Managing risk around upstream services

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Those who clean, sterilise, transport patients and provide administrative support within hospitals and health services are often left out of meaningful participation in multidisciplinary care teams, ward management and other ‘clinical’ operation — to the detriment of safety service standards.

Those who are concerned with the quality and safety of health care know all too well about the ‘systems approach’.

Thinking about quality, safety and risk management from this ‘systems perspective’ is to acknowledge that error and harm in health care are influenced by a variety of ‘upstream factors’ located in the wider system of care.

In this way of thinking, safe care is not just about what happens on the ward, or between practitioner and patient. Instead, thinking about safety means thinking about how upstream factors influence patient care in either a ‘more safe’ or ‘less safe’ direction.

Managing upstream factors

These upstream factors are well known. They include quality of teamwork, communication, the allocation of tasks, workload scheduling, equipment and resource management, and broader service cultures.

Whilst this ‘upstream’ impacts the quality and safety of…

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