Join us for our upcoming SafetyNet webinar exploring when and how workarounds in healthcare might actually support—not compromise—patient safety. Drawing on new research and the Safety II approach, this webinar will challenge traditional thinking around standardisation and highlight the role of adaptability in complex care environments.

 Date: 11 September 2025

Abstract:

For many years standardisation has been relied upon to improve patient safety through reducing variation in care processes. Despite this approach being widely adopted across healthcare systems, safety remains a concern. Recently, there have been developments in the field of patient safety theory that question if standardisation is the panacea for healthcare improvement. ‘Safety II’ is a theory which views healthcare as a complex system and regards safety as the ability to succeed within varying conditions. At the heart of this theory lies the assumption that variation is not inherently risky, and that resilient systems actually rely on the ability of individuals, teams, and organisations to adapt their actions in response to changing work environments. Yet little is known about what is achieved for safety when healthcare staff adapt and work around the rules put in place to create safety. The overarching aim of my doctoral research was to explore whether safety standard workarounds (SSWAs) can be used to support safety as part of an active risk management strategy. Using an exploratory approach this aim was addressed by four objectives. The first objective explored the empirical literature to understand what is known about SSWAs in healthcare. The review found SSWAs are prolific but emphasised the implications of what workarounds achieve for safety is unclear. The second objective used an exemplar practice to explore what workarounds look like within different healthcare settings. Objective three investigated the similarities and differences in the enactment of SSWAs in differing settings and explored what workarounds achieve for safety. Objective four, examined multi-level stakeholder perceptions of SSWAs and explored the potential for operationalising the safer use of workarounds in practice and policy. Together the studies in this project highlight that SSWAs sometimes enhance safety. This has implications for healthcare practice, policy, and future research.

Guest speaker

Dr Debbie Clark, Sheffield Hallam University

Debbie Clark is Critical Care Nurse and the Associate Head of Simulation at Sheffield Hallam University. In this educational role Debbie has focused upon enhancing patient safety, human factors, and quality improvement within pre and post registration education. During her lecturing career, Debbie has enjoyed a secondment with the Yorkshire and Humber Improvement Academy which allowed her to work with a team to support regional work on Human Factors education and collaborate on a Health Foundation funded safety project: The measurement and monitoring of safety framework (Vincent, 2013).

Debbie recently completed her PhD at the University of Leeds. Her doctoral studies took a resilient healthcare lens and explored if and how workarounds contribute to safety. Debbie is a member of Q, the Resilient Healthcare Society and is a HEA fellow.

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