Medication between technology, clinicians and patients—How is medication safety done, with which possibilities and problems—a refiguration of problem spaces for quality improvement

PURPOSE: The aim of this paper is to present results from ethnographic field studies aimed at investigating how ‘medication safety is done in practice’. The field is hospitals and primary care, environments where standard technologies for patient safety are continually implemented. Focus is the older patients, who are often crossing the boundaries in the healthcare sector. THEORY: The paper draws on theories of Social Anthropology and theories of Knowledge in Organizations. METHODS: The paper is based on data from ethnographic field studies in hospitals and primary care in Denmark. RESULTS AND CONCLUSIONS: Ethnographic case stories of ‘safe medication practices’, and ideas for refiguration of problem spaces for safety and quality improvement. DISCUSSION: There seems to be a ruling discourse of how to do, in order to improve safety for patients. At the same time there also seems to be some problems as far as implementation of the systems concerns. Through refiguring of the problem spaces this paper discusses the theories of quality improvement grounded in systems thinking and suggests new ways of thinking.