During the past 70 years, patient safety science has evolved through four organizational frameworks known as Safety-0, Safety -1, Safety-2, and Safety-3. Their evolution reflects the realization over time that blaming people, chasing errors, fixing one-offs, and regulation would not create the desired patient safety. In Safety-0, the oldest framework, harm events arise from clinician failure; event prevention relies on better staffing, education, and basic standards. In Safety-1, used by hospitals, harm events arise from individual and/or system failures. Safety is improved through analytics, workplace culture, high reliability principles, technology, and quality improvement. Safety-2 emphasizes clinicians' adaptability to prevent harm events in an everchanging environment, using resilience engineering principles. Safety-3, used by aviation, adds system design and control elements to Safety-1 and Safety-2, deploying human factors, design-thinking, and operational control or feedback to prevent and respond to harm events. Safety-3 represents a potential way for anesthesia and perioperative care to become safer.

中文翻译：

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麻醉和围手术期患者安全的观点：过去、现在和未来。


在过去的 70 年里，患者安全科学通过四个组织框架发展起来，即 Safety-0、Safety -1、Safety-2 和 Safety-3。它们的演变反映了随着时间的推移，人们认识到，指责人、追逐错误、修复一次性事件和监管不会创造理想的患者安全。在最古老的框架 Safety-0 中，伤害事件是由临床医生的失败引起的;事件预防依赖于更好的人员配备、教育和基本标准。在医院使用的 Safety-1 中，伤害事件是由个人和/或系统故障引起的。通过分析、工作场所文化、高可靠性原则、技术和质量改进来提高安全性。Safety-2 强调临床医生的适应性，以使用弹性工程原理在不断变化的环境中防止伤害事件。航空使用的 Safety-3 为 Safety-1 和 Safety-2 增加了系统设计和控制元素，部署人为因素、设计思维和运营控制或反馈来预防和应对伤害事件。Safety-3 代表了麻醉和围手术期护理变得更加安全的潜在方式。