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A qualitative study of speaking out about patient safety concerns in intensive care units

Overview of attention for article published in Social Science & Medicine, November 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

twitter
268 tweeters
facebook
2 Facebook pages

Citations

dimensions_citation
19 Dimensions

Readers on

mendeley
100 Mendeley
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Title
A qualitative study of speaking out about patient safety concerns in intensive care units
Published in
Social Science & Medicine, November 2017
DOI 10.1016/j.socscimed.2017.09.036
Pubmed ID
Authors

Carolyn Tarrant, Myles Leslie, Julian Bion, Mary Dixon-Woods

Abstract

Much policy focus has been afforded to the role of "whistleblowers" in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 h of ethnographic observation and 98 interviews across 19 English intensive care units (ICUs), we studied how personnel gave voice to concerns about patient safety or poor practice. We observed much low-level social control occurring as part of day-to-day functioning on the wards, with challenges and sanctions routinely used in an effort to prevent or address mistakes and norm violations. Pre-emptions were used to intervene when patients were at immediate risk, and included strategies such as gentle reminders, use of humour, and sharp words. Corrective interventions included education and evidence-based arguments, while sanctions that were applied when it appeared that a breach of safety had occurred included "quiet words", bantering, public exposure or humiliation, scoldings and brutal reprimands. These forms of social control generally functioned effectively to maintain safe practice. But they were not consistently effective, and sometimes risked reinforcing norms and idiosyncratic behaviours that were not necessarily aligned with goals of patient safety and high-quality healthcare. Further, making challenges across professional boundaries or hierarchies was sometimes problematic. Our findings suggest that an emphasis on formal reporting or communication training as the solution to giving voice to safety concerns is simplistic; a more sophisticated understanding of social control is needed.

Twitter Demographics

The data shown below were collected from the profiles of 268 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 100 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 100 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 18%
Researcher 13 13%
Student > Ph. D. Student 13 13%
Student > Bachelor 11 11%
Other 8 8%
Other 21 21%
Unknown 16 16%
Readers by discipline Count As %
Nursing and Health Professions 22 22%
Medicine and Dentistry 21 21%
Psychology 10 10%
Social Sciences 8 8%
Agricultural and Biological Sciences 4 4%
Other 12 12%
Unknown 23 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 162. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 October 2019.
All research outputs
#122,990
of 16,040,711 outputs
Outputs from Social Science & Medicine
#110
of 9,212 outputs
Outputs of similar age
#4,206
of 279,830 outputs
Outputs of similar age from Social Science & Medicine
#3
of 134 outputs
Altmetric has tracked 16,040,711 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 9,212 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.1. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 279,830 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 134 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.