Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure.

Overcoming Challenges to Service Innovation Process Implementation in an SME

This case study research reports on a small and medium-sized (SME) business-to-business (B2B) services firm implementing a novel new service development (NSD) process. It provides accounts of what occurred in practice in terms of the challenges to NSD process implementation and how the firm overcame these challenges. It also considers the implications for NSD in this and other firms’ innovation practices. This longitudinal case study (18 months) was conducted “inside” the case organization. It covered the entire innovation process from the initiation to the launch of a new service. The primary method may be viewed as participant observation. The research involved all those participating in the innovation system in the firm, including decision-makers, middle managers and employees at lower hierarchical levels and the firm’s external networks. Implications for researchers and managers focusing on structured innovation models for the services sector are also presented.

Exploring Service Innovation Practices Through a Longitudinal Ethnographic Case Study

Case study research has the advantage of investigating issues that are embedded within the context of the case. A novel approach to investigation of the implementation of service innovation process has been adopted through a longitudinal ethnographic case study. This approach was found useful, as the outcome of the study was intended to be an in-depth understanding of firm’s current innovation practices and its consequences with the implementation of a novel business process. In this applied research, an array of longitudinal data was generated chiefly through the technique of participant-observation. Participant-observation as a qualitative or naturalistic method has its roots in ethnographic research. Participant-observation involves “participating in the social world, in whatever role, and reflecting on the products of that participation” (Hammersley & Atkinson, 1983, p.16). This method offers a degree of understanding of the context under study that can come only from personal experience. In this presentation, I discuss the role of the researcher-practitioner as participant-observer and the usefulness of ethnographic case study methodology and participant-observation technique to investigating service innovation practices that are embedded within the context-specific setting of the case.

Enjeux de la cueca chilienne : vocalité et représentations sociales

Cette recherche aborde le chant de la cueca chilienne à travers le spectre de la voix dans la construction de représentations sociales, et ce, sur la base d’une méthodologie mixte qui combine la recherche bibliographique, l’observation participante, les entrevues et l’analyse musicale. Comme point de départ, on remarque la pratique d’une cueca surnommée urbana, brava ou chilenera, caractérisée par un timbre vocal singulier associé au milieu « populaire » des chanteurs. Remontant aux premières traces de la cueca, au Chili, le chapitre 2 aborde les descriptions de la voix de la zamacueca au XIXe siècle publié dans des récits de voyage. L’analyse du contexte dans lequel ces récits se publient permet de constater que l’idée du caractère nasal de la cueca s’associe à la constitution d’altérité. Le chapitre 3 aborde la façon dont une théorie spécifique sur l’origine de la cueca chilienne contribue aux conceptions de la voix dans le genre. Le sujet de la nasalité apparaît encore, cette fois-ci imbriqué dans l’imagination de l’origine arabo-andalouse de la cueca. S’intéressant à la représentation du sujet populaire, le chapitre 4 expose deux figures centrales de la culture chilienne : le huaso et le roto, représentants du paysan et du sujet urbain, tous deux entremêlés avec des discours nationalistes. Le « parler populaire » apparaît représenté dans divers styles de cueca, en produisant des vocalités affectées par l’imagination de la classe sociale, et ce dans le contexte de débats sur l’authenticité. Le chapitre 5 aborde finalement l’expérience vécue par de jeunes chanteurs actifs sur une scène de revitalisation. Leurs dynamiques de chant en groupe soulignent l’impact de la compétition sur le déploiement de la voix. La pratique structurée selon le chant en ronde - chant à la rueda – montrera que la production d’un « bon pito », soit d’une voix adéquate à la cueca, révèle la nécessité d’adapter les voix aux besoins du groupe. La conclusion met en lumière que le rapport entre voix et style se présente comme une correlation cruciale pour comprendre non seulement la diversité des variantes de cuecas existantes à un moment donné, mais également leurs transformations au cours du temps par l’entremise d’un processus de stylisation. Au-delà du style, pourtant, la voix paraît exprimer quelque chose du sujet qui la fait résonner. Par ce biais, les diverses étiquettes accompagnant le terme cueca nous informent sur les caractéristiques ethniques, du genre et de classe des chanteurs, y compris les différentes voix d’un même sujet qui chante.

