Organisations may become complacent about safety in their work due to either believing they are doing an adequate job and that risks of harm are low, or believing existing procedures are enough. A company must monitor both macro and micro views of safety to make sure it doesn't drift into complacency.An organization should assess how it monitors safety across every level of management, beginning with senior individuals. This ensures alignment between safety measures and business strategy; for instance, using scorecard techniques may help identify problems while providing focus on risk and performance measures as well as allocating sufficient resources toward safety efforts.An ongoing departmental monitoring program should be established and regularly evaluated, taking into account its risk profile and frequency of monitoring activities and areas with higher risks. Monitoring results must be reported back to managers and the Departmental Safety Committee so they may take any necessary actions (e.g. new control measures introduced, refresher training for staff or reviewing departmental arrangements for managing safety). A monitoring programme should also be recorded in RiskNET system to facilitate implementation and enable trend analysis.The Berwick report asserted that most healthcare organisations currently lacked sufficient capacity to analyse, monitor or learn from safety information; hence a framework was required for doing this effectively. This paper presents that framework and suggests it be used to promote self-reflection both at board level and clinical team levels.One of the easiest and most direct ways of monitoring any process is through direct observation. This may mean assigning one worker with performing specific tasks and watching them as they complete them; or by breaking down each step and watching that worker complete them all at once. man down alarm One method of monitoring processes is through the use of checklists. This can be an informal but straightforward method that helps identify any potential safety concerns, for instance asking if workers have verified the fire alarms are working and are on the floor, or conducted risk analyses before taking patients onto walk-in beds.At the center of it all lies patient input. This should take the form of interviews and conversations as well as feedback forms; The Francis and Keogh reports highlight this importance by emphasizing it on an ongoing basis; observations of quality care practice as well as experiences from patients or relatives of those receiving care can serve as useful safety monitoring methods.