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Significant, sustained improvement in patient safety has proved an intractable goal. Attempts to address persistent problems have largely focused on technical solutions to issues conceptualised as clinical, cultural or system based. While communication is at the core of many remediation strategies, the focus has remained largely on communication between clinicians or between clinicians and patients, and on creating centralised guidelines as communicative mechanisms to transmit approved practice. Yet, current attempts at improvement have had limited impact. The purpose of this paper is to highlight vital new ways of conceptualising and exploring the relations and actions that are meant to constitute safety within organisations.

Utilising theory from social sciences, the authors reconceptualise trespass and transgression, traditionally positioned as infringements, as acts of resistance: mechanisms for intrusion which intentionally or unintentionally disrupt the territorial claims of professions and organisations to enhance patient safety.

Drawing on the literature, research and professional experience, two forms of trespass are discussed: the intrusion of largely invisible and understudied ancillary staff into the world of clinicians; and the use of workarounds by clinicians themselves. In both cases, transgressors intend to increase rather than decrease patient safety and may, upon further examination, prove to do so.

Trespasses and transgressions considered in this light offer the opportunity to make visible people, relationships and actions which have previously remained hidden in our understanding of, and therefore proposed solutions to, patient safety.

The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries.

The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people.

The author’s premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems.

This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept.

Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing a growing number of problems and challenges. Being able to inquire on significant challenges in health and social care through a spatial lens has the potential to provide another, highly practical, kind of evidence in this field of work. This lens is, the author contends, very poorly integrated into either health or social care at present. However, doing so would have a variety of useful outcomes for monitoring and intervening on real problems in care integration. An example could be “frequent flyers” in emergency departments as has been done in Camden, New Jersey through patient mapping.

The author’s position in this paper is that the challenges we face in providing integrated care to ageing and increasingly disabled (including both physical and cognitive impairments) populations will only grow in the face of variable governmental responses and increasingly complex funding and service provider arrangements. Without a geographical perspective and the concepts and tools of spatial science the author does not see an adequate response emerging. The shift to community-based care for many groups, including the aged, means that location will become more important rather than less so. This is a societal concern of major proportions and the very concept of integrated care requires of us a geographical perspective.

This is a short but, the author believes, conceptually rich piece with a variety of potential practical implications for health and social care service provision. Issues of equity, quality, safety and even basic access can only grow as population ageing progresses and various forms of chronic disease and disability continue to grow. Knowing where the most affected people and their social and service connections are located will support better integration. And better integration may resolve some of the financial and related resource problems that are already evident but which can only continue to increase. In this context, the author suggests that the integrated care of the future needs to be geographically informed to be effective.

The application of benchmarks developed from a scorecard approach to a total quality management (TQM) programme are discussed. The programme aims to attain quality within an organisation whose primary operations are centred on a number of construction projects. The innovative scorecard measures developed and implemented within the Morrison Construction Group are reviewed and reported upon, and the resulting benefits derived from the implementation of the scorecard are discussed. Real and virtual benchmarks are established and utilised as metrics within this construction organisation’s scorecard. From implementation of the scorecard, it is clear that superior measures are those which incorporate internal and external customer survey findings which include the mapping of practical efforts centred on the perceptions of the client and the myriad other stakeholders in a construction project.

Morrison Construction's innovative business scorecard uses a golf course analogy to transmit best practice and measurement throughout the business. Its goal is not just to break par, but by 2000 to head the leaderboard of UK construction companies.

The construction industry needs effective methods for gathering and utilizing performance information on industry, company and individual project levels. Such benchmarking (BM) information can be collected from project participants’ bi-directional evaluations of each other’s performance during construction projects. The purpose of this paper is to present the method and discuss the features of a multi-company project evaluation system as a BM tool. Also the accumulated results, based on the extensive BM database in the Finnish construction industry, are investigated.

