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Author Szymczak, Julia E.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Philosophy & psychology ♦ Psychology ♦ Social sciences ♦ Economics ♦ Microeconomics & related topics ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Personal health & safety ♦ Incidence & prevention of disease ♦ Diseases ♦ Agriculture & related technologies ♦ Management & auxiliary services ♦ General management
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Behavior and Behavior Mechanisms ♦ Psychiatry and Psychology ♦ Technology, Industry, and Agriculture ♦ Technology and Food and Beverages ♦ Health Care Facilities, Manpower, and Services ♦ Health Care Economics and Organizations ♦ Health Services Administration ♦ Environment and Public Health ♦ Health Care ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Medicine ♦ Hospitals, Pediatric ♦ Organization & Administration ♦ Patient Safety ♦ Quality Improvement ♦ Safety Management ♦ Standards ♦ Humans ♦ Leadership ♦ Organizational Case Studies ♦ Organizational Culture ♦ United States ♦ Journal Article ♦ Research Support, Non-u.s. Gov't ♦ Research Support, U.s. Gov't, P.h.s.
Abstract To improve patient safety, hospitals have implemented interventions to change their culture. Although there is great enthusiasm for these interventions at policy and management levels, we know little about how clinicians talk about 'culture' as they do the work of quality and safety improvement. This article investigates the way talk of culture arises in situ, showing how it is a trope that can frustrate, obscure, and prevent the collective social action necessary to change practice. The findings are based on a two-year ethnographic case study of a large hospital in the United States that undertook an organization-wide safety improvement initiative. They show that culture is frequently talked about as a behavioral trait of individuals, which makes the identification of social barriers and facilitators difficult. Culture talk can also obscure uncomfortable, yet crucial social phenomena, including history, politics and inequalities in power that may contribute to unsafe care delivery. The consequences of this obscurity are (1) practices that might make care safer are not considered, and (2) responsibility for enacting safe practice is allocated to those with the least authority and capacity to mitigate risk. The article closes by discussing how talk of culture obscures the role of social context and its contribution to risk in patient safety.
Spatial Coverage United States
Description Author Affiliation: Szymczak JE ( Division of Infectious Diseases, The Children's Hospital of Philadelphia, USA)
ISSN 02779536
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2014-11-01
Publisher Place Great Britain (UK)
e-ISSN 18735347
Journal Social Science & Medicine
Volume Number 120


Source: WHO-Global Index Medicus