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Successful Implementation (successful + implementation)
Selected AbstractsThe 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] Matching network design using non-Foster impedancesINTERNATIONAL JOURNAL OF RF AND MICROWAVE COMPUTER-AIDED ENGINEERING, Issue 2 2006*Article first published online: 8 FEB 200, Stephen E. Sussman-Fort Abstract Non-Foster synthesis bypasses the gain-bandwidth limitations of conventional LC matching and achieves superior broadband performance by employing negative circuit elements, which are realized via negative impedance converters. The idea is to construct a negative-image model of an antenna, which cancels the antenna's parasitic reactance and transforms its frequency-dependent radiation resistance to a constant value. Successful implementation of negative-image modeling requires the realization of stable, low-loss negative elements. After a discussion of the basic ideas of non-Foster matching, we present experimental results for broadband, stable, high- Q, grounded negative capacitance. Next, in the first experimental confirmation of non-Foster impedance matching for signal reception, we use a floating negative capacitor to cancel a substantial portion of the reactance of a 6-in. monopole antenna. Over 20,110 MHz, the signal-to-noise ratio improved by up to 6 dB as compared to the same antenna with no matching, or to a lossy-matched blade antenna of twice the size. © 2006 Wiley Periodicals, Inc. Int J RF and Microwave CAE, 2006. [source] Undernutrition among children in South and South-East AsiaJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9 2010Sant-Rayn Pasricha Abstract Undernutrition remains a major public health problem among children living in Asia. Although the burden is maximal among poorer, rural and Indigenous communities, the problem affects the majority in many Asian countries, especially in South Asia. In order to prevent the pervasive consequences of undernutrition, strategies that address this burden are required. Successful implementation of strategies may be limited by the complex aetiology of undernutrition, including the political setting. Rising food insecurity because of climate change, land use for biofuel production and the recent global financial crisis threaten to exacerbate childhood malnutrition. In this review, we describe the burden of undernutrition among Asian children and discuss contributing factors and potential solutions. [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] Successful implementation of a nurse-led teaching programme to independently administer subcutaneous methotrexate in the community setting to children with Crohn's diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009V. GARRICK Summary Background, Methotrexate is increasingly used as a third line immunosuppression agent in children with Crohn's disease (CD). Methotrexate is traditionally administered in the hospital setting. Aim, To set up a nurse-led education programme to teach children/their parents to administer subcutaneous methotrexate in the community. Methods, All patients were given methotrexate over a 16-month period. Patient demographics including previous treatments were collected. A competency based teaching package was implemented by the inflammatory bowel disease nurse. Distances and travel times together with costings were calculated. Results, Thirty two patients (19 male; 13 female) with a median treatment age of 11.96 years (IQR 10.67,13.92) were studied. Thirty of 32 (17 children, 13 parents) were independently administering methotrexate. The median return journey distance to hospital was 23 miles (IQR 14.4,42.4) taking a median time of 52 min (IQR 41.0,73.5) for each injection. The total patient travel saving was £10 537 (average £730 per patient) and nursing time saving was £12 808 with home administration (total saving £23 345). Conclusions, This paediatric study demonstrates that methotrexate injections can be given successfully in the majority (94%) of patients with CD independently in the community, resulting in significant time and money savings for patients and health professionals alike. [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] Teledermatology in the U.K.: lessons in service innovationBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2007T.L. Finch Summary Background, Teledermatology has the potential to revolutionize the delivery of dermatology services by facilitating access to specialist services at a distance. In the U.K. over the previous decade there have been numerous attempts at introducing and using teledermatology; however, the development of teledermatology as routine service provision remains limited. Objectives, To identify factors that promote successful use of teledermatology as a part of routine service provision. Methods, A longitudinal qualitative study of teledermatology, drawing on data from in-depth semistructured interviews; observations of systems in practice; and public meetings. Data were analysed collectively by the research team using established qualitative analytical techniques to identify key thematic categories. The sample consisted of teledermatology services within the U.K. (n = 12) studied over 8 years (1997,2005). Individual participants (n = 68 