Rules, safety and the narrativisation of identity: a hospital operating theatre case study

Sociology of Health & Illness
R McDonaldStephen Harrison

Abstract

Patient safety has become a health policy priority around the world. Acknowledging that 'to err is human' has led to attempts to design systems and rules that limit the capacity for individual discretion and thereby reduce clinical errors. In addition, great emphasis is being placed on the need to eradicate cultures of blame, which are assumed to discourage clinicians from reporting errors, and to establish a 'safety culture', which encourages openness and honesty. These efforts are underpinned by cognitive psychological explanations of the way individuals process information, which leads them to make errors of judgement. This paper examines the attitudes of hospital doctors and managers to the implementation of rules in the context of patient safety. Our analysis, using interpretive research focused on narrative identity, provides an alternative perspective to that offered by the current safety orthodoxy. This leads us to suggest that the achievement of a 'safety culture' is a remote prospect. The failure to follow formal written rules relates not to a deficiency in the cognitive capacity of individuals acting in isolation, but to the identities which individuals occupy, create and negotiate and the social rules (as opposed to...Continue Reading

References

Apr 1, 1992·The British Journal of Oral & Maxillofacial Surgery·V Ilankovan, I T Jackson
May 11, 1991·Lancet·D A Rees
Jan 1, 1982·Social Science & Medicine·J E WennbergM Zubkoff
Dec 1, 1982·Journal of Behavioral Medicine·N D Weinstein
Nov 6, 1995·The Medical Journal of Australia·R M WilsonJ D Hamilton
Jul 1, 1994·British Journal of Anaesthesia·R Dingwall, P Fenn
Mar 4, 1996·The Medical Journal of Australia·J R Caplehorn
Apr 22, 1999·The Journal of the American Academy of Psychiatry and the Law·D A Pinals, P F Buckley
Nov 30, 1999·American Heart Journal·K J Anstrom, J G Jollis
Mar 17, 2000·BMJ : British Medical Journal·J Reason
Mar 17, 2000·BMJ : British Medical Journal·T W Nolan
Sep 7, 2000·Social Science & Medicine·D Parker, R Lawton
Feb 7, 2001·BMJ : British Medical Journal·D M Berwick
Jan 30, 2002·Cardiology in the Young·E Baker
Dec 4, 2003·Quality & Safety in Health Care·D M Berwick
Dec 4, 2003·Quality & Safety in Health Care·D Parker, R Lawton
Feb 21, 2004·BMJ : British Medical Journal·Hugh RogersJill Copeland
Jan 1, 2005·BMJ : British Medical Journal·Clare Dyer
May 1, 1995·Ergonomics·Dianne ParkerStephen G Stradling

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Citations

Oct 23, 2008·Ergonomics·Denham L PhippsPaul C W Beatty
Mar 2, 2010·Ergonomics·Denham L PhippsPaul C W Beatty
Apr 29, 2009·British Journal of Anaesthesia·D L PhippsG H Meakin
Aug 24, 2010·Clinical Medicine : Journal of the Royal College of Physicians of London·Iain E Yardley, Liam J Donaldson
May 3, 2014·Journal of Health Organization and Management·Sara A KreindlerElliott S Fisher
Aug 1, 2008·Anthropology & Medicine·Cynthia L HunterAdam Scheinberg
Mar 7, 2014·Journal of Interprofessional Care·Paula Rowland, Simon Kitto
Nov 9, 2015·Sociology of Health & Illness·Penny RhodesCaroline Sanders
Dec 15, 2015·Sociology of Health & Illness·Justin WaringJane Sandall
Jan 6, 2016·Social Science & Medicine·Elisa Giulia LiberatiGiuseppe Scaratti
May 29, 2012·Social Science & Medicine·Alison E Powell, Huw T O Davies
Nov 4, 2009·Social Science & Medicine·Justin J Waring
Jan 30, 2013·Sociology of Health & Illness·Alexandra HillmanSimon Read
May 25, 2013·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Sara A Kreindler
Oct 13, 2011·Journal of Advanced Nursing·Akuma O Akuma, Sue Jordan
Apr 30, 2015·Leadership in Health Services·Thomas Andersson
Mar 19, 2011·Social Science & Medicine·Zoe J RadnorJustin Waring
Feb 11, 2015·Cognition, Technology & Work·Robert L Wears
Jul 12, 2016·Sociology of Health & Illness·Kirstine Zinck Pedersen
Jun 16, 2010·Qualitative Health Research·Anat Drach-Zahavy, Anit Somech
Apr 15, 2014·Review of Human Factors and Ergonomics·Pascale CarayonTosha B Wetterneck
Jan 28, 2010·Journal of Health Services Research & Policy·Justin WaringToby Murcott
May 8, 2019·Critical Reviews in Clinical Laboratory Sciences·Deirdre L Church, Christopher Naugler
Mar 19, 2014·Sociology of Health & Illness·Olga BoikoChristian A Gericke
Feb 15, 2011·Sociology of Health & Illness·Judith GreenNick Black
Aug 29, 2016·Australian Health Review : a Publication of the Australian Hospital Association·Anneke Fitzgerald, Yong Wu
Aug 10, 2018·BMC Health Services Research·Stéphane CullatiMonica Escher
Aug 16, 2017·International Journal of Health Policy and Management·Russell Mannion, Mark Exworthy
Oct 14, 2020·Journal of Health Organization and Management·Eloise RadcliffeMark Ashworth
Oct 29, 2020·Advances in Health Sciences Education : Theory and Practice·Joanne GoldmanBrian Wong
Mar 4, 2021·Journal of Interprofessional Care·Kirstine Z Pedersen, Jessica Mesman
Aug 22, 2021·BMC Health Services Research·Christian ColldénIda Gremyr

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