A poesia promovendo o trabalho integrado e colaborativo na escola: uma contribuição à formação de professores na educação básica

Este estudo, desenvolvido através de uma investigação-ação, busca aprofundar a compreensão sobre o papel da poesia e de sua abordagem associado à integração curricular e ao trabalho colaborativo, em programas de formação de professores, inicial e continuada, visando à mudança de uma prática docente solitária para uma prática mais reflexiva e solidária. Esta investigação desenvolveu-se em uma escola pública de São Paulo - Brasil, com professores de diferentes disciplinas, coordenação pedagógica e estagiários do curso de Letras de duas universidades privadas. Com o propósito de contribuir para o debate, associamos o estudo teórico à investigação empírica, numa investigação-ação, recorrendo à observação participante e às entrevistas semiestruturadas. Elegemos para este trabalho três grandes eixos e suas respectivas referências teóricas: i) formação de professores; ii) currículo e desenvolvimento curricular; e iii) poesia e abordadem da poesia. Com base nesses eixos, elaboramos e desenvolvemos o estudo empírico que nos mostrou sua relevância através dos resultados obtidos: viabilidade de construção e implementação de projetos interdisciplinares nas escolas da rede pública; importância da interação entre professores e restante comunidade escolar; humanização do ambiente escolar; protagonismo de professores e alunos. Mostrou-nos também algumas limitações, especialmente o pouco investimento e apoio das equipes de gestão ao desenvolvimento de projetos integrados, assim como a falta de tempo necessário à construção de ambiente propício à criação da cultura de colaboração docente. Esperamos ter contribuído, através deste projeto, para que um novo olhar seja lançado aos programas de formação, inicial e continuada, de professores, menos tecnicista, mais crítico e reflexivo, mais solidário e integrado, mais humanizado e democrático, bem como à potencialidade da poesia/abordagem da poesia nesses contextos.

Percepção Ambiental em Museus Paisagens de Arte Contemporânea: a legibilidade dos museus Inhotim/Brasil e em Serralves/Portugal avaliada pelo público/visitante

This thesis nalyzes the wayfinding in Landscape Museum of Contemporary Art (MPAC), based on the Institute of Contemporary Art CACI, Minas Gerais, Brazil and the Museum of Contemporary Art of the Serralves Foundation, Porto, Portugal. The study focuses on the interrelationship of the public/visitors with the landscape, architecture and contemporary art museums in these, in order to understand visual perception and apprehension of such an environment for their users. For both were confronted documentation (visual and written) and people talk. The main hypothesis put forward is that the audience/visitor MPAC appreciates the interrelationship between the natural environment (park/garden) and built environment (the works of contemporary art and the galleries), giving equal value to both. To complement this, a second hypothesis is that during the visit to MPACS, visitors define their paths spontaneously, but strongly influenced by existing visual indicators (maps, signage and striking landscape elements), which facilitate the readability of space, which also contribute to the offered services and the experiences of similar institutions. The analytical basis of the research used the concepts of legibility (LYNCH, 2009), wayfinding (GIBSON, 2009; ARTHUR, PASSINI, 2002; WEISMAN, 1982), Experiential Cotinnum (TUAN, 1985), Space Bound (CRUZ PINTO, 2007) and habitus (BOURDIEU, 1992). Methodologically was used qualitative research (DEMO 2000) by means of a case study (YIN, 2005; STAKE, 1999) and participant observation (WHYTE, 2005). In the two institutions interviews with researchers and curators, behavior observation and questionnaires from employees, trainees, monitors and the public/visitor of the two museums were performed. Although partially referende the initial hypothesis, the research showed that the public/visitor value appears more natural environments, they experience a greater intensity and in addition to the factors listed in the second case, your perception and definition of paths suffer significant influence of emotional relations established with space. Generally the audience/visitor adapts easily to different demands of contemporary art exhibition in the two museums and the built environment (park/garden and museum) interferes with your reading path during the visit, perceived by the public/visitor condition as a factor that favors the enjoyment of works on different mounts (wayfinding), though often become a factor that hinders the legibility of the building and its built environment

Identificando práticas musicais e processos de aprendizagem musical no contexto urbano de Montes Claros-MG

MENDES,Jean Joubert Freitas; BRITO,Leila de Jesus Ferreira de;CARMO, Raiana Alves Maciel Leal do. Identificando práticas musicais e processos de aprendizagem musical no contexto urbano de Montes Claros-MG. In: ENCONTRO DA ASSOCIAÇAO NACIONAL DE PESQUISA E POS-GRADUAÇAO EM MUSICA (ANPPOM), 17.,2007, Sao Paulo. Anais... Sao Paulo: ANPPOM, 2007.

