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Documentation of in-hospital falls on incident reports: Qualitative investigation of an imperfect process
Terry P Haines, Petrea Cornwell, Jennifer Fleming, Paul Varghese, Len Gray
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-254
Abstract: This research aimed to identify contextual factors influencing recording of in-hospital falls on incident reports. A qualitative multi-centre investigation using an open written response questionnaire was undertaken. Participants were asked to describe any factors that made them feel more or less likely to record a fall on an incident report. 212 hospital staff from 30 wards in 7 hospitals in Queensland, Australia provided a response. A framework approach was employed to identify and understand inter-relationships between emergent categories.Three main categories were developed. The first, determinants of reporting, describes a hierarchical structure of primary (principle of reporting), secondary (patient injury), and tertiary determinants that influenced the likelihood that an in-hospital fall would be recorded on an incident report. The tertiary determinants frequently had an inconsistent effect. The second and third main categories described environmental/cultural facilitators and barriers respectively which form a background upon which the determinants of reporting exists.A distinctive framework with clear differences to recording of other types of adverse events on incident reports was apparent. Providing information to hospital staff regarding the purpose of incident reporting and the usefulness of incident reporting for preventing future falls may improve incident reporting practices.Reporting of falls on hospital incident reports is an accepted standard for collating falls data in both clinical practice and research. [1-4] Concerns have previously been expressed regarding the ability of this system to accurately measure the "true" number of falls taking place on hospital wards.[3] In particular, discrepancies in the definition of a fall used in different facilities, time pressures on staff and the existence of a "blame" culture have been postulated to contribute to inconsistency in reporting and under-reporting respectively.[3,5,6]It is plausible that more f
To what extent are adverse events found in patient records reported by patients and healthcare professionals via complaints, claims and incident reports?
Ingrid Christiaans-Dingelhoff, Marleen Smits, Laura Zwaan, Sanne Lubberding, Gerrit van der Wal, Cordula Wagner
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-49
Abstract: We conducted a retrospective study using a database from a record review study of 5375 patient records in 14 hospitals in the Netherlands. Trained nurses and physicians using a method based on the protocol of The Harvard Medical Practice Study previously reviewed the records. Four reporting systems were linked with the database of reviewed records: 1) informal and 2) formal complaints by patients/relatives, 3) medico-legal claims by patients/relatives and 4) incident reports by healthcare professionals. For each adverse event identified in patient records the equivalent was sought in these reporting systems by comparing dates and descriptions of the events. The study focussed on the number of adverse event matches, overlap of adverse events detected by different sources, preventability and severity of consequences of reported and non-reported events and sensitivity and specificity of reports.In the sample of 5375 patient records, 498 adverse events were identified. Only 18 of the 498 (3.6%) adverse events identified by record review were found in one or more of the four reporting systems. There was some overlap: one adverse event had an equivalent in both a complaint and incident report and in three cases a patient/relative used two or three systems to complain about an adverse event. Healthcare professionals reported relatively more preventable adverse events than patients.Reports are not sensitive for adverse events nor do reports have a positive predictive value.In order to detect the same adverse events as identified by patient record review, one cannot rely on the existing reporting systems within hospitals.For hospital managers and healthcare providers involved in patient safety issues it is important to have access to patient safety data to facilitate decisions on interventions aimed at improving the quality and safety of hospital care. Ideally there is real-time information about patient safety, capturing incidents that reflect actual or potential risks of a
Indians culture in the tourism of Ontario  [PDF]
Besermenji Sne?ana,Mili? Nata?a,Mulec Ivo
Journal of the Geographical Institute Jovan Cvijic, SASA , 2011, DOI: 10.2298/ijgi1103119b
Abstract: The first association to potential tourists, when they mention Ontario or Canada, is endless and untouched natural area. Numerous forest areas and beautiful lakes, wild animals moving freely in these expanses of the famous Niagara Falls are important part of Ontario tourism offer. Regarding cultural assets of Ontario and of the entire Canada, it may not have old city quarters as Europe, but it certainly has a long history. This history includes Indians whose customs and culture are very interesting for tourists.
