Source: BMJ Quality & Safety [Epub ahead of print]
Date of publication: February 2016
Publication type: Journal article
In a nutshell: Healthcare worldwide is faced with a crisis of patient safety. Notwithstanding occasional successes in relation to specific harms, safety as a system characteristic has remained elusive. The authors of this article propose that one neglected reason why the safety problem has proved so stubborn is that healthcare suffers from a pathology known in the public administration literature as the problem of many hands. It is a problem that arises in contexts where multiple actors—organisations, individuals, groups—each contribute to effects seen at system level, but it remains difficult to hold any single actor responsible for these effects. This paper calls for recognition of the problem of many hands and for attention to be given to how it might most optimally be addressed in a healthcare context.
Length of publication: 5 pages
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