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Diagrams are effective instruments of thought and a valuable tool in conveying those thoughts to others. As such, they can be usefully employed as representations of a research domain and act as stimulus materials in interviews. This process of graphic elicitation may encourage contributions from interviewees that are difficult to obtain by other means. By representing concepts and relationships that other visual artefacts cannot depict, diagrams provide a complementary addition to conventional interview stimuli. This article discusses the application of graphic elicitation within the broader context of the diagramming process. Consideration is given to the unique characteristics of diagrams and the ways in which they are interpreted. Thus, the specific benefits that diagrams offer as interview stimuli may be understood. Following this, an example study is described in which the graphic elicitation process was employed in interviews with industrial designers. Reporting on a study in which the interviewees possessed a well-developed graphic sensibility allows a broad range of graphic elicitation's potential benefits to be illustrated. In closing the article, a discussion is held on the range of methodological issues that must be addressed when employing diagrams in a research study.

In recent years, the healthcare sector has adopted the use of operational risk assessment tools to help understand the systems issues that lead to patient safety incidents. But although these problem‐focused tools have improved the ability of healthcare organizations to identify hazards, they have not translated into measurable improvements in patient safety. One possible reason for this is a lack of support for the solution‐focused process of risk control. This article describes a content analysis of the risk management strategies, policies, and procedures at all acute (i.e., hospital), mental health, and ambulance trusts (health service organizations) in the East of England area of the British National Health Service. The primary goal was to determine what organizational‐level guidance exists to support risk control practice. A secondary goal was to examine the risk evaluation guidance provided by these trusts. With regard to risk control, we found an almost complete lack of useful guidance to promote good practice. With regard to risk evaluation, the trusts relied exclusively on risk matrices. A number of weaknesses were found in the use of this tool, especially related to the guidance for scoring an event's likelihood. We make a number of recommendations to address these concerns. The guidance assessed provides insufficient support for risk control and risk evaluation. This may present a significant barrier to the success of risk management approaches in improving patient safety.

AbstractAlthough relatively rare, surgical instrument retention inside a patient following central venous catheterization still presents a significant risk. The research presented here compared two approaches to help reduce retention risk: Bow‐Tie Analysis and Systems‐Theoretic Accident Model and Processes. Each method was undertaken separately and then the results of the two approaches were compared and combined. Both approaches produced beneficial results that added to existing domain knowledge, and a combination of the two methods was found to be beneficial. For example, the Bow‐Tie Analysis gave an overview of which activities keep controls working and who is responsible for each control, and the Systems‐Theoretic Accident Model and Processes revealed the safety constraints that were not enforced by the supervisor of the controlled process. Such two‐way feedback between both methods is potentially helpful for improving patient safety. Further methodology ideas to minimize surgical instrument retention risks are also described.

Objective: Patterns of capability loss and disability onset among older people were investigated prospectively. Background: With aging, the gap between personal capability and environmental demand becomes wider, resulting in higher levels of disability in daily activities. Methods: Data from a longitudinal, population-based study were obtained for analysis, which recruited a representative sample of 13,004 people aged 65 years and older from five sites in Great Britain. Participants completed a baseline interview during 1990 to 1994 and follow-up interviews after 1, 2, 3, 6, 8, and 10 years. Those who reported full vision, hearing, thinking, locomotion, reaching, and dexterity ability as well as no disability in cooking, housework, shopping, and transportation at baseline were included in a survival analysis. Results: Locomotion was the first ability to be lost, followed by reaching, thinking, hearing, vision, and dexterity. Age at onset of disability was earliest for shopping, then housework, transportation, and cooking. Women were consistently younger at capability loss and disability onset than men except in terms of hearing and cooking. Conclusion: These findings suggest that capabilities required for product and service interaction follow a hierarchical pattern of loss, which has practical implications for design. Although interventions to reduce disability in the older population are likely to require changes that address more than one demand, capabilities lost early in old age should take precedence over those lost later. Application: A potential application of this research is in the development of an overall design strategy to enhance older people's ability to live independently.