In high-stakes resource use struggles currently playing out across the world, different beliefs about economics and "growth-first" regional development underpin decisions and dynamics that have far-reaching consequences. Neoliberalizing political economies rely on the maintenance of particular beliefs associated with these themes, and work to delegitimize and silence alternatives. Thus understanding the beliefs of actors concerning these themes, especially with respect to neoliberal ideas, is key to understanding these sociopolitical struggles. This article uses a combination of literature review, critical discourse analysis and selected fieldwork data to explore the recent debate about coal seam gas (CSG) in Eastern Australia. In particular, it examines the ideas that underlie texts produced by CSG production companies, the Queensland Government, and Lock the Gate (a key group opposed to rapid CSG industry expansion). The analysis indicates that with respect to the above themes, Lock the Gate expresses their opposition to CSG through perspectives that mostly depart from those with a key role in maintaining neoliberalizing political economies. In contrast, the Queensland government and CSG companies, despite each encompassing significant internal diversity, have expressed relatively similar and consistent positions, aligned with neoliberalizing ideas. The article problematizes descriptions of the state government as a neutral arbitrator that can restore balance between the beliefs of gas companies and groups like Lock the Gate, and advances consideration of deeper differences. Key Words: coal seam gas, neoliberalizing discourse, regional development, role of government, Queensland RésuméEn luttes «high-stakes» sur l'utilisation des ressources, des croyances différentes sur l'économie et le développement régional sous-tendent les décisions et les dynamiques qui ont de lourdes conséquences. L'économie politique néolibéral reposent sur le maintien de croyances particulières, et il travailler à délégitimer et silencer des alternatives. Ainsi la compréhension des croyances des acteurs sur ces thèmes, en particulier en ce qui concerne les idées néolibérales, est la clé de la compréhension de ces luttes sociopolitiques. Cet article utilise une combinaison de revue de la littérature, l'analyse critique du discours et des données de terrain sélectionnés à explorer le débat récent sur le gaz de couche de charbon (CSG) dans l'Est de l'Australie. En particulier, il examine les idées qui sous-tendent les textes produits par des sociétés de production CSG, le gouvernement du Queensland, et «Verrouiller la porte» (Lock the Gate) (un groupe clé dans opposition à l'expansion de CSG). L'analyse indique que par rapport aux thèmes ci-dessus, «Verrouiller la porte» exprime leur opposition à la CSG par les perspectives qui partent la plupart de ceux qui soutiennent néolibéral économies politiques. ResumenEn conflictos sobre el uso de recursos de alto riesgo, los cuales se está produciendo hoy en día en todo el mundo, diferen...

Implementation of I-PASS has been associated with substantial improvements in patient safety and can be applied to a variety of disciplines and types of patient handoffs. Widespread implementation of I-PASS has the potential to substantially improve patient safety in the United States and beyond.

Objectives:We sought to characterize the nature and prevalence of medication order errors (MOEs) occurring at hospital admission for children with medical complexity (CMC), as well as identify the demographic and clinical risk factors for CMC experiencing MOEs.Methods: Prospective cohort study of 1233 hospitalizations for CMC from November 1, 2015, to October 31, 2016, at 2 children's hospitals. Medication order errors at admission were identified prospectively by nurse practitioners and a pharmacist through direct patient care. The primary outcome was presence of at least one MOE at hospital admission. Statistical methods used included χ 2 test, Fisher exact tests, and generalized linear mixed models.Results: Overall, 6.1% (n = 75) of hospitalizations had ≥1 MOE occurring at admission, representing 112 total identified MOEs. The most common MOEs were incorrect dose (41.1%) and omitted medication (34.8%). Baclofen and clobazam were the medications most commonly associated with MOEs. In bivariable analyses, MOEs at admission varied significantly by age, assistance with medical technology, and numbers of complex chronic conditions and medications (P < 0.05). In multivariable analysis, patients receiving baclofen had the highest adjusted odds of MOEs at admission (odds ratio, 2.2 [95% confidence interval, 1.2-3.8]).Conclusions: Results from this study suggest that MOEs are common for CMC at hospital admission. Children receiving baclofen are at significant risk of experiencing MOEs, even when orders for baclofen are correct. Several limitations of this study suggest possible undercounting of MOEs during the study period. Further investigation of medication reconciliation processes for CMC receiving multiple chronic, home medications is needed to develop effective strategies for reducing MOEs in this vulnerable population.

BACKGROUND AND OBJECTIVES: Hospitalized children with medical complexity (CMC) are at high risk of medical errors. Their families are an underutilized source of hospital safety data. We evaluated safety concerns from families of hospitalized CMC and patient/parent characteristics associated with family safety concerns. METHODS: We conducted a 12-month prospective cohort study of English- and Spanish-speaking parents/staff of hospitalized CMC on 5 units caring for complex care patients at a tertiary care children’s hospital. Parents completed safety and experience surveys predischarge. Staff completed surveys during meetings and shifts. Mixed-effects logistic regression with random intercepts controlling for clustering and other patient/parent factors evaluated associations between family safety concerns and patient/parent characteristics. RESULTS: A total of 155 parents and 214 staff completed surveys (&gt;89% response rates). 43% (n = 66) had ≥1 hospital safety concerns, totaling 115 concerns (1–6 concerns each). On physician review, 69% of concerns were medical errors and 22% nonsafety-related quality issues. Most parents (68%) reported concerns to staff, particularly bedside nurses. Only 32% of parents recalled being told how to report safety concerns. Higher education (adjusted odds ratio 2.94, 95% confidence interval [1.21–7.14], P = .02) and longer length of stay (3.08 [1.29–7.38], P = .01) were associated with family safety concerns. CONCLUSIONS: Although parents of CMC were infrequently advised about how to report safety concerns, they frequently identified medical errors during hospitalization. Hospitals should provide clear mechanisms for families, particularly of CMC and those from disadvantaged backgrounds, to share safety concerns. Actively engaging patients/families in reporting will allow hospitals to develop a more comprehensive, patient-centered view of safety.