How mature is your organisation’s approach to measuring and monitoring safety? Is your Board over-confident it ‘has safety sorted’ and doing nothing to evolve its approach? Are you entrenched in ticking the box to prove the organisation is safe to external regulators? Or is your organisation continuously innovating to improve its safety metrics and methods?

The Safety Measurement and Monitoring Matrix (SaMMM), (see Figure 1), has been developed to support healthcare organisations self-reflect on their safety measurement culture. Based on Robert Westrum’s theory of different organisational personality types (1992),  and the approach taken to develop a previous tool, the Manchester Patient Safety Framework (Kirk, Parker et al., 1997), SaMMM maps out what different organisational personalities look like on each of the Health Foundation’s Measurement and Monitoring of Safety Framework dimensions (Vincent, Burnett and Carthey, 2013). Those dimensions are:

i.  Past harm

ii. Reliability

iii.Sensitivity to operations

iv. Anticipation and preparedness and

v. Learning and integration

SaMMM is currently being tested in workshops with healthcare teams. Initial feedback has shown SaMMM can be used to stimulate conversations and self-reflection. In a recent workshop, one healthcare professional commented how it takes a ‘seismic shift’ for an organisation to mature from the bureaucratic personality type to a more proactive level of maturity. Evolving our measurement culture may not be a gradual evolution – it may require a fundamental re-focusing of energy and resource, prompted by a change in leadership or leaders completely re-thinking their vision for safety.

Another participant commented how the Trust Board in his organisation believes they are proactive and will not be told otherwise. This has paralysed attempts to evolve the safety measurement culture in specific teams and divisions. Thus SaMMM highlights the gulf that sometimes exists between senior managers and frontline staff about how evolved their approach is.

Please feel free to download and use SaMMM [Download here…] in your organisation or team. I would be interested in hearing your feedback and how you have used the tool, so please drop me an email at

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