In their recent editorial Mannion and Braithwaite provide an insightful critique of traditional patient safety improvement efforts, and offer a powerful alternative vision based on Safety-II thinking that has the potential to radically transform the way we approach patient safety. In this commentary, I explore how the Safety-II perspective points to new directions for organisational learning in...

evaluating the investment that healthcare organisations make in quality improvement requires knowledge of impact at multiple levels, including patient care, workforce and other organisational resources. the degree to which these resources help organisations to survive and thrive in the challenging contexts in which healthcare is designed and delivered is unknown. investigating this question fro...

Evaluating the investment that healthcare organisations make in quality improvement requires knowledge of impact at multiple levels, including patient care, workforce and other organisational resources. The degree to which these resources help organisations to survive and thrive in the challenging contexts in which healthcare is designed and delivered is unknown. Investigating this question fro...

In their recent editorial Mannion and Braithwaite provide an insightful critique of traditional patient safety improvement efforts, and offer a powerful alternative vision based on Safety-II thinking that has the potential to radically transform the way we approach patient safety. In this commentary, I explore how the Safety-II perspective points to new directions for organisational learning in...

PURPOSE The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work. DESIGN/METHODOLOGY/APPROACH Primary healthcare centre (n = 1,031) and clinical hospital department (n = 1,542) managers were surveyed in spring 2007 (response rate 46 per cent). This article compares results from this survey with a study in 2003...

BACKGROUND Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applyin...

Healthcare institutions continue to face challenges in providing safe patient care in increasingly complex organisational and regulatory environments while striving to maintain financial viability. The clinical microsystem provides a conceptual and practical framework for approaching organisational learning and delivery of care. Tensions exist between the conceptual theory and the daily practic...

Following the Public Enquiry into avoidable deaths and poor standards of care at Mid Staffordshire NHS Foundation Trust, the English National Health Service (NHS) is aiming to become a system devoted to continual learning and improvement of patient care. The paper aims to explore current perceptions of healthcare staff towards reporting and organisational learning for improving patient safety. ...

In their valuable discussion of whistleblowing in healthcare organisations, Mannion and Davies highlight the importance of organisational culture in influencing whether people raise concerns, and whether these concerns are listened to and acted upon. The role of leadership in shaping organisational culture is well-established1 and in this commentary, we will examine the influence of leaders in ...