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This chapter provides foundations of differentiating the sophisticated and various theoretical approaches towards safe spaces demonstrated in this book. For the purpose of framing the examples provided in this collection, we offer three broad ways of thinking about safe spaces: safe learning spaces as separate, counterhegemonic, or third spaces; safe learning spaces of difference, sameness, and intersecting identities; and deliberative and democratic learning spaces. It needs to be noted, however, that these are not mutually exclusive but different aspects to consider and that they each operate within and across, and are therefore influenced by, the five levels of inequity discussed in Chapter 2. That said, not all levels of inequity are necessarily addressed by any given space, regardless of the frame used to interpret it. This discussion respects the multiple paradoxes in education, especially the one of pluralism and sameness, offering approaches to modes and learning settings of inclusion and exclusion and how they create different, yet “safe,” spaces.

The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services.

The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ² analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables.

In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool.

Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

The optimum response to the different stages of a major burns incident is still not established. The fire in a café in Volendam on New Year's Eve 2000 was the worst incident in recent Dutch history and resulted in mass burn casualties. The fire has been the subject of several investigations concerned with organisational and medical aspects. Based on the findings in these investigations, a multidisciplinary research group started a consensus study. The aim of this study was to further identify areas of improvement in the care after mass burns incidents.

The consensus process comprised three postal rounds (Delphi Method) and a consensus conference (modified nominal group technique). The multidisciplinary panel consisted of 26 Dutch‐speaking experts, working in influential positions within the sphere of disaster management and healthcare.

In response to the postal questionnaires, consensus was reached for 66 per cent of the statements. Six topics were subsequently discussed during the consensus conference; three topics were discussed within the plenary session and three during subgroup meetings. During the conference, consensus was reached for seven statements (one subject generated two statements). In total, the panel agreed on 21 statements. These covered the following topics: registration and evaluation of disaster care, capacity planning for disasters, pre hospital care of victims of burns disasters, treatment and transportation priorities, distribution of casualties (including interhospital transports), diagnosis and treatment and education and training.

In disaster medicine, the paper shows how a consensus process is a suitable tool to identify areas of improvement of care after mass burns incidents.

This paper seeks to review current approaches to learning from health and safety incidents in the workplace. The aim of the paper is to identify the diversity of approaches and analyse them in terms of learning aspects.

A literature review was conducted searching for terms incident/accident/near misses/disaster/crisis modified with learning/training and safety. Shortlisted articles were analysed by questioning who is learning, what kind of learning process is undertaken, what type of knowledge is employed and the type of problem that these incidents addressed. Current approaches to learning from incidents were critically analysed and gaps identified.

Very few papers addressed all the envisaged aspects when developing their learning from incidents approaches. With support from literature, it was concluded that all the four perspectives, namely participants of learning (participation and inclusion), learning process (single loop, double learning), type of incident and its relation to learning (Cynefin complexity framework) and types of knowledge (conceptual, procedural, dispositional and locative) are important when deciding on an appropriate learning from incidents approach.

The literature review focused on journal articles and identified keywords, which might have narrowed the scope. Further research is needed in identifying ways to embed the learning from incidents aspects in the organisation.

The framework developed could be useful by safety planners, safety managers, human resource managers and researchers in the area of organisational learning and safety.

The paper concludes by outlining key questions and proposing a framework that could be useful in systematically analysing and indentifying effective approaches to learning from incidents.

The purpose of this paper is to explore the benefits of the internet of things (IoT) technology on geriatric telehealth.

An exploratory case study approach is used to understand the applicability of the internet of medical things in geriatric telehealth. Data was collected from several managers who analyzed rates of re-hospitalizations for patients using telehealth services compared to those not using telehealth services and observations of patient satisfaction rates with telehealth services.

Benefits from the use of IoT included significant reductions in re-hospitalization rates for older adults and patients became more engaged in maintaining their health and wellness goals while becoming more tech-savvy, empowered and satisfied with the telehealth experience.

The present manuscript is among the few reports on the benefits of IoT on geriatric health care.

The purpose of this paper is to evaluate the impact of adopting the Six Sigma define, measure, analyze, improve and control (DMAIC) approach in reducing patients fall rate in an Academic Medical Center, Saudi Arabia.

A prospective study design was adopted and this study was conducted at King Fahd Hospital of the University (KFHU) during the year 2014. Based on the historical data of the patients’ falls reported at KFHU during the year 2013, the goal was fixed to reduce the falls rate from 7.18 to<3 (over 60 percent reduction) by the end of December 2014. This study was conducted through the five phases of “DMAIC” approach using various quality tools. Three time periods were identified, namely, pre-intervention phase; intervention phase; and post-intervention phase. Appropriate strategies were identified through the process of brainstorming and were implemented to study the potential causes leading to the occurrence of falls.

The pre-intervention falls rate was reported as 6.57 whereas the post-intervention falls rate was measured as 1.91 (demonstrating a 70.93 percent reduction) after the implementation of improvement strategies. The adherence rate toward the practice of carrying falls risk assessment and hourly rounding was observed to be high where 88 percent of nurses are regularly practicing it. A control plan was also executed to sustain the improvements obtained.

The Six Sigma “DMAIC” approach improves the processes related to the prevention of falls. A greater reduction in patients falls rate (over 70 percent) was observed after the implementation of the improvement strategy.

