It’s time to step it up. Why safety investigations in healthcare should look more to safety science

Accident models and theoretical foundations underpinning safety investigations are key to understanding how investigators construct causality and make recommendations. Safety science has devoted large efforts to investigating and theorizing about accidents. Why doesn’t healthcare pay more interest to these theories when investigating healthcare accidents? We use established accident theories to suggest how these can support safety investigations in healthcare and provide new lenses to investigatory bodies. We reflect on examples from research and practice in healthcare systems and other high-risk industries. Investigation processes and reports serve multiple purposes. We argue there is an untapped improvement potential for healthcare safety investigations and suggest new ways of integrating different accident theoretical reflections with investigatory practice.