Kelly M. Smith
1*, Annette L. Valenta
21 MedStar Institute for Quality and Safety, MedStar Health, Columbia, MD, USA.
2 Department of Medical Education, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
In their editorial, Mannion and Braithwaite contend that the approach to solving the problem of unsafe care,
Safety I, is flawed and requires a shift in thinking to what they are calling Safety II. We have reservations as to
whether by itself the shift from Safety I to Safety II is sufficient. Perhaps our failure to improve outcomes in
the field of patient safety and quality lies less in our approach – Safety I vs. Safety II – and more in the lack of
an agreed upon, commonly understood set of core competencies (knowledge, skills, and attitudes) needed in
its workforce. The authors explore in this commentary the need to establish core competencies as part of the
pathway to professionalism for the discipline of patient safety and quality.