Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups.

To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation.

Healthcare human reliability analysis - By heart

As part of the investigations into a surgical incident involving the accidental retention inside a patient's venous system of a guide wire for central venous catheterisation (CVC), the Human Error Assessment and Reduction Technique (HEART) was used to examine the potential for further occurrences. It was found to be time-efficient and to yield plausible probabilities of human error, although its use in healthcare has challenges, suggesting adaptation would be beneficial.

Stakeholder engagement in early stage product-service system development for healthcare informatics

This paper presents the findings from four case studies on stakeholder engagement in new health information and communication technology (ICT) product-service system (PSS) development. The degree of connectivity between the new health ICT PSS and its intended operating environment has emerged to be an important contextual factor that may impact the decision of stakeholder engagement in the early stage development process. Along with the proposition of a four-level framework to guide stakeholder identification for new PSS development, three stakeholder engagement propositions that are based on the degree of connectivity are developed. Analysis has shown that there can be two types of connectivity: data and process. Moreover, each connectivity type can be characterized by how much the new PSS is connected with its environment: independent if there is no linkage, linked if it interfaces with, or incorporated if it is embedded into. Furthermore, depending upon whether and to what extent the PSS has data and process connectivity with its intended operating environment, the stakeholder engagement needs in early stage development vary. The propositions presented in this paper provide important directions for future work exploring PSS characterization and stakeholder engagement decision in early stage new PSS development in the healthcare industry. © 2013 PICMET.

The evolution of a stratified turbulent cloud

Localized regions of turbulence, or turbulent clouds, in a stratified fluid are the subject of this study, which focuses on the edge dynamics occurring between the turbulence and the surrounding quiescent region. Through laboratory experiments and numerical simulations of stratified turbulent clouds, we confirm that the edge dynamics can be subdivided into materially driven intrusions and horizontally travelling internal wave-packets. Three-dimensional visualizations show that the internal gravity wave-packets are in fact large-scale pancake structures that grow out of the turbulent cloud into the adjacent quiescent region. The wave-packets were tracked in time, and it is found that their speed obeys the group speed relation for linear internal gravity waves. The energetics of the propagating waves, which include waveforms that are inclined with respect to the horizontal, are also considered and it is found that, after a period of two eddy turnover times, the internal gravity waves carry up to 16 % of the cloud kinetic energy into the initially quiescent region. Turbulent events in nature are often in the form of decaying turbulent clouds, and it is therefore suggested that internal gravity waves radiated from an initial cloud could play a significant role in the reorganization of energy and momentum in the atmosphere and oceans.©2013 Cambridge University Press.

Healthcare human reliability analysis – by HEART

This book presents the proceedings of the international conference on Contemporary Ergonomics and Human Factors 2013.