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1

Williams, Alvin J., and Richard C. Vreeland. "Corporate Culture in the Academic Marketing Department." Journal of Marketing Education 10, no. 1 (March 1988): 39–43. http://dx.doi.org/10.1177/027347538801000106.

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The purpose of this article is to provide insight into the efficacy of the corporate culture idea to improved performance in academic marketing departments. All departments have a culture. The challenge is to formulate a healthy and viable culture. Abbreviated case examples are included to demonstrate contrasting cultures.
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Wensong, Yu, Wang Shujun, and Cai Xiaoshen. "Research on Departmental Collaborations in the Local Government Energy Conservation." E3S Web of Conferences 236 (2021): 03009. http://dx.doi.org/10.1051/e3sconf/202123603009.

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The scientific and reasonable departmental collaboration is the key to effective energy conservation work carried out by local governments. This study collects energy-saving policy texts and energy efficiency data of 121 local governments, uses data mining, social network analysis, and related analysis methods to analyze the departmental collaborations in local government energy-saving, and reveals the main problems in departmental collaborations. The results show that: from the structural law, the collaborations with the Department of Water Resources should be strengthened, and the collaborations with Department of Culture and Tourism and Department of Education should be reduced, which can improve energy efficiency. The main problem of current departmental collaborations is that Department of Water Resources is facing obvious lack of collaborations, and the collaborations between relevant departments and Department of Water Resources should be strengthened.
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Rabbiyah and Mahwish Zeeshan. "The Culture of Emergency Department in a Public Hospital." Global Sociological Review IV, no. I (December 30, 2019): 34–44. http://dx.doi.org/10.31703/gsr.2019(iv-i).05.

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The research revolves around the culture of emergency department. Hospital emergency departments make a distinctive subculture inside the healthcare, in an atmosphere of social interaction and variation. Every organization can create its own values. Hospitals or other primary care centers having emergency departments usually. Initially, the emergency room was planned as a treatment room for emergency cases such as road accident cases or other acute conditions in which life is on risk. This department later specialized in the treatment of emergency cases which were presented with no consultation, by an emergency vehicle or any transport available at that time. It was taken place in the Emergency department of Tehsil Headquarter Hospital Pind Dadan Khan. The patients were interviewed regarding their experience, their time of arrival, the medical personnel who received them and their satisfaction level with the provided treatment and care. The other method which was used is participant as observer. The most consistently observed finding associated with higher levels of satisfaction, was the patient-oriented care provided by doctors, nurses and paramedic staff. Doctors and nurses who spent more time with the patient, had better communication skills, showed more empathy and treated the patients within 5 minutes of arrival in the emergency resulted in more patient satisfaction. On the basis of these characteristics, the calculated number of satisfied patients turned was more than the patients who were not satisfied. However, major emergency patients responded that they would not prefer emergency departments of public sector hospitals of Tehsil Pind Dadan Khan for future because major emergency services were not available.
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Acquisto, Nicole M., and Stephanie N. Baker. "Antimicrobial Stewardship in the Emergency Department." Journal of Pharmacy Practice 24, no. 2 (March 14, 2011): 196–202. http://dx.doi.org/10.1177/0897190011400555.

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The practice of antimicrobial stewardship can be defined as optimizing clinical outcomes while minimizing the consequences of antimicrobial therapy such as resistance and superinfection. Antimicrobial stewardship can be difficult to transition to the emergency department (ED) since the traditional activities include the evaluation of broad-spectrum antimicrobial regimens at 72 and 96 hours and intravenous to oral medication conversion. The emergency medicine clinical pharmacist (EPh) has the knowledge and clinical assessment skills to manage an antimicrobial stewardship program focused on culture follow-up for patients discharged from the ED. This paper summarizes the experiences of developing an EPh-managed antimicrobial stewardship and culture follow-up program in the ED from 2 separate institutions. Specifically, the focus is on the steps for establishing an EPh-managed antimicrobial stewardship program, a description of the culture follow-up process, managing the culture data and cultures that require emergent notification and review, medical/legal concerns, and barriers to implementation. Outcomes data available from institutions with similar ED based antimicrobial stewardship programs are also discussed.
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Sun, Shi Yu. "Reflections on Environmental Inspection Culture Building." Applied Mechanics and Materials 253-255 (December 2012): 1024–27. http://dx.doi.org/10.4028/www.scientific.net/amm.253-255.1024.

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This paper analyzed the importance and necessity of building environmental inspection culture system, then system framework has been constructed by referencing that established in labor security supervision department and disciplinary department. Six cultures in the system are: philosophy culture, responsibility culture, organization culture, behavior culture, system culture and incorruptibility culture. By discussing content of each culture, several recommendations have been made including people-oriented philosophy culture abstraction, high-efficient responsibility culture highlight, distinctive organization culture improvement, internal and external behavior culture enhancement, orderly system culture and complete incorruptibility culture construction.
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Chan, A., and A. Sarabia. "LO38: Reducing inappropriate urine culture testing in the emergency department." CJEM 22, S1 (May 2020): S20—S21. http://dx.doi.org/10.1017/cem.2020.93.

