'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.

Tackling Software Navigation Issues of the Smalltalk IDE

The IDE used in most Smalltalk dialects such as Pharo, Squeak or Cincom Smalltalk did not evolve significantly over the last years, if not to say decades. For other languages, for instance Java, the available IDEs made tremendous progress as Eclipse or NetBeans illustrate. While the Smalltalk IDE served as an exemplar for many years, other IDEs caught up or even overtook the erstwhile leader in terms of feature-richness, usability, or code navigation facilities. In this paper we first analyze the difficulty of software navigation in the Smalltalk IDE and second illustrate with concrete examples the features we added to the Smalltalk IDE to fill the gap to modern IDEs and to provide novel, improved means to navigate source space. We show that thanks to the agility and dynamics of Smalltalk, we are able to extend and enhance with reasonable effort the Smalltalk IDE to better support software navigation, program comprehension, and software maintenance in general. One such support is the integration of dynamic information into the static source views we are familiar with. Other means include easing the access to static information (for instance by better arranging important packages) or helping developers re-locating artifacts of interest (for example with a categorization system such as smart groups).