interviews) were consultant dermatologists, researchers, teledermatology nurses, administrators, patient advocates, general practitioners and technologists. Results, The analysis compared services that did or did not become part of routine healthcare practice to identify features that supported the normalization of teledermatology. Requirements for using and integrating teledermatology into practice included: political support; perceived benefit and relative commitment that outweighs effort; pragmatic approaches to proving efficacy and safety; perception of risk as being ,manageable' on the basis of professional judgement; high levels of flexibility in practice (in terms of individuals, technology and organization); and reconceptualizing professional roles. Conclusions, Successful implementation of teledermatology as a routine service requires greater understanding of and attention to the interplay between social and technical aspects of teledermatology, and how this is accommodated both by healthcare professionals and the organizations in which they work. [source] The economic burden of heart failureCLINICAL CARDIOLOGY, Issue S3 2000J. B. O'Connell M.D. Abstract Heart failure, a major cause of morbidity and mortality among the elderly, is a serious public health problem. As the population ages and the prevalence of heart failure increases, expenditures related to the care of these patients will climb dramatically. As a result, the health care industry must develop strategies to contain this staggering economic burden. Strategies may include adopting approaches for preventing heart failure and implementing new treatment modalities with proven efficacy into large-scale clinical practice. Successful implementation of these strategies will require intensive physician and patient education and development of innovative approaches to fund support services. [source] Implementation of kangaroo mother care: A randomized trial of two outreach strategiesACTA PAEDIATRICA, Issue 7 2005Robert C Pattinson Abstract Aim: To test whether a well-designed educational package on the implementation of kangaroo mother care (KMC) used on its own can be as effective in implementing KMC in a healthcare facility as the combination of a visiting facilitator used in conjunction with the package. Setting: Thirty-four hospitals in KwaZulu-Natal Province, South Africa. Method: The hospitals were paired with respect to their geographical location and annual number of births at the facility. One hospital in each pair was randomly allocated to receive either the implementation package alone (group A) or the implementation package and visits from a facilitator (group B). Hospitals in group B received three facilitation visits. All hospitals were evaluated by a site visit 8 mo after launching the process and were scored by means of a progress-monitoring tool. Outcomes: Successful implementation was regarded as demonstrating evidence of practice (score>10) during the site visit. Results: Group B scored significantly better than group A (p<0.05). All 17 hospitals in group B demonstrated evidence of practice, with the median score of the group being 15.44 (range 10.29,22.94). Twelve of the hospitals in group A demonstrated evidence of practice and the median score was 11.33 (range 1.08,21.13). Conclusion: Successful implementation was achieved in most of the hospitals irrespective of the strategy used. However, facilitation with an implementation package was clearly superior to using a package alone. Some sites do not need facilitation for successful implementation. [source] Evaluation of a dynamic multi-class sediment transport model in a catchment under soil-conservation agricultureEARTH SURFACE PROCESSES AND LANDFORMS, Issue 11 2008Peter Fiener Abstract Soil erosion models are essential tools for the successful implementation of effective and adapted soil conservation measures on agricultural land. Therefore, models are needed that predict sediment delivery and quality, give a good spatial representation of erosion and deposition and allow us to account for various soil conservation measures. Here, we evaluate how well a modified version of the spatially distributed multi-class sediment transport model (MCST) simulates the effectiveness of control measures for different event sizes. We use 8 year runoff and sediment delivery data from two small agricultural watersheds (0·7 and 3·7 ha) under optimized soil conservation. The modified MCST model successfully simulates surface runoff and sediment delivery from both watersheds; one of which was dominated by sheet and the other was partly affected by rill erosion. Moreover, first results of modelling enrichment of clay in sediment delivery are promising, showing the potential of MCST to model sediment enrichment and nutrient transport. In general, our results and those of an earlier modelling exercise in the Belgian Loess Belt indicate the potential of the MCST model to evaluate soil erosion and deposition under different agricultural land uses. As the model explicitly takes into account the dominant effects of soil-conservation agriculture, it should be successfully applicable for soil-conservation planning/evaluation in other environments. Copyright © 2008 John Wiley & Sons, Ltd. [source] Advancing the metabolic theory of