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Tracing the foundations of a conceptual framework for a patient safety ontology
  1. William B Runciman1,2,
  2. G Ross Baker3,
  3. Philippe Michel4,
  4. Susan Dovey5,
  5. Richard J Lilford6,
  6. Natasja Jensen7,
  7. Rhona Flin8,
  8. William B Weeks9,
  9. Pierre Lewalle7,
  10. Itziar Larizgoitia10,
  11. David Bates11 on behalf of the Methods & Measures Working Group of the World Health Organization World Alliance for Patient Safety
  1. 1The University of South Australia and the Safety and Quality Research Unit, Joanna Briggs Institute, Adelaide, Australia
  2. 2Australian Patient Safety Foundation, Adelaide, Australia
  3. 3Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada
  4. 4Regional Center for Quality and Safety, Bordeaux University Hospital, Bordeaux, France
  5. 5Department of General Practice, Dunedin School of Medicine, Dunedin, New Zealand
  6. 6Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham, UK
  7. 7World Health Organization, Geneva, Switzerland
  8. 8School of Psychology, University of Aberdeen, Aberdeen, UK
  9. 9The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA
  10. 10World Alliance for Patient Safety, World Health Organization, Geneva, Switzerland
  11. 11Division of Internal Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Professor W B Runciman, Australian Patient Safety Foundation, GPO Box 400, Adelaide, SA 5001, Australia; bill.runciman{at}


Background In work for the World Alliance for Patient Safety on research methods and measures and on defining key concepts for an International Patient Safety Classification (ICPS), it became apparent that there was a need to try to understand how the meaning of patient safety and underlying concepts relate to the existing safety and quality frameworks commonly used in healthcare.

Objectives To unfold the concept of patient safety and how it relates to safety and quality frameworks commonly used in healthcare and to trace the evolution of the ICPS framework as a basis of the electronic capture of the component elements of patient safety.

Conclusion The ICPS conceptual framework for patient safety has its origins in existing frameworks and an international consultation process. Although its 10 classes and their semantic relationships may be used as a reference model for different disciplines, it must remain dynamic in the ever-changing world of healthcare. By expanding the ICPS by examining data from all available sources, and ensuring rigorous compliance with the latest principles of informatics, a deeper interdisciplinary approach will progressively be developed to address the complex, refractory problem of reducing healthcare-associated harm.

  • Patient safety
  • classification
  • quality
  • ontology
  • informatics
  • information technology
  • quality of care
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  • Funding The work was supported by a Program Grant by the National Health and Medical Research Council of Australia, Canberra, ACT, Australia.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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