Background It is now widely accepted that the mixed effect and success rates of strategies to
improve quality and safety in health care are in part due to the different contexts in which the …

Attempts to learn from high-risk industries such as aviation and nuclear power have been a
prominent feature of the patient safety movement since the late 1990s. One noteworthy …

Although it is probably the best‐known prospective hazard analysis (PHA) tool, failure mode
and effects analysis (FMEA) is far from the only option available. This article introduces one …

Background Despite over a decade of efforts to reduce the adverse event rate in healthcare,
the rate has remained relatively unchanged. Root cause analysis (RCA) is a process used …

Introduction Poor teamwork and communication between healthcare staff are correlated to
patient safety incidents. However, the organisational factors responsible for these issues are …

Healthcare providers are investing considerable resources for the development of quality
management systems in hospitals. Contrary to these efforts, the number of tools that allow …

Many healthcare systems recommend root-cause analysis (RCA) as a key method for
investigating critical incidents and developing recommendations for preventing future …

Objective To assess the strength of root cause analysis (RCA) recommendations and their
perceived levels of effectiveness and sustainability. Design All RCAs related to sentinel …

Despite concerted effort to improve quality and safety, high reliability remains a distant goal.
Although this likely reflects the challenge of organizational change, persistent controversy …

Root cause analysis is perhaps the most widely used tool in healthcare risk management,
but does it actually lead to successful risk control? Are there categories of risk control that …