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In this chapter, I analyse the implementation of the reform to the regimen of alternatives to prison in Chile which occurred in 2013 and how the reform affected how punishment is conceived and translated into practice by professionals supervising probation and community services. The findings suggest the reform that led to the new ‘substitutive sanctions’ also introduced a new risk-oriented-managerial culture that has permeated how punishment is currently enforced and envisaged by supervision professionals; a situation that has been deepening over the years, not only through practice, but also via on-going training that has helped to generate the emergence of ‘cultural’ capital that distinguishes supervision professionals from the larger organisation. This has been combined with a rapid expansion in the use of substitutive sanctions, especially probation and ‘partial reclusion’ that can aptly be analysed under the ‘mass supervision’ premise.

Purpose – This chapter explores claims of social problem workers in criminal justice and mental health with regard to how to manage males who are identified as or self-identify as both victims and perpetrators (V/Ps) of sexual abuse. We also examine the claims of V/Ps with regard to how they manage their dual status.

Methodology – This chapter is based on an action research project on intervention services for V/Ps in Ontario, Canada. Our data include literature reviews, interviews with intervention professionals, V/P narratives, and a transcription of a stake-holder's workshop.

Findings – Intervention workers whose mandate is offender risk management state they give little attention to victimization-related issues of V/Ps, whereas workers in victims’ services often state that adult V/Ps are not covered under their mandate. This suggests that the status of offender is the master status for adult V/Ps. Our V/P narratives recount efforts at self-management and some V/Ps and intervention professionals have expressed interest in the possibility of developing programs specially designed for V/Ps.

Practical Implications – An examination of issues related to the dual status of sexual abuse V/Ps suggests that V/Ps may require special services that cannot be provided by existing programs for perpetrators and victims.

Originality/Value of Paper – Studies of social problem work might benefit from considering not only professionals’ viewpoints but also those of their clients. This chapter explores new intervention models (GLM and RJ) that incorporate ethical concerns based on a rights perspective (“moral repair”) and the experiential concerns of V/Ps.

In this chapter, we describe the policy and practical decisions one school district and school had to make to implement a progress monitoring and Response to Intervention (RtI) model in an historically low-achieving school with a substantial population of students at risk tfor academic failure – characteristics that are common to many public schools across the nation. We contrast the lofty goals and theoretical orientations of RtI described in a burgeoning literature in special and general education with the “real life” burdens of capacity, resources, time, and school culture in a struggling school.

Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement toward evidence-based practice. Results from several studies indicate that youth served in traditional residential or inpatient care may experience difficulty re-entering their natural environments, or were released into physically and emotionally unsafe homes (Bruns & Burchard, 2000; President's Commission on Mental Health, 1978; Stortz, 2000; Stroul & Friedman, 1986; U.S. Department of Health and Human Services, 1999). The cost of hospitalizing youth also became a policy concern (Henggeler et al., 1999b; Kielser, 1993; U.S. Department of Health and Human Services, 1999). For example, it is estimated that from the late 1980s through 1990 inpatient treatment consumed nearly half of all expenditures for child and adolescent mental health care although the services were found not to be very effective (Burns, 1991; Burns & Friedman, 1990). More recent analyses indicate that at least 1/3 of all mental health expenditures for youth are associated with inpatient hospitalization (Ringel & Sturm, 2001).

In recent years, a wide range of psychosocial health interventions have been implemented among military service members and their families. However, there are questions over the evaluative rigor of these interventions. We conducted a systematic review of this literature, rating each relevant study (k = 111) on five evaluative rigor scales (type of control group, approach to participant assignment, outcome quality, number of measurement time points, and follow-up distality). The most frequently coded values on three of the five scales (control group type, participant assignment, and follow-up distality) were those indicating the lowest level of operationally defined rigor. Logistic regression results indicate that the evaluative rigor of intervention studies has largely remained consistent over time, with exceptions indicating that rigor has decreased. Analyses among seven military sub-populations indicate that interventions conducted among soldiers completing basic training, soldiers returning from combat deployment, and combat veterans have had, on average, the greatest evaluative rigor. However, variability in mean scores across evaluative rigor scales within sub-populations highlights the unique methodological hurdles common to different military settings. Recommendations for better standardizing the intervention evaluation process are discussed.

Alternative Education Placements (AEPs) are unique and complex settings that serve students with varieties of needs and strengths, though in practice such settings may be used most frequently to serve students with serious challenging behavior. Although research supports a number of individual interventions for students with emotional and behavioral disorders (EBD), including intensive, individualized interventions, less is known about adapting such interventions for AEPs, and especially about the potential for AEPs to adopt a flexible, positive, multitiered framework for behavior and school climate. Emerging evidence suggests that Positive Behavioral Interventions and Supports (PBIS) can be integrated into alternative education settings with careful planning. This chapter provides (1) an overview of AEPs, (2) a description of six steps recommended for integrating PBIS into AEPs, and (3) a brief overview of recent literature regarding PBIS in AEPs.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.

Hospitals worldwide are facing the same opportunities and threats: the demographics of an aging population; steady increases in chronic diseases and severe illnesses; and a steadily increasing demand for medical services with more intensive treatment for multi-morbid patients. Additionally, patients are becoming more demanding. They expect high quality medicine within a dignity-driven and painless healing environment.

The severe financial pressures that these developments entail oblige care providers to more and more cost-containment and to apply process reengineering, as well as continuous performance improvement measures, so as to achieve future financial sustainability. At the same time, regulators are calling for improved patient outcomes. Benchmarking and best practice management are successfully proven performance improvement tools for enabling hospitals to achieve a higher level of clinical output quality, enhanced patient satisfaction, and care delivery capability, while simultaneously containing and reducing costs.

This chapter aims to clarify what benchmarking is and what it is not. Furthermore, it is stated that benchmarking is a powerful managerial tool for improving decision-making processes that can contribute to the above-mentioned improvement measures in health care delivery. The benchmarking approach described in this chapter is oriented toward the philosophy of an input–output model and is explained based on practical international examples from different industries in various countries.

Benchmarking is not a project with a defined start and end point, but a continuous initiative of comparing key performance indicators, process structures, and best practices from best-in-class companies inside and outside industry.

Benchmarking is an ongoing process of measuring and searching for best-in-class performance:

• Measure yourself with yourself over time against key performance indicators

• Measure yourself against others

• Identify best practices

• Equal or exceed this best practice in your institution

• Focus on simple and effective ways to implement solutions

Measure yourself with yourself over time against key performance indicators

Measure yourself against others

Identify best practices

Equal or exceed this best practice in your institution

Focus on simple and effective ways to implement solutions

Comparing only figures, such as average length of stay, costs of procedures, infection rates, or out-of-stock rates, can lead easily to wrong conclusions and decision making with often-disastrous consequences. Just looking at figures and ratios is not the basis for detecting potential excellence. It is necessary to look beyond the numbers to understand how processes work and contribute to best-in-class results. Best practices from even quite different industries can enable hospitals to leapfrog results in patient orientation, clinical excellence, and cost-effectiveness.

Despite common benchmarking approaches, it is pointed out that a comparison without “looking behind the figures” (what it means to be familiar with the process structure, process dynamic and drivers, process institutions/rules and process-related incentive components) will be extremely limited referring to reliability and quality of findings.

In order to demonstrate transferability of benchmarking results between different industries practical examples from health care, automotive, and hotel service have been selected.

Additionally, it is depicted that international comparisons between hospitals providing medical services in different health care systems do have a great potential for achieving leapfrog results in medical quality, organization of service provision, effective work structures, purchasing and logistics processes, or management, etc.