Martin Graham, Pralat Robert, Waring Justin, Peerally Mohammad Farhad, Lamont Tara
Director of Research, THIS Institute, University of Cambridge, Cambridge, UK.
Research Associate, THIS Institute, University of Cambridge, Cambridge, UK.
J Health Serv Res Policy. 2025 Jan;30(1):40-51. doi: 10.1177/13558196241268441. Epub 2024 Aug 2.
While safety-dedicated professional roles are common in other high-risk industries, in health care they have tended to have a relatively narrow, technical focus. We present initial findings from a mixed-methods evaluation of a novel, senior role with responsibility for leadership of safety in English National Health Service organisations: the patient safety specialist. We conducted interviews with those responsible for designing, developing and overseeing the introduction of the role. We also carried out a national survey of current patient safety specialists. Data collection and analysis focused on the rationale for the role, its theory of change, and experiences of putting the theory into practice. Interview participants articulated a clear theory of change for the role, highlighting ways in which the focus of the role, the seniority, responsibility and influence of role holders, and the expertise they brought might result in better safety management and speedier implementation of initiatives to manage risk and improve safety. Survey respondents had mixed experiences of the role to date, particularly in terms of material and symbolic support from their organisations. Together, findings from the two datasets indicated the need for a careful balance between strategic and operational activities to secure impact for patient safety specialists while ensuring they were embedded in the realities of clinical work as done-a balance that not all role holders found easy to achieve. The vision for the patient safety specialist role is clear, and supported by a plausible account of how the work of role holders might result in the intended objectives. The degree to which specialists are supported and resourced to deliver on these ambitions, however, varies markedly across organisations.
虽然安全专职专业角色在其他高风险行业很常见，但在医疗保健领域，它们往往具有相对狭隘的技术重点。我们展示了对英国国家医疗服务体系（NHS）组织中一个负责安全领导的新的高级角色——患者安全专家进行的混合方法评估的初步结果。我们采访了负责设计、开发和监督该角色引入的人员。我们还对现任患者安全专家进行了全国性调查。数据收集和分析集中在该角色的基本原理、变革理论以及将理论付诸实践的经验上。访谈参与者阐明了该角色明确的变革理论，强调了该角色的重点、角色持有者的资历、责任和影响力以及他们所具备的专业知识可能带来更好的安全管理，并更快地实施管理风险和改善安全的举措的方式。到目前为止，调查受访者对该角色的体验参差不齐，尤其是在组织给予的物质和象征性支持方面。两个数据集的结果共同表明，需要在战略和运营活动之间谨慎平衡，以确保患者安全专家产生影响，同时确保他们融入临床工作的实际情况——并非所有角色持有者都能轻松实现这种平衡。患者安全专家角色的愿景是明确的，并且有一个合理的解释说明角色持有者的工作如何可能实现预期目标。然而，各组织在支持专家并为其提供资源以实现这些抱负方面的程度差异显著。
