WorldWideScience

Sample records for hit implementation success

  1. Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation.

    Science.gov (United States)

    Yen, Po-Yin; McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

    2017-09-07

    In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. ©Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 07.09.2017.

  2. Implementation of a rapid HIT immunoassay at a university hospital - Retrospective analysis of HIT laboratory orders in patients with thrombocytopenia.

    Science.gov (United States)

    Black, Anne; Heimerl, Susanne; Oertli, Linnéa; Wilczek, Wolf; Greinacher, Andreas; Spannagl, Michael; Herr, Wolfgang; Hart, Christina

    2017-10-01

    Heparin-induced thrombocytopenia (HIT) is a rare cause of thrombocytopenia and a potentially life-threatening adverse drug reaction. Clinical overdiagnosis of HIT results in costly laboratory tests and anticoagulation. Criteria and algorithms for diagnosis are established, but their translation into clinical practice is still challenging. In a retrospective approach we studied all HIT related laboratory test requests within four years and evaluated data before (1st period, 24month) and after (2nd period, 24month) replacing particle gel immunoassay (PaGIA) and enzyme-linked immunosorbent assay (ELISA) by a chemiluminescent immunoassay (CLIA). HIT was confirmed by heparin-induced platelet activation (HIPA) test. Clinical pretest probability for HIT using an implemented simplified 4Ts score and platelet count were evaluated. Costs for laboratory tests and alternative anticoagulation were calculated. In 1850 patients with suspected HIT, 2327 laboratory orders were performed. In 87.2% of these orders an intermediate/high simplified 4Ts score was found. Thrombocytopenia was present in 87.1%. After replacing PaGIA and ELISA by CLIA the number of immunological and functional laboratory tests was reduced by 38.2%. The number of positive HIT immunoassays declined from 22.6% to 6.0%, while the number of positive HIPA tests among positive immunological tests increased by 19%. Altogether, acute HIT was confirmed in 59 patients. A decline in the use of alternative anticoagulants was observed in the 2nd period. Our study shows that in a university hospital setting HIT is well-known, but diagnosis requires a precise laboratory confirmation. Replacing PaGIA and ELISA by CLIA did not influence laboratory order behavior but results in reduced overall costs for laboratory diagnostics and alternative anticoagulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Auditing Marketing Strategy Implementation Success

    OpenAIRE

    Herhausen, Dennis; Egger, Thomas; Oral, Cansu

    2014-01-01

    What makes a marketing strategy implementation successful and how can managers measure this success? To answer these questions, we developed a two-step audit approach. First, managers should measure the implementation success regarding effectiveness, efficiency, performance outcomes, and strategic embeddedness. Second, they should explore the reasons that have led to success or failure by regarding managerial, leadership, and environmental traps. Doing so will also provide corrective action p...

  4. Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT

    Directory of Open Access Journals (Sweden)

    Mair Frances

    2010-10-01

    Full Text Available Abstract Background The use of Information and Communication Technology (ICT or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice. This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format. Results The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience. Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls Conclusions The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations.

  5. An Analytic Model for the Success Rate of a Robotic Actuator System in Hitting Random Targets.

    Science.gov (United States)

    Bradley, Stuart

    2015-11-20

    Autonomous robotic systems are increasingly being used in a wide range of applications such as precision agriculture, medicine, and the military. These systems have common features which often includes an action by an "actuator" interacting with a target. While simulations and measurements exist for the success rate of hitting targets by some systems, there is a dearth of analytic models which can give insight into, and guidance on optimization, of new robotic systems. The present paper develops a simple model for estimation of the success rate for hitting random targets from a moving platform. The model has two main dimensionless parameters: the ratio of actuator spacing to target diameter; and the ratio of platform distance moved (between actuator "firings") to the target diameter. It is found that regions of parameter space having specified high success are described by simple equations, providing guidance on design. The role of a "cost function" is introduced which, when minimized, provides optimization of design, operating, and risk mitigation costs.

  6. Critical success factors in ERP implementation

    Directory of Open Access Journals (Sweden)

    Blerta Abazi Chaushi

    2016-11-01

    Full Text Available This study conducts state of the art literature review of critical success factors for enterprise resource planning systems implementation success. Since research on critical success factors for ERP implementation success is very rare and fragmented, this study provides a more comprehensive list of ten factors that companies that have adopted and struggle with the implementation, as well as companies who are in the process of considering implementation of ERP system can easily adopt and follow. The main contribution of this paper is that these ten new critical success factors are identifi ed through a thorough analysis of 22 selected research papers and is more comprehensive and straightforwardly employable for use.

  7. How to implement ITIL successfully?

    OpenAIRE

    Wang, Jingwen; Khosravi Sereshki, Hami

    2010-01-01

    The purpose of this thesis is to reveal how Information Technology  Infrastructure Library (ITIL) should be implemented in an organization in  an efficient and effective way to achieve the goal of reducing wastage, cutting costs and increasing customers’ satisfaction. There are many books dealing with the ITIL. But these publications do not prescribe how to adopt, adapt or implement the guidelines as part of a service management strategy; it would seem useful to explore implementation strateg...

  8. Successful Enterprise System Re-Implementation

    DEFF Research Database (Denmark)

    Svejvig, Per

    2017-01-01

    Achieving success in enterprise systems (ES) implementations is challenging. The success rate is not high in view of the sums invested by many organizations in these companywide systems. The literature is charged with reasons for unsuccessful implementations, such as a lack of top management...... support and insufficient change management. Contrary to this research, empirical data from an ES re-implementation in a Scandinavian high-tech company shows successful implementation despite many problematic shifts in outsourcing partners. Therefore, it is natural to ask: why was the re......-implementation of the ES at SCANDI successful despite the major troubles encountered during the project? Building an analysis based on ten Critical Success Factors (CSFs) combined with an investigation into the institutional structures at play, we present several reasons for the successful implementation. The CSF analysis...

  9. Keys to Successful EPIQ Business Demonstrator Implementation

    NARCIS (Netherlands)

    Shoikova, Elena; Denishev, Vladislav

    2009-01-01

    Shoikova, E., & Denishev, V. (2009). Keys to Successful EPIQ Business Demonstrator Implementation. Paper presented at the 'Open workshop of TENCompetence - Rethinking Learning and Employment at a Time of Economic Uncertainty-event'. November, 19, 2009, Manchester, United Kingdom: TENCompetence.

  10. Barriers To Successful Implementation of STEM Education

    Directory of Open Access Journals (Sweden)

    James A. Ejiwale

    2013-05-01

    Full Text Available The implementation of STEM education in schools across the globe is to prepare the future workforce with strong scientific and mathematical backgrounds to enhance skills development across STEM disciplines. However, for STEM education to achieve its goals and objectives, addressing the barriers to STEM education should start by fixing the problems at the elementary, junior and senior high school levels; the grassroots and potential feeders to colleges and universities. Since many nations including the United States of America is in dire need of the workforce with adequate preparation in science and mathematics to help address the nation’s economy that is in shambles, the barriers to its successful implementation should be identified and addressed. In this paper, (a the definition of STEM education and (b some barriers to successful implementation of STEM education are discussed and elaborated.

  11. Clinical pharmacogenetics implementation: approaches, successes, and challenges.

    Science.gov (United States)

    Weitzel, Kristin W; Elsey, Amanda R; Langaee, Taimour Y; Burkley, Benjamin; Nessl, David R; Obeng, Aniwaa Owusu; Staley, Benjamin J; Dong, Hui-Jia; Allan, Robert W; Liu, J Felix; Cooper-Dehoff, Rhonda M; Anderson, R David; Conlon, Michael; Clare-Salzler, Michael J; Nelson, David R; Johnson, Julie A

    2014-03-01

    Current challenges exist to widespread clinical implementation of genomic medicine and pharmacogenetics. The University of Florida (UF) Health Personalized Medicine Program (PMP) is a pharmacist-led, multidisciplinary initiative created in 2011 within the UF Clinical Translational Science Institute. Initial efforts focused on pharmacogenetics, with long-term goals to include expansion to disease-risk prediction and disease stratification. Herein we describe the processes for development of the program, the challenges that were encountered and the clinical acceptance by clinicians of the genomic medicine implementation. The initial clinical implementation of the UF PMP began in June 2012 and targeted clopidogrel use and the CYP2C19 genotype in patients undergoing left heart catheterization and percutaneous-coronary intervention (PCI). After 1 year, 1,097 patients undergoing left heart catheterization were genotyped preemptively, and 291 of those underwent subsequent PCI. Genotype results were reported to the medical record for 100% of genotyped patients. Eighty patients who underwent PCI had an actionable genotype, with drug therapy changes implemented in 56 individuals. Average turnaround time from blood draw to genotype result entry in the medical record was 3.5 business days. Seven different third party payors, including Medicare, reimbursed for the test during the first month of billing, with an 85% reimbursement rate for outpatient claims that were submitted in the first month. These data highlight multiple levels of success in clinical implementation of genomic medicine. © 2014 Wiley Periodicals, Inc.

  12. Success Factors of Business Process Management Systems Implementation

    NARCIS (Netherlands)

    Johan Versendaal; J.P.P. Ravesteijn

    2007-01-01

    In this research (critical) success factors for Business Process Management Systems implementation are identified and qualitatively validated. Furthermore a list of critical success factors is constructed. Based on the identified factors a BPMS implementation approach is suggested. Future research

  13. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

  14. Training for successful lean manufacturing implementation

    OpenAIRE

    Ichimura, Maki; Jahankhani, Hamid; Arunachalam, Subramaniam

    2006-01-01

    Implementing lean manufacturing is a complex and everlasting task. The workers involving in production processes are the pivot of the lean manufacturing implementation. Training is known as a vehicle to assist the implementation process. Despite awareness of the training importance, so far, a little is available to assist to organise an efficient training. This paper summarises the overview of lean manufacturing and discuss the importance of human resource within lean implementation process. ...

  15. Critical Success Factors for IFRS Implementation

    DEFF Research Database (Denmark)

    Lønne, Henrik; Holm, Claus; Schøler, Finn

    n this paper we compare the implementation process to integrate IFRS in Ireland, Denmark and New Zealand and derive the critical succesfactors in capability to implement IFRS. The implementation phase is divided into three phases before, during and after the implementation process. The description......, it is essential to have a thorough and forward-looking debate and coordination between the legalislative authority, the administrating authority, the accounting profession and the stock exchange. During the implementation process it is vital that the accounting profession has become the right level of education...

  16. Examining Health Information Technology Implementation Success Factors in Critical Access Hospitals

    Science.gov (United States)

    Monkman, Blake D.

    2016-01-01

    As the role of information technology increases throughout the world, healthcare providers in the United States face industry and governmental pressures to implement health information technology (HIT) as a tool to improve healthcare costs, quality, and safety. The problem addressed in this study was the relatively low HIT implementation success…

  17. Decentralisation in developing countries: preconditions for successful implementation

    Directory of Open Access Journals (Sweden)

    Yasin Olum

    2014-07-01

    Full Text Available Decentralisation has been implemented and is being implemented in many developing countries without much success. Although several unique factors inhibit the implementation of decentralisation in individual countries, the paper argues that there are six pre-conditions that these countries should fulfill before decentralisation can be successfully implemented. These preconditions are: institutional mechanisms; creation of spaces for participation; political will and civil will; capacity development at the local level; careful implementation; and democratic governance.

  18. Success Factors of Large Scale ERP Implementation in Thailand

    OpenAIRE

    Rotchanakitumnuai; Siriluck

    2010-01-01

    The objectives of the study are to examine the determinants of ERP implementation success factors of ERP implementation. The result indicates that large scale ERP implementation success consist of eight factors: project management competence, knowledge sharing, ERP system quality , understanding, user involvement, business process re-engineering, top management support, organization readiness.

  19. Hit Parade

    DEFF Research Database (Denmark)

    Backe, Hans-Joachim

    2017-01-01

    Daniel Cermak-Sassenrath, Max Alexander Wrighton, Hans-Joachim Backe. Hit Parade. Installation. Kulturnatten 2017, ITU, Copenhagen, DK, Oct 13, 2017.......Daniel Cermak-Sassenrath, Max Alexander Wrighton, Hans-Joachim Backe. Hit Parade. Installation. Kulturnatten 2017, ITU, Copenhagen, DK, Oct 13, 2017....

  20. Hit Parade

    DEFF Research Database (Denmark)

    Cermak, Daniel; Wrighton, Max Alexander; Backe, Hans-Joachim

    2016-01-01

    Daniel Cermak-Sassenrath, Max Alexander Wrighton, Hans-Joachim Backe. Hit Parade. Installation. Demo Night, ITU, Copenhagen, DK, Oct 5, 2016.......Daniel Cermak-Sassenrath, Max Alexander Wrighton, Hans-Joachim Backe. Hit Parade. Installation. Demo Night, ITU, Copenhagen, DK, Oct 5, 2016....

  1. Hit Parade

    DEFF Research Database (Denmark)

    Cermak, Daniel; Wrighton, Max Alexander; Backe, Hans-Joachim

    2016-01-01

    Daniel Cermak-Sassenrath, Max Alexander Wrighton, Hans-Joachim Backe. Hit Parade. Installation. Kulturnatten 2016, Danish Science Ministry, Copenhagen, DK, Oct 14, 2016.......Daniel Cermak-Sassenrath, Max Alexander Wrighton, Hans-Joachim Backe. Hit Parade. Installation. Kulturnatten 2016, Danish Science Ministry, Copenhagen, DK, Oct 14, 2016....

  2. Successful implementation of self-managing teams

    NARCIS (Netherlands)

    Weerheim, Wilke; Van Rossum, Lisa; Ten Have, Wouter Dirk

    2018-01-01

    Purpose: Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is crucial to

  3. Successful implementation of self-managing teams

    NARCIS (Netherlands)

    Weerheim, W. (Wilke); Van Rossum, L. (Lisa); Ten Have, W.D. (Wouter Dirk)

    2018-01-01

    textabstractPurpose: Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is

  4. Implementing successful strategic plans: a simple formula.

    Science.gov (United States)

    Blondeau, Whitney; Blondeau, Benoit

    2015-01-01

    Strategic planning is a process. One way to think of strategic planning is to envision its development and design as a framework that will help your hospital navigate through internal and external changing environments over time. Although the process of strategic planning can feel daunting, following a simple formula involving five steps using the mnemonic B.E.G.I.N. (Begin, Evaluate, Goals & Objectives, Integration, and Next steps) will help the planning process feel more manageable, and lead you to greater success.

  5. Model of key success factors for Business Intelligence implementation

    Directory of Open Access Journals (Sweden)

    Peter Mesaros

    2016-07-01

    Full Text Available New progressive technologies recorded growth in every area. Information-communication technologies facilitate the exchange of information and it facilitates management of everyday activities in enterprises. Specific modules (such as Business Intelligence facilitate decision-making. Several studies have demonstrated the positive impact of Business Intelligence to decision-making. The first step is to put in place the enterprise. The implementation process is influenced by many factors. This article discusses the issue of key success factors affecting to successful implementation of Business Intelligence. The article describes the key success factors for successful implementation and use of Business Intelligence based on multiple studies. The main objective of this study is to verify the effects and dependence of selected factors and proposes a model of key success factors for successful implementation of Business Intelligence. Key success factors and the proposed model are studied in Slovak enterprises.

  6. Dirty Hits

    OpenAIRE

    Clarke, Louise

    2010-01-01

    Issue 9 of the Saatchi Gallery Magazine: Art&Music is dedicated to Sex. The article Dirty Hits invited a cross-section of contemporary artists and musicians to answer: What makes a dirty hit? As one of the artists invited, I wrote an autobiographical piece to reveal how these fumbling, feral sexual experiences of my childhood landscape, along with irrational superstition and folk law inform my life and underpin my work. The article also included an artwork: Louise Clarke, Sip (2009)

  7. Successful Issues for Implementing Enterprise Resource Planning (ERP)

    Institute of Scientific and Technical Information of China (English)

    LI Bing-guang; Michael W. Riley

    2003-01-01

    Enterprise Resource Planning (ERP) systems have emerged and have matured to become the core of successful information management and the enterprise backbone of organizations for applications such as e-business, Supply Chain Management (SCM) and Customer Relation Management (CRM). This paper theorizes and generalizes the important steps and factors for ERP implementation success. First, the paper gives an introduction to ERP and the relationships between MRP, MPRII and ERP. The benefits and motivations of adoption of ERP systems are introduced. Steps for ERP system selection and implementation are presented. The paper proposes a qualitative analysis of the key factors that affect a successful ERP implementation.

  8. "Actionable" critical success factors for supply chain information system implementations

    NARCIS (Netherlands)

    Denolf, Janne M.; Trienekens, Jacques H.; Nel Wognum, P.M.; Schütz, Verena; Vorst, Van Der Jack G.A.J.; Onno Omta, S.W.F.

    2018-01-01

    Implementing a supply chain information system (SCIS) incurs organizational and technical complexities. For managing these complexities, information system researchers have identified generic critical success factors. However, CSFs are abstract and, therefore, difficult to use in practice. To

  9. Forecasting the Success of Implementing Sensors Advanced Manufacturing Technology

    Directory of Open Access Journals (Sweden)

    Cheng-Shih Su

    2014-08-01

    Full Text Available This paper is presented fuzzy preference relations approach to forecast the success of implementing sensors advanced manufacturing technology (AMT. In the manufacturing environment, performance measurement is based on different quantitative and qualitative factors. This study proposes an analytic hierarchical prediction model based on fuzzy preference relations to help the organizations become aware of the essential factors affecting the AMT implementation, forecasting the chance of successful implementing sensors AMT, as well as identifying the actions necessary before implementing sensors AMT. Then predicted success/failure values are obtained to enable organizations to decide whether to initiate sensors AMT, inhibit adoption or take remedial actions to increase the possibility of successful sensors AMT initiatives. This proposed approach is demonstrated with a real case study involving six influential factors assessed by nine evaluators solicited from a semiconductor engineering incorporation located in Taiwan.

  10. Critical Success Factor for Implementing Vocational Blended Learning

    Science.gov (United States)

    Dewi, K. C.; Ciptayani, P. I.; Surjono, H. D.; Priyanto

    2018-01-01

    Blended learning provides many benefits to the flexibility of time, place and situation constraints. The research’s objectives was describing the factors that determine the successful implementation of blended learning in vocational higher education. The research used a qualitative approach, data collected through observations and interviews by questionnare based on the CSFs indicators refers to TAM and Kliger. Data analysis was inductive method. The result provided an illustration that the success of vocational blended learning implementation was largely determined by the selection of instructional models that are inline with learning achievement target. The effectiveness of blended learning required the existence of policy support, readiness of IT infrastructure. Changing lecturer’s culture by utilizing ICT can also encourage the accelerated process of successful implementation. It can concluded that determinant factor of successful implementation of blended learning in vocational education is determined by teacher’s ability in mastering the pedagogical knowledge of designing instructional models.

  11. Advanced Manufacturing Technology Implementation Process in SME: Critical Success Factors

    Directory of Open Access Journals (Sweden)

    Jani Rahardjo

    2010-01-01

    Full Text Available The aim of this paper is to present critical factors that constitute a successful implementation of the Advanced Manufacturing Technologies (AMT in Small Medium Enterprise (SME. Many large companies have applied AMT and the applications have shown significant results in this global market era. Conveniently, these phenomenons are also engaged to Small Medium Enterprises (SME that of high demands on performing high quality product, fast delivery, reliable and more flexible. The implementation of AMT follow several processes namely pre installation, installation, improvement and mature. In order to guarantee the succesfull of running these processes, one should consider the Critical Success Factors (CSF. We conducted a survey to 125 SMEs that have implemented AMT, and found that the CSF for each process are moderately different. Good leadership is the main critical success factor for preparing and installation of the AMT. Once the AMT started or installed and arrived at growth stage, the financial availability factor turns into a critical success factor in the AMT implementation. In, mature stage, the support and commitment of top management becomes an important factor for gaining successful implementation. By means of factor analysis, we could point out that strategic factors are the main factors in pre-installation and installation stage. Finally, in the growth stage and mature stage, both tactical and strategic factors are the important factors in the successful of AMT implementation

  12. Surveying the critical success factors of BPM-systems implementation.

    NARCIS (Netherlands)

    Ravesteyn, P.; Batenburg, R.

    2010-01-01

    Purpose – The purpose of this paper is to explore if there is a common ground for the definition of business process management (BPM) and BPM-systems, as well as the critical success factors (CSFs) for BPM-system implementation. A BPM-system implementation framework is validated that classifies the

  13. Implementation of critical success factors in construction research ...

    African Journals Online (AJOL)

    Construction research and development (R&D) process has a number of issues that affect its success. These issues imply that Critical Success Factors (CSFs) of construction R&D process are not properly addressed. Not knowing CSFs could lead to not implementing them and not paying proper attention for them. The study ...

  14. Democracy as a political imperative for successful implementation of ...

    African Journals Online (AJOL)

    Against the background of the political context of reforms, it illustratively notes that democratic reforms are usually more successful than authoritarian ones. The paper provides a contextual explication of democracy, on which basis it recommends some strategies for successful and effective implementation of reforms in the ...

  15. Implementation of Balanced Scorecard and the Successful of Implementation Strategy: a Review

    OpenAIRE

    Ellitan, Lena; Anatan, Lina

    2008-01-01

    The balanced scorecard is a formal management technique for development, implementation and management of business strategy. It is difficult to ascertain the success of the technique as most of the literature on its implementation is put out by those with a vested interest in its success as a commercial product. Much has been written about barriers to strategy implementation but not specifically to the implementation of balanced scorecard. This paper presents a review of the factors that cont...

  16. Electronic health records: critical success factors in implementation.

    Science.gov (United States)

    Safdari, Reza; Ghazisaeidi, Marjan; Jebraeily, Mohamad

    2015-04-01

    EHR implementation results in the improved quality of care, customer-orientation and timely access to complete information. Despite the potential benefits of EHR, its implementation is a difficult and complex task whose success depends on many factors. The purpose of this research is indeed to identify the key success factors of EHR. This is a cross-sectional survey conducted with participation of 340 work forces from different types of job from Hospitals of TUMS in 2014. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics. 58.2% of respondents were female and their mean age and work experience were 37.7 and 11.2 years, respectively and most respondents (52.5%) was bachelor. In terms of job, the maximum rate was related to nursing (33 %) and physician (21 %). the main category of critical success factors in Implementation EHRs, the highest rate related to Project Management (4.62) and lowest related to Organizational factors (3.98). success in implementation EHRs requirement more centralization to project management and human factors. Therefore must be Creating to EHR roadmap implementation, establishment teamwork to participation of end-users and select prepare leadership, users obtains sufficient training to use of system and also prepare support from maintain and promotion system.

  17. Forecasting the Success of Implementing Sensors Advanced Manufacturing Technology

    OpenAIRE

    Cheng-Shih Su; Shu-Chen Hsu

    2014-01-01

    This paper is presented fuzzy preference relations approach to forecast the success of implementing sensors advanced manufacturing technology (AMT). In the manufacturing environment, performance measurement is based on different quantitative and qualitative factors. This study proposes an analytic hierarchical prediction model based on fuzzy preference relations to help the organizations become aware of the essential factors affecting the AMT implementation, forecasting the chance of successf...

  18. Critical success factors for implementing healthcare e-Learning.

    Science.gov (United States)

    Lee, Te-Shu; Kuo, Mu-Hsing; Borycki, Elizabeth M; Yunyong, David

    2011-01-01

    The use of e-Learning in educational institutes has rapidly increased along with the development of information and communication technology (ICT). In healthcare, more medical educators are using e-Learning to support their curriculum design, delivery and evaluation. However, no systematic work exists on characterizing a collective set of Critical Success Factors (CSFs) for implementing e-Learning in the healthcare education institutions. The aim of this paper is to study the CSFs of implementing healthcare e-Learning.

  19. Implementing lean office: a successful case in public sector

    OpenAIRE

    Monteiro, Mónica F. J. R.; Pacheco, Claudia C. L.; Dinis-Carvalho, José; Paiva, Francisco C.

    2015-01-01

    Applying lean approaches in office areas can lead to performance improvements and other benefits as achieved in traditional manufacturing environments. The intangibility of office operations may appear as a major difficulty for lean implementations but in fact the benefits achievable are as important as the ones achieved in manufacturing environments. This paper reports a successful case of lean office implementation in a public sector organization giving emphasis to its major performance imp...

  20. Paving the Road to Success: A Framework for Implementing the Success Tutoring Approach

    Directory of Open Access Journals (Sweden)

    Spark Linda

    2017-12-01

    Full Text Available The exponential growth of higher education enrolment in South Africa has resulted in increased diversity of the student body, leading to a proliferation of factors that affect student performance and success. Various initiatives have been adopted by tertiary institutions to mitigate the negative impact these factors may have on student success, and it is suggested that interventions that include aspects of social integration are the most successful. This paper outlines an approach called Success Tutoring (a non-academic tutorial approach used as part of a student success and support programme in the Faculty of Commerce, Law, and Management at the University of the Witwatersrand, which is underscored by empirical evidence drawn from evaluation data collected during Success Tutor symposia. The authors draw conclusions and make recommendations based on a thematic analysis of the dataset, and ultimately provide readers with a framework for implementing Success Tutoring at their tertiary institutions.

  1. Factors Affecting Successful Implementation of Hospital Information Systems.

    Science.gov (United States)

    Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

    2016-02-01

    Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

  2. Critical success factors in implementing clinical pathways/case management.

    Science.gov (United States)

    Choo, J

    2001-07-01

    With the advent of casemix reimbursement implementation, rapid technological changes, an ageing population and changing consumer behaviour, the Singapore health care industry is faced with the impetus to provide a cost-effective and efficient care delivery system. One ubiquitous tool used is the establishment of a clinical pathway/case management programme within the hospital. As the concept of clinical pathway for patient care is a relatively new concept in Singapore, several critical factors must be considered to ensure successful implementation of clinical pathway/case management programme. One key success factor lies in continued clinician support and acceptance. Other factors include top management leadership and support and a dedicated team of case managers, nurses and paramedical professionals.

  3. Success Factors for Clean Development Mechanism Implementation in Malaysia

    Directory of Open Access Journals (Sweden)

    Say Keat Ooi

    2013-09-01

    Full Text Available The Clean Development Mechanism (CDM, established under the Kyoto Protocol, is one of the market-based mechanisms developed to assist industrialized countries mitigate greenhouse gas (GHG emissions, achieve emission reduction targets, and at the same time promote sustainable development in developing countries. The CDM, which provides flexibility and costeffectiveness in meeting GHG emission reduction targets, has captured interest globally. CDM implementation is expected to generate benefits, give developing countries a sense of ownership, and share the global load in tackling global warming and climate change. However, CDM implementation faces several complications. The successful participation of developing countries in emission reduction projects presents ongoing challenges, which inhibit their drive towards sustainable development goals. Through a comprehensive review of the literature and theoretical analysis, several factors have been identified as significant to successful CDM implementation in Malaysia. These success factors, which include regulation and a legal framework, competitive advantage, green supply chain, ethical values, financial benefits, and technology transfer, are presented and the importance of each factor is discussed.

  4. Understanding the End User Perspective: A Multiple-Case Study of Successful Health Information Technology Implementation

    Science.gov (United States)

    Behravesh, Bardia

    2010-01-01

    The United States continues to lag behind other countries in its adoption of health information technology. A failure to increase adoption will jeopardize the nation's ability to reduce medical errors, address the rapid growth of healthcare costs, and enact effective healthcare reform. Health information technology (HIT) implementation success…

  5. The successful implementation of STEM initiatives in lower income schools

    Science.gov (United States)

    Bakshi, Leena

    The purpose of this study was to examine the leadership strategies utilized by superintendents, district administrators and school principals and the impact of these identified strategies on implementing STEM initiatives specifically for lower-income students. This study set out to determine (a) What role does district leadership play in the implementation of STEM initiatives in lower income secondary schools; (b) What internal systems of accountability exist in successful lower income secondary schools' STEM programs; (c) What leadership strategies are used to implement STEM curriculum initiatives; (d) How do school and district leadership support staff in order to achieve student engagement in STEM Initiative curriculum. This study used a mixed-methods approach to determine the impact of leadership strategies utilized by superintendents, district administrators and school principals on implementing STEM initiatives. Quantitative data analyzed survey questionnaires to determine the degree of correlation between the school districts that have demonstrated the successful implementation of STEM initiatives at the school and district levels. Qualitative data was collected using highly structured participant interviews and purposeful sampling of four district superintendents, one district-level administrator and five school leaders to capture the key strategies in implementing STEM initiatives in lower income secondary schools. Through the process of triangulation, the results of the study revealed that superintendents and principals should consider the characteristics of effective STEM initiatives that have shown a considerable degree of correlation with positive outcomes for lower income students. These included the leadership strategies of personnel's making decisions about the district's and school's instructional direction and an emphasis on the conceptual development of scientific principles using the Next Generation Science Standards coupled with the Common Core

  6. An Algorithm of an X-ray Hit Allocation to a Single Pixel in a Cluster and Its Test-Circuit Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Deptuch, G. W. [AGH-UST, Cracow; Fahim, F. [Fermilab; Grybos, P. [AGH-UST, Cracow; Hoff, J. [Fermilab; Maj, P. [AGH-UST, Cracow; Siddons, D. P. [Brookhaven; Kmon, P. [AGH-UST, Cracow; Trimpl, M. [Fermilab; Zimmerman, T. [Fermilab

    2017-05-06

    An on-chip implementable algorithm for allocation of an X-ray photon imprint, called a hit, to a single pixel in the presence of charge sharing in a highly segmented pixel detector is described. Its proof-of-principle implementation is also given supported by the results of tests using a highly collimated X-ray photon beam from a synchrotron source. The algorithm handles asynchronous arrivals of X-ray photons. Activation of groups of pixels, comparisons of peak amplitudes of pulses within an active neighborhood and finally latching of the results of these comparisons constitute the three procedural steps of the algorithm. A grouping of pixels to one virtual pixel that recovers composite signals and event driven strobes to control comparisons of fractional signals between neighboring pixels are the actuators of the algorithm. The circuitry necessary to implement the algorithm requires an extensive inter-pixel connection grid of analog and digital signals that are exchanged between pixels. A test-circuit implementation of the algorithm was achieved with a small array of 32×32 pixels and the device was exposed to an 8 keV highly collimated to a diameter of 3 μm X-ray beam. The results of these tests are given in the paper assessing physical implementation of the algorithm.

