Evaluation of an Access-Risk-Knowledge (ARK) Platform for Governance of Risk and Change in Complex Socio-Technical Systems

Three key challenges to a whole-system approach to process improvement in health systems are the complexity of socio-technical activity, the capacity to change purposefully, and the consequent capacity to proactively manage and govern the system. The literature on healthcare improvement demonstrates the persistence of these problems. In this project, the Access-Risk-Knowledge (ARK) Platform, which supports the implementation of improvement projects, was deployed across three healthcare organisations to address risk management for the prevention and control of healthcare-associated infections (HCAIs). In each organisation, quality and safety experts initiated an ARK project and participated in a follow-up survey and focus group. The platform was then evaluated against a set of fifteen needs related to complex system transformation. While the results highlighted concerns about the platform’s usability, feedback was generally positive regarding its effectiveness and potential value in supporting HCAI risk management. The ARK Platform addresses the majority of identified needs for system transformation; other needs were validated in the trial or are undergoing development. This trial provided a starting point for a knowledge-based solution to enhance organisational governance and develop shared knowledge through a Community of Practice that will contribute to sustaining and generalising that change.

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Infection Prevention and Control

Textbook of Patient Safety and Clinical Risk Management ◽

10.1007/978-3-030-59403-9_9 ◽

2020 ◽

pp. 99-116

Author(s):

Anna L. Costa ◽

Gaetano Pierpaolo Privitera ◽

Giorgio Tulli ◽

Giulio Toccafondi

Keyword(s):

Public Health ◽

Risk Management ◽

Prevention And Control ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Clinical Risk Management ◽

Cross Sectional ◽

Healthcare Associated ◽

And Control ◽

Avoidable Risk

AbstractHealthcare-associated infections (HAI) are adverse events exposing patients to a potentially avoidable risk of morbidity and mortality. Antimicrobial resistance (AMR) is increasingly contributing to the burden of HAIs and emerging as of the most alarming challenges for public health worldwide. Practically, harm mitigation and risk containment demand cross-sectional initiatives incorporate both approaches to infection prevention and control and methodologies from clinical risk management.

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Analysis of the incidence of surgical site infections after open reposition of long bone fractures and closed fracture settings in a 7-year follow-up in an orthopedic and trauma ward in southern Poland

Przeglad Epidemiologiczny ◽

10.32394/pe.74.26 ◽

2020 ◽

pp. 336-345

Author(s):

Róża Słowik ◽

Marta Wałaszek ◽

Witold Zieńczuk

Keyword(s):

Bone Fractures ◽

Risk Index ◽

Trauma Surgery ◽

Surgical Site Infections ◽

Long Bone ◽

Women Patients ◽

Surveillance Network ◽

Healthcare Associated ◽

And Control

INTRODUCTION. Surgical Site Infection (SSI) is the most common clinical form of Healthcare-Associated Infections (HAI) in orthopedic and trauma wards. MATERIAL AND METHOD. A retrospective study was conducted at the Department of Orthopedics and Trauma Surgery in Tarnów in 2012-2018. 3 155 patients treated for bone fractures were analyzed, including 1961 Open Reduction of Fracture (FX) and 1 194 Closed Reduction of Fracture with Internal Fixation (CR) surgeries. The study was conducted in accordance with the methodology recommended by the Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). The aim of the study was to assess the incidence of SSI in patients undergoing the FX and CR procedures. RESULTS. 28 SSIs were identified in the examined ward; 16 SSI cases related to the FX procedure and 12 cases related to CR. The incidence for FX was 0.8% and for CR 1%. In patients with diagnosed SSI, the stay in the ward was longer (p <0.001) than in patients without SSI. In FX operations, the standardized risk index (SIR) did not exceed the value of one. Staphylococcus aureus was the most common organism isolated from materials from patients with SSI. CONCLUSIONS. In the examined period, the median age of women was higher than that of men, which may indicate a higher incidence of fractures in women. Patients with diagnosed SSI had a longer stay in the ward than patients without SSI. The incidence of SSI in FX and CR has been reduced compared to previous studies in the same ward.

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Crowd Behaviour Theory

Crowd Management ◽

10.23912/978-1-911396-88-8-4311 ◽

2019 ◽

Author(s):

William O’Toole ◽

Dr Stephen Luke ◽

Travis Semmens ◽

Dr Jason Brown ◽

Andrew Tatrai

Keyword(s):

Risk Management ◽

Crowd Management ◽

Human Safety ◽

Event Risk ◽

Crowd Control ◽

Starting Point ◽

Crowd Behaviour ◽

And Control

Crowds and crowd behaviour are consistently studied in an attempt to make sense of the phenomena that affect human safety. However, crowd deaths and incidents continue to occur frequently, suggesting modern theories around crowd behaviour are not being appropriately understood and applied to crowd management and crowd control. You don’t have to have the academic acumen of Alexander E. Berlonghi, the pioneer in event risk management, to agree that without an understanding of crowd behaviour, crowd management and control activities are random, and ineffectual. This chapter will provide an overview of crowd behaviour theories as a starting point for understanding how they can be utilised to assist in effective crowd control and crowd management. It is helpful to imagine that crowd theories and crowd models are as diverse as crowds themselves and that as crowds change, evolve and develop, the theories and models must either change with them or the definitions move to a different phase. This text proposes future pathways for crowd management.

