Key principles for using the framework

You should bear in mind the following key principles when applying the framework to your own practice.

To get the most out of the framework, you should be:

  • open
  • thoughtful
  • reflective
  • inquisitive.

Be open

When seeking measures to answer the five questions in the framework, you would not expect to have comprehensive measures for each. For example, there are fewer measures to understand how risks are anticipated and prepared for than there are for measuring past harm. The framework works most effectively if it is used as part of an honest assessment about where your strengths and weaknesses are in terms of understanding safety, and to then target your efforts on those weaknesses.

Be thoughtful

We received feedback that the framework is ‘deceptively simple’. Accessibility is one of its strengths, however this should not hide the depth of thought and consideration that effectively using the framework requires. The questions in the framework may be simple, but the underlying issues are complex and will undoubtedly be challenging to solve. They will require the input of patients and carers and staff from across the full range of clinical, managerial and support functions, with sufficient time made available for in-depth discussion.

Be reflective

When considering the types of measures to help answer the five questions in the framework, discussion is likely to lead to a reflection of current practice and to highlight some difficult decisions which may need to be made. Reflective questions might include:

  • What information do you currently collect?
  • Does it add value and contribute to your understanding of how safe the care you provide is?
  • Is your organisation’s data accurate, comparable and meaningful?
  • Should your organisation stop collecting some types of information and start collecting others?
  • Does your organisation have enough of the right kind of support and expertise to develop, collect, analyse and use meaningful information?

Be inquisitive

The actual process of asking questions, rather than stipulating answers and ‘ticking them off’, will increase the sense of ownership of safety in an organisation. An approach which focuses on measures that are helpful in the day-to-day management of care, and that also provide evidence to meet the requirements of external bodies, will offer benefits to staff, patients and the public like.

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