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A knowledge transfer and sharing action for developing A new integrative approach to mitigating errors in hospitals: Resolving tensions in error research

Periodic Reporting for period 1 - Errspitals (A knowledge transfer and sharing action for developing A new integrative approach to mitigating errors in hospitals: Resolving tensions in error research)

Reporting period: 2016-01-01 to 2017-12-31

Policy makers, healthcare administrators and caregivers, and researchers in Europe and around the world generally agree that medical errors in healthcare pose a serious problem to the society at large. As a result, healthcare organizations invest a considerable amount of effort in the development and implementation of a variety of error elimination and quality improvement programs. Nevertheless, so far, there is little evidence that healthcare is becoming safer, and the system is still functioning at significantly lower safety levels than it could and should be. Why is the healthcare system still unable to achieve a breakthrough in mitigating errors? Some policy makers believe that this is a problem resulting from lack of commitment to patient safety or insufficient implementation of error elimination and quality assurance practices. We, however, suggest that either organizational goodwill or implementation difficulties is a simplistic explanation of the problem. Rather, one of the origins of the healthcare challenges is nested in current state of error research. That is, a lack of cross-fertilization between different insights from distinct approaches to errors indeed raises inconsistent views or research tensions that have yet to be reconciled. As a timely response to such a call, in this Marie Skłodowska-Curie Actions we aim to develop a new, integrative approach to mitigating medical errors and promoting quality, efficiency, and innovation in hospitals.
We conducted an integrative research on error by exploring the diffuse or tensional themes in existing research and the possible consequences of these conflicts, with a goal of potentially bridging diverse disciplinary backgrounds and methodological approaches. We performed a keyword search in databases (e.g. Business Source Complete, ISI Web of Science, PsycInfo, ProQuest, and EBSCO) and in top management, organizational behavior (OB), and applied psychology journals (according to the Web of Science Journal Citation Report, 2014). Our key research words included “error(s)”, “mistake(s)”, “latent errors”, “error taxonomy”, “error training”, “error management”, “learning from error(s)”, “error orientation”, “error culture”, “individual error(s)”, “team error(s)”, and “organizational error(s)”. We developed an integrative theory of errors in organizations by identifying discrepancies, tensional issues, and opportunities for research synthesis via level of analysis, temporal, and priority lenses.
By emphasizing the coexistence of conflicting forces and orientations, we strive to not only acknowledge the interplay between opposing forces and foci affecting error pathways in organizations, but also to suggest potential syntheses between these oppositions in an effort to stimulate integrative studies and critical dialogues. We developed a better understanding of error in hospitals and specifically identify conditions that explain why and how errors management would have a positive effect on hospital units’ efficiency, quality, and potential for innovation. Improving efficiency and quality in the error management method has the potential to save healthcare costs, improve quality, save lives, and increase technological and administrative innovation.