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Implementation Process (implementation + process)
Selected AbstractsA Collective Case Study of the Implementation Process of the Nebraska Foreign Language Frameworks by Six TeachersMODERN LANGUAGE JOURNAL, Issue 4 2001Georgia Janavara Sarroub This case study explores the process of implementing the Nebraska Foreign Language Frameworks in an urban, Midwestern school district. The participants were two elementary, two middle school, and two high school teachers; the languages taught were French and Spanish. Data were collected through interviews, classroom observations, and lesson plans. The findings show that the 6 teachers implemented the Frameworks and that the implementation process differed, depending mainly on teaching experience and involvement in the writing of the Frameworks document. Among the 5 Cs, communication was the easiest to implement, whereas communities was the most challenging. Connections was implemented in depth by the elementary teachers due to their interdisciplinary teaching. By implementing the standards, the teachers learned to set clear objectives focusing on the learner, to plan with the outcomes in mind, to create thematic units addressing the 5 Cs, and to use various assessments, including portfolio and rubrics. [source] The Water Framework Directive and agricultural nitrate pollution: will great expectations in Brussels be dashed in Lower Saxony?ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 4 2007Britta Kastens Abstract This paper discusses the opportunities and constraints regarding the effective implementation of the European Water Framework Directive (WFD) in the area of diffuse nitrate pollution. Owing to the subsidiarity principle and a new procedural mode of governance, the WFD only sets distinct environmental targets, leaving most decisions on how to operationalize and institutionalize the reduction of diffuse nitrate pollution to the member states. This is a particular challenge for Germany, where lower scale regions have become the main implementers of European water policy. Successful implementation of the WFD, i.e. the actual improvement of water quality, depends on a series of key contextual and contingent factors, operating at a regional scale. In a Northwest German region with intensive agriculture and severe nitrate pollution, we analyse the historical and economic context and actor network of the region as well as the influence of environmental groups on public participation, the potential of biogas technology and new financial options. Besides the specific influence of these factors on the implementation process, we explore the uncertainties and difficulties surrounding European legislation and its operationalization in Germany and on a regional scale. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source] The German sustainable development strategy: facing policy, management and political strategy assessmentsENVIRONMENTAL POLICY AND GOVERNANCE, Issue 3 2007Ralf Tils Abstract The Germans' conviction of being an international frontrunner in environmental policy stands in contrast to the unwillingness of the German national governments of the 1990s to undertake a commitment for a nationwide sustainable development strategy. Using five core strategy categories, namely horizontal and vertical integration, participation, implementation mechanism, monitoring and evaluation, this article provides an overview of the German sustainable development strategy preparation and implementation process. While the strategy is an ambitious concept, it also exhibits important shortcomings when viewed with different analytical perspectives such as policy, management and political strategy. Only with all of these perspectives combined can we arrive at specific conclusions about the assessment of the strategy process and make the essential characteristics of political strategy apparent. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source] Conceptualizing desertification in Southern Europe: stakeholder interpretations and multiple policy agendasENVIRONMENTAL POLICY AND GOVERNANCE, Issue 4 2005M. Juntti Abstract This paper explores the link between agricultural, environmental and structural policies and desertification in Southern Europe. The focus is on the way policy goals evolve in the implementation process and become translated into actions at the operative level. The results derive from policy stakeholder interviews from four research areas situated in Greece, Italy, Portugal and Spain. The significance of policies as drivers of desertification varies between the case study areas, and harmful land management practices often result from power imbalances between interest groups involved in land-use planning and policy implementation rather than from flaws in the policies themselves. The vagueness of the definition of what ,desertification' constitutes allows for different interpretations of its nature, significance and the consequent weight it is given in land management decision-making, thus lending itself to be both misinterpreted and misappropriated by different stakeholder interests. The paper discusses the interplay between five different discourses of desertification and four distinct agendas of policy implementation and land use. The agendas either enhance or mitigate desertification and represent the interests of actors who have acquired a powerful position in the network of stakeholders, often relying on, and simultaneously maintaining, discourses and structures that lend them first right to decision-making over the natural resources of the locality. