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Titolo:
Clinical risk and collective competence in the hospital emergency department in the UK
Autore:
Boreham, NC; Shea, CE; Mackway-Jones, K;
Indirizzi:
Univ Manchester, Human Factors Res Grp, Fac Educ, Manchester M13 9PL, Lancs, England Univ Manchester Manchester Lancs England M13 9PL M13 9PL, Lancs, England Cent Manchester Hlth Care NHS Trust, Dept Emergency Med, Manchester Royal Infirm, Manchester M13 9WL, Lancs, England Cent Manchester Hlth Care NHS Trust Manchester Lancs England M13 9WL land
Titolo Testata:
SOCIAL SCIENCE & MEDICINE
fascicolo: 1, volume: 51, anno: 2000,
pagine: 83 - 91
SICI:
0277-9536(200007)51:1<83:CRACCI>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
WORK; DOCTORS;
Keywords:
emergency medicine; clinical risk; critical incident technique; professions; division of labour; UK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Boreham, NC Univ Manchester, Human Factors Res Grp, Fac Educ, Manchester M13 9PL, Lancs, England Univ Manchester Manchester Lancs England M13 9PL ncs, England
Citazione:
N.C. Boreham et al., "Clinical risk and collective competence in the hospital emergency department in the UK", SOCIAL SC M, 51(1), 2000, pp. 83-91

Abstract

The hospital emergency department (ED) is a risky environment, often subject to litigation for negligence. Risk is defined as an avoidable increase in the probability of an adverse outcome for a patient. With the aim of identifying the sources of risk, this study carried out participant observationand collected critical incidents in two EDs in the UK for a period of 30 months. Active failures included delay in beginning investigations or treatment, failure to obtain diagnostic information, misinterpretation of diagnostic information and the administration of inappropriate treatment. Three latent conditions underlay these failures: patients' unrestricted access to the ED, cognitive errors by individual members of staff and a strict horizontal and vertical division of labour. An analysis of the incidents resultingfrom the third latent condition identified a contradiction between the division of labour and working conditions in the ED. The paradigm circumstances under which this contradiction can result in active failures are described. The management of risks arising in this way could be improved by developing a workplace culture in which 'sapiential authority' - authority derivedfrom experience, special access to information or being at hand in an emergency - is recognised in addition to authority derived from a formal status: However, as long the contradictions between the division of labour and working conditions remain, accidents should be considered normal events. (C) 2000 Elsevier Science Ltd. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 21:20:50