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Abstract

Details

The Handbook of Road Safety Measures
Type: Book
ISBN: 978-1-84855-250-0

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Article

Rachel Canaway, Marie Bismark, David Dunt and Margaret Kelaher

The purpose of this paper is to understand the concerns and factors that impact on hospital quality and safety, particularly related to use of performance data, within a…

Abstract

Purpose

The purpose of this paper is to understand the concerns and factors that impact on hospital quality and safety, particularly related to use of performance data, within a setting of devolved governance.

Design/methodology/approach

This qualitative study used thematic analysis of interviews with public hospital medical directors. For additional context, findings were framed by themes from a review of hospital safety and quality in the same jurisdiction.

Findings

Varying approaches and levels of complexity were described about what and how performance data are reviewed, prioritised, and quality improvements implemented. Although no consistent narrative emerged, facilitators of improvement were suggested relating to organisational culture, governance, resources, education, and technologies. These hospital-level perspectives articulate with and expand on the system-level themes in a state-wide review of hospital safety and quality.

Research limitations/implications

The findings are not generalisable, but point to an underlying absence of system-wide agreement on how to perceive, retrieve, analyse, prioritise and action hospital performance data.

Practical implications

Lack of electronic medical records and an inefficient incident reporting system limits the extent to which performance and incident data can be analysed, linked and shared, thus limiting hospital performance improvement, oversight and learning.

Social implications

Variable approaches to quality and safety, standards of care, and hospital record keeping and reporting, mean that healthcare consumers might expect inconsistency across Victorian hospitals.

Originality/value

The views of medical directors have been little researched. This work uses their voice to better understand contextual factors that situate and impact on hospital quality and safety towards understanding the mixed effectiveness of hospital quality improvement strategies.

Details

Journal of Health Organization and Management, vol. 31 no. 7/8
Type: Research Article
ISSN: 1477-7266

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Book part

Sallie J. Weaver, Xin Xuan Che, Peter J. Pronovost, Christine A. Goeschel, Keith C. Kosel and Michael A. Rosen

Early writings about teamwork in healthcare emphasized that healthcare providers needed to evolve from a team of experts into an expert team. This is no longer enough. As…

Abstract

Purpose

Early writings about teamwork in healthcare emphasized that healthcare providers needed to evolve from a team of experts into an expert team. This is no longer enough. As patients, accreditation bodies, and regulators increasingly demand that care is coordinated, safe, of high quality, and efficient, it is clear that healthcare organizations increasingly must function and learn not only as expert teams but also as expert multiteam systems (MTSs).

Approach

In this chapter, we offer a portrait of the robust, and albeit complex, multiteam structures that many healthcare systems are developing in order to adapt to rapid changes in regulatory and financial pressures while simultaneously improving patient safety, quality, and performance.

Findings and value

The notion of continuous improvement rooted in continuous learning has been embraced as a battle cry from the boardroom to the bedside, and the MTS concept offers a meaningful lens through which we can begin to understand, study, and improve these complex organizational systems dedicated to tackling some of the most important goals of our time.

Details

Pushing the Boundaries: Multiteam Systems in Research and Practice
Type: Book
ISBN: 978-1-78350-313-1

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Book part

Ann Scheck McAlearney

Increased attention to improve patient safety in healthcare has challenged healthcare managers to consider innovative approaches to meet this need. Organizational…

Abstract

Increased attention to improve patient safety in healthcare has challenged healthcare managers to consider innovative approaches to meet this need. Organizational development (OD) programs have been used in both health services and other industries to address organizational training and development requirements, and can provide focused, timely, and effective education and training to a broad spectrum of program participants. In healthcare organizations, OD programs can serve an important institutional function by providing a framework through which patient safety can be emphasized as an organizational priority, and patient safety training can be delivered as part of OD efforts. In addition, organizations committed to creating a patient-focused safety culture can use OD initiatives strategically to support organizational culture change efforts. This chapter describes different approaches to including patient safety in an OD framework, drawing from both management theory and practice. Findings from three extensive qualitative studies of leadership development and corporate universities in healthcare provide specific examples of how healthcare organizations discuss patient safety improvement using this alternative approach. Considering the concepts and findings described in this chapter can help healthcare organizations make strides toward positive changes in organizational culture that will promote patient safety on the organizational agenda.

Details

Patient Safety and Health Care Management
Type: Book
ISBN: 978-1-84663-955-5

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Article

Luise Vassie

Claims there is growing application of continuous improvement strategies across a wide range of operational activities. This paper reports on a case study, set in the UK…

Abstract

Claims there is growing application of continuous improvement strategies across a wide range of operational activities. This paper reports on a case study, set in the UK research division of a multinational chemical company, in which the six key principles of continuous improvement have been applied to health and safety management. The case study builds on the benefits of a proactive team‐based approach and addresses workforce behaviours and practices. The study emphasises, in particular, the importance of the integration of the process into the existing health and safety management system in order to address the long‐term maintenance issues. In order to achieve this, communication of strategic targets, milestones, progress and the involvement of all employees in the continuous improvement process have been identified as of paramount importance.

