1. Is quality safety or safety quality?
Peter Lachman
Inspiring and driving improvement in the quality and safety of healthcare worldwide through education and knowledge sharing, external evaluation, supporting health systems and connecting people through global networks.

2. Can one have quality care without being safe?

3. Can one have safe care and not have quality?

4. Quality Effective care Efficient care Safe care Good access to care
Equitable care
Person centred
Safe care

5. Is quality all about
person centred care?

6. Safety is about what really matters for people
Personalised Safe care
Coordinated, Safe and Effective care
Enabling Safe care
Dignity and compassion

7. Safety is all about culture
Generative
Safety is how we do business here
Increasing
informedness
or mindfulness
Proactive
We work on problems
we still find
Calculative
we have systems in place to manage all hazards
Reactive
Safety is important - we do a lot when something happens
Increasing information
Pathological
It is ok as long as nothing happens
Hudson P. Applying the lessons of high risk industries to health care
Qual Saf Health Care 2003

8. Improvement aims to move healthcare
Safety is how
we do business here

9. Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives, the cumulative experience of many masters of craftsmanship. Quality also marks the search for an ideal after necessity has been satisfied and mere usefulness achieved.
Will Foster

10. An improvement approach for safety
Quality and safety planning
Quality and safety control
Standards
Quality and safety management
Quality and safety improvement
Based on Juran

11. Sensitivity to operations
A framework for the measurement and monitoring of safety
Safety
What did we do well?
Past Harm
Reliability
Sensitivity to operations
Anticipation
Learning
Source: Vincent C, Burnett S, Carthey J. The measurement and monitoring of safety. The Health Foundation, 2013.

12. Quality and safety are about systems
Understand the system in which we work
Variation in the system
Examine the way people think – beliefs and attitudes
Do they believe safety is our business?
Theory and method of change
Based on Deming

13. Charles Vincent Rene Amalberti Safer Healthcare Strategies for the Real World

14. Charles Vincent Rene Amalberti Safer Healthcare Strategies for the Real World

15. Aim to do what we are supposed to do reliability
Regarding small errors as a symptom that something is wrong
Preoccupation with failure
Paying attention to what’s happening on the front-line
Sensitivity to operations
Encouraging diversity in experience, perspective, and opinion
Reluctance to simplify
Capabilities to detect, contain, and bounce-back from events
Commitment to resilience
Pushing decision making down to the front line
Deference to expertise
Aim to do what we are supposed to do reliability
Contain
Anticipate
Based on Weick and Sutcliffe 15

16. Safe and reliable quality care
Effective
Right treatment
Access
Right place
Where, how and when
Timely
No delays in diagnosis
or treatment
Person centred
& equitable
Personalised care
Efficient
Right care giver
ward or clinic

17. Learning to be resilient in face of complexity
Learning from what works
as well as what does not work
And
Being safe under all conditions
Reference Hollnagel and Braithwaite

18. And to this one needs to understand context and study generalisability

19. Key elements for quality and safety
Listen to patients
Share decisions
Enable
Listen

20. Safety
Person
Quality

21.
peterlachman