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment. [source] The need for adaptability in EU environmental policy design and implementationENVIRONMENTAL POLICY AND GOVERNANCE, Issue 5 2001Matthieu Glachant Is the application of the EU environmentally policy satisfying in the field? In particular, are the environmental objectives set in the directives met? This paper explores the issue of the effectiveness of the European environmental policy. It is based on the results of a recent study, which has consisted in evaluating the implementation of three pieces of EU environmental legislation in France, Germany, Netherlands and United Kingdom. The legislation studied was Directive 89/429 regulating atmospheric emissions from domestic waste incinerators, Directive 88/609 dealing with SO2 and NOx emissions from large combustion plants (LCPs) and Council Regulation 1836/93 concerning the voluntary participation of industrial companies in an EU Eco-Management and Audit Scheme (EMAS). The result of the study suggests that simply posing the problem in terms of ,implementation deficit' is not sufficient. In fact, over-compliance with directive goals is even observed in certain cases. By contrast, the evaluation suggests the prevalence of interactions between the considered implementation process and other parallel policy processes at the implementation stage. The study shows that this interplay between policies has a huge impact on implementation environmental results, which can be either positive or negative. Based on this statement, an important question for EU policy is how implementation can efficiently cope with such interactions, which means finding ways to maximize potential synergies, or alternatively to reduce inconsistencies, with the other policy components. Given that policy interactions are difficult to predict at the policy formulation stage of the policy, adjustments necessarily occur at the implementation stage. In this context, implementing EU environmental policy requires policy systems able to adjust at low costs. In this paper, this property is called adaptability and is given a precise content. Copyright © 2001 John Wiley & Sons, Ltd. and ERP Environment [source] Patient Care Competency in Emergency Medicine Graduate Medical Education: Results of a Consensus Group on Patient CareACADEMIC EMERGENCY MEDICINE, Issue 11 2002Randall W. King MD "Patient Care" is the first listed core competency of the six new core competencies recently formulated by the Accreditation Council for Graduate Medical Education (ACGME) and, arguably, the most important. To assist emergency medicine (EM) program directors in incorporating and assessing this competency, the Council of Emergency Medicine Residency Directors (CORD-EM) held a consensus conference in March 2002. Definitions of this competency were generated that are specific for the training of practitioners in EM. These built upon the ACGME base definition, but include elements unique to or critically important in EM. In addition, all of the ACGME assessment tools were examined and prioritized for use in assessing the competency of EM residents in the area of patient care. Suggestions for an implementation process are also described. [source] The application of change management theory to HR portal implementation in subsidiaries of multinational corporationsHUMAN RESOURCE MANAGEMENT, Issue 1 2005Cataldo Dino Ruta HR portals are complex information technology (IT) applications that can be accessed by all employees of a given organization. By placing more applications and information online, HR portals reduce the reliance employees have on HR personnel. Given this relational change, from human to computer, the HR portal implementation process must take into account the challenges of both change management and technology acceptance. By integrating change management theories with IT user acceptance models, this article adds to HR's collective knowledge of ways to effectively implement HR portals. In addition, this article describes the cross-national challenges that exist when a global firm attempts to implement an HR portal around the world. Thus, this article will present a model that (1) integrates change management theories and IT user acceptance models and (2) illustrates the ways in which change management plans may need to be adapted to be effective in various subsidiaries. A case study of Hewlett-Packard's (HP's) worldwide implementation of their @HP Employee Portal in the Italian subsidiary of HP illustrates the key issues of these theories. © 2005 Wiley Periodicals, Inc. [source] Mind the gap: national and local partnership in the Irish public sectorINDUSTRIAL RELATIONS JOURNAL, Issue 5 2010Michael Doherty ABSTRACT This article uses case study data from a major Irish city council to investigate and explain public sector worker attitudes towards social partnership at local and national level. It is argued that the more sceptical attitudes to workplace partnership reflect structural differences between local and national arrangements, which have enabled public sector employers to use ,social partnership' as a constraint in the implementation process of a pre-determined public sector reform agenda. [source] Towards consistent modes of e-health implementation: structurational analysis of a telecare programme's limited successINFORMATION SYSTEMS JOURNAL, Issue 6 2010Albert Boonstra Abstract Telecare is the use of information and communication systems to facilitate care delivery to individuals in their homes. Although the expectations of telecare are high, its implementation has proved complex. This case study demonstrates this complexity through a structurational analysis of a telecare implementation process. The paper shows how structuration concepts enable a combined analysis of actors' interactions with a technology and of the interaction among these actors from different institutional contexts. In this example, fragmented multi-actor agency induced an inconsistent implementation mode, leading to unsuccessful telecare appropriation. This paper concludes with a preliminary