Standardisation or resilience? The paradox of stability and change in patient safety

Dados Bibliográficos

ID2249151
AutoresKirstine Zinck Pedersen (0000-0002-7058-131X, Department of Organization Copenhagen Business School Denmark, autor correspondente)
Ano2016
Volume38
Fascículo7
Páginas1180-1193
Data de publicação2016-09-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoSociology of Health & Illness (JOURNAL)
Identificadores do periódicoISSN: 0141-9889 • E-ISSN: 1467-9566
EditoraWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12449
PMID27397546
OpenAlexW2473256951
IdiomaEN
Citações recebidas7
Referências citadas30

This article explores an apparent paradox of stability and change in patient safety thinking and practice. The dominant approach to patient safety has largely been focused on closing 'safety gaps' through standardisation in seemingly stable healthcare systems. However, the presupposition of system stability and predictability is presently being challenged by critics who insist that healthcare systems are complex and changing entities, thereby shifting focus towards the healthcare organisation's resilient and adaptive capacities. Based on a close reading of predominant patient safety literature, the article analyses how a separation between stability and change is articulated in ontological, historical, and situated terms, and it suggests the way in which predetermining healthcare settings as either stable or unstable paves the way for a system engineering approach to patient safety that pre-empts certain types of safety solutions. Drawing on John Dewey's influential ideas about the interconnectedness of stability and change, this prescriptive perspective is discussed and challenged. It is suggested that only by rethinking the relationship between change and stability can patient safety efforts begin to address the uncertainty of medical practice as well as the necessary competences of healthcare professionals to act with 'safety dispositions' as a precondition for delivering safe care

Business · Physics · Resilience (materials science) · Risk analysis (engineering) · Stability (learning theory) · Thermodynamics · Computer Science · Healthcare Quality and Management · Medical Malpractice and Liability Issues · Patient Safety and Medication Errors · Psychology