Joanne Travaglia
1*1 Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Abstract
In a recent edition of this journal, Mannion and Braithwaite provide a succinct analysis of the emergence, and
ultimately limited impact, of what they term the current ‘Safety I’ movement in healthcare. They describe the arc
of this field from denial, through engagement via mechanisms and approaches imported from other industries,
to the current situation where, despite ‘best efforts,’ error rates remain stubbornly recalcitrant.
In examining the failure of system-wide efforts to produce sustained reductions in errors and adverse events,
that article exposes the doxa, or what Bourdieu calls ‘the taken for granted’ which is central to this latest wave
of patient safety movement. In this commentary, I would like to take focus on two key elements of Mannion
and Braithwaite’s argument: that harm is caused by misguided but otherwise well-intentioned actions and
the ‘embracing’ of patient safety. I then conclude by briefly considering the implications of these for Safety II,
particularly as envisaged by the authors as an evolutionary, and therefore linear progression, from Safety I.