Freeman Tim, Millar Ross, Mannion Russell, Davies Huw
Leadership, Work and Organisation, Middlesex University, UK.
Health Services Management Centre, Birmingham, UK.
Sociol Health Illn. 2016 Feb;38(2):233-51. doi: 10.1111/1467-9566.12309. Epub 2015 Aug 4.
The governance of patient safety is a challenging concern for all health systems. Yet, while the role of executive boards receives increased scrutiny, the area remains theoretically and methodologically underdeveloped. Specifically, we lack a detailed understanding of the performative aspects at play: what board members say and do to discharge their accountabilities for patient safety. This article draws on qualitative data from overt non-participant observation of four NHS hospital Foundation Trust boards in England. Applying a dramaturgical framework to explore scripting, setting, staging and performance, we found important differences between case study sites in the performative dimensions of processing and interpretation of infection control data. We detail the practices associated with these differences--the legitimation of current performance, the querying of data classification, and the naming and shaming of executives--to consider their implications.
患者安全管理是所有医疗系统面临的一个具有挑战性的问题。然而，尽管执行委员会的作用受到了越来越多的审查，但该领域在理论和方法上仍未得到充分发展。具体而言，我们对其中发挥作用的实践方面缺乏详细了解：董事会成员为履行其对患者安全的责任而说了什么和做了什么。本文借鉴了对英格兰四个国民保健服务医院基金会信托董事会进行公开非参与式观察的定性数据。应用戏剧化框架来探索脚本、场景、舞台布置和表演，我们发现在感染控制数据的处理和解释的实践维度上，案例研究地点之间存在重要差异。我们详细阐述了与这些差异相关的做法——当前绩效的合法化、数据分类的质疑以及对管理人员的点名批评——以考虑其影响。
