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A library user, who was in a wheelchair, mentioned recently that she had no idea how libraries are organized Or the amount of resources available in them. She explained that until the passage of Section 504 of the National Rehabilitation Act, when public buildings were required to be accessible, she could not get inside a library building.

The complex and occasionally chaotic nature of health care has been previously described in the literature, as has the broadening recognition that different management approaches are required for different types of problems rather than a “one size fits all” approach. The CYNEFIN framework from Snowden outlines a consistent cognitive approach that offers the leader and leadership team an ability to urgently apply the correct actions to a given situation. This paper proposes a variant CYNEFIN approach for healthcare.

Consistent and accurate decision-making within health care is the hallmark of an effective and pragmatic leader and leadership team. An awareness of how one’s cognitive biases and heuristics may adversely impact on this cognitive process is paramount, as is an understanding of the calibration between fast and slow thinking.

The authors propose a variant CYNEFIN approach for health care of “act-probe-sense-respond” to resolve complex and time-critical emergency scenarios, using the differing contexts of a cardiac arrest and an evolving crisis management problem as examples. The variant serves as a pragmatic sense-making framework for the health-care leader and leadership team that can be adopted for many time-critical crisis situations.

The variant serves as a pragmatic sense-making framework for the health-care leader that can be adopted for many crisis situations.

This index accompanies the index that appeared in Reference Services Review 16:4 (1988). As noted in the introduction to that index, the articles in RSR that deal with specific reference titles can be grouped into two categories: those that review specific titles (to a maximum of three) and those that review titles pertinent to a specific subject or discipline. The index in RSR 16:4 covered the first category; it indexed, by title, all titles that had been reviewed in the “Reference Serials” and the “Landmarks of Reference” columns, as well as selected titles from the “Indexes and Indexers,” “Government Publications,” and “Special Feature” columns of the journal.

The River City Marsh Conflict negotiation exercise describes a conflict between two government organizations—the River City Planner's Office and the Wisconsin State Department of Natural Resources—in a dispute over what to do with the LaCrosse River Marsh. The City Planner's Office wanted to fill part of the marsh to use for expansion of the industrial park. River City officials also wanted to build an additional highway through part of the marsh to accommodate anticipated traffic increases. The Wisconsin Department of Natural Resources wanted the marsh habitat enhanced and protected from development so that threatened species could increase in numbers. These officials also wanted to build trails, canoe access points, and other facilities in order to promote recreational activities in the marsh. In this exercise, students are assigned to the role of either the River City Planner's Office or the State Department of Natural Resources office. Both sides are provided with the same set of facts and many options for consideration involving road construction or expansion, wildlife enhancement, and trail construction. Using these interrelated issues, students must negotiate a plan for the marsh that integrates both side's objectives.

This article is based on extracts from a booklet Careers in Nursing and other health service professions 1979 which is obtainable price 90p (post paid) from The New Opportunity Press Ltd., 76 St. James's Lane, London N10 3RD.