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Shaping Health PolicyCase Study Methods and Analysis$
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Mark Exworthy, Stephen Peckham, Martin Powell, and Alison Hann

Print publication date: 2011

Print ISBN-13: 9781847427588

Published to Policy Press Scholarship Online: May 2012

DOI: 10.1332/policypress/9781847427588.001.0001

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Normal accidents: learning how to learn about safety

Normal accidents: learning how to learn about safety

(p.107) Seven Normal accidents: learning how to learn about safety
Shaping Health Policy

Justin Keen

Policy Press

Charles Perrow's Normal Accidents sets out detailed accounts of major accidents in organisations managing complex technologies. It focuses on the near-meltdown of the Three Mile Island nuclear plant in the USA in 1979, but also examines accidents in a number of other industries. Perrow developed a general framework for understanding why accidents — and particularly major accidents — are more common in some industries than others, and why there are rare but catastrophic accidents in the nuclear and some other industries. Three lessons for health service research are drawn: case studies have a role in investigations of safety in health care processes; Normal Accidents is an excellent example of a retrospective, inductive, process-tracing case study; and there are both possibilities and problems of learning from accidents, and from past events in general.

Keywords:   medical errors, patient safety, Charles Perrow, normal accidents, case studies

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