Details

Employee Relations, vol. 20 no. 6
Type: Research Article
ISSN: 0142-5455

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Article

Johan Hellings, Ward Schrooten, Niek S. Klazinga and Arthur Vleugels

Improving hospital patient safety means an open and stimulating culture is needed. This article aims to describe a patient safety culture improvement approach in five…

Abstract

Purpose

Improving hospital patient safety means an open and stimulating culture is needed. This article aims to describe a patient safety culture improvement approach in five Belgian hospitals.

Design/methodology/approach

Patient safety culture was measured using a validated Belgian adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. Studies before (autumn 2005) and after (spring 2007) the improvement approach was implemented were completed. Using HSOPSC, safety culture was measured using 12 dimensions. Results are presented as evolving dimension scores.

Findings

Overall, 3,940 and 3,626 individuals responded respectively to the first and second surveys (overall response rate was 77 and 68 percent respectively). After an 18 to 26 month period, significant improvement was observed for the “hospital management support for patient safety” dimension – all main effects were found to be significant. Regression analysis suggests there is a significant difference between professional subgroups. In one hospital the “supervisor expectations and actions promoting safety” improved. The dimension “teamwork within hospital units” received the highest scores in both surveys. There was no improvement and sometimes declining scores in the lowest scoring dimensions: “hospital transfers and transitions”, “non‐punitive response to error”, and “staffing”.

Research limitations/implications

The five participating hospitals were not randomly selected and therefore no representative conclusions can be made for the Belgian hospital sector as a whole. Only a quantitative approach to measuring safety culture was used. Qualitative approaches, focussing on specific safety cultures in specific parts of the participating hospitals, were not used.

Practical implications

Although much needs to be done on the road towards better hospital patient safety, the study presents lessons from various perspectives. It illustrates that hospital staff are highly motivated to participate in measuring patient safety culture. Safety domains that urgently need improvement in these hospitals are identified: hospital transfers and transitions; non‐punitive response to error; and staffing. It confirms that realising progress in patient safety culture, demonstrating at the same time that it is possible to improve management support, is complex.

Originality/value

Safety is an important service quality aspect. By measuring safety culture in hospitals, with a validated questionnaire, dimensions that need improvement were revealed thereby contributing to an enhancement plan.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 5
Type: Research Article
ISSN: 0952-6862

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Article

Farshid Baniassadi, Amin Alvanchi and Ali Mostafavi

Safety and productivity are key concerns in the construction projects. While safety looks to the construction workers need to work in a safe environment, productivity…

Abstract

Purpose

Safety and productivity are key concerns in the construction projects. While safety looks to the construction workers need to work in a safe environment, productivity affects the project’s profitability and is of a paramount importance from the project owner’s view. The different perspective to the safety and productivity from these two major players in construction projects poses a potential for the conflict between the two. This problem can be fundamentally addressed by methods concurrently improving project safety and productivity. The paper aims to discuss this issue.

Design/methodology/approach

To this aim, a discrete event simulation (DES) based framework applicable was proposed for complex and hazardous operations. The utility of the framework was tested using a case study of an eight-story residential building in the north-east part of Tehran, Iran. The excavation and stabilization operation was identified as the most hazardous and critical operation in this case. The framework could improve safety and productivity of this operation by 38 and 4 percent, respectively.

Findings

This framework is a complement to the conventional construction project safety and productivity planning methods. Its main application is in complex and hazardous construction operations.

Originality/value

For the first time, a comprehensive framework for concurrently improving safety and productivity of an entire project was proposed in this research. DES was used as the main modeling tool in the framework to provide an ex-ante evaluation foundation applicable to a wide range of construction projects.

Details

Engineering, Construction and Architectural Management, vol. 25 no. 11
Type: Research Article
ISSN: 0969-9988

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Article

Chantal Backman, Paul C. Hebert, Alison Jennings, David Neilipovitz, Omar Choudhri, Akshai Iyengar, Romain Rigal and Alan J. Forster

Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to…

Abstract

Purpose

Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to quality improvement. Despite these organizational efforts to better detect adverse events, efficient resolution of safety problems remains a significant challenge. The authors developed and implemented a comprehensive multimodal patient safety improvement program called SafetyLEAP. The term “LEAP” is an acronym that highlights the three facets of the program including: a Leadership and Engagement approach; Audit and feedback; and a Planned improvement intervention. The purpose of this paper is to evaluate the implementation of the SafetyLEAP program in the intensive care units (ICUs) of three large hospitals.

Design/methodology/approach

A comparative case study approach was used to compare and contrast the adherence to each component of the SafetyLEAP program. The study was conducted using a convenience sample of three (n=3) ICUs from two provinces. Two reviewers independently evaluated major adherence metrics of the SafetyLEAP program for their completeness. Analysis was performed for each individual case, and across cases.

