Organizing Patient Safety by Kirstine Zinck Pedersen

Author:Kirstine Zinck Pedersen
Language: eng
Format: epub
Publisher: Palgrave Macmillan UK, London

Organizing Principles in Patient Safety

The patient safety programme has not only brought safety but has simultaneously redistributed uncertainty, responsibility, tasks and focuses in ways that introduce new types of context-specific problems, risks and safety threats in clinical practice. Much of the identified risks in this chapter are not specific to patient safety, and thus the arguments are largely analytically generalizable to discussions on unwanted consequences and distributed effects of introducing rationalizing technologies, control systems, management tools or new types of knowledge or innovations into organizations and the organizational practices, routines, roles, responsibility structures and visible and invisible work that constitute such. At the same time, this chapter has strived to demonstrate that the specific character of the patient safety programme and the particular rationalities it imposes on healthcare practices introduce risks, which are closely connected to the highly principle-based nature of the current paradigm, its strong standardization claims, its ‘measure-and-manage’ strategies and its blame-free ethos. These are the risks that could be determined as the self-inflicted plagues of the programme. Thus, on the basis of all four risk categories, it can be argued that the programme’s specific set of ideals of, and methods for, organizing are a strong contributing factor in creating a particular kind of overarching risk: the risk of determining a set of golden principles for organizing a priori an analysis of the specificities of the situation (see also Du Gay and Vikkelsø 2013a, b). As we have seen in this chapter, this principle-based character of safety policy and its vision of risk elimination through standardization have certain concrete unwanted consequences for clinical practice and the organization of healthcare, as well as more intangible consequences for the possibilities of approaching safety from a pragmatic, situated and context-specific perspective, where the particularities of the clinical situation and the uncertainty of medical knowledge determine the questions to be asked and the solutions to be suggested.

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