Advancing Patient Safety in the U.S. Department of Veterans Affairs

As part of a systemwide transformation, the VA formed its National Center for Patient Safety to foster an organizational culture of safety within its nationwide network of hospitals and outpatient clinics. A recent medical team training program designed to improve communication among operating room staff was associated with a reduction in surgical mortality and improvements in quality of care, on-time surgery starts, and staff morale. The program is now being expanded to other clinical units, along with a patient engagement program that prevents errors by facilitating communication relating to patients' daily care plans. A recognition program stimulated facilities to conduct timelier and higher-quality root-cause analyses of reported safety events to identify stronger actions for preventing their recurrence. Other initiatives have reduced rates of health care -- associated infections, patient mortality, and post-operative complications. Success factors include leadership accountability for performance and organizational support for testing, expanding, and adopting improvements

Annotated bibliography of community music research review, AHRC connected communities programme

This research review, consisting of a 90-entry annotated bibliography, was produced as part of an AHRC Connected Communities programme project entitled Community Music, its History and Current Practice, its Constructions of ‘Community’, Digital Turns and Future Soundings. It supports a 2,500 word report written with this same title for the AHRC

Developing sustainable business models for institutions’ provision of open educational resources: Learning from OpenLearn users’ motivations and experiences

Universities across the globe have, for some time, been exploring the possibilities for achieving public benefit and generating business and visibility through releasing and sharing open educational resources (OER). Many have written about the need to develop sustainable and profitable business models around the production and release of OER. Downes (2006), for example, has questioned the financial sustainability of OER production at scale. Many of the proposed business models focus on OER’s value in generating revenue and detractors of OER have questioned whether they are in competition with formal education. This paper reports on a study intended to broaden the conversation about OER business models to consider the motivations and experiences of OER users as the basis for making a better informed decision about whether OER and formal learning are competitive or complementary with each other. The study focused on OpenLearn - the Open University’s (OU) web-based platform for OER, which hosts hundreds of online courses and videos and is accessed by over 3,000,000 users a year. A large scale survey and follow-up interviews with OpenLearn users worldwide revealed that university provided OER can offer learners a bridge to formal education, allowing them to try out a subject before registering on a formal course and to build confidence in their abilities as learners. In addition, it was found that using OER during formal paid-for study can improve learners’ performance and self-reliance, leading to increased retention and satisfaction with the learning experience

Open educational resources for all? Comparing user motivations and characteristics across The Open University’s iTunes U channel and OpenLearn platform.

With the rise in access to mobile multimedia devices, educational institutions have exploited the iTunes U platform as an additional channel to provide free educational resources with the aim of profile-raising and breaking down barriers to education. For those prepared to invest in content preparation, it is possible to produce interactive, portable material that can be made available globally. Commentators have questioned both the financial implications for platform-specific content production, and the availability of devices for learners to access it (Osborne, 2012). The Open University (OU) makes its free educational resources available on iTunes U and via its web-based open educational resources (OER) platform, OpenLearn. The OU’s OER on iTunes U reached the 60 million download mark in 2013; its OpenLearn platform boasts 27 million unique visitors since 2006. This paper reports the results of a large-scale study of users of the OU’s iTunes U channel and OpenLearn platform. A survey of several thousand users revealed key differences in demographics between those accessing OER via the web and via iTunes U. In addition, the data allowed comparison between three groups: formal learners, informal learners and educators. The study raises questions about whether university-provided OER meet the needs of users and makes recommendations for how content can be modified to suit their needs. As the publishing of OER becomes core to business, we reflect on reasons why understanding users’ motivations and demographics is vital, allowing for needs-led resource provision and content that is adapted to best achieve learner satisfaction, and to deliver institutions’ social mission

The Clean Energy Economy: Repowering Jobs, Businesses and Investments Across America

Examines U.S. and state-by-state clean energy policies and trends in and potential for growth in jobs, businesses, and investments. Explores policy options for a comprehensive plan, including financial incentives and energy efficiency standards

Maintaining the Master Patient Index: The impact of patient registration processes on data integrity

The master patient index is one of the most important components within a healthcare system. It ensures that an individual patient is given a unique identifier that is used across the various separate clinical, financial and administrative systems and ensures that all information about that patient is organized and complete. Ensuring the MPI is accurate is critical since errors can have significant costs- both financially and in terms of patient outcomes. Patient registrars are the first line of defense when it comes to correctly identifying incoming patients and is where many errors in the MPI occur. Errors can be simple misspellings in a patient name, unknowingly assigning a patient a second medical record number, or the worst type, registering a patient under a different patient’s MRN leading to intertwined medical histories being viewed by providers. This study looked specifically at a major health system in Richmond, Virginia to determine the existing workflows on how patients were identified in the MPI and how errors were corrected once known. A literature review was performed to determine if any evidence based practices exist for maintaining MPI data integrity and how the focus health system compares. In addition, two other comparable health organizations were surveyed to determine how they compare with the target and with national standards. It was found that the health system of focus did not have a MPI quality program in place at all which explains why it struggles with errors. A plan for a MPI program using criteria in the Improvement Focused Model was created and implemented. This plan focused on better collection of data on errors, more standardized procedures for registrars, and constructive feedback to registrars when errors do occur. Although after a relatively short period of implementation, there was little difference seen in the number of new errors being generated, it did find that there were a relatively few areas that were creating the majority of errors. Focus on these areas will undoubtedly help reduce future errors. Other factors that impact the lack of a decrease of errors is the complexity of how new registrations are created- some are generated by interfaces and have no human intervention at all. The takeaway from this study is that there are many more players with a critical role in data integrity than previously expected and that a quality MPI integrity program needs to be an ongoing program that focuses on continuous education, monitoring, and feedback to those players involved