  7. Task-selective memory effects for successfully implemented encoding strategies.

    Science.gov (United States)

    Leshikar, Eric D; Duarte, Audrey; Hertzog, Christopher

    2012-01-01

    Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies--visual imagery and sentence generation--facilitate memory through the production of different types of mediators (e.g., mental images and sentences). Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator). It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences) for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness) of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study.

  8. An Exploratory Study on the Critical Success Factors in the Implementation of Enterprise Resource Planning Systems in Venezuela

    Directory of Open Access Journals (Sweden)

    Leopoldo Colmenares

    2005-08-01

    Full Text Available This paper reports on an exploratory study, carried out in seven Venezuelan organizations who have successfully implemented an enterprise resource planning (ERP system. The data were collected by means of both a questionnaire and of conducted interviews to the seven project managers of the project of implementation of ERP systems in these enterprises. The purpose of the study was to know the perceptions the project managers, on aspects and activities of the process of implementing an ERP system and that are strongly correlated with the Critical Success Factors (FCE’s for this kind of projects. The FCE’s were identified in a deep revision of the literature. The questionnaire included, among others, questions on the top management support to the project, the process of selection of the system, team work implementation and the participation and training of the users. Additionally were identified the problems that organizations confronted during the implementation process. The study concludes that organizations must take care the elements that indicate the FCE’s, because them hit positively the project, additionally describe aspects, which must take into account the enterprises who are in the process to adopt an ERP system to facilitate its implementation.

  9. Hospital IT adoption strategies associated with implementation success: implications for achieving meaningful use.

    Science.gov (United States)

    Ford, Eric W; Menachemi, Nir; Huerta, Timothy R; Yu, Feliciano

    2010-01-01

    Health systems are facing significant pressure to either implement health information technology (HIT) systems that have "certified" electronic health record applications and that fulfill the federal government's definition of "meaningful use" or risk substantial financial penalties in the near future. To this end, hospitals have adopted one of three strategies, described as "best of breed," "best of suite," and "single vendor," to meet organizational and regulatory demands. The single-vendor strategy is used by the simple majority of U.S. hospitals, but is it the most effective mode for achieving full implementation? Moreover, what are the implications of adopting this strategy for achieving meaningful use? The simple answer to the first question is that the hospitals using the hybrid best of suite strategy had fully implemented HIT systems in significantly greater proportions than did hospitals employing either of the other strategies. Nonprofit and system-affiliated hospitals were more likely to have fully implemented their HIT systems. In addition, increased health maintenance organization market penetration rates were positively correlated with complete implementation rates. These results have ongoing implications for achieving meaningful use in the near term. The federal government's rewards and incentives program related to the meaningful use of HIT in hospitals has created an organizational imperative to implement such systems. For hospitals that have not begun systemwide implementation, pursuing a best of suite strategy may provide the greatest chance for achieving all or some of the meaningful use targets in the near term or at least avoiding future penalties scheduled to begin in 2015.

  10. Task-selective memory effects for successfully implemented encoding strategies.

    Directory of Open Access Journals (Sweden)

    Eric D Leshikar

    Full Text Available Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies--visual imagery and sentence generation--facilitate memory through the production of different types of mediators (e.g., mental images and sentences. Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator. It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study.

  11. Rocky Flats Cleanup Agreement implementation successes and challenges

    International Nuclear Information System (INIS)

    Shelton, D.C.

    1997-01-01

    On July 19, 1996 the US Department of Energy (DOE), State of Colorado (CDPHE), and US Environmental Protection Agency (EPA) entered into an agreement called the Rocky Flats Cleanup Agreement (RFCA) for the cleanup and closure of the Rocky Flats Environmental Technology Site (RFETS or Rocky Flats). Major elements of the agreement include: an Integrated Site-Wide Baseline; up to twelve significant enforceable milestones per year; agreed upon soil and water action levels and standards for cleanup; open space as the likely foreseeable land use; the plutonium and TRU waste removed by 2015; streamlined regulatory process; agreement with the Defense Nuclear Facilities Safety Board (DNFSB) to coordinate activities; and a risk reduction focus. Successful implementation of RFCA requires a substantial effort by the parties to change their way of thinking about RFETS and meet the deliverables and commitments. Substantial progress toward Site closure through the implementation of RFCA has been accomplished in the short time since the signing, yet much remains to be done. Much can be learned from the Rocky Flats experience by other facilities in similar situations

  12. Strong advocacy led to successful implementation of smokefree Mexico City.

    Science.gov (United States)

    Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A

    2011-01-01

    To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court's ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries.

  13. Risk and Performance Technologies: Identifying the Keys to Successful Implementation

    International Nuclear Information System (INIS)

    McClain, Lynn; Smith, Art; O'Regan, Patrick

    2002-01-01

    The nuclear power industry has been utilizing risk and performance based technologies for over thirty years. Applications of these technologies have included risk assessment (e.g. Individual Plant Examinations), burden reduction (e.g. Risk-Informed Inservice Inspection, RI-ISI) and risk management (Maintenance Rule, 10CFR50.65). Over the last five to ten years the number of risk-informed (RI) burden reduction initiatives has increased. Unfortunately, the efficiencies of some of these applications have been questionable. This paper investigates those attributes necessary to support successful, cost-effective RI-applications. The premise to this paper is that by understanding the key attributes that support one successful application, insights can be gleaned that will streamline/coordinate future RI-applications. This paper is an extension to a paper presented at the Pressure Vessel and Piping (PVP-2001) Conference. In that paper, a number issues and opportunities were identified that needed to be assessed in order to support future (and efficient) RI-applications. It was noted in the paper that a proper understanding and resolution of these issues will facilitate implementation of risk and performance technology in the operation, maintenance and design disciplines. In addition, it will provide the foundation necessary to support regulatory review and approval. (authors)

  14. Creating a safe place for pediatric care: A no hit zone.

    Science.gov (United States)

    Frazier, Erin R; Liu, Gilbert C; Dauk, Kelly L

    2014-07-01

    Our goal was to create and implement a program, Kosair Children's Hospital's No Hit Zone, which trains health care workers in de-escalation techniques to address parental disruptive behaviors and physical discipline of children commonly encountered in the hospital environment. The Child Abuse Task Force, a multidisciplinary group, along with key hospital administrators developed specific content for the policy, as well as marketing and educational materials. The No Hit Zone policy designates Kosair Children's Hospital as "an environment in which no adult shall hit a child, no adult shall hit another adult, no child shall hit an adult, and no child shall hit another child. When hitting is observed, it is everyone's responsibility to interrupt the behavior as well as communicate system policy to those present." Via a multidisciplinary, collaborative approach, the No Hit Zone was successfully implemented at Kosair Children's Hospital in 2012. Cost was nominal, and the support of key hospital administrators was critical to the program's success. Education of health professionals on de-escalation techniques and intervention with families at the early signs of parental stress occurred via live sessions and online training via case-based scenarios. The No Hit Zone is an important program used to provide a safe and caring environment for all families and staff of Kosair Children's Hospital. Demand for the program continues, demonstrated by the establishment of No Hit Zones at other local hospitals and multiple outpatient clinics. This article offers information for other organizations planning to conduct similar initiatives. Copyright © 2014 by the American Academy of Pediatrics.

  15. A Critical Element to Successful Implementation Of Future Safeguards Systems

    International Nuclear Information System (INIS)

    Dickman, Deborah A.

    2003-01-01

    As we look to the future of nuclear materials management and safeguards systems, it is essential to place significant emphasis on creation of a strong infrastructure to support and sustain modern systems. Traditionally, safeguards infrastructure development has focused on such elements as equipment development, strengthening of the national regulatory base, creation of state-of-the-art accounting and control systems, and procedure development. Less emphasis has been placed on recognition of the 'human element' as a primary component of the necessary infrastructure and the key to successful implementation of new or existing systems. The importance of the human element can be recognized by considering the broad span of influence and control, direction, regulation and implementation of safeguards systems exhibited by a large number of professionals: diplomats, scholars, politicians, facility managers, program directors and technical specialists. These individuals provide the connectivity or 'glue' that binds together a myriad of smaller safeguards program elements and ensures a holistic approach is fostered and maintained. The education and training of our future leaders and experts must receive the highest priority. In addition, this effort must consider factors beyond development of technical capabilities. Given the rapidly evolving world climate since the end of the cold war, our safeguards leaders and experts need education and training that will provide a well-developed understanding of the broader political dimensions of current nonproliferation challenges. They need to learn how to think, rather than what to think. A sustained effort is required to highlight the importance of the human dimension of safeguards and nuclear materials management and how these systems support international nonproliferation efforts. New educational initiatives are needed to better prepare the next generation of leaders and experts. Increased regional and national cooperation in the

  16. Tripartite Governance: Enabling Successful Implementations with Vulnerable Populations.

    Science.gov (United States)

    Kennedy, Margaret Ann

    2016-01-01

    Vulnerable populations are often at a distinct disadvantage when it comes to the implementation of health information systems in an equitable, appropriate, and timely manner. The disadvantages experienced by vulnerable populations are innumerable and include lack of representation, lack of appropriate levels of funding, lack of resources and capacity, and lack of representation. Increasingly, models of representation for complex implementations involve a tripartite project governance model. This tripartite partnership distributes accountability across all partners, and ensures that vulnerable populations have an equitable contribution to the direction of implementation according to their needs. This article shares lessons learned and best practices from complex tripartite partnerships supporting implementations with vulnerable populations in Canada.

  17. Paving the Road to Success: A Framework for Implementing the ...

    African Journals Online (AJOL)

    This paper outlines an approach called Success Tutoring (a non-academic tutorial approach used as part of a student success and support programme in the Faculty of Commerce, Law, and Management at the University of the Witwatersrand), which is underscored by empirical evidence drawn from evaluation data ...

  18. Can groundwater be successfully implemented as a bulk water ...

    African Journals Online (AJOL)

    These properties define typical fractured aquifers in which the selection of drilling sites requires a thorough scientific approach to locate a successful productive borehole. While most water service authorities in the Province have been randomly developing new boreholes with limited success rates, the analysis of datasets in ...

  19. Successful implementation of spacer treatment guideline for acute asthma

    OpenAIRE

    Powell, C; Maskell, G; Marks, M; South, M; Robertson, C; LENNEY, W.

    2001-01-01

    AIMS—To develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination.
METHODS—Defined strategies were used for the development and implementation of a guideline, assessed by a prospective, descriptive, study using notes review, and patient, nursing, and medical staff telephone contact. The setting was a tertiary referral hospital in Victoria, Australia with 25 000 yearly admissions, and asthma acco...

  20. Identifying a practice-based implementation framework for sustainable interventions for improving the evolving working environment: Hitting the Moving Target Framework.

    Science.gov (United States)

    Højberg, Helene; Rasmussen, Charlotte Diana Nørregaard; Osborne, Richard H; Jørgensen, Marie Birk

    2018-02-01

    Our aim was to identify implementation components for sustainable working environment interventions in the nursing assistant sector to generate a framework to optimize the implementation of workplace improvement initiatives. The implementation framework was informed by: 1) an industry advisory group, 2) interviews with key stakeholder, 3) concept mapping workshops, and 4) an e-mail survey. Thirty five stakeholders were interviewed and contributed in the concept mapping workshops. Eleven implementation components were derived across four domains: 1) A supportive organizational platform, 2) An engaged workplace with mutual goals, 3) The intervention is sustainably fitted to the workplace, and 4) the intervention is an attractive choice. The highest rated component was "Engaged and Active Management" (mean 4.1) and the lowest rated was "Delivered in an Attractive Form" (mean 2.8). The framework provides new insights into implementation in an evolving working environment and is aiming to assist with addressing gaps in effectiveness of workplace interventions and implementation success. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Constructive Technology Assessment for HIT development

    DEFF Research Database (Denmark)

    Høstgaard, Anna Marie Balling; Bertelsen, Pernille; Petersen, Lone Stub

    2013-01-01

    Experience and time has shown a need for new evaluation methods for evaluating Health Information Technology (HIT), as summative evaluation methods fail to accommodate the rapid and constant changes in HIT over time and to involve end-users, which has been recognized as an important success facto...... during all the phases in the process. Thereby anumber of problems were prevented to occur later on.Thus, the CTA method and its framework are useful for evaluators and project-management in order to facilitate and support successful HIT development....

  2. Multidisciplinary approach to successful implementation of production information system (PRISM)

    Energy Technology Data Exchange (ETDEWEB)

    Shariff, M.R.; Gopalakrishnan, S.G.; Francis, N. [and others

    1995-12-31

    A company wide corporate and regional production database supporting all production areas was envisaged critical to the current expansion within Petronas Carigali Sdn Bhd (PCSB). A multi disciplinary project team was thus formed to analyze the requirements prior to developing, testing, implementing and training users. PCSB has currently evolved into a mature E & P company on par with other E & P companies within the region. This expansion necessitates a common Production Information System for the efficient dissemination of vital Production Information for Production Surveillance, Reservoir Management, Reserve Assessment, Special Studies and Standardized Group-wide Reporting. This paper will discuss all the phases involved in the project which includes Systems Requirement Study, Data Migration, System Development, System Implementation and Post-Implementation Plan.

  3. School Based Management: A Detailed Guide for Successful Implementation.

    Science.gov (United States)

    Neal, Richard G.

    This book examines school-based management and provides strategies to implement management changes. The 14 chapters examine the components of good schools, including clarity of purpose, leadership, professionalism, lack of bureaucratic control, competition, and choice. The text describes the components of school-based management and the need for…

  4. Effect of leadership styles on successful implementation of a ...

    African Journals Online (AJOL)

    Inkanyiso: Journal of Humanities and Social Sciences ... Although a well implemented performance management system (PMS) can have immense benefits, it has ... However, empirical investigation of this relationship is lacking. ... The study recommends that organisations should adopt more strategic leadership style if they ...

  5. Implementing Technology in the Classroom: Paths to Success and Failure.

    Science.gov (United States)

    Harvey, Glen; And Others

    This paper discusses the change process experienced by teachers participating in a study of a computer-based language arts instructional program for the early elementary grades--the Apple Learning Series: Early Language (ALS-EL). The study explored ways in which the teachers were implementing ALS-EL in their classrooms before attempting to…

  6. Barriers to the successful implementation of school health services ...

    African Journals Online (AJOL)

    Although South Africa accepted the Convention on the Rights of the Child (CRC) in 1996 thereby committing itself to prioritisation of children, the implementation of school health services in South Africa has deteriorated to levels that contravene these rights. The promotion of health in schools requires a strong political ...

  7. Key factors influencing the implementation success of home telecare application.

    NARCIS (Netherlands)

    Postema, T.R.F.; Peeters, J.M.; Friele, R.D.

    2012-01-01

    Rationale: The introduction of home telecare in healthcare organizations has shown mixed results in practice. The aim of this study is to arrive at a set of key factors that can be used in further implementation of video communication. We argue that key factors are mainly found in the organizational

  8. Determinants of successful telemedicine implementations: a literature study

    NARCIS (Netherlands)

    Broens, T.H.F.; Huis in 't Veld, M.H.A.; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.; van Halteren, Aart; Nieuwenhuis, Lambertus Johannes Maria

    Telemedicine implementations often remain in the pilot phase and do not succeed in scaling-up to robust products that are used in daily practice. We conducted a qualitative literature review of 45 conference papers describing telemedicine interventions in order to identify determinants that had

  9. Succession planning for RNs: implementing a nurse management internship.

    Science.gov (United States)

    Wendler, M Cecilia; Olson-Sitki, Kristi; Prater, Marsha

    2009-01-01

    The nursing shortage affects all levels, including the pivotal role of nurse managers, who may find themselves functioning in a complex, stressful work environment. In this increasingly difficult milieu, succession planning for nurse manager turnover is imperative. The authors describe an evidence-based, theoretically driven nurse management internship that allows staff nurses to explore the nurse manager role.

  10. Searching for Student Success: Implementing Immediacy in Online Courses

    Science.gov (United States)

    Jennings, Amy B.

    2013-01-01

    Growing demand for higher education has contributed to the popularity of online education. While online courses can be effective in terms of student learning and success, and there are many potential benefits, there are also still areas that can be improved. There is evidence that students can experience online courses as impersonal and lacking…

  11. Participatory action research: The key to successful implementation ...

    African Journals Online (AJOL)

    Unfortunately many of these innovative changes in training have met resistance from lecturers and students simply because they are just imposed on them. One way of ensuring acceptability and success of innovative and evidence-based training methods in health sciences could be the use of participatory action research ...

  12. Bosnia: Crime and Corruption Threaten Successful Implementation of the Dayton Peace Agreement

    National Research Council Canada - National Science Library

    Johnson, Harold

    2000-01-01

    Endemic crime and corruption in Bosnia are threatening the successful implementation of the Dayton Peace Agreement and until the situation is satisfactorily addressed the conditions for the complete...

  13. Interpersonal success factors for strategy implementation: a case study using group model building

    OpenAIRE

    Rodney J Scott; Robert Y Cavana; Donald Cameron

    2015-01-01

    Strategy implementation has been identified as an area of system dynamics literature requiring greater attention. Most strategies fail to be implemented successfully, and processes for effectively implementing strategy are yet to be fully explained and explored. The reported interpersonal success factors for strategy implementation are reported outcomes for group model building, suggesting potential applicability. A case study using validated survey methods yielded promising results, and sugg...

  14. Model of key success factors for Business Intelligence implementation

    OpenAIRE

    Peter Mesaros; Tomas Mandicak; Daniela Mackova; Stefan Carnicky; Martina Habinakova; Marcela Spisakova

    2016-01-01

    New progressive technologies recorded growth in every area. Information-communication technologies facilitate the exchange of information and it facilitates management of everyday activities in enterprises. Specific modules (such as Business Intelligence) facilitate decision-making. Several studies have demonstrated the positive impact of Business Intelligence to decision-making. The first step is to put in place the enterprise. The implementation process is influenced by many factors. This a...

  15. KPI Building Blocks For Successful Green Transport Corridor Implementation

    Directory of Open Access Journals (Sweden)

    Prause Gunnar

    2015-12-01

    Full Text Available The green transport corridor concept represents a cornerstone in the development of integrated and sustainable transport solutions. Important properties of green corridors are their transnational character and their high involvement of large numbers of public and private stakeholders, including political level, requiring sophisticated approaches for implementation, management and governance. The current scientific discussion focusses on Key Performance Indicators (KPI for monitoring and management of green transport corridor performance emphasizing the operational aspects.

  16. Freescale Semiconductor Successfully Implements an Energy Management System

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-06-30

    Through the Superior Energy Performance (SEP) plant certification program, Freescale Semiconductor implemented projects at the company's Oak Hill Fab plant that reduced annual energy consumption by 28 million kilowatt hours (kWh) of electricity and 26,000 million British thermal units (Btu) of natural gas between 2006 and 2009, saving more than $2 million each year. The plant is now certified at the SEP silver level, and has a management system in place to proactively manage the facility's energy resources in the future.

  17. Successful Training Development and Implementation in Plant Modernization Projects

    International Nuclear Information System (INIS)

    Kuhn, A.; Schoenfelder, C.

    2012-01-01

    In plant modernization projects, for life extension or power update, the competence development (in particular, job and needs oriented training) of the plant staff plays an important role for ensuring the highest standard of nuclear safety, and for facilitating an economic operation of the plant. This paper describes challenges, methodology, activities, and results obtained so far from an on-going project in Sweden. - - As conclusion, critical factors for a successful staff training in plant modernization projects include a systematic approach to training, a dedicated training management team, and good interfaces between supplier's engineering teams, experienced training providers, and equipment suppliers.

  18. Towards a framework of critical success factors for implementing supply-chain information systems

    NARCIS (Netherlands)

    Denolf, J.M.; Wognum, P.M.; Trienekens, J.H.; Vorst, van der J.G.A.J.; Omta, S.W.F.

    2015-01-01

    Supply chain information systems (SCISs) have emerged as the core of successful management in supply chains. However, the difficulties of SCIS implementations have been widely cited in the literature. Research on the critical success factors (CSFs) for SCIS implementation is rather scarce and

  19. Understanding a Successful Implementation of Organizational Social Media: A Multi-Site Case Study

    Science.gov (United States)

    Lahman, Caroline D.

    2017-01-01

    The purpose of this dissertation was to examine the successful implementation of social media strategies in multiple organizations. Examining the factors an organization used to implement social media can provide the understanding of the benefits and risks associated with this technology. Some businesses are considered successful using social…

  20. A successful enterprise system re-implementation against all odds – A multisourcing case study

    DEFF Research Database (Denmark)

    Svejvig, Per

    2011-01-01

    Achieving success in enterprise systems (ES) implementations is challenging. The success rate is not high in view of the sums invested by many organizations in these companywide systems. The literature is charged with reasons for unsuccessful implementations, such as a lack of top management supp...... support and insufficient change management. Contrary to this research, empirical data from an ES re-implementation in a Scandinavian high-tech company shows successful implementation despite many problematic shifts in outsourcing partners. Therefore, it is natural to ask: why was the re...

  1. Chronicling a successful secondary implementation of Studio Physics

    Science.gov (United States)

    Kohl, Patrick B.; Vincent Kuo, H.

    2012-09-01

    The Colorado School of Mines (CSM) has taught its first-semester calculus-based introductory physics course (Physics I) using a hybrid lecture/Studio Physics format since the spring of 1997. Starting in the fall of 2007, we have been converting the second semester of our calculus-based introductory physics course (Physics II) to a hybrid lecture/Studio Physics format, beginning from a traditional lecture/lab/recitation course. In this paper, we document the stages of this transformation, highlighting what has worked and what has not, and the challenges and benefits associated with the switch to Studio Physics. A major goal in this study is to develop a method for secondary implementations of Studio physics that keeps the time and resource investments manageable. We describe the history of Studio at CSM and characterize our progress via several metrics, including pre/post Conceptual Survey of Electricity and Magnetism (CSEM) scores, Colorado Learning About Science Survey scores (CLASS), exam scores, failure rates, and a variety of qualitative observations. Results suggest that Studio has increased student performance and satisfaction despite an aggressive expansion of class sizes in the past few years. Gains have been concentrated mostly in problem-solving skills and exam performance (as opposed to conceptual survey gains), in contrast to what has sometimes been seen in other studies.

  2. The preliminary success of ALARA implementation in Daya Bay NPP

    International Nuclear Information System (INIS)

    Yang Maochun; Chen Degan

    2000-01-01

    Based on the practical condition of the plant and in reference to advanced management experiences worldwide, Daya Bay Nuclear Power Plant has established its own peculiar management system for radiation protection management and ALARA implementation. The characteristics of the system are: radiation protection training to all workers, active involvement of all managers and staffs, and whole process safety control to maintenance activities. The management philosophy of 'workers are responsible for their own radiation safety' is adopted in the plant. A strict, formalized and systematic whole staff radiation protection training, evaluation, authorization and periodically refreshing mechanism had been established and executed in the plant. In the organizational point of view, the responsibilities of line managers were specified in plant procedures, ALARA coordination organization on plant level and for specific activities were established. Meanwhile, the plant highlighted the defining, following up, controlling and advertising of radiation protection targets. All these measures made radiation protection management be the responsibilities of a safety network in which whole staffs are involved. In the practical radiation protection activities, the plant focuses on works of high radiation risk and performs whole process control. In addition, professional radiation protection staff played an important and active role in technical advisory and control of radiation protection. Satisfactory results have been achieved in Daya Bay NPP in radiation protection in the past years. The collective dose including that of contractors per unit and year have been declining from 0.99 man·Sv/Unit·Year in 1995 to 0.667 man·Sv/Unit·Year in 1998, which were consistently lower than the best quartile result of PWR plants in WANO reports each year. Individual dose was also controlled at a very low level, no one was overexposed in the past years

  3. Vicious and virtuous cycles in ERP implementation : a case study of interrelations between critical success factors

    NARCIS (Netherlands)

    Akkermans, H.A.; Helden, van K.

    2002-01-01

    ERP implementations are complex undertakings. Recent research has provided us with plausible critical success factors (CSFs) for such implementations. This article describes how one list of CSFs (Somers & Nelson, 2001) was used to analyse and explain project performance in one ERP implementation in

  4. 42 CFR 495.340 - As-needed HIT PAPD update and as-needed HIT IAPD update requirements.

    Science.gov (United States)

    2010-10-01

    ... limited to any of the following: (a) A projected cost increase of $100,000 or more. (b) A schedule... implementation approach, or scope of activities beyond that approved in the HIT planning advance planning document or the HIT implementation advance planning document. (d) A change in implementation concept or a...

  5. Nedley Depression Hit Hypothesis

    OpenAIRE

    Nedley, Neil; Ramirez, Francisco E.

    2014-01-01

    Depression is often diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. We propose how certain lifestyle choices and non-modifiable factors can predict the development of depression. We identified 10 cause categories (hits or ?blows? to the brain) and theorize that four or more active hits could trigger a depression episode. Methods. A sample of 4271 participants from our community-based program (70% female; ages 17-94 years) was assessed ...

  6. Evaluation of the Influence of Selected Factors on a Successful ERP Software Implementation

    Directory of Open Access Journals (Sweden)

    Grażyna Hołodnik-Janczura

    2010-01-01

    Full Text Available Based on a pilot study, a list of critical success factors for an IT project was developed. These factors were subjected to statistical analysis on the basis of the results of a questionnaire. Two samples of projects, called "success" and "failure" respectively, were analysed. The groups were distinguished in order to evaluate the influence of selected factors on the success of an implementation project. Furthermore, a non-parametric test was applied, in order to conduct statistical data analysis, which confirmed the influence of the majority of the selected factors on the success of an implementation project. (original abstract

  7. What characterizes the work culture at a hospital unit that successfully implements change - a correlation study.

    Science.gov (United States)

    André, Beate; Sjøvold, Endre

    2017-07-14

    To successfully achieve change in healthcare, a balance between technology and "people ware", the human recourses, is necessary. However, the human aspect of the change implementation process has received less attention than the technological issues. The aim was to explore the factors that characterize the work culture in a hospital unit that successfully implemented change compared with the factors that characterize the work culture of a hospital unit with unsuccessful implementation. The Systematizing Person-Group Relations method was used for gathering and analyzing data to explore what dominate the behavior in a particular work environment identifying challenges, limitations and opportunities. This method applied six different dimensions, each representing different behavior in a work culture: Synergy, Withdrawal, Opposition, Dependence, Control and Nurture. We compared two different units at the same hospital, one that successfully implemented change and one that was unsuccessful. There were significant statistical differences between healthcare personnel working at a unit that successfully implemented change contrasted with the unit with unsuccessful implementation. These significant differences were found in both the synergy and control dimensions, which are important positive qualities in a work culture. The results of this study show that healthcare personnel at a unit with a successful implementation of change have a working environment with many positive qualities. This indicates that a work environment with a high focus on goal achievement and task orientation can handle the challenges of implementing changes.

  8. Exploring the success, failure and factors influencing M-government implementation in developing countries

    CSIR Research Space (South Africa)

    Ogunleye, OS

    2014-05-01

    Full Text Available and to provide better services to citizens, businesses, and government agencies through using mobile technology. This research reviews the success, failures and factors influencing m-Government development and implementation in developing countries...

  9. The impact of middle manager affective commitment on perceived improvement program implementation success.

    Science.gov (United States)

    Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

    Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective

  10. NIMROD Simulations of the HIT-SI and HIT-SI3 Devices

    Science.gov (United States)

    Morgan, Kyle; Jarboe, Tom; Hossack, Aaron; Chandra, Rian; Everson, Chris

    2017-10-01

    The Helicity Injected Torus with Steady Inductive helicity injection (HIT-SI) experiment uses a set of inductively driven helicity injectors to apply non-axisymmetric current drive on the edge of the plasma, driving an axisymmetric spheromak equilibrium in a central confinement volume. Significant improvements have been made to extended MHD modeling of HIT-SI, with both the resolution of disagreement at high injector frequencies in HIT-SI in addition to successes with the new upgraded HIT-SI3 device. Previous numerical studies of HIT-SI, using a zero-beta eMHD model, focused on operations with a drive frequency of 14.5 kHz, and found reduced agreement with both the magnetic profile and current amplification at higher frequencies (30-70 kHz). HIT-SI3 has three helicity injectors which are able to operate with different mode structures of perturbations through the different relative temporal phasing of the injectors. Simulations that allow for pressure gradients have been performed in the parameter regimes of both devices using the NIMROD code and show improved agreement with experimental results, most notably capturing the observed Shafranov-shift due to increased beta observed at higher finj in HIT-SI and the variety of toroidal perturbation spectra available in HIT-SI3. This material is based upon work supported by the U.S. Department of Energy, Office of Science, Office of Fusion Energy Sciences under Award Number DE-FG02- 96ER54361.

  11. An overview of Hydro-Quebec's implementation of ISO14001 - principles and success factors

    International Nuclear Information System (INIS)

    Bourbonniere, M.

