‘Balancing risk, that is my life’: The politics of risk in a hospital operating theatre department

Abstract

The management of risk has become a policy priority in health systems around the world. Current orthodoxy within patient safety policy circles stresses the need to identify and manage risk to reduce harm to patients. However, this rests on an assumption that there is common agreement that risk can be managed, together with a shared set of beliefs about what constitutes risk and the methods for managing risk. The framing of particular issues as risks and the methods chosen to manage these can be interpreted as a challenge to medical autonomy. In this sense, risk management can be seen as a political tool intended to change behaviours and existing forms of organization. In this paper we present findings from a 2-year research study conducted within a hospital operating theatre department. Our findings based on observation and interviews suggest that sophisticated risk discourses can be used by those who seek to challenge the current patient safety orthodoxy. In particular, doctors were able to deploy discourses which emphasize the scientific nature of risk measurement as well as capitalizing on the ambiguous nature of probabilistic risk calculations. The implications for clinical risk management policy are discussed.