biodiversityECOLOGY LETTERS, Issue 10 2009James C. Stegen Abstract A component of metabolic scaling theory has worked towards understanding the influence of metabolism over the generation and maintenance of biodiversity. Specific models within this ,metabolic theory of biodiversity' (MTB) have addressed temperature gradients in speciation rate and species richness, but the scope of MTB has been questioned because of empirical departures from model predictions. In this study, we first show that a generalized MTB is not inconsistent with empirical patterns and subsequently implement an eco-evolutionary MTB which has thus far only been discussed qualitatively. More specifically, we combine a functional trait (body mass) approach and an environmental gradient (temperature) with a dynamic eco-evolutionary model that builds on the current MTB. Our approach uniquely accounts for feedbacks between ecological interactions (size-dependent competition and predation) and evolutionary rates (speciation and extinction). We investigate a simple example in which temperature influences mutation rate, and show that this single effect leads to dynamic temperature gradients in macroevolutionary rates and community structure. Early in community evolution, temperature strongly influences speciation and both speciation and extinction strongly influence species richness. Through time, niche structure evolves, speciation and extinction rates fall, and species richness becomes increasingly independent of temperature. However, significant temperature-richness gradients may persist within emergent functional (trophic) groups, especially when niche breadths are wide. Thus, there is a strong signal of both history and ecological interactions on patterns of species richness across temperature gradients. More generally, the successful implementation of an eco-evolutionary MTB opens the perspective that a process-based MTB can continue to emerge through further development of metabolic models that are explicit in terms of functional traits and environmental gradients. [source] From plan to practice: Implementing watershed-based strategies into local, state, and federal policy,ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 4 2000Alice L. Jones Abstract Planners are becoming increasingly interested in watershed-based plans as a way to more accurately reflect the natural landscape processes that cross the borders of political jurisdictions. Although developing plans that cross political boundaries is a relatively simple matter, establishing the transboundary authority necessary to implement such plans is often a much different matter. We investigated the regulatory mechanisms under which a watershed-based storm-water management plan could be implemented in the Big Darby Creek, Ohio, USA, a national scenic river currently facing critical threats from nonpoint sediment- and pollutant-loaded storm-water runoff in the rapidly urbanizing portions of the watershed. The watershed encompasses portions of 7 counties, 11 incorporated areas, and 26 townships, each of which has some authority over land use and storm water. The transboundary options explored include creation of a storm-water utility, creating a conservancy district, or an independent approach requiring all jurisdictions in the watershed to simultaneously adopt a series of storm-water ordinances. We evaluated these options on a number of characteristics, including their relative ability to control runoff quality and quantity, the locus of political control and enforcement authority under each, funding considerations, and the likelihood of acceptance given the region's existing political realities. Although a central authority such as a conservancy district or storm-water management district would likely be most effective in protecting water quality, the long tradition of local controls on land use makes this politically infeasible. Thus, we argue that a watershed-based protection plan for the Darby region will require the simultaneous independent approach. The case study of the Big Darby suggests that the successful implementation of watershed-based plans may be more dependent on the plan's political savvy than its technical superiority. [source] Quality assurance of specialised treatment of eating disorders using large-scale internet-based collection systems: Methods, results and lessons learned from designing the Stepwise databaseEUROPEAN EATING DISORDERS REVIEW, Issue 4 2010Andreas Birgegård Abstract Computer-based quality assurance of specialist eating disorder (ED) care is a possible way of meeting demands for evaluating the real-life effectiveness of treatment, in a large-scale, cost-effective and highly structured way. The Internet-based Stepwise system combines clinical utility for patients and practitioners, and provides research-quality naturalistic data. Stepwise was designed to capture relevant variables concerning EDs and general psychiatric status, and the database can be used for both clinical and research purposes. The system comprises semi-structured diagnostic interviews, clinical ratings and self-ratings, automated follow-up schedules, as well as administrative functions to facilitate registration compliance. As of June 2009, the system is in use at 20 treatment units and comprises 2776 patients. Diagnostic distribution (including subcategories of eating disorder not otherwise specified) and clinical characteristics are presented, as well as data on registration compliance. Obstacles and keys to successful implementation of the Stepwise system are discussed, including possible gains and on-going challenges inherent in large-scale, Internet-based quality assurance. