Search results

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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”.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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).

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.

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.

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.

Globally, safety in healthcare services has become an important focus. The Sultan Qaboos University Hospital (SQUH), located in the Sultanate of Oman in the Arabian Gulf, has begun to take active steps in delivering safer healthcare services while moving towards healthcare excellence. The purpose of this paper is to show the importance of prioritizing hospital‐wide safety and discuss how it has become essentially linked to the multi‐faceted dimension of quality through acceptability, efficiency accessibility and continuity in SQUH.

In an effort to shift all cultural elements of SQUH staff, system and activities towards addressing the goal of safety, SQUH has brought on a safety culture by holistic and systemic approach to quality improvement. Illustrated herein is the journey of how the hospital is addressing and measuring the goal of safety as an organizational priority through values, beliefs, goals, policies and operations.

The progressive steps that SQUH initiated since 2008 which measure, assess and ultimately change the perception of safety in the hospital are described. Specific recommendations include addressing safety culture elements of communicated values and objectives and measuring them, raising the awareness and training barriers, adopting safety goals specific to hospital environment, and centralizing a monitoring system to track input, progress and closure of safety mechanisms and activities.

The paper presents a model for improving safety in healthcare services through the initiatives of a university hospital, implementing a measureable phase approach over a two‐year period for addressing the goal of safety.

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.

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.

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.

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.

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.

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.

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.

Describes the use of safety attitudes as the basis for an intervention to improve safety performance in a power generation company. Following an initial survey using the safety attitude questionnaire developed by the SRU, a set of initiatives was developed. The initiatives included setting up safety teams, the introduction of written action plans, the provision of workforce safety budgets and an enhanced profile for management action. The initiatives were implemented by the SRU over a period of one year. Following the intervention there were improvements in safety attitude, lost time accident rates, self‐reported accident rates and absenteeism levels.

Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis.

In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix.

The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals.

Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system’s weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success.

Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.