MEDICAL EQUIPMENTS

Medical equipments and reflective accounts, Incident of the hospital



Medical equipments and reflective accounts, Incident of the hospital

Introduction

In the 50 years since Flanagan (1954) first published the seminal piece “The critical incident technique,” the critical incident technique (CIT) has progressed through a variety of applications in many different settings. CIT was originally designed to develop procedures for use in the selection and classification of aircrew personnel in the US Air Force. CIT has been used since that original application for selection and classification of employees in many other settings.

Many researchers have used CIT to investigate various organizational phenomena. Only recently have researchers begun using CIT to investigate culture and some of these studies have been conducted in healthcare organizations. Earlier studies, such as one by Gundry and Rousseau (1994) used CIT to surface newcomer perceptions of behavioral norms in electronics manufacturers; they found team norms to be negatively related to role conflict and positively related to role clarity. Edvardsson and Strandvik (2000) studied CIT in examining customer relationships in a hotel setting and identified the value of putting critical service incidents in context - both internally and externally. Longo et al. (1993) used CIT to identify “standards of excellence” in hospital services, as defined by patients, physicians, hospital employees, and payers.

Their findings produced the most incidents in the categories of “administrative policy” issues and “nurturing” incidents. Brant (1992) applied CIT to assess patient satisfaction. She noted the value of the technique in order to properly define quality from the patient's perspective. Her position was that the critical incident analysis was essential to quality healthcare delivery and the development of patient-centered approaches to care. Kemppainen (2000) used CIT to identify dimensions of nursing care quality; her findings focused primarily on how to use CIT in a nursing setting rather than sharing the actual results of nursing care quality dimensions.

A 'patient safety' agenda is now well established in countries such as Australia, the US and the UK (Department of Health, 2000; Institute of Medicine, 2009; Wollf & Bourke, 2000). In the NHS, health policies have adopted the principles and practices of error management that have been successfully utilised in other industries, such as aviation or nuclear energy (Department of Health (2000) and Department of Health (2001); Reason & Hobbs, 2003). Here the theories of cognitive and social psychology, ergonomics and 'human factors' have combined to produce a new orthodoxy of error management (Reason, 2007). From this perspective threats to safety are elaborated along two dimensions.

The first recognises the individual component where cognitive lapses or aberrations lead to active errors. The second emphasises the latent factors that enable or exacerbate human error within organisational systems (Reason, 2007). Human behaviour is regarded as inherently error-prone but importantly these errors are facilitated or amplified by actions, decisions, and plans made elsewhere, or 'upstream' within the system.

Drawing from this theoretical background and with specific focus on the medical profession, this paper aims to explore the cultural attitudes and barriers to incident reporting in ...