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [source] The design process of expert systems development: some concernsEXPERT SYSTEMS, Issue 2 2006Mehdi Sagheb-Tehrani Abstract: A discussion is presented of why some expert systems that organizations have developed are not successful. The concept of design process plays a very significant role at the outset of the expert system development process. This concept has not been the subject of much debate and attention in expert systems development. From the author's point of view, one of the main issues is how the designer (knowledge engineer) thinks about the design process. In general, the designer's process is influenced by the knowledge engineer's conception. This paper endeavors to disclose some of the main factors related to the knowledge engineer's conception of the design process and an attempt is made to put forward a conceptual model of the expert system design process. This conceptual model is an initial step towards a successful implementation of expert system projects. [source] Inclusive Design in Apparel Product Development for Working Women With Physical DisabilitiesFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 4 2007Kate E. Carroll Consumers with physical limitations want apparel products and retail environments that work for them. Inclusive design is a framework for developing products to satisfy multiple consumers, regardless of their physical ability. This qualitative study reports on physical limitations and apparel preferences of working women (n = 9) with a variety of limitations. A prototype for a garment was developed, wear-tested, and evaluated using inclusive design criteria. Subsequently, manufacturers (n = 6) were interviewed regarding production and distribution within the existing system. Results indicate that (a) the effect of disability on the body supercedes clinical definition for apparel product development, (b) working women with various disabilities have similar apparel needs, (c) inclusive design can be a successful strategy for product development, and (d) current industry perceptions about disability present the greatest barrier to successful implementation. The researchers conclude that further studies should focus on industry "buy-in" of inclusive design as a framework for product development. [source] Integrating physiology and life history to improve fisheries management and conservationFISH AND FISHERIES, Issue 4 2006Jeffery L. Young Abstract Knowledge of life-history traits is increasingly recognized as an important criterion for effective management and conservation. Understanding the link between physiology and life history is an important component of this knowledge and in our view is particularly relevant to understanding marine and freshwater fishes. Such linkages (i.e. the life-history/physiology nexus) have been recently advocated for avian systems and here we explore this concept for fish. This paper highlights the gap in fisheries literature with regard to understanding the relationship between physiology and life history, and proposes ways in which this integration could improve fisheries management and conservation. We use three case studies on different fishes (i.e. the Pacific salmon, the grouper complex and tuna) to explore these issues. The physiological structure and function of fish plays a central role in determining stock response to exploitation and changes in the environment. Physiological measures can provide simple indicators necessary for cost-effective monitoring in the evaluation of fisheries sustainability. The declining state of world fisheries and the need to develop and implement restoration strategies, such as hatchery production or protected areas, provides strong incentive to better understand the influence of physiology on population and reproductive dynamics and early life history. Physiology influences key population-level processes, particularly those dealing with reproduction, which must be incorporated into the design and successful implementation of specific and broadscale initiatives (e.g. aquatic protected areas and bycatch reduction). Suggestions are made for how to encourage wider application of the physiology/life-history link, in fisheries management and conservation, as well as more broadly in education and research. [source] Organizational power and culture shift at Ducati motorcyclesGLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 1 2007Maktoba Omar In this research into corporate culture at Ducati Motorcycles, Spa., the qualitative approach was used based on Johnson's theory of corporate culture, relying on structured and unstructured interviews followed up by participant observation. Corporate culture was used as a strategic tool in changing the Ducati corporate mindset. The results show that the recognition and alteration of corporate culture played a large role in the successful implementation of a new corporate