Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care

Boiko, Olga, Sheaff, Rod, Child, Susan and Gericke, Christian A. (2014) Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care. Sociology of Health and Illness, 36 6: 932-947. doi:10.1111/1467-9566.12127


Author Boiko, Olga
Sheaff, Rod
Child, Susan
Gericke, Christian A.
Title Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care
Journal name Sociology of Health and Illness   Check publisher's open access policy
ISSN 0141-9889
1467-9566
Publication date 2014-07
Year available 2014
Sub-type Article (original research)
DOI 10.1111/1467-9566.12127
Open Access Status
Volume 36
Issue 6
Start page 932
End page 947
Total pages 16
Place of publication Chichester, West Sussex, England
Publisher Wiley-Blackwell Publishing
Collection year 2015
Language eng
Abstract Drawing on wider sociologies of risk, this article examines the complexity of clinical risks and their management, focusing on risk management systems, expert decision-making and safety standards in health care. At the time of this study preventing venous thromboembolism (VTE) among in-patients was one of the top priorities for hospital safety in the English National Health Service (NHS). An analysis of 50 interviews examining hospital professionals' perceptions about VTE risks and prophylaxis illuminates how National Institute for Health and Clinical Excellence (NICE) guidelines influenced clinical decision-making in four hospitals in one NHS region. We examine four themes: the identification of new risks, the institutionalisation and management of risk, the relationship between risk and danger and the tensions between risk management systems and expert decision-making. The implementation of NICE guidelines for VTE prevention extended managerial control over risk management but some irreducible clinical dangers remained that were beyond the scope of the new VTE risk management systems. Linking sociologies of risk with the realities of hospital risk management reveals the capacity of these theories to illuminate both the possibilities and the limits of managerialism in health care.
Keyword Risk theory
Venous thromboembolism
Hospital decision-making
Clinical guidelines
Risk management
NHS
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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