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Healthcare-associated infection control and biosecurity measures for nurses in the emergency department of a National Essalud Hospital [Healthcare-associated infection control and biosecurity measures for nurses in the emergency department of a National Essalud Hospital]

Journal of Global Health and Medicine ◽

10.32829/ghmj.v4i1.185 ◽

2020 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Diana Leonor Uceda Ochoa ◽

Monica Elisa Meneses La Riva

Keyword(s):

Emergency Department ◽

Infection Control ◽

Nursing Care ◽

Emergency Services ◽

Healthcare Associated Infection ◽

Cross Sectional ◽

Healthcare Associated ◽

And Control ◽

The Relationship

Biosecurity measures are indispensable in the work of nursing care to ensure the quality and impact of nursing care interventions in the areas of care. Objective: To determine the relationship between biosecurity measures and healthcare-associated infection control in the work of nurses in the emergency department of a National Hospital, Essalud, 2019. The methodology was a quantitative, correlational, cross-sectional, non-experimental design, whose population consisted of 152 nurses working in the emergency area, for which 3 instruments were applied: Scale of knowledge of biosecurity measures with 14 items with multiple answers, Checklist of biosecurity measures with 17 items, and Handwashing checklist with 11 items, both instruments with a dichotomous scale. Both instruments were evaluated by experts and their reliability was 0.8. The results obtained show that there is a significant positive average correlation between the variables measured of biosecurity and the control of infections associated to health care. It is concluded that nurses' knowledge of biosecurity measures and HAIs pose a high risk to health personnel and patients. Therefore, it is essential to continue training, monitoring, follow-up and control to ensure the quality and impact of nursing care in emergency services.

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Risk Management in the Process of Personnel Allocation to Jobs

System Safety Human - Technical Facility - Environment ◽

10.2478/czoto-2020-0011 ◽

2020 ◽

Vol 2 (1) ◽

pp. 82-90

Author(s):

Marek Krynke

Keyword(s):

Mathematical Model ◽

Risk Management ◽

Safety Management ◽

Acceptable Level ◽

Management Process ◽

Quantitative Expression ◽

Planning And Control ◽

Starting Point ◽

Personnel Allocation ◽

And Control

AbstractThe strategy should be designed in such a way as the risk management can operate not only as a system for avoiding losses, but also risk management should allow recognizing and making use of occasions and create new opportunities for the organization. Risk management includes both an evaluation (analytical and evaluation) undertaking as well as planning and control activities aimed at minimizing (reducing) risk or maintaining it at an acceptable level. Security management can in particular be reduced to the issue of risk management, because risk is a quantitative expression of the functioning of systems in an environment where there are active sources of threats to system security. The article presents the problem of personnel allocation in hazardous conditions, emphasizing the possibilities of undertaking optimization actions in the safety management process. A mathematical model was formulated for this issue. An algorithm solving the problem of personnel allocation is presented. The proposed analysis is the starting point for determining the risk when using multi-station work.

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Organizations, Power, and Resistance

Oxford Research Encyclopedia of Communication ◽

10.1093/acrefore/9780190228613.013.140 ◽

2016 ◽

Author(s):

Dennis K. Mumby

Keyword(s):

Critical Theory ◽

Stakeholder Groups ◽

Critical Tradition ◽

Knowledge Based ◽

Discourse Processes ◽

Power And Resistance ◽

Power And Control ◽

Starting Point ◽

And Control ◽

The Relationship

In the last 30 years or so, the relationship between power and resistance has been theorized as a defining feature of organizations and organizing. While there is little consensus around its definition, a useful starting point for thinking about the organization–power–resistance relationship is to view organizations as political sites of contestation where various stakeholder groups compete for resources—economic, political, and symbolic. Much of the research on power, resistance, and organizations has emerged out of a critical tradition that draws on numerous theoretical and philosophical threads, including Marxism, neo-Marxism, critical theory, poststructuralism, and feminism. Common to these threads are various efforts to link power and resistance to issues of meaning, identity, and discourse processes. In this sense—and particularly in the last 30 years—there have been multiple efforts to theorize power as intimately connected to communication. This connection has become particularly important with the shift from Fordist (bureaucratic, hierarchical, centralized, deskilled) organizational forms to post-Fordist (flexible, flat, dispersed, knowledge-based) organizations that place a premium on decentralized, “consensual” forms of power and control (as opposed to the coercive methods of Fordist regimes). Exploring communicative conceptions of power and resistance shows how these phenomena are closely tied to the regulation of meaning and identities in the contemporary workplace.

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Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽

10.1027/0227-5910/a000025 ◽

2010 ◽

Vol 31 (5) ◽

pp. 238-246 ◽

Cited By ~ 9

Author(s):

Paul W. C. Wong ◽

Wincy S. C. Chan ◽

Philip S. L. Beh ◽

Fiona W. S. Yau ◽

Paul S. F. Yip ◽

...

Keyword(s):

Ethical Issues ◽

Research Participation ◽

Self Report ◽

Initial Contact ◽

Psychological Autopsy ◽

Autopsy Study ◽

The People ◽

And Control ◽

The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

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