from the article: Abstract Based on a review of recent literature, this paper addresses the question of how urban planners can steer urban environmental quality, given the fact that it is multidimensional in character, is assessed largely in subjective terms and varies across time. The paper explores three questions that are at the core of planning and designing cities: ‘quality of what?’, ‘quality for whom?’ and ‘quality at what time?’ and illustrates the dilemmas that urban planners face in answering these questions. The three questions provide a novel framework that offers urban planners perspectives for action in finding their way out of the dilemmas identified. Rather than further detailing the exact nature of urban quality, these perspectives call for an approach to urban planning that is integrated, participative and adaptive. ; ; sustainable urban development; trade-offs; quality dimensions
This report is the second in a series of three reports named Value Added Planning, consisting of three unique, but interconnected tools, namely the Green Credit Tool, the Workbench Method and Value Added Planning, These tools have been developed and/or tested in the context of the European INTERREG programme: VALUE (INTERREG IVB North West Europe - Valuing Attractive Landscapes in the Urban Economy), in which the municipality of Amersfoort is involved. Aim of this programme is to understand how green space in urban centres can become more competitive with other urban functions. In this context, the municipality of Amersfoort has introduced the interactive method named Workbench Spatial Quality (Werkbank Ruimtelijke Kwaliteit in Dutch) in their spatial design in several areas in their municipality. The Workbench Spatial Quality (to be referred to as Workbench) has been applied on two cases in Amersfoort: Park Randenbroek and Vathorst NW. In this report the Workbench as applied in Amersfoort is evaluated. Research was done on the basis of literature research, case-material and interviews performed with several experts. Furthermore, research was done by students at the Wageningen University and Research Centre (WUR). Part of the evaluation in this report makes use of a quick scan of 19 Dutch cases. The question addressed in this report is: 1.How was the Workbench Spatial Quality applied in Amersfoort? 2.Can the Workbench contribute to sustainable spatial planning?
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Background: Advanced medical technologies (AMTs), such as respiratory support or suction devices, are increasingly used in home settings and incidents may well result in patient harm. Information about risks and incidents can contribute to improved patient safety, provided that those are reported and analysed systematically. Objectives: To identify the frequency of incidents when using AMTs in home settings, the effects on patient outcomes and the actions taken by nurses following identification of incidents. Methods: A cross-sectional study of 209 home care nurses in the Netherlands working with infusion therapy, parenteral nutrition or morphine pumps, combining data from a questionnaire and registration forms covering more than 13 000 patient contacts. Descriptive statistics were used. Results: We identified 140 incidents (57 adverse events; 83 near misses). The frequencies in relation to the number of patient contacts were 2.7% for infusion therapy, 1.3% for parenteral nutrition and 2.6% for morphine pumps. The main causes were identified as related to the product (43.6%), the organisation of care (27.9%), the nurse as a user (15.7%) and the environment (12.9%). 40% of all adverse events resulted in mild to severe harm to the patient. Incidents had been discussed in the team (70.7%), with the patient/informal caregiver(s) (50%), or other actions had been taken (40.5%). 15.5% of incidents had been formally reported according to the organisation's protocol. Conclusions: Most incidents are attributed to product failures. Although such events predominantly cause no harm, a significant proportion of patients do suffer some degree of harm. There is considerable underreporting of incidents with AMTs in home care. This study has identified a discrepancy in quality circles: learning takes place at the team level rather than at the organisational level.
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