Understanding safety in healthcare: the system evolution, erosion and enhancement model

DOI https://doi.org/10.4081/jphr.2013.e25

Jane Carthey(1*)


The paper summarises previous theories of accident causation, human error, foresight, resilience and system migration. Five lessons from these theories are used as the foundation for a new model which describes how patient safety emerges in complex systems like healthcare: the System Evolution Erosion and Enhancement model. It is concluded that to improve patient safety, healthcare organisations need to understand how system evolution both enhances and erodes patient safety.