Systems approach to learning from patient safety incidents

Training to support the development of core understanding and application of systems-based patient safety incident response throughout the healthcare system - in line with NHS guidance, based upon national and internationally recognised good practice.

This course covers the end-to-end systems-based patient safety incident response based upon the new NHS PSIRF and includes:

• purpose of patient safety incident response framework

• introduction to complex systems, system thinking and human factors

• restorative just and learning culture

• duty of candour

• involving staff in incident response

• involving patients, families and carers in incident response

• improvement science and developing system improvement plans

• general response techniques

• interviewing and asking questions

• conducting observations, understanding work as done

• systems frameworks

• response types

• patient safety investigation planning, analysis and report writing

• commissioning and oversight of an internal investigation

• a high-level overview of system-based response tools.

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