Journal of Medical Safety (e-version)2016 p.1-p.2

ISSN 1349-5240
This munuscript is published on 26 September 2016.

(Title) H-R Model: Basic Framework of Sciences and Technologies in Patient Safety.
By Ryoji Sakai
International Association of Risk Management in Medicine
Tokyo, Japan(Summary)Patient safety is a basic support to smart healthcare. However, massive practices in patient safety
world are composed of huge complex of sciences and technologies.
The present “H-R Model” outlines the above complexed body, and generates several new concepts inpatient safety world.
The Model can also perform to check and evaluate effectiveness in a total of complexed system ofpatent safety practices in healthcare. So, the Model is applicable to “stress test” of healthcare safety.

A hospital is a huge complex of mega medical practices by hundreds or thousands health staffs andhuge patients, every day. Such a mega complex may generate massive medical errors every day,every place, so huge amount and huge kinds of practices happen in dairy patient safety world in ahospital. Patient safety world is also a huge complex body of sciences, technologies and arts. Smart
healthcare is very difficult to be established.
One simple question now arises; What is a basic framework in patient safety world?
At present, there are two major safety sciences.

First, risk science is composed with 4 basic

elements; risk assessment, risk management, risk communication and risk governance.
Assessment, management, communication and governance are the fundamental tools in safety
promotion.
Second, human factors is another major safety science. Human factor science conducts to prevent
risk before accident generation, and to prevent crisis after accident generation.

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Journal of Medical Safety (e-version)2016 p.1-p.2

ISSN 1349-5240

Combination of risk science and human factors can generate H-R Model as shown in Table 1. The
Model discloses 8 basic categories for patient safety practices.

At the stage before medical accident

and error, patient safety practices are performed based on clinical risk assessment, clinical riskmanagement, clinical risk communication and clinical risk governance to prevent risk. On a while,at the stage after medical accident or medical error, patient safety practices should be performedbased on clinical crisis assessment, clinical crisis management, clinical crisis communication andclinical crisis governance to prevent crisis.
The Model summarizes patient safety world.

The Model can allow us to check and evaluate

effectiveness of a total complexed system in patient safety activities in healthcare. So, the Model isapplicable to “stress test” for healthcare safety. At present, “Stress Test” is carried out in bank toprevent bank crush, and in atomic power plant to prevent plant crush.

【H-R Model】(H: Human Factors)-----------------------------------------------------------------------------------------(R: Risk Science) Before accident --- risk prevention

After accident--- crisis prevention

Assessment

Clinical risk assessment

Clinical crisis assessment

Management

Clinical risk management

Clinical crisis management

Communication

Clinical risk communication

Clinical crisis communication

Governance

Clinical risk governance

Clinical crisis governance

Patient safety is a basic support to smart healthcare. However, massive practices in patient safety world are composed of huge complex of sciences,technologies and arts.
The present “H-R Model” can summarize the above complexed body, and generate several new concepts in patient safety world. The Model can also
perform to check and evaluate effectiveness in a total of complexed system of patent safety practices in healthcare. So, the Model is applicable to“stress test” of healthcare safety.

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