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Qual Saf Health Care 2008;17:158-162 doi:10.1136/qshc.2007.023630
  • Developing research and practice

An epistemology of patient safety research: a framework for study design and interpretation. Part 1. Conceptualising and developing interventions

  1. C Brown1,
  2. T Hofer2,
  3. A Johal1,
  4. R Thomson3,4,
  5. J Nicholl5,
  6. B D Franklin6,
  7. R J Lilford1
  1. 1
    Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
  2. 2
    University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3
    National Patient Safety Agency, London, UK
  4. 4
    Newcastle upon Tyne Medical School, Newcastle upon Tyne, UK
  5. 5
    University of Sheffield, Sheffield, UK
  6. 6
    London School of Pharmacy, London, UK
  1. Dr C Brown, Research Methodology Programme, Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; c.a.brown{at}bham.ac.uk
  • Accepted 18 January 2008

Abstract

This is the first of a four-part series of articles examining the epistemology of patient safety research. Parts 2 and 3 will describe different study designs and methods of measuring outcomes in the evaluation of patient safety interventions, before Part 4 suggests that “one size does not fit all”. Part 1 sets the scene by defining patient safety research as a challenging form of service delivery and organisational research that has to deal (although not exclusively) with some very rare events. It then considers two inter-related ideas: a causal chain that can be used to identify where in an organisation’s structure and/or processes an intervention may impact; and the need for preimplementation evaluation of proposed interventions. Finally, the paper outlines the authors’ pragmatist ontological stance to patient safety research, which sets the philosophical basis for the remaining three articles.

Footnotes

  • See Editorial, p 154

  • Competing interests: None.

  • Authors’ contributions: RL conceived the Network and formulated the first draft of the report and the current paper with assistance from AJ. CB contributed to subsequent drafts of the report and this paper. BDF, TH, RT and JN contributed to the Research Network and provided comments on drafts of the report and papers in their areas of expertise.

  • This work forms part of the output of a Cross-Council Research Network in Patient Safety Research funded by the Medical Research Council (Reference G0300370). More details of the Research Network can be found at: http://www.pcpoh.bham.ac.uk/publichealth/psrp/MRC.htm

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