https://doi.org/10.4081/qrmh.2023.11496
A narrative journey into the borderland of patient safety: Toward an expanded, relational concept of safety
Submitted: 30 May 2023
Accepted: 24 December 2023
Published: 16 January 2024
Accepted: 24 December 2023
Abstract Views: 787
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
“Patient safety” is routinely defined in health services globally as “safety for patients against harm and risk of injury in health care.” (Danish Board of Quality in Health Care, 2022, p. 28; translated by the author). This is a standardized, broad, and general definition of what counts as safety. In this article, I argue for an expanded, relational concept of patient safety revolving around experienced patient safety. Recognizing safety as vital for all groups of patients, I follow a dialogical, critical-reflexive approach to focus on safety in a somatic hospital setting in Denmark as it is experienced by people with lived experience of mental distress. Safety in this context is often compromised, contributing to inequity in health for people with mental distress. I present and analyze the narratives of two experts by experience about their somatic hospital stay. As an analytical approach, I draw on Frank’s dialogical narrative analysis together with elements from Bakhtin’s theory of dialogue and Foucault’s theory of power/knowledge. Forefronting voices of those rarely asked and seldom heard, dialogical narrative analysis provides insight into how “patient safety” is enacted through situated negotiations of meaning in the narratives of people with lived experience. The storytellers are continuously struggling to fit in and to be seen as human beings, trying to resist public narratives on mental distress that threaten to limit their scope of action and who they can become. The discussion highlights how unintended emotional and psychosocial harm limit the benefits of patient safety for certain groups in society. In particular, shame, individualized responsibility, and internalized inferiority hinder equity in health. Building on my analysis, I suggest a collaborative, participatory approach for coproducing further knowledge through joint analysis with people with lived experience and nurses from somatic hospital wards.
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How to Cite
Lauge Andersen, Lisbeth. 2024. “A Narrative Journey into the Borderland of Patient Safety: Toward an Expanded, Relational Concept of Safety”. Qualitative Research in Medicine and Healthcare 7 (3). https://doi.org/10.4081/qrmh.2023.11496.
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