A Socio-cultural Perspective on Patient Safety

This edited volume of original chapters brings together researchers from around the world who are exploring the facets of health care organization and delivery that are sometimes marginal to mainstream patient safety theories and methodologies but offer important insights into the socio-cultural and organizational context of patient safety. By examining these critical insights or perspectives and drawing upon theories and methodologies often neglected by mainstream safety researchers, this collection shows we can learn more about not only the barriers and drivers to implementing patient safety programmes, but also about the more fundamental issues that shape notions of safety, alternate strategies for enhancing safety, and the wider implications of the safety agenda on the future of health care delivery. In so doing, A Socio-cultural Perspective on Patient Safety challenges the taken-for-granted assumptions around fundamental philosophical and political issues upon which mainstream orthodoxy relies. The book draws upon a range of theoretical and empirical approaches from across the social sciences to investigate and question the patient safety movement. Each chapter takes as its focus and question a particular aspect of the patient safety reforms, from its policy context and theoretical foundations to its practical application and manifestation in clinical practice, whilst also considering the wider implications for the organization and delivery of health care services. Accordingly, the chapters each draw upon a distinct theoretical or methodological approach to critically explore specific dimensions of the patient safety agenda. Taken as a whole, the collection advances a strong, coherent argument that is much needed to counter some of the uncritical assumptions that need to be described and analyzed if patient safety is indeed to be achieved.

Dr Emma Rowley is a senior research fellow at the University of Warwick UK. Emma's work combines theoretical arguments from medical sociology, science and technology studies and organizational studies in investigating the translation and utilization of innovative medical technologies in a number of health care contexts. She is particularly interested in how patient safety is negotiated when technologies and guidelines are introduced into practice. Professor Justin Waring is Professor of Health Systems and Policy at the Nottingham University Business School. His research seeks to develop theoretical and methodological synthesis across social science disciplines to better understand clinical risk and organizational learning. This includes a study on the implementation of incident reporting, an ethnographic study of the threats to patient safety in the operating theatre, a real-time study of accident investigation, an evaluation of electronic prescribing in primary care and a mixed-methods study of learning across organizational and occupational boundaries in new clinical settings.

Contents: Foreword, Paul Barach; Introduction; a socio-cultural perspective on patient safety, Emma Rowley and Justin Waring; Part 1 Patients and Publics: 'All news is bad news': patient safety in the news media, Cecily Palmer and Toby Murcott; Broadening the patient safety movement: listening, involving and learning from patients and the public, Josephine Ocloo. Part 2 Clinical Practice: Narrowing the gap between safety policy and practice: the role of nurses' implicit theories and heuristics, Anat Drach-Zahavy and Anit Somech; Resources of strength: an exnovation of hidden competences to preserve patient safety, Jessica Mesman. Part 3 Technology: Deviantly innovative: when risking patient safety is the right thing to do, Emma Rowley; The precarious gap between information technology and patient safety: lessons from medication systems, Habibollah Pirnejad and Roland Bal. Part 4 Knowledge Sharing: The politics of learning: the dilemma for patient safety, Justin Waring and Graeme Currie; Exploring the contributions of professional-practice networks to knowledge sharing, problem-solving and patient safety, Simon Bishop and Justin Waring. Part 5 Learning: Challenges to learning from clinical adverse events: a study of root cause analysis in practice, Jeanne Mengis and Davide Nicolini; Patient safety and clinical practice improvement: the importance of reflecting on real-time, in situ care processes, Rick Iedema; Concluding remarks: the gaps and future directions for patient safety research, Justin Waring and Emma Rowley; Index.