Table 1

Five most frequently cited theories in the review

TheoryNo of times citedDescription
High Reliability Organisation (HRO) Theory16Humans operating and managing complex systems are not sufficiently complex to sense and anticipate the problems generated by the system. Proper organisations of people, process and technology can handle complex and hazardous activities improving reliability.4
Model of Cultural Maturity7Safety cultures evolve through five levels of maturity, from the least mature (pathological) through to mature (generative). Each level describes the stage of safety culture development. This information can enable organisations to diagnose their current level of maturity, identify areas of strength and weakness, and actions to reach the next level.5
Donabedian's Process–Structure–Outcome Model5Healthcare organisations can be described in terms of structure, process and outcomes. Structure is defined as the conditions in which care is provided (materials, human resources, organisational characteristics). Process includes activities to provide care. Outcomes are results or changes that can be attributed to care. Each component is dynamic and transactional, and may influence safety outcomes.6
Organisational Theory4To understand corporate culture, one must look at a number of key organisational characteristics, such as common understandings, the workplace environment, everyday language and employee attitudes towards the organisation4
Systems Theory4The final state of a system may be reached from different initial conditions and in different ways. Thus, an organisation with a particular set of cultural attributes may be successful in achieving patient safety, while another organisation with a different set of cultural attributes can also potentially achieve the same levels of success7