Background Traditional approaches to safety management in health care have focused
primarily on counting errors and understanding how things go wrong. Resilient Health Care …

Technologies are often viewed as the route to better, safer and more efficient care, but
technology projects rarely deliver all the benefits expected of them. Based on a literature …

Background Healthcare represents a paradox. While change is everywhere, performance
has flatlined: 60% of care on average is in line with evidence-or consensus-based …

Changing how we think about healthcare improvement Page 1 the bmj | BMJ 2018;361:k2014
| doi: 10.1136/bmj.k2014 1 QUALITY IMPROVEMENT Changing how we think about …

Executive summary The publication of the IOM report To Err is Human in 2000 served as a
catalyst for a growing interest in improving the safety of health care. Yet despite decades of …

The current approach to patient safety, labelled Safety-I, is predicated on a 'find and
fix'model. It identifies things going wrong, after the event, and aims to stamp them out, in …

Victor Hugo once wrote “Greater than the march of mighty armies is an idea whose time has
come”. Complexity science is not a new idea, but in 2017 its time has surely come in relation …

Background Interruptions and multitasking have been demonstrated in experimental studies
to reduce individuals' task performance. These behaviours are frequently used by clinicians …

Rationale, aims, and objectives “Implementation science,” the scientific study of methods
translating research findings into practical, useful outcomes, is contested and complex, with …

Resilience principles show promise for improving the quality of healthcare, but there is a
need for further theoretical development to include all levels and scales of activity across the …