A largely uncoordinated patient safety movement arose in response to the Institute of Medicine’s 1999 report on patient safety, To Err Is Human. Two key outcomes have resulted from that movement: (a) new guidelines that enlarge requirements for documenting compliance with patient safety data and (b) a new obligation for health care organizations to create a “safety culture” based on the “science” of safety. The organizational title patient safety officer (PSO) designates a member of an emerging occupation charged with assuming these enlarged responsibilities. This article seeks, first, to describe the emergence of this new organizational role, the PSO; second, to identify the new tensions that task and mission inflation have created for PSOs; and third, to examine how PSOs manage the tensions between their increased core work task and their new professional mission as agents of organizational change. Drawing on interviews conducted with 32 PSOs, 127 nurses, and 36 physicians in 17 surgical departments across 5 states in the United States from 2012 to 2015, the authors find that PSOs most commonly resolve the tension between core work activity and professional mission by focusing on their task as agents of audit and compliance. The authors find, as well, that when PSOs attempt to use their expanded role as social reformers to change behaviors in surgery, they must overcome the resistance of frontline workers. They require cooperation from executives and surgeons to effect change. When this support is unavailable, PSOs lose their voice and may abandon efforts to improve safety.

中文翻译：

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美国的外科患者安全官员：协商合规性和工作场所转型之间的矛盾

作为对医学研究所 1999 年关于患者安全的报告“To Err Is Human”的回应，出现了一场很大程度上不协调的患者安全运动。该运动产生了两个关键成果：(a) 新指南扩大了记录患者安全数据合规性的要求，以及 (b) 医疗保健组织有新义务创建基于安全“科学”的“安全文化” . 组织头衔患者安全官 (PSO) 指定一名新兴职业的成员负责承担这些扩大的职责。本文首先试图描述这个新的组织角色 PSO 的出现；其次，确定任务和任务膨胀为 PSO 造成的新紧张局势；第三，研究 PSO 如何管理他们增加的核心工作任务和他们作为组织变革推动者的新专业使命之间的紧张关系。通过对 2012 年至 2015 年美国 5 个州 17 个外科部门的 32 名 PSO、127 名护士和 36 名医生的访谈，作者发现 PSO 最常通过关注以下方面来解决核心工作活动与专业使命之间的紧张关系他们作为审计和合规代理人的任务。作者还发现，当 PSO 试图利用其作为社会改革者的扩大作用来改变手术行为时，他们必须克服一线工人的阻力。他们需要高管和外科医生的合作才能实现变革。当这种支持不可用时，PSO 就会失去发言权，并可能放弃提高安全性的努力。