Legal Challenges and Market Rewards to the Use and Acceptance of Remote Sensing and Digital Information as Evidence

Bakgrund I den nutida forskningen är det essentiellt att företag tar hänsyn till medarbetarnas motivation så att de gynnas av det arbetssätt som tillämpas. En arbetsmetod som blivit allt vanligare är konceptet Lean som ursprungligen kommer från den japanska bilindustrin. Lean har idag utvecklats till ett allmängiltigt koncept som tillämpas i flertalet branscher världen över. Trots att konceptet innebär flertalet positiva aspekter har det fått utstå stark kritik när det kommer till de mänskliga aspekterna och forskare har ställt sig frågan om Lean är "Mean". Kritiken härleds främst till medarbetares arbetsmiljö i form av stress och brist på variation, självbestämmande, hälsa och välmående. Få empiriska studier har däremot genomförts som undersöker konsekvenserna som Lean får på medarbetares upplevda motivation. Syfte Vårt syfte är att undersöka och öka förståelsen för medarbetares upplevelser av motivationen i företag som tillämpar Lean. Vidare har studien för avsikt att utreda om det föreligger en paradox mellan Lean och vad som motiverar medarbetare på en arbetsplats. Metod Studien har utgått från en kvalitativ metod via intervjuer. För att göra en djupare undersökning och analysera hur vårt fenomen, motivation, upplevs i en kontext med Lean tillämpade vi Små-N-studier. Vi har även haft en iterativ forskningsansats som förenat den deduktiva och induktiva ansatsen där studien pendlat mellan teorier och empiriska observationer fram tills det slutgiltiga resultatet. Slutsatser Utefter medarbetarnas upplevelser har vi identifierat att det inte föreligger någon paradox mellan Lean och motivation eftersom övervägande antal medarbetare upplevde att de är motiverade även om företaget tillämpar Lean. Dock har studien kunnat urskilja både stödjande och motverkande faktorer när det kommer till medarbetarnas upplevda arbetsförhållanden som i sin tur inverkar på motivationen. De motverkande faktorerna menar vi främst beror på att arbetsförhållandena i somliga fall innehåller höga prestationskrav, målstyrning samt standardiseringar. Vidare upplevs motivationen överlag som mer positiv när företagen använder en mjukare form av Lean där samtliga medlemmars intressen beaktas.Background In modern research, it is essential that companies consider employees’ motivation so that they benefit from the applied practices. A working method that has become increasingly common is the concept Lean, which has its origin in the Japanese automotive industry. Today, Lean has evolved into a universal concept that is applied in many industries worldwide. Although the concept involves numerous positive aspects it has endured strong criticism when it comes to the human aspects and researchers have raised the question if Lean is "Mean". Criticism is derived primarily to employees’ working conditions in terms of stress and lack, variation, autonomy, health and wellbeing. However, few empirical studies have been carried out that examines the impact that Lean has on employees’ experienced motivation. Aim The aim is to increase the understanding of employees’ experienced motivation in companies that practice Lean. Further on the study has the intention to investigate if there is a paradox between Lean and what motivates employees on work. Methodology The study has been conducted through a qualitative method by interviews and to be able to do a deeper examination and analyze how our phenomenon, motivation, is experienced in a Lean context we applied small-N-studies. Our strategy has been iterative, combining both a deductive and inductive approach, where the study has varied between theories and empirical observations until the final result. Conclusions We have identified that there is no paradox between Lean and motivation since the majority of employees’ experienced that they are motivated even though the company practice Lean. Nevertheless the study shows that there are both supportive and counteractive factors when it comes to the employees’ experienced working conditions. The counteractive factors consists foremost of high performance standards, goal steering and standardizations, and have in some cases a negative influence on the working conditions. Furthermore the experienced motivation is more positive overall when the companies use a softer form of Lean where all the members’ interests are taken into account

A More Perfect Union: A National Citizenship Plan

A More Perfect Union: A National Citizenship Plan sets forth the resources, activities, and partnerships that would be required to naturalize as many eligible immigrants as possible. It calls for a national mobilization in support of citizenship, identifying the roles of government, immigrant service agencies, and other sectors of society in a coordinated plan. It describes a program that could serve as a linchpin of an emerging U.S. immigrant integration strategy.Access the complete report via the download link below. An executive summary and individual chapters may be downloaded at http://www.cliniclegal.org/DNP/citzplan.html

Key Topics on End-of-Life Care for African Americans

Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications. Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African-Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end of life care in African-American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families