Männlichkeitskonzeptionen in geschlechterdifferenzierender Schulkultur

Unter dem Titel Männlichkeitskonzeptionen in geschlechterdifferenzierender Schulkultur untersuchen die Autoren den aufschlussreichen Fall eines Gymnasiums, das parallel mono- und koedukative Klassen eingeführt hat. Damit wird hier Geschlechterdifferenz explizit zu einem Ausgangspunkt der Gestaltung institutioneller Strukturen. Dies bildet sich auf der Ebene der Programmatik als das Anliegen ab, innerhalb monoedukativer Gruppen eine größere Differenzierung von Männlichkeiten und Weiblichkeiten zu ermöglichen. Auf den Ebenen der Unterrichtsplanung und der Unterrichtspraxis zeigen sich jedoch in Interviews und teilnehmenden Beobachtungen eine binäre Geschlechterunterscheidung und eine „latente Privilegierung von Männlichkeit“. Die Autor_innen begreifen dies als einen Ausdruck der tiefen Verankerung von Differenz und insbesondere Geschlechterdifferenz in der Institution Schule. (DIPF/Orig.)

Conselho de cooperação educativa – o processo de clarificação ética

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e do 2.º Ciclo do Ensino Básico

A comunicação oral formal: a exposição oral

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º Ciclos de Ensino Básico

As dimensões individual e coletiva no ensino exploratório da matemática

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção do grau de mestre em Ensino do 1.º e 2.º Ciclos do Ensino Básico

Programa ciclovida como política de mobilidade urbana sustentável: estudo empírico na Universidade Federal do Paraná

The urban mobility has in the bicycle its symbol of the most environmentally sustainable modal of transportation of the planet, title conferred by the United Nations Organization (ONU). Nevertheless, the cities suffer with the traffic jam caused by the automobile fleet growth, what implies in a larger displacement time, injuries to the environment, to financials and to the quality of life. In order to build in a sustainable way the urban mobility, public policies are necessary to encourage the preferential usage, by the society, of the mass transit or the non-motorized type of transportation. Objecting cooperate with the public power and the civil society, this study intents to, through an analysis about the UFPR Extension Program - CICLOVIDA, propose a sustainable urban mobility public policy development, with emphasis in the bicycle´s usage. eferentially, it is discussed concepts such as Society, State and Government as well as public policies, which go in cycles to the State´s and Government´s responsibilities; and are presented the Sustainable Urban Mobility Public Policies (PPMUS) in Brazil. Also, it is debated about the transport by bicycle as an option to the sustainable mobility. Methodologically, the study is of an empiric-social nature, with the application of both qualitative and observational methods, what characterizes as an exploratory level of research, with the researcher´s involvement in the participant form, due to her acting on the Program. Regarding the research lineation, it was used the bibliographic and documental form as well as case study, by means of the nonparametric sampling by accessibility or convenience. Related to the data collection technique, it was used structured interviews with self-applied questionnaires and natural participant observation. Aligned with the research´s objective and matter, the outcome confirmed that the Extension Program CICLOVIDA of the Federal University of Paraná (UFPR) may effectively contribute in the development of a PPMUS proposal with emphasis in the bicycle usage. Thus, it was built a political proposal with a free form writing, objecting subsidize policies both institutional as public MUS through the bicycle usage and therefore, support the mobility, also contributing to the sustainability and to the public development planning.

English: its role as the language of comity in an employment programme for Canadian immigrants.

This study explores the experiences of a culturally and linguistically diverse group of immigrant adult students as they attended a 12-week employment preparation course for newcomers to Canada. The main aim of the course was to equip the immigrants with knowledge and skills, including English for employment purposes, which are necessary to be competitive in the labour market. Using ethnographic methods, mainly participant observation with audio recording, to collect data, this paper analyses the communicative strategies that this group of multilingual speakers and their Canadian teachers deployed to discursively construct a ‘heterotopia’ defined here as ‘intensely affective spaces that redefine the experiential feeling of being and becoming’. Analysis of transcribed audio recordings reveals that despite differences in communication conventions and sociocultural backgrounds, the research participants from Congo, Haiti, India, Bangladesh, Jordan and the Philippines managed to establish a socially cohesive team that emphasises shared relational identity and in-group membership. The findings show how they creatively mobilised previously acquired pragmatic strategies and resources from their L1 to suit the demands of the ongoing interaction in English. It is suggested that language teaching in the context of preparing immigrants for labour market integration entails a pedagogical approach that foregrounds the affordances of English not only as the language of employment but perhaps more importantly as the ‘language of comity’. It is therefore suggested that the teaching of the host country’s language should focus less on grammatical correctness and focus more on providing the adult learners with opportunities to activate existing pragmatic resources and strategies which have to do with establishing rapport and friendly relations.