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Background: Urinary tract infections (UTI) are a common emergency department (ED) presentation. Urine cultures (UC) are frequently ordered to confirm the diagnosis, however, it can be challenging to differentiate between a true infection and asymptomatic bacteriuria (ASB) which does not generally benefit from antibiotics. This over-treatment of ASB leads to serious adverse side effects, growing antimicrobial resistance and increased healthcare costs. By reducing inappropriate ED urine culture testing, we can concomitantly avoid the false positives that contribute to this large-scale problem. Aim Statement: We aimed to reduce ED urine culture testing at Credit Valley Hospital, a large community hospital based in Mississauga, Ontario by 30%, from a baseline average of 97 cultures per 1000 ED visits in 2017, to 68 cultures per 1000 ED visits by year end 2019. Measures & Design: Multiple PDSA cycles were ran with our multi-disciplinary ED team. Our interventions to encourage rational urine culture testing are three-fold, including (1) medical directive optimization (removal of routine sending of UC), (2) individualized physician feedback and (3) physician education with introduction of a clinical decision aid. Our outcome measure is rate of UC per 1000 ED patient visits with a balance measure of rate of 30-day ED return visit of hospital admission for patients with a UTI. Evaluation/Results: Despite a parallel surge in ED volumes, we observed a significant decrease in urine culture testing, from an annual average of 97 cultures per 1000 ED visits to 60 cultures per 1000 ED visits in 2019 year-to-date. There was no increase in the rate of ED 30-day return visit or admission for UTI or a diagnostic equivalent. Discussion/Impact: Our multipronged approach effectively decreased the rate of UC testing during the study period. ED physicians provide higher quality care with judicious use of resources to guide diagnosis and management. Active ongoing interventions include our transition to a 2-step UC order protocol (uncoupling urinalysis with culture) using BD vacutainer urine collection products, which will allow for 48 hour storage of uncompromised urine. Further work will leverage our knowledge and experience with optimizing urine culture testing to other culture specimens.
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Birch, David A. "Understanding Department and Institutional Culture: An Important Responsibility for Department Chairs." American Journal of Health Education 35, no. 6 (December 2004): 342–44. http://dx.doi.org/10.1080/19325037.2004.10604774.

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Coughlin, Ryan F., David Peaper, Craig Rothenberg, Marjorie Golden, Marie-Louise Landry, Jeffrey Cotton, Vivek Parwani, Marc Shapiro, Andrew Ulrich, and Arjun K. Venkatesh. "Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency." American Journal of Medical Quality 35, no. 3 (July 11, 2019): 252–57. http://dx.doi.org/10.1177/1062860619861947.

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The authors evaluated the effectiveness of an electronic health record (EHR)-based reflex urine culture testing algorithm on urine test utilization and diagnostic yield in the emergency department (ED). The study implemented a reflex urine culture order with EHR decision support. The primary outcome was the number of urine culture orders per 100 ED visits. The secondary outcome was the diagnostic yield of urine cultures. After the intervention, the mean number of urine cultures ordered was 5.95 fewer per 100 ED visits (9.3 vs 15.2), and there was a decrease in normal, or negative, cultures by 2.42 per 100 ED visits. There also was a statistically significant decrease in urine culture utilization and an increase in the positive proportion of cultures. Simple EHR clinical decision-support tools along with reflex urine culture testing can significantly reduce the number of urine cultures performed while improving diagnostic yield in the ED.
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Clay-Williams, Robyn, Natalie Taylor, Hsuen P. Ting, Gaston Arnolda, Teresa Winata, and Jeffrey Braithwaite. "Do quality management systems influence clinical safety culture and leadership? A study in 32 Australian hospitals." International Journal for Quality in Health Care 32, Supplement_1 (January 2020): 60–66. http://dx.doi.org/10.1093/intqhc/mzz107.

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Abstract Objective This study aimed to explore the associations between the organization-level quality arrangements, improvement and implementation and department-level safety culture and leadership measures across 32 large Australian hospitals. Design Quantitative observational study, using linear and multi-level modelling to identify relationships between quality management systems and clinician safety culture and leadership. Setting Thirty-two large Australian public hospitals. Participants Quality audit at organization level, senior quality manager at each participating hospital, 1382 clinicians (doctors, nurses and allied health professionals). Main outcome measures Associations between organization-level quality measures and department-level clinician measures of teamwork climate, safety climate and leadership for acute myocardial infarction (AMI), hip fracture and stroke treatment conditions. Results We received 1332 valid responses from participants. The quality management systems index (QMSI, a questionnaire-based measure of the hospitals’ quality management structures) was ‘positively’ associated with all three department-level scales in the stroke department, with safety culture and leadership in the emergency department, but with none of the three scales in the AMI and hip fracture departments. The quality management compliance index (QMCI, an external audit-based measure of the quality improvement activities) was ‘negatively’ associated with teamwork climate and safety climate in AMI departments, after controlling for QMSI, but not in other departments. There was no association between QMCI and leadership in any department, after controlling for QMSI, and there was no association between the clinical quality implementation index (CQII, an external audit-based measure of the level of implementation of quality activities) and any of the three department-level scales in any of the four departments, after controlling for both QMSI and QMCI. Conclusions The influence of organization-level quality management systems on clinician safety culture and leadership varied depending on the hospital department, suggesting that whilst there was some consistency on patient safety attitudes and behaviours throughout the organizations, there were also other factors at play.
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Gupta, Itisha, and Jane Codd. "Reducing Blood Culture Contamination; a Quality Improvement Project in Emergency Department." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s368—s369. http://dx.doi.org/10.1017/ice.2020.995.

