Neil Spenceley is a paediatric intensivist and is the National Lead for Paediatric Patient Safety.
This talk is packed with nuggets that will change the way you view the world in which you practice. Neil explains Safety 1 and Safety 2 thinking. The talk is wide-ranging and covers poor behaviours in healthcare both at a personal level and at an institutional level.
If you just want to read one key paper to get you started then read this one from paediatric surgeon, Lucian Leape.
Leape LL. Error in medicine. Jama. 1994 Dec 21;272(23):1851-7.
If you want to read two papers (and we suggest you should) then download this one too.
Hollnagel E. Human error. InPosition paper for NATO conference on human error 1983 Aug.
Doodle medicine sketch by @char_durand 
This talk was recorded live at DFTB19 in London, England. With the theme of “The Journey” we wanted to consider the journeys our patients and their families go on, both metaphorical and literal. DFTB20 will be held in Brisbane, Australia.
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