From good intentions to successful implementation: the case of patient safety in Canada

Abstract: Improvements to patient safety have become a major issue on Canada's already crowded health care policy agenda. This paper applies implementation theory to the practical issues involved with the adoption of patient safety reforms. It is based on a review of the literature and official reports on patient safety and on the author's experience as the chair of the Board of Directors of the Manitoba Institute for Patient Safety created in June 2004. The obstacles and possible solutions to advance the patient safety agenda are discussed. While implementation theory was found to provide a general guide, the author's experience leads him to conclude the literature on governance and organizational change offers more practical advice. Sommaire: L'amélioration de la sécurité des patients est devenue une question majeure du programme déjà chargé des politiques en matière de soins de santé. Le présent article applique une théorie de mise en œuvre aux questions pratiques découlant de l'adoption des réformes sur la sécurité du patient. II est fondé sur une étude de publications et rapports officiels sur la sécurité du patient, ainsi que sur l'expérience de l'auteur en tant que président du conseil d'administration de l'Institut pour la sécurité des patients du Manitoba, créé en juin 2004. II passe en revue les obstacles et les solutions possibles à la promotion du programme de la sécurité des patients. Si l'auteur trouve que la théorie de la mise en œuvre fournit un guide général, son expérience le pousse à conclure que la documentation sur la gouvernance et les changements organisationnels offre davantage de conseils pratiques.     

Toxicological findings in military aircraft fatalities from 1986-1990.

Toxicological findings in all military aircraft fatalities investigated by the Division of Forensic Toxicology at the Armed Forces Institute of Pathology from 1986-1990 are presented. Carbon monoxide saturation levels greater than 10% were found in 4% of the 535 cases where appropriate specimens were collected. Positive ethanol findings were more indicative of postmortem formation than antemortem consumption. In only 1 case were abused drugs (cannabinoids in a passenger) detected. Other drugs identified included nicotine, chloroquine and over-the-counter analgesic agents, antihistamines and sympathomimetic drugs.     

Is crime scene examination science, and does it matter anyway?

This short piece aims to assess the kind of data collected by Crime Scene Examiners (CSEs), and to discuss whether this collection constitutes a scientific process. It also seeks to examine the balance of roles performed by the CSE, between data gatherer and investigator. The piece also aims to conclude on whether a clearer understanding of the structure of data collected by CSEs might be of some practical use in developing a greater understanding of the architecture of knowledge that forensic science as a whole relies upon. As a piece of work it is unapologetically theoretical in its perspective, and seeks to prompt further discussion regarding the structure of scientific knowledge, and any relevance this might have to its application in a forensic context. Ultimately, it seeks the inclusion of the processes of data gathering performed largely by CSEs within the wider processes of forensic science.     

Reactions to inequity

Law and Human Behavior - This article proposes a model for integrating equity theory, a framework for studying the psychology of the legal process, with some tenets of attribution theory. Attempts...     

Legal vs. quantified definitions of standards of proof

Law and Human Behavior - Three laboratory experiments were conducted to compare legal (unquantified) definitions of three standards of proof (“preponderance of the evidence,”...     

PLANNING: LESSONS FROM THE PORTS

The National Ports Council, created in 1964 and abolished in 1982, was engaged in one of the rare sustained attempts at planning in Britain. This article explains the Council's decision not to carry out full-scale planning because of the difficulties of collecting information, assessing technological and economic changes, and reconciling rational economic planning with short term political pressures.     

Biological factors and crime: implications for forensic psychiatry

To summarize, we can say that (1) Criminal behavior, especially chronic criminal behavior, seems to be partly genetically predisposed; (2) An important task at this point is to attempt to determine the biological factors which predispose people to crime; and (3) We have related some tentative initial steps being taken in the study of the autonomic nervous system as one possible heritable, biological basis for the failure of normal social learning forces in inhibiting criminal behavior. Early in this paper we discussed the tenability of asserting criminal responsibility on individuals whose criminal behavior has a partly genetic etiology. But this special consideration seems to set biological factors apart as being in some unique causal category. In fact, genetic, physiological, and biochemical factors are causal agents in the same sense as family, social class, or neighborhood factors. Of course, criminal behavior (like all other behavior) must be caused; one class of causal variables is the biological category. The legal doctrine of responsibility is not challenged by identifying biological factors as partially determining crime any more than it is by findings of social causation. Only in cases in which abnormal biological factors are exceptionally powerful influences might responsibility be challenged. Such cases will be quite rare.