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Background: Blood culture is an important investigation in diagnosing sepsis. Positive culture helps to tailor therapy and is crucial in antimicrobial stewardship (AMS). However, positive blood culture does not always denote a bloodstream infection. Sometimes, false-positive results occur because of contamination from organisms outside the bloodstream, leading to significant negative consequences to patient treatment decisions and financial implications. Rates of blood culture contamination vary widely (0.6%–6%) between organizations, and although it is very difficult to eliminate contamination, it can be minimized. Our hospital group has multiple sites including emergency departments (EDs). We have been intermittently monitoring blood culture contamination rates since 2008, which decreased from 6.8% to 4.8% in 2009 but remained static when audited in 2010, 2012, and 2015. Objectives: To reduce our blood culture contamination rate further by targeting 2 busy EDs and by introducing continuous surveillance of blood culture contamination across 3 hospitals beginning in April 2016. Methods: In 2015, for the first time, blood culture contamination rates for both EDs, based in 2 different hospitals, were calculated. The ED results were communicated to the healthcare workers (HCWs), who agreed to establish a continuous surveillance of blood culture contamination and to participate in a reduction plan. Competency training was conducted according to training needs analysis. For example, phlebotomists were trained to ensure the use of the appropriate blood culture kit and educational sessions were tailored to staff groups. The blood culture contamination rate was monitored from April 2016 to March 2019 for 3 hospitals and both EDs to determine the impact of various measures introduced during this time. Results: In 2015, contamination rate of the 3 hospitals was 4.07%, and 10.2% of total blood cultures flagged positive. Also, 25% of blood cultures were requested from Eds, but these samples comprised 54% of the total contamination. The contamination rates for EDs A and B were 7.4% and 10.6%, respectively, which were significantly higher than the overall rate. From April 16 to March 19, there was 22% increase in total blood cultures performed. Results were analyzed quarterly. In total, 8,525 blood culture sets were received in January–March 2019; of these, the EDs contributed 2,799 sets (32.8%). The total blood culture contamination rate in January–March 2019 decreased to 3.1%. Both EDs A and B showed decreases in their contamination rates to 5.5% and 7.4%, respectively, in 2018–2019. The quarterly decreases were 5.2% and 4.9% in January–March 2019. Conclusions: The emphasis on the sepsis pathway probably led to year-on-year increases in total blood culture sets. Both ED blood culture contamination rates decreased. Consistent efforts in education, training, ensuring competency to various HCW groups, and provision of adequate blood culture kits are important for sustaining these improvements.Funding: NoneDisclosures: None
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11

Webb, A., D. Lussier, M. Ngo, J. Klassen, R. Steigerwald, and A. Buchel. "P102: TeamSTEPPS: promoting a culture of safety." CJEM 18, S1 (May 2016): S112. http://dx.doi.org/10.1017/cem.2016.278.

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Introduction / Innovation Concept: Adverse events due to medical error are a significant source of preventable morbidity and mortality in Canada’s emergency departments. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was introduced in 2006 as a strategy to minimize these errors. Although these strategies have been available and widely implemented in hospitals over the last decade, the optimal method of teaching these tools and strategies has not been elucidated. Methods: We endeavoured to introduce a twelve month longitudinal TeamSTEPPS program to physicians, nurses, and allied health care professionals in a busy tertiary care hospital via a multi-pronged approach consisting of group huddles, props in the department, and several social media strategies. Dedicated observers in the emergency department recorded the use of the strategies by staff members to identify improved and sustained use of TeamSTEPPS behaviours after they were introduced. Curriculum, Tool, or Material: The program that consists of five modules to improve patient safety outcomes: Team structure; Leadership; Situation Monitoring; Mutual support; and Communication. Each module consisted of educational tools including posters in the department explaining the concepts, twice weekly department huddles to discuss the importance of the monthly topic and promote team sharing with real life examples, as well as stimulating and generating discussions around the monthly theme on social media (Facebook, Twitter, and an on-line blog). For several modules, extra prompts, such as I PASS the BATON handover cards were also provided to act as reminder visual cues. The first two modules were rolled out with on-line music videos rewritten to promote the significance of the modules. A team performance observation tool was adopted from the TeamSTEPPS program, and behaviors were evaluated and recorded under the five domains. Conclusion: Although unable to detect a meaningful difference in our pre and post-implementation observations, we present a novel approach to educating a multi-disciplinary team about TeamSTEPPS in a busy emergency department, along with the challenges encountered in this unique area of research, and recommendations for further study to interested parties. The TeamSTEPPS program likely could offer as much to the emergency department as similar programs have to the aviation industry yet it requires extensive investigation within this health care venue.
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Panagopoulou, Paraskevi, Joanna Filioti, Evangelia Farmaki, Avgi Maloukou, and Emmanuel Roilides. "Filamentous Fungi in a Tertiary Care Hospital Environmental Surveillance and Susceptibility to Antifungal Drugs." Infection Control & Hospital Epidemiology 28, no. 1 (January 2007): 60–67. http://dx.doi.org/10.1086/508832.

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Objective.To evaluate filamentous fungi with respect to environmental load and potential drug resistance in a tertiary care teaching hospital.Design.Monthly survey in 2 buildings of the hospital during a 12-month period.Setting.Hippokration Hospital in Thessaloniki, Greece.Methods.Air, surface, and tap water sampling was performed in 4 departments with high-risk patients. As sampling sites, the solid-organ transplantation department and the hematology department (in the older building) and the pediatric oncology department and the pediatric intensive care unit (in the newer building) were selected.Results.From January to May of 2000, the fungal load in air (FLA) was low, ranging from 0 to 12 colony-forming units (cfu) per m3 in both buildings. During the summer months, when high temperature and humidity predominate, the FLA increased to 4-56 cfu/m3. The fungi commonly recovered from culture of air specimens wereAspergillus niger(25.9%),Aspergillus flavus(17.7%), andAspergillus fumigatus(12.4%). Non-Aspergillusfilamentous fungi, such asZygomycetesandDematiaceousspecies, were also recovered. The pediatric intensive care unit had the lowest mean FLA (7.7 cfu/m3), compared with the pediatric oncology department (8.7 cfu/m3), the solid-organ transplantation department (16.1 cfu/m3), and the hematology department (22.6 cfu/m3). Environmental surfaces were swabbed, and 62.7% of the swab samples cultured yielded filamentous fungi similar to the fungi recovered from air but with low numbers of colony-forming units. Despite vigorous sampling, culture of tap water yielded no fungi. The increase in FLA observed during the summer coincided with renovation in the building that housed the solid-organ transplantation and hematology departments. All 54Aspergillusair isolates randomly selected exhibited relatively low minimum inhibitory or effective concentrations for amphotericin B, itraconazole, voriconazole, posaconazole, micafungin, and anidulafungin.Conclusion.Air and surface fungal loads may vary in different departments of the same hospital, especially during months when the temperature and humidity are high. EnvironmentalAspergillusisolates are characterized by lack of resistance to clinically important antifungal agents.
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Andruko, J., and T. Green. "P138: Parental leave policies and culture for physicians in emergency medicine." CJEM 22, S1 (May 2020): S114. http://dx.doi.org/10.1017/cem.2020.342.