    1999-01-01

    Reasons for Hydro-Quebec to have an environmental management system are described. It is said to form the basis of the new 'hands-off' governance, empowerment and accountability regime, it supports expansion of the electricity market, demonstrates effectiveness of environmental management, implements a systematic approach to environmental management, and most of all, because it makes good business sense. The principles of implementation such as embedding responsibility for environmental management system implementation and maintenance into the mission of individual unit, thus recognizing the different needs and rates of implementation by the 1800+ sites and activities of the Corporation, success factors, and the current state of implementation are also reviewed

  12. From Project Management Capabilities to ERP Implementation Success: The Mediating Effect of IT Executives' Capabilities

    Science.gov (United States)

    Touir, Maatallah

    2016-01-01

    Enterprise resource planning project implementation success is necessary for organizations to enhance productivity and achieve operational efficiency; however, the failure rates of ERP projects remain high, ranging between 10% and 90%, and costing organizations $500,000 to $300 million. The problem addressed in this study was the low success rate…

  13. Barriers to Successful Implementation of Technology Integration in Educational Settings: A Case Study

    Science.gov (United States)

    Laferrière, T.; Hamel, C.; Searson, M.

    2013-01-01

    Representing issues discussed at the EduSummIT 2011 relative to essential conditions and barriers to successful technology integration, this article presents a systemic analysis of barriers that needed to be overcome for an information technology initiative (Remote Networked School project) to be successfully implemented. The analysis was…

  14. Defining critical success factors in TOD implementation using rough set analysis

    NARCIS (Netherlands)

    Thomas, R.; Bertolini, L.

    2017-01-01

    This paper defines critical success conditions in transit-oriented development (TOD), evaluating the impact of practices, policies, and governance models on implementation. As part of a meta-analysis of 11 international case studies, 16 critical success factors were developed and validated using

  15. Examining Success Factors Related to ERP Implementations in Higher Education Shared Services Projects

    Science.gov (United States)

    Stoyanoff, Dawn Galadriel Pfeiffer

    2012-01-01

    This study examined the enterprise resource planning (ERP) implementations that utilized a shared services model in higher education. The purpose of this research was to examine the critical success factors which were perceived to contribute to project success. This research employed a quantitative non-experimental correlational design and the…

  16. How internal audit can contribute to the success of ERP implementation projects in an Irish context.

    OpenAIRE

    Bennett, John Michael Anthony

    2014-01-01

    non-peer-reviewed The aim of this study is to explore how Internal Audit can contribute towards the successful implementation of ERP (Enterprise Resource Planning) projects in an Irish context. ERP projects are well documented for high failure rates and adverse impact on receiving businesses. Although there is limited literature available concerning the role of Internal Audit within ERP implementations, there is plenty available relating to ERP implementations which document risks, problem...

  17. The SVT Hit Buffer

    International Nuclear Information System (INIS)

    Belforte, S.; Dell'Orso, M.; Donati, S.

    1996-01-01

    The Hit Buffer is part of the Silicon Vertex Tracker, a trigger processor dedicated to the reconstruction of particle trajectories in the Silicon Vertex Detector and the Central Tracking Chamber of the Collider Detector at Fermilab. The Hit Buffer is a high speed data-traffic node, where thousands of words are received in arbitrary order and simultaneously organized in an internal structured data base, to be later promptly retrieved and delivered in response to specific requests. The Hit Buffer is capable of processing data at a rate of 25 MHz, thanks to the use of special fast devices like Cache-Tag RAMs and high performance Erasable Programmable Logic Devices from the XILINX XC7300 family

  18. Implementing IT processes the main 17 IT processes and directions for a successful implementation

    CERN Document Server

    Pilorget, Lionel

    2015-01-01

    Information Technology plays a major role in our society. Due to system integration and process automation, a company has to rely on performant information systems. To achieve this objective, it is important to have relevant IT processes in place on the one hand to ensure current operation and on the other hand to enable the successful introduction of new technologies. Once IT processes are defined and described, interrelations become visible, which allow to gain an appropriate level of maturity.

  19. What are the requirements of a successful ERP implementation in SMEs? Special focus on Southern Africa

    Directory of Open Access Journals (Sweden)

    Victoria Hasheela-Mufeti

    2017-01-01

    Full Text Available Many international Enterprise Resource Planning (ERP systems were developed based on the best practices of organizations in which they were developed. These organizations are usually large, and in developed countries. However, small organizations in other parts of the world are also implementing ERP. Implementing a system based on different practices that differ from yours is certainly bound to come with issues. The objective of the study is to identify challenges experienced by SMEs when implementing ERP systems, and to suggest requirements of achieving successful implementations in SMEs in Southern Africa. A thematic analysis methodology was used to explore identified challenges from fourteen SMEs and to identify themes within the data. The study suggested that a successful ERP implementation requires sufficient and appropriate training, reliable internet connection, involvement of end-users, change management, as well as sufficient demonstration of the prospective ERP system.

  20. A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

    Science.gov (United States)

    MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

    2017-04-01

    Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

  1. How does interorganisational implementation behaviour challenge the success of Football Fitness?

    DEFF Research Database (Denmark)

    Bennike, Søren; Ottesen, Laila

    2016-01-01

    three crucial interconnected factors influencing interorganisational implementation behaviour and representing complications for the successful implementation of Football Fitness: (1) The implementation is being carried out by multiple actors with different implementation tasks. These actors operate......This article explores the role of the interorganisational implementation behaviour of the relevant actors in the implementation of Football Fitness, a Danish football-based, health-related activity. Football Fitness was designed by the Danish Football Association in 2010 and introduced in several...... volunteer football clubs in 2011. Today, around 200 of ∼1,600 potential clubs are involved. The analysis deployed a qualitative approach, including document analysis, individual interviews and focus group interviews. The theoretical framework is rooted in policy implementation theory. The findings reveal...

  2. Maternity Nurses' Perceptions of Implementation of the Ten Steps to Successful Breastfeeding.

    Science.gov (United States)

    Cunningham, Emilie M; Doyle, Eva I; Bowden, Rodney G

    The purpose of this study was to determine maternity nurses' perceptions of implementing the Ten Steps to Successful Breastfeeding. An online survey and a focus group were used to evaluate perceptions of maternity nurses of implementing the Ten Steps to Successful Breastfeeding in an urban Texas hospital at the onset of the project initiation. Responses were transcribed and coded using Nvivo software. Thematic analysis was conducted and consensus was reached among the research team to validate themes. Twenty-eight maternity nurses participated. Nurses perceived a number of barriers to implementing the Ten Steps to Successful Breastfeeding including nurse staffing shortages, variations in practice among nurses, different levels of nurse education and knowledge about breastfeeding, lack of parental awareness and knowledge about breastfeeding, culture, and postpartum issues such as maternal fatigue, visitors, and routine required procedures during recovery care that interfered with skin-to-skin positioning. Maternity nurses desired more education about breastfeeding; specifically, a hands-on approach, rather than formal classroom instruction, to be able to promote successful implementation of the Ten Steps. More education on breastfeeding for new mothers, their families, and healthcare providers was recommended. Nurse staffing should be adequate to support nurses in their efforts to promote breastfeeding. Skin-to-skin positioning should be integrated into the recovery period. Hospital leadership support for full implementation and policy adherence is essential. Challenges in implementing the Ten Steps were identified along with potential solutions.

  3. A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

    Science.gov (United States)

    Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

    2010-01-01

    We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

  4. BPR implementation process: an analysis of key success and failure factors

    Directory of Open Access Journals (Sweden)

    Mohamad Reza Khoshlafz

    2016-08-01

    Full Text Available This paper investigates the effects of different factors influencing on the successful implementation of the business process re-engineering (BPR in Iran. The study selects 386 experts randomly and using some statistical tests examines the effects of four groups of factors including strategic, organizational, methodologic and technological & educational issues on the success of the BPR implementation in Iran. The study designs a questionnaire in Likert scale and distributes it among some experts where Cronbach alpha was calculated as 0.71. The implementation of Pearson correlation ratio has confirmed that technological and educational factors marinated the highest effects (r = 0.523, Sig. = 0.000 followed by strategic (r = 0.505, Sig. = 0.000, organizational (r = 0.352, Sig. = 0.000 and methodologic issues (r = 0.267, Sig. = 0.000. In addition, the implementation of Stepwise regression has confirmed that technological & educational, strategic and methodologic factors influence on BPR in Iran.

  5. Success factors for implementation of the balanced scorecard in a NHS multi-agency setting.

    Science.gov (United States)

    Radnor, Zoe; Lovell, Bill

    2003-01-01

    Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration. This paper then outlines some factors to be taken into account for "successful" BSC implementation in a NHS multi-agency setting. These findings emerged from a series of focus groups that took place with contributors drawn from all the key organisations within the Bradford Health Action Zone. Finally, this paper argues that if key criteria are met, successful implementation of the BSC may then proceed. However, "blind" BSC implementation without consideration of these factors may result in potential "failure".

  6. Implementation of success factors in new product development: The missing link

    DEFF Research Database (Denmark)

    Jensen, Bjarne; Harmsen, Hanne

    2001-01-01

    This paper addresses companies' lack of implementation of success factors in new product development. Drawing on theory in the competence perspective and an exploratory empirical study, the paper points to two major areas that have not been covered by previous studies on new product development s...... success factors. The two areas are knowledge and skills of individual employees, values and norms and it is suggested that increased understanding of these two areas hold potential in making identified success factors more accessible to companies.......This paper addresses companies' lack of implementation of success factors in new product development. Drawing on theory in the competence perspective and an exploratory empirical study, the paper points to two major areas that have not been covered by previous studies on new product development...

  7. Critical success factors in implementing an e-rostering system in a healthcare organisation.

    Science.gov (United States)

    Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

    2017-01-01

    Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

  8. Implementation of Green New Product Development Among SMEs: Barriers and Critical Success Factors

    Directory of Open Access Journals (Sweden)

    Abu Noor Hidayah

    2018-01-01

    Full Text Available Green New Product Development (GNPD is very important due to environmental issues increasing. GNPD is defined as creating, designing and develop ecological product which could help in protecting the environment. Small and medium enterprise (SME firms is one of the contributor to the environmental issues but they could not afford to implement GNPD because there are several obstacles which prevent the successful of GNPD implementation. The objective of this paper are to identify the critical success factors and to determine the obstacles of GNPD implementation among SMEs. The method used in this study is conceptual review of previous literature in green and NPD area of research. The result finding of this paper consist of 9 critical success factors and 12 obstacles. All the critical success factors and obstacles will be grouped. The finding of this study could be a source and fundamental guideline for future study in developing framework for GNPD implementation especially for manufacturing SMEs in Malaysia. Besides that, the result of this study could help organization especially SMEs’s owner and manager in assessing their initiative to implement GNPD in organization.

  9. The Key Success and Strategic Role of Accrual Based Accounting Implementation

    OpenAIRE

    Surepno, Surepno

    2015-01-01

    Central Government policy to adopt accrual-based accounting system providing consequences for local governments to apply accrual accounting in the financial statements. Empirical evidence shows that the readiness of the local government in Indonesia in the process of implementation of accrual accounting is still relatively low. This study aimed to analyze the success of Semarang Government in implementing accrual accounting. This study also analyzes the offender's response to the implementati...

  10. A Strategic Analysis for Successful Implementation of Social Media for SFU Business

    OpenAIRE

    Leung, Eric Yuk Wai

    2010-01-01

    Universities and other educational institutions are increasingly looking to leverage the power of social media to recruit new student, communicate with student, improve student services and collect feedback. Understanding social media is an important first step to ensure a successful implementation of social media as a communication strategy. This paper introduces social media and provides social media implementation strategies for SFU Business by focusing on the communication objectives of t...

  11. Critical success factors for implementing supply chain information systems : insights from the pork industry

    OpenAIRE

    Denolf, J.M.

    2014-01-01

    Critical success factors for implementing supply chain information systems – Janne M. Denolf Due to intensified competition, companies realize that they should closely collaborate with their supply-chain partners to further cut costs and stay competitive. To do so, supply-chain partners should intensify information sharing, which is often facilitated through supply chain information systems (SCIS). Implementation of such a system is a complex undertaking due to the umpteen technical and organ...

  12. Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success.

    Science.gov (United States)

    Rangachari, Pavani

    2018-01-01

    In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as "innovation implementation failure" in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the "what"), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the "how"). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health

  13. Critical success factors for offshoring of enterprise resource planning (ERP implementations

    Directory of Open Access Journals (Sweden)

    Rajneesh Chauhan

    2012-01-01

    Full Text Available Background: In recent years, offshoring enterprise resource planning (ERP implementation has been an emerging trend in the field of offshoring information technology (IT. However, both ERP implementations and IT offshoring are fraught with risks, and when both ERP implementation and IT offshoring happen together, the risks become even more pronounced. Therefore, it is important to understand and identify the issues of ERP implementation in an offshoring situation. Objectives: The purpose of this paper is to highlight the key factors that enable successful offshoring ERP implementation from the client and the vendor perspective. Methods/Approach: The paper uses literature as a basis for identifying a critical success factor, data collected through semi-structured interviews with ERP managers at various levels of the subject organizations, and eventually their analysis. Results: The findings of the paper reveal that various factors are critical while implementing offshoring ERP. They include: offshoring partnership, project management, project team composition, people issues, communications and compliance of the onsite team composition. It is also noticed that ten factors are grouped into three categories: the client side, the vendor side, and both. Conclusions: Organizations are currently undertaking or considering the offshoring ERP implementation particularly from India. This paper will enable them to understand the possible challenges and areas of offshoring the ERP implementation program. The value and originality of the paper comes from the fact that up to now, ERP implementation in offshoring has not been comprehensively explored. This research provides a complete understanding of the critical success factors from the client, the vendor or both the client and the vendor perspective. It also enables researchers to analyse ili rethink ili review offshoring in different service areas.

  14. Critical success factors simplified implementing the powerful drivers of dramatic business improvement

    CERN Document Server

    Howell, Marvin T

    2010-01-01

    Critical-to-success factors (CSFs) have become essential elements to strategic planning and no business can achieve consistent success without effectively adopting them. To take full advantage of CSFs, however, an organization must first understand what they are and how they can be used to drive organizational initiatives and processes. Critical Success Factors Simplified: Implementing the Powerful Drivers of Dramatic Business Improvement provides a concise manual on CSFs that will teach you how to identify and select the right CSFs, measure their impact, and adjust them as needed to reach your goals.

  15. Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success

    Science.gov (United States)

    Rangachari, Pavani

    2018-01-01

    In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as “innovation implementation failure” in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on “innovation implementation” in hospitals and health systems over the last decade, since the spotlight was cast on “innovation implementation failure” in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the “what”), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the “how”). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and

  16. Lessons for Implementation from the World's Most Successful Programme: The Global Eradication of Smallpox.

    Science.gov (United States)

    Pratt, David

    1999-01-01

    Focuses on lessons educators might learn from the Intensified Campaign for the Global Eradication of Smallpox. Outlines the history of smallpox eradication. Discusses the eradication effort's obstacles, campaign, and costs and benefits. Considers five factors relevant to the successful implementation of educational programs. (CMK)

  17. Critical success factors for implementing supply chain information systems : insights from the pork industry

    NARCIS (Netherlands)

    Denolf, J.M.

    2014-01-01

    Critical success factors for implementing supply chain information systems – Janne M. Denolf

    Due to intensified competition, companies realize that they should closely collaborate with their supply-chain partners to further cut costs and stay competitive. To do so,

  18. Health information exchange implementation: lessons learned and critical success factors from a case study.

    Science.gov (United States)

    Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

    2014-08-15

    Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

  19. Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

    Science.gov (United States)

    Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

    2016-03-01

    Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

  20. Steps to Ensure a Successful Implementation of Occupational Health and Safety Interventions at an Organizational Level

    Science.gov (United States)

    Herrera-Sánchez, Isabel M.; León-Pérez, José M.; León-Rubio, José M.

    2017-01-01

    There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention’s effectiveness and for understanding how and why the intervention has been (un)successful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade. PMID:29375413

  1. Human Factors Predicting Failure and Success in Hospital Information System Implementations in Sub-Saharan Africa.

    Science.gov (United States)

    Verbeke, Frank; Karara, Gustave; Nyssen, Marc

    2015-01-01

    From 2007 through 2014, the authors participated in the implementation of open source hospital information systems (HIS) in 19 hospitals in Rwanda, Burundi, DR Congo, Congo-Brazzaville, Gabon, and Mali. Most of these implementations were successful, but some failed. At the end of a seven-year implementation effort, a number of risk factors, facilitators, and pragmatic approaches related to the deployment of HIS in Sub-Saharan health facilities have been identified. Many of the problems encountered during the HIS implementation process were not related to technical issues but human, cultural, and environmental factors. This study retrospectively evaluates the predictive value of 14 project failure factors and 15 success factors in HIS implementation in the Sub-Saharan region. Nine of the failure factors were strongly correlated with project failure, three were moderately correlated, and one weakly correlated. Regression analysis also confirms that eight factors were strongly correlated with project success, four moderately correlated, and two weakly correlated. The study results may help estimate the expedience of future HIS projects.

  2. Ethical budgets: a critical success factor in implementing new public management accountability in health care.

    Science.gov (United States)

    Bosa, Iris M

    2010-05-01

    New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

  3. The Key Success and Strategic Role of Accrual Based Accounting Implementation

    Directory of Open Access Journals (Sweden)

    Surepno Surepno

    2015-09-01

    Full Text Available Central Government policy to adopt accrual-based accounting system providing consequences for local governments to apply accrual accounting in the financial statements. Empirical evidence shows that the readiness of the local government in Indonesia in the process of implementation of accrual accounting is still relatively low. This study aimed to analyze the success of Semarang Government in implementing accrual accounting. This study also analyzes the offender's response to the implementation of the strategic role of accrual accounting in transparency and accountability. Furthermore, the method used in this study is a qualitative approach to perform a case study at the Department of Finance and Asset Management Area (DPKAD Semarang by means of interviewing the key actors of implementation. The results showed that the successful implementation of accrual accounting Semarang government is supported by four main strategies, namely management commitment, regulatory development, information systems development and human resource development. Furthermore, based on the conclusions of the implementers shows that accrual accounting has a strategic role in increasing transparency and accountability through financial reporting.

  4. Critical success factors for implementing risk management systems in developing countries

    Directory of Open Access Journals (Sweden)

    M.Reza Hosseini

    2016-03-01

    Full Text Available A review of published studies on risk management in developing countries reveals that critical success factors for implementing risk management has remained an under-researched area of investigation. This paper is aimed at investigating the perceptions of construction professionals concerning the critical success factors (CSFs for implementation of risk management systems (IRMS. Survey data was collected from 87 construction professionals from the Iranian construction industry as a developing country. The results indicate that four factors are regarded as highly critical: ‘support from managers’, ‘inclusion of risk management in construction education and training courses for construction practitioners’, ‘attempting to deliver projects systematically’, and ‘awareness and knowledge of the process for implementing risk management’. Assessing the associations among CSFs also highlighted the crucial role of enhancing the effectiveness of knowledge management practices in construction organisations. Study also revealed that parties involved in projects do not agree on the level of importance of CSFs for implementing risk management in developing countries. This study contributes to practice and research in several ways. For practice, it increases understanding of how closely knowledge management is associated with the implementation of risk management systems in developing countries. For research, the findings would encourage construction practitioners to support effective knowledge management as a precursor to higher levels of risk management implementation on construction projects.

  5. A Method to Evaluate Critical Factors for Successful Implementation of Clinical Pathways.

    Science.gov (United States)

    Dong, W; Huang, Z

    2015-01-01

    Clinical pathways (CPs) have been viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care. Despite widespread enthusiasm for CPs, research has shown that many CP initiatives are unsuccessful. To this end, this study provides a methodology to evaluate critical success factors (CSFs) that can aid healthcare organizations to achieve successful CP implementation. This study presents a new approach to evaluate CP implementation CSFs, with the aims being: (1) to identify CSFs for implementation of CPs through a comprehensive literature review and interviews with collaborative experts; (2) to use a filed study data with a robust fuzzy DEMATEL (the decision making trial and evaluation laboratory) approach to visualize the structure of complicated causal relationships between CSFs and obtain the influence level of these factors. The filed study data is provided by ten clinical experts of a Chinese hospital. 23 identified CSF factors which are initially identified through a review of the literature and interviews with collaborative experts. Then, a number of direct and indirect relationships are derived from the data such that different perceptions can be integrated into a compromised cause and effect model of CP implementation. The results indicate that the proposed approach can systematically evaluate CSFs and realize the importance of each factor such that the most common causes of failure of CP implementation could be eliminated or avoided. Therefore, the tool proposed would help healthcare organizations to manage CP implementation in a more effective and proactive way.

  6. Once the shovel hits the ground : Evaluating the management of complex implementation processes of public-private partnership infrastructure projects with qualitative comparative analysis

    NARCIS (Netherlands)

    S. Verweij (Stefan)

    2015-01-01

    markdownabstractAbstract Much attention is being paid to the planning of public-private partnership (PPP) infrastructure projects. The subsequent implementation phase – when the contract has been signed and the project ‘starts rolling’ – has received less attention. However, sound agreements

  7. Developing and validating a model to predict the success of an IHCS implementation: the Readiness for Implementation Model

    Science.gov (United States)

    Gustafson, David H; Hawkins, Robert P; Brennan, Patricia F; Dinauer, Susan; Johnson, Pauley R; Siegler, Tracy

    2010-01-01

    Objective To develop and validate the Readiness for Implementation Model (RIM). This model predicts a healthcare organization's potential for success in implementing an interactive health communication system (IHCS). The model consists of seven weighted factors, with each factor containing five to seven elements. Design Two decision-analytic approaches, self-explicated and conjoint analysis, were used to measure the weights of the RIM with a sample of 410 experts. The RIM model with weights was then validated in a prospective study of 25 IHCS implementation cases. Measurements Orthogonal main effects design was used to develop 700 conjoint-analysis profiles, which varied on seven factors. Each of the 410 experts rated the importance and desirability of the factors and their levels, as well as a set of 10 different profiles. For the prospective 25-case validation, three time-repeated measures of the RIM scores were collected for comparison with the implementation outcomes. Results Two of the seven factors, ‘organizational motivation’ and ‘meeting user needs,’ were found to be most important in predicting implementation readiness. No statistically significant difference was found in the predictive validity of the two approaches (self-explicated and conjoint analysis). The RIM was a better predictor for the 1-year implementation outcome than the half-year outcome. Limitations The expert sample, the order of the survey tasks, the additive model, and basing the RIM cut-off score on experience are possible limitations of the study. Conclusion The RIM needs to be empirically evaluated in institutions adopting IHCS and sustaining the system in the long term. PMID:20962135

  8. Modeling antecedents of electronic medical record system implementation success in low-resource setting hospitals.

    Science.gov (United States)

    Tilahun, Binyam; Fritz, Fleur

    2015-08-01

    With the increasing implementation of Electronic Medical Record Systems (EMR) in developing countries, there is a growing need to identify antecedents of EMR success to measure and predict the level of adoption before costly implementation. However, less evidence is available about EMR success in the context of low-resource setting implementations. Therefore, this study aims to fill this gap by examining the constructs and relationships of the widely used DeLone and MacLean (D&M) information system success model to determine whether it can be applied to measure EMR success in those settings. A quantitative cross sectional study design using self-administered questionnaires was used to collect data from 384 health professionals working in five governmental hospitals in Ethiopia. The hospitals use a comprehensive EMR system since three years. Descriptive and structural equation modeling methods were applied to describe and validate the extent of relationship of constructs and mediating effects. The findings of the structural equation modeling shows that system quality has significant influence on EMR use (β = 0.32, P quality has significant influence on EMR use (β = 0.44, P service quality has strong significant influence on EMR use (β = 0.36, P effect of EMR use on user satisfaction was not significant. Both EMR use and user satisfaction have significant influence on perceived net-benefit (β = 0.31, P mediating factor in the relationship between service quality and EMR use (P effect on perceived net-benefit of health professionals. EMR implementers and managers in developing countries are in urgent need of implementation models to design proper implementation strategies. In this study, the constructs and relationships depicted in the updated D&M model were found to be applicable to assess the success of EMR in low resource settings. Additionally, computer literacy was found to be a mediating factor in EMR use and user satisfaction of

  9. Using the partial least squares (PLS) method to establish critical success factor interdependence in ERP implementation projects

    OpenAIRE

    Esteves, José; Pastor Collado, Juan Antonio; Casanovas Garcia, Josep

    2002-01-01

    This technical research report proposes the usage of a statistical approach named Partial Least squares (PLS) to define the relationships between critical success factors for ERP implementation projects. In previous research work, we developed a unified model of critical success factors for ERP implementation projects. Some researchers have evidenced the relationships between these critical success factors, however no one has defined in a form...

  10. Determinants of successful implementation of population-based cancer screening programmes

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Törnberg, Sven; von Karsa, Lawrence

    2012-01-01

    consider when planning, implementing and running population based cancer screening programmes. The list is general and is applicable to breast, cervical and colorectal cancer screening. It is based on evidence presented in the three European Union guidelines on quality assurance in cancer screening...... and diagnosis, supplemented with other literature and expert experience presented at a European Science Advisory Network for Health workshop. The implementation of a cancer screening programme should be divided into the following seven phases: (1) before planning, (2) planning, (3) feasibility testing, (4......) piloting or trial implementation, (5) scaling up from pilot to service, (6) running of full-scale programme, and (7) sustainability. For each phase, a substantial number of specified conditions have to be met. Successful implementation of a cancer screening programme requires societal acceptance and local...

  11. Key factors in the successful implementation of enterprise resource planning system

    Directory of Open Access Journals (Sweden)

    Farajollah Rahnavard

    2014-04-01

    Full Text Available Enterprise Resource Planning Systems (ERP are considered as the newest and most effective tools of enterprise resource planning and include an interconnected information, management and engineering system that meets all the needs of an organization. ERP implementation is costly and time-consuming and makes fundamental change in the process, if not implemented correctly it will cause challenges in most parts of the organization and will certainly fail. Therefore, the identification of key success factors in implementing ERP helps organizations avoid the loss of the project. This research aims to identify key success factors for ERP by examining 185 managers, professionals, experts of the Information and Communication Technology Institute associated with the Ministry of Communications and Information Technology of Iran. A questionnaire was used to collect data. Findings from exploratory factor analysis indicate that five factors: 1 user friendliness, flexible and consistency 2 establishment of project management; 3 alignment with user needs; 4 Management of organizational changes, and 5 observing the principles of successful implementation of ERP affect the institute and the corresponding suggestions are proposed consistent with these findings.

  12. Steps to Ensure a Successful Implementation of Occupational Health and Safety Interventions at an Organizational Level

    Directory of Open Access Journals (Sweden)

    Isabel M. Herrera-Sánchez

    2017-12-01

    Full Text Available There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention’s effectiveness and for understanding how and why the intervention has been (unsuccessful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade.

  13. Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals.

    Science.gov (United States)

    Alakaam, Amir; Lemacks, Jennifer; Yadrick, Kathleen; Connell, Carol; Choi, Hwanseok Winston; Newman, Ray G

    2018-05-01

    Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces. Research aim: This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals. A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% ( N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high. The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments. Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

  14. Obstacles to Successful Implementation of eHealth Applications into Clinical Practice.

    Science.gov (United States)

    Voogt, Marianne P; Opmeer, Brent C; Kastelein, Arnoud W; Jaspers, Monique W M; Peute, Linda W

    2018-01-01

    eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.

  15. A Primary Human Critical Success Factors Model for the ERP System Implementation

    Directory of Open Access Journals (Sweden)

    Jenko Aleksander

    2016-08-01

    Full Text Available Background and Purpose: Many researchers have investigated various Critical success factors (CSFs and the different causes of ERP implementation project failures. Despite a detailed literature preview, we were unable to find an appropriate research with a comprehensive overview of the true causes behind CSFs, observed from a human factors perspective. The objective of this research was therefore to develop and evaluate the Primary human factors (PHFs model and to confirm the significant impact of PHFs on traditional CSFs and on the project success.

  16. Positive School and Classroom Environment: Precursors of Successful Implementation of Positive Youth Development Programs

    Directory of Open Access Journals (Sweden)

    Rachel C. F. Sun

    2008-01-01

    Full Text Available This case study was based on a school where the Tier 1 Program of the Project P.A.T.H.S. was integrated into the formal curriculum. In this case study, an interview with the school principal, vice-principal, and social worker was conducted in order to understand their perceptions of administrative arrangements and issues in the school, implementation characteristics, program effectiveness, program success, and overall impression. Results showed that several positive school and classroom attributes were conducive to program success, including positive school culture and belief in students' potentials, an inviting school environment, an encouraging classroom environment, high involvement of school administrative personnel, and systematic program arrangement.

  17. Computational Physics' Greatest Hits

    Science.gov (United States)

    Bug, Amy

    2011-03-01

    The digital computer, has worked its way so effectively into our profession that now, roughly 65 years after its invention, it is virtually impossible to find a field of experimental or theoretical physics unaided by computational innovation. It is tough to think of another device about which one can make that claim. In the session ``What is computational physics?'' speakers will distinguish computation within the field of computational physics from this ubiquitous importance across all subfields of physics. This talk will recap the invited session ``Great Advances...Past, Present and Future'' in which five dramatic areas of discovery (five of our ``greatest hits'') are chronicled: The physics of many-boson systems via Path Integral Monte Carlo, the thermodynamic behavior of a huge number of diverse systems via Monte Carlo Methods, the discovery of new pharmaceutical agents via molecular dynamics, predictive simulations of global climate change via detailed, cross-disciplinary earth system models, and an understanding of the formation of the first structures in our universe via galaxy formation simulations. The talk will also identify ``greatest hits'' in our field from the teaching and research perspectives of other members of DCOMP, including its Executive Committee.

  18. User acceptability--a critical success factor for picture archiving and communication system implementation.

    Science.gov (United States)

    Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

    2000-05-01

    The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

  19. Critical success factors for TQM implementation and their impact on performance of SMEs

    OpenAIRE

    Salaheldin, S.I.

    2009-01-01

    Abstract: Purpose – The purpose of this paper is to identify the critical success factors of TQM implementation, to evaluate their impact on the primary measures as expressed by the operational performance and the secondary measures as expressed by the organizational performance, and to find out the effect of the operational performance on the organizational performance of small and medium-sized enterprises (SMEs) in the Qatari industrial sector using the structured equation modeling (SEM) ap...

