Fra Safety-I til Safety-II: Mot nye perspektiver på pasientsikkerhet i selvmordsforebygging

Abstract

Safety-II is a core concept in resilient healthcare. The Safety-II approach perceives adaptation as the central
tenet to create safe care for each patient. The author argues that resilient healthcare provides useful perspectives to the suicide field. From a Safety-I perspective, suicide is prevented by ensuring that all healthcare professionals follow procedures and correct failures. While the Safety-I approach can give successful results in clinical practices with predictable
outcomes of the implemented safety measures, this approach has some limitations when applied to
practices in which the risk is not completely understood. In such practices, deviations from standards
may be necessary to respond to varying conditions, e.g., patient heterogeneity and changing needs. Safety-II is the presence of an ability that enables things to go right across varying conditions. Research on resilient healthcare and the Safety-II-perspective in suicide prevention is in its early beginning. The studies provides insight that a Safety-II perspective in clinical
suicide prevention involves integrating individualised and relational components in the patient safety work.
At the level of regulatory authorities and health supervisions, a Safety-II perspective involves moving away
from perceiving healthcare professionals and improper suicide risk assessments as the main cause of the
patient suicides, to acknowledge the complexity clinicians face when making the decisions and adapting
treatment to individuals.