proposal for more consistent telecare implementation modes. These modes may better support the actors' reflexive monitoring and dialogue and inform further research. [source] Understanding the implementation of software process improvement innovations in software organizationsINFORMATION SYSTEMS JOURNAL, Issue 1 2004Karlheinz Kautz Abstract., The development of software is a complex task frequently resulting in unfinished projects, project overruns and system failures. Software process improvement (SPI) approaches have been promoted as a promising remedy for this situation. The organizational implementation of such approaches is a crucial issue and attempts to introduce SPI into software organizations often fail. This paper presents a framework to understand, and subsequently successfully perform, the implementation of SPI innovations in software organizations. The framework consists of three perspectives on innovation: an individualist, a structuralist and an interactive process perspective. Applied to SPI, they emphasize different aspects of implementing SPI innovations. While the first focuses on leadership, champions and change agents, the second focuses on organization size, departmental and task differentiation and complexity, and the third perspective views the contents of the innovation, the social context and process of the implementation as related in an interactive process. We demonstrate the framework's applicability through two cases. We show that the three perspectives supplement each other and together provide a deeper understanding of the implementation process. Such understanding is crucial for the successful uptake of SPI approaches in software organizations. [source] Implementation of cognitive pharmaceutical services (CPS) in professionally active pharmaciesINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2005Trine R. Hopp Phd student Objective To investigate the implementation process of cognitive pharmaceutical services (CPS) in ,professionally active' pharmacies in Denmark; to describe the factors that influence the implementation process in the context of organisational theory. Method Twenty semi-structured interviews were conducted with pharmacy staff and owners in ,professionally active' pharmacies from 16 community pharmacies in Denmark. Key findings Fifty-one factors that influence the implementation process were identified. Based on their content and relationships, the factors were categorised into nine ,common sense' dimensions: network and relations with the environment; the environment's expectations and pressure for change; barriers to implementation of CPS; competence in relation to CPS; organising the pharmacy for provision of CPS; culture of the pharmacy; resources within the pharmacy; management within the pharmacy; the role of the pharmacy. Subsequently the 51 factors were categorised and described in relation to Leavitt's model of an organisation. Conclusion Implementation of CPS in the pharmacy is a very complex process, which is unique to the individual pharmacy. The model formed a relevant basis for describing the factors, and the theoretical analysis showed a complex interdependence of the factors identified in the study. Many interdependent factors influence the process and this has to be taken into account in designing future models for implementation of CPS. Such models should support comprehensive and flexible strategies that can be adapted to the dynamics of the individual organisation. [source] Promoting acute thrombolysis for ischaemic stroke (PRACTISE)INTERNATIONAL JOURNAL OF STROKE, Issue 2 2007Protocol for a cluster randomised controlled trial to assess the effect of implementation strategies on the rate, effects of thrombolysis for acute ischaemic stroke (ISRCTN 20405426) Rationale Thrombolysis with intravenous rtPA is an effective treatment for patients with ischaemic stroke if given within 3 h from onset. Generally, more than 20% of stroke patients arrive in time to be treated with thrombolysis. Nevertheless, in most hospitals, only 1,8% of all stroke patients are actually treated. Interorganisational, intraorganisational, medical and psychological barriers are hampering broad implementation of thrombolysis for acute ischaemic stroke. Aims To evaluate the effect of a high-intensity implementation strategy for intravenous thrombolysis in acute ischaemic stroke, compared with regular implementation; to identify success factors and obstacles for implementation and to assess its cost-effectiveness, taking into account the costs of implementation. Design The PRACTISE study is a national cluster-randomised-controlled trial. Twelve hospitals have been assigned to the regular or high-intensity intervention by random allocation after pair-wise matching. The high-intensity implementation consists of training sessions in conformity with the Breakthrough model, and a tool kit. All patients who are admitted with acute stroke and onset of symptoms not longer than 24 h are registered. Study outcomes The primary outcome measure is treatment with thrombolysis. Secondary outcomes are admission within 4 h after onset of symptoms, death or disability at 3 months, the rate of haemorrhagic complications in patients treated with thrombolysis, and costs of implementation and stroke care in the acute setting. Tertiary outcomes are derived from detailed criteria for the organisational characteristics, such as door-to-needle time and protocol violations. These can be used to monitor the implementation process and study the effectiveness of specific interventions. Discussion This study will provide important information on the effectiveness and cost-effectiveness of actively implementing an established treatment for acute ischaemic stroke. The multifaceted aspect of the intervention will make it difficult to attribute a difference in the primary outcome measure