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

Waring, Justin

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Justin Waring


‘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 recognise the latent factors that threaten safety. This paper 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 semistructured interviews with specialist physicians working within one NHS District General Hospital in the English Midlands. It is shown that, rather then favouring a '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)organised. This line of thinking serves to mitigate individual wrong-doing and
protect professional credibility by encouraging doctors to accept and accommodate the shortcomings of the system, rather than participate in new forms of organisational learning.

Journal Article Type Article
Deposit Date Jan 10, 2008
Journal Health
Print ISSN 1949-4998
Electronic ISSN 1363-4593
Publisher Scientific Research Publishing
Peer Reviewed Peer Reviewed
Volume 11
Issue 1
Keywords Patient safety, medical culture, discursive regimes, systems thinking
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