What can Raskolnikov teach us about patient safety? An essay from Simon Holliday

Summary

The ongoing problem of how to improve patient safety might readily be summarised as a list of notable (or notorious) surnames; e.g., Kennedy, Shipman, Francis, Letby, Ockenden, Allitt. A list that pertains to a span of decades, and serves to illustrate the repetitive and seemingly irredeemable problem that is faced by an extremely large, technologically and organisationally complex and highly adaptive system such as a modern healthcare service like the NHS.

The greatest efforts to improve the quality of care and the standards of patient safety have been driven by the concept of evidence-based practice. Though of course this has been understandable and valid, it has been an approach that appears to have drawn an impotent blank when it comes to the very human problems of organisational culture, teamwork and interprofessional relationships at the core of healthcare provision.

In the attached essay, Simon Holliday, Senior Teaching Fellow (Nursing) at the University of Portsmouth, proposes an alternative humanistic perspective to the problem, illustrated by a subjective and flawed consideration of the lessons that the Dostoyevsky's protagonist from the novel Crime and Punishment could teach us about patient safety.