Cause Identification from Aviation Safety Incident Reports via Weakly Supervised Semantic Lexicon Construction  [PDF]
Muhammad Arshad Ul Abedin,Vincent Ng,Latifur Khan
Computer Science , 2014, DOI: 10.1613/jair.2986
Abstract: The Aviation Safety Reporting System collects voluntarily submitted reports on aviation safety incidents to facilitate research work aiming to reduce such incidents. To effectively reduce these incidents, it is vital to accurately identify why these incidents occurred. More precisely, given a set of possible causes, or shaping factors, this task of cause identification involves identifying all and only those shaping factors that are responsible for the incidents described in a report. We investigate two approaches to cause identification. Both approaches exploit information provided by a semantic lexicon, which is automatically constructed via Thelen and Riloffs Basilisk framework augmented with our linguistic and algorithmic modifications. The first approach labels a report using a simple heuristic, which looks for the words and phrases acquired during the semantic lexicon learning process in the report. The second approach recasts cause identification as a text classification problem, employing supervised and transductive text classification algorithms to learn models from incident reports labeled with shaping factors and using the models to label unseen reports. Our experiments show that both the heuristic-based approach and the learning-based approach (when given sufficient training data) outperform the baseline system significantly.
Cooperatives and the State: The Case of Ontario  [cached]
Jen Heneberry,Rachel Laforest
Canadian Journal of Nonprofit and Social Economy Research , 2011,
Abstract: In the early 2000s, the cooperative movement in Ontario came together in order to lobby its provincial government for active cooperative development support programs. Momentum was building for these types of programs. Already, many provincial governments had implemented active support programs in their jurisdiction. Despite having one of the largest cooperative sectors in Canada, Ontario was lagging behind. This article assesses the progress of the efforts of the Ontario cooperative movement to date. It details how the Ontario cooperative movement developed a sectoral identity for itself and framed its objectives in an effort to strengthen its relationship with the Ontario government. / Le mouvement coopératif en Ontario s'est rassemblé au début des années 2000 afin de faire pression sur le gouvernement provincial pour qu'il développe des programmes de soutient actif pour coopératives. Déjà plusieurs gouvernements provinciaux avaient mis en place de telles politiques. L'Ontario tardait malgré le fait qu'il avait un des plus grands secteurs coopératifs au Canada. Cet article examine le progrès qu'a connu le mouvement coopératif en Ontario dans ses efforts. Il décrit comment le mouvement coopératif a construit une identité sectorielle autour de laquelle il a pu ancrer ses demandes auprès du gouvernement ontarien.
Patient expectations of fair complaint handling in hospitals: empirical data
Roland D Friele, Emmy M Sluijs
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-106
Abstract: Subjects were patients who had lodged a complaint at the complaint committees of 74 hospitals in the Netherlands. A total of 424 patients (response 75%) completed a written questionnaire at the start of the complaint procedures. Derived from justice theory, we asked what they expected from fair procedures, fair communication and fair outcome of complaint handling.The predominant reason for complainants to lodge a complaint was to prevent the incident from happening again. Complainants expected fair procedures from the complaint committee, in particular an impartial position. This was most important to 87% of the complainants. They also expected to be treated respectfully. Furthermore, they expected the hospital and the professional involved to respond to their complaint. A change in hospital performances was the most wanted outcome of complaint handling, according to 79% of the complainants. They also expected disclosure from the professionals. Professionals should admit a mistake when it had occurred. More complainants (65%) considered it most important to get an explanation than an apology (41%). Only 32% of complainants expected the professional to make an effort to restore the doctor-patient relationship. A minority of complainants (7%) wanted financial compensation.Nearly all complainants want to prevent the incident from happening again, not out of pure altruism, but in order to restore their sense of justice. We conclude that complaint handling that does not allow for change is unlikely to meet patients' expectations. Secondly, complaint handling should not be left exclusively to complaint committees, the responses of hospital and professionals are indispensable.Many patients appear to be dissatisfied with legal litigation procedures [1] and also with non-legal complaints handling in hospitals [2-4]. This phenomenon is not well understood.Little is known on patients' motives to lodge complaints and about patients' needs and expectations regarding the complain
The Far North Act (2010) Consultative Process: A New Beginning or the Reinforcement of an Unacceptable Relationship in Northern Ontario, Canada?  [PDF]
Holly L. Gardner,Stephen R.J. Tsuji,Daniel D. McCarthy,Graham S. Whitelaw
International Indigenous Policy Journal , 2012,
Abstract: In northern Ontario, Canada, there have been two “negotiated” documents that required consultation between First Nations and the federated government of the land: Treaty No. 9 signed in 1905-1906 (Dominion of Canada, with the concurrence of the Province of Ontario) and Ontario’s Far North Act (2010). Treaty No. 9 has defined the relationship between First Nations and Canada; while, the Far North Act will define the relationship with Ontario. This article evaluated whether the Far North Act marked a new beginning or the reinforcement of an unacceptable relationship, using primary and secondary data analyses. Analyses revealed that the passing of the Far North Act was not a new beginning, but the continuation of an unacceptable relationship.