Findings

A total of 257 patients were included in the study. Overall, the proportion of the SafetyLEAP tasks completed was 64.47, 100, and 26.32 percent, respectively. ICU nos 1 and 2 were able to identify opportunities for improvement, follow a quality improvement process and demonstrate positive changes in patient safety. The main factors influencing adherence were the engagement of a local champion, competing priorities, and the identification of appropriate resources.

Practical implications

The SafetyLEAP program allowed for the identification of processes that could result in patient harm in the ICUs. However, the success in improving patient safety was dependent on the engagement of the care teams.

Originality/value

The authors developed an evidence-based approach to systematically and prospectively detect, improve, and evaluate actions related to patient safety.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 2
Type: Research Article
ISSN: 0952-6862

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Article

Tariq Umar

construction industry in the Gulf Cooperation Council (GCC) member countries is at the peak as the region is in the stage of developing its infrastructures. Apart from…

Abstract

Purpose

construction industry in the Gulf Cooperation Council (GCC) member countries is at the peak as the region is in the stage of developing its infrastructures. Apart from some positive sign of this boost, several other issues have also been developed in the region. One of such issues is the safety of workers at the construction sites. This article, based on a variety of applications of drones in other industrial sectors, considers the use of drones for construction safety improvement in the GCC countries. This article aimed to investigate the safety-related applications of drones considering technical features and barriers and enablers for safety-related tasks.

Design/methodology/approach

A mixed research approach using both qualitative and quantitative methods was adopted to achieve the aims and objectives of this research. Data were collected through a systematic literature review, semistructured interviews and using a structured questionnaire. A total of 37 relevant research items and 10 interviews were held with construction safety professionals, and 92 responses collected from the safety managers through a structured questionnaire was used to derive the conclusion of this research. The collected data were processed and analyzed using the Statistical Product and Service Solutions (SPSS) program. Descriptive analyses were carried out in which means and importance factors were calculated.

Findings

25.92% of participants confirmed that they or their company had used the drone in different activates. The most common application of drones reported by the respondents was photography for marketing purposes followed by surveying application and quality inspections. The camera movability was the top-rated technical feature required for safety-related inspections. Similarly, “Working near the corner or edge of unprotected opening” was the top-rated application of drone for safety-related tasks. The safety concerns of using drones at job sites were rated as the most important barrier by the participants. Technical challenges associated with the use of drones for safety improvement was rated as the second most important barrier by the participants.

Research limitations/implications

Although, the research presented in this article is based on the GCC construction industry, however, since the data collected through systematic review and semistructured interviews are not a regional base, therefore the finding of this research could also be useful in other regions. Further research however, needs to be conducted to reduce the implications of the barriers identified in this paper so that the drone can be effectively used for safety improvement in construction not only in the GCC region but also in other countries.

Practical implications

Once the GCC construction industry will be able to overcome the challenges associated with the application of drones in safety improvement, the safety managers will be able to monitor the site more effectively which could be helpful to improve the safety performance of the construction organization.

Social implications

Improved safety performance in not only in the greater interest of the construction organizations as they can reduce the costs associated with poor safety but can also avoid the delay caused by construction accidents. Similarly, improved safety performance reduces the accidents at construction sites, and thus reduces injuries and disabilities caused by such accidents, making the construction workers a useful part of the society. The application of drones in safety-related tasks is one of the key solutions that can lead us to improved safety performance.

Originality/value

Although, the use of drone technology has revolutionized a number of industrial sectors due to its variety of applications, the application in construction particularly in the GCC region is still very limited. As noted in the results of this research, only 21 participants (25.92%) expressed that they or their company had used the drone in different activates. This means that the industry is not getting the full advantage of the available drone technology. The results of this research will enable construction industry stakeholders to know the challenges associated with the application of drones for safety improvement and to develop strategies to overcome these challenges.

Details

Engineering, Construction and Architectural Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0969-9988

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Article

Maria Crema and Chiara Verbano

In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue…

Abstract

Purpose

In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue and achieve multiple objectives. Inside the research stream that intends to combine health lean management (HLM) and clinical risk management (CRM), the purpose of this paper is to study the significant features that characterize HLM projects obtaining patient safety improvements (L&S projects).

Design/methodology/approach

The novelty of the research implies to adopt qualitative research methodology, analyzing in-depth case studies. L&S projects at different organizational levels have been selected from the same hospital. Following a research protocol, data have been collected through semi-structured interviews and they have been triangulated studying reports and archival documentation.

Findings

Comparing the three cases, it emerges that HLM can be a support for CRM since safety improvements can be achieved solving organizational issues. Analyzing the significant features of the three cases, relevant differences have been highlighted among them. At the end, first indications useful for achieving safety improvements from lean project implementation have been grasped.

Originality/value

This research provides a preliminary contribution to a new research stream that aims to develop a synergic methodology combining HLM and CRM. The first provided indications can be followed by hospital managers who wish to learn how to implement projects achieving patient safety improvements besides efficiency enhancement. After testing and exploiting the obtained results, a new methodology should be developed moving toward a safer and more sustainable healthcare system.

Details

International Journal of Quality & Reliability Management, vol. 33 no. 8
Type: Research Article
ISSN: 0265-671X

Keywords

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