Sue S. Feldman, Scott Buchalter, Dawn Zink, Donna J. Slovensky and Leslie Wynn Hayes
The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality…
Abstract
Purpose
The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality improvement and patient safety education program focused on developing leaders to change the future of healthcare quality and safety.
Design/methodology/approach
The safety attitudes questionnaire (SAQ) short-form was used for measuring the culture of quality and safety among healthcare workers who were graduates of an academic medical center’s healthcare quality and safety program. A 53 percent response rate from program alumni resulted in 54 usable responses.
Findings
This study found that 42 (78 percent) of the respondents report that they are currently working in a healthcare quality and safety culture, with 25 (59 percent) reporting promotion into a leadership role after completion of the quality improvement education program. This compares favorably to AHRQ culture of safety survey results obtained by the same academic medical center within the year prior revealing only 63 percent of all inpatient employees surveyed reported working in a quality and safety culture.
Research limitations/implications
The study design precluded knowing to what degree a quality and safety culture, as measured by the SAQ, existed prior to attending the healthcare quality and safety program.
Originality/value
This study has practical value for other organizations considering a quality and safety education program. For organizations seeking to build capacity in quality and safety, training future leaders through a robust curriculum is essential. This may be achieved through development of an internal training program or through attending an outside organization for education.
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Brad Hagen and Christopher Armstrong‐Esther
Despite the increasing evidence about the inappropriate use of medications by older people, there is very little published evidence about the control and monitoring of neuroleptic…
Abstract
Despite the increasing evidence about the inappropriate use of medications by older people, there is very little published evidence about the control and monitoring of neuroleptic drugs used in nursing homes. As others have indicated, this is all the more worrying when set in the context of the paucity of research on nursing home care and the trend to replace registered nurses with untrained care assistants. In the United States, legislation in the form of the Nursing Home Reform Act (OBRA 1987) was introduced, in part, to regulate the prescribing and administration of neuroleptic (antipsychotic) drugs. No such legislation exists in Canada or the United Kingdom. In the case of the latter jurisdiction, the recent Royal Commission on Long‐Term Care for older people (The Stationery Office, 1999) has recommended a national care commission to monitor care, and set assessment and quality benchmarks. In Canada this debate has not even begun, and the purpose of this paper is not to ignite controversy, but to raise questions about the use of these drugs with nursing home residents. Voluntary guidelines and education of physicians, nurses and care attendants would be infinitely better than legislation. In the meantime, we need research to address the following questions: For what reasons should these drugs be given to older people? Are these drugs being used appropriately? Is the risk of side‐effects too great with these drugs? Are the numbers and type of staff employed in nursing homes adequate/qualified to detect and report side‐effects? How well do these drugs manage the behaviours they are given to control? Are they being used as chemical restraints or to make the older person compliant? Are the so‐called ‘atypical’ neuroleptic drugs any better? What we offer in this article is background information that might encourage others to not only review their practice but also to address these questions.
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The purpose of this paper is to explore the Thriving City Initiative (TCI) model in relation to Public Mental Health and Well-being. The initiative does not have an obvious…
Abstract
Purpose
The purpose of this paper is to explore the Thriving City Initiative (TCI) model in relation to Public Mental Health and Well-being. The initiative does not have an obvious coherence across the cities which implement it. Is there a consistent model as seen in other city-led public health initiatives? Can the TCI model continue to be adopted by urban areas worldwide without clear conceptualisation? This paper explores the discourse of what it means to be a TCI and whether or not there are key ingredients which tie them all together, justifying the common name-branding.
Design/methodology/approach
This exploratory paper uses existing literature on public health and discussions with public health leaders.
Findings
Despite the proliferation of TCIs across countries, there lacks a consistent model or identity across the different implementations. There are, however, some key ingredients across them: partnerships, a focus on prevention and promotion and changing perceptions of mental health and well-being.
Practical implications
This paper paves the way for future research on TCIs and creates a foundation for future exploration or evaluation of the initiatives and their impacts or effectiveness.
Originality/value
There is very little academic literature on individual TCIs and even less on the public health model itself. As of now, there is no outline, guidance or framework that identifies what a TCI is. To the best of the author’s knowledge, this paper is the first of its kind, exploring the concepts and defining features of a TCI.