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​​This plenary investigates the interaction between healthcare organizations and several external stakeholders who shape behaviours within such organizations and their microsystems (small units of work that actually give the care that the patient experiences). Examining the impact of the external environment is crucial to understanding barriers to change that impede the advancement of systems-safety approaches. Opinion leaders now call for alignment of these sectors behind the healthcare system’s systems transformation agenda. Vertical integration across stakeholders is examined in this model, and the roles of specific stakeholder groups such as media, patient and regulators is explored. One of the focuses of the module is the fault-basedmalpractice system which is mismatched with patient-centered, systems-based improvement strategies.

This module will provide you with an understanding of:

  • the role of the external environment in shaping the safety work of organizations and microsystems;
  • the importance of alignment between organizations and external factors; and
  • the mismatch between the fault based malpractice system and systems based approaches to promoting patient safety.

Learning Objectives include:

  • describing the hierarchy of systems needs set forth in Crossing the Quality Chasm;
  • describing roles the media can play in supporting systems-based approaches to safety;
  • describing the role the legal system can play in supporting systems-based approaches to safety; and
  • describing roles governments or employers can play in supporting systems-based approaches to safety.

Want to learn more? Download the module.

      This document was revised in September 2017.

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