Is there value in using physician billing claims along with other administrative health care data to document the burden of adolescent injury? An exploratory investigation with comparison to self-reports in Ontario, Canada
Beth K Potter, Douglas Manuel, Kathy N Speechley, Iris A Gutmanis, M Karen Campbell, John J Koval
BMC Health Services Research , 2005, DOI: 10.1186/1472-6963-5-15
Abstract: The sample included adolescents aged 12 to 19 years who participated in the 1996–1997 cross-sectional Ontario Health Survey, and whose survey responses were linked to administrative health care datasets (N = 2067). Descriptive analysis was used to document the burden of injuries as a proportion of all physician care by gender and location of care, and to examine the distribution of both administratively-defined and self-reported activity-limiting injuries according to demographic characteristics. Administratively-defined and self-reported injuries were also directly compared at the individual level.Approximately 10% of physician care for the sample was identified as injury-related. While 18.8% of adolescents had self-reported injury in the previous year, 25.0% had documented administratively-defined injury. The distribution of injuries according to demographic characteristics was similar across data sources, but congruence was low at the individual level. Possible reasons for discrepancies between the data sources included recall errors in the survey data and errors in the physician billing data algorithm.If further validated, physician billing data could be used along with hospital inpatient data to make an important and unique contribution to adolescent injury surveillance. The limitations inherent in different datasets highlight the need to continue rely on multiple information sources for complete injury surveillance information.The contribution of surveillance systems in providing valuable information for injury prevention and control is widely recognized; for example, surveillance data can be used to highlight the burden of injury, set priorities for prevention, and evaluate preventive strategies [1,2]. Estimates of the population burden of injuries differ, though, depending on how information is obtained. Detailed trauma registries and special surveillance systems [e.g., [3]] contain rich contextual information on particular subsets of injuries, but since suc
Mapping Ontario’s Wind Turbines: Challenges and Limitations  [PDF]
Tanya Christidis,Jane Law
ISPRS International Journal of Geo-Information , 2013, DOI: 10.3390/ijgi2041092
Abstract: Despite rapid and vast development of wind turbines across the Canadian province of Ontario, there is no map available indicating the location of each wind turbine. A map of this nature is crucial for health and environmental risk research and has many applications in other fields. Research examining health and wind turbines is limited by the available maps showing the nearest community to a wind farm as opposed to each unique wind turbine. Data from provincial-level organizations, developers, and municipalities were collected using government development approval documents, planning documents, and data given directly from municipalities and developers. Wind turbines were mapped using Google Earth, coordinate lists, shapefiles, and translating data from other maps. In total, 1,420 wind turbines were mapped from 56 wind farms. The limitations of each data source and mapping method are discussed. There are numerous challenges in creating a map of this nature, for example incorrect inclusion of wind farms and inaccuracies in wind turbine locations. The resultant map is the first of its kind to be discussed in the literature, can be used for a variety of health and environmental risk studies to assess dose-response, wind turbine density, visibility, and to create sound and vibration models.
Complaint Attitudes and Behavior in Academic Libraries
Shiao-Feng Su
Journal of Library and Information Studies , 2012,
Abstract: After experiencing library service failure, the user may directly or indirectly voice his/her complaint, which is the best prescription to improve library public services. The paper explores the academic librarians and users’ attitudes towards complaints. Through surveying six hundred students from twenty universities and applying descriptive and inferential statistical techniques, the study investigates student users’ complaint preference and behavior afterwards, and perception of complaint handling and outcome. The study reports and compares their attitudes and perspectives towards library complaints. It further examines the differences in attitudes and behavior intention among respondents who had prior experience in filing complaints at libraries, did not complain, and had no prior experience in service failure. An ultimate analysis was made to contrast the user’s perception towards complaint handling of the library and of for-profit organization. [Article content in Chinese]
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