Alcohol, assault and licensed premises in inner-city areas

This report contains eight linked feasibility studies conducted in Cairns during 2010. These exploratory studies examine the complex challenges of compiling and sharing information about incidents of person-to-person violence in a late night entertainment precinct (LNEP). The challenges were methodological as well as logistical and ethical. The studies look at how information can be usefully shared, while preserving the confidentiality of those involved. They also examine how information can be compiled from routinely collected sources with little or no additional resources, and then shared by the agencies that are providing and using the information.Although the studies are linked, they are also stand-alone and so can be published in peer-reviewed literature. Some have already been published, or are ‘in press’ or have been submitted for review. Others require the NDLERF board’s permission to be published as they include data related more directly to policing, or they include information provided by police.The studies are incorporated into the document under section headings. In each section, they are introduced and then presented in their final draft form. The final published form of each paper, however, is likely to be different from the draft because of journal and reviewer requirements. The content, results and implications of each study are discussed in summaries included in each section.Funded by the National Drug Law Enforcement Research Fund, an initiative of the National Drug StrategyAlan R Clough (PhD) School of Public Health, Tropical Medicine and Rehabilitation Sciences James Cook UniversityCharmaine S Hayes-Jonkers (BPsy, BSocSci (Hon1)) James Cook University, Cairns.Edward S Pointing (BPsych) James Cook University, Cairns

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis

Introduction: Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. Materials and Methods: We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. Results: We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. Conclusions: We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings

Enhancing health care non-technical skills: the TINSELS programme

Background and Context: Training in ‘non-technical skills’, social (communication and team work) and cognitive (analytical and personal behaviour) skills, in healthcare have been of great interest over the last decade. Whilst the majority of publications focus on ‘whether’ such education can be successful, they overlook the question of ‘how’ they enhance skills. We designed and piloted an original, theoretically robust and replicable teaching package that addresses non-technical skills in the context of medicines safety through simulation-based inter professional learning: the TINSELS (Training In Non-technical Skills to Enhance Levels of Medicines Safety) Programme. Innovation: A modified Delphi process was completed to identify learning outcomes, and recruitment of multi-professional teams was through local publicity. The faculty developed a three-session simulation based intervention: session one was a simulated ward encounter with multiple medicine related activities; session two was an extended debrief and facilitated discussion; and session three a ‘chamber of horrors’ where inter professional teams identified potential sources of error. Each session was completed in the simulation suite with 6 – 9 participants, lasted approximately 90m minutes, and took place over 2 weeks. Full details of the course will be presented to facilitate dissemination. Implications: Likert scale feedback was collected after the course (1 strongly disagree-5 strongly agree). Mean scores were all greater than 4, with qualitative feedback noting the fidelity of the authentic inter professional learner groups. A previously validated safety attitudes questionnaire found changes in attitudes towards handover of care and perceptions of safety levels in the workplace post intervention. An original, simulation based, multi-professional training programme has been developed with learning and assessment materials available for widespread replication

Ludic Learning Lab: Serious Games for Nurses. Theatre Training Reimagined

Theatre improvisation supports the development of interpersonal skills, building verbal and physical imagination, whilst enabling compassionate interaction between people to enhance connections. Improvisation is emerging in health care as a pedagogical tool that can enhance human to human connections such as the interaction between a nurse and patient enabling experiential learning. This thesis argues that the ludic nature of improvisation exercises stimulates enhanced interaction skills (Toivanen, 2011). The ancient body-mind practices that improvisation draws on offer valuable skills to the learner, contributing to the andragogy of nurse practice and pre-registration education and training. Nurses require unique cognitive capabilities to multi-task, problem-solve and prioritise urgent needs in a fast-paced hospital environment. Human factors such as communication and situational awareness are essential to maintaining high-level patient care across a challenging environment (Eisenhardt, 2021). The World Health Organisation (WHO, 2019) and The Australian Commission for Quality and Safety in Health Care (Report The State of Patient Safety and Quality in Australian Hospitals, 2019; Fotis, 2010) found that deficiencies in human factor skills in hospital settings are affecting patient safety; fifty per cent of adverse events are preventable. Communicating for safety in training is a number one priority to reduce preventable adverse events. This thesis explores the principles and theories of theatrical improvisation through engaging with the work of Viola Spolin, Rudolph Laban, Augusto Boal, Jacob L Moreno, David Kolb and Howard Gardner. It comprises both a theoretical/critical component and a creative component which is a digital toolkit, the Improv-e-toolkit designed to be used in blended delivery, face-to-face and digital mode. The Improv-e-toolkit is a prototype that aims to unite important clinical nursing skills such as situational awareness, decision making and relationship management. I argue, drawing on the work of Hager (2004) that improvisation training develops team-based trust and effective communication to support positive nurse-patient connections which deliver favourable patient outcomes

Social and interactional practices for disseminating current awareness information in an organisational setting.

