Huey Peng Loh, Dirk Frans de Korne, Soon Phaik Chee and Ranjana Mathur
Wrong lens implants have been associated with the highest frequency of medical errors in cataract surgery. The purpose of this paper is to explore the use of the Systems…
Abstract
Purpose
Wrong lens implants have been associated with the highest frequency of medical errors in cataract surgery. The purpose of this paper is to explore the use of the Systems Engineering Initiative for Patient Safety (SEIPS) framework to sustainably reduce wrong intraocular lens (IOL) implants in cataract surgery.
Design/methodology/approach
In this mixed-methods study, the SEIPS framework was used to analyse a series of (near) misses of IOL implants in a national tertiary specialty hospital in Singapore. A series of interventions was developed and applied in the case hospital. Risk assessment audits were done before the interventions (2012; n=6,111 surgeries), during its implementation (n=7,475) and in the two years post-interventions (2013-2015; n=39,390) to compare the wrong IOL-rates.
Findings
Although the absolute number of incidents was low, the incident rate decreased from 4.91 before to 2.54 per 10,000 cases after. Near miss IOL error decreased from 5.89 before to 3.55 per 1,000 cases after. The number of days between two IOL incidents increased from 35 to an initial peak of 385 before stabilizing on 56. The large variety of available IOL types and vendors was found as the main root cause of wrong implants that required reoperation.
Practical implications
The SEIPS framework seems to be helpful to assess components involved and develop sustainable quality and safety interventions that intervene at different levels of the system.
Originality/value
The SEIPS model is supportive to address differences between person and system root causes comprehensively and thereby foster quality and patient safety culture.
Details
Keywords
Kuldeep Singh and Deepa Pillai
Research signifies that well-governed companies exhibit long-run financial results and sustainable growth. In the context of SMEs, this paper aims to review the literature on…
Abstract
Purpose
Research signifies that well-governed companies exhibit long-run financial results and sustainable growth. In the context of SMEs, this paper aims to review the literature on corporate governance, the implementation challenges of corporate governance and its relationship with performance. Entwined with Indian scenarios, the study can be generalized to other emerging economies, with geographic considerations.
Design/methodology/approach
Studies from 1990 to 2020 are included in the literature review. Three databases were used for the extraction of relevant research articles: Scopus, EBSCO and ScienceDirect. To identify the relevant work, keywords along with Boolean operators for literature search were used from the research databases. The selected articles were further refined based on the authors’ keywords, journal type, data analysis methodologies and abstract analysis. Finally, 115 articles were selected and categorized into themes based on inclusion criteria for further study.
Findings
Corporate governance provides tangible and intangible benefits to SMEs. The study emphasizes on designing a cost-effective discrete governance mechanism for SMEs than the prevailing corporate governance code for large firms. Furthermore, implementing the corporate governance structure with a great level of discipline and stability is equally essential and related to performance.
Originality/value
Listing of SMEs is a relatively new phenomenon in emerging economies, including India. With listing, corporate governance and financial performance are expected to shift. The inclusion of the changing landscape of SME governance makes this study unique and relevant in the current scenario. The study will benefit the policymakers and firms to adopt optimum governance practices and link it optimally with performance.