Multiple Accountabilities in Incident Reporting and Management

TY - JOUR

T1 - Multiple Accountabilities in Incident Reporting and Management

AU - Hor, Su-yin

AU - Iedema, Rick

AU - Williams, Katrina

AU - White, Les

AU - Kennedy, Peter

AU - Day, Andrew S.

PY - 2010/8/1

Y1 - 2010/8/1

N2 - In this article, we examine the current and increasing emphasis on accountability and patient safety in health care, focusing on practices of incident reporting and management in New South Wales, Australia. We describe the frames of accountability associated with an incident reporting system, and explore how this system manifests in practice. In contrast to literature that situates incident reporting and local practices as oppositional, we used ethnographic methods to observe the incident management practices of clinical staff in a hospital, and found evidence to characterize this relationship differently. We found that accountability has multiple conceptualizations, and we present three findings that demonstrate how the reporting system and incident management policy are interwoven with local enactments of accountability. We suggest that systematic efforts toward improvement cannot be divorced from the local context, and emphasize the importance of local ecologies of practice in facilitating the meaningful utilization of such incident reporting systems.

AB - In this article, we examine the current and increasing emphasis on accountability and patient safety in health care, focusing on practices of incident reporting and management in New South Wales, Australia. We describe the frames of accountability associated with an incident reporting system, and explore how this system manifests in practice. In contrast to literature that situates incident reporting and local practices as oppositional, we used ethnographic methods to observe the incident management practices of clinical staff in a hospital, and found evidence to characterize this relationship differently. We found that accountability has multiple conceptualizations, and we present three findings that demonstrate how the reporting system and incident management policy are interwoven with local enactments of accountability. We suggest that systematic efforts toward improvement cannot be divorced from the local context, and emphasize the importance of local ecologies of practice in facilitating the meaningful utilization of such incident reporting systems.

U2 - 10.1177/1049732310369232

DO - 10.1177/1049732310369232

M3 - Article

SN - 1049-7323

VL - 20

SP - 1091

EP - 1100

JO - Qualitative Health Research

JF - Qualitative Health Research

IS - 8

ER -