In contemporary societies, safety represents for hospitals and healthcare organizations a vital principle. Even the smallest organizational and/or work practice may have attendant outcomes and costs at the individual and organizational level, and for the society as a whole.

Starting from this observation, this project aims to investigate the issue of safety in one of the places where errors more frequently occur: the operating theatre. The project proposes to integrate the activities of risk management of patients, workers and facilities, enabling an organizational culture and climate focused on the safety of the patient and the operator.

The Local Administration for Provincial Health Services of Trento Autonomous Province (Azienda Provinciale per i Servizi Sanitari - APSS), since 2000, has developed a systemic approach to security management of staff and patients. First, building a management system based on a clear organizational structure, which performs a series of activities to properly manage operators and patient’s safety. Then (since 2004), activating processes at an organizational level in order to create a corporate culture of risk prevention and thus stimulating organizational actors to report errors and near-misses.

In particular, the research pays close attention to the modes of interpretation and translation into practice of the institutional and legal norms with which healthcare organizations must comply; the communities of practice and professionals internally to them; the guidelines and protocols (clinical and organizational) that regulate the work of the health practitioners; the material and technological aspects of everyday work. The research aims to underline how the reciprocal influence between everyday organizational and work practices enables organizational safety to be translated into an ordered and enduring series of actions and interventions, constantly standing in relation to other technologies, practices, actors and knowledges.

The project, thus, focusing on systematic and direct observations of daily organizational and working practices in the operating room, has the following core objectives:

• to promote the culture of safety within healthcare organization;
• to activate organizational processes to improve patients and operator’s safety;
• to reflexively learn from everyday organizational processes and working practices.

Researchers: Silvia Gherardi (scientific referee), Attila Bruni (coordinator), Giusi Orabona, Beatrice Gusmano.
Period: 2007-2009
Funding: Fondazione Cassa di Risparmio di Trento e Rovereto (CARITRO).