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3D simulation as a tool for improving the safety culture during remediation work at Andreeva Bay.

https://arctichealth.org/en/permalink/ahliterature265458
Source
J Radiol Prot. 2014 Dec;34(4):755-73
Publication Type
Article
Date
Dec-2014
Author
K. Chizhov
M K Sneve
I. Szoke
I. Mazur
N K Mark
I. Kudrin
N. Shandala
A. Simakov
G M Smith
A. Krasnoschekov
A. Kosnikov
I. Kemsky
V. Kryuchkov
Source
J Radiol Prot. 2014 Dec;34(4):755-73
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Decontamination - methods
Hazardous Waste Sites
Imaging, Three-Dimensional - methods
Models, organizational
Norway
Organizational Culture
Radiation Monitoring - methods
Radiation Protection - methods
Radioactive Waste - prevention & control
Russia
Safety Management - organization & administration
Abstract
Andreeva Bay in northwest Russia hosts one of the former coastal technical bases of the Northern Fleet. Currently, this base is designated as the Andreeva Bay branch of Northwest Center for Radioactive Waste Management (SevRAO) and is a site of temporary storage (STS) for spent nuclear fuel (SNF) and other radiological waste generated during the operation and decommissioning of nuclear submarines and ships. According to an integrated expert evaluation, this site is the most dangerous nuclear facility in northwest Russia. Environmental rehabilitation of the site is currently in progress and is supported by strong international collaboration. This paper describes how the optimization principle (ALARA) has been adopted during the planning of remediation work at the Andreeva Bay STS and how Russian-Norwegian collaboration greatly contributed to ensuring the development and maintenance of a high level safety culture during this process. More specifically, this paper describes how integration of a system, specifically designed for improving the radiological safety of workers during the remediation work at Andreeva Bay, was developed in Russia. It also outlines the 3D radiological simulation and virtual reality based systems developed in Norway that have greatly facilitated effective implementation of the ALARA principle, through supporting radiological characterisation, work planning and optimization, decision making, communication between teams and with the authorities and training of field operators.
PubMed ID
25254659 View in PubMed
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Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

https://arctichealth.org/en/permalink/ahliterature190330
Source
Air Med J. 2002 May-Jun;21(3):39-45
Publication Type
Article
Author
Torhild Heggestad
Knut Yngve Børsheim
Author Affiliation
SINTEF Unimed Health Services Research, Trondheim, Norway.
Source
Air Med J. 2002 May-Jun;21(3):39-45
Language
English
Publication Type
Article
Keywords
Air Ambulances - supply & distribution - utilization
Emergency Medical Services - supply & distribution - utilization
Geography
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Health Services Research
Humans
Multivariate Analysis
National Health Programs
Norway
Physician's Practice Patterns
Regression Analysis
Safety Management
Time Factors
Transportation of Patients
Abstract
To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998.
The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases.
The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS.
Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.
PubMed ID
11994734 View in PubMed
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Achieving the National Quality Forum's "Never Events": prevention of wrong site, wrong procedure, and wrong patient operations.

https://arctichealth.org/en/permalink/ahliterature164254
Source
Ann Surg. 2007 Apr;245(4):526-32
Publication Type
Article
Date
Apr-2007
Author
Robert K Michaels
Martin A Makary
Yasser Dahab
Frank J Frassica
Eugenie Heitmiller
Lisa C Rowen
Richard Crotreau
Henry Brem
Peter J Pronovost
Author Affiliation
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Source
Ann Surg. 2007 Apr;245(4):526-32
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Canada
Clinical Protocols
Humans
Joint Commission on Accreditation of Healthcare Organizations
Medical Errors - prevention & control
Medical Laboratory Science
Risk factors
Safety
Safety Management - methods
Societies, Medical
Surgery Department, Hospital - organization & administration - standards
Surgical Procedures, Operative - standards
United States
United States Department of Veterans Affairs
Abstract
Review the evidence regarding methods to prevent wrong site operations and present a framework that healthcare organizations can use to evaluate whether they have reduced the probability of wrong site, wrong procedure, and wrong patient operations.
Operations involving the wrong site, patient, and procedure continue despite national efforts by regulators and professional organizations. Little is known about effective policies to reduce these "never events," and healthcare professional's knowledge or appropriate use of these policies to mitigate events.
A literature review of the evidence was performed using PubMed and Google; key words used were wrong site surgery, wrong side surgery, wrong patient surgery, and wrong procedure surgery. The framework to evaluate safety includes assessing if a behaviorally specific policy or procedure exists, whether staff knows about the policy, and whether the policy is being used appropriately.
Higher-level policies or programs have been implemented by the American Academy of Orthopaedic Surgery, Joint Commission on Accreditation of Healthcare Organizations, Veteran's Health Administration, Canadian Orthopaedic, and the North American Spine Society Associations to reduce wrong site surgery. No scientific evidence is available to guide hospitals in evaluating whether they have an effective policy, and whether staff know of the policy and appropriately use the policy to prevent "never events."
There is limited evidence of behavioral interventions to reduce wrong site, patient, and surgical procedures. We have outlined a framework of measures that healthcare organizations can use to start evaluating whether they have reduced adverse events in operations.
Notes
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Cites: J Bone Joint Surg Am. 2003 Feb;85-A(2):193-712571293
PubMed ID
17414599 View in PubMed
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Activating knowledge for patient safety practices: a Canadian academic-policy partnership.

