Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety

• Published in: The Sociology of Healthcare Safety and Quality pp. 140 - 154
• Main Author: Szymczak, Julia E
• Format: Book Chapter
• Language: English
• Published: United Kingdom John Wiley & Sons, Incorporated 2016; John Wiley & Sons, Ltd
• Subjects: Collins's theory; Goffman's microsociological emphasis; healthcare quality; hospital acquired infections; infection prevention practice; interaction ritual chains; patient safety strategies
• ISBN: 1119276349; 9781119276340
• DOI: 10.1002/9781119276371.ch9

This chapter provides a sociological examination of a behaviour that has been promoted as a technique to improve patient safety: clinicians 'speaking up' to each other and intervening in situations that might lead to harm. It focuses on lapses in practice known to prevent the transmission of hospital acquired infections (HAIs). HAIs are a common complication of hospital care and cause significant morbidity, mortality, excess cost and unnecessary suffering. The chapter provides an analysis of verbal accounts generated in interviews with clinicians wherein they reflect on past experience speaking up or not when they observed a breach in infection prevention practice. It considers Collins's theory of interaction ritual chains (IRCs) as an analytic framework. This general theoretical model combines Durkheim's emphasis on solidarity as it is produced in rituals via collective effervescence with Goffman's microsociological emphasis on face‐to‐face interaction.