Historically, the approach to health care safety has been viewed through a Safety-I perspective, focusing primarily on error prevention and failure investigation. Although this model continues to hold importance, the intricate, dynamic, and interconnected nature of modern health care demands proactive and flexible safety methodologies. The newly introduced Safety-II and Safety-III models offer fresh insights into safety by emphasizing resilience, immediate adaptation, and learning from successes instead of failures.
Safety-II redirects attention from failures to successes. It recognizes that a majority of health care processes are effective on a daily basis, despite underlying risks and system variability. Safety-II assesses positive outcomes to understand why certain processes work well even in challenging conditions. It cultivates systems that are not only restricted by rules but also possess resilience and adaptability. This enhances our adaptive capability and influences how clinicians respond to unexpected incidents. Consequently, health systems need to develop flexible protocols for future emergencies by integrating the insights acquired from these adaptive measures.
Safety-III builds on Safety-II by introducing anticipatory safety, which utilizes data, predictive analytics, and real-time oversight to prevent harm before it happens. This approach is closely tied to the principles of high-reliability organizations and modern digital health technologies. Safety-III employs predictive data analytics (AI, big data) to foresee potential risks and enact timely interventions. It promotes the creation of ongoing learning connections between leadership actions and frontline experiences. By incorporating human factors engineering, we can formulate safer workflows. In fact, Safety-III converts safety from a reactive duty into a proactive, real-time system that is seamlessly woven into everyday operations.
The integration of Safety-II and Safety-III redefines health care safety from a focus on errors to a practice centered on resilience and anticipation. This allows for comprehensive learning since it captures both elements that prevent harm and factors that secure success. It can be put into action by involving frontline personnel and encouraging the reporting of positive deviations (innovative practices that enhance care) in addition to incident documentation. Health care leaders should exemplify commitment through the promotion of a just and learning-oriented culture that values adaptability and foresight. Investment in technology that utilizes AI, machine learning, and real-time dashboards will bolster predictive safety efforts. Continuous feedback mechanisms might incorporate daily safety meetings and debriefs to gather insights from regular and extraordinary occurrences.
In an increasingly intricate health care landscape, health systems can evolve safety into a responsive, proactive framework that prevents harm while fostering innovation, trust, and high-quality care by analyzing successes, anticipating risks, and embedding adaptability. A robust safety culture will motivate staff to share innovations and insights, not merely mistakes. Proactive risk management should integrate predictive tools to foresee harm while also learning from routine clinical achievements. Indeed, health care organizations need to strengthen resilience by creating frameworks or systems that can adapt to uncertainty rather than falter in the face of pressure.
Olumuyiwa Bamgbade is a distinguished health care leader with a keen emphasis on value-based health care delivery. A specialist physician with extensive training throughout Nigeria, the United Kingdom, the United States, and South Korea, Dr. Bamgbade provides a global perspective on clinical practice and health system advancements.
He holds a position as an adjunct professor at educational institutions across Africa, Europe, and North America, and has authored 45 peer-reviewed scientific articles in PubMed-indexed journals. His international research partnerships extend to over 20 countries, including Nigeria, Australia, Iran, Mozambique, Rwanda, Kenya, Armenia, South Africa, the U.K., China, Ethiopia, and the U.S.
Dr. Bamgbade is the director of Salem Pain Clinic in Surrey, British Columbia, Canada, a clinic that specializes in and emphasizes research. His work there focuses on pain management, health equity, injury rehabilitation, neuropathy, insomnia, societal safety, substance misuse, medical sociology, public health, medicolegal science, and perioperative care.