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This is the core concept of the Safety-II approach.
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These mismatches might sometimes lead to safety problems and there is, therefore, value in learning from the full range of work outcomes, including usual outcomes (when things go right), negative outcomes (for example, errors) and everything in between, despite the inevitable risks and complexity. There is often a mismatch, however, between how everyday work is accomplished (Work As Done) and how work is presumed to have happened (Work As Imagined). Safety problems are not always a direct result of a lack of knowledge or effort by health care professionals − they are usually a result of work that is complex, often involving the use of technology. Regulators, policy makers and managers control and balance the resources, constraints and multiple demands imposed on health care professionals.
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In a health care context, health care professionals interact directly with a hazardous process, representing the actual workplace. This is often conceptualised as a ‘wedge’ with a sharp proximal point and a blunt distal edge. As the viewer moves further from the work, their understanding becomes necessarily more simplified and less accurate. The closer the viewer is to the work (whether in space, time or knowledge/experience), the more accurate their understanding about how the work is done. A Safety-II approach, however, recognises that work can be viewed from different perspectives. The traditional approach to increasing safety has focused on counting incidents, identifying system failures, and understanding the causes of incidents in order to develop strategies to eliminate or reduce them. Health care organisations may struggle to provide safe and high quality care, and as a result, people might experience unintentional harm. Globally, it is reported that about 10% of hospitalised patients experience adverse health care events. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. We believe that journalism, education and culture improve people's lives and that reliable, unbiased information and universal access to knowledge are fundamental rights.Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Our radio broadcasts in ten languages continue to reach many people in Africa and parts of Asia. The DW app offers online content according to user preferences. We rely on a global satellite network, on our roughly 5,000 partner stations, on the internet and increasingly, on mobile distribution. Our German-language offerings are directed towards German speakers abroad and to those who teach or want to learn German. We provide platforms for dialogue, we listen to their concerns, speak their languages and close information gaps. Through our audience approach, we tell stories close to the hearts of our users, viewers and listeners and their everyday reality. We reach out to young people, to opinion leaders, to those actively involved in public debate, and to everyone striving to understand what is happening in the world.
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