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Organizational Barriers (organizational + barrier)
Selected AbstractsProfiles in Patient Safety: Organizational Barriers to Patient SafetyACADEMIC EMERGENCY MEDICINE, Issue 8 2002Shawna J. Perry MD No abstract is available for this article. [source] EMS models for business strategy developmentBUSINESS STRATEGY AND THE ENVIRONMENT, Issue 6 2002Dr. Stephen Tinsley This research investigation identifies the organizational barriers that can occur within large organizations to impede the introduction and development of environmental management systems (EMSs). The findings from the six case study investigations into multinational electronic and telecommunications organizations enabled the construction of four categorical models: devoid, isolated, devolved and integrated. They provide a profile of the way organizations use their EMSs and detail the types of organizational barrier that are likely to occur in each case. The models are designed to offer insight into the profile of the organization, the type of EMS being used and the operational advantages and disadvantages of using each model. They offer managers additional decision-making tools with which to assess the EMS profile of their own organization and those of competitor organizations and to assess the effectiveness of an organization's EMS in weak and strong economic conditions. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment [source] Alignment and Alliances for Research Institutes Engaged in Product Innovation.CREATIVITY AND INNOVATION MANAGEMENT, Issue 2 2003Two Case Studies Research institutes mainly engage in product innovation for the purpose of applying, testing and usually also transferring knowledge or technology. Managing product innovation processes in this type of environment leads to various problems with the establishment and managent of alliances and alignment. In this paper a systematic analysis of product innovation at two energy research institutes is presented, paying explicit attention to the strategic alliances in terms of alignment mechanisms. The cases illustrate clearly how the research institutes manage their external networks for product innovation, allowing comparison of the strengths and weaknesses of the two research institutes, and an indication of lessons to be learned from each other. The systematic analysis contributes to the identifying of the appropriate product innovaiton objectives to be pursued through strategic alliances, as well as the determination of suitable alignment mechanisms for product innovation. Lessons learned are presented in the area of context and contingency influences, crossing organizational barriers, differences in culture and the balancing of operational effectiveness and strategic flexibility. [source] Evaluation of a multifaceted intervention to limit excessive antipsychotic co-prescribing in schizophrenia out-patientsACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010L. Baandrup Baandrup L, Allerup P, Lublin H, Nordentoft M, Peacock L, Glenthoj B. Evaluation of a multifaceted intervention to limit excessive antipsychotic co-prescribing in schizophrenia out-patients. Objective:, To evaluate the effect of a multifaceted educational intervention on the frequency of antipsychotic co-prescribing in adult schizophrenia out-patients. Method:, Controlled quasi-experimental study performed in two Danish municipalities matched for baseline prevalence of antipsychotic polypharmacy, socioeconomic status and functional level of patients. The intervention was aimed at psychiatric healthcare providers and consisted of 1 day of didactic lectures, six 3-h educational outreach visits and an electronic reminder during drug prescribing. Results:, Between-group use of antipsychotic polypharmacy was compared at baseline (intervention group, N = 232/control group, N = 351) and after 1 year of intervention (intervention group, N = 216/control group, N = 386). The prevalence of antipsychotic polypharmacy at follow-up was not significantly different between treatment settings when adjusting for differences in case-mix (P = 0.07). Conclusion:, This multifaceted educational intervention failed to reduce the frequency of antipsychotic co-prescribing, but it suggested that future efforts to improve prescribing practice should address organizational barriers to implementation. [source] Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort studyDIABETIC MEDICINE, Issue 6 2008L. Prompers Abstract Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6,55%). At study entry, 77% of the patients had no or inadequate offloading. During follow-up, casting was used in 35% (0,68%) of the plantar fore- or midfoot ulcers. Predictors of use of casting were male gender, large ulcer size and being employed. Vascular imaging was performed in 56% (14,86%) of patients with severe limb ischaemia; revascularization was performed in 43%. Predictors of use of vascular imaging were the presence of infection and ischaemic rest pain. Conclusion Treatment of many patients is not in line with current guidelines and there are large differences between countries and centres. Our data suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot disease. [source] Strategic adaptation to change: A practical system for achieving breakthrough performanceGLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 3 2002Martin M. Stein One of the best ways to understand the value of and need for organizational learning is to begin by setting a goal. Then examine the organizational barriers to achieving it,and design the policies, programs, and practices that will overcome them. This process, properly sustained, can continuously upgrade an organization's core competencies and intellectual capital. People get energized, knowledge gets communicated and applied, and change becomes a challenge rather than a threat. © 2002 Wiley Periodicals, Inc. [source] Hospital inpatients' experiences of access to food: a qualitative interview and observational studyHEALTH EXPECTATIONS, Issue 3 2008Smriti Naithani BSc MSc Abstract Background, Hospital surveys indicate that overall patients are satisfied with hospital food. However undernutrition is common and associated with a number of negative clinical outcomes. There is little information regarding food access from the patients' perspective. Purpose, To examine in-patients' experiences of access to food in hospitals. Methods, Qualitative semi-structured interviews with 48 patients from eight acute wards in two London teaching hospitals. Responses were coded and analysed thematically using NVivo. Results, Most patients were satisfied with the quality of the meals, which met their expectations. Almost half of the patients reported