What Exactly Is Patient Safety?

We articulate an intellectual history and a definition, description, and model of patient safety. We define patient safety as a discipline in the health care professions that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery. We also define patient safety as an attribute of health care systems that minimizes the incidence and impact of adverse events and maximizes recovery from such events. Our description includes: why the field of patient safety exists (the high prevalence of avoidable adverse events); its nature; its essential focus of action (the microsystem); how patient safety works (e.g., highreliability design, use of safety sciences, methods for causing change, including cultural change); and who its practitioners are (i.e., all health care workers, patients, and advocates). Our simple and overarching model identifies four domains of patient safety (recipients of care, providers, therapeutics, and methods) and the elements that fall within the domains. Eleven of these elements are described in this paper.