Sociological Reconfigurations of Patient Safety
Sociological Reconfigurations of Patient Safety
Situated Intervention as Multiple Ontologies
Sociological interventions in national improvement programs are the topic of this chapter. It deals with a sociological evaluation of a large improvement program for care of older adults. This was a patient safety quality improvement collaborative that presented a narrow definition of ‘useful’ research in which social scientists are supposed to discover the factors that support or hamper the implementation of existing policy agendas. Such definitions are unfortunate, since they undo the capacity to complexify the taken-for-granted conceptualizations of the object of study that is crucial for situated intervention research. As an alternative to this definition of ‘usefulness’, this chapter explores a focus on multiple ontologies in the making when studying patient safety. Through this focus, social scientists become involved in refiguring the problem space of patient safety, the relations between research subjects and objects, and the existing policy agendas. This role gives social scientists the opportunity to focus on which practices of ‘effective care’ and ‘participation’ are enacted through different approaches to dealing with patient safety and what their consequences are for the care practices under study. Such a focus on multiple ontologies of safety opens up new ways for intervention in quality improvement collaborative, but also points to the limitations of evaluation as intervention.
Keywords: Multiple ontologies, Multiplicity, Evaluation, Formative evaluation, Quality and safety, Patient safety, Effectiveness, Participation
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