The web-based project evaluation tool was established in 2007 as a joint research project between the Helsinki University of Technology, construction organizations and main associations widely representing the construction industry in Finland. The evaluation method is based on soft, subjective measures, such as client satisfaction and project participants’ satisfaction. The empirical observations of the study are based on over 5,500 evaluations during which the BM system was used in the Finnish construction industry.

The use of the evaluation is presented as a multi-level BM tool to evaluate the performance of different discipline groups on project, company and industry levels. The Finnish case shows an example of the industry-level performance BMs of project consultants, main contractors, sub-contractors and architects/designers. The BM categories include project management, staff, collaboration and project goal accomplishment. According to the results, the participants are satisfied with each other’s performance. However, main development targets in the Finnish industry are related to risk management and managing design. Also, the development of sub-contractors’ selection procedures will contribute to the performance of the industry.

The industry-level feedback is linked to the Finnish construction industry. Similar studies in other countries would enable international comparisons.

Client satisfaction and project participants’ satisfaction have been identified as one of the key factors affecting project success. With the help of mutual project evaluation, different BMs enable organizations to monitor their performance and to improve their operations in various areas. They also make it possible to position an organization’s performance in comparison to the competitors and help to perceive black spots in the process on project level. As a common system for the parties in the industry, the project evaluation BM system promotes quality improvement, customer orientation and collaboration between participants.

Project evaluation between the project participants’ enhance collaboration and mutual learning.

Multi-company project evaluation is a new and promising topic in performance measurement which holds potential for performance improvement through the utilization of network information and team dynamics. The study presents its wider utility as the basis of national, company and project BM.

IT is curious to note how many more books are written for boys than for girls. Considering the growing number of women writers, it might be expected that girls' books would predominate. It may be that women writers are canny enough to write with their eye on the boy reader knowing that while a totally feminine story will not attract boys, girls often read their brothers' books. Most of the children's classics appeal to both sexes—Peter Pan, Pinocchio, A Christmas Carol, Hans Brinker, The Wind in the Willows, and The Bastable Children, for example. Even the classics of adventure such as Treasure Island, and Robinson Crusoe, have their female devotees and therefore stand a greater chance of survival than books like Little Women, the Katy series, and Rebecca of Sunnybrook Farm. With the development of the “family story” popularised by E. Nesbit, there seems to have been a decline in the school story—at least among boys. Either they prefer natural tales of boys and girls together at home, or on holiday, or realistic adventures. A. S. Tring keeps a foot in all three camps, so to speak, with his tale of out‐of‐school activities, adventures and feuds between two day schools. His story entitled The Old Gang (O.U.P., 7/6) is told by the hero himself, in a racy style, and is amusingly illustrated by John Camp. Of the realistic adventure type is The Missing Legatee, by Wilfrid Robertson (O.U.P., 7/6), and it has its setting in the wilds of the Zambesi where the author himself has made expeditions, exploring and big game hunting. It satisfies the boy's demand for plenty of action and at the same time conforms to a good stylistic standard. Another tale of a search undertaken at great risk is David Gammon's Against the Golden Gods (Lutterworth, 5/‐) in which a seventeen year old boy goes out among the head hunters of Papua to rescue his captive father. Fog in the Channel, by Percy Woodcock (Nelson, 7/6) relates stirring adventures by sea, beginning with a collision in the fog when two schoolboys board a mysterious vessel supposed to be on secret service.

The management of children′s literature is a search for value and suitability. Effective policies in library and educational work are based firmly on knowledge of materials, and on the bibliographical and critical frame within which the materials appear and might best be selected. Boundaries, like those between quality and popular books, and between children′s and adult materials, present important challenges for selection, and implicit in this process are professional acumen and judgement. Yet also there are attitudes and systems of values, which can powerfully influence selection on grounds of morality and good taste. To guard against undue subjectivity, the knowledge frame should acknowledge the relevance of social and experiential context for all reading materials, how readers think as well as how they read, and what explicit and implicit agendas the authors have. The good professional takes all these factors on board.