Aviation, nuclear energy, and healthcare can each be characterized as safety-critical industries. However, healthcare has a higher number of preventable serious adverse events in comparison to aviation and nuclear energy. In Canada alone, more than 138,000 acute care hospitalizations in 2014–2015 involved occurrences of harm.
The aviation and nuclear energy industries employ tactics to improve consistency in the delivery of safety-critical services. These tactics could be adopted in healthcare to improve outcomes, however, many of the safety practices used in aviation and nuclear energy are largely unknown or unused in healthcare.
Interviews with healthcare stakeholders and subject-matter experts found that safety management system implementation is not consistently applied in the delivery of care and is not as comprehensive as in aviation and nuclear energy. Several themes were derived from these interviews and many challenges were identified for addressing these gaps in process, policy and regulation in healthcare delivery. Shortcomings were found within the following themes in healthcare delivery:
- Explicit safety management
- Control processes to ensure uniform, consistent practice
- Proactive risk management and mitigation effectiveness verification
- Fatigue management practices
- Reliability of safety-critical tasks
Given the safety-critical nature of healthcare delivery and the lack of explicit safety management systems, it is recommended that a standard be developed to address the noted safety deficiencies in healthcare organizations and the regulation of practitioners.