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Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

Adverse events in health care became more evident at the beginning of the 21st century, being an emerging problem worldwide and impacting the lives of people receiving health care, contributing to preventable injuries and deaths. This evidence has motivated the development of specific training in the area of patient safety with a strong focus on the education and training of health professionals, and, more recently, it also aimed at patient, informal caregiver and all citizens. In this sense, the use of digital technology for patient safety training has been an important challenge and proves to be a good solution for training and continuous learning, both for professionals and people in general. The use of multimedia, videos, games, simulators, among others, are effectively essential resources to improve people’s health literacy and safety of care.

This chapter presents a narrative review on patient safety training and the contributions of digital technology. The experience report will also be used, presenting some examples of quality improvement projects developed by Portuguese and Brazilian entities, in training contexts, highlighting the importance of investing in the health literacy of professionals, patients/informal caregivers and civil society, through applying specific techniques and using digital technology.

The emerging industrial revolution referred to as Industry 5.0 is focusing on leveraging human creativity with intelligent and autonomous systems to derive user-friendly work environment for the businesses. Industry 5.0 stresses on people centric work ecosystem, zero accident policy and the well-being of labour within the production processes. This approach of Industry 5.0 to obtain human-centric safety solutions through the deployment of digital technologies deduces workplace accidents and costs leading to the development of Safety 4.0. This chapter aims to investigate the opportunities and challenges of Safety 4.0 and its enabling technologies aspiring towards the greater impact on safety management. Further, we have proposed a framework for the role of human centric digital transformations concerning safety in the manufacturing industry propelling Safety 4.0. Concluding, we discuss the implications for managers and practitioners. We found that Safety 4.0 will strengthen industrial safety, and instead of reacting to accidents, the concept evolved towards a preventive and proactive approach for a healthy industrial ecosystem.

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 endpoint and hallmark of the success of intercultural teaching is often seen as the attainment of intercultural competence. Yet, there is a need for a detailed examination of some of the enduring personal and professional identity and culture aspects of cross-cultural teaching. In this chapter, I deliberate over the application of narrative inquiry tools for unpacking teachers' experiences of immersion in a foreign country and culture of schooling. I reflect on my own experiences as a teacher in Japan and draw on an inquiry into the experiences of novice Canadian teachers in Hong Kong or Japan to shed light on fluid conceptions of culture shock and reverse culture shock in terms of cultural identity transformations. I also raise to the forefront inquiry puzzles about the phenomenon of intercultural competence acquisition.

In this chapter, the author delves into the third ‘C:’ compliance, which is fundamentally linked to business ethics. The chapter introduces the concept of business ethics and its significance in contemporary business strategy while interpreting Taoist principles from a compliance perspective. Compliance deals with our recognition of the potentially harmful or imprudent actions we take or our belief that we are superior to others. Compliance refers to an individual's expression of altered attitudes or behaviours in response to adhering to others' requests. Compliance encompasses humility, integrity, accountability and more. This chapter concentrates on the influence of Taoist ethical principles, particularly humility and integrity, on responsible management.