title: Healthcare quality and safety: a review of policy, practice and research.
abstract: 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.
authors.affiliation: Nottingham University Business School, University of Nottingham, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Waring
authors.affiliation: School of Healthcare Sciences, Cardiff University, UK.
authors.forename: Davina
authors.initials: D
authors.lastname: Allen
authors.affiliation: Australian Institute for Healthcare Innovation, Macquarie University, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
authors.affiliation: Women's Health Academic Centre, King's College London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Sandall
mesh_terms: D001291:Attitude of Health Personnel; D002985:Clinical Protocols / Q000592:standards; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D061214:Patient Safety; D057766:Policy; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D012449:Safety; D017751:Safety Management / Q000458:organization & administration; D012962:Sociology, Medical / Q000458:organization & administration*
keywords: human factors; quality; safety; social factors; socio-cultural; sociology