Safety-II
Patient Safety
Definition. Safety-II defines safety as the ability to succeed under varying conditions, focusing on why things usually go right rather than only on why they occasionally go wrong.
Explanation
Hollnagel contrasted Safety-I, which seeks to eliminate failures, with Safety-II, which seeks to understand and support everyday performance variability (Hollnagel, 2014). Studies combining both perspectives, for example in remote primary care, show that each reveals different safety issues (Payne et al., 2024).
Safety-II encourages learning from normal work and from successful adaptations made by teams under pressure (Sanford et al., 2025).
Related concepts
Resilience engineering STAMP and STPA High reliability organization (HRO) Human factors
Read on The Health Topics
- Understanding Safety Science: Key Theories & Frameworks
- Safety I and Safety II Perspectives
- Hospital Team Adaptation to Demand-Capacity Misalignments: An Ethnographic Study
References
Hollnagel, E. (2014). Safety-I and Safety-II: The Past and Future of Safety Management. CRC Press.
Payne, R., Clarke, A., Swann, N., et al. (2024). Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis. BMJ Quality & Safety, 33 (7), 573–586. https://doi.org/10.1136/bmjqs-2023-016674
Sanford, N., Lavelle, M., Markiewicz, O., Reedy, G., Rafferty, A. M., Darzi, A., & Anderson, J. E. (2025). Contextual influences on adaptation in four types of hospital teams: An ethnographic study. Applied Ergonomics, 128, 104529. https://doi.org/10.1016/j.apergo.2025.104529
Cite this entry: Kurutkan, M. N. (2026). Safety-II. In The Health Topics glossary. https://healthtopic.org/glossary/safety-ii/