• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of qualsafetyQuality and Safety in Health CareCurrent TOCInstructions for authors
Qual Saf Health Care. Apr 2005; 14(2): 130–134.
PMCID: PMC1743994

"Going solid": a model of system dynamics and consequences for patient safety

Abstract



Rather than being a static property of hospitals and other healthcare facilities, safety is dynamic and often on short time scales. In the past most healthcare delivery systems were loosely coupled—that is, activities and conditions in one part of the system had only limited effect on those elsewhere. Loose coupling allowed the system to buffer many conditions such as short term surges in demand. Modern management techniques and information systems have allowed facilities to reduce inefficiencies in operation. One side effect is the loss of buffers that previously accommodated demand surges. As a result, situations occur in which activities in one area of the hospital become critically dependent on seemingly insignificant events in seemingly distant areas. This tight coupling condition is called "going solid". Rasmussen's dynamic model of risk and safety can be used to formulate a model of patient safety dynamics that includes "going solid" and its consequences. Because the model addresses the dynamic aspects of safety, it is particularly suited to understanding current conditions in modern healthcare delivery and the way these conditions may lead to accidents.

Full Text

The Full Text of this article is available as a PDF (169K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Render Marta L, Hirschhorn Larry. An irreplaceable safety culture. Crit Care Clin. 2005 Jan;21(1):31–viii. [PubMed]
  • Gaba DM, Maxwell M, DeAnda A. Anesthetic mishaps: breaking the chain of accident evolution. Anesthesiology. 1987 May;66(5):670–676. [PubMed]
  • Patterson Emily S, Cook Richard I, Render Marta L. Improving patient safety by identifying side effects from introducing bar coding in medication administration. J Am Med Inform Assoc. 2002 Sep-Oct;9(5):540–553. [PMC free article] [PubMed]

Articles from Quality & Safety in Health Care are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...