Integration of multiple methods in identifying patient safety risks

There is a growing awareness that risk identification plays an important role in the investigation of actual and potential harm to patients. Although current risk identification methods in healthcare have strengths and limitations, it is an open question whether they have been implemented optimally and how well they have been integrated to provide a complete picture of risk within complex healthcare systems. To shed light on this, this paper reviews the characteristics of reactive and proactive risk identification methods along with their implication on risk identification practices. Various learning points from other safety-critical industries are identified and integration of multiple methods are discussed to provide a more comprehensive view within the scope of risk management. As a particular example, this paper reviews a prognostic method, developed by the Future Aviation Safety Team (FAST), to enhance existing risk identification in the aviation industry by identifying risks that arise due to future changes. The FAST method also demonstrates integration of risk identification methods proposing four complementary approaches for use in the aviation industry. Similarly, our study provides a conceptual framework that can be used in healthcare to integrate multiple methods to accelerate patient safety improvement through comprehensive system coverage. While this paper suggests that such integration may provide better framework for identifying patient safety risks, the low-level maturity of safety management and safety culture should be considered prior to the integration. Future research is also required to provide evidence on effectiveness of integration and relevant costs involved with such integration in healthcare.