Table 1

Perceiving safety risks inherent in care

SubthemesInterview quotes
1aBeing aware that some safety risks and incidents may be unpreventable
  • “… there were a lot of problems in trying to get him into ICU … there was somebody else out on the ward that was crashing so the crash team had gone there.” [wife, intw#053]

  • “And it was more that, you know, it could be seen that he'd made a mistake, or hadn't done a good job kind of thing, which wasn't the case.” [patient, intw#66]

1bExperiencing what is perceived as a safety risk
  • “When I came out of the anaesthetic they forgot to put the pressure balloons on my legs for about 24hours which is supposed to help my circulation. … Then the next day they moved me to a room and they lost me for 6hours. … They called me [name A] when my name is [name B] for about 3days. …” [patient, intw#072]

  • “When I went into hospital not one single person read my medical alert bracelet, nobody would read the emergency treatment sheet. They just put it to one side and wouldn't listen to me and I could feel myself slipping back into a coma … Now what they did, they misdiagnosed me.” [patient, intw#006]

1cExperiencing what are perceived as unresolved safety risks
  • “And then I started looking into it after the first month I started asking more and more questions about it, because I was getting worried about it by then. And that's when I started finding out that it had happened to quite a lot of people.” [patient, intw#83]

  • “Subsequently we learned that this [incident] happened six times every day … We just wanted them to say, ‘Look we spoke to the [clinicians]. We've put a system in place. There is now a procedure. We've debriefed people’.” [mother, intw#039]

1dExperiencing what is perceived as unreasonable care and communication
  • “But I mean she did…she got some really um abusive treatment from the night nurses and that's stuff that's under investigation at the moment.” [daughter, intw#18]

  • “And there had been a fight within intensive care [among] the nurses – there were the ‘pro-[patient name]s' and the ‘get-rid-of-[patient name]s’ … so he ended up with a large pressure area that was because they weren't turning him.” [daughter, intw#059]