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The role of dynamic trade-offs in creating safety - a qualitative study of handover across care boundaries in emergency care
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Sujan, Mark-Alexander, Spurgeon, Peter and Cooke, Matthew (2015) The role of dynamic trade-offs in creating safety - a qualitative study of handover across care boundaries in emergency care. Reliability Engineering & System Safety, 141 . pp. 54-62. doi:10.1016/j.ress.2015.03.006 ISSN 0951-8320.
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Official URL: http://dx.doi.org/10.1016/j.ress.2015.03.006
Abstract
The paper aims to demonstrate how the study of everyday clinical work can contribute novel insights into a common and stubborn patient safety problem – the vulnerabilities of handover across care boundaries in emergency care. Based on a dialectical interpretation of the empirical evidence gathered in five National Health Service organisations, the paper argues that performance variability is an essential component in the delivery of safe care, as practitioners translate tensions they encounter in their everyday work into safe practices through dynamic trade-offs based on their experience and the requirements of the specific situation. The findings may shed new light on the vulnerabilities of the handover process, and they might help explain why improvements to handover have remained largely elusive and what type of future recommendations may be appropriate for improving patient safety.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > R Medicine (General) | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Emergency medical services -- Patients -- Safety measures, Medical care | ||||||
| Journal or Publication Title: | Reliability Engineering & System Safety | ||||||
| Publisher: | Elsevier Ltd. | ||||||
| ISSN: | 0951-8320 | ||||||
| Official Date: | September 2015 | ||||||
| Dates: |
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| Volume: | 141 | ||||||
| Page Range: | pp. 54-62 | ||||||
| DOI: | 10.1016/j.ress.2015.03.006 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 5 July 2016 | ||||||
| Date of first compliant Open Access: | 5 July 2016 | ||||||
| Funder: | National Institute for Health Research (Great Britain). Health Services and Delivery Research (NIHR HS&DR) | ||||||
| Grant number: | (Project number 10/1007/26) |
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