The “patient safety” movement aims to bring systems thinking and analytical
techniques from other high-risk industries to bear on healthcare. These industries –
mass transportation, nuclear power and chemical engineering plants made great safety
gains, but there is still some way to go before their principles are embedded and
transferred to healthcare (Department of Health, 2006). Reason’s (1990) accident
causation model, well known within healthcare, argues that within a given system,
there are many possible factors causing or contributing to accidents. This continuous
“normal” propensity for accidents is usually offset by the effect of several barriers or
controls that exist within the system (Perrow, 1994). It is these acts that prevent
potential accidents, but when they fail, causal factors are exposed and an accident can
occur. One important process in the defence against error in a healthcare context may
involve checking behaviours. However, this fundamental human activity appears to be
poorly researched (Armitage, 2007).