Fig. 1

Three models of safety and examples of associated risk strategies. Elaboration of Vincent and Amalberti text and figures [3, 25], with additional reference to collective mindfulness – typical of high reliability organisations models of safety [27]. Collective mindfulness manifests when people on the frontline collectively show preoccupation with failure (ongoing wariness that errors are possible), reluctance to simplify interpretations of unexpected events (questioning assumptions, uncovering blind spots), sensitivity to operations (having an integrated understanding of current situation, e.g. awareness of how one’s actions affect others), commitment to resilience (awareness that it is impossible to anticipate all situations, needs for adaptation) and deference to expertise (persons with expertise to make decisions regardless of hierarchy) [27]