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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.

The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater patient safety in hospitals.

The Patient Safety Culture Hospital questionnaire was distributed hospital‐wide in five general hospitals. It evaluates ten patient safety culture dimensions and two outcomes. The scores were expressed as the percentage of positive answers towards patient safety for each dimension. The survey was conducted from March through November 2005. In total, 3,940 individuals responded (overall response rate = 77 per cent), including 2,813 nurses and assistants, 462 physicians, 397 physiotherapists, laboratory and radiology assistants, social workers and 64 pharmacists and pharmacy assistants.

The dimensional positive scores were found to be low to average in all the hospitals. The lowest scores were “hospital management support for patient safety” (35 per cent), “non‐punitive response to error” (36 per cent), “hospital transfers and transitions” (36 per cent), “staffing” (38 per cent), and “teamwork across hospital units” (40 per cent). The dimension “teamwork within hospital units” generated the highest score (70 per cent). Although the same dimensions were considered problematic in the different hospitals, important variations between the five hospitals were observed.

A comprehensive and tailor‐made plan to improve patient safety culture in these hospitals can now be developed.

Results indicate that important aspects of the patient safety culture in these hospitals need improvement. This is an important challenge to all stakeholders wishing to improve patient safety.

The work environment is known to influence professional attitudes toward quality and safety. This study sought to measure these attitudes amongst health professionals working in New Zealand District Health Boards (DHBs), initially in 2012 and again in 2017.

Three questions were included in a national New Zealand health professional workforce survey conducted in 2012 and again in 2017. All registered health professionals employed with DHBs were invited to participate in an online survey. Areas of interest included teamwork amongst professionals; involvement of patients and families in efforts to improve patient care and ease of speaking up when a problem with patient care is perceived.

In 2012, 57% of respondents (58% in 2017) agreed health professionals worked as a team; 71% respondents (73% in 2017) agreed health professionals involved patients and families in efforts to improve patient care and 69% (65% in 2017) agreed it was easy to speak up in their clinical area, with none of these changes being statistically significant. There were some response differences by respondent characteristics.

With no change over time, there is a demand for improvement. Also for leadership in policy, management and amongst health professionals if goals of improving quality and safety are to be delivered upon.

This study provides a simple three-question method of probing perceptions of quality and safety and an important set of insights into progress in New Zealand DHBs.

Selective laser melting (SLM) is an additive manufacturing process suitable for fabricating metal porous scaffolds. The unit cell topology is a significant factor that determines the mechanical property of porous scaffolds. Therefore, the purpose of this paper is to evaluate the effects of unit cell topology on the compression properties of porous Cobalt–chromium (Co-Cr) scaffolds fabricated by SLM using finite element (FE) and experimental measurement methods.

The Co-Cr alloy porous scaffolds constructed in four different topologies, i.e. cubic close packed (CCP), face-centered cubic (FCC), body-centered cubic (BCC) and spherical hollow cubic (SHC), were designed and fabricated via SLM process. FE simulations and compression tests were performed to evaluate the effects of unit cell topology on the compression properties of SLM-processed porous scaffolds.

The Mises stress predicted by FE simulations showed that different unit cell topologies resulted in distinct stress distributions on the bearing struts of scaffolds, whereas the unit cell size directly determined the stress value. Comparisons on the stress results for four topologies showed that the FCC unit cell has the minimum stress concentration due to its inclined bearing struts and horizontal arms. Simulations and experiments both indicated that the compression modulus and strengths of FCC, BCC, SHC, CCP scaffolds with the same cell size presented in a descending order. These distinct compression behaviors were correlated with the corresponding mechanics response on bearing struts. Two failure mechanisms, cracking and collapse, were found through the results of compression tests, and the influence of topological designs on the failure was analyzed and discussed. Finally, the cell initial response of the SLM-processed Co-Cr scaffold was tested through the in vitro cell culture experiment.

A focus and concern on the compression properties of SLM-processed porous scaffolds was presented from a new perspective of unit cell topology. It provides some new knowledge to the structure optimization of porous scaffolds for load-bearing bone implants.

The purpose of this study is to investigate the effect of the strut size and tilt angle on the densification behavior, surface roughness and dimensional accuracy of the selective laser melting AlSi10Mg lattice structure was investigated in this study. In this study, the characteristics such as the density, up-skin and down-skin roughness and dimensional accuracy of selective laser melting forming technology manufacturing (SLMed) AlSi10Mg cellular lattice structure were carried. This work reveals the effect of the strut size and tilt angle on the geometric characteristics of SLMed AlSi10Mg and is benefit for controlling the forming performance of the SLMed cellular lattice structure.

