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I was in a primary school the other day and found myself in a classroom where the teacher was supervising a library period. Some of the children were absorbed in reading, others were busily engaged in consulting books piled around them, and taking notes. So engrossed were they that I felt it almost an unwarranted intrusion to bid them “Good morning”. The teacher explained that the children taking notes were preparing articles for their class magazine—on subjects as diverse as “The Earth and the Moon”, “Adventure in the Amazon”, “I was a Racing Driver”, “A Night Hunter of the Sea Bed”—and that their researches took them regularly to the public library.

During October, 1959, the British Council's representative in Germany asked for a team of experts from Glasgow to study and discuss with the German authorities the cultural life of the City of Hamburg, with special reference to the Volkshochschule system of adult education and including, if practicable, music, drama, the fine arts and the public libraries. The purpose of the visit, which was arranged as part of the British Council's programme of educational and cultural visits and exchanges, was to assess what is being done in the field of Further Education in Hamburg, to discuss post war developments and to give members of the delegation an opportunity to exchange opinions with their “opposite numbers” on common problems and possible ways of dealing with them.

So far in these articles I have dealt with Scottish publishers of books in all lines of literature, and have not covered the subject, but the material presented is sufficient to indicate a fine record. Now I shall deal with a number of publishers of books of special character. In this case also selection is eclectic; even so it is quite significant.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.