  20. Critical success factors model developing for sustainable Kaizen implementation in manufactur-ing industry in Ethiopia

    OpenAIRE

    Haftu Hailu; Abdelkadir Kedir; Getachew Bassa; Kassu Jilcha

    2017-01-01

    The purpose of the research is to identify critical success factors and model developing for sustaining kaizen implementation. Peacock shoe is one of the manufacturing industries in Ethiopia facing challenges on sustaining. The methodology followed is factor analysis and empirically testing hypothesis. A database was designed using SPSS version 20. The survey was validated using statistical validation using the Cronbach alpha index; the result is 0.908. The KMO index value was obtained for th...

  1. Fire fighters as basic life support responders: A study of successful implementation

    Directory of Open Access Journals (Sweden)

    Christensen Erika

    2009-04-01

    Full Text Available Abstract Background First responders are recommended as a supplement to the Emergency Medical Services (EMS in order to achieve early defibrillation. Practical and organisational aspects are essential when trying to implement new parts in the "Chain of Survival"; areas to address include minimizing dispatch time, ensuring efficient and quick communication, and choosing areas with appropriate driving distances. The aim of this study was to implement a system using Basic Life Support (BLS responders equipped with an automatic external defibrillator in an area with relatively short emergency medical services' response times. Success criteria for implementation was defined as arrival of the BLS responders before the EMS, attachment (and use of the AED, and successful defibrillation. Methods This was a prospective observational study from September 1, 2005 to December 31, 2007 (28 months in the city of Aarhus, Denmark. The BLS responder system was implemented in an area up to three kilometres (driving distance from the central fire station, encompassing approximately 81,500 inhabitants. The team trained on each shift and response times were reduced by choice of area and by sending the alarm directly to the fire brigade dispatcher. Results The BLS responders had 1076 patient contacts. The median response time was 3.5 minutes (25th percentile 2.75, 75th percentile 4.25. The BLS responders arrived before EMS in 789 of the 1076 patient contacts (73%. Cardiac arrest was diagnosed in 53 cases, the AED was attached in 29 cases, and a shockable rhythm was detected in nine cases. Eight were defibrillated using an AED. Seven of the eight obtained return of spontaneous circulation (ROSC. Six of the seven obtaining ROSC survived more than 30 days. Conclusion In this study, the implementation of BLS responders may have resulted in successful resuscitations. On basis of the close corporation between all participants in the chain of survival this project

  2. Successes and challenges from formation to implementation of eleven broad-extent conservation programs

    Science.gov (United States)

    Beever, Erik A.; Bradford, John B.; Germino, Matthew J.; Mattsson, Brady J.; Post van der Burg, Max; Brunson, Mark

    2014-01-01

    Integration of conservation partnerships across geographic, biological, and administrative boundaries is increasingly relevant because drivers of change, such as climate shifts, transcend these boundaries. We explored successes and challenges of established conservation programs that span multiple watersheds and consider both social and ecological concerns. We asked representatives from a diverse set of 11 broadextent conservation partnerships in 29 countries 17 questions that pertained to launching and maintaining partnerships for broad-extent conservation, specifying ultimate management objectives, and implementation and learning. Partnerships invested more funds in implementing conservation actions than any other aspect of conservation, and a program’s context (geographic extent, United States vs. other countries, developed vs. developing nation) appeared to substantially affect program approach. Despite early successes of these organizations and benefits of broad-extent conservation, specific challenges related to uncertainties in scaling up information and to coordination in the face of diverse partner governance structures, conflicting objectives, and vast uncertainties regarding future system dynamics hindered long-term success, as demonstrated by the focal organizations. Engaging stakeholders, developing conservation measures, and implementing adaptive management were dominant challenges. To inform future research on broad-extent conservation, we considered several challenges when we developed detailed questions, such as what qualities of broad-extent partnerships ensure they complement, integrate, and strengthen, rather than replace, local conservation efforts and which adaptive management processes yield actionable conservation strategies that account explicitly for dynamics and uncertainties regarding multiscale governance, environmental conditions, and knowledge of the system?

  3. Using the "customer service framework" to successfully implement patient- and family-centered care.

    Science.gov (United States)

    Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

    2011-01-01

    Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.

  4. Successes and challenges from formation to implementation of eleven broad-extent conservation programs.

    Science.gov (United States)

    Beever, Erik A; Mattsson, Brady J; Germino, Matthew J; Burg, Max Post Van Der; Bradford, John B; Brunson, Mark W

    2014-04-01

    Integration of conservation partnerships across geographic, biological, and administrative boundaries is increasingly relevant because drivers of change, such as climate shifts, transcend these boundaries. We explored successes and challenges of established conservation programs that span multiple watersheds and consider both social and ecological concerns. We asked representatives from a diverse set of 11 broad-extent conservation partnerships in 29 countries 17 questions that pertained to launching and maintaining partnerships for broad-extent conservation, specifying ultimate management objectives, and implementation and learning. Partnerships invested more funds in implementing conservation actions than any other aspect of conservation, and a program's context (geographic extent, United States vs. other countries, developed vs. developing nation) appeared to substantially affect program approach. Despite early successes of these organizations and benefits of broad-extent conservation, specific challenges related to uncertainties in scaling up information and to coordination in the face of diverse partner governance structures, conflicting objectives, and vast uncertainties regarding future system dynamics hindered long-term success, as demonstrated by the focal organizations. Engaging stakeholders, developing conservation measures, and implementing adaptive management were dominant challenges. To inform future research on broad-extent conservation, we considered several challenges when we developed detailed questions, such as what qualities of broad-extent partnerships ensure they complement, integrate, and strengthen, rather than replace, local conservation efforts and which adaptive management processes yield actionable conservation strategies that account explicitly for dynamics and uncertainties regarding multiscale governance, environmental conditions, and knowledge of the system? © 2014 Society for Conservation Biology.

  5. Critical success factors model developing for sustainable Kaizen implementation in manufactur-ing industry in Ethiopia

    Directory of Open Access Journals (Sweden)

    Haftu Hailu

    2017-12-01

    Full Text Available The purpose of the research is to identify critical success factors and model developing for sustaining kaizen implementation. Peacock shoe is one of the manufacturing industries in Ethiopia facing challenges on sustaining. The methodology followed is factor analysis and empirically testing hypothesis. A database was designed using SPSS version 20. The survey was validated using statistical validation using the Cronbach alpha index; the result is 0.908. The KMO index value was obtained for the 32 items and had a value of 0.642 with Bartlett's Test of Sphericity Approx. Chi-Square 4503.007, degree of freedom 496 and significance value 0.000. A factor analysis by principal components and varimax rotation was applied for finding the critical success factors. Finding designates that 32 items were merged into eight critical success factors. All the eight factors together explain for 76.941 % of the variance. Multiple regression model analysis has indicated that some of the critical success factors had relationship with success indicators. Due to constraint of time, the researcher focused only at peacock shoe manufacturing industry. Other limitation also includes the absence of any local research that shows the critical success factors at the moment.

  6. 76 FR 55914 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-09-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... standards, implementation specifications, and certification criteria are needed. Date and Time: The HIT...

  7. 76 FR 46297 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-08-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... standards, implementation specifications, and certification criteria are needed. Date and Time: The HIT...

  8. 76 FR 4352 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2011-01-25

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National... only. Name of Committees: HIT Policy Committee's Workgroups: Meaningful Use, Privacy & Security Tiger..., implementation specifications, and certification criteria are needed. Date and Time: The HIT Policy Committee...

  9. 76 FR 28784 - HIT Standards Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Standards Committee's... implementation of the Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT...

  10. 76 FR 22399 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-04-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... standards, implementation specifications, and certification criteria are needed. Date and Time: The HIT...

  11. 76 FR 28784 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... standards, implementation specifications, and certification criteria are needed. Date and Time: The HIT...

  12. 76 FR 50736 - HIT Standards Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-08-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Standards Committee's... implementation of the Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT...

  13. 76 FR 14975 - HIT Standards Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-03-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Standards Committee's... implementation of the Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT...

  14. 76 FR 14974 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-03-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... standards, implementation specifications, and certification criteria are needed. Date and Time: The HIT...

  15. 76 FR 50735 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-08-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... standards, implementation specifications, and certification criteria are needed. Date and Time: The HIT...

  16. Implementing Indigenous Education Policy Directives in Ontario Public Schools: Experiences, Challenges and Successful Practices

    Directory of Open Access Journals (Sweden)

    Emily Milne

    2017-08-01

    Full Text Available The Ontario Ministry of Education has declared a commitment to Indigenous student success and has advanced a policy framework that articulates inclusion of Indigenous content in schooling curriculum (Ontario Ministry of Education, 2007. What are the perceptions among educators and parents regarding the implementation of policy directives, and what is seen to encourage or limit meaningful implementation? To answer these questions, this article draws on interviews with 100 Indigenous (mainly Haudenosaunee, Anishinaabe, and Métis and non-Indigenous parents and educators from Ontario Canada. Policy directives are seen to benefit Indigenous and non-Indigenous students. Interviews also reveal challenges to implementing Indigenous curricular policy, such as unawareness and intimidation among non-Indigenous educators regarding how to teach material. Policy implications are considered.

  17. The factors affecting Nigeria's success toward implementation of global public health priorities.

    Science.gov (United States)

    Echebiri, Vitalis C

    2015-06-01

    This paper examines the challenges facing the Nigerian government toward the implementation of global public health priories. The Nigerian government recognizes the need to implement these priorities by putting in place the necessary policy framework, but political instability, poor infrastructural development and inadequate funding have remained barriers toward the achievement of success in implementing these priorities. The rest of the paper elucidates the fact that despite leadership and influence from the World Health Organization and other United Nations agencies, and some responses from the Nigerian government, tackling these public health problems requires much more fundamental reform to primary health services and a reduction in poverty. Although the government has shown enough political will to tackle these problems, it is expected that a better result will be achieved through injecting more funds into the Nigerian health sector, and deploying astute health administrators to manage the sector rather than pure health professionals without managerial acumen. © The Author(s) 2014.

  18. Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

    Science.gov (United States)

    Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

    2017-05-01

    Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

  19. CRITICAL SUCCESS FACTORS FOR IMPLEMENTING LEAN PRACTICES IN IT SUPPORT SERVICES

    Directory of Open Access Journals (Sweden)

    Goutam Kundu

    2012-12-01

    Full Text Available Many studies have been done to identify the critical success factors (CSFs in for successful lean implementation in the manufacturing firms. But, till date, no systematic study has been done to identify the CSFs from the perspective of lean implementation in IT support service sector. This paper aims to address this area. A detailed literature review was undertaken to identify CSFs for lean implementation in manufacturing and services context and to consider their applicability to the IT support services sector. This paper is based on a conceptual discussion of CSFs as applied to the IT support services sector. The authors proposed a set of CSFs which is believed to be suitable for IT support service enterpri ses. The relevance of CSFs will need to be tested and qualitative research is needed to inform further work. The proposed CSFs are aimed at being useful to IT support services sector as a guideline, so as to ensure a positive outcome of the lean implementation process in IT support services sector.

  20. Clinical Computer Systems Survey (CLICS): learning about health information technology (HIT) in its context of use.

    Science.gov (United States)

    Lichtner, Valentina; Cornford, Tony; Klecun, Ela

    2013-01-01

    Successful health information technology (HIT) implementations need to be informed on the context of use and on users' attitudes. To this end, we developed the CLinical Computer Systems Survey (CLICS) instrument. CLICS reflects a socio-technical view of HIT adoption, and is designed to encompass all members of the clinical team. We used the survey in a large English hospital as part of its internal evaluation of the implementation of an electronic patient record system (EPR). The survey revealed extent and type of use of the EPR; how it related to and integrated with other existing systems; and people's views on its use, usability and emergent safety issues. Significantly, participants really appreciated 'being asked'. They also reminded us of the wider range of administrative roles engaged with EPR. This observation reveals pertinent questions as to our understanding of the boundaries between administrative tasks and clinical medicine - what we propose as the field of 'administrative medicine'.

  1. Which factors are important for the successful development and implementation of clinical pathways? A qualitative study.

    Science.gov (United States)

    De Allegri, Manuela; Schwarzbach, Matthias; Loerbroks, Adrian; Ronellenfitsch, Ulrich

    2011-03-01

    Clinical pathways (CPs) are detailed longitudinal care plans delineating measures to be conducted during a patient's treatment. Although positive effects on resource consumption and quality of care have been shown, CPs are still underutilised in many clinical settings because their development and implementation are difficult. Evidence underpinning successful development and implementation is sparse. The authors conducted semistructured face-to-face interviews with key staff members involved in the design and implementation of CPs in a large surgery department. Interviewees were asked to provide opinions on various issues, which were previously identified as potentially important in CP development and implementation. The transcribed text was read and coded independently by two researchers. Respondents highlighted the importance of a multidisciplinary participatory approach for CP design and implementation. There was a strong initial fear of losing individual freedom of treatment, which subsided after people worked with CPs in clinical everyday life. It was appreciated that the project originated from people at different levels of the department's hierarchy. Likewise, it was felt that CP implementation granted more autonomy to lower-level staff. The structured qualitative approach of this study provides information on what issues are considered important by staff members for CP design and implementation. Whereas some concepts such as the importance of a multidisciplinary approach or continuous feedback of results are known from theories, others such as strengthening the authority especially of lower-level health professionals through CPs have not been described so far. Many of the findings point towards strong interactions between factors important for CP implementation and a department's organisational structure.

  2. Survey and Explain the role of Sensemaking in Successful Strategy Implementation in Iran’s Automotive Companies

    Directory of Open Access Journals (Sweden)

    Seyed Farhad Hosseini

    2016-09-01

    Full Text Available There is not a dominant model that could explain key factors of sensemaking of strategy implementation and interactions between them. The purpose of this study is designing and explaining the role of sensemaking in successful strategy implementation along with a combination of factors which influence implementation sensemaking. This study surveyed the factors influencing sensemaking of successful strategy implementation in top Iran’s automotive companies. This is a qualitative research that uses grounded theory to obtain insight about the role of sensemaking in successful implementation through in-depth interviews with 22 individuals (Managers, Assistant Directors and Academic Professors and used gathered data to design a model of sensemaking in successful strategy implementation. Based on open and axial coding, 21 effective variables were conceptualized and classified in seven major categories then final model was designed. This theory explains factors that affect the sensemaking of successful strategy implementation and how these factors interact with each other. Sensemaking in Successful implementation of strategies depends on Sensemaking Context, Key Executers, Discourse Context, Intervening Conditions and Collective Sensemaking. Sensemaking Context cause sensemaking and sensegiving of key executers and key executers itself along with Discourse Context and Intervening Conditions lead to collective sensemaking. The consequence of model is sensemaking of successful strategy implementation that consists of maintaining and recording the meaning and its strengthening, collective effort, continuous strategy implementation and operational excellence of the organization.

  3. Success criteria for electronic medical record implementations in low-resource settings: a systematic review.

    Science.gov (United States)

    Fritz, Fleur; Tilahun, Binyam; Dugas, Martin

    2015-03-01

    Electronic medical record (EMR) systems have the potential of supporting clinical work by providing the right information at the right time to the right people and thus make efficient use of resources. This is especially important in low-resource settings where reliable data are also needed to support public health and local supporting organizations. In this systematic literature review, our objectives are to identify and collect literature about success criteria of EMR implementations in low-resource settings and to summarize them into recommendations. Our search strategy relied on PubMed queries and manual bibliography reviews. Studies were included if EMR implementations in low-resource settings were described. The extracted success criteria and measurements were summarized into 7 categories: ethical, financial, functionality, organizational, political, technical, and training. We collected 381 success criteria with 229 measurements from 47 articles out of 223 articles. Most papers were evaluations or lessons learned from African countries, published from 1999 to 2013. Almost half of the EMR systems served a specific disease area like human immunodeficiency virus (HIV). The majority of criteria that were reported dealt with the functionality, followed by organizational issues, and technical infrastructures. Sufficient training and skilled personnel were mentioned in roughly 10%. Political, ethical, and financial considerations did not play a predominant role. More evaluations based on reliable frameworks are needed. Highly reliable data handling methods, human resources and effective project management, as well as technical architecture and infrastructure are all key factors for successful EMR implementation. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Implementing Traceability Systems in Specific Supply Chain Management (SCM through Critical Success Factors (CSFs

    Directory of Open Access Journals (Sweden)

    Shahbaz Khan

    2018-01-01

    Full Text Available Traceability plays a vital role in the success of Halal Supply Chain (HSC. HSC revolve around the essential dimension of Halal Integrity (HI, whereas traceability is seemed to be medium to assure integrity. Thus, a need is felt to identify the factors which are critical to the successful implementation of traceability in Halal Supply Chain Management (HSCM. Identified Twelve Critical Success Factors (CSFs through an extensive review of literature and opinion of experts. Further, a contextual relationship among the CSFs is developed using Total Interpretive Structure Modelling (TISM approach and derived a model. The structural model is analyzed using Fuzzy MICMAC (Matrice d’Impacts Croises-Multipication Applique and Classment-cross-impact matrix multiplication applied to classification approach to identify the importance of CSFs by driving and dependence power. The primary result indicates towards; that improving the HSCM with the higher level of Halal awareness. Assuring HI will enhance the consumer satisfaction which leads to a competitive advantage for the organization. Academic researchers, industrial practitioners and Supply Chain executives can understand the complex interrelationship of CSFs by visualizing the TISM. It can help the management, lobbies and government to develop the policies regarding the implementation.

  5. Implementing Moodle for e-learning for a successful knowledge management strategy

    Directory of Open Access Journals (Sweden)

    Dana Tessier

    2016-09-01

    Full Text Available A knowledge management strategy was implemented in a call centre organization. Part of this strategy included an e-learning tool ‘Moodle’ to support employee training and knowledge management (KM initiatives. The research looked at the ways in which the e-learning tool could be used to help successfully implement the knowledge management strategy – specifically, to improve knowledge transfer between employees, improve individual and organizational performance and have a better understanding of the critical success factors involved for the KM strategy. The study analyzed three different methods of knowledge transfer to determine which resulted in the highest frequency of use for the knowledge repository. The results showed that by using e-learning, the knowledge repository had a high frequency of use and this shows that e-learning was a successful method of knowledge transfer. To keep employees functioning at an optimal level, employers will need to ensure knowledge management, training, and performance management strategies are aligned, measurable and maximized.

  6. Implementation of computerized physician order entry in National Guard Hospitals: assessment of critical success factors.

    Science.gov (United States)

    Altuwaijri, Majid M; Bahanshal, Abdullah; Almehaid, Mona

    2011-09-01

    The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia. The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live training", the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to learn from mistakes before expanding the system to other

  7. Implementation of computerized physician order entry in National Guard hospitals: Assessment of critical success factors

    Directory of Open Access Journals (Sweden)

    Majid M Altuwaijri

    2011-01-01

    Full Text Available Objective: The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE system in a leading healthcare organization in Saudi Arabia. Materials and Methods: The National Guard Health Affairs (NGHA deployed the CPOE in a pilot department, which was the intensive care unit (ICU in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. Results: The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live" training, the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. Conclusion: The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at

  8. What makes end-user training successful? : a mixed method study of a business process management system implementation

    NARCIS (Netherlands)

    Benny de Waal; Ronald Batenburg

    2012-01-01

    Under what conditions is end-user training (EUT) as part of the implementation of a business process management (BPM) system successful? This question is addressed in this paper. Based on the literature on EUT and implementation success, we first argue that user involvement with, and attitude

  9. What makes end-user training successful? A mixed method study of a business process management system implementation.

    NARCIS (Netherlands)

    Waal, B.M.E. de; Batenburg, R.

    2012-01-01

    Under what conditions is end-user training (EUT) as part of the implementation of a business process management (BPM) system successful? This question is addressed in this paper. Based on the literature on EUT and implementation success, we first argue that user involvement with, and attitude

  10. How to successfully select and implement electronic health records (EHR in small ambulatory practice settings

    Directory of Open Access Journals (Sweden)

    Detmer Don E

    2009-02-01

    Full Text Available Abstract Background Adoption of EHRs by U.S. ambulatory practices has been slow despite the perceived benefits of their use. Most evaluations of EHR implementations in the literature apply to large practice settings. While there are similarities relating to EHR implementation in large and small practice settings, the authors argue that scale is an important differentiator. Focusing on small ambulatory practices, this paper outlines the benefits and barriers to EHR use in this setting, and provides a "field guide" for these practices to facilitate successful EHR implementation. Discussion The benefits of EHRs in ambulatory practices include improved patient care and office efficiency, and potential financial benefits. Barriers to EHRs include costs; lack of standardization of EHR products and the design of vendor systems for large practice environments; resistance to change; initial difficulty of system use leading to productivity reduction; and perceived accrual of benefits to society and payers rather than providers. The authors stress the need for developing a flexible change management strategy when introducing EHRs that is relevant to the small practice environment; the strategy should acknowledge the importance of relationship management and the role of individual staff members in helping the entire staff to manage change. Practice staff must create an actionable vision outlining realistic goals for the implementation, and all staff must buy into the project. The authors detail the process of implementing EHRs through several stages: decision, selection, pre-implementation, implementation, and post-implementation. They stress the importance of identifying a champion to serve as an advocate of the value of EHRs and provide direction and encouragement for the project. Other key activities include assessing and redesigning workflow; understanding financial issues; conducting training that is well-timed and meets the needs of practice staff

  11. How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings.

    Science.gov (United States)

    Lorenzi, Nancy M; Kouroubali, Angelina; Detmer, Don E; Bloomrosen, Meryl

    2009-02-23

    Adoption of EHRs by U.S. ambulatory practices has been slow despite the perceived benefits of their use. Most evaluations of EHR implementations in the literature apply to large practice settings. While there are similarities relating to EHR implementation in large and small practice settings, the authors argue that scale is an important differentiator. Focusing on small ambulatory practices, this paper outlines the benefits and barriers to EHR use in this setting, and provides a "field guide" for these practices to facilitate successful EHR implementation. The benefits of EHRs in ambulatory practices include improved patient care and office efficiency, and potential financial benefits. Barriers to EHRs include costs; lack of standardization of EHR products and the design of vendor systems for large practice environments; resistance to change; initial difficulty of system use leading to productivity reduction; and perceived accrual of benefits to society and payers rather than providers. The authors stress the need for developing a flexible change management strategy when introducing EHRs that is relevant to the small practice environment; the strategy should acknowledge the importance of relationship management and the role of individual staff members in helping the entire staff to manage change. Practice staff must create an actionable vision outlining realistic goals for the implementation, and all staff must buy into the project. The authors detail the process of implementing EHRs through several stages: decision, selection, pre-implementation, implementation, and post-implementation. They stress the importance of identifying a champion to serve as an advocate of the value of EHRs and provide direction and encouragement for the project. Other key activities include assessing and redesigning workflow; understanding financial issues; conducting training that is well-timed and meets the needs of practice staff; and evaluating the implementation process. The EHR

  12. Implementation of oral health initiatives by Australian rural communities: Factors for success.

    Science.gov (United States)

    Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

    2018-01-01

    In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.

  13. Content validity of critical success factors for e-Government implementation in Indonesia

    Science.gov (United States)

    Napitupulu, D.; Syafrullah, M.; Rahim, R.; Amar, A.; Sucahyo, YG

    2018-05-01

    The purpose of this research is to validate the Critical Success Factors (CSFs) of e-Government implementation in Indonesia. The e-Government initiative conducted only to obey the regulation but ignoring the quality. Defining CSFs will help government agencies to avoid failure of e-Government projects. A survey with the questionnaire was used to validate the item of CSF based on expert judgment through two round of Delphi. The result showed from 67 subjects in instrument tested; there are 11 invalid items deleted and remain only 56 items that had good content validity and internal reliability. Therefore, all 56 CSFs should be adopted by government agencies in Indonesia to support e-Government implementation.

  14. Organizational and technological insight as important factors for successful implementation of IT.

    Science.gov (United States)

    Nikula, R. E.

    1999-01-01

    Politicians and hospital management in Sweden and Denmark focus on IT and especially Electronic Patient Record, EPR as a tool for changes that will lead to better economy as well as better quality and service to the patients. These changes are not direct effects of the new medium for patient records but indirect effects due to the possibilities embedded in the new technology. To ensure that the implementation is successful, i.e. leads to changes in organization structure and workflow, we need tools to prepare clinicians and management. The focus of this paper is the individual insight in technology and organization and it proposes a model to assess and categorize the possibilities of individuals and groups to participate in and make an implementation process powerful. PMID:10566426

  15. Ecosystem-Based Management in Fiji: Successes and Challenges after Five Years of Implementation

    Directory of Open Access Journals (Sweden)

    Stacy D. Jupiter

    2011-01-01

    Full Text Available In 2005, a network of 3 large, district-wide marine protected areas (MPAs and 17 village-managed closures (tabu was established in Kubulau District, Fiji. Underwater visual census (UVC data of fish biomass and benthic cover were collected between 2007 and 2009 and analysed with PERMANOVA and ANOSIM to assess differences between closed and open areas. High reef fish biomass (>1000 kg/ha within closures, significantly elevated over open areas, was consistently observed from: (1 tabu areas on naturally productive reefs within visual distance from villages; and (2 the large, long-term permanent closure located away from fishing pressure. Factors that may have contributed to low fish biomass within closures include small size of closures; noncompliance with management rules; and disclosure of management success to fishers from villages with high reliance on fisheries products. Future success of the network depends on improving awareness of management rules and ensuring implementation within a broader ecosystem framework.

  16. RESISTANCE TO CHANGE AND ERP IMPLEMENTATION SUCCESS: THE MODERATING ROLE OF CHANGE MANAGEMENT INITIATIVES

    Directory of Open Access Journals (Sweden)

    Zafar U. Ahmed

    2006-01-01

    Full Text Available Enterprise Resource Planning (ERP is a useful tool that builds strong capabilities, improves performance, supports better decision making, and provides competitive advantage for businesses. ERP aims to help the management by setting better business practices and equipping them with the right information to take timely decision. In any new technology implementation, one of the issues that need to be addressed is the resistance to change. Many implementations have failed due to strong resistance from the end users. Thus, the main purpose of this paper is to test the impact of resistance to change on ERP's implementation success and how change management initiatives acts in the capacity of a moderating role. Using data collected from 69 manufacturing organizations through a mail survey, it was found that resistance to change is negatively related to achievement of predetermined goals (b = –0.930, p < 0.01 and usersatisfaction (b = –0.952, p < 0.01. Further, change management initiatives did not moderate the relationship between resistance and predetermined goals but it moderated the relationship between resistance and user satisfaction. In addition, change management initiatives have a direct positive impact on user satisfaction. This research concludes that the human factor is very important in ERP's implementation.

  17. Understanding nurses' views on a pressure ulcer prevention care bundle: a first step towards successful implementation.

    Science.gov (United States)

    Chaboyer, Wendy; Gillespie, Brigid M

    2014-12-01

    To explore nurses' views of the barriers and facilitators to the use of a newly devised patient-centred pressure ulcer prevention care bundle. Given pressure ulcer prevention strategies are not implemented consistently, the use of a pressure ulcer care bundle may improve implementation given bundles generally assist in standardising care. A quality improvement project was undertaken after a pressure ulcer prevention care bundle was developed and pilot-tested. Short, conversational interviews with nurse explored their views of a patient-centred pressure ulcer care bundle. Interviews were audio-taped and transcribed. Inductive content analysis was used to analyse the transcripts. A total of 20 nurses were interviewed. Five categories with corresponding subcategories emerged from the analysis. They were increasing awareness of pressure ulcer prevention, prompting pressure ulcer prevention activities, promoting active patient participation, barriers to using a pressure ulcer prevention care bundle and enabling integration of the pressure ulcer prevention care bundle into routine practice. Benefits of using a patient-centred pressure ulcer prevention care bundle may include prompting patients and staff to implement prevention strategies and promote active patient participation in care. The success of the care bundle relied on both patients' willingness to participate and nurses' willingness to incorporate it into their routine work. A patient-centred pressure ulcer prevention care bundle may facilitate more consistent implementation of pressure ulcer prevention strategies and active patient participation in care. © 2014 John Wiley & Sons Ltd.

  18. ANALYSIS OF INFORMATION SYSTEM IMPLEMENTATION IN BINUS UNIVERSITY USING DELONE AND MCLEAN INFORMATION SYSTEM SUCCESS MODEL AND COBIT FRAMEWORK

    OpenAIRE

    Johan Muliadi Kerta; Angellia Debora Suryawan

    2013-01-01

    The success of implementation of information system in an organization will supportthe organization in the process of achieving goals. Successful information system will support theorganization's day-to-day operations, so that problem can be resolved more quickly and easily. Theinformation system which has been developed and implemented is also necessary to measure thematurity level. Therefore, it can determine whether the implementation of information systemsmade in accordance with the goals...

  19. A successful model to learn and implement ultrasound-guided venous catheterization in apheresis.

    Science.gov (United States)

    Gopalasingam, Nigopan; Thomsen, Anna-Marie Eller; Folkersen, Lars; Juhl-Olsen, Peter; Sloth, Erik

    2017-12-01

    Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient. Apheresis nurses completed a systematic training program for ultrasound-guided vascular access. All independent catheterizations were registered during the implementation stage. The number of CVCs in the pre- and postimplementation stages of the ultrasound guidance was compared. Six nurses completed the training program within a median of 48 days (range 38-83 days). In 77 patients, 485 independent ultrasound-guided PVC placements were performed during the implementation stage. All apheresis treatments (485/485) were accomplished using PVCs without requiring CVC as rescue. During the preimplementation stage, 125 of 273 (45.8%) procedures required a CVC for completion of apheresis procedures; during the postimplementation stage only 30 of 227 (13.2%) procedures required a CVC (p < 0.001). In the postimplementation stage, no CVCs were placed as rescue caused by failed PVCs but were only placed for patients where the ultrasound machine was unavailable. It indicates an effective success rate of 100% for ultrasound-guided PVC use. This study showed that ultrasound guidance could be implemented among apheresis nurses as a routine tool eliminating the need of CVC as a rescue. © 2017 Wiley Periodicals, Inc.