to a specific aspect of the intervention. However, careful monitoring of intermediate parameters as well as monitoring of accomplished SMART tasks can be expected to provide useful insights into the nature and role of factors associated with implementation of thrombolysis for acute ischaemic stroke, and of effective acute interventions in general. [source] Distributional Impacts of Pension Policy in Argentina: Winners and Losers within and Across GenerationsINTERNATIONAL SOCIAL SECURITY REVIEW, Issue 3 2006Camila Arza The paper deals with the life-cycle intra- and intergenerational income transfers operated by the pension system in Argentina by estimating the internal rates of return obtained by different generations and types of workers from their participation in the system. The empirical analysis confirms that earlier generations of workers benefited from higher social security returns than later generations, which retired under a matured system with large deficits. The worst-affected cohorts were those born after 1920, particularly suffering from a social security crisis and falling real wages. For future generations retiring fully under the new mixed pension system, returns will more closely depend on financial market performance and the evolution of administration costs. Intragenerational transfers were also observed for all cohorts under study, as a result of the original system design as well as adjustments adopted during the implementation process. The real distributional impact of progressive benefit formulas could, however, be offset by state transfers to cover pension deficits and forward tax shifting in a context of unequal pension coverage. [source] The essentials of Advance Care Planning for end-of-life care for older peopleJOURNAL OF CLINICAL NURSING, Issue 3-4 2010Sarah Yeun-Sim Jeong Aims and objectives., The aim of the study was to investigate the phenomenon of Advance Care Planning and the use of Advance Care Directives in residential aged care facilities in Australia. The objectives were to: ,,investigate the implementation process of Advance Care Planning and the use of Advance Care Directives; ,,investigate the outcomes of Advance Care Planning and experiences of people involved in Advance Care Planning and Advance Care Directives, including residents, families and nursing staff. Background., Benefits of Advance Care Planning for older residents are considerable given their degenerative health-breakdown and minimal chance of recovery. To date, the use of Advance Care Planning and Advance Care Directives is limited and models of service delivery and processes are needed to enhance best practice with Advance Care Planning and positive outcomes for older Australians. Design., Case study. Methods., The study conducted using multiple sources of evidence to enrich understanding of the phenomenon of Advance Care Planning. The researcher engaged in data collection over six months involving participant observation, field notes, semi-structured interviews and document analysis. The findings contribute to the limited knowledge of options currently available to older adults and their families in their decision-making about end-of-life care options. Permission to conduct the study., Prior to commencement of the data collection, ethics clearances from the University of Newcastle and the regional Area Health Service were achieved. Permission to access the residential aged care facilities to undertake the study was obtained from the relevant residential aged care facility ethics committees or designated authorities. The researcher undertook several strategies to ensure all the ethical principles were considered and adhered to while conducting the project. Results., The research identified the components and factors involved in the Advance Care Planning process and in attaining desired outcomes. The conceptual framework developed elaborates how Advance Care Planning should be implemented and what may constitute successful implementation of Advance Care Planning in residential aged care facilities. The four main elements (input, throughput, output, feedback), and 20 sub-elements were requisites for nurses to initiate and implement the Advance Care Planning. Conclusion., The essential components for end-of-life care are identified in the implementation processes of Advance Care Planning in residential aged care facilities. The study contributes to greater awareness of the processes needed for ,dying well' and highlights the need to explore experiences of ,successful dying' and the way nurses contribute to these events. Relevance to clinical practice., The case study identified four determinative requisites for successful implementation of Advance Care Planning in aged care facilities: the expert nurse, discussion, education and involvement of a multidisciplinary team. Nurses should take these factors into account and use person-centred approach in formalised processes to encourage participation in plans for end-of-life care. [source] Implementing peer support in schools: using a theoretical framework in action researchJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2004Maretha J. Visser Abstract The implementation of a peer support project in 13 schools from a disadvantaged background is discussed using the social ecological, systems and social construction theory as a theoretical guide in action research. The goal was to establish an alternative helping system in schools that was sustainable within the school system. In the implementation of peer support attention was given to the integration of the project into the existing context; encouraging participation on all levels, facilitating change and creating shared meanings, supporting the process of reorganizing and restructuring and providing feedback to facilitate further change. From a process evaluation of the programme