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Introduction: Medicine demands a sacrifice of physicians’ personal life, but culture has slowly changed towards valuing a balanced work life. Parental leave is linked to better physical and mental health, but policies and culture surrounding parental leave are largely unstudied in the Canadian Emergency Medicine landscape. Anecdotally, experiences vary widely. This study was designed to determine what proportion of Canadian Emergency Departments have formal parental leave policies (maternity, paternity, and other ex. adoption) and what proportion of Canadian EM physicians are satisfied with their department's parental leave policies. Methods: Two surveys were generated; one to assess attitudes and experiences of emergency physicians, and a second survey for department chiefs assessed the policies and their features. These were approved by the UBC REB and distributed through the CAEP Research Committee. Primary outcomes were physician satisfaction with their department's parental leave policy (4-5/5 Likert Scale), and departments with a formal parental leave policy (Y/N). Results: 38% (8/21) of department chiefs reported having a formal policy for maternity leave, 29% (6/21) for paternity leave, and 24% (5/21) other. The survey of Emergency Physicians revealed similar rates at 48% (90/187) maternity, 40% (70/184) paternity, 29% (53/181) other. Among physicians who were aware of them, 69% (62/90) were somewhat or very satisfied with the maternity leave policies, 58% (51/88) with paternity leave policies, and 48% (39/81) with other parental leave. Less than 10% were somewhat or very dissatisfied with any of these. Several department chiefs commented that they had never refused anyone parental leave, but have no formal policy. However, 87% (147/187) of physicians reported a formal maternity leave policy was somewhat or very important to them; similarly 80% (134/187) paternity leave. Less than 15% felt each was somewhat or extremely unimportant. Conclusion: Presence and type of parental leave policy varies across the country. Most physicians were satisfied with the support they had available, but the vast majority felt that a formal maternity and paternity leave policy itself was important. This study would suggest that, without actually changing practice, the introduction of a formal parental leave policy is of value. Our research group will use this data to collaborate on a template parental leave policy to be made available for this purpose.
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DeGaspari, John. "Cell Culture." Mechanical Engineering 123, no. 03 (March 1, 2001): 56–59. http://dx.doi.org/10.1115/1.2001-mar-1.

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This article focuses on Tribon Bearing Co. plant in Brook Park, OH, a manufacturer of discrete carbon composite parts and shapes that had been plagued by problems that threatened its existence. The old Tribon plant was a traditional manufacturing setup, in which operations were highly compartmentalized. Equipment was arranged according to purpose and job functions were narrowly defined. The plant’s production control manager, there was plenty of distrust and bad feelings between front-line management and the plant floor workforce. Workcell leaders work with manufacturing engineers to develop a process for a new product or to improve on an established process. Each manufacturing engineer is assigned two or three product lines. If a cell leader determines that a process change saves time or money, she/he will make it a permanent change. The manufacturing engineer makes the quality department aware of what the workcell is doing, and the quality department signs off the change.
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McLeod, Casey G. "Reducing Blood Culture Contamination in the Emergency Department." Journal of Nursing Care Quality 35, no. 3 (2020): 245–51. http://dx.doi.org/10.1097/ncq.0000000000000441.

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McCarthy, Claudine. "Create a culture of accountability within your department." Student Affairs Today 22, no. 4 (June 20, 2019): 1–7. http://dx.doi.org/10.1002/say.30624.

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Scholz, Robert L., and Marc R. Summerfield. "Changing department culture through a code of conduct." American Journal of Health-System Pharmacy 54, no. 2 (January 15, 1997): 142. http://dx.doi.org/10.1093/ajhp/54.2.142.

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Hodgins, Marie, and Deborah L. Meeks. "Reducing Blood Culture Contamination in the Emergency Department." American Journal of Infection Control 40, no. 5 (June 2012): e135. http://dx.doi.org/10.1016/j.ajic.2012.04.238.

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Jones, Christopher W., Karissa D. Culbreath, Abhi Mehrotra, and Peter H. Gilligan. "Reflect Urine Culture Cancellation in the Emergency Department." Journal of Emergency Medicine 46, no. 1 (January 2014): 71–76. http://dx.doi.org/10.1016/j.jemermed.2013.08.042.

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Wei, E., B. Bassin, S. Santen, B. Sharp, L. Hopson, D. Somand, J. Fischer, and R. Hemphill. "145 Patient Safety Culture in the Emergency Department." Annals of Emergency Medicine 66, no. 4 (October 2015): S51—S52. http://dx.doi.org/10.1016/j.annemergmed.2015.07.177.

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Skinner, Helen Machelle. "Promotion of Just Culture in the Emergency Department." Journal of Emergency Nursing 38, no. 6 (November 2012): 511. http://dx.doi.org/10.1016/j.jen.2012.04.019.

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McCarthy, Claudine. "Create a culture of accountability within your department." Campus Security Report 16, no. 5 (August 15, 2019): 6–7. http://dx.doi.org/10.1002/casr.30555.

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Pace, Chris. "Why HR and IT departments should talk talk." Strategic HR Review 15, no. 3 (June 13, 2016): 118–22. http://dx.doi.org/10.1108/shr-12-2015-0096.

