If People Were Kaleidoscopes: Sharpening the Resolution on Patient Engagement in Safety

Healthcare is unacceptably error prone. The question remains why, with 20 years of evidence, is error and harm reduction not being effective? While precise numbers may be debated, all stakeholders recognize the frequency of healthcare errors is unacceptable, and greater efforts to ensure safety must occur. In recent years, one of these strategies has been the inclusion of the patient and their family as partners in safety, and has been a required organizational practice of Accreditation Canada in many of their standard sets. Existing patient advisories created to encourage engagement, have typically not included patient perspectives in their development or been comprehensively evaluated. There are no existing tools to determine if and how a patient wants to be involved in safety engagement. As such, a multi-phased study was undertaken to advance our knowledge about the client’s and family’s role in promoting safety. Phase 1 of the study was a scoping review to methodically review the existing literature about patients’ and families’ attitudes, beliefs and behaviours about their involvement in healthcare safety. Phase 2 was designed to inductively explore how a group of patients in an Ontario, Canada, community hospital, describe healthcare safety and see their role in preventing error. The study findings, which include the narratives of 30 patients and 4 family members, indicate that although there are shared themes that influence a patient’s engagement in patient safety, every individual has unique, changing beliefs, experiences and reasons for involvement. Five conceptual themes emerged from their narratives: Personal Capacity, Experiential Knowledge, Personal Character, Relationships, and Meaning of Safety. These study results will be used to develop and test a pragmatic, accessible tool to enable providers a way to collaborate with patients for determining their personal level and type of safety involvement. The most ethical and responsible approach to healthcare safety is to consider every facet and potential way for improvement. This exploratory study provides fundamental insights into the complexity of patient engagement in safety, and evidence for future steps.

UTILIZATION OF GIS AND SPATIAL ANALYSIS TECHNIQUES IN ARTISANAL AND SMALL SCALE MINING TO LOCATE A CENTRALIZED PROCESSING CENTRE

One of the global phenomena with threats to environmental health and safety is artisanal mining. There are ambiguities in the manner in which an ore-processing facility operates which hinders the mining capacity of these miners in Ghana. These problems are reviewed on the basis of current socio-economic, health and safety, environmental, and use of rudimentary technologies which limits fair-trade deals to miners. This research sought to use an established data-driven, geographic information (GIS)-based system employing the spatial analysis approach for locating a centralized processing facility within the Wassa Amenfi-Prestea Mining Area (WAPMA) in the Western region of Ghana. A spatial analysis technique that utilizes ModelBuilder within the ArcGIS geoprocessing environment through suitability modeling will systematically and simultaneously analyze a geographical dataset of selected criteria. The spatial overlay analysis methodology and the multi-criteria decision analysis approach were selected to identify the most preferred locations to site a processing facility. For an optimal site selection, seven major criteria including proximity to settlements, water resources, artisanal mining sites, roads, railways, tectonic zones, and slopes were considered to establish a suitable location for a processing facility. Site characterizations and environmental considerations, incorporating identified constraints such as proximity to large scale mines, forest reserves and state lands to site an appropriate position were selected. The analysis was limited to criteria that were selected and relevant to the area under investigation. Saaty’s analytical hierarchy process was utilized to derive relative importance weights of the criteria and then a weighted linear combination technique was applied to combine the factors for determination of the degree of potential site suitability. The final map output indicates estimated potential sites identified for the establishment of a facility centre. The results obtained provide intuitive areas suitable for consideration