Search results

The purpose of this paper is to posit that it is possible to identify contributing factors for “never events,” preventable adverse events in the healthcare setting, and to develop “best practices” to prevent them.

This paper focuses on three specific never events: patient falls, pressure ulcers, and hospital acquired pneumonia. A model is suggested to identify “gold standard best practice” protocols to be used to prevent these events. A literature review identifies two categories of factors: uncontrollable patient‐related factors and controllable environmental related factors. The methodology is to use the Institute for Healthcare Improvement (IHI) Breakthrough Series Collaborative Model to develop best practice protocols for controllable environmental factors.

Controllable environmental variables may be positively impacted by using Theory of Inventive Problem Solving (TRIZ), Value Stream Mapping, Kanban, 5S technique, Reduction of Complexity, Total Production Maintenance, Poke‐Yoke, and Quick Change Overs. Controllable environmental variables may then be positively impacted by these methodologies and tools.

The tools and methods indicated have been used individually in the healthcare sector, but this approach has never been used in an integrated manner. The concept is to work with patient safety organizations in order to reduce never events in healthcare; events that, to date, have significantly increased the costs of healthcare and reduced the quality of processes and outcomes in healthcare.

For contemporary American young adults (aged 18–29), coresidence with parents is now the most common living arrangement. Recent research on residential transitions out of and back into the parental home shows that residential independence is still common, meaning that many young adults coreside with parents after first leaving the nest. The timing of residential independence and subsequent coresidence is often tied to other life-course outcomes, such as relationships and employment, as well as characteristics of the family context, such as family structure and financial resources. A small body of research also demonstrates that residential transitions are common following criminal justice contact experiences such as arrests and periods of incarceration. While this association does not appear to be explained by the family context, the current study argues there are several reasons to anticipate heterogeneity in coresidence patterns based on the childhood family context. Drawing on data from the 1997 cohort of the National Longitudinal Survey of Youth, I find that criminal justice contact is associated with coresidence with parents during young adulthood in a fairly consistent manner across different dimensions of family context (although parental education may play a role). These findings demonstrate the power of the criminal justice system in directing or redirecting residential trajectories and have implications for both individuals with contact and their families.

The paper seeks to describe the development of an internet web site to commemorate Holocaust Memorial Day 2004.

The paper provides a descriptive overview of the development of the site, detailing the planning of the site, its contents and the subsequent reaction.

That the public library is well‐placed to engage in creation of information resources that challenge ignorance and racism.

The paper suggests that further research needs to be done into library‐created resources created for communities.

It is of practical use for libraries planning the creation of subject‐specific internet resources or community web sites.

The paper discusses the role of the public library in creating unique information resources and as such develops the theme of the public library as content creator as well as content provider.

The purpose of this paper is to introduce the first new hospital accreditation option in over 40 years, and the only accreditation scheme for US hospitals which is ISO‐based. It seeks to explore factors prompting design of a fundamentally new approach, patient and provider experiences thus far, outlook for adoption of this alternative, and potential for improving delivery of health services in US hospitals.

The approach takes the form of a review of available materials, industry and popular press accounts, federal documents; interviews with hospital executives and managers and with prime developers of the new accreditation process; access to personal prior industry research and experiences.

Frustrated by an established accreditation process seen as wasteful and ancillary to standard operations, administrators and clinicians developed a new approach designed to use accreditation as a strategic business tool to reinforce clinical and business process integration, efficiencies, innovation, accountability, and sustained improvement in day‐to‐day hospital operations. The accreditation process has been approved for hospitals providing care to US Medicare beneficiaries.

Pressures to reform the financing and delivery of health services in the USA – and to address concerns of escalating costs, decreased access, limited improvements in patient safety, poor care coordination, and an absence of accountability – intensify. The introduction of a novel hospital accreditation option into an arena long dominated by a single powerful accreditor provides opportunity for disruptive innovation. The rate of adoption of this new approach and its impact on existing challenges will be of interest to multiple stakeholders.

This study aims to investigate a unique approach to learning languages through self-directed online learning. Specifically, it explores the self-management abilities and skills learners need while learning a language outside traditional classroom settings when using mobile-assisted learning technology.

A mixed-methods approach was used in this study, including an online survey of 84 people and 10 semi-structured interviews.

Findings reveal the significant role of specific and well-defined learning goals in enhancing learners’ performance. These goals can be either self-initiated by the learners themselves or defined by the technological features of the learning platform. However, the presence of distractions in learners’ daily lives presents challenges to effective time management, affecting learners both physically and psychologically. A key aspect of self-directed language learning lies in the learners’ ability to seek out relevant human and material resources beyond the confines of a single mobile-assisted language learning (MALL) tool. The authenticity of these resources is crucial in ensuring meaningful and effective learning experiences.

Understanding how learners navigate and discover valuable resources is a central focus of this study. This research offers valuable insights into the field of self-directed language learning, revealing the pivotal role of self-management skills with mobile-assisted learning technology. The findings contribute to the broader field of language education and offer practical implications for educators and developers seeking to optimize self-directed language learning experiences through innovative and technologically driven approaches.

MALL is often ideal for individualized informal learning, but the existing literature focuses heavily on formal learning situations, underestimating the importance of MALL practices in various informal settings. Most research reports on MALL-based self-directed learning primarily sample traditional English-learning university students. Therefore, there is a need for research on how nontraditional older adult learners self-direct their language learning with mobile technology outside the classroom.

This paper will discuss the potential impact of a range of cognitive impairments when working with sex offenders who present with them. It will begin by outlining the nature of cognitive impairment and the research examining the extent of such difficulties in sex offenders. It will then explore the impact of such impairments when engaging a sex offender in treatment, including the role that cognitive impairment might play in the function of their offence. Finally, some methods by which to manage and compensate for cognitive impairments will be presented. While the focus of this paper is on sex offenders, the issues presented in this paper are not exclusive to this group and may be applied to offenders in general.

The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems.

Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision . Data were analyzed inspired by a deductive, direct content analytical framework.

The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which “blames” the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation.

The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations.

Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear.

The purpose of this paper is to propose an integrated framework to simultaneously identify and improve healthcare processes that are important from the healthcare provider's and patient's perspectives.

A modified quality function deployment (QFD) chart is introduced to the field of healthcare quality assurance. A healthcare service example is used to demonstrate the utility of the proposed chart.

The proposed framework is versatile and can be used in a wide variety of healthcare quality improvement contexts, wherein, two different perspectives are needed to be considered for identifying and improving critical healthcare processes.

The modified QFD chart used in conjunction with the stacked Pareto chart will facilitate the identification of key performance metrics from the patient's and the hospital's perspectives. Subsequently, the chief contributory factors at different levels are identified in a very efficient manner.

Healthcare quality improvement professionals will be able to use the proposed modified QFD chart in association with stacked Pareto chart for effective quality assurance.