Efforts to improve the management of medical incidents have derived from two main perspectives, namely, the promotion of patient safety and quality improvement, and the strategic management of organizational crisis. These two streams have produced different sets of policies and endeavors, although they are sometimes closely interrelated and supplementary. Around the turn of the century, promotion of medical safety came to focus mainly on systemic failures, institutional learning, risk communication, and a safety culture, which resulted in a shift away from risk management toward safety management, and then from safety management to a safety culture and (service/ treatment) quality management.

Although a crisis management perspective has thus moved away from being the central topic of public policy, its importance undoubtedly remains. With increased expectations of medical services, as well as lawsuits, effective management of health crises is called for, more than ever, and healthcare organizations and professionals should be sufficiently prepared to address these events. Depending on the phase of a crisis (i.e., before, during. and after a crisis), a set of actions is required, along with advanced planning and coordination. Basic principles for risk and crisis management should be applied to the management of medical incidents, which in turn improves patient safety. In addition, communications play a key part in this regard. Advance plans (for preparation, response, and recovery) are especially imperative, aside from efforts to prevent medical incidents.

This article first presents the basic components of crisis management, along with the promotion of patient safety, with a focus on communications. It then introduces recent policies regarding safety promotion, as well as efforts to manage the crises caused by medical incidents in Japan.