Systems Approach to daily clinical care

Safety and quality of healthcare provision are affected by a number of factors. These factors include the clinical skills of the treating surgeon or other physician, but also the way practitioners think and behave as members of a healthcare team, and the clinical environment in which care is provided. We first discuss Bahal et al.'s paper as a demonstration of the Systems Approach to clinical performance and patient safety. We then highlight recent advances driven by the Systems Approach in understanding and measuring clinical decision-making, teamworking, and the clinical environment. We conclude that human factors research can provide an understanding of how to balance conflicting opinions and priorities in clinical care with the best interests of the patient, in a manner which allows each doctor to fulfil their duty of care. (C) 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.