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Purpose The purpose of this paper is to examine the impact that cyberattacks are having on organizations and the growing need these create for H.R. departments to collaborate more closely with IT departments. Design/methodology/approach Current thinking regarding managing cybersecurity suggests that it should be managed holistically, i.e. by the human resources (HR) department and information technology (IT) department working together more closely. This sees the IT department providing the IT security tools and the HR department providing the appropriate processes and procedures that need to be followed, as well as creating a necessarily more “vigilant” culture. Findings Several practical steps are outlined that will help HR departments protect themselves against a data breach. Originality/value Cyberthreats are amongst the top threats to UK business, according to the government. Managing cybersecurity has long been left almost solely to the technology experts. The continuing number of high-profile data breaches suggests that cybersecurity tools alone will not stop information leaking from companies. There is an important role for HR teams in encouraging and enforcing a more proactive, vigilant culture amongst the workforce and working more closely with IT to improve security practices.
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Shannon, Laura. "Civil service, 2017." Administration 66, no. 1 (February 1, 2018): 9–16. http://dx.doi.org/10.2478/admin-2018-0002.

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Abstract With the election of a new Taoiseach, Leo Varadkar, TD, in June 2017, a number of changes were made to government departments. A new Department of Rural and Community Development was established, taking functions from the Department of Arts, Heritage, Regional, Rural and Gaeltacht Affairs (renamed the Department of Culture, Heritage and the Gaeltacht), and from the Department of Housing, Planning, Community and Local Government (renamed the Department of Housing, Planning and Local Government). The employment brief was moved to the Department of Social Protection to create the Department of Employment Affairs and Social Protection. Finally, the Department of Jobs, Enterprise and Innovation was renamed the Department of Business, Enterprise and Innovation.
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Armstrong, Brian, John Maxwell, Eoghan Ferrie, Emma Greenwood, and Linsey Sheerin. "Diagnosis of organisational culture within an NHS Emergency Department." BMJ Leader 3, no. 1 (March 2019): 19–23. http://dx.doi.org/10.1136/leader-2018-000127.

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BackgroundThe academic literature demonstrates that organisational culture contributes to variation between healthcare organisations in outcomes and performance, patient satisfaction, innovation, healthcare quality and safety and employee job satisfaction.Objectives/methodsThe aims of this research were: (1) to review literature on organisational culture; (2) to identify the dominant culture within the Belfast RVH Emergency Department by using a combination of both the ‘Organisational Culture Assessment Instrument’ and ‘Rich Pictures’ soft systems methodology; and (3) to formulate recommendations.Results/conclusionWe found that the dominant organisational culture is a market culture (29.74 points), followed by hierarchy culture (28.97 points) then a clan culture (25.55 points) and an adhocracy culture (15.74 points), this infers an emphasis is placed predominantly on results and profitability. The results also look at the difference between current and preferred organisational culture. The largest desired difference can be seen in clan culture, with an increase of 12.93 points. Market culture decreases by 12.39 points. Hierarchy culture decreases with 3.58 points and adhocracy culture increases with 3.04 points. The dominant culture in the preferred situation becomes clan culture, followed by hierarchy culture, adhocracy culture and market culture. The results also show there was a differing gap within all professional groupings with admin (24.97 points), doctors (33.71 points), nurses (40.36 points) and others (11.08 points). The Rich Pictures results highlight contrasting multidisciplinary dynamics in regard to hierarchy, interteam cooperation and a team while working under extreme pressure, and were committed to quality, patient safety and service innovation.
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Sartore, Melanie, and George Cunningham. "The Lesbian Label as a Component of Women’s Stigmatization in Sport Organizations: An Exploration of Two Health and Kinesiology Departments." Journal of Sport Management 24, no. 5 (September 2010): 481–501. http://dx.doi.org/10.1123/jsm.24.5.481.

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The purpose of this inquiry was to explore the meanings and organizational implications of lesbianism and the lesbian label within the sport organization context. Fourteen faculty members from two health and kinesiology departments were asked how they, their colleagues, and their departments defined, responded to, coped with, and managed the lesbian label. First and foremost, the words of these faculty members identify the lesbian label as a component of a lesbian stigma at both the individual and departmental levels and within the field of health and kinesiology as a whole. The consequences of the stigma, however, varied by department suggesting the importance of departmental culture and atmosphere. Implications of these findings, as they pertain to sport managers, are discussed.
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Marlowe, Lauren, Rakesh D. Mistry, Susan Coffin, Kateri H. Leckerman, Karin L. McGowan, Dingwei Dai, Louis M. Bell, and Theoklis Zaoutis. "Blood Culture Contamination Rates after Skin Antisepsis with Chlorhexidine Gluconate versus Povidone-Iodine in a Pediatric Emergency Department." Infection Control & Hospital Epidemiology 31, no. 2 (February 2010): 171–76. http://dx.doi.org/10.1086/650201.

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Objective.To determine blood culture contamination rates after skin antisepsis with Chlorhexidine, compared with povidone-iodine.Design.Retrospective, quasi-experimental study.Setting.Emergency department of a tertiary care children's hospital.Patients.Children aged 2-36 months with peripheral blood culture results from February 2004 to June 2008. Control patients were children younger than 2 months with peripheral blood culture results.Methods.Blood culture contamination rates were compared using segmented regression analysis of time-series data among 3 patient groups: (1) patients aged 2-36 months during the 26-month preintervention period, in which 10% povidone-iodine was used for skin antisepsis before blood culture; (2) patients aged 2-36 months during the 26-month postintervention period, in which 3% Chlorhexidine gluconate was used; and (3) patients younger than 2 months not exposed to the Chlorhexidine intervention (ie, the control group).Results.Results from 11,595 eligible blood cultures were reviewed (4,942 from the preintervention group, 4,274 from the postintervention group, and 2,379 from the control group). For children aged 2-36 months, the blood culture contamination rate decreased from 24.81 to 17.19 contaminated cultures per 1,000 cultures (P< .05) after implementation of Chlorhexidine. This decrease of 7.62 contaminated cultures per 1,000 cultures (95% confidence interval, —0.781 to —15.16) represented a 30% relative decrease from the preintervention period and was sustained over the entire postintervention period. No change in contamination rate was observed in the control group (P= .337).Conclusion.Skin antisepsis with Chlorhexidine significantly reduces the blood culture contamination rate among young children, as compared with povidone-iodine.
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Bentley, James, Shobhan Thakore, L. Muir, Alastair Baird, and Jennifer Lee. "A change of culture: reducing blood culture contamination rates in an Emergency Department." BMJ Quality Improvement Reports 5, no. 1 (2016): u206760.w2754. http://dx.doi.org/10.1136/bmjquality.u206760.w2754.

