Abstract:

This article analyses the emotional and generic dimensions of critical incident reports. These incident reports have been selected from the specialty of retrieval medicine; that is, a specialized service that transports patients from distant accident sites to hospitals. With its focus on emergencies in distant locations, this area of medicine and the care it provides is a hothouse for procedural difficulties, medical complications and, therefore, emotive language. The analysis demonstrates, firstly, that these reports can contain a range of evaluative expressions, including personal and depersonalized affect, interpersonal and normative udgements, and assessments of the functionality of objects. Secondly, these evaluations frequently harbour a tension between informal (private, emotional, self-oriented) and formal (public, depersonalized, formalized) discourse. Thirdly, the overall structure of incident reports is such as to effect a complex discursive transformation from personal sentiments into organizational assessments and solutions. The article concludes that incident reporting is an important postbureaucratic technique, in that it creates a space where clinicians are invited to link experiential dilemmas to service redesign strategies, and display their commitment
to the ethos and practices of organizational improvement.

Author: Rick Iedema