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Competing Priorities (competing + priority)
Selected AbstractsPlanning for online courses at rural community collegesNEW DIRECTIONS FOR COMMUNITY COLLEGES, Issue 150 2010Jay Leist Rural community colleges often expand their online course offerings in an ad hoc manner. Due to limited resources and competing priorities, the necessary, careful planning for online instruction is often forgotten. [source] Using evaluation data to strike a balance between stakeholders and accountability systemsNEW DIRECTIONS FOR EVALUATION, Issue 117 2008Lisa N. T. Schmitt A district evaluator in a large Texas district examines new challenges arising since implementation of No Child Left Behind, relating to (1) navigating competing requirements in state and federal accountability systems; (2) evaluating effectiveness of sanctions districts are required to address; (3) using scientifically based research (SBR) to select effective programs and interventions; and (4) initiating SBR given high student mobility, inefficient data-management systems, and competing priorities of local schools. This chapter details these challenges for district-level evaluators and highlights how they can implement processes that strike a balance between supporting decision making and conducting rigorous evaluation. © Wiley Periodicals, Inc. [source] The National Socialist Sisterhood: an instrument of National Socialist health policyNURSING INQUIRY, Issue 2 2009Christoph Schweikardt When Adolf Hitler (1889,1945) came to power in 1933, the new Nazi government focused the German health system on their priorities such as the creation of a racially homogeneous society and the preparation of war. One of the measures to bring nursing under their control was the foundation of a new sisterhood. In 1934, Erich Hilgenfeldt (1897,1945), the ambitious head of the National Socialist People's Welfare Association (Nationalsozialistische Volkswohlfahrt), founded the National Socialist (NS) Sisterhood (Nationalsozialistische Schwesternschaft) to create an elite group that would work for the goals of the National Socialist German Workers' Party (Nationalsozialistische Deutsche Arbeiterpartei, NSDAP). Hilgenfeldt proclaimed community nursing as a priority for NS Sisterhood nurses. Catholic and Protestant sisters, who were traditionally dedicated to community nursing, were to be gradually replaced. However, other competing priorities, such as hospital service for the training of junior nurses and work in conquered regions, as well as the lack of NS nursing personnel, hampered the expansion of community nursing. The paper also addresses areas for future research: everyday activities of NS nurses, the service of NS Sisterhood nurses for NSDAP organisations such as the elite racist paramilitary force SS (Schutzstaffel, Protective Squadron), and involvement in their crimes have hardly been investigated as yet. [source] Evaluation of the Acceptability and Usability of a Decision Support System to Encourage Safe and Effective Use of Opioid Therapy for Chronic, Noncancer Pain by Primary Care ProvidersPAIN MEDICINE, Issue 4 2010Jodie Trafton PhD Abstract Objective., To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. Design., CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Results., Volunteers provided detailed feedback to guide improvements in the graphical user interface, and content and design changes to increase clinical usefulness, understandability, clinical workflow fit, and ease of completing guideline recommended practices. Revisions based on feedback increased CDSS usability ratings over time. Practice concerns outside the scope of the CDSS were also identified. Conclusions., Usability testing optimized the CDSS to better address barriers such as lack of provider education, confusion in dosing calculations and titration schedules, access to relevant patient information, provider discontinuity, documentation, and access to validated assessment tools. It also highlighted barriers to good clinical practice that are difficult to address with CDSS technology in its current conceptualization. For example, clinicians indicated that constraints on time and competing priorities in primary care, discomfort in patient-provider communications, and lack of evidence to guide opioid prescribing decisions impeded their ability to provide effective, guideline-adherent pain management. Iterative testing was essential for designing a highly usable and acceptable CDSS; however, identified barriers may limit the impact of the ATHENA-Opioid Therapy system and other CDSS on clinical practices and outcomes unless CDSS are paired with parallel initiatives to address these issues. [source] Incorporating employee resourcing requirements into deployment decision makingPROJECT MANAGEMENT JOURNAL, Issue 2 2009Andrew R. J. Dainty Abstract Employee resourcing is the process of matching human resource capabilities to the strategic and operational needs of the