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Learning from high risk industries may not be straightforward: a qualitative study of the hierarchy of risk controls approach in healthcare

Overview of attention for article published in International Journal for Quality in Health Care, December 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#5 of 1,136)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

twitter
326 tweeters
facebook
1 Facebook page

Citations

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4 Dimensions

Readers on

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60 Mendeley
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Title
Learning from high risk industries may not be straightforward: a qualitative study of the hierarchy of risk controls approach in healthcare
Published in
International Journal for Quality in Health Care, December 2017
DOI 10.1093/intqhc/mzx163
Pubmed ID
Authors

Elisa G Liberati, Mohammad Farhad Peerally, Mary Dixon-Woods

Abstract

Though healthcare is often exhorted to learn from 'high-reliability' industries, adopting tools and techniques from those sectors may not be straightforward. We sought to examine the hierarchies of risk controls approach, used in high-risk industries to rank interventions according to supposed effectiveness in reducing risk, and widely advocated as appropriate for healthcare. Classification of risk controls proposed by clinical teams following proactive detection of hazards in their clinical systems. Classification was based on a widely used hierarchy of controls developed by the US National Institute for Occupational Safety and Health (NIOSH). A range of clinical settings in four English NHS hospitals. The four clinical teams in our study planned a total of 42 risk controls aimed at addressing safety hazards. Most (n = 35) could be classed as administrative controls, thus qualifying among the weakest type of interventions according to the HoC approach. Six risk controls qualified as 'engineering' controls, i.e. the intermediate level of the hierarchy. Only risk control qualified as 'substitution', classified as the strongest type of intervention by the HoC. Many risk controls introduced by clinical teams may cluster towards the apparently weaker end of an established hierarchy of controls. Less clear is whether the HoC approach as currently formulated is useful for the specifics of healthcare. Valuable opportunities for safety improvement may be lost if inappropriate hierarchical models are used to guide the selection of patient safety improvement interventions. Though learning from other industries may be useful, caution is needed.

Twitter Demographics

The data shown below were collected from the profiles of 326 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 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 60 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 20%
Researcher 8 13%
Student > Ph. D. Student 7 12%
Student > Postgraduate 7 12%
Unspecified 6 10%
Other 19 32%
Unknown 1 2%
Readers by discipline Count As %
Medicine and Dentistry 22 37%
Nursing and Health Professions 11 18%
Unspecified 11 18%
Engineering 5 8%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Other 8 13%
Unknown 1 2%

Attention Score in Context

This research output has an Altmetric Attention Score of 216. 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 22 February 2019.
All research outputs
#62,117
of 13,754,586 outputs
Outputs from International Journal for Quality in Health Care
#5
of 1,136 outputs
Outputs of similar age
#3,393
of 392,365 outputs
Outputs of similar age from International Journal for Quality in Health Care
#1
of 18 outputs
Altmetric has tracked 13,754,586 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 1,136 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.0. This one has done particularly well, scoring higher than 99% 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 392,365 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 99% of its contemporaries.
We're also able to compare this research output to 18 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 94% of its contemporaries.