The Rise of Patient Safety-II: Should We Give Up Hope on Safety-I and Extracting Value From Patient Safety Incidents?; Comment on “False Dawns and New Horizons in Patient Safety Research and Practice”

Document Type : Commentary


1 Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK

2 London School of Hygiene and Tropical Medicine, London, UK

3 Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK


Who could disagree with the seemingly common-sense reasoning that: “We must learn from the things that go wrong.”? Despite major investments to improve patient safety, relatively few evaluations demonstrate convincing reductions in risk, harm, serious error or death. This disappointing trajectory of improvement from learning from errors or Safety-I as it is sometimes known has led some researchers to argue that there is more to be gained by learning from the majority of healthcare episodes: the things that go right. Based on this premise, socalled Safety-II has emerged as a new paradigm. In this commentary, we consider the ongoing value of Safety-I based approaches and explore whether now is the time to abandon learning from “the bad” and re-energise data collection and analysis by focusing on “the good.”


Main Subjects

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  • Receive Date: 22 December 2017
  • Revise Date: 24 February 2018
  • Accept Date: 25 February 2018
  • First Publish Date: 01 July 2018