Table 1 Safety Measurement and... | Emerald Publishing

Table 1

Safety Measurement and Monitoring Framework (SMMF)

Dimension	Question & definition	Examples
Harm	Has patient care been safe in the past? The measurement of multiple types of harm, over time, to help assess whether care has been safe in the past	Physical harm - pressure ulcers, malnutrition and weight loss, and physical harm caused by other residents Psychological harm - lacking dignity and respect for the residents
Reliability	Are our clinical systems and processes reliable? Gauging the probability that a task, process, intervention, or pathway will be carried out/followed as specified	Protocols for safety critical care activities Problems with systems and process
Sensitivity to operations	Is care safe today? This domain concentrates on the day to day, hour by hour and even minute by minute management of safety	Monitored through the residents’ voice, or changes to residents’ health or staff health or other factors that can be used to indicate that the safety of care might be under threat e.g., low staffing
Anticipation and preparedness	Will care be safe in the future? This domain focuses on the identification of possible sources of future harm and working to become more resilient to them	Training before an event occurs
Integration and learning	Are we responding and improving? The development of systems to promote a cycle of learning and sharing from safety incidents, multiple sources of safety intelligence and insights developed through the other domains	Learning from incidents and responding to previous failures. For example, training following an event

Dimension	Question & definition	Examples
Harm	Has patient care been safe in the past?The measurement of multiple types of harm, over time, to help assess whether care has been safe in the past	Physical harm - pressure ulcers, malnutrition and weight loss, and physical harm caused by other residentsPsychological harm - lacking dignity and respect for the residents
Reliability	Are our clinical systems and processes reliable?Gauging the probability that a task, process, intervention, or pathway will be carried out/followed as specified	Protocols for safety critical care activitiesProblems with systems and process
Sensitivity to operations	Is care safe today?This domain concentrates on the day to day, hour by hour and even minute by minute management of safety	Monitored through the residents’ voice, or changes to residents’ health or staff health or other factors that can be used to indicate that the safety of care might be under threat e.g., low staffing
Anticipation and preparedness	Will care be safe in the future?This domain focuses on the identification of possible sources of future harm and working to become more resilient to them	Training before an event occurs
Integration and learning	Are we responding and improving?The development of systems to promote a cycle of learning and sharing from safety incidents, multiple sources of safety intelligence and insights developed through the other domains	Learning from incidents and responding to previous failures. For example, training following an event

Source: Adapted from the Health Foundation (2014) and Vincent et al. (2014)