John Sutton's Avatar

John Sutton

@johnsutton.bsky.social

Patient Safety. Why do we not learn? #TMNHA Student @PDHealthBath. Eternal Pragmatist! Animal lover/owner 🫏🐏 🦙and 🐝 keeper

76 Followers  |  166 Following  |  9 Posts  |  Joined: 16.11.2024  |  1.6302

Latest posts by johnsutton.bsky.social on Bluesky

Such a valid close. If ever ‘this must never happen again’ should be quoted… it’s at the start of this restructure.

Single/double loop learning theories are great but I think there is sadly I feel there often ease of un-learning too in memory.

04.04.2025 19:24 — 👍 0    🔁 0    💬 0    📌 0
An organisation with a memory In many ways the year 2000 was the start of the safety movement as we know it today.  There are many safety scholars out there who will cite the work as far back as the late 1800s that helped our thinking in patient safety and the brilliance of our anaesthetic colleagues who were in fact the first people to coin the term 'patient safety' in the 1970s.

An organisation with a memory

In many ways the year 2000 was the start of the safety movement as we know it today.  There are many safety scholars out there who will cite the work as far back as the late 1800s that helped our thinking in patient safety and the brilliance of our anaesthetic…

04.04.2025 11:00 — 👍 5    🔁 3    💬 3    📌 0

I think a PSII is just an RCA done well… with more knowledge of system factors??

05.12.2024 13:09 — 👍 1    🔁 0    💬 0    📌 0

Love this platform but feel I’m missing out. I had so many alerts set up on the app that shall not be named. Missing tweet alerts from individuals… is it still possible?

04.12.2024 17:09 — 👍 1    🔁 0    💬 0    📌 0

Even when your brain is full and you think academic supervision will just add to that fullness… it’s totally what is needed to strip your thoughts and ideas right back. Obviously I have an amazing supervisory team who I know are running the race with me. Never skip supervision!

29.11.2024 18:53 — 👍 0    🔁 0    💬 0    📌 0

LFPSE - weekly thought - how can we learn from incidents when the rates are still love and every and the shift from ‘other’ cause category to ‘not reported’ has increased. It is still very worrying!

28.11.2024 13:09 — 👍 0    🔁 0    💬 0    📌 0
Post image

2nd PhenoLab Summer School in Umbria - call for papers
'Phenomenology in mental health. Transdisciplinary approaches and qualitative research' - June 9-13, 2025.
www.britishphenomenology.org.uk/2nd-phenolab...
#phenomenology #philosophy

22.11.2024 09:51 — 👍 6    🔁 2    💬 0    📌 1

Think I’d add the need to consider organisational and individual un-learning theories here… it’s the layering of add ons (sticky plaster) without striping back and giving permission to forget (safely) and rebuild - with rationale embedded. Idealistic maybe!

21.11.2024 20:27 — 👍 2    🔁 1    💬 0    📌 0
Qualitative Remote Data Collection Guidance 2024 | University of Warwick Press


Really useful resource from Warwick here!

19.11.2024 18:51 — 👍 0    🔁 0    💬 0    📌 0

Thanks for this! Made my life easy with one click!

16.11.2024 16:46 — 👍 1    🔁 0    💬 1    📌 0

I'm trying to follow folk who work in the research or practice of safety, patient safety, or human factors.

So I created a small starter pack. Please let me know who I have missed!

#safetysky
#hfesky

go.bsky.app/Ukaym74

12.11.2024 15:40 — 👍 74    🔁 38    💬 33    📌 2

So I’ve made it to the land of the blue butterfly!

Sorry for the mass scatter gun of following - don’t want to loose my world I built up on other platform (not to be named)

16.11.2024 16:38 — 👍 1    🔁 0    💬 0    📌 0

@johnsutton is following 19 prominent accounts