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Remembering to learn: the overlooked role of remembrance in safety improvement
  1. Carl Macrae
  1. Correspondence to Dr Carl Macrae, Department of Experimental Psychology, University of Oxford, Tinbergen Building, 9 South Parks Road, Oxford OX1 3UD, UK; carlmacrae{at}

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Memory, and remembering the past, are fundamental to patient safety. One of the core objectives of safety improvement is to learn from the past in order to improve the future. This commitment to remember and to learn is central to the strategies that have shaped the evolution of patient safety such as ‘An organisation with a memory’,1 and underpins definitive academic research such as Bosk's ‘Forgive and Remember’.2 Remembering the past to improve the future is institutionalised across healthcare in a variety of activities such as safety incident reporting, morbidity and mortality meetings, coroner investigations and public inquiries. Despite this, healthcare systems still suffer striking and acute episodes of forgetfulness3 that are deeply consequential: when harmful events are forgotten, they are likely to be repeated.

Given the central importance of memory in patient safety, it is surprising that one of the most long-standing forms of collective memory-making has remained largely unexplored in healthcare: the social practices of remembrance. These practices colour our daily lives, from memorial services that commemorate the lives of those who have passed away, to remembrance events that bring people together to remember harmful past events and honour those affected. The nature of remembrance is the subject of a small and sophisticated literature,4 ,5 ,6 but there has been little systematic exploration of these ideas in safety-critical settings in general, or healthcare in particular. However, what we already know about remembrance suggests that more detailed study could offer rich insights into the practical, social and emotional aspects of remembering and learning from past adverse events in healthcare. To explore these issues, this paper first examines what remembrance is and what its defining features look like, drawing on three practical examples in safety-critical settings. Then, the paper analyses the functions and purposes …

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  • Competing interests CM declares consultancy and advisory work in patient safety and risk management for the National Health Service and other organisations.

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