ABSTRACT
Efforts to improve patient safety have traditionally focused on learning from adverse events, a paradigm termed ‘Safety-1’. Deep-rooted cognitive biases such as loss aversion underlie our tendency to favour this perspective, yet the ‘Safety-2’ paradigm of learning from the countless, often unnoticed, instances of healthcare events going well has much to offer. The chapter explores hidden factors that allow for things to go right despite the challenging nature of the evolving and complex clinical environment. These include workplace civility, psychological safety, a flattened hierarchy and psychological skills that are useful in emergency situations. The chapter also discusses “sideways escalation” as a strategy for new doctors who have legitimate patient safety concerns but are struggling to obtain adequate help from within their own team.
