Systems Thinking in Action

What is PHIRES?

The Patient Handling Injuries Review of Systems (PHIRES) toolkit is a systems-thinking toolkit for reviewing and revising risk control measures following the report of a staff injury relating to patient handling.

The toolkit was developed through a co-design process with two Universities (Monash University & University of the Sunshine Coast), WorkSafe Victoria and subject matter experts from a range of health care providers in Victoria. It is based on an existing systems accident analysis method, Rasmussen’s Accimap* technique. The toolkit includes guidance and standardised templates for reviewing information and risk controls following an injury relating to patient handling.

The PHIRES toolkit has been specifically designed to collect information about the contributory factors of a patient handling injury. The tool has targeted prompts and an accompanying data collection guide (with specific questions) that assists in identifying why risk controls were ineffective in an injury events sustained through patient handling.

Grounded in systems-thinking principles, the PHIRES toolkit asks questions related to the injury event, beyond that of usual incident investigations.

*The Accimap approach is a systems-based technique for accident analysis, specifically for analysing the causes of accidents and incidents that occur in complex sociotechnical systems.

VIDEO: Systems Thinking in Action: Preventing Patient Handling InjuriesPHIRES video

Feedback from Victorian healthcare:

  • Helped identify trends that influenced incidents, especially higher levels of the system
  • Encouraged a more comprehensive and considered approach to investigation and development of controls
  • Facilitates collaboration around investigation and development of controls
  • Provides justification to senior management for implementing controls

The STIR Research Project

Monash University, in collaboration with WorkSafe Victoria and the healthcare sector in Victoria are undertaking a project to build upon the success of the PHIRES Project. This new project has been funded by WorkSafe Victoria and aims to:

  1. Develop a digital application (App) to support the sustainable implementation of the Toolkit across the healthcare and social assistance sector. The new Toolkit is referred to as Systems Thinking in Review (STIR);
  2. Develop an online training/coaching program on using systems-thinking to review and revise risk controls to support the reliable implementation of the STIR Toolkit; and
  3. Evaluate the cultural, safety and financial benefits health services and aged care providers realise by using the STIR Toolkit to review and revise their risk controls following the report of a workplace injury. The STIR Toolkit can be used to investigate All workplace injuries (e.g., injuries sustained through workplace violence).

We are currently recruiting health services (hospitals and aged care facilities) to participate in the STIR project.

If you would like more information on involvement in this project, please contact:

Assoc. Professor Sharon Newnam
Associate Professor (Research), Accident Research Centre
M: 0422 723 957