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Sociotechnical safety risks in oncology: a framework-guided qualitative study
Chantelle Recsky1, Michelle B Tam2, Arlyn Heywood2
1School of Nursing, University of British Columbia, Vancouver, BC, V6T 1Z1, Canada.
Objective:
To analyze oncology nurses' accounts of technology-related safety events and the sociotechnical factors contributing to patient-, workforce-, and system-level harms.
Materials And Methods:
A framework-guided qualitative descriptive study was conducted with 28 oncology nurses from outpatient, chemotherapy, inpatient, and radiation settings at a large Canadian cancer center. Semistructured interviews and small focus groups elicited 98 technology-related safety events. Data were analyzed using a framework-guided qualitative descriptive approach informed by the WHO International Classification for Patient Safety, a sociotechnical model of health information technology, and a health data-related harm framework.
Results:
Reported adverse events most often involved clinical administration, documentation, and organizational processes. Contributing sociotechnical factors included workflow complexity, communication breakdowns, people-related challenges, and interface usability issues. Harms extended beyond patients and included system inefficiencies, delays in care, and adverse effects on workforce well-being such as frustration and moral distress.
Discussion:
Nurses described technology-related safety issues as recurring sociotechnical patterns arising from workflow, documentation, and organizational misalignments, rather than isolated technical failures. These patterns had interconnected impacts across patients, care delivery, and the healthcare workforce. Structured framework analysis of clinicians' narratives helped illuminate these relationships.
Conclusion:
Technology-related safety events in oncology reflect recurring sociotechnical misalignments, rather than isolated technical failures, and have consequences that affect patients, care processes, and the healthcare workforce.
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