Hello everyone. Welcome to the first of many short blog articles aimed at improving and challenging our understanding of how we can better support our global efforts to enhance healthcare quality and safety. 

My name is Paul Bowie and I’m the recently appointed Education Editor here at ISQua.  A key part of this role is to help our Fellows and wider membership keep up-to-date with the latest evidence and thinking around how we can make healthcare safer and enhance the patient experience. 

Oh, and we can’t forget our workforces.  We need also to better focus on how to support their everyday work to make things as easy and safe as possible for them.  In this way we can look after their wellbeing as well as that of our patients, service users and their families and carers. Coming up in future blogs we can expect to:

• Explore the complex issue of how to make work procedures, such as checklists, guidelines and clinical protocols, work successfully in healthcare while acknowledging many of the challenges surrounding their use.
• Make the case for focusing more on improving the quality and safety of primary care services. Arguably, related efforts in terms of guiding policy, and related educational and national initiatives in this sector often lag behind the attention given to hospital-based care.
• Introduce the Human Factors discipline and profession and outline how beneficial it is for our quality and safety improvement efforts to embed key principles and approaches from this important science discipline.
• Challenge our progress over previous decades in making tangible gains in improving patient safety. Is it time to abandon some of our deeply-held beliefs and assumptions about how we go about this, and embrace a different way of thinking about this hugely complex challenge?
• Outline different ways of thinking about the complexity of ‘human work’ in healthcare and introduce novel approaches to help us do this as part of our improvement endeavours.

And there will be much more to come!

For example, challenging the idea and helpfulness of terms such as ‘medical error’ and ‘situation awareness’, which are an everyday part of our healthcare language, especially in the patient safety field.  Taking a ‘systems approach’ to understanding everyday problems and challenges, especially those related to our efforts to reduce risks and improves the design and functioning of health services delivery and introducing a “systems thinking” mindset as a core part of our ongoing efforts to analyse and learn more meaningfully from when things go wrong.

We will, of course, highlight key contemporary advances in the published evidence base so we can keep up-to-date in our improvement thinking and approaches, and this may also serve as a basis to foster debate and challenge the status quo.

Perhaps you wish to challenge or agree with some of the arguments made or have ideas for future blogs? Please let us know in the Discussion Board/Comments Section, we’re keen to hear your voices!

Thank you.

Paul

Education Editor

Further reading:

Paul O’Connor, Caoimhe Madden, Emily O’Dowd, Dara Byrne, SinÉad Lydon, A meta-review of methods of measuring and monitoring safety in primary care, International Journal for Quality in Health Care, Volume 33, Issue 3, 2021, mzab117, https://doi.org/10.1093/intqhc/mzab117

Carlos Aceves-González, Yordán Rodríguez, Carlos Manuel Escobar-Galindo, Elizabeth Pérez, Beatriz Gutiérrez-Moreno, Sue Hignett, Alexandra Rosewall Lang, Frontiers in human factors: integrating human factors and ergonomics to improve safety and quality in Latin American healthcare systems, International Journal for Quality in Health Care, Volume 33, Issue Supplement_1, January 2021, Pages 45–50, https://doi.org/10.1093/intqhc/mzaa135

Ken Catchpole, Paul Bowie, Sarah Fouquet, Joy Rivera, Sue Hignett, Frontiers in human factors: embedding specialists in multi-disciplinary efforts to improve healthcare, International Journal for Quality in Health Care, Volume 33, Issue Supplement_1, January 2021, Pages 13–18, https://doi.org/10.1093/intqhc/mzaa108

Paul Bowie, Ian Davidson, Suzanne Anderson-Stirling, Manoj Kumar, The need for certification of safety investigators and learning reviewers in Scotland’s health service, IJQHC Communications, Volume 3, Issue 1, 2023, lyad004, https://doi.org/10.1093/ijcoms/lyad004

Jeffrey Braithwaite, Robert L. Wears, Erik Hollnagel, Resilient health care: turning patient safety on its head, International Journal for Quality in Health Care, Volume 27, Issue 5, October 2015, Pages 418–420, https://doi.org/10.1093/intqhc/mzv063