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This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

The purpose of this study is to understand the meaning of the term well-being as conceptualised by parents, grandparents, principals and teachers in the Irish primary education system.

A hermeneutic phenomenological approach was adopted to understand the nature and meaning of the phenomenon of well-being. Interviews were carried out with 54 principals, teachers, parents and grandparents from a representative sample of primary schools in Ireland. Each participant was asked the same, open, question: “What does well-being mean to you?” Responses were transcribed verbatim and analysed using a combination of the principles of the hermeneutic circle and Braun and Clarke’s framework for thematic analysis.

Three conceptualisations of well-being were identified (1) well-being is about being happy, (2) well-being is about being healthy and safe and (3) well-being is something you “do”.

To the best of our knowledge this paper is the first of its kind to describe how well-being is conceptualised by adults in Irish primary school contexts. In particular it highlights how neoliberal conceptualisations of well-being as a “thing”, a commodity exchanged on assumptions of individualism, moralism and bio-economism, have crept into the education of our youngest citizens.

The consolidation process and morphology evolution in ceramics-based additive manufacturing (AM) are still not well-understood. As a way to better understand the ceramic selective laser sintering (SLS), a dynamic three-dimensional computational model was developed to forecast thermal behavior of hydroxyapatite (HA) bioceramic.

AM has revolutionized automotive, biomedical and aerospace industries, among many others. AM provides design and geometric freedom, rapid product customization and manufacturing flexibility through its layer-by-layer technique. However, a very limited number of materials are printable because of rapid melting and solidification hysteresis. Melting-solidification dynamics in powder bed fusion are usually correlated with welding, often ignoring the intrinsic properties of the laser irradiation; unsurprisingly, the printable materials are mostly the well-known weldable materials.

The consolidation mechanism of HA was identified during its processing in a ceramic SLS device, then the effect of the laser energy density was studied to see how it affects the processing window. Premature sintering and sintering regimes were revealed and elaborated in detail. The full consolidation beyond sintering was also revealed along with its interaction to baseplate.

These findings provide important insight into the consolidation mechanism of HA ceramics, which will be the cornerstone for extending the range of materials in laser powder bed fusion of ceramics.

This study aims to describe key elements that are critical to virtual qualitative research especially while working with practitioners as participants.

This paper takes a reflexive researcher approach using a case study to explore how researchers adopted a qualitative research approach using digital technology. We use five principles suggested by Boland et al. (2022) as a framework to consider and reflect on our experiences as researchers and those of our participants.

We highlight the gatekeeper’s support, trusted relationship with the organisations, interpersonal skills of interviewers, stringent measures of securing data and shared experiences of interviewee and interviewers helped complete virtual research. We recommend that four key factors such as digital competency, feasibility, flexibility and resilience should be considered while undertaking or commissioning virtual, qualitative research studies.

Social care practitioners and qualitative researchers increasingly negotiate with digital technologies to undertake their work. In this paper, we evidence how online qualitative approaches can be effective provided challenges are dealt with diligently in each stage of the research process.

This study aimed to develop a taxonomy of research areas in open government data (OGD) through a bibliometric mapping tool and a qualitative analysis software.

In this study, the authors extracted metadata of 442 documents from a bibliographic database. The authors used a bibliometric mapping tool for familiarization with the literature. After that, the authors used qualitative analysis software to develop taxonomy.

This paper developed taxonomy of OGD with three research areas: implementation and management, architecture, users and utilization. These research areas are further analyzed into seven topics and twenty-eight subtopics. The present study extends Charalabidis et al. (2016) taxonomy by adding two research topics, namely the adoption factors and barriers of OGD implementations and OGD ecosystems. Also, the authors include artificial intelligence in the taxonomy as an emerging research interest in the literature. The authors suggest four directions for future research: indigenous knowledge in open data, open data at local governments, development of OGD-specific theories and user studies in certain research themes.

Early career researchers and doctoral students can use the taxonomy to familiarize themselves with the literature. Also, established researchers can use the proposed taxonomy to inform future research. Taxonomy-building procedures in this study are applicable to other fields.

This study developed a novel taxonomy of research areas in OGD. Taxonomy building is significant because there is insufficient taxonomy of research areas in this discipline. Also, conceptual knowledge through taxonomy creation is a basis for theorizing and theory-building for future studies.

Organizational change is a key mechanism to ensure the sustainability of healthcare systems. However, healthcare organizations are persistently difficult to change, and literature is riddled with examples of failed change endeavors. In this chapter, we attempt to unravel the underlying causes for failed organizational change. We distinguish three types of change with different levels of depth that require different change approaches. Transformations are the deepest forms of change where beliefs and principles need to be modified to successfully influence routines. Renewals are deep forms of change where principles need to be modified to successfully influence routines. Improvements are shallow forms of change where only modifications at the level of routines are needed. Using deoxyribonucleic acid (DNA) as our metaphor, we propose a theory of “organizational DNA” to understand organizations and these three types of organizational changes. We posit that organizations are made up of a double helix consisting of a so-called “social string,” which contains the “soft” interaction or communication among the organization's members, and a so-called “technical string,” which contains “hard” organizational aspects such as structure and technology. Ladders of organizational nucleotides (i.e., Routines, Principles, and Beliefs) connect this double helix in various combinations. Together, the double helix and accompanying nucleotides make up the DNA of an organization. Without knowledge of the architecture of organizational DNA and whether a change addresses beliefs, principles, and/or routines, we believe that organizational change is constrained and based on luck rather than change management expertise. Following this metaphor, we show that organizational change fails when it attempts to change one part of the DNA (e.g., routines) in a way that renders it incompatible with the connecting components (e.g., principles and beliefs). We discuss how the theory can be applied in practice using an exemplar case.

The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents.

This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 – SARS, MERS, Ebola, and COVID-19.

The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study.

Comparison of key issues and lessons learned among the four major events described in this article – SARS, MERS, Ebola, and COVID-19 – highlight that several lessons are “relearned” with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.

Values have long guided special education services and supports for students with extensive support needs; over the past four decades, those values have been backed by research evidence demonstrating the critical nature of values related to inclusive education, self-determination, and seeking strengths and assets. In this chapter, we investigate these values and their supporting research, documenting strengths and needs in extant research. We emphasize the need to continue to embrace and maintain these values while pursuing research that addresses research gaps while centering the priorities, perspectives, and preferences of people with extensive support needs.