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Patients Safety in cancer care from a systems perspective
KTH Royal Institute of Technology.ORCID iD: 0000-0002-4108-391X
KTH Royal Institute of Technology.
2012 (English)In: The 2nd Nordic Conference in Patient Safety and Healthcare: Book of Abstracts / [ed] Anne Hjøllund Christiansen, Henning Boje Andersen, Knut Borch-Johnsen, Technical University of Denmark , 2012, p. 76-77Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

It has long been an accepted knowledge that structural issues are important for patient safety. The organization of cancer care is divided into many specialties, clinics and levels of care, making patients particularly vulnerable to medical mishaps. It is clear that practitioners at "the sharp end" (physicians, nurses, technicians, pharmacists and others) have to cope with a complex, rapidly changing care, highly advanced technology and potent treatment, and in particular, with the “gaps” of discontinuities, that complexity spawns. 

One question that needs to be addressed in relation to this complexity is whether existing laws, rules and guidelines regulating cancer care cover issues of responsibility sufficiently throughout the entire continuum of care. Another one is to what extent professionals at “the sharp end” have the opportunity to follow guidelines for patient safety. 

Gaps often occur between different organizations or health-care providers, or when responsibility is transferred within an organization. However, it is through an increased understanding of practitioners' normal ability to bridge gaps that safety is increased. 

We know little about how practitioners identify and bridge gaps that occur within the cancer-care continuum, from the patients´ first visit to their general practitioner, through hospital care and transmission to advanced home care. Therefore, the aim of this ongoing study is to perform an exploration of gaps in the cancer-care continuum and the way practitioners anticipate, detect and bridge them, as a means of pursuing robust improvements in patient safety. 

Methods and materials 

Twelve qualitative interviews (individual or in group) were performed with healthcare professionals working with various healthcare providers in cancer care in three county councils in central Sweden. The participants were managers, administrators, secretaries, medical doctors, general practitioners, district nurses or nurses in patient care, palliative care or advanced home care. A total of 28 persons were interviewed. The participants were instructed to describe situations when they managed to avoid risks of medical injury, or situations where they failed to prevent human errors. The interviews were transcribed verbatim and analyzed using a qualitative latent and manifest content analysis method. 

Preliminary results 

This study is currently under analysis and final results are planned to be presented and discussed at the meeting. This study will contribute to the discussion with some patterns of the complexities and hazards in cancer care that practitioners at the sharp end have identified. 

Preliminary findings deal with issues of communication deficits within the organization and between different levels of care, unclear guidance and lack of knowledge among practitioners, technical challenges and lack of resources, hierarchies and attitudes that impede patient safety; and the fact that cancer patients often face a variety of actors in a complicated chain of care, without someone taking a clear and collective responsibility for their care. 

Place, publisher, year, edition, pages
Technical University of Denmark , 2012. p. 76-77
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-62890ISBN: 978-87-92706-43-0 (print)OAI: oai:DiVA.org:lnu-62890DiVA, id: diva2:1095057
Conference
The 2nd Nordic Conference in Patient Safety and Healthcare, 2012, March 6-7, Copenhagen, Denmark
Available from: 2014-10-16 Created: 2017-05-11 Last updated: 2018-05-17Bibliographically approved

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Ekstedt, Mirjam

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