feeling hungry during their stay and identified a variety of difficulties in accessing food. These were categorized as: organizational barriers (e.g. unsuitable serving times, menus not enabling informed decision about what food met their needs, inflexible ordering systems); physical barriers (not in a comfortable position to eat, food out of reach, utensils or packaging presenting difficulties for eating); and environmental factors (e.g. staff interrupting during mealtimes, disruptive and noisy behaviour of other patients, repetitive sounds or unpleasant smells). Surgical and elderly patients and those with physical disabilities experienced greatest difficulty accessing food, whereas younger patients were more concerned about choice, timing and the delivery of food. Conclusions, Hospital in-patients often experienced feeling hungry and having difficulty accessing food. These problems generally remain hidden because staff fail to notice and because patients are reluctant to request assistance. [source] Young people's perceptions of complaints procedures in local governmentINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 4 2002Carol Brennan Abstract This study examined 46 young people aged 16,24 years and evaluated their knowledge and awareness of the formal complaints procedures used by local government. Two areas in Scotland, one city (Edinburgh) and one town (Stirling), were chosen to participate in the study. Six focus groups, three in each area, were carried out to identify the level of awareness among the respondents and to permit a cross-section of educational backgrounds to be obtained. A questionnaire was used to assemble a profile on each participant. After analysis of the focus groups, a focused interview with the Corporate Complaints Officers from two councils was undertaken. Each interview incorporated an in-depth discussion regarding the formal complaints procedure while focusing on the young people within their constituency. The research revealed that young people's knowledge and awareness of local government complaints procedures is low, regardless of educational background and area of residence. For a minority, social factors such as confidence and competence do play a role although it is mainly organizational barriers, such as lack of information and access, which are the main causes of the problem. A number of young people indicated that they would complain if they knew how to execute a complaint successfully. The service providers were knowledgeable that awareness is low among this age group. [source] Disasters, Lessons Learned, and Fantasy DocumentsJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2009Thomas A. Birkland This article develops a general theory of why post-disaster ,lessons learned' documents are often ,fantasy documents'. The article describes the political and organizational barriers to effective learning from disasters, and builds on general theory building on learning from extreme events to explain this phenomenon. Fantasy documents are not generally about the ,real' causes and solutions to disasters; rather, they are generated to prove that some authoritative actor has ,done something' about a disaster. Because it is difficult to test whether learning happened after an extreme event, these post-disaster documents are generally ignored after they are published. [source] The relative effectiveness of practice change interventions in overcoming common barriers to change: a survey of 14 hospitals with experience implementing evidence-based guidelinesJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2007Fiona Simpson MND Abstract Aims and objectives, Changing practice to reflect current best evidence can be costly and time-consuming. The purpose of this survey was to determine the optimal combination of practice change interventions needed to overcome barriers to practice change commonly encountered in the intensive care unit (ICU). Design, A survey instrument delivered by mail with email follow-up reminders. Setting, Fourteen hospitals throughout Australia and New Zealand. Subjects, Individuals responsible for implementing an evidence-based guideline for nutritional support in the ICU. Survey, Practice change interventions were ranked in order of effectiveness and barriers to change were ranked in order of how frequently they were encountered. Results, A response rate of 100% was achieved. Interventions traditionally regarded as strong (academic detailing, active reminders) were ranked higher than those traditionally regarded as moderate (audit and feedback), or weak (posters, mouse mats). The high ranks of the site initiation visit (educational outreach, modest) and in-servicing (didactic lectures, weak) were unexpected, as was the relatively low rank of educationally influential, peer-nominated opinion leaders. Four hospitals reported the same doctor-related barrier as ,most common' and the remaining 10 hospitals reported three different doctor-related barriers, two nursing-related barriers and three organizational barriers as most common. Conclusions, When designing a multifaceted, multi-centre change strategy, the selection of individual practice change interventions should be based on: (1) an assessment of available resources; (2) recognition of the importance of different types of barriers to different sites; (3) the potential for combinations of interventions to have a synergistic effect on practice change, and (4) the potential for combinations of interventions to actually reduce workload. [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] EMS models for business strategy developmentBUSINESS STRATEGY AND THE ENVIRONMENT, Issue 6 2002Dr. Stephen Tinsley This research investigation identifies the organizational barriers that can occur within large organizations to impede the introduction and development of environmental management systems (EMSs). The findings from the six case study investigations into multinational electronic and telecommunications organizations enabled the construction of four categorical models: devoid, isolated, devolved and integrated. They provide a profile of the way organizations use their EMSs and detail the types of organizational barrier that are likely to occur in each case. The models are designed to offer insight into the profile of the organization, the type of EMS being used and the operational advantages and disadvantages of using each model. They offer managers additional decision-making tools with which to assess the EMS profile of their own organization and those of competitor organizations and to assess the effectiveness of an organization's EMS in weak and strong economic conditions. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment [source] | |||||||||||||