organization. This is exceptionally problematic in project-based organizations due to the competing priorities of the project, the individual employee, and the wider succession needs of the organization. This article presents the findings of research examining the human resource management practices that form the key components of the resourcing process. These included, inter alia, human resource planning, recruitment and selection, team deployment, performance management, and human resource administration. Current practices were examined in seven leading construction firms, all of which faced dynamic resourcing priorities. Within an inductive methodology, semistructured interviews were carried out with senior executives, human resource management (HRM) specialists, senior operational managers, and project-based staff. Based on a synthesis of the promising practices extracted from the case-study organizations, an innovative approach to project resourcing was developed that aims to balance organizational, project, and individual employee requirements. Team deployment resides at the center of resourcing process for the project-based organization as it determines the success of the project, which in turn determines the competitiveness of the organization. Long-term planning and employee involvement enable team deployment to integrate with other elements of HRM effectively and thus help to balance the organizational strategic priorities, project requirements, and individual employee needs and preferences. [source] A Preliminary Report of Knowledge Translation: Lessons From Taking Screening and Brief Intervention Techniques From the Research Setting Into Regional Systems of CareACADEMIC EMERGENCY MEDICINE, Issue 11 2009Edward Bernstein MD Abstract This article describes a limited statewide dissemination of an evidence-based technology, screening, brief intervention, and referral to treatment (SBIRT), and evaluation of the effects on emergency department (ED) systems of care, utilizing the knowledge translation framework of reach, effectiveness, adoption, implementation, and maintenance (RE-AIM), using both quantitative and qualitative data sources. Screening and brief intervention (SBI) can detect high-risk and dependent alcohol and drug use in the medical setting, provide early intervention, facilitate access to specialty treatment when appropriate, and improve quality of care. Several meta-analyses demonstrate its effectiveness in primary care, and the federal government has developed a well-funded campaign to promote physician training and adoption of SBI. In the busy environment of the ED, with its competing priorities, researchers have tested a collaborative approach that relies on peer educators, with substance abuse treatment experience and broad community contact, as physician extenders. The ED-SBIRT model of care reflects clinician staff time constraints and resource limitations and is designed for the high rates of prevalence and increased acuity typical of ED patients. This report tracks services provided during dissemination of the ED-SBIRT extender model to seven EDs across a northeastern state, in urban, suburban, and rural community settings. Twelve health promotion advocates (HPAs) were hired, trained, and integrated into seven ED teams. Over an 18-month start-up period, HPAs screened 15,383 patients; of those, 4,899 were positive for high risk or dependent drinking and/or drug use. Among the positive screens, 4,035 (82%) received a brief intervention, and 57% of all positives were referred to the substance abuse treatment system and other community resources. Standardized, confidential interviews were conducted by two interviewers external to the program with 24 informants, including HPAs and their supervisors, clinicians, nurse managers, and ED directors across five sites. A detailed semistructured format was followed, and results were coded for thematic material. Barriers, challenges, and successes are described in the respondents' own words to convey their experience of this demonstration of SBIRT knowledge translation. Five of seven sites were sustained through the second year of the program, despite cutbacks in state funding. The dissemination process provided a number of important lessons for a large rollout. Successful implementation of the ED-SBIRT HPA model depends on 1) external funding for start-up; 2) local ED staff acting as champions to support the HPA role, resolve territorial issues, and promote a cultural shift in the ED treatment of drug and alcohol misuse from "treat and street" to prevention, based on a knowledge of the science of addiction; 3) sustainability planning from the beginning involving administrators, the billing and information technology departments, medical records coders, community service providers, and government agencies; and 4) creation and maintenance of a robust referral network to facilitate patient acceptance and access to substance abuse services. [source] | |||||||||||||