30th June 2015

The soft stuff is the hard stuff

So, we have a bias towards negativity: we see error without trying, and we have a preference to criticise and focus on others’ errors and misfortunes.  If you don’t believe me, check out the most read news stories on any ‘news’ media source and count the ratio of negative to positive stories. Hardly reflective of reality is it? Click here for the BBC most read stories today.  While I’m on the subject, I should also point you to Kahneman’s work on loss aversion. We value loss more than the equivalent amount of gain. Weird but true.

But here’s a paradox: it’s actually easier to give sincere praise than criticism. It takes less effort, and it makes us feel better (both giving and receiving). This is especially true in face to face encounters.

So what does this mean for patient safety? In my opinion the “safety 1” culture (reacting to error and harm) has got out of hand. Learning from error is important but the agenda is being driven by a ‘movement’ which gives no acknowledgement to loss aversion. Mistakes happen, and will always happen. But it is time to attribute the correct value to them and to acknowledge the value of excellence. Then we may be able to open the doors to the immensely fruitful study of learning from what goes well.

Safety 2 is a great start. Read about it here. But where are the tools to use this approach? Learning from Excellence  (or positive event reporting in any form) is our offering.

In case you think this is all a bit ‘soft’, consider this: doctors and nurses are leaving their jobs, getting sick and killing themselves.  So I would argue that the ‘soft’ stuff is the ‘hard’ stuff.

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