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Healthcare quality and safety: a review of policy, practice and research

机译：医疗保健质量和安全：政策，实践和研究的回顾

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摘要

Over the last two decades healthcare quality and safety have risen to the fore of health policy and research. This has largely been informed by theoretical and empirical ideas found in the fields of ergonomics and human factors. These have enabled significant advances in our understanding and management of quality and safety. However, a parallel and at time neglected sociological literature on clinical quality and safety is presented as offering additional, complementary, and at times critical insights on the problems of quality and safety. This review explores the development and contributions of both the mainstream and more sociological approaches to safety. It shows that where mainstream approaches often focus on the influence of human and local environment factors in shaping quality, a sociological perspective can deepen knowledge of the wider social, cultural and political factors that contextualise the clinical micro-system. It suggests these different perspectives can easily complement one another, offering a more developed and layered understanding of quality and safety. It also suggests that the sociological literature can bring to light important questions about the limits of the more mainstream approaches and ask critical questions about the role of social inequality, power and control in the framing of quality and safety.
机译：在过去的二十年中，医疗保健的质量和安全性已经上升到健康政策和研究的前沿。在很大程度上，这是从人体工程学和人为因素领域中发现的理论和经验思想中得出的。这些使我们对质量和安全的理解和管理取得了重大进步。但是，关于临床质量和安全性的平行且有时被忽视的社会学文献被提出来，它提供了关于质量和安全性问题的补充，补充，有时是关键的见解。这篇评论探讨了主流和更社会学的安全方法的发展和贡献。它表明，在主流方法通常将重点放在人和地方环境因素对塑造质量的影响上的情况下，社会学观点可以加深对使临床微观系统相关的更广泛的社会，文化和政治因素的认识。它表明这些不同的观点可以轻松地相互补充，从而提供了对质量和安全性的更深入和分层的理解。它还表明，社会学文献可以揭示关于更主流方法的局限性的重要问题，并可以提出有关社会不平等，权力和控制在质量和安全框架中的作用的关键问题。

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