A Review of Risk Matrices Used in Acute Hospitals in England.

In healthcare, patient safety has received substantial attention and, in turn, a number of approaches to managing safety have been adopted from other high-risk industries. One of these has been risk assessment, predominantly through the use of risk matrices. However, while other industries have criticized the design and use of these risk matrices, the applicability of such criticism has not been investigated formally in healthcare. This study examines risk matrices as used in acute hospitals in England and the guidance provided for their use. It investigates the applicability of criticisms of risk matrices from outside healthcare through a document analysis of the risk assessment policies, procedures, and strategies used in English hospitals. The findings reveal that there is a large variety of risk matrices used, where the design of some might increase the chance of risk misprioritization. Additionally, findings show that hospitals may provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms of risk matrices. Consequently, this is likely to lead to variation in the quality of risk assessment and in the subsequent deployment of resources to manage the assessed risk. Finally, the article outlines ways in which hospitals could use risk matrices more effectively

Bridging the domestic building fabric performance gap

It is recognized that there is often a discrepancy between the measured fabric thermal performance of dwellings as built and the predicted performance of the same dwellings and that the magnitude of this difference in performance can be quite large. This paper presents the results of a number of in-depth building fabric thermal performance tests undertaken on three case study dwellings located on two separate Passivhaus developments in the UK: one masonry cavity and the other two timber-frame. The results from the tests revealed that all the case study dwellings performed very close to that predicted. This is in contrast with other work that has been undertaken regarding the performance of the building fabric, which indicates that a very wide range of performance exists in new-build dwellings in the UK, and that the difference between the measured and predicted fabric performance can be greater than 100%. Despite the small non-random size of the sample, the results suggest that careful design coupled with the implementation of appropriate quality control systems, such as those required to attain Passivhaus Certification, may be conducive to delivering dwellings that begin to ‘bridge the gap’ between measured and predicted fabric performance

Vision zero: from accident prevention to the promotion of health, safety and well-being at work

There is growing attention in industry for the Vision Zero strategy, which in terms of work-related health and safety is often labelled as Zero Accident Vision or Zero Harm. The consequences of a genuine commitment to Vision Zero for addressing health, safety and well-being and their synergies are discussed. The Vision Zero for work-related health, safety and well-being is based on the assumption that all accidents, harm and work-related diseases are preventable. Vision Zero for health, safety and well-being is then the ambition and commitment to create and ensure safe and healthy work and to prevent all accidents, harm and work-related diseases in order to achieve excellence in health, safety and well-being. Implementation of Vision Zero is a process – rather than a target, and healthy organizations make use of a wide range of options to facilitate this process. There is sufficient evidence that fatigue, stress and work organization factors are important determinants of safety behaviour and safety performance. Even with a focus on preventing accidents these additional factors should also be addressed. A relevant challenge is the integration of the Vision Zero into broader business policy and practice. There is a continued need more empirical research in this area

Sustainable bike-sharing systems: characteristics and commonalities across cases in urban China

Bicycles are a desirable form of transportation for many reasons, including the fact that taking a bicycle is environmentally-friendly, economically cost-effective, a way to keep fit and healthy and, on occasions, an enjoyable social activity. This paper explores the characteristics and commonalities between particular bike-sharing systems in urban areas, with a view to deriving influences on the sustainability of such systems. The empirical study is China and the paper analyses bike-sharing systems in five Chinese cities. China is suffering from the severe negative consequences of high private vehicle usage in large and densely populated cities. Nevertheless a long history of bicycle usage in the country provides great potential for such a green form of travel to be part of public and private transportation. The findings show that bike-sharing systems have varying degrees of success. The configurations which seem the most sustainable consider and integrate elements relating to transport planning, system design and choice of business model. Key conclusions are that those responsible for developing policy and practices in relation to bike-sharing systems need to understand the diverse aspects of value for the stakeholders wishing to engage with such a system. Public bicycle sharing, as a Product Service System, needs to be carefully developed to appreciate the quality and timely interplay between the physical design of the system and the provision of services being offered. Keywords Bike-sharing system; Sustainable development; Sustainability; China; Case studie

Hierarchical structures for a robustness-oriented capacity design

In this paper, the response of two-dimensional framed structures made of rectangular cells to the sudden removal of columns is studied. A simulation algorithm based on the discrete-element method is employed, where the structural elements are represented by elasto-plastic Euler-Bernoulli beams with elongation-rotation failure threshold. The effect of structural cell slenderness and of topological hierarchy on the dynamic residual strength after damage R1 is investigated. Topologically hierarchical frames have a primary structure made of a few massive elements, while homogeneous frames are made of many thin elements. It is also shown how R1 depends on the activated collapse mechanisms, which are determined by the mechanical hierarchy between beams and columns, i.e., by their relative strength and stiffness. Finally, principles of robustness-oriented capacity design that seem to be in contrast to the conventional antiseismic capacity design are addresse