  20. Implementation of clinical governance in hospitals: challenges and the keys for success.

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Hadi Mousavi

    2014-07-01

    Full Text Available There is a number of models and strategies for improving the quality of care such as total quality management, continuous quality improvement and clinical governance. The policy of clinical governance is part of the governments overall strategy for monitoring, assuring and improving in the national health services organization. Clinical governance has been introduced as a bridge between managerial and clinical approaches to quality. For successful implementing of clinical governance, it is necessary to pay attention to firm foundations of the structure, including equipment, staffing arrangement, supporting specialties, and staff training. Therefore, as clinical governance improves safety and quality in health care services, the current situation in hospitals should be evaluated before any intervention while barriers and blocks on structure and process should be determined to select a method for changing them. Considering these points could guarantee success in implementation of clinical governance; otherwise there would be a little chance to achieve the desired results despite consumption of plenty of time and huge paper works.

  1. What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders.

    Science.gov (United States)

    Peek, Sebastiaan Theodorus Michaël; Wouters, Eveline J M; Luijkx, Katrien G; Vrijhoef, Hubertus J M

    2016-05-03

    There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard

  2. Key Success Factors of Renewable Energy Projects Implementation in Rural Areas of Indonesia

    Directory of Open Access Journals (Sweden)

    Wati Hermawati

    2017-12-01

    Full Text Available This paper is an exploratory study on renewable energy implementation in the rural areas of Indonesia. The study aim was to investigate the factors contributing to the sustainability of renewable energy projects in the rural areas. It mostly uses a qualitative approach. Primary data was mainly obtained from in-depth interviews conducted in site areas with the project owners, project managers, a key person in each local government, industry representatives, and the local community, including local leaders and users of renewable energy. Secondary data in the form of various official project reports was also used. The results indicated that the success of energy project implementation lay not only in good technology performance and long-term maintenance, but was also highly dependent on six key factors, namely: (1 project planning and development; (2 community participation; (3 active communication and beneficiaries; (4 availability of maintenance program, workshop and technician; (5 project management and institutionalization; (6 local government support and networks. The findings from this study provide useful insights to all stakeholders involved in the implementation of renewable energy technology for the rural areas in Indonesia.

  3. SU-F-P-04: Implementation of Dose Monitoring Software: Successes and Pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Och, J [Geisinger Medical Center, Danville, PA (United States)

    2016-06-15

    Purpose: to successfully install a dose monitoring software (DMS) application to assist in CT protocol and dose management. Methods: Upon selecting the DMS, we began our implementation of the application. A working group composed of Medical Physics, Radiology Administration, Information Technology, and CT technologists was formed. On-site training in the application was supplied by the vendor. The decision was made to apply the process for all the CT protocols on all platforms at all facilities. Protocols were painstakingly mapped to the correct masters, and the system went ‘live’. Results: We are routinely using DMS as a tool in our Clinical Performance CT QA program. It is useful in determining the effectiveness of revisions to existing protocols, and establishing performance baselines for new units. However, the implementation was not without difficulty. We identified several pitfalls and obstacles which frustrated progress. Including: Training deficiencies, Nomenclature problems, Communication, DICOM variability. Conclusion: Dose monitoring software can be a potent tool for QA. However, implementation of the program can be problematic and requires planning, organization and commitment.

  4. Road-map to successful implementation of geological disposal in the EU

    International Nuclear Information System (INIS)

    Patrakka, Eero

    2010-01-01

    In the conclusions from its first meeting in Bratislava (2007), the European Nuclear Energy Forum (ENEF) identified the management of spent fuel and radioactive waste as an important subject to be looked into with the objective 'to encourage Member States and industry to swiftly implement adequate nuclear waste disposal facilities, in particular deep geological repositories for high level waste'. To this end the Sub-Working Group 'Waste Management' (SWG-WM) was created in the context of the ENEF Working Group 'Risks'. As a first task, the SWG-WM was requested to compile a road-map that includes the essential elements of what is required at national level to foster the implementation of geological disposal for high level waste and spent fuel. In October 2009, a 'Road-map to Successful Implementation of Geological Disposal in the EU' was endorsed. The aim of this document is to provide guidance to EU Member States that are starting out or are at an early stage on the decades-long process leading towards the implementation of geological repositories for high level radioactive wastes or spent nuclear fuel, if this is deemed to be a waste. The guidance is based to a large extent on the positive progress that has been made in a number of Member States. Small and new nuclear states may take a long time to reach such a position - but a strong message of this Road-map is that the process should be initiated as soon as possible. The Road-map is intended to be generic enough to be applicable to all Member States, independently of their current position; the national Road-maps to be developed should be compatible with this, but will differ in the specifics of approach and of timing. (authors)

  5. Regional media coverage influences the public's negative attitudes to policy implementation success in Sweden.

    Science.gov (United States)

    Fredriksson, Mio; Tiainen, Anne; Hanning, Marianne

    2015-12-01

    One central aspect of health literacy is knowledge of patients' rights. Being an important source of information about health and health care, the media may influence health literacy and act as a policy implementer. To investigate whether regional news media coverage in Sweden is linked to (i) the public's awareness and knowledge of a patient's rights policy, the waiting-time guarantee and (ii) the public's attitudes to how the guarantee's time limits are met, that is, implementation success. Three types of data are used. First, a national telephone survey of the public's awareness, knowledge and attitudes; second, media coverage information from digital media monitoring; and third, official waiting-time statistics. Bivariate and multivariate regression analyses are performed with the 21 Swedish county councils/regions as a base. In the county councils/regions, non-awareness ranged from 1 to 15% and knowledge from 47 to 67%. There are relatively large differences between population groups. The amount of regional media coverage shows no significant correlation to the level of awareness and knowledge. There is, however, a significant correlation to both positive and negative attitudes; the latter remains after controlling for actual waiting times. At the national level, the media function as a policy implementer, being the primary source of information. At the regional level, the media are part of the political communication, reporting more extensively in county councils/regions where the population holds negative views towards the achievement in implementing the guarantee. We conclude that Swedish authorities should develop its communication strategies to bridge health literacy inequalities. © 2014 John Wiley & Sons Ltd.

  6. Eight critical factors in creating and implementing a successful simulation program.

    Science.gov (United States)

    Lazzara, Elizabeth H; Benishek, Lauren E; Dietz, Aaron S; Salas, Eduardo; Adriansen, David J

    2014-01-01

    Recognizing the need to minimize human error and adverse events, clinicians, researchers, administrators, and educators have strived to enhance clinicians' knowledge, skills, and attitudes through training. Given the risks inherent in learning new skills or advancing underdeveloped skills on actual patients, simulation-based training (SBT) has become an invaluable tool across the medical education spectrum. The large simulation, training, and learning literature was used to provide a synthesized yet innovative and "memorable" heuristic of the important facets of simulation program creation and implementation, as represented by eight critical "S" factors-science, staff, supplies, space, support, systems, success, and sustainability. These critical factors advance earlier work that primarily focused on the science of SBT success, to also include more practical, perhaps even seemingly obvious but significantly challenging components of SBT, such as resources, space, and supplies. SYSTEMS: One of the eight critical factors-systems-refers to the need to match fidelity requirements to training needs and ensure that technological infrastructure is in place. The type of learning objectives that the training is intended to address should determine these requirements. For example, some simulators emphasize physical fidelity to enable clinicians to practice technical and nontechnical skills in a safe environment that mirrors real-world conditions. Such simulators are most appropriate when trainees are learning how to use specific equipment or conduct specific procedures. The eight factors-science, staff, supplies, space, support, systems, success, and sustainability-represent a synthesis of the most critical elements necessary for successful simulation programs. The order of the factors does not represent a deliberate prioritization or sequence, and the factors' relative importance may change as the program evolves.

  7. Accelerating Digital Mental Health Research From Early Design and Creation to Successful Implementation and Sustainment.

    Science.gov (United States)

    Mohr, David C; Lyon, Aaron R; Lattie, Emily G; Reddy, Madhu; Schueller, Stephen M

    2017-05-10

    Mental health problems are common and pose a tremendous societal burden in terms of cost, morbidity, quality of life, and mortality. The great majority of people experience barriers that prevent access to treatment, aggravated by a lack of mental health specialists. Digital mental health is potentially useful in meeting the treatment needs of large numbers of people. A growing number of efficacy trials have shown strong outcomes for digital mental health treatments. Yet despite their positive findings, there are very few examples of successful implementations and many failures. Although the research-to-practice gap is not unique to digital mental health, the inclusion of technology poses unique challenges. We outline some of the reasons for this gap and propose a collection of methods that can result in sustainable digital mental health interventions. These methods draw from human-computer interaction and implementation science and are integrated into an Accelerated Creation-to-Sustainment (ACTS) model. The ACTS model uses an iterative process that includes 2 basic functions (design and evaluate) across 3 general phases (Create, Trial, and Sustain). The ultimate goal in using the ACTS model is to produce a functioning technology-enabled service (TES) that is sustainable in a real-world treatment setting. We emphasize the importance of the service component because evidence from both research and practice has suggested that human touch is a critical ingredient in the most efficacious and used digital mental health treatments. The Create phase results in at least a minimally viable TES and an implementation blueprint. The Trial phase requires evaluation of both effectiveness and implementation while allowing optimization and continuous quality improvement of the TES and implementation plan. Finally, the Sustainment phase involves the withdrawal of research or donor support, while leaving a functioning, continuously improving TES in place. The ACTS model is a step

  8. Telehealth: seven strategies to successfully implement disruptive technology and transform health care.

    Science.gov (United States)

    Schwamm, Lee H

    2014-02-01

    "Telehealth" refers to the use of electronic services to support a broad range of remote services, such as patient care, education, and monitoring. Telehealth must be integrated into traditional ambulatory and hospital-based practices if it is to achieve its full potential, including addressing the six domains of care quality defined by the Institute of Medicine: safe, effective, patient-centered, timely, efficient, and equitable. Telehealth is a disruptive technology that appears to threaten traditional health care delivery but has the potential to reform and transform the industry by reducing costs and increasing quality and patient satisfaction. This article outlines seven strategies critical to successful telehealth implementation: understanding patients' and providers' expectations, untethering telehealth from traditional revenue expectations, deconstructing the traditional health care encounter, being open to discovery, being mindful of the importance of space, redesigning care to improve value in health care, and being bold and visionary.

  9. Implementation Process of 5S for a Company in Real Life - Problems, Solutions, Successes

    Science.gov (United States)

    Czifra, György

    2017-09-01

    Developed in Japan, 5S is a system of organizing workplace for efficiency, effectiveness and safety. Is 5s important? The answer is: "YES", because the implementation is about empowering employees to control their work area and create an environment where they want to work every day. It is a program that only works with grass roots level engagement. With commitment to safety, we are equally committed to 5S to ensure a safe place to work. It enabled us to indicate where waste was occurring and thus improve the work area sustainably. We recognized real problems, found solutions and ultimately we were successful in our endeavors. Throughout different companies, various words of similar meaning are used. No matter what specific words are used to identify the steps in 5S, the purpose remains the same: create a clean, organized and efficient work environment.

  10. Didactical contract: An analytical concept to facilitate successful implementation of open-ended physics labs

    DEFF Research Database (Denmark)

    Jacobsen, Lærke Bang; Johannsen, Bjørn Friis; Rump, Camilla Østerberg

    outcomes of alternative laboratory work in secondary and tertiary physics education we decided to approach the underlying cause of the problem. Framed in the theory of Didactical Situations in mathematics we adapt the concept of the didactical contract to the physics education context to locate aspects...... of the traditional laboratory learning environment that would lead to resistance from those involved if faced with alternatives. We conclude that both teachers and students lean heavily on a type of algorithm that ensures an appearance of having successfully completed the assigned tasks. This algorithmic didactical...... contract permeates through secondary education into university physics education. Our results allow for a better renegotiation of didactical contracts and thus for avoiding typical problems related to the implementation of alternative tasks. One might expect physics students to be special in their explicit...

  11. Performance Improvement in 503A Compounding Pharmacies: A PLAN FOR ASSESSMENT, IMPLEMENTATION, AND SUSTAINED SUCCESS.

    Science.gov (United States)

    Pritchett, Jon; Mixon, William; O'Connell, Kevin

    2016-01-01

    Performance improvement is the continual effort to objectively assess current performance and then restructure the practices that support it to more closely achieve desired performance. A plan for performance improvement, unlike other approaches to correcting problems in job fulfillment, is a systematic method used to first find the root causes of areas of concern and then apply corrections to remedy those deficits. Implementing a performance improvement plan that can be easily adapted to ensure compliance with evolving and increasingly complex state and federal regulations is crucial to a successful compounding practice. In this article, we discuss the need for performance improvement in 503A compounding pharmacies, list the steps necessary to develop such a plan, and present three case reports of performance improvement plans in differing compounding settings.

  12. Potential Success and Barrier Factors for Implementation of the Transition to Independence (TIP Model

    Directory of Open Access Journals (Sweden)

    Christopher M. Kalinyak

    2017-01-01

    Full Text Available In this qualitative study, 28 key stakeholders who work with transition-aged youth participated in focus group discussions addressing success and barrier factors regarding implementation of a transition to independence process (TIP program for youth, ages 14–29, in three Midwestern cities. All participants had prior knowledge of TIP. The paradigm shift to client-oriented goals and services was acknowledged by respondents as the prime benefit of TIP; youth are more motivated to follow through on self-determined goals. Barrier factors for providers involved collaboration with agencies adhering to provider-oriented interventions, provision of TIP methods training, and reallocation of time and money. Barrier factors for youth involved mistrust of service providers, overcoming maturational deficits, and acquiring and maintaining relationships, reputations, and social supports.

  13. Implementation Process of 5S for a Company in Real Life - Problems, Solutions, Successes

    Directory of Open Access Journals (Sweden)

    Czifra György

    2017-09-01

    Full Text Available Developed in Japan, 5S is a system of organizing workplace for efficiency, effectiveness and safety. Is 5s important? The answer is: “YES”, because the implementation is about empowering employees to control their work area and create an environment where they want to work every day. It is a program that only works with grass roots level engagement. With commitment to safety, we are equally committed to 5S to ensure a safe place to work. It enabled us to indicate where waste was occurring and thus improve the work area sustainably. We recognized real problems, found solutions and ultimately we were successful in our endeavors. Throughout different companies, various words of similar meaning are used. No matter what specific words are used to identify the steps in 5S, the purpose remains the same: create a clean, organized and efficient work environment.

  14. Successful implementation of inquiry-based physiology laboratories in undergraduate major and nonmajor courses.

    Science.gov (United States)

    Casotti, G; Rieser-Danner, L; Knabb, M T

    2008-12-01

    Recent evidence has demonstrated that inquiry-based physiology laboratories improve students' critical- and analytical-thinking skills. We implemented inquiry-based learning into three physiology courses: Comparative Vertebrate Physiology (majors), Human Physiology (majors), and Human Anatomy and Physiology (nonmajors). The aims of our curricular modifications were to improve the teaching of physiological concepts, teach students the scientific approach, and promote creative and critical thinking. We assessed our modifications using formative (laboratory exams, oral presentations, and laboratory reports) and summative evaluations (surveys, laboratory notebook, and an end of semester project). Students appreciated the freedom offered by the new curriculum and the opportunity to engage in the inquiry process. Results from both forms of evaluation showed a marked improvement due to the curricular revisions. Our analyses indicate an increased confidence in students' ability to formulate questions and hypotheses, design experiments, collect and analyze data, and make conclusions. Thus, we have successfully incorporated inquiry-based laboratories in both major and nonmajor courses.

  15. Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands

    NARCIS (Netherlands)

    Sijpkens, M.K. (Meertien K.); E.A.P. Steegers (Eric); Rosman, A.N. (Ageeth N.)

    2016-01-01

    textabstractObjectives Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in

  16. From national air carriers to low-cost companies: Effects of successful marketing strategy implementation

    Directory of Open Access Journals (Sweden)

    Aćimović Slobodan

    2009-01-01

    Full Text Available Huge changes in marketing strategies and, more generally - in business philosophies are not so often. During the last 20 years global and/or national companies have already defined their general approaches of marketing instruments implementation. Therefore, when a contemporary company changes something in its marketing approach, it usually only refers to 'subtle adjustment' of the already determined strategy. Another reason for changes in a particular segment of marketing is a crisis of some kind that forces firms to implement innovations, especially regarding the elements such as costs - price - or service quality. A global enterprise segment consisting of low tariff airline companies is here identified as the one that has dramatically changed its marketing approach within the last 20 years, which continually resulted in its improved market position and business results. Changes in marketing strategies of low-cost companies have truly been revolutionary and are completely the consequence of recognizing the real needs of clients who use services of air transport. The success of low-cost airline companies is forcing the traditional, classic, air carriers to adapt their marketing instruments to this new model of business management. This paper also identifies one very significant assumption of the low-cost carriers phenomenon and their marketing approach - the liberalization of the global air transport market.

  17. A Guide for Planning and Implementing Successful Mental Health Educational Programs.

    Science.gov (United States)

    Blanco-Vieira, Thiago; Ramos, Fernando Augusto da Cunha; Lauridsen-Ribeiro, Edith; Ribeiro, Marcos Vinícius Vieira; Meireles, Elisa Andrade; Nóbrega, Brunno Araújo; Motta Palma, Sonia Maria; Ratto, Maria de Fátima; Caetano, Sheila Cavalcante; Ribeiro, Wagner Silva; Rosário, Maria Conceição do

    2018-01-01

    Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. These results will be helpful for planning and improving the quality of future educational programs in mental health.

  18. Using career ladders to motivate and retain employees: an implementation success story.

    Science.gov (United States)

    Garletts, Joseph A

    2002-01-01

    In October 2000, Phoenix-based Sonora Quest Laboratories, LLC (SQL), commissioned The Gelfond Group to survey SQL employees. Responding to negative survey scores, SQL developed and implemented an entry-level career ladder for line staff of the specimen management/referral testing department. The program was piloted in February 2001, and was implemented fully shortly thereafter. The ladder was designed to provide job enrichment opportunities through company-conducted training and advancement provisions. It contained requirements for productivity and quality of work performed in addition to increasingly rigorous training and competency documentation. Employees were accountable for their own advancement and for ensuring that all documentation was complete. Advancement was automatic once requirements were completed. Pay increases accompanied each advancement on a predetermined scale. At the end of 12 months, employee turnover dropped from 39% to less than 20% annually. Both productivity and morale improved, and results on a second employee survey indicated dramatic improvement in five key areas. The career ladder concept has been replicated successfully in several other departments, including phlebotomy, and a six-tiered ladder is under development for the clinical laboratory. It will encompass CLA, MLT, and MT positions from entry level to technical coordinator.

  19. Job sharing in clinical nutrition management: a plan for successful implementation.

    Science.gov (United States)

    Visocan, B J; Herold, L S; Mulcahy, M J; Schlosser, M F

    1993-10-01

    While women continue to enter the American work force in record numbers; many experience difficulty in juggling career and family obligations. Flexible scheduling is one option used to ease work and family pressures. Women's changing work roles have potentially noteworthy implications for clinical nutrition management, a traditionally female-dominated profession where the recruitment and retention of valued, experienced registered dietitians can prove to be a human resources challenge. Job sharing, one type of flexible scheduling, is applicable to the nutrition management arena. This article describes and offers a plan for overcoming obstacles to job sharing, including determining feasibility, gaining support of top management, establishing program design, announcing the job share program, and using implementation, monitoring, and fine-tuning strategies. Benefits that can be derived from a successful job share are reduced absenteeism, decreased turnover, enhanced recruitment, improved morale, increased productivity, improved job coverage, and enhanced skills and knowledge base. A case study illustrates one method for achieving job sharing success in clinical nutrition management.

  20. Successful implementation effect of insurance services in money and capital financial markets

    Directory of Open Access Journals (Sweden)

    Nemat Tahmasebi

    2016-11-01

    Full Text Available One of the most important sectors of the economy of each country is capital market. Economic growth can lead to the development and prosperity of the capital market. On the other hand to achieve the desired economic development, without existence of effective financial institutions and appropriate equipment of financial resources, it is impossible. In this regard, efficient financial systems through seeking information about investment opportunities, integrate and mobilize savings, monitoring investments and exert corporate governance can facilitate the exchange of goods and services, distribution and risk management, reducing transaction costs and data analysis may lead to better allocation of resources and ultimately economic growth. Insurance companies and generally insurance industry in each country is the most important and active financial institutions operating in the financial market especially capital markets in addition to securing economic activity could have basic role in mobility of financial markets and providing funds to invest in the economic activity through the provision of insurance services. In this study, successful financial services of insurance and investment funds in insurance companies such as Dana, Alborz, and Asia have been studied in Tehran. According to the hypothesis, there is a significant correlation between successful implementation of insurance services and money and capital financial markets. There is a significant correlation between different types of insurance services (institution-building, instrument making, and general insurance policies and money and capital financial markets.

  1. Concocting that Magic Elixir: Successful Grant Application Writing in Dissemination and Implementation Research.

    Science.gov (United States)

    Brownson, Ross C; Colditz, Graham A; Dobbins, Maureen; Emmons, Karen M; Kerner, Jon F; Padek, Margaret; Proctor, Enola K; Stange, Kurt C

    2015-12-01

    This paper reports core competencies for dissemination and implementation (D&I) grant application writing and provides tips for writing a successful proposal. Two related phases were used to collect the data: a card sorting process among D&I researchers and an expert review among a smaller set of researchers. Card sorting was completed by 123 respondents. In the second phase, a series of grant application writing tips were developed based on the combined 170 years of grant review experience of the writing team. The card sorting resulted in 12 core competencies for D&I grant application writing that covered the main sections in a grant application to the US National Institutes of Health: (a) specific aims that provide clear rationale, objectives, and an overview of the research plan; (b) significance that frames and justifies the importance of a D&I question; (c) innovation that articulates novel products and new knowledge; and (d) approach that uses a relevant D&I model, addresses measurement and the D&I context, and includes an analysis plan well-tied to the aims and measures. Writing a successful D&I grant application is a skill that can be learned with experience and attention to the core competencies articulated in this paper. © 2015 Wiley Periodicals, Inc.

  2. How to successfully implement a robotic pediatric surgery program: lessons learned after 96 procedures.

    Science.gov (United States)

    de Lambert, Guénolée; Fourcade, Laurent; Centi, Joachim; Fredon, Fabien; Braik, Karim; Szwarc, Caroline; Longis, Bernard; Lardy, Hubert

    2013-06-01

    Both our teams were the first to implement pediatric robotic surgery in France. The aim of this study was to define the key points we brought to light so other pediatric teams that want to set up a robotic surgery program will benefit. We reviewed the medical records of all children who underwent robotic surgery between Nov 2007 and June 2011 in both departments, including patient data, installation and changes, operative time, hospital stay, intraoperative complications, and postoperative outcome. The department's internal organization, the organization within the hospital complex, and cost were evaluated. A total of 96 procedures were evaluated. There were 38 girls and 56 boys with average age at surgery of 7.6 years (range, 0.7-18 years) and average weight of 26 kg (range, 6-77 kg). Thirty-six patients had general surgery, 57 patients urologic surgery, and 1 thoracic surgery. Overall average operative time was 189 min (range, 70-550 min), and average hospital stay was 6.4 days (range, 2-24 days). The procedures of 3 patients were converted. Median follow-up was 18 months (range, 0.5-43 months). Robotic surgical procedure had an extra cost of 1934 compared to conventional open surgery. Our experience was similar to the findings described in the literature for feasibility, security, and patient outcomes; we had an overall operative success rate of 97 %. Three main actors are concerned in the implementation of a robotic pediatric surgery program: surgeons and anesthetists, nurses, and the administration. The surgeon is at the starting point with motivation for minimally invasive surgery without laparoscopic constraints. We found that it was possible to implement a long-lasting robotic surgery program with comparable quality of care.

  3. Designing and Implementation of a Course on Successful Dental Practice for Dentists

    Directory of Open Access Journals (Sweden)

    Yaser Safi

    2015-11-01

    Full Text Available Objectives: We aimed to design, implement and evaluate the efficacy of a comprehensive course on non-clinical competencies that dentists must possess for a successful dental practice.Materials and Methods: In this interventional before-after study an expert panel of five academic staff members and five general practitioners derived the topics for a course on successful dental practice, and aggregated them in the form of a two-day course. It was held for 46 randomly selected dentists in January 2010, at the School of Dentistry, Tehran University of Medical Sciences. The participants completed an anonymous questionnaire asking about their self-perceived need to receive training in each of the proposed topics and their self-assessed knowledge about each topic before and after attending the course.Results: Participants gave a higher priority to the necessity of training on “ergonomics and professional health” and communication skills in post-test compared to pre-test (P<0.05. The self-assessed knowledge of dentists improved significantly after attending the course in seven domains: ergonomics and occupational health, workplace design, documentation principles and IT applications in dentistry, national rules and regulations of dental practice, medical emergencies, dental ethics and communication skills (P<0.05. More than 70% of the participants were completely satisfied or satisfied with practical implication of the course, conformity of the contents with the title and course settings.Conclusion: The designed course seemed to be successful in revealing the need of participants for further education. Considering the high satisfaction rate of the attendants, this course can serve as a model for continuing education purposes.

  4. Cosmic Ray Hit Detection with Homogenous Structures

    Science.gov (United States)

    Smirnov, O. M.

    Cosmic ray (CR) hits can affect a significant number of pixels both on long-exposure ground-based CCD observations and on the Space Telescope frames. Thus, methods of identifying the damaged pixels are an important part of the data preprocessing for practically any application. The paper presents an implementation of a CR hit detection algorithm based on a homogenous structure (also called cellular automata ), a concept originating in artificial intelligence and dicrete mathematics. Each pixel of the image is represented by a small automaton, which interacts with its neighbors and assumes a distinct state if it ``decides'' that a CR hit is present. On test data, the algorithm has shown a high detection rate (~0.7 ) and a low false alarm rate (frame. A homogenous structure is extremely trainable, which can be very important for processing large batches of data obtained under similar conditions. Training and optimizing issues are discussed, as well as possible other applications of this concept to image processing.

  5. Beyond "Hitting the Books"

    Science.gov (United States)

    Entress, Cole; Wagner, Aimee

    2014-01-01

    Scientists, science teachers, and serious students recognize that success in science classes requires consistent practice--including study at home. Whether balancing chemical equations, calculating angular momentum, or memorizing the steps of cell division, students must review material repeatedly to fully understand new ideas--and must practice…

  6. Government-to-private sector energy programs: Identification of common elements leading to successful implementation

    Science.gov (United States)

    Stockton, Keith M.

    This dissertation examines six distinct government energy programs implemented in the United States during the last three decades. A common element within these programs is an attempt by government to drive commercialization of energy technologies leading to changes in energy production or consumptive behavior. We seek to understand the factors that lead to success or failure of these programs with two goals in mind. The first is theoretical in that we test a hypothesis that market-based energy programs have substantially higher success rates than command-and-control programs. The second goal is operational in nature, in which we desire to identify common factors within energy programs that lead either to program success or to failure. We investigate and evaluate three market-based and three command-and-control energy programs. The market-based programs include the federal Corporate Average Fuel Economy and Sulfur Dioxide Emissions Control programs as well as Colorado's Amendment 37. The command-and-control programs include the federal Synthetic Fuels Corporation and Corn Based Ethanol programs as well as Colorado's Solar Electric Power program. We conduct the analysis of each program based on composite methodology derived from leading academics within the Policy Sciences. From our research findings, we conclude that both market-based and command-and-control programs can achieve their legislative goals and objectives, resulting in permanent changes in energy production or consumptive behavior. However, we also find that the economic efficiency is the differentiator between market-based and command-and-control programs. Market-based programs, because of the inherent flexibility, allow participants to react to changing economic and/or technical conditions. In contrast, command-and-control programs lack such flexibility and often result in economic inefficiency when economic conditions change. The financial incentives incorporated in the three command

  7. ANALYSIS OF INFORMATION SYSTEM IMPLEMENTATION IN BINUS UNIVERSITY USING DELONE AND MCLEAN INFORMATION SYSTEM SUCCESS MODEL AND COBIT FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Johan Muliadi Kerta

    2013-05-01

    Full Text Available The success of implementation of information system in an organization will supportthe organization in the process of achieving goals. Successful information system will support theorganization's day-to-day operations, so that problem can be resolved more quickly and easily. Theinformation system which has been developed and implemented is also necessary to measure thematurity level. Therefore, it can determine whether the implementation of information systemsmade in accordance with the goals of the organization. Measuring the success of informationsystems used the DeLone and McLean IS success model. To measure the maturity level ofinformation systems used COBIT (Control Objectives for Information and related Technologyframeworks that provides best practices for IT governance and control. The results of this analysiswill assist and support the IT team in order to develop and build information systems that better fitthe needs and goals of the organization.

