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This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.

This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

This paper identified that organizations within the health care industry can apply the principles behind being a high reliability organization effectively and improve outcomes.

The briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that these benefits span physical, emotional and social spheres and can make a significant contribution towards quality of life. However, care settings often present specific challenges to promoting such connections due to a range of factors including risk-averse cultures and environmental limitations. The purpose of this paper is to report on a project that aims to explore the opportunities, benefits, barriers and enablers to interaction with nature for people living with dementia in residential care and extra care housing schemes in the UK.

Data were gathered from 144 responses to an online survey by managers/staff of extra care housing schemes and care homes in the UK. In depth-case studies were carried out at three care homes and three extra care housing schemes, involving interviews with residents, staff and family carers.

A wide variety of nature-based activities were reported, both outdoor and indoor. Positive benefits reported included improved mood, higher levels of social interaction and increased motivation for residents, and greater job satisfaction for staff. The design and layout of indoor and outdoor spaces is key, in addition to staff who feel enabled to promote connections with nature.

This paper is based on a relatively small research project in which the participants were self-selecting and therefore not necessarily representative.

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Outdoor activities can promote social interaction for people living with dementia in care settings. The authors’ findings are relevant to the recent policy focus on social prescribing.

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

In this paper, we offer a model of how leaders and managers can create energy for change by influencing patterns of conversation across the organization. We develop the model by linking social constructionist thought with theory from the field of positive psychology. We propose that effective leaders work with others to co-author persuasive narratives of change that generate energy by providing people (including themselves) with a sense of autonomy, competence, and relatedness. Energy is expressed in the form of support, time, money, and resources, which contribute to the success of the work. Continuous attention to crafting persuasive narratives in a collaborative way creates upward spirals of energy, and increases the probability of successful change over time. We illustrate these ideas with a case study of a successful IT change initiative in a Fortune 100 insurance company, and conclude by discussing implications for research and practice.

Roland Joffé, the film-maker behind the significant critical hits The Killing Fields (1984) and The Mission (1986), employed a hypnotic aesthetic, which unflinchingly depicted violence and brutality within different cultural contexts. In 2007, he used a no less impressive aesthetic in a similar way, although this film, Captivity, was met with public outcry, including from self-proclaimed feminist film-maker Joss Whedon. This was based upon the depiction, in advertisements, of gendered violence in the popularly termed ‘torture porn’ subgenre, which itself has negative gendered connotations.

We aim to revisit the critical reception of Captivity in light of this public controversy, looking at the gendered tensions within considerations of genre, narration and aesthetics. Critics assumed Captivity was an attempt to capitalize on the popularity of the torture horror subgenre, and there is evidence that the film-makers inserted scenes of gore throughout the narrative to encourage this affiliation. However, this chapter will consider how the film works as both an example of post-peak torture horror and an interesting precursor to more overtly feminist horror, such as A Girl Walks Home Alone at Night (2014) and Raw (2017). This is seen through the aesthetic and narrative centralizing of a knowing conflict between genders, which, while not entirely successful, does uniquely aim to provide commentary on the gender roles which genre criticism of horror has long considered implicit to the genre’s structures and pleasures.

Health-care professionals undergo numerous training programs each year in order to fulfill licensure requirements and organizational obligations. However, evidence suggests that a substantial amount of what is taught during training is never learned or transferred back to routine work. A major contributor to this issue is low training motivation. Prior conceptual models on training transfer in the organizational sciences literature consider this deficit, yet do not account for the unique conditions of the hospital setting. This chapter seeks to close this gap by adapting conceptual models of training transfer to this setting that are grounded in organizational science. Based on theory and supplemented by semistructured key informant interviews (i.e., organizational leaders and program directors), we introduce an applied model of training motivation to facilitate training transfer in the hospital setting. In this model, training needs analysis is positioned as a key antecedent to ensure support for training, relevant content, and perceived utility of training. We posit that these factors, along with training design and logistics, enhance training motivation in hospital environments. Further, we suggest that training motivation subsequently impacts learning and transfer, with elements of the work environment also serving as moderators of the learning-transfer relationship. Factors such as external support for training content (e.g., from accrediting bodies) and allocation of time for training are emphasized as facilitators. The proposed model suggests there are factors unique to the hospital work setting that impact training motivation and transfer that should be considered when developing and implementing training initiatives in this setting.

This paper examines the depth, erudition, and rigor of contemporary research on knowledge management as a causal factor that influences the ultimate outcome of multinational corporation (MNC) expansion, bounded by the confines of information and communication technology (ICT) competences identified as behavioral, business, and technological. Through discussion highlighting the dominant knowledge management (KM) research themes within the milieu of the global firm, readers will gain definitive and practical insight into relevant topics that may be used to stimulate development of growth strategies for the firm.

This study aims to present Lean Six Sigma (LSS) deployment and sustainment strategies for the healthcare sector from a multi-level perspective. The objective is to present LSS implementation insights to enable policymakers, practitioners and academicians to test and develop an LSS framework for healthcare sectors.

The strategies identified are the result of a multi-method research design involving literature review, action research (AR) and Delphi study. Further, the AR portion of the study involved more than 10 years of projects focused on the deployment of LSS in the healthcare sector.

The strategies include a holistic view from the multi-level perspective, considering the Top Management Level, Middle Management Level and Operational Level. The authors ascertained 27 strategies across the three levels of organizational structure for the effective deployment of LSS. Further, the authors present a customized LSS “pocket guide” from the healthcare perspective for quick reference.

The strategies delineated in this study are based on the Indian healthcare section only; thus, further research in additional geographic contexts is needed. Also, further research is necessary to provide additional empirical validation of the effects of the identified strategies on LSS program outcomes and to verify that the strategies operate at the proposed organizational levels. Future research should also focus on identifying the interrelationships between strategies within and across levels, developing a “road map” for LSS implementation in hospitals and designing the LSS curriculum for medical schools and other medical training programs.

Observations of this study can contribute to developing a holistic framework for successful LSS implementation in the healthcare sector for academicians, practitioners and policymakers. This, in turn, ensures an enhanced value proposition, improved quality of life and reduced healthcare operational costs. Thus, it ensures a win-win situation among all the stakeholders of the healthcare sector.

The strategies put forth will enable the LSS researchers, academicians and, more particularly, practitioners to delve deeper into specific enablers and safeguard the LSS deployment from backlash. The research has two significant benefits. Firstly, it enhances the understanding of LSS from the healthcare perspective. Secondly, it provides direction for future studies with specific components for hospitals’ LSS framework, which can be further tested, refined and improved.