Electronic adverse incident reporting in hospitals

The purpose of this study was to assess attitudes toward and use of an electronic adverse incident reporting system in all four hospitals in one NHS Scotland Health Board area. A questionnaire was used to assess Medical Consultants', Managers', and Nurses' attitudes and perceptions about electronic adverse incident reporting. Actual adverse incident reporting data were also analysed. The main findings from this study are that Consultants, Managers, and Nurses all had positive attitudes about responsibility for reporting adverse incidents. All respondents indicated that the design of and information collected by the electronic adverse incident reporting system (DATIX) was adequate but Consultants had more negative attitudes and perceptions than Managers and Nurses about DATIX. All respondents expressed negative attitudes about the amount and type of feedback they receive from reporting, and Consultants expressed more negative attitudes about how DATIX is managed than Managers and Nurses. Analysis of adverse incident reporting data found that the proportion of Consultants using DATIX to report incidents was significantly lower than that of Managers and Nurses. The findings suggest that there are no additional barriers to incident reporting associated with the use of a bespoke electronic adverse incident reporting system as compared to other types of systems. Although an electronic adverse incident reporting system may be able to increase incident reporting and facilitate organisational learning by making it easier to report incidents and analyse incident reporting data, strong leadership within hospitals / healthcare professions (or healthcare subcultures) is still required in order to promote and sustain incident reporting to improve patient safety

What are the barriers to implementing and sustaining an electronic adverse incident recording and reporting management system in an acute healthcare organisation?

Patient safety is an important topic for policy makers, health service clinicians and managers, and researchers. One way that many organisations are trying to improve patient safety is by incident reporting but they are meeting with limited success. The question this dissertation investigates is "What are the barriers to implementing and sustaining an Electronic Adverse Incident Reporting and Recording System in an acute healthcare environment?" As part of answering that question, this dissertation develops a socio-technical systems model of those barriers. A mixed methods approach (questionnaire survey and semi-structured interviews) was used to investigate the research question. By triangulating the findings from the questionnaire and interview studies, one technical barrier and three socio-barriers were identified. The technical barrier was Information and Technology, and the three socio-barriers were: 1) Attitudes and Values, 2) Training, Staffing and Skills, and 3) Leadership and Feedback. A model was then proposed which posits that the three socio-barriers interact with each other as part of the socio sub-system and that the socio sub-system interacts with the technical sub-system to form a socio-technical system. The overarching implication of the proposed model is that an NHS organization cannot just purchase a commercial Electronic Adverse Incident Reporting and Recording System and expect improvements in patient safety. The principle of joint optimization requires that changes to the socio- and / or technical sub-system be considered concurrently. The proposed model offers opportunities for future research such as investigating barriers to reporting in other national healthcare contexts and other high risk industries.Patient safety is an important topic for policy makers, health service clinicians and managers, and researchers. One way that many organisations are trying to improve patient safety is by incident reporting but they are meeting with limited success. The question this dissertation investigates is "What are the barriers to implementing and sustaining an Electronic Adverse Incident Reporting and Recording System in an acute healthcare environment?" As part of answering that question, this dissertation develops a socio-technical systems model of those barriers. A mixed methods approach (questionnaire survey and semi-structured interviews) was used to investigate the research question. By triangulating the findings from the questionnaire and interview studies, one technical barrier and three socio-barriers were identified. The technical barrier was Information and Technology, and the three socio-barriers were: 1) Attitudes and Values, 2) Training, Staffing and Skills, and 3) Leadership and Feedback. A model was then proposed which posits that the three socio-barriers interact with each other as part of the socio sub-system and that the socio sub-system interacts with the technical sub-system to form a socio-technical system. The overarching implication of the proposed model is that an NHS organization cannot just purchase a commercial Electronic Adverse Incident Reporting and Recording System and expect improvements in patient safety. The principle of joint optimization requires that changes to the socio- and / or technical sub-system be considered concurrently. The proposed model offers opportunities for future research such as investigating barriers to reporting in other national healthcare contexts and other high risk industries

General Equilibrium Benefit Transfers for Spatial Externalities: Revisiting EPA's Prospective Analysis

Environmental policy analyses increasingly require the evaluation of benefits from large changes in spatially differentiated public goods. Such changes are likely to induce general equilibrium effects through changes in household expenditures and local migration, yet current practice "transfers" constant marginal values for even the largest changes. Moreover, it ignores important distributional effects of policy. This paper demonstrates that recently developed locational equilibrium models can provide transferable general equilibrium benefit measures. Our results suggest that taking account of the potential for adjustment and household heterogeneity is important. Applying benefits estimated from this method to the effect of the Clean Air Act amendments in Los Angeles, we find that the estimated annual general equilibrium benefits in 2000 and 2010 are dramatically different by income group and location. The gains range from $33 to about$2,400 per household. These differences arise from variations in the air quality conditions, income, and the effects of general equilibrium price adjustment.air quality, clean air act, non-market valuation, Tiebout model

Estimating the General Equilibrium Benefits of Large Policy Changes: The Clean Air Act Revisited

This paper reports the first comprehensive approach for measuring the general equilibrium willingness to pay for large changes in air quality. It is based on a well defined locational equilibrium model. The approach allows estimation of households' indirect utility function and the underlying distribution of household types. With these estimates it is possible to compute a new locational equilibrium and the resulting housing prices in response to exogenous changes in air quality. This permits construction of welfare measures which properly take into consideration the adjustments of households in equilibrium to non-marginal changes in air quality. These types of measures are outside the scope of more traditional approaches. The empirical approach of this paper provides, for the first time, an internally consistent framework for estimation and applied general equilibrium welfare analysis. We compute the general equilibrium willingness to pay for the changes in air quality between 1990 and 1995. We implement our empirical framework using data from Southern California, an area which has experienced dramatic improvements in air quality during the past 20 years. Our findings are by and large supportive for our approach and suggest that accounting for general equilibrium effects in applied welfare can be especially important.

