A transactional approach to patient safety: understanding safe care as a collaborative accomplishment. Issue 4 (4th July 2021)

• Record Type: Journal Article
• Authors: Pedersen, Kirstine Z.; Mesman, Jessica
• Is Part Of: Journal of interprofessional care. Volume 35:Issue 4(2021)
• Page Start: 503
• Page End: 513
• Publication Date: 2021-07-04
• Subjects: Transaction -- patient safety -- systems approach -- video-reflexive ethnography -- collaborative practices -- pragmatism; Holistic medicine -- Periodicals; Interprofessional relations -- Periodicals; Health care teams -- Periodicals; 361
• DOI: 10.1080/13561820.2021.1874317
• Languages: English
• ISSNs: 1356-1820

Abstract

ABSTRACT: Within the last two decades, it has been commonly agreed that patient safety and error management in healthcare organizations can best be attained by adopting a systems approach via re-engineering efforts and the introduction of industrial safety technologies and methodologies. This strategy has not delivered the expected result. Based on John Dewey's pragmatism, we propose another vocabulary for understanding, inquiring into and learning from safety situations in healthcare. Drawing especially on Dewey's understanding of transaction as the inseparability between human and environment, we develop an analytical approach to patient safety understood as a transactional accomplishment thoroughly dependent on the quality of situated and shared habits and collaborative practices in healthcare. We further illustrate methodologically how a transactional attitude can be situationally practised through video-reflexive ethnography, a method that allows for inquiry into mundane safety practices by letting interprofessional teams see, reflect upon and possibly modify their shared practices and safety habits.