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Schirmer, Patricia, Cynthia Lucero-Obusan, Gina Oda, and Mark Holodniy. "1534. Gonorrhea Testing and Ceftriaxone Resistance in the Department of Veterans Affairs (VA), 2010-2019." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S767—S768. http://dx.doi.org/10.1093/ofid/ofaa439.1714.

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Abstract Background Gonorrhea (GC) infections caused by Neisseria gonorrhoeae are an ongoing public health issue and have shown resistance to nearly all antibiotic classes, including cephalosporins which are a CDC recommended treatment. We investigated national GC testing and Ceftriaxone resistance in VA. Methods GC cases identified from VA data sources from 1/1/2010-12/15/2019 by either molecular laboratory testing or GC culture with sensitivity testing. Patients were reviewed for positive results, whether culture testing was performed after 2 positive molecular GC results in &lt; 90 days, and sensitivity patterns. Results 10,642 of 644,968 (2%) GC molecular results were positive with annual number of positive cases (1,365 to 3,225), number of tests performed (97,636 to 164,085) and percent positive for GC (1.4% to 2%) increasing over the time period studied. 2,358/10,642 (22%) of positive molecular test results had repeat testing &lt; 3mo with 351 (15%) positive on repeat testing which is concerning for possible resistance. 2,624 GC cultures were performed with 2,179 (83%) positive. 1,480/2,179 (68%) positive GC culture tests had some sensitivity testing performed. Culture testing remained stable with 287 in 2010 to 289 in 2019 with percent positive ranging from 78-89%. Of the 351 patients with repeat positive GC molecular testing done &lt; 3mo from their positive molecular test, only 18 (5%) had GC culture testing performed proximal to the second positive test. Among all cultured isolates, resistance to Ceftriaxone was noted in 1 sample in 2017 in Missouri (also intermediate resistance to Tetracycline) and 1 in 2019 in New Jersey (also resistant to Penicillin, Tetracycline, and Ciprofloxacin). Conclusion In VA, GC infections have increased from 2010 to 2019 and GC culture testing has remained stable despite increasing molecular testing. Only 2 samples were identified with Ceftriaxone resistance. However, the low percentage of GC culture testing after persistent positive molecular testing in VA could mask treatment failures and possible resistance. Culture testing with sensitivity testing should be increased in VA in cases where patients may have resistance to initial treatments (i.e., – repeat positive testing less than 3 months after a positive test). Disclosures All Authors: No reported disclosures
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Sarangi, Kausik Kumar, Dipti Pattnaik, Surya Narayan Mishra, Manas Kumar Nayak, and Jagadananda Jena. "Comparative study between automated blood culture and conventional blood culture in neonatal septicaemia cases isolated in a tertiary care hospital in Odisha." International Journal of Research in Medical Sciences 8, no. 12 (November 27, 2020): 4267. http://dx.doi.org/10.18203/2320-6012.ijrms20204939.

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Background: Neonatal sepsis is the third leading cause of neonatal mortality and a major public health problem, especially in developing countries. In developing countries sepsis being cause of neonatal mortality is responsible for 30-50% of the 5 million of total neonatal deaths each year. The detection of microorganisms in a patient's blood has a great diagnostic and prognostic significance. Blood cultures provide essential information for the evaluation of a variety of diseases like endocarditis, pneumonia, and pyrexia of unknown origin particularly in patients with suspected sepsis. In our study we have done blood cultures from patients on a neonatal intensive care unit by both automated and conventional system simultaneously and have done comparative analysis between the two systems.Methods: The aim of this study was to compare the results of blood culture employing the conventional and BacT/Alert and VITEK-2 methods for detection of neonatal septicaemia cases. A prospective study was carried out in the Department of Microbiology in association with Department of Paediatrics and NICU, of Kalinga Institute of Medical Sciences, Bhubaneswar. 250 neonates with clinically suspected septicaemia were included in the study group. Three (3) ml of venous blood was collected aseptically of which 2ml was cultured by automated BacT/Alert and VITEK-2 method for rapid isolation and sensitivity test and rest 1 ml of blood for conventional culture.Results: Isolation of bacterial pathogens by culture using the automated system showed greater positivity (32.8%) as compared to 18% by conventional blood culture system.Conclusions: This study shows that automated blood culture system is superior to conventional blood culture system in terms of rapid and specific isolation of organism.
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Vazquez Deida, Axel, Veronica Salazar, Lilly Lee, and Lilian Abbo. "2080. Impact of an Emergency Department Post-discharge Blood Culture Follow-up Program." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S701—S702. http://dx.doi.org/10.1093/ofid/ofz360.1760.

