Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure

Life support system for space flights of extended time periods - Liquid/gas separation mechanisms

Life support system for extended space flights - liquid-gas separation mechanism

21st century social work: reducing re-offending - key practice skills

This literature review was commissioned by the Scottish Executive’s Social Work Services Inspectorate in order to support the work of the 21st Century Social Work Review Group. Discussions in relation to the future arrangements for criminal justice social work raised issues about which disciplines might best encompass the requisite skills for reducing re-offending in the community. Rather than starting with what is known or understood about the skills of those professionals currently involved in such interventions, this study sought to start with the research evidence on effective work with offenders to reduce re-offending and then work its way back to the skills required to promote this outcome

A study of the intensity of the self-broadened fundamental band of hydrogen chloride

Intensity study of self-broadened fundamental band of hydrogen chlorid

Quantum imaging of spin states in optical lattices

We investigate imaging of the spatial spin distribution of atoms in optical lattices using non-resonant light scattering. We demonstrate how scattering spatially correlated light from the atoms can result in spin state images with enhanced spatial resolution. Furthermore, we show how using spatially correlated light can lead to direct measurement of the spatial correlations of the atomic spin distribution

Development during adolescence of the neural processing of social emotion

In this fMRI study, we investigated the development between adolescence and adulthood of the neural processing of social emotions. Unlike basic emotions (such as disgust and fear), social emotions (such as guilt and embarrassment) require the representation of another's mental states. Nineteen adolescents (10–18 years) and 10 adults (22–32 years) were scanned while thinking about scenarios featuring either social or basic emotions. In both age groups, the anterior rostral medial prefrontal cortex (MPFC) was activated during social versus basic emotion. However, adolescents activated a lateral part of the MPFC for social versus basic emotions, whereas adults did not. Relative to adolescents, adults showed higher activity in the left temporal pole for social versus basic emotions. These results show that, although the MPFC is activated during social emotion in both adults and adolescents, adolescents recruit anterior (MPFC) regions more than do adults, and adults recruit posterior (temporal) regions more than do adolescents

Quantum Walks with Entangled Coins

We present a mathematical formalism for the description of unrestricted quantum walks with entangled coins and one walker. The numerical behaviour of such walks is examined when using a Bell state as the initial coin state, two different coin operators, two different shift operators, and one walker. We compare and contrast the performance of these quantum walks with that of a classical random walk consisting of one walker and two maximally correlated coins as well as quantum walks with coins sharing different degrees of entanglement. We illustrate that the behaviour of our walk with entangled coins can be very different in comparison to the usual quantum walk with a single coin. We also demonstrate that simply by changing the shift operator, we can generate widely different distributions. We also compare the behaviour of quantum walks with maximally entangled coins with that of quantum walks with non-entangled coins. Finally, we show that the use of different shift operators on 2 and 3 qubit coins leads to different position probability distributions in 1 and 2 dimensional graphs.Comment: Two new sections and several changes from referees' comments. 12 pages and 12 (colour) figure