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PSNet: Patient Safety Network
Journal Article

What would you ideally do if there were no targets? An ethnographic study of the unintended consequences of top-down governance in two clinical settings.

Allard J, Bleakley A. Advances in health sciences education : theory and practice. 2016;21:803-17.

This ethnographic study examined the effects of top-down targets and protocols on health care providers' practices in an emergency department and a mental health ward in the United Kingdom. Top-down policy directives seemed to disrupt work patterns and led to unintended consequences.