Emergency care delivery is a process requiring input from various healthcare professionals within the hospital. To deliver efficient and effective emergency care, professionals must integrate rapidly at multiple interfaces, working across functional, spatial and professional boundaries. Yet, the interdisciplinary nature of emergency care presents a challenge to the optimization of patient flow, as specialization and functional differentiation restrict integration efforts. This study aims to question what boundaries exist at the level of professionals and explores how these boundaries may come to influence integration and operational performance.

To provide a more holistic understanding of the inherent challenges to integration at the level of professionals and in contexts where professionals play a key role in determining operational performance, the authors carried out an in-depth case study at a busy, Level 1 trauma center in The Netherlands. In total, 28 interviews were conducted over an 18-month period.

The authors reveal the existence of structural, relational and cultural barriers between (medical) professionals from different disciplines. The study findings demonstrate how relational and cultural boundaries between professionals interrupt flows and delay service processes.

This study highlights the importance of interpersonal and cultural dynamics for internal integration and operational performance in emergency care processes. The authors unveil how the presence of professional boundaries creates opportunity for conflict and delays at important interfaces within the emergency care process, and can ultimately accumulate, disrupting patient flow and increasing lead times.

Selective laser melting (SLM) is an additive manufacturing process suitable for fabricating metal porous scaffolds. The unit cell topology is a significant factor that determines the mechanical property of porous scaffolds. Therefore, the purpose of this paper is to evaluate the effects of unit cell topology on the compression properties of porous Cobalt–chromium (Co-Cr) scaffolds fabricated by SLM using finite element (FE) and experimental measurement methods.

The Co-Cr alloy porous scaffolds constructed in four different topologies, i.e. cubic close packed (CCP), face-centered cubic (FCC), body-centered cubic (BCC) and spherical hollow cubic (SHC), were designed and fabricated via SLM process. FE simulations and compression tests were performed to evaluate the effects of unit cell topology on the compression properties of SLM-processed porous scaffolds.

The Mises stress predicted by FE simulations showed that different unit cell topologies resulted in distinct stress distributions on the bearing struts of scaffolds, whereas the unit cell size directly determined the stress value. Comparisons on the stress results for four topologies showed that the FCC unit cell has the minimum stress concentration due to its inclined bearing struts and horizontal arms. Simulations and experiments both indicated that the compression modulus and strengths of FCC, BCC, SHC, CCP scaffolds with the same cell size presented in a descending order. These distinct compression behaviors were correlated with the corresponding mechanics response on bearing struts. Two failure mechanisms, cracking and collapse, were found through the results of compression tests, and the influence of topological designs on the failure was analyzed and discussed. Finally, the cell initial response of the SLM-processed Co-Cr scaffold was tested through the in vitro cell culture experiment.

A focus and concern on the compression properties of SLM-processed porous scaffolds was presented from a new perspective of unit cell topology. It provides some new knowledge to the structure optimization of porous scaffolds for load-bearing bone implants.

The purpose of this paper is to adopt rapid prototyping (RP) technology to fabricate self‐hardening calcium phosphate composite (CPC) scaffolds with a controlled internal channel network to facilitate nutrient supplying and cell growth using RP technique and investigate their in vitro performance.

Porous scaffolds should possess branched channels to ensure uniform cell feeding and even flow of culture medium to promote uniform cell attachment and growth. A new three dimensional (3D) flow channel structure has been designed based on conversation of energy and flow. The CPC scaffold possessing such a channel network was made by indirect solid free form fabrication. Negative model of scaffold was designed by Pro/E software and its epoxy resin mold was fabricated on a sterolithography apparatus and the CPC slurry was filled in these molds. After CPC was self hardened, the mold was baked. The mold was removed by pyrolysis and then the designed scaffold was obtained.

The sizes of the fabricated scaffolds were consistent with the designed. The average compressive strength of the scaffold is approximately 6.0 MPa. Computational fluid dynamics and perfusion culture results showed that such a 3D flow channel arrangement would lead to a more uniform distribution of flow and cells and good transportation of nutrients.

The size errors of fabricated scaffolds could not escape and perfusion methods were difficult to control.

The basic design concept presented showed great promise for use in bone tissue engineering and fabrication method enhanced the versatility of scaffold fabrication. The designed scaffold structure made it possible to keep integrality of the scaffold when direct observation cells inside the channel by scanning electron microscopy (SEM).

The purpose of this study was to pilot an undergraduate teaching assistantship for Emirati students, an area of scholarship underexplored in the Middle East. The teaching assistantship was developed to better prepare students for the workforce, amidst the push for Emiratization.

Over the course of one semester, four undergraduate teaching assistants documented their experience through reflexive journals that were analysed using a reflexive thematic analysis.

Undergraduate teaching assistants characterised their experience as providing professional development and learning to connect with student learners. Findings suggest that relationality may be an important factor in student engagement and learning.

Understanding the experience of undergraduate teaching assistants can help develop targeted opportunities to enhance career readiness. Exploring the role of relationality could be important in the training and development of the Emirati workforce and help address some of the gaps in skills. Understanding the way in which undergraduate teaching assistants perceive their teaching experience can also provide faculty with insight into their teaching practices.

This exploratory study shows that students are able to acquire skills that may be applied in a variety of work settings (e.g. balancing multiple responsibilities). However, undergraduate teaching assistants expressed wanting to connect with student learners; this may be more culturally rooted and is less explored within the Emirati context. Given the socio-cultural context of the United Arab Emirates (UAE), female Emiratis may benefit from work-type opportunities, which to the authors’ knowledge has not been explored previously.