Abstract：
Objectives: While safety-dedicated professional roles are common in other high-risk industries, in health care they have tended to have a relatively narrow, technical focus. We present initial findings from a mixed-methods evaluation of a novel, senior role with responsibility for leadership of safety in English National Health Service organisations: the patient safety specialist. Methods: We conducted interviews with those responsible for designing, developing and overseeing the introduction of the role. We also carried out a national survey of current patient safety specialists. Data collection and analysis focused on the rationale for the role, its theory of change, and experiences of putting the theory into practice. Results: Interview participants articulated a clear theory of change for the role, highlighting ways in which the focus of the role, the seniority, responsibility and influence of role holders, and the expertise they brought might result in better safety management and speedier implementation of initiatives to manage risk and improve safety. Survey respondents had mixed experiences of the role to date, particularly in terms of material and symbolic support from their organisations. Together, findings from the two datasets indicated the need for a careful balance between strategic and operational activities to secure impact for patient safety specialists while ensuring they were embedded in the realities of clinical work as done-a balance that not all role holders found easy to achieve. Conclusions: The vision for the patient safety specialist role is clear, and supported by a plausible account of how the work of role holders might result in the intended objectives. The degree to which specialists are supported and resourced to deliver on these ambitions, however, varies markedly across organisations.
摘要：
目标：虽然安全专用的专业角色在其他高风险行业中很常见，在医疗保健方面，他们往往有一个相对狭窄的，技术焦点。我们提出了一个新的混合方法评估的初步发现，负责英国国家卫生服务组织安全领导的高级角色：患者安全专家。方法：我们对设计负责人进行了访谈，发展和监督角色的引入。我们还对当前的患者安全专家进行了全国调查。数据收集和分析侧重于角色的基本原理，它的变化理论，以及将理论付诸实践的经验。结果：访谈参与者阐述了一个清晰的角色变化理论，强调角色的重点，资历,角色持有人的责任和影响，他们带来的专业知识可能会导致更好的安全管理和更快地实施管理风险和提高安全性的举措。迄今为止，调查受访者对这一角色的经验参差不齐，特别是在他们的组织的物质和象征性支持方面。一起,来自这两个数据集的研究结果表明,需要在战略活动和业务活动之间谨慎平衡,以确保对患者安全专家的影响,同时确保将其纳入临床工作的现实中,这一平衡并非所有的角色都容易实现.结论:专科医生对患者安全的愿景明确,并得到关于角色持有人的工作如何导致预期目标的合理说明的支持。专家在实现这些雄心方面得到支持和资源的程度，然而,各组织之间明显不同。
