It depends who you ask: divergences in staff and external stakeholder narratives about the causes of a healthcare failure

Hald, E. Julie, Gillespie, Alex ORCID: 0000-0002-0162-1269 and Reader, Tom W. (2023) It depends who you ask: divergences in staff and external stakeholder narratives about the causes of a healthcare failure. Journal of Contingencies and Crisis Management, 31 (4). 752 - 766. ISSN 1468-5973

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Abstract

Investigations of institutional failure in healthcare typically use staff narratives to identify the cultural factors contributing to the incident. But, to what extent can staff, who are embedded in the culture and who were part of the failing, reflect on and report on the culture? We investigate this by comparing 40 witness statements from staff and 53 witness statements from patients and relatives collected by a public inquiry into a major UK healthcare failure (Clostridium difficile outbreak).Through quantitative text analysis, we found that, while staff and external stakeholders both recognised problems in care, they diverged on the factors considered paramount. Staff emphasised underlying factors such as under‐resourcing and training (causal culture), while patients and relatives emphasised corrective behaviours such as communication for identifying and taking precautions against the spread of C. difficile (corrective culture). The results indicate that patients and relatives may be able to report on cultural factors that staff do not report or are unaware of, thus allowing a more complete analysis. Even in light of an institutional failure, staff may have incomplete accounts of the contributing cultural factors, with implications for learning and post incident improvement.

Item Type:	Article
Additional Information:	© 2023 The Authors
Divisions:	Psychological and Behavioural Science
Subjects:	B Philosophy. Psychology. Religion > BF Psychology H Social Sciences
Date Deposited:	30 May 2023 15:06
Last Modified:	18 Nov 2024 18:09
URI:	http://eprints.lse.ac.uk/id/eprint/119283

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