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Learn from what goes right: A demonstration of a new systematic method for identification of leading indicators in healthcare

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  • Raben, Ditte Caroline
  • Bogh, Søren Bie
  • Viskum, Birgit
  • Mikkelsen, Kim L.
  • Hollnagel, Erik

Abstract

The work in patient safety is often centred on adverse events and errors. Typical methods to improve patient safety are reactive and focus on understanding past failures. This article presents the development of a proactive method towards improving patient safety and understanding why processes function as intended on a daily basis. The paper presents the steps of how the method was developed and demonstrates it by using a former case study of early detection of sepsis. Emphasis is on understanding complex processes and identify aspects important for things going right and achieving intended outcomes. The study resulted in the development of six overall steps for identifying leading indicators in complex healthcare processes. These were (1) identification of relevant functions, (2) cluster of functions in sets, (3) identification of functions with variability, (4) identification of functions with upstream–downstream functions, (5) identification of leading indicators, and (6) confirmation of leading indicators through experts and adverse events. The study outlined the development a new method on the topic of leading indicators in the context of patient safety.

Suggested Citation

  • Raben, Ditte Caroline & Bogh, Søren Bie & Viskum, Birgit & Mikkelsen, Kim L. & Hollnagel, Erik, 2018. "Learn from what goes right: A demonstration of a new systematic method for identification of leading indicators in healthcare," Reliability Engineering and System Safety, Elsevier, vol. 169(C), pages 187-198.
    • Handle: RePEc:eee:reensy:v:169:y:2018:i:c:p:187-198
    DOI: 10.1016/j.ress.2017.08.019
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    References listed on IDEAS

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    1. Martha Grabowski & Premnath Ayyalasomayajula & Jason Merrick & Denise Mccafferty, 2007. "Accident precursors and safety nets: leading indicators of tanker operations safety," Maritime Policy & Management, Taylor & Francis Journals, vol. 34(5), pages 405-425, October.
    2. Sujan, Mark, 2015. "An organisation without a memory: A qualitative study of hospital staff perceptions on reporting and organisational learning for patient safety," Reliability Engineering and System Safety, Elsevier, vol. 144(C), pages 45-52.
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    Cited by:

    1. Read, G.J.M. & Naweed, A. & Salmon, P.M., 2019. "Complexity on the rails: A systems-based approach to understanding safety management in rail transport," Reliability Engineering and System Safety, Elsevier, vol. 188(C), pages 352-365.
    2. Li, Weijun & He, Min & Sun, Yibo & Cao, Qinggui, 2019. "A proactive operational risk identification and analysis framework based on the integration of ACAT and FRAM," Reliability Engineering and System Safety, Elsevier, vol. 186(C), pages 101-109.
    3. Victoria Smirniakova & Valerii Smirniakov & Yana Almosova & Alena Kargopolova, 2021. "“Vision Zero” Concept as a Tool for the Effective Occupational Safety Management System Formation in JSC “SUEK-Kuzbass”," Sustainability, MDPI, vol. 13(11), pages 1-19, June.

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