Table 2

The safety skills: illustrative quotes and individual skills are as they appeared on the final questionnaire

Category	Individual skills (questionnaire items in Stage 2)	Illustrative quotes
Anticipation and preparedness	Anticipation of organisational problems Being able to anticipate the deteriorating patient Contingency planning with clearly defined levels of care Developing risk averse methods of working Thinking ‘what could go wrong today?’ and trying to prepare for it	‘Contingency planning—if patient fails to improve with a we will try b and c. If x happens, we will escalate care to y’ (S) ‘One thing that I do on a daily basis, and I would like my juniors to do as well, is to think, what could go wrong today? And I try to cover for that …’ (FG)
Awareness of the patient (including empathy)	Caring about patients Empathy Not hating patients you can't solve Not thinking of re-attenders as a nuisance Thinking physiologically	‘Remember ‘The secret of care of the patient is caring for the patient’ (S)
Awareness of oneself	Not letting your emotions interfere with patient care Continuous questioning of self and others Having up to date knowledge/training Learning from previous mistakes Reflective thinking Self awareness—recognising one's own limitations Thinking ‘how am I today?’ (tiredness etc.) Knowing who, when and how to call for help appropriately	‘Be aware of your own abilities—when negative life events will affect your judgements and working ability.’ (S) ‘If you are tired, you take a break, and you actually stop and … you say, I'm going out’ (FG)
Awareness of the situation	Being able to minimise distractions Recognising error prone situations Information gathering	‘Being error- aware and recognising situations that may give rise to errors, for example a high workload.’ (S)
Awareness of one's team	Awareness of others around you Being aware of unsafe members in the team Being receptive to others in the team Team awareness and monitoring	‘Recognising the skills and limitations of one's team and delegating accordingly’ (S)
Common sense	Having a common sense approach Being able to follow instructions	‘Just having common sense’ (S)
Confidence	Being able to speak up Being confident in decision making Having an appropriate level of confidence/assertiveness	‘Having the confidence to speak up if you notice any potential hazards.’ (S)
Conscientiousness	Being thorough /paying attention to detail Checking and re checking Conducting a thorough history and examination Going out of your way to help Hunting for answers	‘Cogitate if there is an unexplained clinical problem—keep thinking (and hunting).’ (S)
Crisis management	The ability to think clearly in a crisis situation Acting decisively in a crisis	‘Risk mitigation—knowing either what to do if something does go wrong or who to ask to come and fix the problem if one cannot do so personally’ (S)
Honesty	Honesty Proactive and open communication Being open about error	‘Honesty—i.e. openly communicating mistakes, issues and areas of concern’ (S)
Humility	Taking criticism constructively Humility Being courteous and considerate Willingness to listen/take advice Allowing others to take over	‘Doesn't have a chip on his/ her shoulder about taking advise from nurses and juniors’ (S)
Leadership	Having good leadership skills	‘The leadership and the behaviour of the team as a whole, influences one's behaviour …’ (FG)
Open-mindedness	Being open minded	‘Recognising clinical patterns but not ignoring facts that don't fit.’ (S)
Organisational skills and efficiency	Organisational skills/efficiency Co ordination Prioritisation/multi tasking	‘The ability to process multiple information sources at the same time and prioritise.’ (S)
Responsiveness	Acting decisively if hazards are noticed Changing one's behaviour in response to tiredness Responding to changes in circumstances Thinking and problem solving	‘The ability to adapt to rapidly changing circumstances’ (S)
Team working and communication	Asking team for reminders Being available and perceived as available Delegating appropriately Encouraging frequent/regular team meetings Giving constructive feedback Having a sense of togetherness within the team Team working	‘If you initiate an action make it absolutely clear who is to do what, when—and who is to be called if the patient goes ‘off track’ and—and who will review progress when’ (S)
Technical Skills	Having good technical skills	‘In surgery, it's the doing, it's about technical skills and the high level technical skills’ (FG)

Vigilance	Alertness/ being ‘on the ball’ Pattern recognition and vigilance for deviation from patterns Regularly re-reviewing the situation	‘Through knowledge and experience comes vigilance for any deviation from an expected course of events.’ (FG)

S indicates an illustrative quote from the survey and FG indicates an illustrative quote from the focus group.