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The purpose of this paper is to draw attention to the problem of second victims involved in adverse events and their need for adequate support.

The impact on second victims involved in adverse events and implications for organisational support were determined from previous studies and relevant publications about this problem.

The impact of adverse events on health professionals who are involved in them can be profound. These second victims can suffer extreme emotional distress, anxiety regarding perceptions of their competence and professional isolation, and may endure long-term professional and personal consequences. Some of the more severe outcomes include leaving the profession, symptoms of post-traumatic stress disorder and suicide. Many studies report a substantial lack of organisational support for second victims. Key strategies have been recommended for organisations to implement to support second victims.

The authors note that recently published studies continue to report that organisational support is inadequate for second victims. Improved mechanisms of support would prevent the loss of second victims from the workforce, and ameliorate the severity and duration of the impact on second victims.

Aims to describe the growing importance of information and its governance within public services. The paper starts by considering how scandals in three national public health systems have focused public attention on information issues. It describes a theoretical framework for improving information governance, and its practical implementation as a management tool. The paper concludes with a discussion of the benefits of the approach, and the consequences of not improving information governance.

The framework brings together a number of existing methodological approaches, principally the maturity model approach to process improvement, first described in the Software Engineering Institute's capability maturity model, and the novice‐to‐expert approach to competency.

The paper describes how these approaches can be synthesised into an integrated framework to manage organisational change and how that can be used to improve information governance within public sector organisations.

The paper compares the framework and its practical implementation with existing solutions, arguing that existing solutions provide only partial solutions.

Considers how plans for future service improvements will be restricted unless information governance issues can be addressed.

Many organisations, including the Royal College of Obstetricians and Gynaecologists, have recommended increasing the number of hours of consultant obstetric presence in UK National Health Service maternity units to improve patient care. St Mary’s Hospital, Manchester implemented 24-7 consultant presence in September 2014. The paper aims to discuss these issues.

To assess the impact of 24-7 consultant presence upon women and babies, a retrospective review of all serious clinical intrapartum incidents occurring between September 2011 and September 2017 was carried out by two independent reviewers; disagreements in classification were reviewed by a senior Obstetrician. The impact of consultant presence was classified in a structure agreed a priori.

A total of 72 incidents were reviewed. Consultants were directly involved in the care of 75.6 per cent of cases before 24-7 consultant presence compared to 96.8 per cent afterwards. Negative impact due to a lack of consultant presence fell from 22 per cent of the incidents before 24-7 consultant presence to 9.7 per cent after implementation. In contrast, positive impact of consultant presence increased from 14.6 to 32.3 per cent following the introduction of 24-7 consultant presence.

Introduction of 24-7 consultant presence reduced the negative impact caused by a lack of, or delay in, consultant presence as identified by serious untoward incident (SUI) reviews. Consultant presence was more likely to have a positive influence on care delivery.

This is the first assessment of the impact of 24-7 consultant presence on the SUIs in obstetrics.

Recurrent pregnancy losses (RPL), a major contributor of reproductive wastage, affect maternal health both physically and mentally. Folate and B12 (Vitamin B12) deficiency anemia is common in the reproductive age group women in developing countries like India. And due to proven role of folate in various maternal and fetal anomalies, women are routinely prescribed folic acid under various national policies. However, B12 supplementation is rare, despite known deleterious effects of its deficiency. The purpose of this paper is to understand RPL through anemia with special reference to folate and B12 imbalance.

Multiparous women with normal obstetric outcomes (n=135) and women with Idiopathic RPL (n=105) were recruited in the study. All women were non-pregnant and belonged to North Indian population. Hb, serum folate and B12 and plasma homocysteine were measured in all the women. Anemia was classified according to WHO guidelines (Hemoglobin (Hb)<12g/dL).

The incidence of Anemia was more among normal multiparous women (73 percent) as compared to women with RPL (60 percent). However, unlike folate deficiency anemia among controls, B12 deficiency anemia was observed in women with RPL. Moreover, these women, despite being less anemic, with high B12 deficiency and folate sufficiency (presumably due to folate supplementation) had more imbalanced vitamin metabolism, as evident from homocysteine levels. The study suggests that anemic or non-anemic deficiencies of B12 and folate among women with RPL may be combated by screening for both vitamins, rather than supplementing folate indiscriminately to all.

One of the limitations is that ferritin levels for iron deficiency anemia could not be measured in this study.

The present study is the first study, to the best of our knowledge, where we looked for the role of imbalance of folate and B12 in women with RPL.

The purpose of the International Journal of Health Governance (IJHG) review is to present a synopsis of the accepted articles in each issue, thus allowing readers to identify articles of particular interest to themselves.

The review editor reads all the submissions for each issue and then prepares an overview presenting the major themes with reference to supporting literature

The findings from all articles are presented in a succinct format.

The value of the IJHG review lies in the fact that no other Emerald publication includes a review section of this type. This unique contribution to this particular journal enhances usability and reader satisfaction.

A successful relationship between manufacturer and supplier is vital for the pursuit of mutual benefits, which can be affected by one of the partners’ opportunistic behavior, causing disequilibrium in the existing relationship. The extant research has mainly focused on opportunism as a single phenomenon rather than the detectable strong form and unnoticeable weak form of opportunistic behavior in an exchange relationship that affects the relational outcomes in various ways. This study aims to contribute toward explaining the effect of economic and social forces on a strong and a weak form of opportunism and, in turn, its impact on relational outcomes in manufacturer-supplier relationships.