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Abstract Background Blood cultures are the gold standard in the identification of laboratory confirmed bloodstream infections (LCBI) but contamination can lead to unnecessary interventions. This study sought to assess the number of unwarranted admissions in patients with contaminated blood cultures post-discharge and at low risk for LCBI before and after the implementation of a multidisciplinary emergency department (ED) blood culture follow-up program. Methods This was a two-phase retrospective cohort study at a tertiary care, 1,550-bed, academic hospital and level I trauma center in southeast Florida. Phase 1 assessed interventions made on patients 18 years of age or older discharged from the ED or a hospital observation unit with a positive blood culture result post-discharge from March 2018 to July 2018. Phase 2 assessed interventions made from December 2018 to March 2019 post-implementation of the multidisciplinary follow-up program. The criteria for low risk of LCBI were lack of risk factors for infection and < 2 positive blood cultures with a commensal bacteria with no symptoms of fever or hypotension on the date of specimen collection and 3 days before or after such date. Results Among patients at low risk for LCBI (46% of 24 patients in phase 1 vs. 59% of 22 patients in phase 2), unwarranted admissions due to contaminated blood cultures occurred in 27.3% of patients in phase 1 vs. 0% of patients in phase 2 (P = 0.08). Phase 1 represented a period in which systematic reporting and evaluation of positive results and patient follow-up were not in place. Phase 2 consisted of daily pharmacist-led blood culture reviews with callback nurse follow-up and therapeutic care plan development with ED physicians. The number of contaminant isolates was relatively high (Figures 1 and 2). Pharmacist-led interventions were diverse (Figure 3). The program led to an estimated total cost avoidance of $16,410.80 in a median of 4.5 months due to unnecessary admissions. Conclusion Implementation of a multidisciplinary ED post-discharge blood culture follow-up program can be an effective strategy in improving patient care and avoiding unnecessary antibiotic therapy. Further interventions aimed at reducing blood culture contamination could have a direct impact on improving ED antimicrobial stewardship. Disclosures All authors: No reported disclosures.
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Baker, Stephanie N., Nicole M. Acquisto, Elizabeth Dodds Ashley, Rollin J. Fairbanks, Suzanne E. Beamish, and Curtis E. Haas. "Pharmacist-Managed Antimicrobial Stewardship Program for Patients Discharged From the Emergency Department." Journal of Pharmacy Practice 25, no. 2 (November 17, 2011): 190–94. http://dx.doi.org/10.1177/0897190011420160.

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Positive outcomes of antimicrobial stewardship programs in the inpatient setting are well documented, but the benefits for patients not admitted to the hospital remain less clear. This report describes a retrospective case–control study of patients discharged from the emergency department (ED) with subsequent positive cultures conducted to determine whether integrating antimicrobial stewardship responsibilities into practice of the emergency medicine clinical pharmacist (EPh) decreased times to positive culture follow-up, patient or primary care provider (PCP) notification, and appropriateness of antimicrobial therapy. Pre- and post-implementation groups of an EPh-managed antimicrobial stewardship program were compared. Positive cultures were identified in 177 patients, 104 and 73 in pre- and post-implementation groups, respectively. Median time to culture review in the pre-implementation group was 3 days (range 1-15) and 2 days (range 0-4) in the post-implementation group ( P = .0001). There were 74 (71.2%) and 36 (49.3%) positive cultures that required notification in the pre- and post-implementation groups, respectively, and the median time to patient or PCP notification was 3 days (range 1-9) and 2 days (range 0-4) in the 2 groups ( P = .01). No difference was seen in the appropriateness of therapy. In conclusion, EPh involvement reduced time to positive culture review and time to patient or PCP notification when indicated.
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Dunlap, Scotty. "Frametown: Addressing Declining Volunteerism through Empowering Female Engagement." Fire 3, no. 3 (July 7, 2020): 27. http://dx.doi.org/10.3390/fire3030027.

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The goal of this research is to identify the drivers that have resulted in an exceptionally high level of female engagement in the Frametown Volunteer Fire Department (FVFD) in the rural community of Frametown, West Virginia. Females comprise only 11% of the volunteer fire service in the US, however, they comprise approximately 60% of the Frametown Volunteer Fire Department, including the Chief, President, and Secretary. Structured interviews were used to investigate factors that have led to recruitment and retention of female volunteers. Interviews were conducted with 24 of the department’s 29 members with representation from female (n = 14) and male members (n = 10). Male members were included in the study to gain meaningful information from both gender perspectives as their story-telling added context to the evolution and current organizational culture of the department. Themes from the interviews included organic growth of the department, a sense of service to the community, a mentoring family environment, a heightened level of compassion as a value women bring to the fire department, and gender inclusiveness within the department as key recruitment and retention factors. The results of this study may provide insight into how other volunteer fire departments can increase female volunteers, particularly in an age of declining volunteerism.
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34

Cunningham, George B. "Diversity Training in Intercollegiate Athletics." Journal of Sport Management 26, no. 5 (September 2012): 391–403. http://dx.doi.org/10.1123/jsm.26.5.391.

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The purpose of this study was to examine the prevalence, antecedents, and outcomes of diversity training in intercollegiate athletics. Data were collected from senior level administrators and aggregated to the department level for NCAA Division I (n= 239), Division II (n= 205), and Division III (n= 231) athletic departments. Only 53% of the athletic departments offered training. Logistic regression indicated that gender diversity, sexual orientation diversity, divisional affiliation, and the presence of a proactive diversity culture were all predictive of whether the department offered training. Additional analysis indicated that sensitivity to individual needs and understanding different cultures were the topics most covered in the training. Finally, the motivation for training (either compliance- or effectiveness-based) and the degree to which the training was systematically integrated were predictive of transfer of training, with the latter variable holding the strongest association. Implications, limitations, and future directions are discussed.
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Sheps, R., K. Kirk, V. Burkoski, and D. Shelton. "LO88: Reducing urine culture testing in the emergency department." CJEM 21, S1 (May 2019): S39—S40. http://dx.doi.org/10.1017/cem.2019.130.

