SPHERE Workshop Outline

Day One

Module 1: The Context for Patient Safety Efforts in Canada
Module 2: Healthcare And Complexity Science
Module 3: Approaches to Safety Investigations: Methods to Make Sense of Events
Module 4: Systemic Non-linear Analysis Method
- A: Identifying and Engaging the Investigation Participants
- B: Building a Narrative Understanding

Module 4: Systemic Non-linear Analysis Method (cont’d)
- E: Generating Recommendations
Applying the Method (Sections A to E) to Case Examples

Content

- Are patients active partners in your system?
- Is your healthcare system like a rainforest?
- Is safety simply the absence of risk?
- Does “accountability” = “responsibility”?
- Is health more than the absence of disease?
- Is yours a complex adaptive system (CAS)?
- Is safety a commodity you can count?
- What is your accountability framework?
- Is healthcare a spectrum of services?
- Does your system value relationships?
- Is safety an emergent property?
- Do you promote system accountability?
- Do goal conflicts exist in healthcare?
- Do you promote collaborative decision-making?
- Is patient safety a priority in your laundry?
- Who “owns” systemic contributing factors?
- Does your dashboard use qualitative measures?
- Can you describe your system boundaries?
- Does “patient safety” = the “safety of patients”?
- How do you link responsibility and authority?