazard Analysis Techniques for System Safety: Ericson/Hazard Analysis Techniques for System Safety , 2005 .

[7]  C. Vincent,et al.  Framework for analysing risk and safety in clinical medicine. , 1998, BMJ.

[8]  谷門 信,et al.  Cambridge及びThe University of Cambridge起源の一考察 , 1953 .

[9]  Lacey Colligan,et al.  Does the process map influence the outcome of quality improvement work? A comparison of a sequential flow diagram and a hierarchical task analysis diagram , 2010, BMC health services research.

[10]  Clifton A. Ericson,et al.  Hazard Analysis Techniques for System Safety , 2005 .

[11]  Alan J. Card,et al.  Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options. , 2014, The International journal of risk & safety in medicine.

[12]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[13]  Ward,et al.  Prospective hazard analysis: tailoring prospective methods to a healthcare context , 2010 .

[14]  James Ward,et al.  Systems modelling approaches to the design of safe healthcare delivery: ease of use and usefulness perceived by healthcare workers , 2010, Ergonomics.

[15]  W. Runciman,et al.  An integrated framework for safety, quality and risk management: an information and incident management system based on a universal patient safety classification , 2006, Quality and Safety in Health Care.

[16]  Gc Jun.  Design for patient safety: A systematic evaluation of process modelling approaches for healthcare system safety improvement , 2007 .

[17]  Stephen Rogers.  A structured approach for the investigation of clinical incidents in health care: application in a general practice setting. , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[18]  G. T. Jun,et al.  Health care process modelling: which method when? , 2009, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[19]  P. Maurette,et al.  [To err is human: building a safer health system]. , 2002, Annales francaises d'anesthesie et de reanimation.

[20]  Fatih Orhan,et al.  Application of the IHI Global Trigger Tool in measuring the adverse event rate in a Turkish healthcare setting. , 2015, The International journal of risk & safety in medicine.

[21]  P. Carayon,et al.  Work system design for patient safety: the SEIPS model , 2006, Quality and Safety in Health Care.

[22]  Felix Redmill,et al.  Towards System Safety , 1999, Springer London.

[23]  Alan J Card,et al.  Trust-level risk identification guidance in the NHS East of England. , 2015, The International journal of risk & safety in medicine.