  8. Five Steps to Successfully Implement and Evaluate Propensity Score Matching in Clinical Research Studies.

    Science.gov (United States)

    Staffa, Steven J; Zurakowski, David

    2018-01-09

    In clinical research, the gold standard level of evidence is the randomized controlled trial (RCT). The availability of nonrandomized retrospective data is growing; however, a primary concern of analyzing such data is comparability of the treatment groups with respect to confounding variables. Propensity score matching (PSM) aims to equate treatment groups with respect to measured baseline covariates to achieve a comparison with reduced selection bias. It is a valuable statistical methodology that mimics the RCT, and it may create an "apples to apples" comparison while reducing bias due to confounding. PSM can improve the quality of anesthesia research and broaden the range of research opportunities. PSM is not necessarily a magic bullet for poor-quality data, but rather may allow the researcher to achieve balanced treatment groups similar to a RCT when high-quality observational data are available. PSM may be more appealing than the common approach of including confounders in a regression model because it allows for a more intuitive analysis of a treatment effect between 2 comparable groups.We present 5 steps that anesthesiologists can use to successfully implement PSM in their research with an example from the 2015 Pediatric National Surgical Quality Improvement Program: a validated, annually updated surgery and anesthesia pediatric database. The first step of PSM is to identify its feasibility with regard to the data at hand and ensure availability of data on any potential confounders. The second step is to obtain the set of propensity scores from a logistic regression model with treatment group as the outcome and the balancing factors as predictors. The third step is to match patients in the 2 treatment groups with similar propensity scores, balancing all factors. The fourth step is to assess the success of the matching with balance diagnostics, graphically or analytically. The fifth step is to apply appropriate statistical methodology using the propensity

  9. A successful approach for the implementation of symptom-based emergency operating procedures for VVER reactors

    International Nuclear Information System (INIS)

    Lhoest, V.; Prior, R.; Pascal, G.

    2000-01-01

    The paper provides an overview of the organization, the progress and the results of the various Emergence Operating Procedure (EOP) development programs for VVER type reactors conducted by Westinghouse so far. The detailed working process is presented through the solutions to some major plant issues. The EOPs have been developed for the Temelin, Dukovany, Bohunice, Mochovce and Paks VVER nuclear power plants. The procedures are developed in working teams of experts from the utility and Westinghouse. The completion of the programs constitute an indication of the overall success of this approach. This is further reinforced by the general acceptance of the new procedures by the plant personnel, together with the good results obtained so far from procedure testing. This is also confirmed by a new PSA-level 1 analysis for Dukovany plant, which shows a significant improvement in the overall plant safety. This means a 20% reduction in the Core Damage Frequency due to the introduction of the new EOPs. The fact that some modifications have been implemented to the plants to solve design weaknesses identified in the course of this programs also constitute a positive result

  10. A Cross-country Comparison of Success Factor Priorities for Health Information Technology Managers

    DEFF Research Database (Denmark)

    Nguyen, Thi Thanh Hai; Eikebrokk, Tom Roar; Moe, Carl Erik

    2015-01-01

    agree highly with each other in their judgment of the importance of these success factors. While Nordic countries’ healthcare systems and culture are relatively similar, the results suggest that an internationally applicable set of recommendations for the successful completion of HIT implementations...

  11. Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

    Science.gov (United States)

    Giva, Karen R N; Duma, Sinegugu E

    2015-08-31

    Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

  12. Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

    Science.gov (United States)

    Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

    2016-10-01

    Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but

  13. Controlling Neglected Tropical Diseases (NTDs in Haiti: Implementation Strategies and Evidence of Their Success.

    Directory of Open Access Journals (Sweden)

    Jean Frantz Lemoine

    2016-10-01

    Full Text Available Lymphatic filariasis (LF and soil-transmitted helminths (STH have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for

  14. Mixed Hitting-Time Models

    NARCIS (Netherlands)

    Abbring, J.H.

    2009-01-01

    We study mixed hitting-time models, which specify durations as the first time a Levy process (a continuous-time process with stationary and independent increments) crosses a heterogeneous threshold. Such models of substantial interest because they can be reduced from optimal-stopping models with

  15. Method of evaluating the impact of ERP implementation critical success factors - a case study in oil and gas industries

    Science.gov (United States)

    Gajic, Gordana; Stankovski, Stevan; Ostojic, Gordana; Tesic, Zdravko; Miladinovic, Ljubomir

    2014-01-01

    The so far implemented enterprise resource planning (ERP) systems have in many cases failed to meet the requirements regarding the business process control, decrease of business costs and increase of company profit margin. Therefore, there is a real need for an evaluation of the influence of ERP on the company's performance indicators. Proposed in this article is an advanced model for the evaluation of the success of ERP implementation on organisational and operational performance indicators in oil-gas companies. The recommended method establishes a correlation between a process-based method, a scorecard model and ERP critical success factors. The method was verified and tested on two case studies in oil-gas companies using the following procedure: the model was developed, tested and implemented in a pilot gas-oil company, while the results were implemented and verified in another gas-oil company.

  16. Successful field implementation of novel cementing solution for ISC wells : case histories

    Energy Technology Data Exchange (ETDEWEB)

    Meher, R.K.; Suyan, K.M.; Dasgupta, D. [Society of Petroleum Engineers, Dubai (United Arab Emirates)]|[Oil and Natural Gas Corp. Ltd., Tel Bhavan, Dehradun (India); Deodhar, S.; Sharma, V.; Jain, V.K. [Oil and Natural Gas Corp. Ltd., Tel Bhavan, Dehradun (India)

    2008-10-15

    Cementation of in-situ combustion (ISC) wells is challenging since wells are frequently associated with weak and unconsolidated formation. However, cement rise up to surface is desired to prevent casing failure. Moreover, the cement sheath is also required to withstand extreme stresses due to high temperature cycling experienced during in-situ combustion process. In response to the problem of inadequate placement time and flash setting, Portland cement-silica blends were used for cementation of ISC wells in India instead of alumina cement blends. However, the use of the cement-silica blends has resulted in insufficient cement rise because of losses during cementation. The cured cement failed to contain the strength and permeability in course of ISC process causing charge of sub-surface shallower layers. This paper discussed the development and implementation of a non-alumina based thermally stable lightweight lead slurry and a ductile high temperature resistance tail slurry for mitigating these problems. The paper provided details of the study as well as four successful case histories. The cementing practice for ISC wells around the world was first described and illustrated. Next, the paper outlined the formulation of thermally stable tail slurry through laboratory studies. Slurry parameters of the tail slurry were presented, including slurry weight; thickening time; fluid loss; free fluid; and rheology. The paper also reviewed a study of compressive strength and permeability of thermal slurry; slurry parameters of the lightweight lead slurry; and study of compressive strength and permeability of lightweight thermal slurry. 8 refs., 4 tabs., 12 figs.

  17. Key factors for the implementation of successful, stand-alone village electrification schemes in Peru

    Science.gov (United States)

    Sanchez-Campos, Teodoro

    The hypothesis of this work is that there are social, financial, technical, managerial institutional and political key factors that may either support or prevent the success of small stand alone energy systems in rural areas. This research work aims at contributing to the identification of such factors and study their relevance to the performance and sustainability of stand alone energy systems in rural areas; to meet its purpose, a wide range of literature was reviewed including rural electrification programmes and projects, research and development projects on access to electricity in rural areas, impact studies and others, and a field research survey was done the Andes and Upper Jungle regions in Peru. Nineteen possible critical factors were identified, thirteen with relevance at the local context (the community or village), and six with relevance at the national (or wider) context. From literature review it was found that the possible local critical factors were relevant only to four categories of factors instead of the six considered initially (i.e. social, financial, technological and managerial): the other two categories, political and institutional were found to be more relevant to the national context, therefore those were included in the group of possible critical factors of wider context. A series of questionnaires were designed to collect field data information, which was later used to analyse and establish the relation of each identified factor with the success of the systems studied. The survey research was implemented in 14 villages, 7 with small diesel sets and 7 with small hydropower schemes, all spread in the Andes and Upper Jungle of Peru, which were carefully selected to be representative of regions with isolated stand alone systems and with different socioeconomic background. Out of the 13 possible critical factors of local context, it was found that only 3 are really critical, the others are important but not critical; one of them (technical

  18. Good alarm design plays a vital role in successful DCS implementation: Hard learned lessons from petrochemical applications

    International Nuclear Information System (INIS)

    Wilson, C.; Rothenberg, D.

    2006-01-01

    Nuclear operators are eager to update their automation infrastructure, but are apprehensive due to the consequences of failure. The process industries have learned that alarm design is critical to a successful Distributed Control System (DCS) implementation. This paper shares valuable insight into how alarms play a key role in successful management of upsets, help focus operator attention, and supply critical information during periods of high stress. (authors)

  19. Implementing healthier foodservice guidelines in hospital and federal worksite cafeterias: barriers, facilitators and keys to success.

    Science.gov (United States)

    Jilcott Pitts, S B; Graham, J; Mojica, A; Stewart, L; Walter, M; Schille, C; McGinty, J; Pearsall, M; Whitt, O; Mihas, P; Bradley, A; Simon, C

    2016-12-01

    Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings. © 2016 The British Dietetic Association Ltd.

  20. [How patient safety programmes can be successfully implemented - an example from Switzerland].

    Science.gov (United States)

    Kobler, Irene; Mascherek, Anna; Bezzola, Paula

    2015-01-01

    Internationally, the implementation of patient safety programmes poses a major challenge. In the first part, we will demonstrate that various measures have been found to be effective in the literature but that they often do not reach the patient because their implementation proves difficult. Difficulties arise from both the complexity of the interventions themselves and from different organisational settings in individual hospitals. The second part specifically describes the implementation of patient safety improvement programmes in Switzerland and discusses measures intended to bridge the gap between the theory and practice of implementation in Switzerland. Then, the national pilot programme to improve patient safety in surgery is presented, which was launched by the federal Swiss government and has been implemented by the patient safety foundation. Procedures, challenges and highlights in implementing the programme in Switzerland on a national level are outlined. Finally, first (preliminary) results are presented and critically discussed. Copyright © 2015. Published by Elsevier GmbH.

  1. [Implementation of computerized phisician order entry in a hospital setting: what are the keys to success?].

    Science.gov (United States)

    Garçous, R; Remy, G; Bary, M; Amant, F; Cauwe, F; De Beusscher, L; Bouzette, A; De Coster, P; Hecq, J-D

    2013-06-01

    A software of computerized physician order entry [CPOE] was developed by a data-processing company in collaboration with the Mont-Godinne University Hospital By 2006, parallel to the evolution of the software, the progressive implementation of CPOE was carried out, and currently covers 16 wards, the emergency room, the recovery rooms and the center of medical care [day hospital] as well as the day surgical center Complete computerization of the drug supply chain, including the regulation by the physician, the pharmaceutical validation, the delivery and the follow-up of stocks by pharmacy, the validation of the administration by the nurse and the tariffing of the drugs. In 2006, a working group was created in order to validate specifications allowing the development of a software of CPOE, Linked to the computerized medical record. A data-processing company was selected in order to develop this software. Two beds were computerized in the pneumology ward, in order to test and validate the software. From 2007 to 2009, 3 additional wards were computerized [geriatrics, neurosurgery, revalidation]. A steering committee of CPOE, composed of various members (direction, doctors, pharmacists, nurses, data processing specialistsl is created. This committee allows the installation of the means necessary to the deployment of CPOE in the Institution. Structured teams for the deployment are created: medical and nurse coaches. From 2009 to 2012, the deployment of the software is carried out, covering 16 wards, the emergency room, the recovery room and the day-hospitals. The computerization of the drug supply chain is a challenge which concerns the institutional level. The assets of our hospital and our project were: - a strong management committee, making of this project a priority entering the strategical planning of the institution; - a steering committee allowing each type of actor to express his needs, and of prioriser requests; - a closer medical coaching; - teams of nurses

  2. The Data Warehouse: Keeping It Simple. MIT Shares Valuable Lessons Learned from a Successful Data Warehouse Implementation.

    Science.gov (United States)

    Thorne, Scott

    2000-01-01

    Explains why the data warehouse is important to the Massachusetts Institute of Technology community, describing its basic functions and technical design points; sharing some non-technical aspects of the school's data warehouse implementation that have proved to be important; examining the importance of proper training in a successful warehouse…

  3. Special issue of International journal of human resource management: Conceptual and empirical discoveries in successful HRM implementation

    OpenAIRE

    Mireia Valverde; Tanya Bondarouk; Jordi Trullen

    2016-01-01

    Special issue of International journal of human resource management: Conceptual and empirical discoveries in successful HRM implementation DOI: 10.1080/09585192.2016.1154378 URL: http://www.tandfonline.com/doi/full/10.1080/09585192.2016.1154378 Filiació URV: SI Inclòs a la memòria: SI Paraules clau en blanc [No abstract available

  4. Challenges to Successful Total Quality Management Implementation in Public Secondary Schools: A Case Study of Kohat District, Pakistan

    Science.gov (United States)

    Suleman, Qaiser; Gul, Rizwana

    2015-01-01

    The current study explores the challenges faced by public secondary schools in successful implementation of total quality management (TQM) in Kohat District. A sample of 25 heads and 75 secondary school teachers selected from 25 public secondary schools through simple random sampling technique was used. Descriptive research designed was used and a…

  5. Success factors for the implementation of an intended brand personality : Conceptual framework and insights from the Swiss luxury industry

    NARCIS (Netherlands)

    Hoyer, Wayne D.; Krohmer, Harley; Lobschat, Lara

    2015-01-01

    The creation and implementation of an intended brand personality has become a prevailing topic, both for practitioners and researchers. Especially in luxury industry, where brands hold a strong symbolic meaning, marketers are faced with the challenge of successfully establishing an intended brand

  6. Critical Success Factors for the Implementation of PeopleSoft Enterprise Resource Planning in a Public Organization

    Science.gov (United States)

    Mukkamala, Hemanth K.

    2013-01-01

    Organizations of different sizes are changing their information technology (IT) strategies in order to achieve efficiency and effectiveness in today's global economy and to integrate their internal and external information by implementing PeopleSoft Enterprise Resource Planning (ERP) systems. The literature has case studies of successful and…

  7. 42 CFR 495.344 - Approval of the State Medicaid HIT plan, the HIT PAPD and update, the HIT IAPD and update, and...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Approval of the State Medicaid HIT plan, the HIT PAPD and update, the HIT IAPD and update, and the annual HIT IAPD. 495.344 Section 495.344 Public... Requirements Specific to the Medicaid Program § 495.344 Approval of the State Medicaid HIT plan, the HIT PAPD...

  8. Implementing a new model for on-the-job training: critical success factors.

    NARCIS (Netherlands)

    van Zolingen, S.J.; Streumer, Jan; van der Klink, Marcel; de Jong, Rolinda

    2000-01-01

    Post Offices Inc. in The Netherlands has developed and implemented a new instruction model for the training of desk employees. The quality of the new instruction model was assessed by means of the evaluation model of Jacobs and Jones for on-the-job training. It is concluded that the implementation

  9. Critical success factors for implementation of supply chain management in Indian small and medium enterprises and their impact on performance

    Directory of Open Access Journals (Sweden)

    Ravinder Kumar

    2015-06-01

    Full Text Available Globalization of the economy, e-business, and introduction of new technologies pose new challenges to all organizations especially for small and medium enterprises (SMEs. In this scenario, successful implementation of supply chain management (SCM can give SMEs an edge over their competitors. However, SMEs in India and other developing countries face problems in SCM implementation due to lack of resources and direction. Against this backdrop, this paper identified 13 critical success factors (CSFs for implementation of SCM in SMEs and studied their impact on performance of Indian SMEs. Top management commitment, long–term vision, focus on core strengths, devoted resources for supply chain, and development of effective SCM strategy emerged as the most pertinent CSFs. To measure improvement in performance, the authors considered different measures related to customer service and satisfaction, innovation and growth, financial performance, and internal business. Results are analysed by testing research propositions using standard statistical tools.

  10. SHIELD-HIT12A - a Monte Carlo particle transport program for ion therapy research

    DEFF Research Database (Denmark)

    Bassler, Niels; Hansen, David Christoffer; Lühr, Armin

    2014-01-01

    . We experienced that new users quickly learn to use SHIELD-HIT12A and setup new geometries. Contrary to previous versions of SHIELD-HIT, the 12A distribution comes along with easy-to-use example files and an English manual. A new implementation of Vavilov straggling resulted in a massive reduction......Abstract. Purpose: The Monte Carlo (MC) code SHIELD-HIT simulates the transport of ions through matter. Since SHIELD-HIT08 we added numerous features that improves speed, usability and underlying physics and thereby the user experience. The “-A” fork of SHIELD-HIT also aims to attach SHIELD....... It supports native formats compatible with the heavy ion treatment planning system TRiP. Stopping power files follow ICRU standard and are generated using the libdEdx library, which allows the user to choose from a multitude of stopping power tables. Results: SHIELD-HIT12A runs on Linux and Windows platforms...

  11. The Development and Implementation of Successful School-Community Partnerships in Public Elementary Education

    Science.gov (United States)

    Record, Vincent N.

    2012-01-01

    Purpose: The study aimed to define common characteristics of successful school-community partnerships supporting the improvement of academic achievement in public elementary schools. Based on the perceptions of elementary school administrators, this study identified important factors of, barriers to, and benefits of successful school-community…

  12. Similarities of lean manufacturing approaches implementation in SMEs towards the success: Case study in the automotive component industry

    Directory of Open Access Journals (Sweden)

    Rose A.N.M.

    2017-01-01

    Full Text Available Nowadays, manufacturing companies are striving for a better system like lean manufacturing (LM. The primary objective of LM is to identify and eliminate wastes. LM can be applied successfully in all industries providing a full understanding of lean ingredients i.e. concept, principles, and practices. There are a lot of practices which are necessary to be implemented in order to gain full benefits of LM. However, small and medium enterprises (SMEs are lack of knowledge in LM and facing difficulties to adopt all of the LM principles. Therefore, it is necessary to the researchers to come out with a simple guideline for LM implementation. The objective of this paper is to explore the journey of LM implementation including preliminary, in process and post of LM. This research was conducted through multi-case study research. There were four SMEs and two large companies. The gathered information shows that the preliminary stage of LM implementation is similar to each other including large companies. The result shows SMEs still have a potential to success in LM. This finding might give an opportunity to SMEs to prepare the basis for LM implementation effectively. As a result, SMEs able compete in the competitive global marketplace and strive for world class performance through implementation of LM.

  13. Practice and quality improvement: successful implementation of TeamSTEPPS tools into an academic interventional ultrasound practice.

    Science.gov (United States)

    Gupta, Rajan T; Sexton, J Bryan; Milne, Judy; Frush, Donald P

    2015-01-01

    The goal of this study was to implement an evidence-based teamwork system to improve communication and teamwork skills among health care professionals (TeamSTEPPS) into an academic interventional ultrasound program and to assess safety and team-work climate across team members both before and after implementation. Members of a change team (including master trainers) selected specific tools available within TeamSTEPPS to implement into an academic interventional ultrasound service. Tools selected were based on preimplementation survey data obtained from team members (n = 64: 11 attending faculty physicians, 12 clinical abdominal imaging fellows or residents, 17 sonographers, 19 nurses, and five technologist aides or administrative personnel). The survey included teamwork climate and safety climate domains from the Safety Attitudes Questionnaire. Four months after implementation, respondents were resurveyed and post-implementation data were collected. Teamwork climate scores improved from a mean of 67.9 (SD, 12.8) before implementation to a mean of 87.8 (SD, 14.1) after implementation (t = -7.6; p ultrasound practice. The most notable improvements were seen in communication among team members and role clarification. We think that this model, which has been successfully implemented in many nonradiologic areas in medical care, is also applicable in imaging practice.

  14. 77 FR 32639 - HIT Standards Committee and HIT Policy Committee; Call for Nominations

    Science.gov (United States)

    2012-06-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee and HIT Policy Committee; Call for... Health Information Technology Policy Committee (HITPC). Name of Committees: HIT Standards Committee and HIT Policy Committee. General Function of the Committees: The HITSC is charged to provide...

  15. What drives successful implementation of pollution prevention and cleaner technology strategy? The role of innovative capability.

    Science.gov (United States)

    Bhupendra, Kumar Verma; Sangle, Shirish

    2015-05-15

    Firms that are dynamic and prepared to implement environmental strategies have a potential competitive advantage over their industry counterparts. Therefore, it is important to understand, what capabilities are required to implement proactive environmental strategies. The paper discusses the attributes of innovative capability required by firms in order to adopt pollution prevention and cleaner technology strategies. Empirical results show that process and behavioral innovativeness are required by firms to implement a pollution prevention strategy. In addition to process and behavioral innovativeness, firms need a top management with high risk-taking ability as well as market, product, and strategic innovativeness to implement a cleaner technology strategy. The paper proposes some important managerial implications on the basis of the above research findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Successful Implementation of Soil Segregation Technology at the Painesville FUSRAP Site - 12281

    Energy Technology Data Exchange (ETDEWEB)

    Buechi, Stephen P.; Andrews, Shawn M. [U.S. Army Corps of Engineers, Buffalo District, Buffalo, New York (United States); Lombardo, Andrew J. [Safety and Ecology Corporation, Beaver, Pennsylvania (United States); Lively, Jeffrey W. [AMEC Environment and Infrastructure, Grand Junction, Colorado (United States)

    2012-07-01

    segregated as below criteria for reuse as site fill did meet the Record of Decision cleanup criteria for the site. Automatic soil segregation technology was successfully implemented as part of the 2010 - 2011 remediation effort at the Painesville FUSRAP Site. The Orion ScanSortSM system employed at the site demonstrated the ability to accurately determine the radioactivity concentrations in the processed soil and soil-like material and quickly segregate that material for appropriate final disposition. Data from the soil segregation system and confirmatory QC samples indicated that the segregated 'below criteria' soils met the cleanup criteria in the ROD, and was appropriate for reuse as fill in the excavations. The reduction of the total excavated soil volume requiring off-site disposal by 94% yielded significant project cost savings through reduction of transportation and disposal and backfill procurement costs. Use of automatic soil segregation technology was an efficient and cost-effective method for addressing the radiological contamination at the Painesville Site. (authors)

  17. Critical Success Factor for Implementing Km in Government Human Capital Management: Case Study Badan Kepegawaian Negara

    OpenAIRE

    Cahyaningsih, Elin; Sensuse, Dana Indra

    2014-01-01

    Nowadays, knowledge management in organization became a trend strategy in order to improve organization performance. But unfortunately, it's a big challenge to implementing knowledge management in organization, because it's relatively new and not many people knew about this. This research is done in order to realize bureaucratic reform in government service improvement according to PERMENPAN No. 14 Tahun 2011 is about knowledge management (KM) implementation in government. Knowledge managemen...

  18. Quantum walks with infinite hitting times

    International Nuclear Information System (INIS)

    Krovi, Hari; Brun, Todd A.

    2006-01-01

    Hitting times are the average time it takes a walk to reach a given final vertex from a given starting vertex. The hitting time for a classical random walk on a connected graph will always be finite. We show that, by contrast, quantum walks can have infinite hitting times for some initial states. We seek criteria to determine if a given walk on a graph will have infinite hitting times, and find a sufficient condition, which for discrete time quantum walks is that the degeneracy of the evolution operator be greater than the degree of the graph. The set of initial states which give an infinite hitting time form a subspace. The phenomenon of infinite hitting times is in general a consequence of the symmetry of the graph and its automorphism group. Using the irreducible representations of the automorphism group, we derive conditions such that quantum walks defined on this graph must have infinite hitting times for some initial states. In the case of the discrete walk, if this condition is satisfied the walk will have infinite hitting times for any choice of a coin operator, and we give a class of graphs with infinite hitting times for any choice of coin. Hitting times are not very well defined for continuous time quantum walks, but we show that the idea of infinite hitting-time walks naturally extends to the continuous time case as well

  19. Business process re-engineering in the logistics industry: a study of implementation, success factors, and performance

    Science.gov (United States)

    Shen, Chien-wen; Chou, Ching-Chih

    2010-02-01

    As business process re-engineering (BPR) is an important foundation to ensure the success of enterprise systems, this study would like to investigate the relationships among BPR implementation, BPR success factors, and business performance for logistics companies. Our empirical findings show that BPR companies outperformed non-BPR companies, not only on information processing, technology applications, organisational structure, and co-ordination, but also on all of the major logistics operations. Comparing the different perceptions of the success factors for BPR, non-BPR companies place greater emphasis on the importance of employee involvement while BPR companies are more concerned about the influence of risk management. Our findings also suggest that management attitude towards BPR success factors could affect performance with regard to technology applications and logistics operations. Logistics companies which have not yet implemented the BPR approach could refer to our findings to evaluate the advantages of such an undertaking and to take care of those BPR success factors affecting performance before conducting BPR projects.

  20. Implementing Delirium Screening in the Intensive Care Unit: Secrets to Success

    Science.gov (United States)

    Brummel, Nathan E.; Vasilevskis, Eduard E.; Han, Jin Ho; Boehm, Leanne; Pun, Brenda T.; Ely, E. Wesley

    2013-01-01

    Objective To review delirium screening tools available for use in the adult and pediatric ICU, review evidence-based delirium screening implementation and to discuss common pitfalls encountered during delirium screening in the ICU. Data Sources Review of delirium screening literature and expert opinion. Results Over the past decade, tools specifically designed for use in critically ill adults and children have been developed and validated. Delirium screening has been effectively implemented across many ICUs settings. Keys to effective implementation include addressing barriers to routine screening, multi-faceted training such as lectures, case-based scenarios, one-on-one teaching and real-time feedback of delirium screening and interdisciplinary communication through discussion of a patient’s delirium status during bedside rounds and through documentation systems. If delirium is present clinicians should search for reversible or treatable causes since it is often multifactorial. Conclusion Implementation of effective delirium screening is feasible but requires attention to implementation methods, including a change in the current ICU culture that believes delirium is inevitable or a normal part of a critical illness, to a future culture that views delirium as a dangerous syndrome which portends poor clinical outcomes and which is potentially modifiable depending on the individual patients circumstances. PMID:23896832

  1. Change Management as a Critical Success Factor in e-Government Implementation

    Directory of Open Access Journals (Sweden)

    Janja Nograšek

    2011-01-01

    Full Text Available Change management in e-government implementation is a very complex issue. E-government services are frequently distributed over different IT systems and organizations. There are also events from outside the public administration that cause changes such as government policies and legislation, public-private partnership, etc., and finally a huge resistance to change exists in public administration proverbial. Another problem is that the e-government is predominantly seen only as a technology mission and not as an organizational transformation issue. Those are probably the main reasons that the existing literature about change management in e-government is still missing at large. There are articles dealing with some aspects of changes affected by the new technology implementation, however, there is no comprehensive framework that would identify changes that have to be managed in e-government implementation. Therefore, the main aim of the paper is to identify a comprehensive set of changes that have to be considered in e-government implementation and the role of leadership in such processes. Finally, the paper proposes a conceptual model of change management in e-government implementation.

  2. Use of health information technology (HIT) to improve statin adherence and low-density lipoprotein cholesterol goal attainment in high-risk patients: proceedings from a workshop.

    Science.gov (United States)

    Cohen, Jerome D; Aspry, Karen E; Brown, Alan S; Foody, Joanne M; Furman, Roy; Jacobson, Terry A; Karalis, Dean G; Kris-Etherton, Penny M; Laforge, Ralph; O'Toole, Michael F; Scott, Ronald D; Underberg, James A; Valuck, Thomas B; Willard, Kaye-Eileen; Ziajka, Paul E; Ito, Matthew K

    2013-01-01

    The workshop discussions focused on how low-density lipoprotein cholesterol (LDL-C) goal attainment can be enhanced with the use of health information technology (HIT) in different clinical settings. A gap is acknowledged in LDL-C goal attainment, but because of the passage of the American Recovery & Reinvestment Act and the Health Information Technology for Economic and Clinical Health Acts there is now reason for optimism that this gap can be narrowed. For HIT to be effectively used to achieve treatment goals, it must be implemented in a setting in which the health care team is fully committed to achieving these goals. Implementation of HIT alone has not resulted in reducing the gap. It is critical to build an effective management strategy into the HIT platform without increasing the overall work/time burden on staff. By enhancing communication between the health care team and the patient, more timely adjustments to treatment plans can be made with greater opportunity for LDL-C goal attainment and improved efficiency in the long run. Patients would be encouraged to take a more active role. Support tools are available. The National Lipid Association has developed a toolkit designed to improve patient compliance and could be modified for use in an HIT system. The importance of a collaborative approach between nongovernmental organizations such as the National Lipid Association, National Quality Forum, HIT partners, and other members of the health care industry offers the best opportunity for long-term success and the real possibility that such efforts could be applied to other chronic conditions, for example, diabetes and hypertension. Copyright © 2013 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  3. A hybrid algorithm of BSC and QFD to determine the criteria affecting implementation of successful outsourcing

    Directory of Open Access Journals (Sweden)

    Mohammad Hemati

    2012-04-01

    Full Text Available Successful organizations share some identical factors that pave the way for their success. Among these factors, strategic management is the key to success for organizations to contribute more to the competitive world market of today. In this respect, the pivotal role of outsourcing cannot be denied. This research parallelizes the criteria affecting the outsourcing success as presented in Elmuti model with the Balanced score card method in the Tose'e Ta'avon Bank. In this research, questionnaires and interviews with experts helped determine the strategic goals at four perspectives of balanced score card method (at Tose'e Ta'avon Bank and the relative weights were computed for each of balance score card (BSC perspectives by using AHP method. As the next step, the indexes were prioritized by applying the quality function development(QFD technique and considering strategic goals at four perspectives in section "WHAT" and the outsourcing success criteria of Elmuti model in section "HOW". At the end of algorithm, the results are compared with the Elmuti method. Based on the results, the hybrid proposed technique seems to perform better than Elmuti.

  4. Incorporating the user perspective into a proposed model for assessing success of SHS implementations

    Directory of Open Access Journals (Sweden)

    Hans Holtorf

    2015-10-01

    Full Text Available Modern energy can contribute to development in multiple ways while approximately 20% of world's populations do not yet have access to electricity. Solar Home Systems (SHSs consists of a PV module, a charge controller and a battery supply in the range of 100 Wh/d in Sunbelt countries. The question addressed in this paper is how SHS users approach success of their systems and how these user's views can be integrated in to an existing model of success. Information was obtained on the user's approach to their SHSs by participatory observation, interviews with users and by self-observation undertaken by the lead author while residing under SHS electricity supply conditions. It was found that success of SHSs from the users' point of view is related to the ability of these systems to reduce the burdens of supplying energy services to homesteads. SHSs can alleviate some energy supply burdens, and they can improve living conditions by enabling communication on multiple levels and by addressing convenience and safety concerns. However, SHSs do not contribute to the energy services which are indispensable for survival, nor to the thermal energy services required and desired in dwellings of Sunbelt countries. The elements of three of the four components of our previously proposed model of success have been verified and found to be appropriate, namely the user's self-set goals, their importance and SHSs' success factors. The locally appropriate, and scientifically satisfactory, measurement of the level of achievement of self-set goals, the fourth component of our model of success, remains an interesting area for future research.

