Taking a different approach

Safety-II

Studies on video review often focus on quality improvement by measuring a decrease in errors or deviations from guidelines. However, this approach has limitations; it emphasizes safety by minimizing negative outcomes (the Safety-I approach), assuming mistakes stem from individual technical, human, or organizational failures. In the increasingly complex world of healthcare, a newer safety model has emerged: Safety-II. This approach focuses on the ability to succeed under varying conditions, acknowledging that real-world practice often differs from idealized guidelines. Instead of solely analyzing mistakes, Safety-II studies how things usually go right, providing insights into occasional failures. It values learning from variability and performance adjustments as a source of new knowledge.

Safety-II Hollnagel et al. (2013

By visualizing these essential components of care, video review becomes an invaluable quality improvement tool. Reviewing workflow clarifies team member responsibilities and reinforces effective communication. This aligns with the Safety-II approach, which focuses on enhancing a system's ability to succeed under varying conditions and optimizing everyday outcomes. When reviewing videos with all providers involved in hands-on care, opportunities for improvements in daily performance become visible.