Models of Patient Safety and Critique

The previous chapters focused on the growth of quality management within healthcare, its relationship to performance management and its impact on the provision of care. This chapter examines patient safety as a dimension of the quality of care and the related role of managerialism in shaping safety-related agendas. The chapter begins by exploring two related topics: (1) the factors that gave rise to patient safety as a key dimension of the quality of care and (2) the concomitant development of models and frameworks which were created to schematise and manage it. Next, it investigates the limitations that are characteristic of these patient safety models, together with the potential unintended consequences which can arise from their adoption. In this context, a special focus is placed on the managerialist assumptions that underpin mainstream thinking on patient safety and support the questionable hegemony of systems perspectives within the contemporary patient safety literature.