title: Historical investigations: risk management in a New Zealand hospital 1888-1904.
abstract: This article reports an historical research project in which four events within one hospital are examined from the point of view of what, today, would be termed 'risk management'. The examples involve a nurse sustaining injury in the course of her work, a fire in the hospital and two instances of patient complaints--one concerning nursing care and the other relating to a time lag between admission to hospital and receiving medical attention. All would have their counterparts in situations dealt with by today's Risk Management Departments. Analysis of the processes followed in investigating these occurrences reveals what seem to be two major differences when compared to present day practices. As well as being smaller in scale and less bureaucratic the earlier investigations were based on a culture of blame. It is argued that modern risk management approaches rather than being geared toward apportioning blame are more focused on understanding what can be learned from the incident with respect to preventing recurrence.
authors.affiliation: Emergency Department, Taranaki Base Hospital, New Plymouth.
authors.forename: Anne
authors.initials: A
authors.lastname: Smillie
mesh_terms: D000062:Accidents, Occupational; D005390:Fires / Q000266:history; D049672:History, 19th Century; D049673:History, 20th Century; D006761:Hospitals / Q000266:history*; D006801:Humans; D009520:New Zealand; D009741:Nursing Staff, Hospital / Q000266:history; D010344:Patient Advocacy / Q000266:history; D011787:Quality of Health Care / Q000266:history; D012308:Risk Management / Q000266:history*; D014850:Waiting Lists