Metrics details. Behaviours fitting the definition of workarounds often include violations, deviations, problem solving, improvisations, procedural failures and shortcuts.
Clinicians implement workarounds in response to the complexity of delivering patient care. One imperative to understand workarounds lies in their influence on patient safety. A literature assessment was undertaken in β Selection criteria were applied across three phases. Studies conducted across a variety of acute care settings use diverse data collection methods. Organisational, work process, patient-related, individual, social and professional factors contribute to the proliferation of workarounds.
Workarounds enable, yet potentially compromise, the execution of patient care. In some contexts such improvisations may be deemed necessary to the successful implementation of quality care, in others they are counterproductive. Workarounds have individual and cooperative characteristics.
Peer Review reports. Views about workarounds tend to polarise. On the one hand, negative conceptualisations report workarounds as a subset of errors, shortcuts, deviations and violations [ 3 , 16 ]. Terms such as improvisations [ 10 , 17 ] and innovations [ 18 ] offer more positive notions of workarounds. There is a paucity of clear and uniform definitions of these related constructs [ 3 , 16 ]. The definition of workarounds developed for this review has two components.
Workarounds are observed or described behaviours that may differ from organisationally prescribed or intended procedures. Healthcare is a high-hazard industry in which workers have the potential to kill or maim []. More than most other industries, healthcare is complex, fragmented, decentralised and unevenly regulated [ 19 ] with clinicians required to learn on the job at the same time as they are required to display professional autonomy. Healthcare is characterised simultaneously by routine, highly organised and ultra safe practices e.
