I recently presented on LfE at the 2019 Patient Safety Congress. At the end of the presentation there was an interesting question from the audience:
(Paraphrased): “I was stuck by the similarity between LfE philosophy and ancient eastern philosophy; in particular, the common theme of kindness and compassion.”
I was drawn to this question, because I have recently started to think along the same lines. I have been reading about meditation and mindfulness, and for the last few months I have been building meditation into my daily routine.
I am no expert, but I think the comparison with eastern philosophy is worth considering in two overlapping areas:
Firstly, the area of safety-II: LfE is not safety-II per se, but there is a clear overlap, particularly with respect to recognising and understanding Work As Done through appreciative inquiry. Considering Work As Done requires a mindful approach to daily work. In order to recognise the day to day adaptations which underpin work, one has to “take a step back, and observe”. This is akin to observing the mind when meditating, or practicing mindfulness. When one engages in these activities, it is often surprising what is noticed, and with practice, it is possible to gain insights. Taking the time to be still, and observe what we tend to take for granted is a necessary part of meditation / mindfulness and safety-II practice.
Secondly, kindness and compassion underpin both “philosophies”. Through practicing mindfulness and meditation, one gains awareness of one’s mind, and over time it becomes easier to exist in a peaceful state, in which it is easier to be kind and compassionate to others. Forgiveness also becomes easier. Kindness reveals itself as our natural state. LfE is a positive approach to patient safety, in which colleagues (and patients) highlight areas of practice which are working well. LfE reports are almost always characterised by gratitude and appreciation. The vast majority of reports focus on non-technical skills and interventions, and one of the commonest themes is kindness.
So what is the significance of this common ground between LfE and ancient wisdom?
I have always maintained that LfE is not a new idea, and we have always described the initiative as a “philosophy”. I like to think that this reflects an underlying awareness that the ideas behind LfE stem from an ancient axiom: that kindness and compassion are fundamental to wellbeing, and therefore worth recognising and promoting.