https://arctichealth.org/en/permalink/ahliterature129005
Source
Worldviews Evid Based Nurs. 2012 Feb;9(1):49-58
Publication Type
Article
Date
Feb-2012
Author
Margaret B Harrison
Wendy Nicklin
Marie Owen
Christina Godfrey
Janice McVeety
Val Angus
Author Affiliation
School of Nursing, Queen's University, Kingston, Ontario, Canada. margaret.b.harrison@queensu.ca
Source
Worldviews Evid Based Nurs. 2012 Feb;9(1):49-58
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Advisory Committees - organization & administration - standards
Canada
Cooperative Behavior
Delivery of Health Care - organization & administration - standards
Evidence-Based Practice - methods - organization & administration - standards
Health Knowledge, Attitudes, Practice
Humans
Patient Care Team - organization & administration - standards
Quality Assurance, Health Care - methods - organization & administration - standards
Safety Management - methods - organization & administration - standards
State Medicine - organization & administration - standards
Abstract
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.
PubMed ID
22151727 View in PubMed
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Addressing postdischarge adverse events: a neglected area.

https://arctichealth.org/en/permalink/ahliterature158206
Source
Jt Comm J Qual Patient Saf. 2008 Feb;34(2):85-97
Publication Type
Article
Date
Feb-2008
Author
Dennis Tsilimingras
David Westfall Bates
Author Affiliation
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, USA. dtsilimingras@yahoo.com
Source
Jt Comm J Qual Patient Saf. 2008 Feb;34(2):85-97
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Aftercare
Canada
Hospitals, Teaching
Humans
Internal Medicine
Patient Discharge
Quality Assurance, Health Care
Safety Management
Treatment Outcome
United States
Abstract
Postdischarge safety is an area that has long been neglected. Recent studies from the United States and Canada found that about one in five patients discharged home from the general internal medicine services of major teaching hospitals suffered an adverse event.
MEDLINE, Cochrane databases, and reference lists of retrieved articles were used in a literature search of articles published from 1966 through May 2007.
Patient safety research has focused mostly on adverse events in hospitalized patients. Although some data are available about the ambulatory setting, even fewer studies have been done focusing on adverse events following hospital discharge. Only two studies conducted in North America have examined the incidence rate of all types of postdischarge adverse events. On the basis of the available evidence, key areas of opportunity to improve postdischarge care are as follows: (1) improving transitional care, (2) improving information transfer through strategic use of electronic health records, (3) medication reconciliation, (4) improving follow-up of test results, and (5) using screening methods to identify patients with adverse events.
Limited evidence suggests that about one in five internal medicine patients suffers an adverse event after discharge from a North American hospital. The risk of postdischarge adverse events should be recognized by patient safety experts as an important area of concern.
PubMed ID
18351193 View in PubMed
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Addressing the effects of adverse events: study provides insights into patient safety at Canadian hospitals.

https://arctichealth.org/en/permalink/ahliterature177436
Source
Healthc Q. 2004;7(4):20-1
Publication Type
Article
Date
2004
Author
G Ross Baker
Peter Norton
Author Affiliation
Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada.
Source
Healthc Q. 2004;7(4):20-1
Date
2004
Language
English
Publication Type
Article
Keywords
Canada
Humans
Medical Errors - prevention & control
Safety Management - organization & administration
PubMed ID
15540395 View in PubMed
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Administration of the adjuvanted pH1N1 vaccine in egg-allergic children at high risk for influenza A/H1N1 disease.