Current awareness services are designed to keep users informed about recent developments based around user need profiles. In organisational settings, they may operate through both electronic and social interactions aimed at delivering information that is relevant, pertinent and current. Understanding these interactions can reveal the tensions in current awareness dissemination and help inform ways of making services more effective and efficient. We report an in-depth, observational study of electronic current awareness use within a large London law firm. The study found that selection, re-aggregation and forwarding of information by multiple actors gives rise to a complex sociotechnical distribution network. Knowledge management staff act as a layer of “intelligent filters” sensitive to complex, local information needs; their distribution decisions address multiple situational relevance factors in a situation fraught with information overload and restrictive time-pressures. Their decisions aim to optimise conflicting constraints of recall, precision and information quantity. Critical to this is the use of dynamic profile updates which propagate back through the network through formal and informal social interactions. This supports changes to situational relevance judgements and so allows the network to ‘self-tune’. These findings lead to design requirements, including that systems should support rapid assessment of information items against an individual’s interests; that it should be possible to organise information for different subsequent uses; and that there should be back-propagation from information consumers to providers, to tune the understanding of their information needs

A review of clinical decision-making: Models and current research

Aims and objectives: The aim of this paper was to review the current literature with respect to clinical decision-making models and the educational application of models to clinical practice. This was achieved by exploring the function and related research of the three available models of clinical decision making: information processing model, the intuitive-humanist model and the clinical decision making model. Background: Clinical decision-making is a unique process that involves the interplay between knowledge of pre-existing pathological conditions, explicit patient information, nursing care and experiential learning. Historically, two models of clinical decision making are recognised from the literature; the information processing model and the intuitive-humanist model. The usefulness and application of both models has been examined in relation the provision of nursing care and care related outcomes. More recently a third model of clinical decision making has been proposed. This new multidimensional model contains elements of the information processing model but also examines patient specific elements that are necessary for cue and pattern recognition. Design: Literature review Methods: Evaluation of the literature generated from MEDLINE, CINAHL, OVID, PUBMED and EBESCO systems and the Internet from 1980 – November 2005

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

Being While Doing: An Inductive Model of Mindfulness at Work

Mindfulness at work has drawn growing interest as empirical evidence increasingly supports its positive workplace impacts. Yet theory also suggests that mindfulness is a cognitive mode of “Being” that may be incompatible with the cognitive mode of “Doing” that undergirds workplace functioning. Therefore, mindfulness at work has been theorized as “being while doing,” but little is known regarding how people experience these two modes in combination, nor the influences or outcomes of this interaction. Drawing on a sample of 39 semi-structured interviews, this study explores how professionals experience being mindful at work. The relationship between Being and Doing modes demonstrated changing compatibility across individuals and experience, with two basic types of experiences and three types of transitions. We labeled experiences when informants were unable to activate Being mode while engaging Doing mode as Entanglement, and those when informants reported simultaneous co-activation of Being and Doing modes as Disentanglement. This combination was a valuable resource for offsetting important limitations of the typical reliance on the Doing cognitive mode. Overall our results have yielded an inductive model of mindfulness at work, with the core experience, outcomes, and antecedent factors unified into one system that may inform future research and practice. We did a full hour … of [mindfulness] training… My pager went off like three times. … He\u27s telling us to meditate, and everyone\u27s pager was just beeping. It was not very conducive to meditating. –medical residen

Why Catastrophic Organizational Failures Happen

Excerpt from the introduction: The purpose of this chapter is to examine the major streams of research about catastrophic failures, describing what we have learned about why these failures occur as well as how they can be prevented. The chapter begins by describing the most prominent sociological school of thought with regard to catastrophic failures, namely normal accident theory. That body of thought examines the structure of organizational systems that are most susceptible to catastrophic failures. Then, we turn to several behavioral perspectives on catastrophic failures, assessing a stream of research that has attempted to understand the cognitive, group and organizational processes that develop and unfold over time, leading ultimately to a catastrophic failure. For an understanding of how to prevent such failures, we then assess the literature on high reliability organizations (HRO). These scholars have examined why some complex organizations operating in extremely hazardous conditions manage to remain nearly error free. The chapter closes by assessing how scholars are trying to extend the HRO literature to develop more extensive prescriptions for managers trying to avoid catastrophic failures