Whereas in health care the focus of patient safety research is on the absence of safety, that is (potential) errors and mistakes, improvement of patient safety benefits also from a thorough understanding of the presence of safety. After all, considering the complexity of today’s health care we can wonder why things do not go wrong more often. How do clinicians manage to maintain an adequate level of safety despite the complexity of their tasks? If we are to understand the vigor and success of practices to establish adequate levels of safety, we need to investigate the full spectrum of safety, including the aspects that contribute to its presence! Identifying already existing – but often overlooked or forgotten – resources and competencies can be considered an act of ‘exnovation’. Exnovation foregrounds the implicit aspects of practices.
A route that facilitates exnovation is the method of ‘video-reflexivity’. Video reflexive ethnography (VRE) is a collaborative visual methodology used by researchers and/or practitioners to understand, interpret, and optimize ‘everyday’ work practices. VRE involves collecting video footage of in-situ work practices, editing of the footage, and discussing the footage during video reflexive meetings among practitioners. The outcome of this discussion acts as vital input for practice improvement. As a structural, pro-active evaluation of daily practices VRE triggers discussion, which provides renewed awareness and another perspective on daily routines. As a bottom-up approach it taps into group wisdom that results into tailor-made improvements and high motivation for implementation.
The research project Exnovation: another Perspective on Patient Safety provides training for clinicians in order to implement the method of video reflexivity as a structural feature of their practice. Since the application of VRE is not bound to health care or safety, the training method also involves other topics in health care as well as other practices such as education.
Coordinator: Jessica Mesman
The research project ties in with research conducted in the Maastricht University Science, Technology and Society Studies research programme.