implementation challenges in the implementation process were identified and recommendations made that could contribute to the optimal functioning and sustainability of the project to address the needs of learners and enhance well being in the school community. Copyright © 2004 John Wiley & Sons, Ltd. [source] Computerized physician order entry (CPOE) system: expectations and experiences of usersJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2010Jasperien E. Van Doormaal PharmD Abstract Objectives, To explore physicians' and nurses' expectations before and experiences after the implementation of a computerized physician order entry (CPOE) system in order to give suggestions for future optimization of the system as well as the implementation process. Method, On four internal medicine wards of two Dutch hospitals, 18 physicians and 42 nurses were interviewed to measure expectations and experiences with the CPOE system. Using semi-structured questionnaires, expectations and experiences of physicians and nurses with the CPOE system were measured with statements on a 5-point Likert scale (1 = completely disagree, 5 = completely agree). The percentage respondents agreeing (score of 4 or 5) was calculated. Chi-squared tests were used to compare the expectations versus experiences of physicians and nurses and to assess the differences between physicians and nurses. Results, In general, both physicians and nurses were positive about CPOE before and after the implementation of this system. Physicians and nurses did not differ in their views towards CPOE except for the overview of patients' medication use that was not clear according to the nurses. Both professions were satisfied with the implementation process. CPOE could be improved especially with respect to technical aspects (including the medication overview) and decision support on drug,drug interactions. Conclusion, Overall we conclude that physicians and nurses are positive about CPOE and the process of its implementation and do accept these systems. However, these systems should be further improved to fit into clinical practice. [source] Stakeholder perspectives on new ways of delivering unscheduled health care: the role of ownership and organizational identityJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2007Gill Haddow MA PhD Abstract Rationale, aims and objectives, To explore stakeholder perspectives of the implementation of a new, national integrated nurse-led telephone advice and consultation service [National Health Service 24 (NHS 24)], comparing the views of stakeholders from different health care organizations. Methods, Semi-structured interviews with 26 stakeholders including partner organizations located in primary and secondary unscheduled care settings [general practitioner (GP) out-of-hours cooperative; accident and emergency department; national ambulance service, members of NHS 24 and national policy makers. Attendance at key meetings, documentary review and email implementation diaries provided a contextual history of events with which interview data could be compared. Results, The contextual history of events highlighted a fast-paced implementation process, with little time for reflection. Key areas of partner concern were increasing workload, the clinical safety of nurse triage and the lack of communication across the organizations. Concerns were most apparent within the GP out-of-hours cooperative, leading to calls for the dissolution of the partnership. Accident and emergency and ambulance service responses were more conciliatory, suggesting that such problems were to be expected within the developmental phase of a new organization. Further exploration of these responses highlighted the sense of ownership within the GP cooperative, with GPs having both financial and philosophical ownership of the cooperative. This was not apparent within the other two partner organizations, in particular the ambulance service, which operated on a regional model very similar to that of NHS 24. Conclusions, As the delivery of unscheduled primary health care crosses professional boundaries and locations, different organizations and professional groups must develop new ways of partnership working, developing trust and confidence in each other. The results of this study highlight, for the first time, the key importance of understanding the professional ownership and identity of individual organizations, in order to facilitate the most effective mechanisms to enable that partnership working. [source] Interest group strategies in multi-level EuropeJOURNAL OF PUBLIC AFFAIRS, Issue 1 2007John Constantelos This article analyzes the political responses of French and Italian business associations to Economic and Monetary Union (EMU) in the EU. I propose and test the empirical relevance of a multi-level lobbying model for multi-tiered systems, a model assumed by, but never systematically examined in, the pluralism literature. Data for this ten-sector cross-national panel study come from personal interviews with the presidents of French and Italian business associations. The interviews were held at the beginning and the end of the euro implementation process. The research shows that organized groups routinely overstep their territorial jurisdictions to lobby across multiple levels of government in multi-level Europe. The degree of state political decentralization is a statistically significant variable in explaining the choice of lobbying target. This ,crucial comparative case study' finds that, in adjusting to deeper economic integration, regional associations in France focus their energy on the central government, while Italian groups favour the regional government. Copyright © 2007 John Wiley & Sons, Ltd. [source] Knowledge management implementation frameworks: a reviewKNOWLEDGE AND PROCESS MANAGEMENT: THE JOURNAL OF CORPORATE TRANSFORMATION, Issue 