Navigation Links
Tolerate, accommodate, innovate -- how doctors deal with the risk embedded in the medical system
Date:12/17/2007

Risk is an inherent element of the hospital system and the resulting dangers are often normalised by medical staff to allow them to do their job, according to research by a University of Nottingham academic.

Dr Justin Waring, Lecturer in Medical Sociology and Health Policy at the University, found that medical staff were inevitably pessimistic about the ability of their management team to understand the level of risk that doctors and nurses dealt with on a day-to-day basis. They felt that management were too far removed from the realities of clinical safety to judge best practice and that the priorities and targets that drive risk management such as cost savings and cutting waiting times diverged from those of the clinicians.

Dr Waring identified the operating theatre as a complex hub within the hospital system, which had a symbiotic relationship with other departments including surgical wards, the anaesthetic department, sterile services and lab and imaging services. Problems in the operating theatre were found to spill over into related departments, creating cascade chains of risk, which clinicians in all areas then had to deal with.

As a result, medical staff develop ritualistic behaviours that are based on shared cultural norms and expectations just to get the job done. They tolerate and endure levels of risk and sub-standard working; accommodate or accept the presence of risk by making small modifications to clinical practice; and innovate, developing new procedures to work around risk. This emphasis on coping has come to be seen as a mark of professionalism among medical staff.

The study found minimal participation in incident reporting and risk management among clinicians not because they were trying to conceal dangers and mistakes, but because coping was the mark of a professional, Dr Waring said. Risk is part of a clinicians daily life; its inherent in medical culture. Doctors can only work to minimise and control risk; they dont feel that they can eliminate it totally.

The research team identified these key themes of hospital culture during an 18-month ethnographical study in the operating department of a large teaching hospital. They carried out 300 hours of observations on site and conducted around 80 interviews with staff. The study was funded by the Department of Health.

Dr Waring has already presented his findings to Sir Liam Donaldson, Chief Medical Officer and the UKs key advisor to the government on healthcare issues and he is now contributing to a review of NHS conducted by Professor Lord Darzi, Parliamentary Under Secretary of State at the Department of Health.. This review coincides with the 60th anniversary of the NHS. A follow-up study into the way medical professionals share patient information in a bid to eliminate risk is set to begin in the New Year.

Dr Waring said: These studies reveal neglected but critical perspectives on patient safety. Critical in the sense that they are not just offering an alternative to mainstream research but also because they are of immense importance if we really want to understand and tackle the root causes of safety in healthcare.


'/>"/>

Contact: Justin Waring
justin.waring@nottingham.ac.uk
University of Nottingham
Source:Eurekalert

Related medicine news :

1. UK junior doctors gaining less experience of common procedures
2. Doctors Often Miss High Blood Pressure in Kids
3. One-fourth of HIV patients believe their doctors stigmatize them
4. Annual flu shot cuts need for doctors visits, hospitalization among children
5. Teens need to see their doctors more often
6. Doctors and medical ethicist discuss whether doctors should participate in capital punishment
7. Doctors and Medical Ethicist Discuss Whether Doctors Should Participate in Capital Punishment
8. South Texas Doctors Report More Severe Cases of Community Staph Super Bug Hospitalizing Children
9. Maimonides Expands Circulation of Physicians Practice Journal to Staten Island Doctors
10. Doctors Debate Drugs vs. Surgery for Angina
11. UCI Medical Affiliates Inc. Opens a New Doctors Care Center in Anderson
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/27/2017)... PORT RICHEY, Fla. (PRWEB) , ... February 27, 2017 , ... ... use disorder, but concern for women who become dependent on opioid painkillers has fallen ... among female patients, compared to a 237% increase in fatal overdoses in male populations.(1) ...
(Date:2/27/2017)... ... ... Orange County dentist, Dr. A. Rassouli, comments on the new ... bacteria in plaque infect the gums and other tissues supporting the teeth. Treatment typically ... SRP, and can include surgical therapies if the condition has led to significant damage. ...
(Date:2/27/2017)... ... ... POUGHKEEPSIE, N. Y. – Peer-reviewed guidelines from the International Lyme and Associated ... Disease Control ( CDC ) and Infectious Diseases Society of America (IDSA) dismiss any ... into a single volume a compelling argument that the disease does exist in his ...
(Date:2/27/2017)... Francisco, CA (PRWEB) , ... February 27, 2017 ... ... center for hair transplantation therapy, is proud to announce a new informational post ... hair therapy procedures. Follicular Unit Extraction (FUE) hair transplant and Follicular Unit Transplantation ...
(Date:2/26/2017)... ... February 25, 2017 , ... The February 13, 2017, assassination of ... concern over nerve agents and the deadly use of chemical weapons. Many questions exist ... how even small doses can be lethal. , Jay Jagannathan, M.D., of Michigan-based Jagannathan ...
Breaking Medicine News(10 mins):
(Date:2/27/2017)... A recent research report published by Grand ... is expected to reach a value of $55.8 billion by 2025. ... 28 states have legalized marijuana for medical uses. In 2016, states ... , North Dakota , Ohio ... the drug in medical applications such as chemotherapies and pain management. ...
(Date:2/27/2017)... 27, 2017 Period October – December 2016 ... result amounted to SEK -16.4 (-6.4) million Result after tax ... before and after dilution Cash flow from operating activities amounted ... ... (0.4) million Operating result amounted to SEK -39.5 (-29.5) million ...
(Date:2/24/2017)... Research and Markets has announced the addition of the ... to 2025" report to their offering. ... The Global Wireless Health Market is ... next decade to reach approximately $330.5 billion by 2025. ... the given segments on global as well as regional levels presented ...
Breaking Medicine Technology: