Patient safety ethics and human error management in ED contexts part I : development of the global patient safety movement

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end patient safety has become the focus of a world-wide endeavour aimed at reducing the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments. In this article (the first of a two-part discussion on the subject) an overview of the incidence and impact of preventable adverse events in ED contexts is explored. The development of a ‘culture of safety’ in other hazardous industries and the ‘lessons learned’ and applied to the health care industry are also briefly examined. In a second article (to be presented as Part II), some of the ethical tensions that have arisen in the context of implementing patient safety processes and their possible implications for ED contexts are explored.

Patient safety ethics and human error management in ED contexts Part II : Accountability and the challenge to change

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end, patient safety has become the focus of a world-wide endeavour – endorsed by the World Health Organisation – to reduce the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments, of which the Emergency Department is a prime example. In Part I of this article series, an overview of the incidence and impact of preventable adverse events in Emergency Department contexts and the development of the global patient safety movement was presented. In this second article brief attention is given to examining some of the ethical tensions that have arisen in response to the patient safety movement and their possible implications for Emergency Department contexts and staff.

Implementation, communication and benefits of corporate codes of ethics : an international and longitudinal approach for Australia, Canada and Sweden

This paper examines the implementation, communication and benefits of corporate codes of ethics by the top companies operating in Australia, Canada and Sweden. It provides an international comparison across three continents. It is also based on a longitudinal approach where three national surveys were performed in 2001–2002 and replications of the same surveys were performed in 2005–2006. The empirical findings of this research show in all three countries that large organisations indicate a substantial interest in corporate codes of ethics. There are, however, differences in the ways that the companies in each country implement and communicate their corporate codes of ethics and the benefits that they see being derived from them. The longitudinal comparison between 2001–2002 and 2005–2006 indicates changes in the implementation, communication and benefits of corporate codes of ethics in the three countries.

A construct of the 'ethos of codes of ethics' (ECE) : the case of private and public Sweden

Purpose – The objective of this paper is to develop and describe a construct of the “ethos of the codes of ethics” (i.e. an ECE construct) in the private and public sectors of Sweden.

Design/methodology/approach – The paper takes a cross-sector approach to codes of ethics amongst the top private sector companies and the top public sector organisations. The paper then examines the measures put in place by the dual sample in order to describe the ethos of their codes of ethics.

Findings – The multivariate techniques used in the statistical analysis indicated that the ECE-construct consists of five dimensions: ethical bodies, ethical tools, ethical support procedures, internal ethics usage, and external ethics usage.

Research limitations/implications – It should be noted that the ECE construct has been derived from large companies and organisations in private and public Sweden, which may indicate less applicability to smaller operations. Another limitation may be the validity and reliability across other cultural samples. The dual sample contains a variety of different types of operations, but it may not be transferable to other countries.

Practical implications – The outcome is based on data from private companies and public organisations that indicated they had corporate codes of ethics. Therefore, a suggestion for further research is to examine the ECE construct in other countries/cultures that differ from the ones in this research effort performed in the private and public sectors of Sweden.

Originality/value – The ECE construct introduced makes a contribution to theory and practice in the field as it is based upon a dual sample. It makes a contribution to theory as it outlines a construct for the benefit of other researchers working in both the private and the public sectors. The authors also believe that it may be of managerial interest as it provides a grounded framework of areas to be considered in the implementation of the codes of ethics in both private companies and public organisations.

Inculcating the ethos of public-sector codes of ethics in Sweden : a longitudinal approach

Purpose – The purpose of this paper is to examine the measures put in place by the largest public sector organizations in Sweden in order to communicate the ethos of their codes of ethics to their employees.

Design/methodology/approach – This paper is based upon a longitudinal survey approach.

Findings – In the public sector organizations of Sweden the use of regulations and staff support is rather modest in respect to the inculcation of codes of ethics artefacts into the organisations. This longitudinal approach indicates an overall increase across the examined areas in the usage of measures to support the ethos of public sector codes of ethics.

Research limitations/implications – The artefacts to support the ethos inherent in public sector codes of ethics are rarely explored in the literature. This paper helps to fill this gap with the present longitudinal approach.

Practical implications – One could speculate that society at large and its public sector organizations may have been influenced not only by the scandalous happenings of recent years in Swedish business, but also by the impact of an Anglo-Saxon style of “corporatisation”, whereby public authorities take on the form of a corporation or business brought on by globalisation.

Originality/value – The present paper may be used as a point of reference for further research efforts.

Structures, processes and performance of corporate and business ethics in supply chains

The objective of this paper is to introduce and describe a conceptual framework of firms' corporate and business ethics in supply chains in terms of ethical structures, ethical processes and ethical performance. A framework is outlined and positioned incorporating an ethical frame of reference in the field of Supply Chain Management (SCM). A number of areas and sub-areas of firms' corporate and business ethics are framed in the context of supply chains. The introduced framework should be seen as a seed for further development and refinement in the field of SCM. It provides opportunities for further research of ethical concerns in supply chains.

Avian color vision and coloration : multidisciplinary evolutionary biology

A fundamental issue in biology is explaining the diversity of coloration found in nature. Birds provide some of the best-studied examples of the evolution and causes of color variation and some of the most arresting color displays in the natural world. They possess perhaps the most richly endowed visual system of any vertebrate, including UV-A sensitivity and tetrachromatic color vision over the 300-700-nm waveband. Birds provide model systems for the multidisciplinary study of animal coloration and color vision. Recent advances in understanding avian coloration and color vision are due to recognition that birds see colors in a different way than humans do and to the ready availability of small spectrometers. We summarize the state of the current field, recent trends, and likely future directions.

Complexity sciences and business ethics : a different perspective

This paper strives to shed some light on organizations' behaviours and practices of business ethics in the marketplace and the surrounding society by the aid of complexity sciences. For this purpose, a conceptual discussion will be based upon the causal frameworks of teleology introduced by Stacey, Griffin and Shaw (2000).

Evolutionary relationships among bluetongue and related orbiviruses

Polymerase chain reaction (PCR) sequencing of specific viral gene segments was used to investigate the phylogenetic relationships among the orbiviruses. Sequence comparisons of the bluetongue virus (BTV) RNA3 from different regions of the world (North America, South Africa, India, Indonesian, Malaysia, Australia and the Caribbean region) showed that geographic separation had resulted in significant divergence, consistent with the evolution of distinct viral populations. There were at least 3 topotypes (Gould, 1987); the Australasian, African - American and another topotype represented by BTV 15 isolated in Australia in 1986. The topotypes of BTV had RNA3 nucleotide sequences that differed by approximately 20 per cent. Analysis of BTV-specific gene segments from animal and insect specimens showed that bluetongue viruses had entered northern Australia from South East Asia, possibly by wind-borne vectors. Nucleotide sequence comparisons were used to show the close genetic relationship between BTV 2 (Ona-A strain) from Florida and BTV 12 from Jamaica, and to investigate the reassortment of BTV genome segments in nature. The mutation rates of the BTV RNA2 and RNA3 segments were estimated to be of the order of 10(-4) nucleotide changes/site/year, similar in magnitude to that reported for other RNA viruses.

Codes of ethics in large private sector Australian businesses

This thesis deals with codes of ethics in the top 500 companies operating in the private sector in Australia. We seek to answer two questions. First, can businesses adopt codes of ethics in a meaningful way, or are business ethics a contradiction in terms for profit seeking organisations in competitive markets? Second, to what extent do Australia’s top 500 private sector firms show commitment to codes of ethics? A number of ancillary questions are explored to form a picture of the current Australian situation and to compare it to the rest of the world, especially the US and Canada. Chapter 1 discusses these questions and the origins of the author’s interest in business ethics. This chapter develops a focus upon codes of ethics and their role in assisting to establish and maintain an ethical culture. The chapter looks at previous research on codes of ethics and demonstrates a lack of understanding in Australia on the subject and the need for research into it. Also included in Chapter 1 is the plan for the thesis. Chapters 2 to 4 review the literature upon which the thesis is based. In Chapter 2, the meaning of the terms ethics and business ethics are considered. Deontological and teleological approaches are distinguished and a (largely) teleological model of business ethics is developed. This chapter also asks whether business ethics are possible. The contention that ethics may be good for a business’s profit is explored in-depth and the conclusion is reached that ethics should be pursued for its inherent worth regardless of the economic benefit that can be attributed to it. A number of models of ethical decision making are discussed in Chapter 3 starting with Kohlberg and Kramer (1969). This discussion leads to the conclusion that organisations must create an ethical culture for staff if they require them to embrace ethical practices. If this is a correct conclusion, then the role of senior managers becomes critical in the process. Chapter 4 looks further at the role of senior managers, organisational culture and ethical/unethical behaviour in organisations. The conclusion is that senior managers do play an integral part in shaping the culture of an organisation. Their actions, either overtly or covertly, impact upon their staff and highlight behaviour that the organisation is or is not willing to tolerate. Sims (1991) proposed ten ways to foster an ethical culture and these ideas are set out and further explored through the work of other writers on management ethics. Finally, the link between ethics and strategic planning is examined. In Chapter 5 the methods used for empirical data gathering are described and justified. A number of factors that can lead us to consider a company’s ‘commitment’ to ethics are outlined. A survey of Australian companies was the primary means of data collection. Each question in the survey instrument is listed and explained. Also the survey response rate is reported, as are major demographic characteristics of respondents. Chapter 6 provides the research findings from the survey of the top 500 companies operating in the private sector in Australia. The research examines: i) the current Australian usage and implementation of codes of ethics; ii) the measures put in place in organisations in order to support a code; From this analysis conclusions are drawn about the ‘commitment’ of companies operating in Australia to codes of ethics. Australian companies are becoming aware of the potential of code usage. Companies operating in Australia that have codes appear to be good at implementing codes and examining staff performance in relation to codes. However, they lack the procedures that incorporate education and training and the implementation of the support mechanisms necessary to enhance employee understanding of the code. In Chapter 7, Australian codes are compared to American and Canadian codes for similarity and disparity. The assessment found that in all three countries codes are primarily concerned with company continuance. Australian codes do tend to be more socially oriented than in the other two countries and also less legalistic. Chapter 8 looks at 4 companies from the first survey that were asked for more in-depth information in a quest to determine current best practice in Australia. These organisations were chosen because they appeared, from the first survey instrument, to have put in place mechanisms to assist employees to better understand the code. The implication is that companies must make a conscious, positive effort to ensure that employees are considered in the process of ethical development. They should have input into the process, rather than just being directed to follow another management initiative. The final chapter summarises the research findings and looks at answers to the two major questions and the seven subordinate empirical questions posed at the start of the thesis. The conclusion reached is that companies operating in Australia appear to be moving towards establishing codes of ethics. Those who already have codes display a real commitment to them. The movement appears to be gathering momentum as more organisations see the value of incorporating ethical business practices into the every day workings of their individual companies. Generally, most Australian companies lag behind the rest of the world, but the pace-setting companies are defining their own best practice and achieving positive outcomes for themselves, their employees and other stakeholders.

Adventures of punctuated equilibria : a struggle for authority in the evolutionary sciences

The theory of ‘punctuated equilibria’ was formulated by two paleontologists, Niles Eldredge and Stephen Gould, in 1972 and has been the focus of considerable controversy within the evolutionary sciences ever since. The primary intentions of this thesis are to relate the history of punctuated equilibria and to examine how it has affected evolutionary science. Several modes of analysis have been used to illuminate the history: The sociological perspectives of Pierre Bourdieu and Bruno Latour (who see scientific debate as a ‘struggle for authority’); Rhetorical analysis of some of the key documents; Communication with practising scientists via questionnaires and correspondence; Citation Analysis. Chapter 1 gives a short summary of the history and introduces the methods and socio-philosophical perspectives used to illuminate the history. Chapters 3 and 4 examine the rhetorical process by which Eldredge and Gould constructed the ‘punctuationist revolution’. Chapters 2, 3, 5 and 6 relate the history of punctuated equilibria.