SafetyInsights.org

This study explored the reliability and utility of risk matrices for ranking hazards relating to public leisure activities. A driving factor for this study is previous research identifying “serious mathematical defects and inconsistencies” in risk matrices. Many of these issues aren’t just user-related but actually inherent and structural to the matrix itself. The study was… Continue reading Further Thoughts on the Utility of Risk Matrices

This explored shared the shared understandings held by UK construction workers towards safety by applying complexity theory. It involved interviews, document review, and site observations. The authors first explains that construction projects have the traits of complex systems, with networks of interrelationships, multiple companies/subcontractors and long supply chains. Further to the multi-nodality of construction projects,… Continue reading Managing “a little bit unsafe”: complexity, construction safety and situational self-organising

Another interesting extract from James Reason below. Jim discusses some paradoxes in safety. A paradox is “a statement contrary to received opinion; seemingly absurd though perhaps well-founded” (p3). It’s noted that the pursuit of safety “abounds with paradox” (and likely all forms of organisational work). I’ll post a summary of his paper in the next… Continue reading Safety paradoxes

This explored the impact that critical events have on healthcare staff and how they “move on” from the events via interviews, memos and field notes. The ‘second victim’ lens was used to situate the findings. Critical events are “’a sudden unexpected event that has an emotional impact sufficient to overwhelm the usually effective coping skills… Continue reading Moving on after critical incidents in health care – A qualitative study of the perspectives and experiences of second victims

ABSTRACT Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk for metabolic syndrome (MetS) due to several biological and environmental changes. The MetS refers to the clustering of several known cardiovascular risk factors, including insulin resistance, obesity, dyslipidemia, and hypertension. This systematic review aims to evaluate the… Continue reading Shift work and the risk for metabolic syndrome among healthcare workers: A systematic review and meta-analysis

This explored the challenges encountered in organisations for staff to raise safety concerns, particularly focused around barriers for frontline insights via formal reporting systems. Providing background, it’s noted: Organisations may move towards comfort seeking rather than problem seeking behaviours, resulting in people remaining silent or leaders failing to hear Soft intelligence poses challenges for organisations.… Continue reading Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns

I’m sure I’ve posted this before (and likely many others have), but I love this idea from Karl Weick (and James Reason’s paraphrase of it) as reliability and safety as “dynamic non-events”. For “nothing” to happen (stable outputs, lack of unexpected or undesirable performance, events etc.), continuous and skilful inputs from adaptable agents is necessary.… Continue reading Safety as a dynamic non-event

This explored the extent and nature of blame in family practice safety incident reports. 2148 incident reports from a database of 14 million reports was analysed. Blame was defined as “evidence in the free-text of a judgement about a deficiency or fault by a person or people” (p457). Problems exist with current approaches to incident… Continue reading Nature of Blame in Patient Safety Incident Reports: Mixed methods analysis of a national database

This was an interesting little study that evaluated the performance of a routine incident reporting system in identifying, and more importantly missing, patient safety incidents. Data was compared between patient case notes and via analysis of the incident report data for the same patients; 1006 hospital admissions were evaluated. Results Of the 1006 admissions, 324… Continue reading Sensitivity of routine system for reporting patient safety incidents in an NHS hospital: retrospective patient case note review