Patient Safety Zone

e-learning module - Why things go wrong and right in complex systems 

*NOTE: You must log into your Turas account to launch the module. 

When things go wrong in many aspects of everyday life ‘human error’ is often cited as the cause. This is true in highly hazardous industries, including healthcare, where media headlines are often quick to blame human error as the cause’ of any safety-related incidents or accidents.  

It is now recommended that we should move away from blaming individual human error as a primary cause’ of adverse healthcare events and adopt a ‘systems view’ when investigating these types of incidents.  This move towards a new way of thinking and acting has proved challenging and progress remains slow.

This e-learning package offers an introduction in understanding the factors that give rise to healthcare outcomes, good and bad, these ideas and concepts need to be grasped (and arguably ‘believed’) by clinicians, managers, senior executives, educators, regulators and policymakers before significant progress can be made in improving the quality and safety of patient care.

Completion Time: 45 minutes

Learning Outcomes: Explain the difference between a blame and just culture; Paraphrase the meaning of the statement – “Human Error is a symptom not a diagnosis”; Explain how resource constraints [whilst normal] affect our ability to be both efficient and thorough; Outline how normal variability results in good and poor outcomes at work