a b s t r a c tEncouraging a sound Health, Safety and Environmental (HSE) culture is a regulatory requirement for petroleum companies operating on the Norwegian Continental Shelf. Although regulators in different industries have increasingly included safety culture in their regulatory repertory, it is still rare that regulators explicitly require sound cultures. In this paper we study how the requirement is 'translated' in two different petroleum companies, discuss why the translations differ and the extent to which they represent good organizational learning about HSE. Translation is seen as a form of organizational learning. The analysis is based on institutional theory, and a virus metaphor for adoption of organizational ideas.The translations of §15 in the two companies differ considerably. There are also signs of translatory 'mutation' or drift from the original intentions behind the requirement. The different translations are explained by differences in histories, complexity and strategy between the companies.The study illustrates the applicability of the translation concept for analyzing organizational learning for safety and the usefulness of a virus metaphor for evaluating learning processes.
BackgroundPatient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories.MethodsA qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel.ResultsThe LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers.ConclusionsAs a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.
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