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Leader; Provider

Shift to Safety

Rewiring your thinking on measuring and monitoring of patient safety.

 Patient safety refers to more than just looking at harm that has occurred in the past. Understanding the difference between the absence of harm and the presence of safety is essential and requires a broader view of safety.

The Measurement and Monitoring Safety Framework, created by Professor Charles Vincent and colleagues from the Health Foundation, consists of five dimensions that organizations, units, or individuals including leaders, providers, patients and families can use to understand, guide and improve patient safety. This new approach assesses and evaluates safety from "ward to board" by providing a comprehensive and accurate real-time view of patient safety. The Framework helps users move from "assurance" to "inquiry" by shifting away from a focus on past cases of harm towards current performance, future risks and organizational resiliency.


"The MMS Framework shifted safety for us from a policy perspective to a day-to-day care-provider and patient interaction. It led to ownership, engagement and passion."

Dr. Jan Sommers, Nova Scotia Health Authority

The Measurement and Monitoring of Safety Framework 

Armed with a series of valuable questions, you can make better decisions about the safety of the care you provide. The primary questions are:

  • Has patient care been safe in the past?
  • Are our clinical systems and processes reliable?
  • Is our care safe now?
  • Will our care be safe in the future?
  • Are we responding and improving?

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"We started out in the safety world really worrying about past harm and I think that was really important because it raised peoples' understanding about the magnitude of the safety issues. But it is insufficient because people don't go to work thinking about past incidents; they go to work thinking about the patients they are going to see today. So that is part of the shift now is that we are putting safety into a much more relevant context for the staff on their units doing their daily jobs. I think we can still build on that. We can build a broader sense of how units function and how units interact with other units."

Dr. G. Ross Baker, PhD, Professor, Institute of Health Policy Management and Evaluation, University of Toronto

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