  5. Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital.

    Science.gov (United States)

    Agulnik, Asya; Mora Robles, Lupe Nataly; Forbes, Peter W; Soberanis Vasquez, Doris Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Kleinman, Monica; Rodriguez-Galindo, Carlos

    2017-08-01

    Hospitalized pediatric oncology patients are at high risk of clinical decline and mortality, particularly in resource-limited settings. Pediatric early warning systems (PEWS) aid in the early identification of clinical deterioration; however, there are limited data regarding their feasibility or impact in low-resource settings. This study describes the successful implementation of PEWS at the Unidad Nacional de Oncología Pediátrica (UNOP), a pediatric oncology hospital in Guatemala, resulting in improved inpatient outcomes. A modified PEWS was implemented at UNOP with systems to track errors, transfers to a higher level of care, and high scores. A retrospective cohort study was used to evaluate clinical deterioration events in the year before and after PEWS implementation. After PEWS implementation at UNOP, there was 100% compliance with PEWS documentation and an error rate of <10%. Implementation resulted in 5 high PEWS per week, with 30% of patients transferring to a higher level of care. Among patients requiring transfer to the pediatric intensive care unit (PICU), 93% had an abnormal PEWS before transfer. The rate of clinical deterioration events decreased after PEWS implementation (9.3 vs 6.5 per 1000-hospitalpatient-days, p = .003). Despite an 18% increase in total hospital patient-days, PICU utilization for inpatient transfers decreased from 1376 to 1088 PICU patient-days per year (21% decrease; P<.001). This study describes the successful implementation of PEWS in a pediatric oncology hospital in Guatemala, resulting in decreased inpatient clinical deterioration events and PICU utilization. This work demonstrates that PEWS is a feasible and effective quality improvement measure to improve hospital care for children with cancer in hospitals with limited resources. Cancer 2017;123:2965-74. © 2017 American Cancer Society. © 2017 American Cancer Society.

  6. Assessing DOE's success in implementing the FFC Act: A federal and state partnership to develop treatment plans

    International Nuclear Information System (INIS)

    Letourneau, M.J.; Bubar, P.M.

    1995-01-01

    Implementation of the Federal Facility Compliance Act (FFCAct) required total cooperation among the Department of Energy (DOE), the involved States and interested stakeholders. Although the effort was time consuming, tedious and (at times) trying, the results obtained [Site Treatment Plans (STP)] were an unprecedented success. Through long-range planning, attention to details and organization of effort, a coordinated, cohesive, focused team was developed that included the DOE Headquarters, the Environmental Protection Agency (EPA), 40 DOE sites, 20 states and multiple interested stakeholders. The efforts of the FFCAct team resulted in the preparation of 37 STPs which outline the methods, locations and schedules for the treatment and disposal of DOE's mixed wastes. The Plans provided a strong foundation upon which consent orders were prepared and approved. The FFCAct approach also resulted in the development of working relationships that will prove not only useful but vital to the planning and implementation necessary to the successful clean-up and disposal DOE's mixed wastes

  7. What it takes to successfully implement technology for aging in place: focus groups with stakeholders

    NARCIS (Netherlands)

    Eveline J.M. Wouters; Katrien G. Luijkx; Hubertus J.M. Vrijhoef; Sebastiaan Theodorus Michaël Peek MSc

    2016-01-01

    BACKGROUND: There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by

  8. Sermons, Carrots or Sticks? Explaining Successful Policy Implementation in a Low Performance Institution

    Science.gov (United States)

    Salazar-Morales, Diego Alonso

    2018-01-01

    This article explains how after 43 years of unsatisfactory outcomes, the Ministry of Education of Peru (MoE) suddenly ranked at the top of governmental performance tables. To do so, this study relies on implementation and major discussions of policy instrument theories to provide a comprehensive explanation of the reasons underlying the MoE's…

  9. The role of incentives in implementing successful transit-oriented development strategies

    NARCIS (Netherlands)

    Tan, W.G.Z.; Janssen-Jansen, L.B.; Bertolini, L.

    2014-01-01

    The pursuit of transit-oriented development strategies (TODS) is a worldwide phenomenon but knowledge of the process of implementation remains approximate. The ingredients for changing from a non-conducive to a conducive environment for TODS and how that change occurs remain unclear. In cases of

  10. The Role of Incentives in Implementing Successful Transit-Oriented Development Strategies

    NARCIS (Netherlands)

    Tan, Wendy G.Z.; Janssen-jansen, Leonie B.; Bertolini, Luca

    2014-01-01

    The pursuit of transit-oriented development strategies (TODS) is a worldwide phenomenon but knowledge of the process of implementation remains approximate. The ingredients for changing from a non-conducive to a conducive environment for TODS and how that change occurs remain unclear. In cases of

  11. Post-Implementation Success Factors for Enterprise Resource Planning Student Administration Systems in Higher Education Institutions

    Science.gov (United States)

    Sullivan, Linda; Bozeman, William

    2010-01-01

    Enterprise Resource Planning (ERP) systems can represent one of the largest investments of human and financial resources by a higher education institution. They also bring a significant process reengineering aspect to the institution and the associated implementation project through the integration of compiled industry best practices into the…

  12. Peer Mediation Services for Conflict Resolution in Schools: What Transformations in Activity Characterise Successful Implementation?

    Science.gov (United States)

    Sellman, Edward

    2011-01-01

    This article presents the findings from research conducted at nine schools (seven primary, two secondary) in England, which had previously implemented a peer mediation service for students experiencing interpersonal conflict. This analysis was informed by themes from a previous stage of research conducted at one additional primary school, where…

  13. The Successful Implementation of Electronic Health Records at Small Rural Hospitals

    Science.gov (United States)

    Richardson, Daniel

    2016-01-01

    Electronic health records (EHRs) have been in use since the 1960s. U.S. rural hospital leaders and administrators face significant pressure to implement health information technology because of the American Recovery and Reinvestment Act of 2009. However, some leaders and managers of small rural hospital lack strategies to develop and implement…

  14. A Contingent Analysis of the Relationship between IS Implementation Strategies and IS Success.

    Science.gov (United States)

    Kim, Sang-Hoon; Lee, Jinjoo

    1991-01-01

    Considers approaches to dealing with user attitudes toward newly implemented information systems (IS), and suggests that behavioral management strategies relevant to IS fall into three categories: (1) empirical/rational; (2) normative/reeducative; and (3) power/coercive, based on "planned change" theories. An integrative contingent model…

  15. Implementation of a Personnel Management System "Beaufort": Successes and failures at a Dutch Hospital

    NARCIS (Netherlands)

    Bondarouk, Tatiana; Khosrow-Pour, M.

    2004-01-01

    This case describes a project concerning the implementation of a personnel management system - Beaufort - in Medinet, one of the larger regional general hospitals in The Netherlands. The project plan included two sequential phases: firstly, the introduction of Beaufort to the central personnel and

  16. Building Systems for Successful Implementation of Function-Based Support in Schools

    Science.gov (United States)

    Anderson, Cynthia M.; Horner, Robert H.; Rodriguez, Billie Jo; Stiller, Brianna

    2013-01-01

    Supporting the full range of students with behavioral challenges requires that schools build the capacity to implement evidence-based behavioral interventions. Fortunately, a substantive body of research documents behavioral interventions are available to both decrease problem behavior and enhance prosocial skills. To date, however, this…

  17. Key factors influencing the implementation success of a home telecare application.

    NARCIS (Netherlands)

    Postema, T.R.F.; Peeters, J.M.; Freide, R.D.

    2012-01-01

    Rationale The introduction of home telecare in healthcare organizations has shown mixed results in practice. The aim of this study is to arrive at a set of key factors that can be used in further implementation of video communication. We argue that key factors are mainly found in the organizational

  18. Essential Measures for Student Success: Implementing Cooperation, Collaboration, and Coordination between Schools and Parents

    Science.gov (United States)

    Kirby, Edwena

    2012-01-01

    This book unveils "essential measures" that create a revitalized educational system of which educators and parents can use to promote student success. When these measures are applied properly, the benefits include, eradicating student fear, elevating student motivation, improving school attendance, and reducing student dropout rates. These…

  19. Arts Achieve, Impacting Student Success in the Arts: Preliminary Findings after One Year of Implementation

    Science.gov (United States)

    Mastrorilli, Tara M.; Harnett, Susanne; Zhu, Jing

    2014-01-01

    The "Arts Achieve: Impacting Student Success in the Arts" project involves a partnership between the New York City Department of Education (NYCDOE) and five of the city's premier arts organizations. "Arts Achieve" provides intensive and targeted professional development to arts teachers over a three-year period. The goal of the…

  20. Conditions, factors and criteria for successful project implementation: generalization of experience of project management

    Directory of Open Access Journals (Sweden)

    Feraru Galina Sergeevna

    2014-11-01

    Full Text Available The article addresses issues characterizing features of project management contributing to their competitive advantage; shows the factors and criteria of success of projects and the main reasons for their failures, making the failed efforts of developers to create projects.

  1. Struggles and Successes Implementing Classroom Communication Technology in a College Pre-Calculus Course

    Science.gov (United States)

    Case, Erin; Pape, Stephen

    2013-01-01

    This case study documents the struggles and successes encountered by a pre-calculus teacher while using Classroom Connectivity Technology (CCT) daily in her community college mathematics course. CCT refers to a wireless communication system that connects a teacher's computer with an individual student's handheld calculator and has been associated…

  2. Successful Implementation of a Computer-Supported Collaborative Learning System in Teaching E-Commerce

    Science.gov (United States)

    Ngai, E. W. T.; Lam, S. S.; Poon, J. K. L.

    2013-01-01

    This paper describes the successful application of a computer-supported collaborative learning system in teaching e-commerce. The authors created a teaching and learning environment for 39 local secondary schools to introduce e-commerce using a computer-supported collaborative learning system. This system is designed to equip students with…

  3. The Implementation of a Structured Nursing Leadership Development Program for Succession Planning in a Health System.

    Science.gov (United States)

    Ramseur, Priscilla; Fuchs, Mary Ann; Edwards, Pamela; Humphreys, Janice

    2018-01-01

    Preparing future nursing leaders to be successful is important because many current leaders will retire in large numbers in the future. A structured nursing leadership development program utilizing the Essentials of Nurse Manager Orientation online program provided future nursing leaders with content aligned with nursing leadership competencies. Paired with assigned mentors and monthly leadership sessions, the participants increased their perception of leadership competence.

  4. Successful Implementation of a Clinical Care Pathway for Management of Epistaxis at a Tertiary Care Center.

    Science.gov (United States)

    Vosler, Peter S; Kass, Jason I; Wang, Eric W; Snyderman, Carl H

    2016-11-01

    We compare the management of patients with severe epistaxis before and after the implementation a clinical care pathway (CCP) to standardize care, minimize hospital stay, and decrease cost. Single prospective analysis with historical control. Tertiary academic hospital. Patients treated for epistaxis between October 2012 to December 2013 were compared with a prospective analysis of patients treated for severe epistaxis after implementation of a CCP from June 2014 to February 2015. Severe epistaxis was defined as nasal bleeding not able to be controlled with local pressure, topical vasoconstrictors, or simple anterior packing. Severe epistaxis was similar in the pre- and post-CCP cohorts: 24.7% (n = 42) vs 18.9% (n = 22), respectively. Implementation of early sphenopalatine artery ligation resulted in decreased number of days packed (3.2 ± 1.6 to 1.4 ± 1.6; P = .001), decreased hospital stay (5.2 ± 3.9 to 2.1 ± 1.3 days; P vs 54.5%; P = .035), admission to an appropriate hospital location with access to key resources (41.7% vs 83.3%; P = .007), and decreased overall cost of hospitalization by 66% ($9435 saved). No patients received embolization after the CCP was implemented. Implementation of a CCP decreased hospital stay and days of packing, facilitated definitive care in patients with severe epistaxis, improved patient safety, and decreased cost. The results of this study can serve as a model for the management of severe epistaxis and for future quality improvement measures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  5. Supporting the Evaluation and Implementation of Musculoskeletal Models of Care: A Globally Informed Framework for Judging Readiness and Success.

    Science.gov (United States)

    Briggs, Andrew M; Jordan, Joanne E; Jennings, Matthew; Speerin, Robyn; Bragge, Peter; Chua, Jason; Woolf, Anthony D; Slater, Helen

    2017-04-01

    To develop a globally informed framework to evaluate readiness for implementation and success after implementation of musculoskeletal models of care (MOCs). Three phases were undertaken: 1) a qualitative study with 27 Australian subject matter experts (SMEs) to develop a draft framework; 2) an eDelphi study with an international panel of 93 SMEs across 30 nations to evaluate face validity, and refine and establish consensus on the framework components; and 3) translation of the framework into a user-focused resource and evaluation of its acceptability with the eDelphi panel. A comprehensive evaluation framework was developed for judging the readiness and success of musculoskeletal MOCs. The framework consists of 9 domains, with each domain containing a number of themes underpinned by detailed elements. In the first Delphi round, scores of "partly agree" or "completely agree" with the draft framework ranged 96.7%-100%. In the second round, "essential" scores ranged 58.6%-98.9%, resulting in 14 of 34 themes being classified as essential. SMEs strongly agreed or agreed that the final framework was useful (98.8%), usable (95.1%), credible (100%) and appealing (93.9%). Overall, 96.3% strongly supported or supported the final structure of the framework as it was presented, while 100%, 96.3%, and 100% strongly supported or supported the content within the readiness, initiating implementation, and success streams, respectively. An empirically derived framework to evaluate the readiness and success of musculoskeletal MOCs was strongly supported by an international panel of SMEs. The framework provides an important internationally applicable benchmark for the development, implementation, and evaluation of musculoskeletal MOCs. © 2016, American College of Rheumatology.

  6. Critical value factors in business intelligence systems implementation success: An empirical analysis of system and information quality

    OpenAIRE

    Hackney, RA; Dooley, P; Levvy, Y; Parrish, J

    2015-01-01

    Business Intelligence (BI) systems have been rated as a leading technology for the last several years. However, organizations have struggled to ensure that high quality information is provided to and from BI systems. This suggests that organizations have recognized the value of information and the potential opportunities available but are challenged by the lack of success in Business Intelligence Systems Implementation (BISI). Therefore, our research addresses the preponderance of failed BI s...

  7. A Best Practices Model for Implementing Successful Electronic Disease Surveillance Systems: Insights from Peru and Around the Globe

    Science.gov (United States)

    2013-06-03

    reports provided detailed information for each case such as age, residential district, gender, and laboratory data. For instance, dengue fever and... region in Management of Childhood Observational study I) Training component I) Experienced high staff turnover. Brazil ; Inclusion Illness) aims to reduce...proved to be key to the successful implementation of such a system. National and regional surveillance teams performed the critical functions of disease

  8. National Science Foundation Grant Implementation: Perceptions of Teachers and Graduate Fellows in One School Regarding the Barriers and Successes

    Science.gov (United States)

    Pickering, Sharon Durham

    The purpose of this qualitative case study was to examine the perceptions of partner teachers and graduate fellows in 1 school regarding the barriers and successes made during their participation in a National Science Foundation Grant. This study included 9 partner teachers and 7 graduate fellows who participated in the Science First! NSF GK-12 Grant. There were 16 participants in this study. This study was conducted at North Side Elementary and East Tennessee State University. Partner teachers and graduate fellows were interviewed to gain perceptions of the barriers and successes of their participation in the implementation of the Science First! grant at North Side and East Tennessee State University from 2008-2013. A list of possible participants in the study was provided from the grant leadership team. The 16 participants in the study were chosen through purposeful sampling. During data analysis, 4 themes arose as successes and 4 themes arose as barriers. The success themes were (a) relationships, (b) mutual appreciation, (c) increased academic depth, and (d) professional growth. The barriers were (a) communication, (b) time, (c) expectations, and (d) preparation. Based on the research, the following conclusions were presented. The coordination of a major NSF-GK12 grant can provide STEM support and academic rigor for a high poverty school with leadership. Positive relationships between the graduate fellows and partner teachers as well as the 2 participating institutions are critical in fostering successful grant implementation. Professional growth through the grant partnerships was obtained. The participants gained a mutual appreciation for the roles and responsibilities of each other. There are ups and downs in implementing a large grant at 1 elementary school with a university, but the rewards of the potential to influence teacher practices in STEM and student learning are great. Recommendations from the study findings may assist future grant award winners or

  9. Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective.

    Science.gov (United States)

    Sidek, Yusof Haji; Martins, Jorge Tiago

    2017-11-01

    Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Workflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review.

    Science.gov (United States)

    Warkentin, Theodore E; Pai, Menaka; Linkins, Lori-Ann

    2017-08-31

    Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, ON, Canada, since January 1, 2015 (when we completed our prospective study of rivaroxaban for HIT), using rivaroxaban for serologically confirmed HIT (4Ts score ≥4 points; positive platelet factor 4 [PF4]/heparin immunoassay, positive serotonin-release assay). We also performed a literature review of HIT treatment using DOACs (rivaroxaban, apixaban, dabigatran, edoxaban). We focused on patients who received DOAC therapy for acute HIT as either primary therapy (group A) or secondary therapy (group B; initial treatment using a non-DOAC/non-heparin anticoagulant with transition to a DOAC during HIT-associated thrombocytopenia). Our primary end point was occurrence of objectively documented thrombosis during DOAC therapy for acute HIT. We found that recovery without new, progressive, or recurrent thrombosis occurred in all 10 Hamilton patients with acute HIT treated with rivaroxaban. Data from the literature review plus these new data identified a thrombosis rate of 1 of 46 patients (2.2%; 95% CI, 0.4%-11.3%) in patients treated with rivaroxaban during acute HIT (group A, n = 25; group B, n = 21); major hemorrhage was seen in 0 of 46 patients. Similar outcomes in smaller numbers of patients were observed with apixaban (n = 12) and dabigatran (n = 11). DOACs offer simplified management of selected patients, as illustrated by a case of persisting (autoimmune) HIT (>2-month platelet recovery with inversely parallel waning of serum-induced heparin-independent serotonin release) with successful outpatient rivaroxaban management of HIT-associated thrombosis. Evidence supporting efficacy and safety of DOACs for acute HIT is increasing, with the most experience reported for rivaroxaban. © 2017 by The American Society of Hematology.

  11. Assessing Cultural Readiness of Organization For Successful Implementation of Knowledge Managment, Appling FMCDM Approach: Case of Central Bank of Iran

    Directory of Open Access Journals (Sweden)

    Shaban Elahi

    2012-02-01

    Full Text Available Supportive organizational culture for knowledge management can vouch for successful implementation of knowledge management. In the case of lacking this kind of supportive culture, the organizational culture is one of the obstacles which can lead the implementation of knowledge management to full failure and waste of organizational assets. In this research, a framework based on FMCDM was utilized to assess the cultural readiness of organization as the knowledge management implementation prerequisite. This framework has been utilized to assess Central Bank of Iran’s cultural readiness. The methodology of research was descriptive and research data were gathered by questionnaire and were answered by experts and CBI executives. In this term, the cultural readiness of CBI was assessed and in accordance with this assessment, embarking on corrective action was proposed.

  12. Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia.

    Science.gov (United States)

    Djellouli, Nehla; Quevedo-Gómez, María Cristina

    2015-05-01

    The Caribbean region presents the highest prevalence of HIV/AIDS worldwide after sub-Saharan Africa; leading to serious social, economic and health consequences at the local scale but also at the regional and global levels. In Colombia, a national plan to tackle the epidemic was formulated with little evidence that its implementation in the local context is effective. This study focused on Cartagena - one of Colombia's largest cities and an international touristic hub - that presents one of the highest HIV prevalences in the country, to investigate whether the national plan accounts for local specificities and what are the barriers to local implementation. Based on the Contextual Interaction Theory (CIT), this qualitative research relied upon 27 interviews and 13 life stories of local inhabitants and stakeholders, collected in a first fieldwork in 2006-2007. A follow-up data collection took place in 2013 with 10 participants: key policymakers and implementers, NGO representatives and local inhabitants. Barriers identified by the participants included: local population's understandings and beliefs on condom use; stigma and discrimination; lack of collaboration from the Church, the education sector and local politicians; corruption; high staff turnover; frequent changes in leadership; lack of economic and human resources; and barriers to health care access. The findings suggest that global influences also have an impact on the CIT framework (e.g. international organisations as a major financier in HIV prevention). The participants put forward several feasible solutions to implementation barriers. We discuss how several of the proposed solutions have been applied in other Latin American and Caribbean countries and yielded positive results. However, further research is needed to find possible ways of overcoming certain barriers identified by this study such as corruption, the lack of collaboration of the Church and barriers to health care access. Copyright © 2015

  13. Barriers and Critical Success Factors for the Implementation of Cooperation Mechanisms

    DEFF Research Database (Denmark)

    Hansen, Lise-Lotte Pade; Klinge Jacobsen, Henrik

    This document reports activities and results of Task 3.1 of the Intelligent Energy Europe supported project RES4Less. This work is the initial analyses and survey of barriers for implementing cooperation mechanisms in the EU countries. This work builds on earlier Intelligent Energy Europe projects...... also shared and enriched by comments from other members of the RES4Less Team during internal meetings of the project....

  14. Successful Models of Implementation of e-HRM Systems in the Private Sector in Romania

    Directory of Open Access Journals (Sweden)

    Aurel TOTOLICI

    2013-12-01

    Full Text Available The essential condition for attaining excellence in the informatized administration of the Human Resources Management (HRM activities is the development and implementation of high-performance e-HRM systems. For this reason, any organization, regardless of her nature and dimensions, needs to make use of the implementation of an e-HRM IT system adapted to its specific needs, because the performances of the HR activities largely depend on the correlation of the software tools with the employees’ abilities. The identification of the benefits of the e-HRM systems and the impact of these systems on the managerial and, implicitly, organizational performances have become highly interesting subjects, both among the theorists and among the practitioners worldwide. In order to detail the effects and the benefits of the implementation of the e-HRM system, we considered it useful to present a case study focused on a private firm of Romania: Arcelor Mittal Company of Galaţi, namely a Steel Mill.

  15. MODEL - INTEGRAL METHODOLOGY FOR SUCCESSFUL DESIGNING AND IMPLEMENTING OF TQM SYSTEM IN MACEDONIAN COMPANIES

    Directory of Open Access Journals (Sweden)

    Elizabeta Mitreva

    2011-12-01

    Full Text Available The subject of this paper is linked with the valorization of the meaning and the perspectives of Total Quality Management (TQM system design and implementation within the domestic companies and creating a model-methodology for improved performance, efficiency and effectiveness. The research is designed as an attempt to depict the existing condition in the Macedonian companies regarding quality system design and implementation, analysed through 4 polls in the "house of quality" whose top is the ultimate management, and as its bases measurement, evaluation, analyzing and comparison of the quality are used. This "house" is being held by 4 subsystems e.g. internal standardization, methods and techniques for flawless work performance, education and motivation and analyses of the quality costs. The data received from the research and the proposal of the integral methodology for designing and implementing of TQM system are designed in turn to help and present useful directions to all Macedonian companies tending to become "world class" organizations. The basis in the creation of this model is the redesign of the business processes which afterword begins as a new phase of the business performance - continued improvement, rolling of Deming's Quality Circle (Plan-Do-Check-Act. The model-methodology proposed in this paper is integral and universal which means that it is applicable to all companies regardless of the business area.

  16. A domestic model for successful implementation of enterprise resource planning (ERP systems in Iranian manufacturing enterprises

    Directory of Open Access Journals (Sweden)

    Mohammad Rahmani

    2012-01-01

    Full Text Available This research investigates the human-behavioral dimension of technology acceptance in enterprises. It is evident that accepting a technology depends on the underlying circumstances of the environment. We have approached this issue from two different angles of social and technological architecture. The research tries to explore proper enterprise architecture for ERP system acceptance. Social Architecture (SA is defined as the set of circumstances that makes people behave in a particular way. So behavior of persons (employees of an enterprise can be a function of SA. Hence acceptance of a system can be dictated by SA and manipulating SA can result in desirable success for a technology system. We have achieved various variables of social architecture and have examined their relevance to system acceptance and success in related enterprises (research domain beside technological architecture variables. The results have indicated that a special form of social and technological architecture can lead to success for ERP system in the enterprises of the research domain. This gave us a model of architecture.

  17. A C++ object-oriented toolkit for track finding with k-dimensional hits

    International Nuclear Information System (INIS)

    Uiterwijk, J.W.E.; Panman, J.; Vyver, B. van de

    2006-01-01

    A library is described for the recognition of tracks in a set of hits. The hits are assumed to be k-dimensional points (k-d), with k>=1, of which a subset can be grouped into tracks by using short-range correlations. A connection graph between the hits is created by sorting the hits first in k-d space using one of the developed, fast, k-space containers. The track-finding algorithm considers any connection between two hits as a possible track seed and grows these seeds into longer track segments using a modified depth-first search of the connection graph. All hit-acceptance decisions are called via abstract methods of an acceptance criterion class which isolates the library from the application's hit and track model. An application is tuned for a particular tracking environment by creating a concrete implementation for the hit and track acceptance calculations. The implementer is free to trade tracking time for acceptance complexity (influencing efficiency) depending on the requirements of the particular application. Results for simulated data show that the track finding is both efficient and fast even for high noise environments

  18. Impact analysis of critical success factors on the benefits from statistical process control implementation

    Directory of Open Access Journals (Sweden)

    Fabiano Rodrigues Soriano

    Full Text Available Abstract The Statistical Process Control - SPC is a set of statistical techniques focused on process control, monitoring and analyzing variation causes in the quality characteristics and/or in the parameters used to control and process improvements. Implementing SPC in organizations is a complex task. The reasons for its failure are related to organizational or social factors such as lack of top management commitment and little understanding about its potential benefits. Other aspects concern technical factors such as lack of training on and understanding about the statistical techniques. The main aim of the present article is to understand the interrelations between conditioning factors associated with top management commitment (Support, SPC Training and Application, as well as to understand the relationships between these factors and the benefits associated with the implementation of the program. The Partial Least Squares Structural Equation Modeling (PLS-SEM was used in the analysis since the main goal is to establish the causal relations. A cross-section survey was used as research method to collect information of samples from Brazilian auto-parts companies, which were selected according to guides from the auto-parts industry associations. A total of 170 companies were contacted by e-mail and by phone in order to be invited to participate in the survey. However, just 93 industries agreed on participating, and only 43 answered the questionnaire. The results showed that the senior management support considerably affects the way companies develop their training programs. In turn, these trainings affect the way companies apply the techniques. Thus, it will reflect on the benefits gotten from implementing the program. It was observed that the managerial and technical aspects are closely connected to each other and that they are represented by the ratio between top management and training support. The technical aspects observed through SPC

  19. Managers' experience of success criteria and barriers to implementing mobile radiography services in nursing homes in Norway: a qualitative study.

    Science.gov (United States)

    Kjelle, Elin; Lysdahl, Kristin Bakke; Olerud, Hilde Merete; Myklebust, Aud Mette

    2018-04-25

    In order to meet the future challenges posed by ageing populations, new technology, telemedicine and a more personalized healthcare system are needed. Earlier research has shown mobile radiography services to be highly beneficial for nursing home residents in addition to being cost-effective. Despite the benefits, mobile radiography services are uncommon in Europe and Norway. The purpose of this study was to explore success criteria and barriers in the process of implementing mobile radiography services, from the point of view of the hospital and municipal managers. Eleven semi-structured interviews were conducted with managers from five hospitals and six municipalities in Norway where mobile radiography services had been implemented. Core issues in the interview guide were barriers and facilitators in the different phases of implementation. The framework method for thematic analysis was used for analysing the data inductively in a research team. Five main categories were developed through the success criteria and barriers experienced by the participants: national health policy, regional and municipal policy and conditions, inter-organizational implementation projects, experienced outcome, and professional skills and personal characteristics. The categories were allocated into three higher-order classifications: macro, meso and micro levels. The main barriers experienced by the managers were financial, procedural and structural. In particular, the reimbursement system, lack of management across healthcare levels and the lack of compatible information systems acted as barriers. The main facilitators were external funding, enthusiastic individuals in the organizations and good collaboration between hospitals and municipalities. The managers experienced financial, structural and procedural barriers. The main success criteria in the process were external funding, and the support and engagement from the individuals in the organizations. This commitment was mainly

  20. Indirect policy instruments and implementation success: the Case of the Food Subsidy Programme in Mozambique

    Directory of Open Access Journals (Sweden)

    Galvani-Silva, Flavia

    2011-08-01

    Full Text Available Governments all over the world face the dilemma of limited resources and increasingly tighter fiscal targets on one hand, and, on the other hand, growing pressure to deliver quality public services. The situation is particularly problematic in developing countries where the gap between resources available and demand for basic public services is much wider. Government policies, plans, targets, such as the Millennium Development Goals and the Poverty Reduction Strategy Papers, often remain on paper or are partially and poorly implemented for lack of resources and institutional frameworks that are weak and outmoded. In this context, governments have been searching for alternatives and experimenting with new approaches to bridge this gap and put their policies into effect. Many of the new approaches and tools being used by governments share a significant common feature: they are highly indirect, that is, they rely on third parties to deliver publicly services and pursue publicly authorized purposes - these include contracting, grants, vouchers, loan guarantees among many others. As a result, third parties are now intimately involved in the implementation, and often the management, of the public´s business and a major share of the discretion over the operations of public programmes now routinely rests outside the responsible government agency (Salamon 2002.

