188 research outputs found
A critical review of the systems approach within patient safety research
The application of concepts, theories and methods from systems ergonomics within
patient safety has proved to be an expanding area of research and application in the
last decade. This paper aims to take a step back and examine what types of research
have been conducted so far and use the results to suggest new ways forward. An
analysis of a selection of the patient safety literature suggests that research has so
far focused on human error, frameworks for safety and risk, and incident reporting.
The majority of studies have addressed system concerns at an individual level of
analysis with only a few analysing systems across multiple system boundaries.
Based on the findings it is argued that future research needs to move away from a
concentration on errors and towards an examination of the connections between
systems levels. Examples of how this could be achieved are described in the paper
System analysis for infection control in acute hospitals
This paper makes the case for applying a systems perspective to the analysis of
hospital-based infection outbreaks. Most of the research that has been
conducted on behavioural aspects of infection control has focused on
explanations at an individual level of analysis (e.g., interventions to improve
hand washing). The infections outbreaks at the Maidstone and Tunbridge Wells
NHS Trust are analysed in detail using an established framework for risk
management. The paper further outlines the human and organisational issues
raised by the analysis and provides a means through which these aspects of
infection can be highlighted as part of a future research agenda within systems
ergonomics
Ergonomics and infection outbreaks
Ergonomics and infection outbreak
Infection outbreaks in acute hospitals: a systems approach
This paper puts forward the case for applying a systems
approach to the analysis of hospital-based
infection outbreaks. A major advantage of the systems
approach is that it affords insights into how actions
or occurrences at one system level (e.g. individual error)
collectively interact with team (e.g. leadership style) and
organisational (e.g. safety culture) levels of analysis.
Most of the research concerned with behavioural aspects
of infection control has focused on a single level of analysis
(e.g. interventions to improve hand washing). The
infection outbreaks at the Maidstone and Tunbridge
Wells NHS Trust are used as a case study in order to
demonstrate the usefulness of the systems approach.
The paper further outlines the human and organisational
issues raised by the analysis and provides a means
through which these aspects of infection can be highlighted
as part of a future research agenda
Sacrifices in the name of science
Sacrifices in the name of scienc
A systems ergonomics analysis of the Maidstone and Tunbridge Wells infection outbreaks
This paper describes a systems ergonomics analysis of the recent outbreaks of
Clostridium difficile which occurred over the period 2005-07 within the UK
Maidstone and Tunbridge Wells NHS Trust. The analysis used documents related to
the outbreak, alongside the construction of a system model in order to probe deeper
into the nature of contributory factors within the Trust. The findings from the analysis
demonstrate the value of looking further at cross-level and whole-system aspects of
infection outbreaks. In particular there is a need for further study of the causal
relationships that exist between hospital management and clinical management levels
within the system. Finally, the paper discusses ways forward and strategies that could
adopted in order to limit the outbreak of hospital-related infections and shape future
research
Taking stock of the systems approach to patient safety
The application of concepts, theories and methods from systems
ergonomics to the domain of patient safety has proved to be an expanding area
of research and application in the last 15 years. This paper describes a review of
the approach which aimed to identify: the main issues that have been
researched; the types of methods of investigation adopted by researchers; the
extent to which different system levels are covered; and, the types of medical
domain in which work has gone on in the last few years. A total of 360 papers
were selected for a detailed review. Approximately 16% of these focused on
human error, followed by safety/error frameworks (13%), incident reporting
(12%) and perceptions of safety/risk (9%). Most studies have addressed system
concerns at the level of the individual (27%). The most frequent methodology
used within research adopting the approach are case studies (33%). The
findings from the review are discussed within the context of previous
evaluations and criticisms of the systems approach and patient safety
Organizing competition for the market
The paper studies competition for the market in a setting where incumbents (and, to a lesser extent, neighboring incumbents) benet from a cost advantage. The paper first compares the outcome of staggered and synchronous tenders, before drawing the implications for market design. We find that the timing of tenders should depend on the likelihood of monopolization. When monopolization is expected, synchronous tendering is preferable, as it strengthens the pressure that entrants exercise on the monopolist. When instead other firms remain active, staggered tenderingis preferable, asitmaximizes the competitive pressure that comes from the other firms
Systemic accident analysis: examining the gap between research and practice
The systems approach is arguably the dominant concept within accident analysis research. Viewing accidents as a result of uncontrolled system interactions, it forms the theoretical basis of various systemic accident analysis (SAA) models and methods. Despite the proposed benefits of SAA, such as an improved description of accident causation, evidence within the scientific literature suggests that these techniques are not being used in practice and that a research–practice gap exists. The aim of this study was to explore the issues stemming from research and practice which could hinder the awareness, adoption and usage of SAA. To achieve this, semi-structured interviews were conducted with 42 safety experts from ten countries and a variety of industries, including rail, aviation and maritime. This study suggests that the research–practice gap should be closed and efforts to bridge the gap should focus on ensuring that systemic methods meet the needs of practitioners and improving the communication of SAA research
The assessment of food safety culture: An investigation of current challenges, barriers and future opportunities within the food industry
Following the 2005 E.coli O157 outbreak in the UK and the recommendations in the subsequent Public Enquiry Report in 2009, the topic of food safety culture became more prominent. In 2012, the United Kingdom’s Food Standards Agency (FSA) commissioned a tool that enforcement officers could use to assess ‘softer aspects’ of risk such as safety culture, attitudes and behaviours. In the present study, we assessed the awareness of and views on safety culture in the food industry among a group of industry stakeholders (Environmental Health Officers, Food and Beverage Managers, Academics). The study also examines their attitudes towards the toolkit and ways in which it could be improved (e.g., its usability). The conclusions of the paper are that whilst there is broad support for implementing safety culture in the food industry, there are also some outstanding challenges (e.g., defining food safety culture, senior management commitment and the role played by ‘micro-cultures’ within food organisations). Assessing safety culture in the food industry is a realistic possibility, but needs to take account of some of the lessons which could be learnt from other industries (e.g., healthcare, rail, oil and gas) and their experiences with safety culture
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