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Patients’ and families’ perspectives of patient safety at the end of life: a video-reflexive ethnography study


Collier, A and Sorensen, R and Iedema, R, Patients' and families' perspectives of patient safety at the end of life: a video-reflexive ethnography study, International Journal for Quality in Health Care, 28, (1) pp. 66-73. ISSN 1353-4505 (2016) [Refereed Article]

Copyright Statement

© The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved

DOI: doi:10.1093/intqhc/mzv095


Objective: The aim of this study was to investigate patients’ and families’ perspectives of safety and quality in the setting of a life-limiting illness.

Design: Data reported here were generated from a qualitative study using video-reflexive ethnographic methodology. Data were collected over 18 months and generated through participant observation, shadowing of clinicians, field-interviews and semi-structured interviews with patients and families.

Setting: The study was conducted at two hospital sites in Sydney, Australia and in patients’ homes.

Participants: Patients with an advanced life-limiting illness (n = 29) ranging in age between 27 and 89 years and family members (n = 5) participated in the study.

Results: Patient safety remains important to dying patients and families. For dying people, iatrogenic harm is not regarded as ‘one off’ incidents. Rather, harm is experienced as a result of an unfolding series of negative events. Critically, iatrogenic harm is emotional, social and spiritual and not solely technical–clinical misadventure and is inextricably linked with feeling unsafe. Thus, patient safety extends beyond narrowly defined technical–clinical parameters to include interpersonal safety.

Conclusions: Current approaches to patient safety do not address fully the needs of dying patients and their families. Patients and their families regard poor communication with and by health professionals to be harmful in and of itself.

Item Details

Item Type:Refereed Article
Keywords:palliative care, end-of-life care, patient safety, adverse event, communication, patient-centred care, qualitative research
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Palliative care
UTAS Author:Iedema, R (Professor Rick Iedema)
ID Code:115236
Year Published:2016
Web of Science® Times Cited:23
Deposited By:Health Sciences
Deposited On:2017-03-10
Last Modified:2017-11-07

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