Working With Evidence For Literature And Academic Narratives

Sense-making and Co-production of Safety in Primary Health Care

Establishing a safer environment for both the health and those undergoing treatments has always been the goal for most individuals, societies, government and particularly those working in health organizations. Primary health care goes beyond the hospital settings; it makes a universal health care available for humans, communities, and families. Ideally, since a society may not experience several forms of harm facing their lives, safety is paramount.  According to the research done on how the patients conceptualize the idea of safety, it has been found out that majority of individuals discern safety as that which is multi-dimensional, fluid, contingent or negotiated. This, therefore, offers a different definition to what health professionals know and therefore need to draw the boundary concerning what safety is and what is necessary to make some sense in the health sector and make primary health an assignment for all (Fulton & Lyon, 2005). When this is harmonized, one script concerning human safety and upholding society would be read. This is a qualitative study explaining the patients’ perspective of primary health care and the people’s conceptualization of it.

Sense-making is a mirror or rather a lens that enables viewing of learned behaviours towards the safety of the patients (Horton?Deutsch & Sherwood, 2008). Co- production of safety is a two-way avenue where the patients have a role to play towards their safety and also the professionals’ way which creates an enabling environment whereby the safety of everyone is considered. It is one of the processes where people explore and enact their surroundings, what to do and what not to do to promote the development of a human-friendly environment. Without understanding the environment, it would be difficult for people to interact with their environment and distinguish between those things that promote human health and those that lead to the deterioration of community health as a whole. The implications of sense- making on humans is insurmountable, besides making people understand who they are and preventing humans from common harms in the environment that are detrimental to their health, it creates a clear picture of the world. Those who spent time in hospitals and those who are in primary health care systems can understand their environments and make informed decisions on safety. For patients to understand their environment, health professionals should play their role in letting the people know what constitutes harm and what is safe (Weiss et al., 2015)

Research Problem

The research problem in the article is to undertake an analysis concerning the manner in which people manage to make sense of their daily encounters or involvements on essential health care in addition to the way the process reshapes as well as shapes the conceptualisation of safety. Moreover, it seeks to understand the degree to which it resonated with the findings on how hospital patients participate in a sense making process and the co-production of safety (Dakar-White et al., 2016). The research is quite relevant in that it raises the question that leads to understanding the way people understand safety and harm; this leads to the endorsement of better methods of dealing with harm. The role played by the health professionals in the society to develop a mutualistic and co-productive safety is also addressed. 

The method applied during the research encompasses recruitment of participants from the Northwest of England; the participants are varied in education, age, career status ethnic background and socio-economic levels. People with multiple long-term conditions are over-sampled deliberately with a perception that they are much vulnerable to safety incidences. Twenty-four women and fourteen men were all interviewed for between thirty minutes to two hours at their homes. The interview process and questions were all done by one person. Fifteen individuals were recruited based on their practice, and the remaining by snowballing. Averagely, the majority of all the participants who took part had at least visited the GP five times. In such a way, twenty-five respondents more or one long-term condition, the result indicated that twelve had more than one condition. The interviews were recorded through audio and transcribed. The questions asked were general; patients were not asked specific questions for example what they know about safety and the possible harm. Some of the issues which came up from the interrogations included the doctor’s manner of handling patients, accessibility, safety and quality of the process (Mantzoukas, 2008). The transcribed information from the various patients was hidden using unique identifiers so as to protect the identities of the interviewees who were identified as either male or female. Fundamentally, transcripts were inserted specifically into functional NVivo10 qualitative data package application software; and analyzed iteratively and thematically, drawing on beached theory procedures that are reliable in generating open codes that were persistently likened across cases (Rhodes et al., 2016).

As opposed to the literature and academic narratives portraying safety under the primary care as focusing on maintaining and designing safer systems, the findings from the patients was somewhat different. The initial attempt to ask the patients what they knew or understood concerning primary health care depicted them as being unsure of it thus rendering them to throw the question back to the interviewer (German, 2014). Nonetheless, many responses were kind of suggestive that the work made sense of the idea that they had not given a thought about its depth previously. The first perceptions were frequently about threats or risks caused by either other features or patients on the physical environs like dangerous staircases and sharp objects in the rooms. Furthermore, the findings were in unison with the previous participants’ perspective that the safety in primary care comprises of physical dimensions as well as the psychosocial perspectives (Rogers et al., 2014).  Evidently, the Psycho-social welfare or safety is principally forms a relational thought that is generated both from individuals expectations on the means an impending relationship could disclose and the collaboration that exists within the re-counting relationship that may confound or underpin expectations. The majority of the contributors in the research, for instance, elaborated a need for medical physicians and health care-givers to take time in a setting of patient weakness.

Methodology

From the study, the accounts of Patients suggested that what they think could make them safe is entirely poles apart from the aspects that emphasize the attention of the clinicians as well as policy makers. To them, safety is not just something readily available in the outside environment, codified and measured by the guidelines. It is an active product of collaboration between people and amid people and their surroundings (Ong et al., 2014). Safety was comprehended as one of the contestable, contingent, fluid, and open accomplishment. Ideally, several patients saw it simpler to make on familiarity when giving meaning to safety as opposed to conceptualizing and articulating it in nonconcrete or abstract form. Furthermore, when interviewed some partakers articulated and reflected on the aspects such as approachability, which deemed critical in a manner that they make them feel safer.

Conclusion

Safety is a basic requirement in human life.  As opposed to the patients in the hospitals, primary care patients prevent themselves from harm by taking the necessary protection measures. However, for co-productivity, health professionals need to take a bigger step in creating awareness to all primary care patients. Most of the harm occur primarily due lack of understanding of some concepts present in the environment. Although the patients and the professionals’ views are likely to coincide, obtaining the views of patients is necessary to have time and space to be reflected. In the absence of proper mechanisms, patients will always continue to apply strategies that try to avoid harm but exposes them to serious risks. This may not only affect the entire population but may result in the emergence of serious health complications to those affected. United minds are therefore needed in the production of safety.  

References

Dakar-White, G., & Sanders, C. (2016). Sense making and the co-production of safety: a qualitative study of primary medical care patients Penny Rhodes, Ruth McDonald, Stephen Campbell. The Sociology of Healthcare Safety and Quality, 39.

Fulton, J., & Lyon, B. (2005). The need for some sense making: Doctor of nursing practice. Online Journal of Issues in Nursing, 10(3).

German, J. (2014). Second opinion: an introduction to health sociology| NOVA. The University of Newcastle’s Digital Repository.

Horton?Deutsch & Sherwood, G. (2008). Reflection: an educational strategy to develop emotionally?competent nurse leaders. Journal of Nursing Management, 16(8), 946-954.

Mantzoukas, S. (2008). A review of evidence?based practice, nursing research and reflection: levelling the hierarchy. Journal of clinical nursing, 17(2), 214-223.

Ong, B. N., Rogers, A., Kennedy, A., Bower, P., Sanders, T., Morden, A., & Stevenson, F. (2014). Behaviour change and social blinkers? The role of sociology in trials of self?management behaviour in chronic conditions. Sociology of health & illness, 36(2), 226-238.

Rhodes, P., McDonald, R., Campbell, S., Dakar?White, G., & Sanders, C. (2016). Sense making and the co?production of safety: a qualitative study of primary medical care patients. Sociology of health & illness, 38(2), 270-285.

Rogers, A., & Pilgrim, D. (2014). A sociology of mental health and illness. McGraw-Hill Education (UK).

Weiss, G. L., & Lindquist, L. E. (2015). Sociology of health, healing, and illness. Rutledge.

White, K. (2016). An introduction to the sociology of health and illness.