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Do expert assessments converge? An exploratory case study of evaluating and managing a blood supply risk

机译:专家评估会收敛吗?评估和管理血液供应风险的探索性案例研究

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Background Examining professional assessments of a blood product recall/withdrawal and its implications for risk and public health, the paper introduces ideas about perceptions of minimal risk and its management. It also describes the context of publicly funded blood transfusion in Canada and the withdrawal event that is the basis of this study. Methods Interviews with 45 experts from administration, medicine, blood supply, laboratory services and risk assessment took place using a multi-level sampling framework in the aftermath of the recall. These experts either directly dealt with the withdrawal or were involved in the management of the blood supply at the national level. Data from these interviews were coded in NVivo for analysis and interpretation. Analytically, data were interpreted to derive typifications to relate interview responses to risk management heuristics. Results While all those interviewed agreed on the importance of patient safety, differences in the ways in which the risk was contextualized and explicated were discerned. Risk was seen in terms of patient safety, liability or precaution. These different risk logics are illustrated by selected quotations. Conclusions Expert assessments did not fully converge and it is possible that these different risk logics and discourses may affect the risk management process more generally, although not necessarily in a negative way. Patient safety is not to be compromised but management of blood risk in publicly funded systems may vary. We suggest ways of managing blood risk using formal and safety case approaches.
机译:背景资料在审查对血液制品召回/撤回及其对风险和公共卫生的影响的专业评估时,本文介绍了有关最小风险及其管理的观念。它还描述了加拿大公共资助输血的背景以及作为本研究基础的戒断事件。方法在召回事件发生后,使用多级抽样框架对来自行政,医学,血液供应,实验室服务和风险评估的45位专家进行了访谈。这些专家要么直接处理撤离问题,要么参与国家一级的血液供应管理。这些访谈的数据均以NVivo编码,以进行分析和解释。从分析上讲,数据被解释为派生类型,以将访谈响应与风险管理启发式方法联系起来。结果尽管所有受访者都同意患者安全的重要性,但可以区分出风险和背景之间的差异。从患者安全,责任或预防方面看风险。这些不同的风险逻辑由选定的引文说明。结论专家评估尚未完全收敛,这些不同的风险逻辑和论述可能会更广泛地影响风险管理流程,尽管不一定会产生负面影响。患者安全不会受到损害,但是公共资助系统中血液风险的管理可能会有所不同。我们建议使用正式和安全案例方法来管理血液风险。

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