[A complex approach to protecting the health of military missile personnel (an interview of Colonel General V. N. Iakovlev, Commander-in-Chief of the Strategic Missile Forces). Interview by N. F. Shalaev].
Over the past decade, the need for healthcare delivery systems to identify and address patient safety issues has been propelled to the forefront. A Canadian survey, for example, demonstrated patient safety to be a major concern of frontline nurses (Nicklin & McVeety 2002). Three crucial patient safety elements, current knowledge, resources, and context of care have been identified by the World Health Organization (WHO 2009). To develop strategies to respond to the scope and mandate of the WHO report within the Canadian context, a pan-Canadian academic-policy partnership has been established.
This newly formed Pan-Canadian Partnership, the Queen's Joanna Briggs Collaboration for Patient Safety (referred throughout as "QJBC" or "the Partnership"), includes the Queen's University School of Nursing, Accreditation Canada, the Canadian Patient Safety Institute (CPSI), the Canadian Institutes of Health Research, and is supported by an active and committed advisory council representing over 10 national organizations representing all sectors of the health continuum, including patients/families advocacy groups, professional associations, and other bodies. This unique partnership is designed to provide timely, focused support from academia to the front line of patient safety. QJBC has adopted an "integrated knowledge translation" approach to identify and respond to patient safety priorities and to ensure active engagement with stakeholders in producing and using available knowledge. Synthesis of evidence and guideline adaptation methodologies are employed to access quantitative and qualitative evidence relevant to pertinent patient safety questions and subsequently, to respond to issues of feasibility, meaningfulness, appropriateness/acceptability, and effectiveness.
This paper describes the conceptual grounding of the Partnership, its proposed methods, and its plan for action. It is hoped that our journey may provide some guidance to others as they develop patient safety models within their own arenas.
The land battle today is different from that of 20 years ago. It now occurs over vast areas, the fluid battlefield. Tanks have undergone important changes (cross-country capability, improved armor, and more lethal weapons). The combat units contain armored personnel carriers, providing protection for the soldier. The weapon effects on armored vehicle personnel are well studied and include ballistic, blast, thermal, and toxic injury. However, casualty statistics for armored units are not extensively reported. The public acceptance of casualties, especially in peacekeeping operations, today is much lower than in the past. A study by the Swedish Armed Forces has identified the need for a new organizational structure. Casualties will be picked up on the battlefield by armored medical evacuation vehicles and transported directly to the battalion aid station. The training level of all medical personnel must be increased, using battlefield-related trauma courses and making better use of existing resources in the form of qualified medical practitioners.
The diffusion and adoption of information technology innovations (e.g. mobile information technology) in healthcare organizations involves a dynamic process of change with multiple stakeholders with competing interests, varying commitments, and conflicting values. Nevertheless, the extant literature on mobile information technology diffusion and adoption has predominantly focused on organizations and individuals as the unit of analysis, with little emphasis on the environment in which healthcare organizations are embedded. We propose the social worlds approach as a promising theoretical lens for dealing with this limitation together with reports from a case study of a mobile information technology innovation in elderly home care in Denmark including both the sociopolitical and organizational levels in the analysis. Using the notions of social worlds, trajectories, and boundary objects enables us to show how mobile information technology innovation in Danish home care can facilitate negotiation and collaboration across different social worlds in one setting while becoming a source of tension and conflicts in others. The trajectory of mobile information technology adoption was shaped by influential stakeholders in the Danish home care sector. Boundary objects across multiple social worlds legitimized the adoption, but the use arrangement afforded by the new technology interfered with important aspects of home care practices, creating resistance among the healthcare personnel.
Analysis of statistical data on forensic chemical studies carried out in the Perm Regional Bureau of Forensic Medical Expert Evaluations in 1997-2000 indicates an increased number of expert evaluations with positive results. The specific share of expert evaluations with positive results for Perm was 66.6% of the total number of evaluations. The absolute number of the detected agents in combinations with other agents increased more than 2-fold over the studied period. The number of detected agents increased 1.8 times, the rate of detection of narcotics increased sharply (6.5 times).