Based on AlSi10Mg powder, the influence of the tilt angle changed from 10° to 45° with an increment of 5° were investigated, the influence of the strut size was varied from 0.4 mm to 1.2 mm with an increment of 0.2 mm were investigated. The characteristics such as the density, up-skin and down-skin roughness, dimensional accuracy and mechanical properties of SLM-ed AlSi10Mg cellular lattice structure was carried.

Greater than 99% relative density can be achieved for different strut size when optimal process parameters are used. In the optimized process interval, the struts with a tilt angle of 10° can still be formed well, which is higher than the design limit of the inclined angle given in the related literature. The tilt angle has a significant effect on the surface roughness of the strut. The microhardness reached to 157 ± 3 HV, and the maximum compressive strength was 58.86 MPa, with the optimal process parameters.

In this study, the characteristics such as the density, up-skin and down-skin roughness and dimensional accuracy of SLMed AlSi10Mg cellular lattice structure were carried. With the optimal geometric parameters, the authors tested microhardness and compressive strength of the cellular lattice structure. The results of this study provide theoretical and experimental basis for the realization of high-quality manufacturing and optimization design of aluminum alloy cellular lattice structure, which will meet more diversified industrial needs.

Selective laser melting (SLM) is increasingly used to manufacture bone implants from titanium alloys with particular interest in porous lattice structures. These complex constructs have been shown to be capable of matching native bone mechanical behaviour leading to improved osseointegration while providing numerous clinical advantages, encouraging their broad use in medical devices. However, producing lattices with a strut diameter similar in scale to a typical SLM melt pool or using the same process parameters and scan strategies intended for bulk solid components may lead to geometric inaccuracies. The purpose of this study is to evaluate and optimise the single contour strategy for the production of Ti-6Al-4V lattices.

Herein, the potential of an unfilled single contour (SC) scanning strategy to improve the reproducibility of porous lattices when compared with a single contour and fill approach (SC + F) is explored. For this purpose, two parametric analysis were carried out on Ti-6Al-4V diamond unit cell lattices with different strut sizes and scan strategies. Porosity and accuracy measurements were correlated with processing parameters and printing strategy to provide the optimal processing window for lattice manufacturing.

SC is shown to be a viable strategy for production of Ti-6Al-4V lattices with a strut diameter below 350 µm. Parametric analysis highlights the limits of this method in producing fully dense struts with energy density presented as a useful practical tool to guide some aspects of parameter selection (design strut diameter achieved at approximately 0.1 J/mm in this study). Finally, a process map combining data from both parametric studies is provided to guide, predict and control lattice strut geometry and porosity obtained using the SC strategy.

These results explore the use of non-standard SC scanning strategy as a viable method for producing strut-based lattice structures and compare against the traditional contour and fill approach (SC + F).

This paper aims to investigate the processability by selective laser melting (SLM) of materials of potential interest for innovative biodegradable implants, pure Fe and pure Zn. The processability of these materials is evaluated with a more established counterpart in permanent implants, stainless steel. In particular, the processing conditions were studied to reduce porosity due to incomplete fusion of the powder.

In the first phase of the experiments, SLM of AISI 316L was studied through design of experiments method. The study was used to identify the significant parameters in the experimental range and estimate the fluence ranges for pure Fe and pure Zn using the lumped heat capacity model. In the second phase, SLM of pure Fe and pure Zn were studied using estimated fluence ranges. In the final phase, best conditions were characterized for mechanical properties.

The results showed that complete melting of AISI 316L and pure Fe could be readily achieved, whereas laser melting generated a foam-like porous structure in Zn samples. The mechanical properties of laser melt implant materials were compared to as-cast and rolled counterparts. Laser melted AISI 316L showed superior mechanical performance compared to as-cast and rolled material, whereas Fe showed mechanical performance similar to rolled mild steel. Despite 12 per cent apparent porosity, laser melted Zn exhibited superior mechanical properties compared to as-cast and wrought material because of reduced grain size.

The paper provides key processing knowledge on the SLM processability of new biodegradable metals, namely, pure Fe, which has been studied sparingly, and pure Zn, on which no previous work is available. The results prefigure the production of new biodegradable metallic implants with superior mechanical properties compared to their polymeric counterparts and with improved degradation rates compared to magnesium alloys, the reference material for biodegradable metals.