2 2004Kuan Yew Wong One reason why many organizations are still struggling with knowledge management (KM) and failing in their endeavours to realize its full potential is that they lack the support of a strong theoretical foundation to guide them in its implementation. A sound KM implementation framework helps to fulfil this need by providing important guiding principles and directions. However, developing such a framework can be a challenging task for managers and practitioners as they may lack the knowledge of what characteristics, elements and constructs should be included in it. Implementation frameworks that do not have the necessary elements in place can paint an incomplete picture of KM and its implementation process, thus providing a suboptimal guidance for conducting KM. This paper reviews the existing KM implementation frameworks presented in the literature in order to determine and propose a set of guidelines for constructing them. By utilizing these guidelines to develop a KM implementation framework, it is hoped that a stronger theoretical foundation can be constructed, thus facilitating the accomplishment of KM. Copyright © 2004 John Wiley & Sons, Ltd. [source] Coercion, Cooperation, and Control: Understanding the Policy Impact of Administrative Courts and the Ombudsman in the NetherlandsLAW & POLICY, Issue 1 2001Marc Hertogh This article examines the way in which administrative courts and the National Ombudsman in the Netherlands seek to control administrative action, and is aimed at developing a heuristic model that can also be useful in a wider context. Two styles of control will be introduced: "coercive" and "cooperative." An exploratory empirical study was conducted of two administrative agencies, investigating the implementation process of court and ombudsman decisions. This article argues that it is likely that the policy impact of the courts and the ombudsman is directly related to their style of control. More empirical research is needed to evaluate this hypothesis. [source] A Collective Case Study of the Implementation Process of the Nebraska Foreign Language Frameworks by Six TeachersMODERN LANGUAGE JOURNAL, Issue 4 2001Georgia Janavara Sarroub This case study explores the process of implementing the Nebraska Foreign Language Frameworks in an urban, Midwestern school district. The participants were two elementary, two middle school, and two high school teachers; the languages taught were French and Spanish. Data were collected through interviews, classroom observations, and lesson plans. The findings show that the 6 teachers implemented the Frameworks and that the implementation process differed, depending mainly on teaching experience and involvement in the writing of the Frameworks document. Among the 5 Cs, communication was the easiest to implement, whereas communities was the most challenging. Connections was implemented in depth by the elementary teachers due to their interdisciplinary teaching. By implementing the standards, the teachers learned to set clear objectives focusing on the learner, to plan with the outcomes in mind, to create thematic units addressing the 5 Cs, and to use various assessments, including portfolio and rubrics. [source] Librarians as agents of change: Working with curriculum committees using change agency theoryNEW DIRECTIONS FOR TEACHING & LEARNING, Issue 114 2008Tiffini A. Travis To sustain integration of information literacy into the university curriculum, librarians and faculty need to investigate theories of change. This chapter examines change agency theory as both a planning tool and an implementation process for integrating information literacy into the general education curriculum at CSULB. [source] Developing Evidence-Based Nursing Roles: Lessons Learned From the Health Care Integrator RoleNURSING FORUM, Issue 2 2008Jennifer J. Hatzfeld MEd, RN-BC TOPIC.,Developing evidence-based nursing roles. PURPOSE.,This study examined a unique nursing role in the United States Air Force to determine if it had been well institutionalized and to identify barriers and facilitators during the implementation process. SOURCE OF INFORMATION.,Individuals functioning in the role were surveyed to measure time spent on specific job-related tasks, additional duties, and positive and negative experiences. CONCLUSIONS.,Eighty-seven percent of the respondents (n = 45) indicated that the role had been well implemented, although wide variation existed in tasks performed and major organizational barriers identified. Findings of this study can be used to guide the development of other evidence-based positions. [source] Reducing alcohol related harm experienced by Indigenous Australians: identifying opportunities for Indigenous primary health care servicesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Anthony Shakeshaft Abstract Objective: Identify key issues and opportunities relating to the dissemination of cost-effective interventions for alcohol in Indigenous-specific settings. Methods: Update previous reviews of the Indigenous alcohol literature, particularly in relation to intervention and dissemination studies aimed at identifying and integrating into routine clinical care those strategies that are most cost-effective in reducing alcohol-related harm. Results: The harmful use of alcohol has been identified as a major public health issue, which has a disproportionately high negative impact on Indigenous Australians. While the disproportionately high burden of harm borne by Indigenous Australian communities is well documented in descriptive studies, attempts to redress this imbalance through well controlled intervention and dissemination studies appear to have been inadequate to date. There is compelling evidence from the non-Indigenous community that brief intervention is an effective treatment for harmful alcohol use, compared to the