https://arctichealth.org/en/permalink/ahliterature133348
Source
Can J Public Health. 2011 May-Jun;102(3):196-9
Publication Type
Article
Author
Jane E Schuler
W James King
Natalie L Dayneka
Lynn Rastelli
Evelyn Marquis
Zave Chad
Charles Hui
Author Affiliation
Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON. jschuler@cheo.on.ca
Source
Can J Public Health. 2011 May-Jun;102(3):196-9
Language
English
Publication Type
Article
Keywords
Canada
Child
Child, Preschool
Egg Hypersensitivity
Female
Humans
Immunization Schedule
Infant
Influenza A Virus, H1N1 Subtype
Influenza Vaccines - administration & dosage - adverse effects
Influenza, Human - prevention & control
Male
Prospective Studies
Safety Management
Abstract
In Canada, the pH1N1 influenza vaccine is recommended for children, particularly those less than 5 years of age or with chronic underlying disease. The pH1N1 vaccine, which contains residual allergenic egg white proteins, may pose a risk for vaccination of egg-allergic children.
To describe the outcome of pH1N1 influenza vaccine administration to egg-allergic children at risk for severe H1N1 disease.
Prospective observational cohort study. Children identified as at high risk for egg allergy and H1N1 influenza were vaccinated using a two-dose split protocol in a controlled medical setting. Children were given an initial test dose; if no reaction was noted, the remainder of the dose was administered and the children were followed for allergic reactions. Those who tolerated the split dose and required a second dose of vaccine were offered vaccination four weeks later as one injection.
Sixty-two egg-allergic children considered at high risk for H1N1 disease received the adjuvanted pH1N1 vaccine. Egg allergy was diagnosed both clinically by an allergist and using skin and/or serum IgE testing. Within one hour of immunization, 2 children developed hives, 1 had a vasovagal response and 1 had a hypo-responsive episode. Fourteen children received the second H1N1 dose and 1 developed erythema and itching. There were no anaphylactic reactions.
Administration of the adjuvanted pH1N1 vaccine in egg-allergic children at risk for severe H1N1 influenza was safe when performed in a two-dose split protocol in a controlled medical setting.
PubMed ID
21714318 View in PubMed
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Advancing health system integration through supply chain improvement.

https://arctichealth.org/en/permalink/ahliterature170152
Source
Healthc Q. 2006;9(1):62-6, 4
Publication Type
Article
Date
2006
Author
Mike Rosser
Author Affiliation
Healthcare Materials Management Services, London, Ontario. mike.rosser@sjhc.london.on.ca
Source
Healthc Q. 2006;9(1):62-6, 4
Date
2006
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Cost Savings
Hospital Distribution Systems
Hospital Information Systems
Hospital Shared Services - organization & administration
Humans
Interinstitutional Relations
Inventories, Hospital
Leadership
Materials Management, Hospital - organization & administration
Ontario
Organizational Case Studies
Purchasing, Hospital
Safety Management
Abstract
Collaboration is a key element to success in the provision of sustainable and integrated healthcare services. Among the many initiatives undertaken to improve service quality and reduce costs, collaboration among hospitals in Ontario has been difficult to achieve; however, voluntary collaboration is vital to achieving transformation of the magnitude envisioned by system leaders.
PubMed ID
16548436 View in PubMed
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Advancing measurement of patient safety culture.

https://arctichealth.org/en/permalink/ahliterature154948
Source
Health Serv Res. 2009 Feb;44(1):205-24
Publication Type
Article
Date
Feb-2009
Author
Liane Ginsburg
Debra Gilin
Deborah Tregunno
Peter G Norton
Ward Flemons
Mark Fleming
Author Affiliation
School of Health Policy and Management, Faculty of Health, York University, HNES Building 413, 4700 Keele Street, Toronto, ON, Canada M3J 1P3. lgins@yorku.ca
Source
Health Serv Res. 2009 Feb;44(1):205-24
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Canada
Cross-Sectional Studies
Factor Analysis, Statistical
Humans
Leadership
Medical Errors - prevention & control
Nursing Staff, Hospital - education - organization & administration
Organizational Culture
Psychometrics
Quality Assurance, Health Care - methods
Questionnaires
Reproducibility of Results
Safety Management - organization & administration
Abstract
To examine the psychometric and unit of analysis/strength of culture issues in patient safety culture (PSC) measurement.
Two cross-sectional surveys of health care staff in 10 Canadian health care organizations totaling 11,586 respondents.
A cross-validation study of a measure of PSC using survey data gathered using the Modified Stanford PSC survey (MSI-2005 and MSI-2006); a within-group agreement analysis of MSI-2006 data. Extraction Methods. Exploratory factor analyses (EFA) of the MSI-05 survey data and confirmatory factor analysis (CFA) of the MSI-06 survey data; Rwg coefficients of homogeneity were calculated for 37 units and six organizations in the MSI-06 data set to examine within-group agreement.
The CFA did not yield acceptable levels of fit. EFA and reliability analysis of MSI-06 data suggest two reliable dimensions of PSC: Organization leadership for safety (alpha=0.88) and Unit leadership for safety (alpha=0.81). Within-group agreement analysis shows stronger within-unit agreement than within-organization agreement on assessed PSC dimensions.
The field of PSC measurement has not been able to meet strict requirements for sound measurement using conventional approaches of CFA. Additional work is needed to identify and soundly measure key dimensions of PSC. The field would also benefit from further attention to strength of culture/unit of analysis issues.
Notes
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Erratum In: Health Serv Res. 2009 Feb;44(1):321
PubMed ID
18823446 View in PubMed
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767 records – page 1 of 77.