strategy. The Ducati strategic initiative focused on repositioning Ducati from a traditional Italian motorcycle manufacturer to a global marketing company. © 2007 Wiley Periodicals, Inc. [source] A collaborative approach to embedding graduate primary care mental health workers in the UK National Health ServiceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2008Janine Fletcher MSc Abstract The UK National Health Service (NHS) workforce has recently seen the arrival of the Graduate Mental Health Worker (GMHW) in primary care. We established a Quality Improvement Collaborative to assist in embedding this new workforce in one Strategic Health Authority Area of England. The intervention utilised ,collaborative' technology which involves bringing together groups of practitioners from different organizations to work in a structured way to improve the quality of their service. The process was evaluated by an action research project in which all stakeholders participated. Data collection was primarily qualitative. During the project, there was an increase in throughput of new patients seen by the GMHWs and increased workforce satisfaction with a sense that the collaborative aided the change process within the organizations. Involvement of managers and commissioners from the Primary Care Trusts where the GMHWs were employed appeared to be important in achieving change. This was not, however, sufficient to combat significant attrition of the first cohort of workers. The project identified several barriers to the successful implementation of a new workforce for mental health problems in primary care, including widespread variation in the level and quality of supervision and in payment and terms of service of workers. A collaborative approach can be used to support the development of new roles in health care; however, full engagement from management is particularly necessary for success in implementation. The problems faced by GMHWs reflect those faced by other new workers in healthcare settings, yet in some ways are even more disturbing given the lack of governance arrangements put in place to oversee these developments and the apparent use of relatively unsupported and inexperienced novices as agents of change in the NHS. [source] Decision aids in routine practice: lessons from the breast cancer initiativeHEALTH EXPECTATIONS, Issue 3 2006Kerry A. Silvia BA Abstract Background, Many decision aids have been developed to help patients make treatment and screening decisions; however, little is known about implementing them into routine clinical practice. Objective, To assess the feasibility of implementing a patient decision aid (PtDA) for the early stage breast cancer surgical decision into routine clinical care. Design, Structured individual interviews. Setting and participants, A convenience sample of providers from nine sites, including two community resource centres, a community hospital and six academic centres. Main outcome measures, Usage data, barriers to and resources for implementing the PtDAs. Results, Six of the nine sites were using the PtDAs with patients. Two sites were primarily using a scheduling system and four sites relied on a lending system. For the academic centres, the keys to successful implementation included integrating the PtDA into the flow of patients through the centre and having physicians who recommended it to patients. At the community centres, the keys to successful implementation included an informed staff and the flexibility to get the PtDAs to patients in different ways. Barriers that limited or prevented sites from using the PtDA included a lack of clinical support, a lack of system support, competing priorities and scheduling problems. Conclusions, It is feasible to implement a breast cancer PtDA into routine clinical care at academic centres and community resource centres. Future research should assess the effectiveness of PtDAs in routine clinical care as well as resources and barriers to their implementation in community hospitals. [source] Clinical Practice Guideline Implementation Strategy Patterns in Veterans Affairs Primary Care ClinicsHEALTH SERVICES RESEARCH, Issue 1p1 2007Sylvia J. Hysong Background. The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success. Objective. This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA. Research Design. Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs. Subjects. One hundred and two employees (management, quality improvement, clinic personnel) involved with guideline implementation at each VAMC primary care clinic. Measures. Participants reported specific strategies used by their facility to implement guidelines in 1-hour semi-structured interviews. Facilities were classified as high or low performers based on their guideline adherence scores calculated through independently conducted chart reviews. Findings. High performing facilities (HPFs) (a) invested significantly in the implementation of the electronic medical record and locally adapting it to provider needs, (b) invested dedicated resources to guideline-related initiatives, and (c) exhibited a clear direction in their strategy choices. Low performing facilities exhibited (a) earlier stages of development for their electronic medical record, (b) reliance on preexisting resources for guideline