relatively lower levels of evidence for primary and tertiary level interventions. The effectiveness of brief intervention for alcohol in Indigenous Australian communities should, therefore, be examined. Conclusions and Implications: An opportunity exists to implement brief intervention into Indigenous primary health care settings, as an evidence-based strategy using established resources. There is the possibility that such Indigenous-specific health services research will lead the dissemination field in demonstrating how the implementation process can be successfully tailored to specific and defined clinical settings. [source] Decision Support Technology in Knowledge TranslationACADEMIC EMERGENCY MEDICINE, Issue 11 2007Brian R. Holroyd MD Information technologies, and specifically clinical decision support systems (CDSSs), are tools that can support the process of knowledge translation in the delivery of emergency department (ED) care. It is essential that during the implementation process, careful consideration be given to the workflow and culture of the ED environment where the system is to be utilized. Despite significant literature addressing factors contributing to successful deployment of these systems, the process is frequently problematic. Careful research and analysis are essential to evaluate the impact of the CDSS on the delivery of ED care, its influence on the health care providers, and the impact of the CDSS on clinical decision-making processes and information behaviors. The logistical and educational implications of CDSSs in the ED must also be considered. The specialty of emergency medicine must actively collaborate with other stakeholders in the design, implementation, and evaluation of CDSSs that will be utilized during the delivery of care to our patients. [source] Vested Interests in Addiction Research and Policy Alcohol policies out of context: drinks industry supplanting government role in alcohol policies in sub-Saharan AfricaADDICTION, Issue 1 2010Øystein Bakke ABSTRACT Background In this paper, we describe an analysis of alcohol policy initiatives sponsored by alcohol producer SABMiller and the International Center on Alcohol Policies, an alcohol industry-funded organization. In a number of sub-Saharan countries these bodies have promoted a ,partnership' role with governments to design national alcohol policies. Methodology A comparison was conducted of four draft National Alcohol Policy documents from Lesotho, Malawi, Uganda and Botswana using case study methods. Findings The comparison indicated that the four drafts are almost identical in wording and structure and that they are likely to originate from the same source. Conclusions The processes and the draft policy documents reviewed provide insights into the methods, as well as the strategic and political objectives of the multi-national drinks industry. This initiative reflects the industry's preferred version of a national alcohol policy. The industry policy vision ignores, or chooses selectively from, the international evidence base on alcohol prevention developed by independent alcohol researchers and disregards or minimizes a public health approach to alcohol problems. The policies reviewed maintain a narrow focus on the economic benefits from the trade in alcohol. In terms of alcohol problems (and their remediation) the documents focus upon individual drinkers, ignoring effective environmental interventions. The proposed policies serve the industry's interests at the expense of public health by attempting to enshrine ,active participation of all levels of the beverage alcohol industry as a key partner in the policy formulation and implementation process'. [source] Toward a hybrid model for usability resource allocation in industrial software product developmentHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2007Colleen M. Duffy The organizational aspects of user-centered software development in a financial services company are presented. The financial services industry sector is one of the industrial sectors to embark on the development of computer software as a consumer product. The nature of business in the service sector predisposes it to encounter difficulties in developing software aimed at meeting customer demands. Lack of familiarity and experience with the product design and implementation processes, as well as reliance on usability for acceptance, are major obstacles encountered. Difficulties, insights, and lessons learned regarding organizational ergonomics issues faced by a user-centered design group are provided, and a hybrid resource distribution model is proposed to guide other service sector companies in their future software development efforts. © 2007 Wiley Periodicals, Inc. Hum Factors Man 17: 245,262, 2007. [source] The essentials of Advance Care Planning for end-of-life care for older peopleJOURNAL OF CLINICAL NURSING, Issue 3-4 2010Sarah Yeun-Sim Jeong Aims and objectives., The aim of the study was to investigate the phenomenon of Advance Care Planning and the use of Advance Care Directives in residential aged care facilities in Australia. The objectives were to: ,,investigate the implementation process of Advance Care Planning and the use of Advance Care Directives; ,,investigate the outcomes of Advance Care Planning and experiences of people involved in Advance Care Planning and Advance Care Directives, including residents, families and nursing staff. Background., Benefits of Advance Care Planning for older residents are considerable given their degenerative health-breakdown and minimal chance of recovery. To date, the use of Advance Care Planning and Advance Care Directives is limited and models of service delivery and processes are needed to enhance best practice with Advance Care Planning and positive outcomes for older Australians. Design., Case study. Methods., The study