Georgetown University Hospital gift shop.
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An outbreak of listeriosis occurred in the Swindon area of the UK in autumn 2003. Five cases were detected in pregnant women. Four of these women were thought to have eaten prepacked sandwiches from a retail outlet in one particular hospital. Sampling at the supplier detected Listeria monocytogenes, which was indistinguishable on molecular testing from the patients isolates. Recent changes in UK food legislation should help diminish the risk of further outbreaks/cases such as ours occurring.
Using professional shopping, or sub rosa investigative methods, an actor was admitted to a hospital with a diagnosis of rule out myocardial infarction to ascertain quality data. An interesting finding was the interrelatedness of quality throughout the organization. The sub rosa investigator described many intraorganizational quality problems, including how the actions of one department affected quality in another. To evaluate the enormous amount of information provided by the investigator, the data were segregated by events that could be evaluated for quality. Only one event led to the conclusion that a new source of quality information was attributable to the sub rose investigator's findings. Hospitals using sub rosa investigative techniques may obtain large amounts of quality information in a relatively short period.
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Many hospitals are re-examining their gift shop operations and concluding that outside experts can do it better. Although only an estimated 30 hospital gift shops are operated by management services companies, interest in outside companies is growing as executives recognize that hospital gift shops can be extremely lucrative, and that hospital gift shop volunteers are an endangered species.
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We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting.
In summary, color psychology is one of the most important, but most often neglected, forces in enhancing the image and profitability of the hospital gift shop. While many hospital gift shops may be updated and beautified with the purchase of costly equipment and the hiring of expensive design consultants, the effective use of color may be all that is necessary to change the shop atmosphere. In addition, color is extremely inexpensive and flexible; it can be changed easily, in lieu of moving heavy displays and fixtures, rewiring, or remodeling. Finally, color is powerful. In an age of intense competition and rapidly expanding technology, color is one design tool that can make a difference.
Public policy assumptions, which view "the public" as passive consumers, are deeply flawed. "The public" are, in fact, active citizens, who constitute the innovation end of the seamless web of relationships, running from research and development laboratory to shop, hospital or farm, or local neighborhood. "The public" do not receive the impact of technology; they are the impact, in that they determine with gene technology (GT) developers and sellers what happens to the technology in our society. In doing so, they, or more rightly we, exercise particular, contextual knowledges and actions. We suggest that it is the ignorance of this aspect of innovation in policy processes that produces the distrust and resentment that we found in our interviews with "publics" interested in gene technology. This is consistent with Beck's description of the deep structural states of risk and fear in modern advanced societies with respect to new technologies, such as gene technology. Only policy processes that recognize the particular, local and contextual knowledges of "the public", which co-construct innovation, can achieve deep, social structural consideration of gene technology. And only such a deep consideration can avoid the polarized attitudes and deep suspicions that we have seen arise in places such as Britain. Such consideration needs the type of processes that involve active consultation and inclusion of "the public" in government and commercial innovation, the so-called deliberative and inclusionary processes (DIPs), such as consensus conferences and citizen juries. We suggest some measures that could be tried in Australia, which would take us further down the path of participation toward technological citizenship.
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