implementation, with little local adaptation, and (c) no clear direction in their strategy choices. Conclusion. A multifaceted, yet targeted, strategic approach to guideline implementation emphasizing dedicated resources and local adaptation may result in more successful implementation and higher guideline adherence than relying on standardized resources and taxing preexisting channels. [source] Design for usability on supply chain management systems implementationHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 5 2009Chao-Hsien Lin Supply chain management (SCM) systems implementation has become a fashion due to advances in information technology and pressures of market competition. Unfortunately, successful implementation was rare. In this article, the concept of usability was extended in an explorative case study to crystallize design for usability (DFU) principles in a large-scale SCM systems implementation project at a leading semiconductor manufacturing company in Taiwan. Proposed was a holistic usability framework to guide the analysis of DFU as well as the compilation of an evidence database composed of design documentation, post hoc evaluation, semistructured interviews, and participant observation. This research revealed a set of usability needs and coping strategies found throughout a series of systems design and redesign processes at the case company. As a result, an emergent usability framework in the form of ICOM (Input, Control, Output, and Mechanism) dimensions was proposed to guide the implementation of SCM systems. © 2009 Wiley Periodicals, Inc. [source] Capabilities, processes, and performance of knowledge management: A structural approachHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 1 2007Young-Chan Lee The purpose of this study is to examine structural relationships among the capabilities, processes, and performance of knowledge management, and suggest strategic directions for the successful implementation of knowledge management. To serve this purpose, the authors conducted an extensive survey of 68 knowledge management-adopting Korean firms in diverse industries and collected 215 questionnaires. Analyzing hypothesized structural relationships with the data collected, they found that there exists statistically significant relationships among knowledge management capabilities, processes, and performance. The empirical results of this study also support the well-known strategic hypothesis of the balanced scorecard (BSC). © 2007 Wiley Periodicals, Inc. Hum Factors Man 17: 21,41, 2007. [source] TPM,Total Productive Maintenance: Impact on competitiveness and a framework for successful implementationHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 4 2001K.S. Park Total Productive Maintenance (TPM) describes a synergistic relationship among all organizational functions, but particularly between production and maintenance, for continuous improvement of product quality, operational efficiency, capacity assurance, and safety. This article provides the key factors that are critical to the successful implementation of TPM. It is thus crucial to provide and discuss those factors for more effective TPM implementation. Also, this study explores the impact of TPM on the competitiveness of the company. This research concludes that long-term benefits of TPM are the result of considerable investment in human resource development and management. For TPM practitioners, we advise to build a supportive culture and environment with a strong emphasis on human and organizational aspects to promote effective TPM implementation. © 2001 John Wiley & Sons, Inc. [source] Ergonomics considerations and management action in the implementation of industrial robotsHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2001Biman Das To obtain maximum benefit from the implementation of industrial robots, it is necessary to identify specific ergonomics problems and provide answers to such problems. Special features of a typical industrial robot are described. Specific ergonomics problems are identified and discussed: sociopsychological factors, systems safety design, communications, training, and workplace design. For the successful implementation of industrial robots, management should take timely action with regard to advanced planning procedures, user involvement plans, communication channels, company labor policies, and continuous training programs. The technological change from conventional to advanced manufacturing, such as industrial robots, must be jointly supported by all levels of management and workers. © 2001 John Wiley & Sons, Inc. [source] Human resource manager insights on creating and sustaining successful reduced-load work arrangementsHUMAN RESOURCE MANAGEMENT, Issue 4 2008Alyssa Friede Although human resource managers have critical insights into the successful implementation of reduced-load work arrangements, relatively few studies focus on their perspective. These arrangements are a growing work form for employees who choose to work less than full-time with a commensurate decrease in salary. Qualitative data analysis was used to identify key success factors noted in interviews with 52 HR managers in 39 companies. Individual employee characteristics (e.g., self-regulatory work habits) were viewed as most critical. Also