conducted using multiple sources of evidence to enrich understanding of the phenomenon of Advance Care Planning. The researcher engaged in data collection over six months involving participant observation, field notes, semi-structured interviews and document analysis. The findings contribute to the limited knowledge of options currently available to older adults and their families in their decision-making about end-of-life care options. Permission to conduct the study., Prior to commencement of the data collection, ethics clearances from the University of Newcastle and the regional Area Health Service were achieved. Permission to access the residential aged care facilities to undertake the study was obtained from the relevant residential aged care facility ethics committees or designated authorities. The researcher undertook several strategies to ensure all the ethical principles were considered and adhered to while conducting the project. Results., The research identified the components and factors involved in the Advance Care Planning process and in attaining desired outcomes. The conceptual framework developed elaborates how Advance Care Planning should be implemented and what may constitute successful implementation of Advance Care Planning in residential aged care facilities. The four main elements (input, throughput, output, feedback), and 20 sub-elements were requisites for nurses to initiate and implement the Advance Care Planning. Conclusion., The essential components for end-of-life care are identified in the implementation processes of Advance Care Planning in residential aged care facilities. The study contributes to greater awareness of the processes needed for ,dying well' and highlights the need to explore experiences of ,successful dying' and the way nurses contribute to these events. Relevance to clinical practice., The case study identified four determinative requisites for successful implementation of Advance Care Planning in aged care facilities: the expert nurse, discussion, education and involvement of a multidisciplinary team. Nurses should take these factors into account and use person-centred approach in formalised processes to encourage participation in plans for end-of-life care. [source] Multi-attribute value theory as a framework for conflict resolution in river rehabilitationJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 2-3 2005Markus Hostmann Abstract Decision making in environmental projects is usually complex because of heterogeneous stakeholder interests, multiple objectives, long planning and implementation processes, and uncertain outcomes. Conflicting stakeholder interests in particular are often an important impediment to the realization and success of projects. Multiple criteria decision analysis (MCDA) methods are potentially useful for facilitating conflict resolution among stakeholder groups. However, some studies that have applied MCDA methods indicate that users are often skeptical about the value of MCDA methods and prefer the freedom of unaided decision making. We examine whether and how multi-attribute value theory (MAVT), a particular kind of MCDA, facilitates conflict resolution in environmental projects. Therefore, the MAVT method is applied to a specific river rehabilitation project in Switzerland (Thur River). The main questions are: (1) Can the MAVT method predict the final preferences of stakeholders and therefore anticipate conflicts at an early stage? (2) Do stakeholders reconsider and change their preferences after using the MAVT method? (3) If they do, does this result in more consensus-oriented decisions? We find that the principal advantage of the method in our case was not the prediction of stakeholders' final preferences, but rather the methods' ability to facilitate more consensus-oriented decisions. The paper discusses possible reasons for this finding and concludes with recommendations for future applications of the MAVT method in environmental decision making. Copyright © 2006 John Wiley & Sons, Ltd. [source] Adaptive Management and Watersheds: A Social Science Perspective,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 1 2008Catherine Allan Abstract: Adaptive management is often proposed as the most effective way to manage complex watersheds. However, our experience suggests that social and institutional factors constrain the search for, and integration of, the genuine learning that defines adaptive management. Drawing on our work as social scientists, and on a guided panel discussion at a recent AWRA conference, we suggest that watershed-scale adaptive management must be recognized as a radical departure from established ways of managing natural resources if it is to achieve its promise. Successful implementation will require new ways of thinking about management, new organizational structures and new implementation processes and tools. Adaptive management encourages scrutiny of prevailing social and organizational norms and this is unlikely to occur without a change in the culture of natural resource management and research. Planners and managers require educational, administrative, and political support as they seek to understand and implement adaptive management. Learning and reflection must be valued and rewarded, and fora established where learning through adaptive management can be shared and explored. The creation of new institutions, including educational curricula, organizational policies and practices, and professional norms and beliefs, will require support from within bureaucracies and from politicians. For adaptive management to be effective researchers and managers alike must work together at the watershed-scale to bridge the gaps between theory and practice, and between social and technical understandings of watersheds and the people who occupy and use them. [source] | |||||||||||||||||||||||||