+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Doctors' thinking about 'the system' as a threat to patient safety



Doctors' thinking about 'the system' as a threat to patient safety



Health 11(1): 29-46



'Systems thinking' is an important feature of the emerging 'patient safety' agenda. As a key component of a 'safety culture', it encourages clinicians to look past individual error to recognize the latent factors that threaten safety. This article investigates whether current medical thinking is commensurate with the idea of 'systems thinking' together with its implications for policy. The findings are based on qualitative semi-structured interviews with specialist physicians working within one NHS District General Hospital in the English Midlands. It is shown that, rather then favouring an individualized or 'person-centred' perspective, doctors readily identify 'the system' as a threat to patient safety. This is not necessarily a reflection of the prevailing safety discourse or knowledge of policy, but reflects a tacit understanding of how services are (dis)organized. This line of thinking serves to mitigate individual wrongdoing and protect professional credibility by encouraging doctors to accept and accommodate the shortcomings of the system, rather than participate in new forms of organizational learning.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 048820624

Download citation: RISBibTeXText

PMID: 17158830

DOI: 10.1177/1363459307070801


Related references

Development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students. Bmj Quality and Safety 21(5): 416-422, 2012

Thinking about thinking: implications for patient safety. Healthcare Quarterly 12 Spec no Patient: E191-E194, 2009

Republished: development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students. Postgraduate Medical Journal 88(1043): 545-551, 2012

Implementation of a patient safety incident management system as viewed by doctors, nurses and allied health professionals. Health 13(3): 277-296, 2009

Safety and complexity: inter-departmental relationships as a threat to patient safety in the operating department. Journal of Health Organization and Management 20(2-3): 227-242, 2006

Junior doctors and patient safety: evaluating knowledge, attitudes and perception of safety climate. Bmj Quality and Safety 22(1): 65-71, 2013

Patient safety under threat. Nursing new Zealand 2(6): 18-19, 1996

Prospective memory failures as an unexplored threat to patient safety: results from a pilot study using patient simulators to investigate the missed execution of intentions. Ergonomics 49(5-6): 526-543, 2006

CKD as an underrecognized threat to patient safety. American Journal of Kidney Diseases 53(4): 681-688, 2009

Thinking About Patient Safety: Cognitive Errors. Journal of Perianesthesia Nursing 31(2): 180-181, 2016

Patient's page. Toy safety: thinking inside the box. Southern Medical Journal 101(12): 1191-1192, 2008

Don't Forget Informatics When Thinking About Patient Safety. Mcn. American Journal of Maternal Child Nursing 27(1): 55, 2002

Patient safety: innovation and critical thinking. American Journal of Orthopedics 43(12): 546-547, 2014

Horizontal hostility: a threat to patient safety. Jona's Healthcare Law Ethics and Regulation 15(1): 51-7; Quiz 58-9, 2013

Hospital overcrowding: a threat to patient safety?. Medical Journal of Australia 184(5): 203-204, 2006