Analysing the “field” of patient safety employing Bourdieusian technologies

Abstract

This paper aims to analyse the development of patient safety as a field within which patients are peripheral stakeholders. The authors examined the patient safety movement from the perspective of a field in which agents struggle for control over various forms of capital, including economic, social, cultural and symbolic capital. In order to undertake this analysis the authors drew on the literature on errors and patient safety, key inquiries into patient safety, and research conducted with health professionals in New South Wales, Australia. The patient safety movement has created a heightened sense of awareness of errors and risk across health systems, thereby attracting and creating significant amounts of capital. The authors argue that in the process of struggle to constitute and contain a new field of health, patients and their narratives are rendered vulnerable to appropriation and incorporation. By considering patient safety from a sociological rather than a technical framework, it is possible to gain new insights into why reducing the levels of medical errors have proven so difficult. Improved knowledge of how patient safety operates as a field may contribute to more effective strategies in reducing those types of errors. Despite the growth in the number of publications in patient safety there has been only minimal analysis of the field itself, rather than its technical or organisational components. This paper contributes to a new way of conceptualising and enacting patient safety, one that acknowledges the vulnerability of the parties involved, particularly patients.