Multiple accountabilities in incident reporting and management

Su Yin Hor, Rick Iedema, Katrina Williams, Les White, Peter Kennedy, Andrew S. Day

Research output: Contribution to journalArticleResearchpeer-review

17 Citations (Scopus)


In this article, we examine the current and increasing emphasis on accountability and patient safety in health care, focusing on practices of incident reporting and management in New South Wales, Australia. We describe the frames of accountability associated with an incident reporting system, and explore how this system manifests in practice. In contrast to literature that situates incident reporting and local practices as oppositional, we used ethnographic methods to observe the incident management practices of clinical staff in a hospital, and found evidence to characterize this relationship differently. We found that accountability has multiple conceptualizations, and we present three findings that demonstrate how the reporting system and incident management policy are interwoven with local enactments of accountability. We suggest that systematic efforts toward improvement cannot be divorced from the local context, and emphasize the importance of local ecologies of practice in facilitating the meaningful utilization of such incident reporting systems.

Original languageEnglish
Pages (from-to)1091-1100
Number of pages10
JournalQualitative Health Research
Issue number8
Publication statusPublished - 1 Aug 2010
Externally publishedYes


  • communication
  • compliance
  • culture
  • culture of
  • ethnography
  • health care
  • health policy
  • observation
  • patient safety
  • technology

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