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Recent reports by the Institute of Medicine (IOM) signal a substantial yet unrealized deficit in patient safety innovation and improvement. With the aim of reducing this dilemma, we provide an introductory account of clinical error resulting from poorly designed systems by reviewing the relevant health care, management, psychology, and organizational accident sciences literature. First, we discuss the concept of health care error and describe two approaches to analyze error proliferation and causation. Next, by applying transdisciplinary evidence and knowledge to health care, we detail the attributes fundamental to constructing safer health care systems as embedded components within the complex adaptive environment. Then, the Health Care Error Proliferation Model explains the sequence of events typically leading to adverse outcomes, emphasizing the role that organizational and external cultures contribute to error identification, prevention, mitigation, and defense construction. Subsequently, we discuss the critical contribution health care leaders can make to address error as they strive to position their institution as a high reliability organization (HRO). Finally, we conclude that the future of patient safety depends on health care leaders adopting a system philosophy of error management, investigation, mitigation, and prevention. This change is accomplished when leaders apply the basic organizational accident and health care safety principles within their respective organizations.

This chapter proposes an optimized innovative information technology as a means for achieving operational functionalities of real-time portable electronic health records, system interoperability, longitudinal health-risks research cohort and surveillance of adverse events infrastructure, and clinical, genome regions – disease and interventional prevention infrastructure. In application to the Dod-VA (Department of Defense and Veteran's Administration) health information systems, the proposed modernization can be carried out as an “add-on” expansion (estimated at $288 million in constant dollars) or as a “stand-alone” innovative information technology system (estimated at $489.7 million), and either solution will prototype an infrastructure for nation-wide health information systems interoperability, portable real-time electronic health records (EHRs), adverse events surveillance, and interventional prevention based on targeted single nucleotide polymorphisms (SNPs) discovery.

The paper seeks to examine the manifestation of management paradigms in personnel magazines of Finnish metal and forest industry corporations from the 1930s to recent years.

The research data consist of articles of personnel magazines on management. The articles were analyzed by quantitative and qualitative content analysis.

The findings indicate that normative paradigms, such as industrial betterment, human relations school, and cultural theories, have been discussed in personnel magazines more than rational paradigms, although earlier studies suggest that in general rational management paradigms have been more influential in Finland. The frequent use of normative paradigms can be seen as a tool in enforcing the role of personnel journals in generating a sense of belonging and togetherness among employees. Normative paradigms are also discussed more frequently in the articles that are written from the viewpoint of the worker than those written from the viewpoint of the manager or company.

The study offers empirical evidence on the adoption of management paradigms in different lines of industries. It also shows that personnel magazines provide a rich and interesting source of data that could be used more frequently than has traditionally been the case.

The purpose of this paper is to describe a symbolic-interpretative research on the leadership culture and its subcultures in one unified comprehensive school in Finland.

The research is a phenomenological, qualitative case study. Its methodology is based on triangulation.

The leadership culture of the unified comprehensive school studied in the present research seemed to be based on equality, communality, appreciation, flow of information and humor. Besides examining the general leadership culture of the school, an attempt was made to study the possible subcultures of the school by examining the six subject groups into which the teachers were divided in the school on the basis of the teachers’ education and tasks. These subject groups formed the subgroups of the research. If a subgroup's interpretation of the leadership culture of the school differed significantly from those of the other subgroups, the subgroup was considered to have a subculture of its own. Only one such subculture was found, that of the mathematic teachers. It, too, although being clearly a subculture of its own, included several common features with the main leadership culture of the unified comprehensive school.

The study is the first one in Finnish schools where leadership culture is conceived as a constantly reforming outcome of the meaning and interpretation processes which form themselves through the social structures of the school in connection to the leadership actions at the school.