The physical environment has a significant impact on health and safety; however, hospitals have not been designed with the explicit goal of enhancing patient safety through facility design. In April 2002, St Joseph’s Community Hospital of West Bend, a member of SynergyHealth, brought together leaders in healthcare and systems engineering to develop a set of safety-driven facility design recommendations and principles that would guide the design of a new hospital facility focused on patient safety. By introducing safety-driven innovations into the facility design process, environmental designers and healthcare leaders will be able to make significant contributions to patient safety.

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During service, freight railroad coupling systems experience heavy loading owing to various train actions. For non-cushioned railcars, the primary tensile component utilized to transfer these forces to the draft system is the yoke. The stress state developed within a yoke was analysed using both strain gauge data and non-linear finite-element methods for both static maximal loads and pseudo-static cyclic loads accounting for the non-linear material behaviour, including plasticity and strain hardening. From the stress profile developed within a yoke, the critical locations were determined and the theoretical fatigue life was calculated using various strain life fatigue analysis methods considering both the uniaxial and biaxial stress conditions that exist. Using these data, a possible failure mode is presented.