ABSTRACT
William Schultz argued in 1979 that understanding progresses through three stages: superficial simplicity, confused complexity and then profound simplicity. The superficial simplicity in risk and patient safety included the notion that should imitate aviation and other high-risk industries with incident reporting, culture change and attention to communication and teamwork. Profound simplicity is only achieved by working through the confused complexity, and this needs to be lived–experiential learning is vital. This chapter explores the methods to move the conversation from one person's experience to the conversations of teams or units, and to use this learning to impact on organisational behaviours and even system-wide strategies for making care safer. Margaret Wheatley talks about how people band together with their colleagues and friends to create the solutions for real social change. The chapter builds on work originating from the 'beneath the surface' experiments and provides a framework for the next stage of that work, gaining more insight into the possibilities.