C2Learn Learning Design for CER: C2Learn project deliverable no. D2.2.2

Deliverable 2.2.2 is the second of the two public versions of the document; the first was delivered in Month 9 and this one in Month 18 of the three-year project. Similarly to D2.2.1, and D2.1.1 Interim, this document explicates the key concepts and principles relating to C2 Learn’s Learning Design. Developed by the OU team working closely with feedback from other consortium members, it sets out the over-arching theoretical frame of the project which encompasses Creative Emotional Reasoning (Deliverable 2.1.2) and its practical application in relation to the project's learning approach. Deliverable 2.2.2 is structured in three parts. The first considers the overall goals of the C2Learn gameful design encompassing a 'playful' digital gaming and social networking environment or "Co-creativity space" (C2Space). The C2Space exemplifies students' and teachers 'playful' experiences or what they do: - free exploration of ideas, concepts, and 'shared' knowledge - opportunities to engage in creative problem-finding and problem-solving - opportunities to be assisted by the system (Creativity Assistants) The second part addresses what the C2Space looks like in practice utilising the affordances of currently available examples of game prototypes and digital tools. The third part documents what will occur next in how the consortium is progressing in designing the C2Space encompassing a digital gaming and social networking environment, with the learning goals in mind. Inevitably as the parts of C2Learn are developing in planned parallel development, the Learning Design will in reality remain a living document throughout the second half of the project, with terminology and processes being refined. This official version though sets down markers as to our expectation of the direction of such evolution

C2Learn Learning Design for CER: C2Learn project deliverable no. D2.2.2

Deliverable 2.2.2 is the second of the two public versions of the document; the first was delivered in Month 9 and this one in Month 18 of the three-year project. Similarly to D2.2.1, and D2.1.1 Interim, this document explicates the key concepts and principles relating to C2 Learn’s Learning Design. Developed by the OU team working closely with feedback from other consortium members, it sets out the over-arching theoretical frame of the project which encompasses Creative Emotional Reasoning (Deliverable 2.1.2) and its practical application in relation to the project's learning approach. Deliverable 2.2.2 is structured in three parts. The first considers the overall goals of the C2Learn gameful design encompassing a 'playful' digital gaming and social networking environment or "Co-creativity space" (C2Space). The C2Space exemplifies students' and teachers 'playful' experiences or what they do: - free exploration of ideas, concepts, and 'shared' knowledge - opportunities to engage in creative problem-finding and problem-solving - opportunities to be assisted by the system (Creativity Assistants) The second part addresses what the C2Space looks like in practice utilising the affordances of currently available examples of game prototypes and digital tools. The third part documents what will occur next in how the consortium is progressing in designing the C2Space encompassing a digital gaming and social networking environment, with the learning goals in mind. Inevitably as the parts of C2Learn are developing in planned parallel development, the Learning Design will in reality remain a living document throughout the second half of the project, with terminology and processes being refined. This official version though sets down markers as to our expectation of the direction of such evolution

Measuring the Impact of Air Quality on Housing Markets and Residential Choices in Southern California

No abstract.

Visible-NIR ‘point’ spectroscopy in postharvest fruit and vegetable assessment: The science behind three decades of commercial use

The application of visible (Vis; 400–750 nm) and near infrared red (NIR; 750–2500 nm) region spectroscopy to assess fruit and vegetables is reviewed in context of ‘point’ spectroscopy, as opposed to multi- or hyperspectral imaging. Vis spectroscopy targets colour assessment and pigment analysis, while NIR spectroscopy has been applied to assessment of macro constituents (principally water) in fresh produce in commercial practice, and a wide range of attributes in the scientific literature. This review focusses to key issues relevant to the widespread implementation of Vis-NIR technology in the fruit sector. A background to the concepts and technology involved in the use of Vis-NIR spectroscopy is provided and instrumentation for in-field and in-line applications, which has been available for two and three decades, respectively, is described. A review of scientific effort is made for the period 2015 - February 2020, in terms of the application areas, instrumentation, chemometric methods and validation procedures, and this work is critiqued through comparison to techniques in commercial use, with focus to wavelength region, optical geometry, experimental design, and validation procedures. Recommendations for future research activity in this area are made, e.g., application development with consideration of the distribution of the attribute of interest in the product and the matching of optically sampled and reference method sampled volume; instrumentation comparisons with consideration of repeatability, optimum optical geometry and wavelength range). Recommendations are also made for reporting requirements, viz. description of the application, the reference method, the composition of calibration and test populations, chemometric reporting and benchmarking to a known instrument/method, with the aim of maximising useful conclusions from the extensive work being done around the world

Using Locational Equilibrium Models to Evaluate Housing Price Indexes

This paper analyses how the properties of locational equilibrium models can be used to evaluate approaches for constructing price indexes for heterogeneous houses. Housing markets play a key role in locational equilibrium models. Prices for houses determine that implicit costs that households bear when locating in a given community. We evaluate a variety of price indexes all relying on hedonic models for predicting interjurisdictional housing prices. The application uses a unique panel data set of housing transactions in Southern California. The rank predictions of different models are robust with respect to the hedonic model and the composite commodity definition used in aggregation. They do not depend significantly on the spatial or temporal definitions used to define the choice set of local housing markets. Finally, housing price estimates are strongly correlated with education and environmental amenities.