What kinds of insights do Safety-I and Safety-II approaches provide? A critical reflection on the use of SHERPA and FRAM in healthcare (2 February 2024)

Summary

This paper aims to explore the insights provided by Safety-I and Safety-II approaches by examining the practical application of two frequently used methods: Systematic Human Error Reduction and Prediction Approach (SHERPA) and Functional Resonance Analysis Method (FRAM). Neither method should be uniquely labelled as a Safety-I or Safety-II approach, however, SHERPA is traditionally used within a Safety-I context, and FRAM is frequently used within a Safety-II context. By examining the application of these two methods to the management of post-surgical deterioration, the authors critically reflect on the analysis logic embedded in each method and their potential contribution to improving patient safety.