The context and influences of safety: An exploration of social networks, actions, and behaviour

Abstract

Background Safety systems are socio-cultural in nature, characterised by people, their relationships to one another and to the whole. This study aimed to (1) map the social networks of New Zealand’s quality improvement and safety leaders (2) illuminate influential characteristics and behaviours of key network players (3) make recommendations regarding how networks might be optimised. Methods Instrumental case study using mixed methods. Purposeful sampling was applied to collect survey data from delegates at two national safety and quality forums (n=85). Social network questions asked respondents who influenced their safety work. Key network players were identified and invited to participate in a semi structured interview (n=7). Results Key players described safety systems in humanistic terms. Safety influence was determined to be a responsive relational process. Adaptive leaders broker relationships between multiple perspectives and contexts, which is essential for safe healthcare. Conclusion Influential safety approaches appreciate the human contribution to safety. Designing the health system to adapt and respond to the needs of people, teams, and communities, rather than the unilateral needs of the system is essential. Adaptive leadership will assist in achieving these aims and will likely be embraced by New Zealand health professionals.

Continuing Professional Development through the lens of complexity science: Becoming agents of change in the healthcare system [Version 2]

“…These policies, it is argued, fail to account for the varied and often discordant perspectives of human participants within the health organization (Thomas, 1966). Other contributing factors are social (Wailling et al, 2020), cultural (Braithwaite et al, 2017), and historical (Classen et al, 2011). Woodruff suggests that we cannot solve complex problems using a reductionist paradigm because complexity exists within all layers of the healthcare system and affects the efforts of clinicians and policy makers to improve and reconcile individuals' healthcare experience, population outcomes and healthcare costs (Woodruff, 2019).…”