Anxiety as a barrier to risk management

Leaders need to recognise that anxiety is an inevitable part of caring for patients and that, without the building of trust, it may affect risk management by reducing the reporting of error. The paper by Kuhn and Youngberg1 in this issue of QSHC takes an historical approach to the evolution of risk management, following it from past failures into the path for its future success. The essence of the change will occur with the primary goal of risk management moving from the protection of the financial concerns of the organisation to the protection of its patients in terms of improved safety and quality of care. For decades risk management has sat uneasily beside quality systems, and it is only with the integration of these systems into one which has good patient care as its ultimate goal—clinical governance in the UK—that there is the possibility of success. Nevertheless, while the structural integration of quality systems may be relatively straightforward, the psychological integration of the concepts of “quality = good” and “error = bad” will take …