Evidence map›Paper›PMID 41664285›Full record

ArticleHealth care management review

Patient and clinician perspectives of high-reliability organizing in practice: A qualitative study of cancer teams.

Megan Salwei, Leigh Anne Tang, Timothy J Vogus, Matthew B Weinger, Daniel J France, Shilo Anders, Carrie Reale, Joyce Harris, Jason M Slagle, Kim M Unertl and 1 more

Abstract read
In one paragraph

Article in Health care management review. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Leigh Anne Tang
Matthew B Weinger
Daniel J France
Shilo Anders
Carrie Reale
Joyce Harris
Jason M Slagle
Kim M Unertl
Laurie L Novak

Funding

Vanderbilt Biomedical Informatics Training ProgramT15LM007450 · NLM · VANDERBILT UNIVERSITY · PI Jessica S. Ancker, Bradley A. Malin · 2002 to 2026
$19.7M
AHRQ HHS K01 HS029042AHRQ HHS K12 HS026395AHRQ HHS R18 HS026616NLM NIH HHS T15 LM007450
6 · The paper itself

Abstract

backgroundHealth care organizations have failed to replicate the performance of high-reliability organizations (HROs), systems that operate nearly error-free despite inherently complex, interdependent, and time-pressured environments. PURPOSES: We sought to better understand conditions that facilitate and inhibit HRO in health care by expanding the conceptualization of who contributes to high reliability to include patients. We also examine how cancer care teams and patients describe jointly enacting (or failing to enact) each of the five HRO principles. METHODOLOGY/APPROACH: We conducted a qualitative field study, interviewing 25 oncology clinicians from diverse roles (e.g., surgery, nursing, dentistry) (17 interviews) and eight cancer patients. Interviews were audio-recorded, transcribed, and deductively coded for barriers and facilitators to the five HRO principles.

findingsWe identified conditions that supported and hindered high-reliability cancer care. HRO principles commonly overlapped to support or hinder system resilience. A common barrier was insufficient processes to proactively identify clinical deterioration. Patients and their family caregiver(s) were primarily responsible for monitoring their health and identifying and communicating any signs of deterioration. Cancer patients and caregivers were routinely engaged as team members, and patients developed expertise throughout treatment, thereby supporting system safety.

conclusionsThese findings expand the conceptualization of how high reliability is produced. Specifically, we highlight the key role that patients play in preventing errors and monitoring care. PRACTICE IMPLICATIONS: Our findings expand our understanding of how HRO principles interact to promote cancer care system safety and elucidate how patients and their family caregivers contribute to system resilience. This work can inform the redesign of care processes to optimize patient safety.

Indexed as

Attitude of Health PersonnelNeoplasmsPatient Care TeamFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchReproducibility of Resultscancer carehigh-reliability organizationmindful organizingpatient safety

Identifiers

PMID41664285
PMCPMC13505956

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.