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Applying the lessons of high risk industries to health care

Centre for Safety Research, Department of Psychology, Leiden University, Leiden, Netherlands

Correspondence to:
P Hudson
Centre for Safety Research, Department of Psychology, Leiden University, Leiden, Netherlands, PO Box 9555, 2300 RB Leiden, Netherlands; Hudson{at}fsw.leidenuniv.nl High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks.

Keywords: accidents; attitudes; high risk industry; safety; safety culture; safety management; systems

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Working differently for better, safer care

F Moss
Qual. Saf. Health Care 2003 12: i1. [Extract] [Full Text] [PDF]

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				F Moss Working differently for better, safer care Qual. Saf. Health Care, December 1, 2003; 12(90001): i1 - 1. [Full Text] [PDF]