important were the design of the arrangement (e.g., clarifying the arrangement in advance) and workgroup relationships (e.g., positive supervisor-employee relationships). We conclude with eight new takeaways for HR managers on how to create and sustain successful reduced-load work arrangements and directions for future research and practice. © 2008 Wiley Periodicals, Inc. [source] 360 Feedback from Another AngleHUMAN RESOURCE MANAGEMENT, Issue 1 2001David W. Bracken How do you know if a 360 process has been implemented successfully? What are the factors that influence its success? How can those factors be controlled by those responsible for its implementation? Despite its popularity, there has been little effort to build a comprehensive model that addresses these fundamental questions about 360 feedback. In a quest for such a model, we identify a host of key factors organized according to whether they exert their influence proximally or distally. We discuss how each factor contributes to successful implementation. After identifying how design features of a 360 process affect these key factors, we recommend how to enhance the probability of implementing 360 feedback successfully and sustaining the process over time. © 2001 John Wiley & Sons, Inc. [source] Creating social capital in MNCs: the international human resource management challengeHUMAN RESOURCE MANAGEMENT JOURNAL, Issue 4 2007Sully Taylor Social capital has assumed a critical role in the successful implementation of global strategy for multinational companies (MNCs). The article focuses on the ways in which the international human resource management (IHRM) system and those responsible for it influence the creation and utilisation of social capital in MNCs. It examines the challenges posed to IHRM by the wide diversity of definitions and manifestations of social capital found in the multiple cultural contexts of the global business environment and provides a framework on how to approach the cultural influences on the definitions and behavioural expressions of social capital. It also critically assesses the recommendations that have been made regarding developing social capital in MNCs, the competencies most critical to the ability to develop social capital in multiple cultural settings, and provides a set of recommendations for future research in this area. [source] Experimental studies of direction of arrivals using a smart antenna testbed in wireless communication systemsINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 3 2003Shiann-Shiun Jeng Abstract This paper presents some preliminary results from experimental studies on space-division-multiple-access (SDMA) for wireless communications. A smart antenna system utilizing direction-of-arrival (DOA)-based beamforming techniques can enhance signal quality by reducing co-channel interference from mobiles located at angles spatially distinct from the base station. Adopting both smart uplink and downlink beamforming, a communication system with an antenna array can increase the cell coverage of a base station and significantly boost capacity compared with conventional antenna systems. However, successful implementation of DOA-based beamforming techniques depends on the DOA characteristics. This paper presented the feasibility of direction finding and DOA variation with respect to frequency. Furthermore, the angle spread was studied for selected environments. The results demonstrate the feasibility of applying proposed smart antenna system utilizing DOA-based beamforming algorithm for increasing channel capacity and improving system performance in frequency-division-duplex (FDD) wireless communication systems. Copyright © 2003 John Wiley & Sons, Ltd. [source] A methodological and operative framework for the evaluation of an e-health projectINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2008Luca Buccoliero Abstract Assessing public sector ICT investments represents the premise for successful implementation of an e-health strategy. The recent literature stresses the importance of going beyond the mere financial and/or technical dimensions of the analysis. Consequently, the paper proposes an example of e-health project evaluation aiming to develop measures which get close to the notion of benefits to the different stakeholders involved: top management, patients, local community. The case study refers to an Italian health care organization that implemented a project of digitalization of its clinical reports production few years ago. Based on on-field research, different approaches are used to assess costs and benefits from different stakeholders' perspectives. The results of a multidimensional evaluation are reported to emphasize the need for different measures to assess the sustainability of an e-health project according to the financial convenience, the social role of the organization, and the contingent situation. Copyright © 2007 John Wiley & Sons, Ltd. [source] Mental health nurse practitioners in Australia: Improving access to quality mental health careINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2005Jacklin E. Fisher ABSTRACT:, Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority ,area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners. 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