UNDERSTANDING THE SYSTEM IN RELATION TO SAFE MEDICAL WORK PRACTICES

Within existing health care safety research, limited attention has been paid to the significance of “the system” in relation to team work, and the term system is also commonly considered to be something vague and therefore unapproachable. In light of this, we explore how different factors of the system influence interdisciplinary operations and safe work practices (research aim #1). We also focus on replicating existing methodological approaches, and on linking our findings to previous research (research aim #2). We find that two particular trends stand out from the data: (1) various combinations of system factors contribute to disrupt the “operational flow”, but the particular operation continues and completes normally, and (2) various system factors compensate for the vulnerabilities and disruptions that arise during operations. We then compare the study findings to existing research, with a focus on identifying the similarities, nuances and differences between the study findings and existing findings.

[1]  Matthew B. Miles,et al.  Qualitative Data Analysis: An Expanded Sourcebook , 1994 .

[2]  Della Freeth,et al.  Supporting structures for team situation awareness and decision making: insights from four delivery suites. , 2009, Journal of evaluation in clinical practice.

[3]  Sriram Dasu,et al.  Assessing the performance of surgical teams , 2009, Health care management review.

[4]  Joanne Greenhalgh,et al.  Tacit and encoded knowledge in the use of standardised outcome measures in multidisciplinary team decision making: a case study of in-patient neurorehabilitation. , 2008, Social science & medicine.

[5]  Helena Wulff.  Yo-yo Fieldwork : Mobility and Time in a Multi-Local Study of Dance in Ireland , 2002 .

[6]  James T. Reason,et al.  Managing the risks of organizational accidents , 1997 .

[7]  Caprice K. Christian,et al.  A prospective study of patient safety in the operating room. , 2006, Surgery.

[8]  M. Utley,et al.  Paediatric cardiac surgery , 2009, Scandinavian cardiovascular journal : SCJ.

[9]  A. Lyndon.  Communication and teamwork in patient care: how much can we learn from aviation? , 2006, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[10]  K. Catchpole,et al.  Identification of systems failures in successful paediatric cardiac surgery , 2006, Ergonomics.

[11]  M. Patton,et al.  Qualitative evaluation and research methods , 1992 .

[12]  K. Catchpole,et al.  Improving patient safety by identifying latent failures in successful operations. , 2007, Surgery.

[13]  A F Smith,et al.  What defines expertise in regional anaesthesia? An observational analysis of practice. , 2006, British journal of anaesthesia.

[14]  D. Silverman.  Qualitative research : theory, method and practice , 2004 .

[15]  A Smith,et al.  Expertise in practice: an ethnographic study exploring acquisition and use of knowledge in anaesthesia. , 2003, British journal of anaesthesia.

[16]  D. P. Baker,et al.  Teamwork as an essential component of high-reliability organizations. , 2006, Health services research.

[17]  Claudia Infante,et al.  Bridging the “system's” gap between interprofessional care and patient safety: Sociological insights , 2006, Journal of interprofessional care.

[18]  K. Weick.  Making Sense of the Organization , 2000 .