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The main goal of the current research was to investigate whether and how leaders in health care organizations can stimulate incident reporting and error management by “walking the safety talk” (enacted priority of safety).

Open interviews (N=26) and a cross-sectional questionnaire (N=183) were conducted at the Rotterdam Eye Hospital (REH) in The Netherlands.

As hypothesized, leaders’ enacted priority of safety was positively related to incident reporting and error management, and the relation between leaders’ enacted priority of safety and error management was mediated by incident reporting. The interviews yielded rich data on (near) incidents, the leaders’ role in (non)reporting, and error management, grounding quantitative findings in concrete case descriptions.

We support previous theorizing by providing empirical evidence showing that (1) enacted priority of safety has a stronger relationship with incident reporting than espoused priority of safety and (2) the previously implied positive link between incident reporting and error management indeed exists. Moreover, our findings extend our understanding of behavioral integrity for safety and the mechanisms through which it operates in medical settings.

Our findings indicate that for the promotion of incident reporting and error management, active reinforcement of priority of safety by leaders is crucial.

Social sciences researchers, health care researchers and health care practitioners can utilize the findings of the current paper in order to help leaders create health care systems characterized by higher incident reporting and more constructive error handling.

The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program’s content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture.

Pre- and post-assessments of the hospitals’ safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice.

The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction.

The study was observational and the hospital’s variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention.

Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on “team” instead of “profession” seems both necessary and difficult in hospital care.

The purpose of this paper is to explore sensemaking of incidents by health care professionals through an analysis of the role of professional identity in narratives of incidents. Using insights from social identity theory, the authors argue that incidents may create a threat of professional identity, and that professionals make use of identity management strategies in response to this identity threat.

The paper draws on a qualitative analysis of incident narratives in 14 semi-structured interviews with physicians, nurses, and residents at a Dutch specialist hospital. The authors used an existing framework of identity management strategies to categorize the narratives.

The analysis yielded two main results. First, nurses and residents employed multiple types of identity management strategies simultaneously, which points to the possible benefit of combining different strategies. Second, physicians used the strategy of patronization of other professional groups, a specific form of downward comparison.

The authors discuss the implications of the findings in terms of the impact of identity management strategies on the perpetuation of hierarchical differences in health care.

The authors argue that efforts to manage incident handling may profit from considering social identity processes in sensemaking of incidents.

This is the first study that systematically explores how health care professionals use identity management strategies to maintain a positive professional identity in the face of incidents. This study contributes to research on interdisciplinary cooperation in health care.

This review arises from a series of multidisciplinary Franco‐British workshops which were supported by a grant from the Economic and Social Research Council (ESRC) and the Agence Nationale de la Recherche (ANR). More than 30 participants from a range of institutions and agencies were involved in compiling the material in this review (Appendix I). The workshops offered an opportunity to exchange ideas from research on the relationships between migration, health and well‐being in Britain and France. In the following discussion we compare and contrast experiences in the two countries, with the aim of assessing the importance of international, national and local contexts, in their various cultural, social and political dimensions, for the relationships of interest. Drawing on these ideas, we suggest the definition of a future international research agenda.

The purpose of this paper is to examine the access to community telecenters (CTs) and the resulting changes in people's livelihood by focusing on the gendered use of computers and the internet in two Thai CTs.

Qualitative methods through participant observation and interviews of 37 respondents are privileged. The assessment of the findings in this study is made by analyzing preset indicators created and adapted from a literature review of telecenters, livelihoods, and gender.

Findings suggest that livelihood changes in specific areas, with a rise in self‐esteem being one of the most noticeable changes. Moreover, financial opportunities, including career enhancement and product development, have expanded as a result of accessing CTs. In regard to gender, although it is found that there is only a small difference in financial opportunity between women and men, the findings point to more positive changes for women than men in terms of health enhancement and social connectedness, while men benefit slightly more in self‐esteem and education.

The paper verifies the possibility of information and communication technology (ICT) as a tool for enhancing the lives of people. It demonstrates that adults in a rural community can get the benefits of ICTs only if they have the opportunity to learn and have access to use. Furthermore, gender differences identified in the paper can support gender‐sensitive projects using ICT for development.

People with dementia in hospital are susceptible to delirium, pain and psychological symptoms. These diagnoses are associated with worse patient outcomes, yet are often underdiagnosed and undertreated. Distress is common in people experiencing delirium, pain and psychological symptoms. Screening for distress may therefore be a sensitive way of recognising unmet needs. The purpose of this paper is to describe the development and feasibility testing of the Distress Recognition Tool (DRT). The DRT is a single question screening tool that is incorporated into existing hospital systems. It encourages healthcare professionals to regularly look for distress and signposts them to relevant resources when distress is identified.

The authors tested the feasibility of using the DRT in people with dementia admitted on two general hospital wards. Mixed methods were used to assess uptake and potential mechanisms of impact, including frequency of use, observation of ward processes and semi-structured interviews with primary stakeholders.

Over a 52-day period, the DRT was used during routine care of 32 participants; a total of 346 bed days. The DRT was completed 312 times; an average of 0.9 times per participant per day. Where participants had an identified carer, 83 per cent contributed to the assessment at least once during the admission. Thematic analysis of stakeholder interviews, and observational data suggested that the DRT was quick and simple to complete, improved ward awareness of distress and had the potential to improve care for people with dementia admitted to hospital.

This is the first short screening tool for routinely detecting distress in dementia in any setting. Its uptake was positive, and if effective it could improve care and outcomes for people with dementia, however it was beyond the scope of the study test this.