Narrativizing errors of care: critical incident reporting in clinical practice.

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Show simple item record Iedema, R Flabouris, A Grant, S Jorm, C 2010-05-28T09:56:10Z 2006-01
dc.identifier.citation Social science & medicine (1982), 2006, 62 (1), pp. 134 - 144
dc.identifier.issn 0277-9536
dc.identifier.other C1UNSUBMIT en_US
dc.description.abstract This paper considers the rise across acute care settings in the industrialized world of techniques that encourage clinicians to record their experiences about adverse events they are personally involved in; that is, to share narratives about errors, mishaps or 'critical incidents'. The paper proposes that critical incident reporting and the 'root cause' investigations it affords, are both central to the effort to involve clinicians in managing and organizing their work, and a departure from established methods and approaches to achieve clinicians' involvement in these non-clinical domains of health care. We argue that critical incident narratives render visible details of the clinical work that have thus far only been discussed in closed, paperless meetings, and that, as narratives, they incite individuals to share personal experiences with parties previously excluded from knowledge about failure. Drawing on a study of 124 medical retrieval incident reports, the paper provides illustrations and interpretations of both the narrative and the meta-discursive dimensions of critical incident reporting. We suggest that, as a new and complex genre, critical incident reporting achieves three important objectives. First, it provides clinicians with a channel for dealing with incidents in a way that brings problems to light in a non-blaming way and that might therefore be morally satisfying and perhaps even therapeutic. Second, these narrations make available new spaces for the apprehension, identification and performance of self. Here, the incident report becomes a space where clinicians publicly perform concern about what happened. Third, incident reporting becomes the basis for radically altering the clinician-organization relationship. As a complex expression of clinical failure and its re-articulation into organizational meta-discourse, incident reporting puts doctors' selves and feelings at risk not just within the relative safety of personal or intra-professional relationships, but also in the normative context of organizational coordination, accountability, planning and management.
dc.format Print-Electronic
dc.language eng
dc.relation.isbasedon 10.1016/j.socscimed.2005.05.013
dc.title Narrativizing errors of care: critical incident reporting in clinical practice.
dc.type Journal Article
dc.parent Social science & medicine (1982)
dc.journal.volume 1
dc.journal.volume 62
dc.journal.number 1 en_US
dc.publocation Oxford, UK en_US
dc.identifier.startpage 134 en_US
dc.identifier.endpage 144 en_US FASS.Faculty of Arts and Social Sciences en_US
dc.conference Verified OK en_US
dc.for 2001 Communication and Media Studies
dc.personcode 100638
dc.personcode 102618
dc.percentage 100 en_US Communication and Media Studies en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US en_US
dc.location.activity en_US
dc.location.activity England
dc.description.keywords Critical incident reporting; Adverse event; Narrative; Acute care; Discourse genre; Self identity en_US
dc.description.keywords Critical incident reporting
dc.description.keywords Adverse event
dc.description.keywords Narrative
dc.description.keywords Acute care
dc.description.keywords Discourse genre
dc.description.keywords Self identity
dc.description.keywords Conflict (Psychology)
dc.description.keywords Critical Care
dc.description.keywords Hospital-Physician Relations
dc.description.keywords Hospitals
dc.description.keywords Humans
dc.description.keywords Iatrogenic Disease
dc.description.keywords Medical Errors
dc.description.keywords Narration
dc.description.keywords Quality Assurance, Health Care
dc.description.keywords Risk Management
dc.description.keywords Safety Management
dc.description.keywords Systems Analysis
dc.description.keywords Truth Disclosure
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Arts and Social Sciences
pubs.organisational-group /University of Technology Sydney/Faculty of Health
pubs.organisational-group /University of Technology Sydney/Strength - Research in Learning and Change
utslib.copyright.status Closed Access 2015-04-15 12:17:09.805752+10
utslib.collection.history Closed (ID: 3)

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