Relação supervisiva e desenvolvimento da identidade profissional: acompanhamento das práticas clínicas dos estudantes de enfermagem

Este estudo centrou-se num Curso de Licenciatura em Enfermagem e teve como objetivo compreender a influência da relação supervisiva no desenvolvimento da identidade profissional dos estudantes. Os eixos estruturantes que suportam esta investigação e que concorrem para a definição do seu objeto de estudo articulam-se em torno da relação supervisiva, do desenvolvimento de competências profissionais e do desenvolvimento da identidade pessoal e profissional em contexto clínico. A formação desenvolvida através da prática clínica destina-se a preparar indivíduos de acordo com a atual realidade socioprofissional, onde os sujeitos, independentemente da singularidade de cada um, desenvolvem saberes adquiridos em sala de aula. Quando comparada com o espaço escolar, a aprendizagem em contexto clínico é condicionada por fatores que se caraterizam por maior imprevisibilidade e obriga frequentemente o estudante a confrontar-se com situações únicas e impares. A identidade dos estudantes torna-se assim construída e vivida a partir de um conjunto de dimensões que ocorrem no decurso das vivências clínicas. Metodologicamente optou-se por um estudo etnográfico no âmbito do paradigma qualitativo, numa abordagem longitudinal segundo a lógica do estudo de caso. A natureza dos dados a recolher englobou ainda o recurso a procedimentos de natureza quantitativa. Como técnica de recolha de dados recorremos à observação participante, entrevistas semiestruturadas e questionários. O estudo desenvolveu-se numa Escola Superior de Enfermagem da Zona Norte do país e fizeram parte da população 69 estudantes de uma turma de segundo ano, quatro tutores e um professor. O plano de estudo da referida escola está organizado de forma a que a aprendizagem dos estudantes seja progressivamente integradora de saberes interligando a componente teórica com a componente prática. Assim, os ensinos clínicos estão distribuídos entre o 2º e o 4º ano. Da análise e discussão dos dados e subsequentes conclusões ressalta que, quer a relação supervisiva, quer os contextos clínicos, foram influenciadores do desenvolvimento de competências profissionais, bem como da identidade pessoal e profissional dos estudantes. Verificamos que os dois contextos clínicos estudados – medicina e cirurgia – favoreceram o desenvolvimento de competências distintas, no entanto complementares. Tornou-se visível que, os supervisores do contexto de medicina, possuidores de uma visão holística da profissão de enfermagem, promoveram nos estudantes uma visão integradora do doente, resultante de uma contínua atitude reflexiva sobre a Pessoa Humana. Por sua vez, no contexto de cirurgia, caraterizada por intervenções mais invasivas e mais centradas no tratar, as competências mais valorizadas pelos tutores, embora que de uma forma não verbalmente assumida, foram do domínio técnicocientífico, com especial relevo pelas competências instrumentais.

Programa Etnomatemática: ponderações da prática pedagógica

The aim of this present work is investigating the interest and motivation for learning, awakened in pupils when the educator practice is guided by the ethnomathematics perspective. The main question is: Can an ethnomathematic approach awaken enthusiasm in pupils, causing it to become more critic and active in building their knowledge? The methodology that guides the investigation is qualitative, based on technical arising of the ethnographic case study. Theoretical contributions that support the investigation are from the scientific methodology and from ethnomathematics. The research material is composed by: researcher’s field diary, audio recording of participant observation, interviews reports of community residents and students parents, highlighting the material produced by students. This study was developed on an 8º year of high school of rural community. During the work were prioritized the ethnomathematics concepts of the Ethnomathematic Program, which establish a link exchange, where the lecturers inserts themselves on the reality of pupils in a way that promote an appreciation of their identity and a commitment to their learning. The educator investigates and values the ideas of pupils throughout dialogues. There are challenges for the application of education with ethno mathematic perspective, pointed out by authors, listed and supplemented in the research. In this context, it is believed that the socio-cultural knowledge must be respect, and as they are understood their specialties, capabilities and characteristics, this can guide teaching practice, making significant process for pupils, providing appropriation of scientific knowledge. Analysis of research practice indicated that students, research subjects, when they decided contextual issues, with their way of life, felt appreciated. The conclusion is that, with continuous action of contextualized of school mathematics, from the recognition of the environment and of cultural identity, the educator has the opportunity of review their own participant condition, and therefore promote an enthusiasm for learning. Because a motivated pupil becomes active, since that the all project is guided in a significant theme.