Safety skills for clinicians: An essential component of patient safety

Health care is on an exciting and evolutionary journey to improve safety and quality in patient care, service provision, and clinical excellence. Systems and processes have been the primary focus of much work on safety and quality, an important reaction to the crude blaming of individuals for safety problems. However, this has led to neglect of the role individuals, both staff and patients', play in maintaining safety and quality. In this paper, we attempt to articulate the concept of safety skills and consider whether it has in relevance to the training of health care professionals. We do this by first making the case for the utility of the concept. We then briefly review concepts of human error and accident causation and turn the analysis round from its usual perspective to consider what skills are needed to anticipate error and prevent harm. These are, for us, the core components of safety skills. These skills are of course already possessed by expert clinicians and others living or working in hazardous domains. However, although they are eventually acquired, they are seldom explicitly articulated and taught in health care. We then briefly review some parallel training courses in hazardous occupations and consider what form safety skills training might take in health care. © 2008 by Lippincott Williams & Wilkins.