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The purpose of this paper is to facilitate an integrative approach to the implementation, monitoring and reporting of risk management in healthcare settings.

A framework, identified by the acronym RADICAL, is presented. The underlying principles and the strengths of the framework are described.

The framework comprises the following domains in an integrated grid: raise awareness, design for safety, involve users, collect and analyse patient safety data, and learn from patient safety incidents.

The RADICAL framework provides a simple but comprehensive approach to the implementation, monitoring and reporting of healthcare risk management. It is designed to facilitate learning and accountability at both individual and organisational levels, advocating a balance between “person” and “system”. It covers all domains of patient safety while also being flexible to allow local customisation of the content and metrics for each domain.

The RADICAL framework can be used by service providers and commissioners to implement and monitor risk management, and by regulators for monitoring performance. It can also be used in education and training, and to provide information on quality and safety to service users.