'New perspectives on well-known issues': patients' experiences and perceptions of safety in Swiss hospitals

Patients' reports of safety-related events and perceptions of safety can be a valuable source for hospitals. Patients of eight acute care hospitals in Switzerland were surveyed for safety-related events and concerns for safety. In workshops with hospitals areas for improvement were analyzed and priorities for change identified. To evaluate the benefit of the approach, semi-structured interviews were conducted with hospital risk managers. 3,983 patients returned the survey (55% response rate). 21.4% reported at least one definite safety event, and the mean number of 'definite' incidents per patient was 0.31 (95% CI=0.29 to 0.34). 3.2% were very concerned and 14.7% were somewhat concerned about medical errors and safety. Having experienced a safety-related event, younger age, length of stay, poor health and a poor education increased the probability of reporting concerns. With some exceptions, results confirmed the hospitals' a priori expectations regarding the strengths and weaknesses of their institutions. Risk managers emphasized the usability of results for their work and the special value of referring to the patient's perspective at their home institutions. A considerable fraction of patients subjectively experiences safety-related events and is concerned about safety. Patient-generated data introduced a new quality into the discussion of safety issues within hospitals, and some expected that patients' experiences and concerns could affect patient volumes. Though the study is limited by the short time horizon and the lack of follow-up, the results suggest that the described approach is feasible and can serve as a supplemental tool for risk identification and management.

Perceptions and evaluations of biosphere reserves by local residents in Switzerland and Ukraine

In a cross-cultural study perceptions of local people living in the surroundings of biosphere reserves in Switzerland and Ukraine were examined using the method of qualitative interviews. In the UNESCO Biosphere Entlebuch in Switzerland people stated that they hoped for a better regional economic development due to the existence of the biosphere reserve. However, at the same time people feared further restrictions regarding land-use. In the Carpathian Biosphere Reserve located in Transcarpathia/Ukraine people tended to connect certain conditions – such as the high price for wood – directly to the existence of the biosphere reserve, when in fact these conditions and the biosphere reserve were separate, parallel developments. In both case studies three key-categories influencing local residents’ perceptions and evaluations of biosphere reserves could be identified. These categories are (1) the economic situation, (2) the history of nature protection, and (3) the power balance between the involved stakeholders. Paying close attention to those three categories will help planners and managers of protected areas to better understand the reasoning of local residents for or against a biosphere reserve in their area.