A sample of 361 manufacturers was drawn randomly using a sampling frame from the western part of India. The authors used covariance-based structural equation modeling to support the proposed model empirically. The authors examined the effect of social capital and transaction cost dimensions on different forms of a supplier’s opportunism.

All three dimensions of social capital have a different impact on both the forms of a supplier’s opportunism in the relationship. The authors found that social capital moderates the relationship between transaction-specific investments on a weak form of opportunism, while social capital is more valuable in curbing opportunism due to the effect of environmental uncertainty and behavioral uncertainty. The authors found that the supplier’s weak form of opportunism than the strong form has a more amplifying effect on governance costs.

This research contributes in three different ways. First, it inquires about the direct effect of transaction cost dimensions and social capital dimensions on a supplier’s multifaceted opportunism (strong form and weak form) in the manufacturer-supplier relationship. Second, it investigates the moderating effect of social capital on the relationship between transaction cost dimensions and forms of supplier opportunism. Third, the weak form of a supplier’s opportunism affects more significantly than the strong form of opportunism on governance costs.

This paper is interested to assist organizations in the task of selecting and use appropriate indicators for their environmental evaluation procedure (EPE). This maximizes the successful deployment of the EPE process and as a consequence the introduction of good environmental practices. The paper aims to discuss these issues.

It consists of a proposal for a combined methodology based on the simultaneous use of environmental risk (ER) approach and RPN-based allocation method.

In the developed methodology, the authors use the principles of risk assessment and purpose a new formulation of weight allowance with reference to the severity of ERs and significance of environmental aspects.

Methodology suggested constitutes an invaluable help to implementation EPE process and as a consequence the introduction of good environmental practices.

Methodology suggested facilitates the process of environmental performance evaluation providing substantial assistance to one of the most important stages that is to decide which particular indicators will be considered.

This study aims to examine the impact of stress as a result of adverse life events on a salesperson’s ability to effectively manage customer relationships. The framework identifies burnout as a key mediating variable and salesperson grit as a coping mechanism.

Survey data is gathered from 364 B2B salespeople and investigated using structural equation modeling in Mplus 8.2.

The findings reveal adverse life events and their corresponding stress diminish a salesperson’s ability to manage customer relationships effectively through the mediators of reduced personal accomplishment and depersonalization. Thus, negative events of a personal nature can have a significant impact on salesperson outcomes and should be taken with the same level of seriousness as job-related stress. Furthermore, results show that salesperson grit provides mixed results as a coping mechanism.

The findings indicate that practitioners should be mindful of the negative impact adverse life events can have on work-related outcomes. Organizations and sales managers must be intentional in managing relationships with their salespeople and strategic in the structure they use to manage customer relationships. Recommendations include the use of regular one-on-one meetings to open up a dialogue about work or personal issues the salesperson is experiencing and assigning multiple resources or staff to service valuable customers, thereby not relying on solitary salespeople.

Employee well-being contributes to firm value; yet, this is the first study in sales to explore the impact of adverse life events on salesperson outcomes.

This paper aims to determine the one‐year incidence of, and risk factors for, perioperative adverse events during in‐patient and out‐patient anesthesia‐assisted procedures.

A quality assurance database was the primary data source. Outcome variables were death and the occurrence of any adverse event. Risk factors were ASA physical status (PS), age, duration and type of anesthesia care, number of operating rooms running, concurrency level and medical staff. Data were stratified by in‐patient or out‐patient, surgical (e.g. thoracotomy) or non‐surgical (e.g. electroconvulsive therapy), and were analyzed using Chi square, Fisher's exact test and generalized estimating equations.

Of 27,970 procedures, 49.8 percent were out‐patient and greater than 80 percent were surgical. For surgical procedures, adverse event rates were higher for in‐patient than out‐patient procedures (2.11 percent vs. 1.45 percent; p<0.001). For non‐surgical procedures, adverse event rates were similar for in‐patients and out‐patients (0.54 percent vs. 0.36 percent). The types of adverse events differed for in‐patient and out‐patient surgical procedures (p<0.001), but not for non‐surgical procedures. ASA PS, age, duration of anesthesia care, anesthesia type and medical staff assigned to the case were each associated with adverse event rates, but the association depended on the type of procedure.

In‐patient and out‐patient surgical procedures differ in the incidence of perioperative adverse events, and in risk factors, suggesting a need to develop separate monitoring strategies.

The paper is the first to assess perioperative adverse events amongst in‐patient and out‐patient procedures.

Adverse events and patient care-related adverse events are a challenging universal problem, among elder residents of geriatric facilities. The aim of this study was to examine which types of adverse events are characteristic of the geriatric center studied and which of the nursing staff reported this event.

Data were retrieved from the computerized adverse event management system at a large geriatric center in central Israel, and all adverse events reported over the past three years were examined.

The study findings indicate that the most common type of adverse event was falls. Older nurses with greater seniority in the facility show a higher tendency to report adverse events. In addition, registered nurses were found to report more often than practical nurses.

This study highlights the important role that nurses can play in reporting and reducing adverse events. The role of the nurse is becoming increasingly complex, especially in geriatric facilities, which serve people with complex mental and physical states who are more susceptible to adverse events to begin with.

Despite the large number of adverse events, few studies have been undertaken on adverse events in geriatrics in general, and in nursing homes and long-term facilities in particular. Answers to these questions will enable improvement in the quality of care provided and ensure a safe care environment for residents. Systematically examining types of adverse events and the characteristics of those who do and do not report them, can contribute to improvement of processes in the healthcare system in general, and in the facility in particular. Additionally, efficient investigation can improve the behavior of those who enable adverse events.