Capabilities in patient safety and quality improvement

Why this matters on day one

This domain expects you to do more than avoid harm — it expects you to improve a system. The distinction that trips people up is between audit (are we meeting a standard?) and QI (can we change a process and measure the effect?).

What the domain requires

1. 1Recognise and report. Incidents and near-misses through the local system. Near-misses are the cheapest learning available.
2. 2Understand why things go wrong. Systems thinking and human factors rather than individual blame — the Swiss cheese model, latent conditions, and why "be more careful" is not an intervention.
3. 3Audit properly. A standard, a sample, a measurement, a change, and a re-measurement. An audit that stops before the re-audit has demonstrated nothing.
4. 4Quality improvement. PDSA cycles, process mapping, run charts, and a measurable outcome. Small and measured beats large and unevaluated.

What evidencing it looks like

• A completed audit cycle including the re-audit and the measured change.
• A QI project with a run chart, not just a description of the intervention.
• Incident reports filed, and participation in a review.

What falls short

• Presenting the first half of an audit as a completed one.
• A QI project whose only outcome measure is "staff felt it was better".
• Blaming an individual for a failure the system made likely.

Demonstrated by