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Background: The Choosing Wisely campaign aims to reduce unnecessary testing. Over testing for urinary tract infections and concomitant overtreatment of asymptomatic bacteriuria is a target of this campaign, aiming to decrease healthcare costs and the risks of side effects such as Clostridium difficile infection, adverse reactions, and antimicrobial resistance. During the study baseline (2017), 95 urine cultures (UC) were sent for every 1000 ED visits (9.5%). Of these, fewer than 20% were positive. Aim Statement: The aim of this improvement initiative was to reduce UC testing in the ED, by 50%, from a baseline average of nearly 100 cultures per 1000 ED patients visits, to 50 cultures per 1000 visits, by May 31st, 2018. Measures &amp; Design: This was an interrupted time series study, analyzed using Statistical Process Control (SPC) methodology. Root cause analysis was performed using an Ishikawa diagram. A Pareto chart was completed via multi-voting. A Driver Diagram was developed using the highest ranked items from the Pareto chart to identify locally relevant and feasible interventions. Interventions 1) Medical directives were modified; Routine paired sending of UC with urinalysis by nurses was removed. 2) Physician Education and implementation of a clinical decision aid (CDA); A CDA was created using PDSA methodology, using an iterative approach from development through implementation. Outcome measure: rate of Urine Cultures sent per 1000 ED patient visits Process measure: percent of positive cultures Balancing measures: rate of 14-day ED return visits and hospital admission for patients diagnosed with UTI/Urosepsis/Pyelonephritis. Evalution/Results: At the study's conclusion, there was a decrease in UC rate, from 95 per 1000 ED visits, to 59 per 1000 ED visits (RR 38%, AR 3.6%) There was evidence of special cause variation on the SPC chart. Positive cultures increased from 19% to 34%. There was no increase in the rate of ED 14-day return visits or hospital admission for patients with a diagnosis of UTI, urosepsis or pyelonephritis. Discussion/Impact: The study interventions of uncoupling routine sending of UA and UC, and physician education and use of a clinical decision aid, effectively decreased the rate of UC testing during the study period. A reduction in inappropriate UC testing is important to limit avoidable patient morbidity and reduce unnecessary health care spending. Further studies are indicated to target interventions on patient subgroups and to reduce unnecessary antibiotic prescriptions.
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Astete, Joaquín A., Astrid Batlle, Susanna Hernandez-Bou, Victoria Trenchs, Amadeu Gené, and Carles Luaces. "Blood culture diagnostic yield in a paediatric emergency department." European Journal of Emergency Medicine 21, no. 5 (October 2014): 336–40. http://dx.doi.org/10.1097/mej.0000000000000099.

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Rivera-Mindt, Monica, and Robin C. Hilsabeck. "TCN culture and gender in Neuropsychology Department: inaugural editorial." Clinical Neuropsychologist 32, no. 8 (October 28, 2018): 1353–55. http://dx.doi.org/10.1080/13854046.2018.1525110.

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Weddle, Gina, Mary Anne Jackson, and Rangaraj Selvarangan. "Reducing Blood Culture Contamination in a Pediatric Emergency Department." Pediatric Emergency Care 27, no. 3 (March 2011): 179–81. http://dx.doi.org/10.1097/pec.0b013e31820d652b.

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Ploussi, Agapi, and Efstathios P. Efstathopoulos. "Importance of establishing radiation protection culture in Radiology Department." World Journal of Radiology 8, no. 2 (2016): 142. http://dx.doi.org/10.4329/wjr.v8.i2.142.

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McCarthy, Claudine. "Learn to create ‘culture of care’ within your department." Disability Compliance for Higher Education 25, no. 12 (June 16, 2020): 8. http://dx.doi.org/10.1002/dhe.30872.

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McCarthy, Claudine. "Learn to create ‘culture of care’ within your department." Recruiting & Retaining Adult Learners 22, no. 10 (June 16, 2020): 9. http://dx.doi.org/10.1002/nsr.30621.

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McCarthy, Claudine. "Learn to create ‘culture of care’ within your department." Student Affairs Today 23, no. 1 (April 2020): 3. http://dx.doi.org/10.1002/say.30728.

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43

Person, John, LeeAnna Spiva, and Patricia Hart. "The culture of an emergency department: An ethnographic study." International Emergency Nursing 21, no. 4 (October 2013): 222–27. http://dx.doi.org/10.1016/j.ienj.2012.10.001.

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Graham, Helen. "Department of Culture, Media and Sport's Peer Review Pilot." Cultural Trends 18, no. 4 (December 2009): 323–31. http://dx.doi.org/10.1080/09548960903268147.

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Jones, Florence, Pradeep Podila, and Cynthia Powers. "Creating a Culture of Safety in the Emergency Department." JONA: The Journal of Nursing Administration 43, no. 4 (April 2013): 194–200. http://dx.doi.org/10.1097/nna.0b013e31828958cd.

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Mullan, Paul C., Sara Scott, James M. Chamberlain, Jeanne Pettinichi, Katura Palacious, Anastasia Weber, Asha S. Payne, Gia M. Badolato, and Kathleen Brown. "Decreasing Blood Culture Contaminants in a Pediatric Emergency Department." Pediatric Quality and Safety 3, no. 5 (2018): e104. http://dx.doi.org/10.1097/pq9.0000000000000104.

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Duraj, Victor, and Debbie M. Decker. "DiSCO — Department Safety Coordinators and Officers: Building Safety Culture." Journal of Chemical Health and Safety 26, no. 6 (November 2019): 84–88. http://dx.doi.org/10.1016/j.jchas.2019.08.002.

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Pressman, Barry D., and Lynne T. Roy. "Developing a Culture of Safety in an Imaging Department." Journal of the American College of Radiology 12, no. 2 (February 2015): 198–200. http://dx.doi.org/10.1016/j.jacr.2014.07.010.

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Harding, Andrew D., and Susan Bollinger. "Reducing Blood Culture Contamination Rates in the Emergency Department." Journal of Emergency Nursing 39, no. 1 (January 2013): e1-e6. http://dx.doi.org/10.1016/j.jen.2012.10.009.

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McCarthy, Claudine. "Learn to create ‘culture of care’ within your department." Campus Security Report 17, no. 2 (May 17, 2020): 6. http://dx.doi.org/10.1002/casr.30660.

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