Challenges in making standardisation work in healthcare: lessons from a qualitative interview study of a line-labelling policy in the UK

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Citation

Kriznik N. M., Lamé G., Dixon-Woods M., (2019), Challenges in making standardisation work in healthcare: lessons from a qualitative interview study of a line-labelling policy in a UK region. BMJ Open. doi: 10.1136/bmjopen-2019-031771

  • 05 December 2019
  • Journal article

Contributors

THIS Institute

Professor Mary Dixon-Woods

THIS Institute

Why it matters

Standardisation can seem like a common-sense way to deal with challenges in healthcare. It offers the potential to improve efficiency, reduce variation, and remove uncertainty. But standards comes with their own set of challenges.

When a regional health system in the UK wanted to improve its line-labelling processes, standardisation seemed like a natural solution. Lines are ubiquitous medical devices like intravenous infusions, feeding tubes, and catheters that allow patients to receive food and medication or drain substances from the body. They are so commonly used that people may have a number of lines in close proximity. Because they are inconsistently labelled, the risk of confusion, infection, and errors may be increased.

Some health systems have tried to reduce the potential for error by standardising how lines are labelled. In the absence of a nationwide policy, one UK regional health system launched its own line-labelling policy.

This case study examines the design and implementation of that policy, seeking to better understand how standardisation occurs through sociotechnical processes in healthcare, and to inform similar improvement efforts in the future.

Our approach

For this single case study, we took an in-depth look at how this particular line-labelling policy was created and rolled out.

We interviewed policymakers involved in the working group that designed the standards, as well as frontline NHS staff who were directly involved in implementing them at three hospitals. We also analysed documents related to the policy.

What we found

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