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J Healthc Risk Manag. 2018 Oct;38(2):47-55. doi: 10.1002/jhrm.21325. Epub 2018 Jul 2.

The dilemma of patient safety work: Perceptions of hospital middle managers.

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Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.


Patient safety continues to be a challenge for health care. Medical errors are not decreasing but continue to show roughly the same patterns in Sweden and other Western countries. This interview study aims to explore how 27 hospital middle managers responsible for patient safety work in a Swedish university hospital perceive this task. A qualitative analysis was performed. A code template was created, and each code was explored in depth and summarized into six categories. We conclude that patient safety work appears to have low priority; hospital top management does not seem to have any real interest in patient safety; incidents are underreported; and the organization of patient safety work seems to be insufficient and carried out insofar as resources are available. These parameters may explain why medical errors remain on a certain level and do not seem to decrease in spite of various support programs.


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