Ian Clarke is a consultant in general adult psychiatry in the west of Glasgow (Arndale Resource Centre, 80–90 Kinfauns Drive, Drumchapel, Glasgow, G15 7TS, UK. Email: ian.clarke{at}ggc.scot.nhs.uk). He is clinical lead for the Greater Glasgow and Clyde Patient Safety Group. He obtained a Masters in Business Administration in 2004 and is lead clinician for the west of Glasgow.
Critical incident reviews are an integral part of modern psychiatric practice. The issue is central to the clinical governance agenda in the UK, yet there is widespread debate about their usefulness. There is a lack of systematic research into their impact on clinical outcomes, with most authors commenting on their form, their political implications, and whether they should exist at all. This article explores the historical basis to incident investigation, outlines an ideal method of review and discusses the concepts of the learning organisation and root cause analysis. Further discussion focuses on what the objectives of critical incident review might be and whether organisations as a whole can learn from them.