Patient Safety and Escalation

Patient safety is the single most important consideration in any SJT scenario. When patient safety is at risk, all other concerns — maintaining relationships, following social norms, avoiding awkwardness — take a back seat. This lesson covers when to escalate concerns, who to escalate to, and the correct approach in various scenarios.

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The Primacy of Patient Safety

In SJT, patient safety overrides:

• Loyalty to colleagues — you must report a colleague who is putting patients at risk, even if they are your friend
• Hierarchy — you must challenge a senior's decision if you believe it endangers a patient
• Convenience — you must act even if it is inconvenient, time-consuming, or uncomfortable
• Your own reputation — you must speak up even if others might view you negatively

The Core Principle

If in doubt, act. It is always better to raise a concern that turns out to be unfounded than to stay silent about a genuine risk. No reasonable person will criticise you for being appropriately cautious about patient safety.

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When to Escalate

Immediate Escalation Required

These situations require you to escalate immediately, without delay: