Design a bad system and it will lead to an increased rate of human error and an increased rate of at risk or risky behaviour
David Marx
What do we mean by risky behaviour?
Risky behaviour is a choice that comes with risks. It could be a deviation from a rule or procedure, it could be that it is easier to deviate from the required behaviour. Some refer to this kind of behaviour as violation or simply cutting corners.
Humans make mistakes and they drift into risky behaviours, it is part of being human. Throughout our day to day lives we take risks, some of us more than others. We can be placed into various camps; the risk averse, the risk takers, the risk lovers.
The deviation could drift over time towards the risky behaviour becoming simply habit or the new norm and may eventually become such that the level of risk and the new behaviour is accepted.
David Marx suggests that error, risky behaviour and reckless behaviour all have their own defined meanings. That they are labels that can guide our actions and guide decisions in relation to individual performance and actions. Being able to differentiate them is important in order to determine what might be done with system design and how we might understand the individuals behaviour within that system.
Is all risky behaviour bad?
Not necessarily.
- Is it risky behaviour for people to adjust what they do to match the conditions of work or the patients they are caring for
- Is it risky behaviour to interpret policies and procedures to make them work
- Is it risky behaviour for people to change what they do so that they succeed under unexpected conditions
What do we do about risky behaviour?
Behind every error and every risky behaviour there is an explanation. When you see people exhibiting risky behaviour then one step would be to ask them about it, try to understand why they are behaving in that way and provide them with a form of coaching, a conversation about the risk they are taking and whether they see it as a risk to either themselves, their colleagues or their patients.
For healthcare in particular it is imperative that we move away from the punitive approach to risky behaviour and to create a learning culture so that individuals are encouraged to talk about what they are doing and why. We need to understand that what some may see as risky behaviour for others it may be providing the most optimum service for patients in their care.
Ref: David Marx in Dave’s Subs: a novel about workplace accountability
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