  1. How best can we plan & implement HIV prevention? A review of successful evidence based practices & research

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Chattu

    2014-07-01

    Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.

  2. Success in Implementation of a Resident In-Service Examination Review Series

    Science.gov (United States)

    Forcucci, Jessica A.; Hyer, J. Madison; Bruner, Evelyn T.; Lewin, David N.; Batalis, Nicholas I.

    2017-01-01

    Abstract Objectives: Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Methods: Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability. Linear models were used to evaluate differences in average RISE performance prior to and following the initiation of the review series in addition to controlling for relevant covariates. Results: Significant improvement was noted in the grand total, anatomic pathology section average, clinical pathology section average, and transfusion medicine section. Although not statistically significant, improvement was noted on the cytopathology and clinical chemistry sections. There was no significant difference in scores in hematopathology, molecular pathology, and the special topics section average. In addition, improvement in primary pathology board certification rates was also noted. Conclusions: Institution of a month-long RISE review series demonstrated improved overall performance within our training program. The success could easily be replicated in any training program without significant disruption to an annual didactic series. PMID:28340222

  3. Success in Implementation of a Resident In-Service Examination Review Series.

    Science.gov (United States)

    Forcucci, Jessica A; Hyer, J Madison; Bruner, Evelyn T; Lewin, David N; Batalis, Nicholas I

    2017-04-01

    Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability. Linear models were used to evaluate differences in average RISE performance prior to and following the initiation of the review series in addition to controlling for relevant covariates. Significant improvement was noted in the grand total, anatomic pathology section average, clinical pathology section average, and transfusion medicine section. Although not statistically significant, improvement was noted on the cytopathology and clinical chemistry sections. There was no significant difference in scores in hematopathology, molecular pathology, and the special topics section average. In addition, improvement in primary pathology board certification rates was also noted. Institution of a month-long RISE review series demonstrated improved overall performance within our training program. The success could easily be replicated in any training program without significant disruption to an annual didactic series. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users.

    Science.gov (United States)

    de Veer, Anke J E; Fleuren, Margot A H; Bekkema, Nienke; Francke, Anneke L

    2011-10-27

    A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel), of whom 685 (67%) completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly. Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive.The factors most frequently mentioned as impeding actual use were related to the (kind of) technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy. A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived) characteristics of the technology itself.

  5. The VOICES/VOCES success story: effective strategies for training, technical assistance and community-based organization implementation.

    Science.gov (United States)

    Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

    2006-08-01

    The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a comprehensive and user-friendly intervention kit, comprising (a) an implementationmanual and othermaterials necessary for conducting the intervention (b) a Training of Facilitators (TOF) curriculum used to teach agency staff how to implement the EBI in their setting, (c) a network of expert trainers who attend a training institute to become adept at using the TOF curriculum to train facilitators, (d) a comprehensive training coordination center to plan and deliver TOF trainings, (e) proactive technical assistance to trainers, and (f) post-TOF technical assistance for local implementers. This article reports on those strategies and a local CBO's successful participation in DEBI, resulting implementation of VOICES/VOCES, with unique approaches to adaptation and tailoring.

  6. Achieving successful evidence-based practice implementation in juvenile justice: The importance of diagnostic and evaluative capacity.

    Science.gov (United States)

    Walker, Sarah Cusworth; Bumbarger, Brian K; Phillippi, Stephen W

    2015-10-01

    Evidence-based programs (EBPs) are an increasingly visible aspect of the treatment landscape in juvenile justice. Research demonstrates that such programs yield positive returns on investment and are replacing more expensive, less effective options. However, programs are unlikely to produce expected benefits when they are not well-matched to community needs, not sustained and do not reach sufficient reach and scale. We argue that achieving these benchmarks for successful implementation will require states and county governments to invest in data-driven decision infrastructure in order to respond in a rigorous and flexible way to shifting political and funding climates. We conceptualize this infrastructure as diagnostic capacity and evaluative capacity: Diagnostic capacity is defined as the process of selecting appropriate programing and evaluative capacity is defined as the ability to monitor and evaluate progress. Policy analyses of Washington State, Pennsylvania and Louisiana's program implementation successes are used to illustrate the benefits of diagnostic and evaluate capacity as a critical element of EBP implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Successful implementation of controlled aerobic bioremediation technology at hydrocarbon contaminated sites in the state of Delaware

    International Nuclear Information System (INIS)

    Harmon, C.D.; Hiller, A.V.; Carberry, J.B.

    1994-01-01

    WIK Associates, Inc. of New Castle, Delaware, has been working over the last two years to improve and advance a cost effective method of treating hydrocarbon contaminated soils. The first section of this paper describes treatment methods and associated benefits such as increased control over environmental parameters. The second part of this paper describes work performed in attempting to predict degradation rates for varying types of hydrocarbon contamination under varying conditions. This research is based on data gathered in performing on-site bioremediation as described. A third section included in this paper describes the unique perspective of a State regulator responsible for overseeing remediation efforts evolving from leaking underground storage tanks. This section describes regulatory issues and procedures in Delaware and how the Department handles the submission and implementation of corrective action work plans, through project closure with thorough documentation of the remediation

  8. Implementing health management information systems: measuring success in Korea's health centers.

    Science.gov (United States)

    Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S

    1994-01-01

    This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.

  9. An Analytic Hierarchy Process-based Method to Rank the Critical Success Factors of Implementing a Pharmacy Barcode System.

    Science.gov (United States)

    Alharthi, Hana; Sultana, Nahid; Al-Amoudi, Amjaad; Basudan, Afrah

    2015-01-01

    Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.

  10. Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

    Science.gov (United States)

    Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

    2018-06-01

    Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

  11. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Science.gov (United States)

    Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

    2006-08-24

    Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering

  12. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2006-08-01

    Full Text Available Abstract Background Telehealth, as other information and communication technologies (ICTs introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and

  13. Pattern recognition with vector hits

    International Nuclear Information System (INIS)

    Frühwirth, R

    2012-01-01

    Trackers at the future high-luminosity LHC, designed to have triggering capability, will feature layers of stacked modules with a small stack separation. This will allow the reconstruction of track stubs or vector hits with position and direction information, but lacking precise curvature information. This opens up new possibilities for track finding, online and offline. Two track finding methods, the Kalman filter and the convergent Hough transform are studied in this context. Results from a simplified fast simulation are presented. It is shown that the performance of the methods depends to a large extent on the size of the stack separation. We conclude that the detector design and the choice of the track finding algorithm(s) are strongly coupled and should proceed conjointly.

  14. Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

    Science.gov (United States)

    Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

    2017-12-01

    Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

  15. Successful implementation of a perioperative glycemic control protocol in cardiac surgery: barrier analysis and intervention using lean six sigma.

    Science.gov (United States)

    Martinez, Elizabeth A; Chavez-Valdez, Raul; Holt, Natalie F; Grogan, Kelly L; Khalifeh, Katherine W; Slater, Tammy; Winner, Laura E; Moyer, Jennifer; Lehmann, Christoph U

    2011-01-01

    Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.

  16. Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

    Science.gov (United States)

    Martinez, Elizabeth A.; Chavez-Valdez, Raul; Holt, Natalie F.; Grogan, Kelly L.; Khalifeh, Katherine W.; Slater, Tammy; Winner, Laura E.; Moyer, Jennifer; Lehmann, Christoph U.

    2011-01-01

    Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period. PMID:22091218

  17. Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Martinez

    2011-01-01

    Full Text Available Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.

  18. Clickers at UMass: a successful program of campus-wide implementation

    Science.gov (United States)

    Schneider, Stephen

    2006-12-01

    In the early 1990s, the Physics Department of the University of Massachusetts was a testing ground for one of the forerunners of the modern classroom response systems. Today, UMass is one of largest users of the wireless descendants of this system, with “clickers” being used across all disciplines. In Astronomy (and many other departments) we use clickers primarily in our large lecture classrooms. We have found that they can be used to (a) engage students in making predictions about classroom experiments. (b) encourage cooperative work with other students to develop mathematical and reasoning skills. (c) help students explore their own misconceptions. (d) All of the above. [correct answer!] Our early uses of clickers showed that simple testing of student knowledge was often perceived negatively as, in effect, “just taking attendance.” However, when students are challenged with difficult and interesting problems, the classroom response system is a positive addition to classroom teaching. Several successful examples, using demos, experiments, and even horoscopes, are shown, and the process involved in developing a strong campus-wide program at UMass is described.

  19. [The world is free of pox - Implementation and success of a grandiose program].

    Science.gov (United States)

    Dittmann, S

    1980-12-15

    At the beginning of this century the compulsory vaccination and revaccination which was legally founded after the introduction of the vaccination by Jenner (1796) led to the removal of the smallpox in Europe and Northern America. However, up to the sixties in the developing countries of Asia, Africa as well as of Southern America and Middle America still fell ill and died of small-pox millions of people. Between 1953 and 1973 importations into countries of Europe and Northern America took place in 51 cases. In 1959 on the motion of the USSR the WHO decided performance of a world-wide eradication programme of small-pox which could be led to success with comprehensive personal, material and financial support of many countries. Flanking scientific, technological and methodical measures were of essential importance. In May 1980 the World Health Assembly in Geneva announced in solemn form the world-wide eradication of the small-pox and gave recommendations to the member countries for concluding measures concerning the small-pox vaccination, the foundation of vaccine reserves and the control of the epidemiological situation in the world. Also in the GDR the small-pox vaccination in childhood could be abolished.

  20. Goals and hurdles for a successful implementation of genomic selection in breeding programme for selected annual and perennial crops.

    Science.gov (United States)

    Jonas, Elisabeth; de Koning, Dirk Jan

    Genomic Selection is an important topic in quantitative genetics and breeding. Not only does it allow the full use of current molecular genetic technologies, it stimulates also the development of new methods and models. Genomic selection, if fully implemented in commercial farming, should have a major impact on the productivity of various agricultural systems. But suggested approaches need to be applicable in commercial breeding populations. Many of the published research studies focus on methodologies. We conclude from the reviewed publications, that a stronger focus on strategies for the implementation of genomic selection in advanced breeding lines, introduction of new varieties, hybrids or multi-line crosses is needed. Efforts to find solutions for a better prediction and integration of environmental influences need to continue within applied breeding schemes. Goals of the implementation of genomic selection into crop breeding should be carefully defined and crop breeders in the private sector will play a substantial part in the decision-making process. However, the lack of published results from studies within, or in collaboration with, private companies diminishes the knowledge on the status of genomic selection within applied breeding programmes. Studies on the implementation of genomic selection in plant breeding need to evaluate models and methods with an enhanced emphasis on population-specific requirements and production environments. Adaptation of methods to breeding schemes or changes to breeding programmes for a better integration of genomic selection strategies are needed across species. More openness with a continuous exchange will contribute to successes.

  1. Health Information Technologies-Academic and Commercial Evaluation (HIT-ACE) methodology: description and application to clinical feedback systems.

    Science.gov (United States)

    Lyon, Aaron R; Lewis, Cara C; Melvin, Abigail; Boyd, Meredith; Nicodimos, Semret; Liu, Freda F; Jungbluth, Nathaniel

    2016-09-22

    Health information technologies (HIT) have become nearly ubiquitous in the contemporary healthcare landscape, but information about HIT development, functionality, and implementation readiness is frequently siloed. Theory-driven methods of compiling, evaluating, and integrating information from the academic and commercial sectors are necessary to guide stakeholder decision-making surrounding HIT adoption and to develop pragmatic HIT research agendas. This article presents the Health Information Technologies-Academic and Commercial Evaluation (HIT-ACE) methodology, a structured, theory-driven method for compiling and evaluating information from multiple sectors. As an example demonstration of the methodology, we apply HIT-ACE to mental and behavioral health measurement feedback systems (MFS). MFS are a specific class of HIT that support the implementation of routine outcome monitoring, an evidence-based practice. HIT-ACE is guided by theories and frameworks related to user-centered design and implementation science. The methodology involves four phases: (1) coding academic and commercial materials, (2) developer/purveyor interviews, (3) linking putative implementation mechanisms to hit capabilities, and (4) experimental testing of capabilities and mechanisms. In the current demonstration, phase 1 included a systematic process to identify MFS in mental and behavioral health using academic literature and commercial websites. Using user-centered design, implementation science, and feedback frameworks, the HIT-ACE coding system was developed, piloted, and used to review each identified system for the presence of 38 capabilities and 18 additional characteristics via a consensus coding process. Bibliometic data were also collected to examine the representation of the systems in the scientific literature. As an example, results are presented for the application of HIT-ACE phase 1 to MFS wherein 49 separate MFS were identified, reflecting a diverse array of characteristics

  2. 77 FR 23250 - HIT Standards Committee; Schedule for the Assessment of HIT Policy Committee Recommendations

    Science.gov (United States)

    2012-04-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee; Schedule for the Assessment of HIT Policy Committee Recommendations AGENCY: Office of the National Coordinator for Health Information... 2009 mandates that the HIT Standards Committee develop a schedule for the assessment of policy...

  3. 76 FR 25355 - HIT Standards Committee; Schedule for the Assessment of HIT Policy Committee Recommendations

    Science.gov (United States)

    2011-05-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee; Schedule for the Assessment of HIT Policy Committee Recommendations AGENCY: Office of the National Coordinator for Health Information... 2009 mandates that the HIT Standards Committee develop a schedule for the assessment of policy...

  4. 78 FR 29134 - HIT Standards Committee; Schedule for the Assessment of HIT Policy Committee Recommendations

    Science.gov (United States)

    2013-05-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee; Schedule for the Assessment of HIT Policy Committee Recommendations AGENCY: Office of the National Coordinator for Health Information... 2009 mandates that the HIT Standards Committee develop a schedule for the assessment of policy...

  5. Developing Health Information Technology (HIT) Programs and HIT Curriculum: The Southern Polytechnic State University Experience

    Science.gov (United States)

    Zhang, Chi; Reichgelt, Han; Rutherfoord, Rebecca H.; Wang, Andy Ju An

    2014-01-01

    Health Information Technology (HIT) professionals are in increasing demand as healthcare providers need help in the adoption and meaningful use of Electronic Health Record (EHR) systems while the HIT industry needs workforce skilled in HIT and EHR development. To respond to this increasing demand, the School of Computing and Software Engineering…

  6. The IGSN Experience: Successes and Challenges of Implementing Persistent Identifiers for Samples

    Science.gov (United States)

    Lehnert, Kerstin; Arko, Robert

    2016-04-01

    Physical samples collected and studied in the Earth sciences represent both a research resource and a research product in the Earth Sciences. As such they need to be properly managed, curated, documented, and cited to ensure re-usability and utility for future science, reproducibility of the data generated by their study, and credit for funding agencies and researchers who invested substantial resources and intellectual effort into their collection and curation. Use of persistent and unique identifiers and deposition of metadata in a persistent registry are therefore as important for physical samples as they are for digital data. The International Geo Sample Number (IGSN) is a persistent, globally unique identifier. Its adoption by individual investigators, repository curators, publishers, and data managers is rapidly growing world-wide. This presentation will provide an analysis of the development and implementation path of the IGSN and relevant insights and experiences gained along its way. Development of the IGSN started in 2004 as part of a US NSF-funded project to establish a registry for sample metadata, the System for Earth Sample Registration (SESAR). The initial system provided a centralized solution for users to submit information about their samples and obtain IGSNs and bar codes. Challenges encountered during this initial phase related to defining the scope of the registry, granularity of registered objects, responsibilities of relevant actors, and workflows, and designing the registry's metadata schema, its user interfaces, and the identifier itself, including its syntax. The most challenging task though was to make the IGSN an integral part of personal and institutional sample management, digital management of sample-based data, and data publication on a global scale. Besides convincing individual researchers, curators, editors and publishers, as well as data managers in US and non-US academia, state and federal agencies, the PIs of the SESAR project

  7. Assessing the Challenges in Successful Implementation and Adoption of Crop Insurance in Thailand

    Directory of Open Access Journals (Sweden)

    Shweta Sinha

    2016-12-01

    Full Text Available The purpose of this paper is to assess the gaps in the adoption of crop insurance in Thailand and suggest possible solutions relating to policy support and framework, implementation mechanisms, technology adoption, and awareness amongst farmers. The methodology includes a literature review, interaction with officials, rice experts and insurance experts, and discussion with farmers. A study was undertaken at province level to assess the impact of using rainfall index as a threshold. Additionally, focused group discussions (FGD were conducted with rice farmers at the village level. Key issues targeted in the FGD were to understand the behavior and practices during droughts, impact of drought on crop yield, methods already in use to reduce the impact, such as plantation of drought-resistant rice, and the adoption of crop insurance. Data availability is a challenge and has led to withdrawal of Weather Index Insurance (WII in 2015. WII have threshold levels based on historical rainfall. Adoption of coping mechanisms, such as drought-resistant rice and irrigation increases the chances of adverse selection. In absence of ground based weather data, a combination of satellite agriculture drought information can be used to make crop insurance more attractive as it would help in reducing basis risk and improving insurers and farmers’ confidence in the product. Discussion with farmers, insurance companies, and the Bank of Agriculture and Agricultural Cooperatives (BAAC in Thailand suggested low awareness among farmers about the potential benefits of weather index insurance products. Relatively low compensation is also an obstacle. Proper marketing and awareness raising campaigns should also accompany the introduction of index-based insurance products.

  8. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    Science.gov (United States)

    Ludwick, D. A.; Doucette, John

    2009-01-01

    Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787

  9. Primary Care Physicians' Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service Environment

    Directory of Open Access Journals (Sweden)

    D. A. Ludwick

    2009-01-01

    Full Text Available Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT. Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation.

  10. Statistics of hits to bone cell nuclei

    International Nuclear Information System (INIS)

    Kruglikov, I.L.; Polig, E.; Jee, W.S.S.

    1993-01-01

    The statistics of hits to the nuclei of bone cells irradiated from alpha sources labeling bone tissue is described. It is shown that the law of remodeling of a bone structural unit (BSU), which describes the distribution of quiescence periodes of this unit, affects the statistics of hits. It the irradiation of bone cells occurs during the whole cell cycle, the mean number of hits is independent of the law of remodeling. In this case the variance of hits has the minimum value for constant quiescence periods of BSUs (deterministic remodeling) and the maximum value for exponentially distributed quiescence periods (random remodeling). For the first generation of bone cells, i.e. for the cells which existed at the moment of the uptake of the nuclide, the mean number of hits depends on the law of remodeling. For random remodeling the mean number is equal to the mean value for the complete remodeling cycle. For deterministic remodeling the mean is only half this value. For the first generation of bone cells, changing the law of remodeling from random to deterministic increases the probability of no hits to the nuclei of bone cells. For the same mean value of hits, the difference does not exceed 13.3% of the total number of cells. For the subsequent generations of bone cells, such a change of the law of remodeling decreases the probability of no hits up to 20.4% of the total number of cells. (orig.)

  11. Improving Emergency Department radiology transportation time: a successful implementation of lean methodology.

    Science.gov (United States)

    Hitti, Eveline A; El-Eid, Ghada R; Tamim, Hani; Saleh, Rana; Saliba, Miriam; Naffaa, Lena

    2017-09-05

    Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay. The objective of this study is to determine the effectiveness of using Lean management methods on improving Emergency Department transportation times for plain radiography. We performed a before and after study at an academic urban Emergency Department with 49,000 annual visits after implementing a Lean driven intervention. The primary outcome was mean radiology transportation turnaround time (TAT). Secondary outcomes included overall study turnaround time from order processing to preliminary report time as well as ED length of stay. All ED patients undergoing plain radiography 6 months pre-intervention were compared to all ED patients undergoing plain radiography 6 months post-intervention after a 1 month washout period. Post intervention there was a statistically significant decrease in the mean transportation TAT (mean ± SD: 9.87 min ± 15.05 versus 22.89 min ± 22.05, respectively, p-value <0.0001). In addition, it was found that 71.6% of patients in the post-intervention had transportation TAT ≤ 10 min, as compared to 32.3% in the pre-intervention period, p-value <0.0001, with narrower interquartile ranges in the post-intervention period. Similarly, the "study processing to preliminary report time" and the length of stay were lower in the post-intervention as compared to the pre-intervention, (52.50 min ± 35.43 versus 54.04 min ± 34.72, p-value = 0.02 and 3.65 h ± 5.17 versus 4.57 h ± 10.43, p < 0.0001, respectively), in spite of an increase in the time it took to elease a preliminary report in the post-intervention period. Using Lean change management

  12. Trials at Sea: Successful Implementation of a Unique Two-Month Professional Development Program

    Science.gov (United States)

    Peart, L. W.; Orcutt, B. N.; Fisher, A. T.; Tsuji, T.; Petronotis, K. E.; Iodp Expedition 327 Participants

    2010-12-01

    During the summer of 2010, Integrated Ocean Drilling Program (IODP) Expedition 327 conducted coring and observatory installations on the Juan de Fuca Plate to characterize the hydrogeology of ridge-flank ocean crust. Due to the nature of the expedition, a smaller science party than usual was needed. IODP took this opportunity to expand education, outreach, and communication (EOC) activities with a previously untested model. Up to now, the IODP U.S. Implementing Organization had sailed either individual teachers on regular (2-month long) expeditions or groups of teachers and informal educators during short (2-week long) transits (School of Rock workshops). After two shipboard (Expeditions 312 and 321T) and two shore-based (Gulf Coast Repository) programs, we have recognized that sailing a group of educators is a beneficial model for IODP and the participants. What has been unavoidable is that these workshops took place outside typical expedition activities. Expedition 327 provided a unique opportunity to sail a diverse group of outreach officers on a regular expedition with a full range of scientific activities. The group included individuals with a wide variety of skills and backgrounds. US participants included a late-career high school physics teacher, a visualization graduate student, an undergraduate engineering student from an historically black university, and an artist. French participants included two middle and high school earth and life science teachers. This diversity made the group more dynamic but it also posed a challenge. Numerous scientific and technical staff also participated in EOC activity design and leadership, including development of dedicated web sites and blogs. After a seminar on constructivist and inquiry-based methods, we spent the first few weeks investigating earth science concepts so EOC participants could gain a basic understanding of the regional geology and the scientific objectives of the expedition. Close to the beginning of the

  13. Implementing GLOBE in the New York City Metropolitan Area: Trials, Errors, and Successes

    Science.gov (United States)

    Ludman, A.; Schmidt, P.; Borman, G.

    2003-12-01

    The Queens College GLOBE NY Metro Partnership was created to introduce GLOBE to more than 1.5 million students in southern NY State and provide continuing support for their teachers. In our first 18 months, we have trained 185 teachers from 82 schools and will triple these numbers this year. Teachers and administrators are attracted to GLOBE by its scientific rigor, the authentic research it offers students, and its fit with NYS standards. They are also eager to interact with our science faculty. Early difficulties included problems with the "standard" 5-day GLOBE training format and misconceptions that protocols are not suitable for urban settings and that preparing for the NYS Regents exams leaves no room for GLOBE. We held information meetings for school districts and for Queens high schools before our first workshop. These identified the most committed schools, energetic teachers, and potential implementation problems. Creative participants at these meetings countered the misconceptions and suggested solutions to the problems better than any outsider could, and generated an atmosphere leading to nearly 100% recruitment. The following stratagems have worked well: a close working relationship with the NYC Dept of Education, BOCES, and other environmental educators; affiliations with government agencies and community environmental groups; two bribes (giving a GLOBE instrument kit and GPS unit to each school that we train and awarding graduate or professional development credits for GLOBE training); a user-friendly training format (an initial 3-day workshop followed by two optional days for hydrology and land use); lending seldom-used items (e.g. soil auger) when needed; building a sense of GLOBE community with a graduation "ceremony", local website (www.qc.edu/qcglobe) and newsletter, phone and email helplines, and annual pedagogy and student research conferences. We also urge that three teachers be trained from each school in order to build local GLOBE support

  14. Assessing DOE`s success in implementing the FFC Act: A federal and state partnership to develop treatment plans

    Energy Technology Data Exchange (ETDEWEB)

    Letourneau, M.J.; Bubar, P.M. [Dept. of Energy, Germantown, MD (United States)

    1995-12-31

    Implementation of the Federal Facility Compliance Act (FFCAct) required total cooperation among the Department of Energy (DOE), the involved States and interested stakeholders. Although the effort was time consuming, tedious and (at times) trying, the results obtained [Site Treatment Plans (STP)] were an unprecedented success. Through long-range planning, attention to details and organization of effort, a coordinated, cohesive, focused team was developed that included the DOE Headquarters, the Environmental Protection Agency (EPA), 40 DOE sites, 20 states and multiple interested stakeholders. The efforts of the FFCAct team resulted in the preparation of 37 STPs which outline the methods, locations and schedules for the treatment and disposal of DOE`s mixed wastes. The Plans provided a strong foundation upon which consent orders were prepared and approved. The FFCAct approach also resulted in the development of working relationships that will prove not only useful but vital to the planning and implementation necessary to the successful clean-up and disposal DOE`s mixed wastes.

  15. Facilitators and barriers to the successful implementation of pediatric antibacterial drug trials: Findings from CTTI's survey of investigators

    Directory of Open Access Journals (Sweden)

    Amy Corneli

    2018-03-01

    Full Text Available An urgent need exists to develop new antibacterial drugs for children. We conducted research with investigators of pediatric antibacterial drug trials to identify facilitators and barriers in the conduct of these trials. Seventy-three investigators completed an online survey assessing the importance of 15 facilitators (grouped in 5 topical categories and the severity of 36 barriers (grouped in 6 topical categories to implementing pediatric antibacterial drug trials. Analysis focused on the identification of key factors that facilitate the successful implementation of pediatric antibacterial drug trials and the key barriers to implementation. Almost all investigators identified two factors as very important facilitators: having site personnel for enrollment and having adequate funding. Other top factors were related to staffing. Among the barriers, factors related to parent concerns and consent were prominent, particularly obtaining parental consent when there was disagreement between parents, concerns about the number of blood draws, and concerns about the number of invasive procedures. Having overly narrow eligibility criteria was also identified as a major barrier. The survey findings suggest three areas in which to focus efforts to help facilitate ongoing drug development: (1 improving engagement with parents of children who may be eligible to enroll in a pediatric antibacterial drug trial, (2 broadening inclusion criteria to allow more participants to enroll, and (3 ensuring adequate staffing and establishing sustainable financial strategies, such as funding pediatric trial networks. The pediatric antibacterial drug trials enterprise is likely to benefit from focused efforts by all stakeholders to remove barriers and enhance facilitation.

  16. Success rate evaluation of clinical governance implementation in teaching hospitals in Kerman (Iran) based on nine steps of Karsh's model.

    Science.gov (United States)

    Vali, Leila; Mastaneh, Zahra; Mouseli, Ali; Kardanmoghadam, Vida; Kamali, Sodabeh

    2017-07-01

    One of the ways to improve the quality of services in the health system is through clinical governance. This method aims to create a framework for clinical services providers to be accountable in return for continuing improvement of quality and maintaining standards of services. To evaluate the success rate of clinical governance implementation in Kerman teaching hospitals based on 9 steps of Karsh's Model. This cross-sectional study was conducted in 2015 on 94 people including chief executive officers (CEOs), nursing managers, clinical governance managers and experts, head nurses and nurses. The required data were collected through a researcher-made questionnaire containing 38 questions with three-point Likert Scale (good, moderate, and weak). The Karsh's Model consists of nine steps including top management commitment to change, accountability for change, creating a structured approach for change, training, pilot implementation, communication, feedback, simulation, and end-user participation. Data analysis using descriptive statistics and Mann-Whitney-Wilcoxon test was done by SPSS software version 16. About 81.9 % of respondents were female and 74.5 have a Bachelor of Nursing (BN) degree. In general, the status of clinical governance implementation in studied hospitals based on 9 steps of the model was 44 % (moderate). A significant relationship was observed among accountability and organizational position (p=0.0012) and field of study (p=0.000). Also, there were significant relationships between structure-based approach and organizational position (p=0.007), communication and demographic characteristics (p=0.000), and end-user participation with organizational position (p=0.03). Clinical governance should be implemented by correct needs assessment and participation of all stakeholders, to ensure its enforcement in practice, and to enhance the quality of services.

  17. Empirical testing of selected critical success factors in CRM implementation projects - A study of SMEs in the B2B sector

    OpenAIRE

    Röschmann, Kathrin; Ziyadullaeva, Muhayyo

    2011-01-01

    Purpose:The purpose of this thesis is to describe and analyze critical success factors of CRM implementation projects with a special focus on SME’s in the B2B sector.  Method: This study is based on quantitative research using survey method.  Target Audience: SMEs of B2B business, which are planning to implement a CRM system Academic audience, which is interested in CRM implementation with focus on SME.  Conclusion: There are various critical success factors in CRM implementation projects and...

  18. Computing Principal Eigenvectors of Large Web Graphs: Algorithms and Accelerations Related to PageRank and HITS

    Science.gov (United States)

    Nagasinghe, Iranga

    2010-01-01

    This thesis investigates and develops a few acceleration techniques for the search engine algorithms used in PageRank and HITS computations. PageRank and HITS methods are two highly successful applications of modern Linear Algebra in computer science and engineering. They constitute the essential technologies accounted for the immense growth and…

  19. Development of a framework towards successful implementation of e-governance initiatives in health sector in India.

    Science.gov (United States)

    Ray, Subhasis; Mukherjee, Amitava

    2007-01-01

    The purpose of this paper is to explore the route map for employing efficient e-governance so that at least existing resource and infrastructure are better utilized and deficiencies are tracked for future planning. National health is one of the most important factors in a country's economic growth. India seems to be a victim of the vicious cycle around poor economy and poor health conditions. A detailed study was carried out to find out India's healthcare infrastructure and its standing in e-governance initiatives. After consolidating the fact that effective e-governance can enhance the quality of healthcare service even within limited resources, authors explored success and failure factors of many e-governance initiatives in India and abroad. Finally, an e-governance framework is suggested based on the above factors together with the authors' own experience of implementing e-governance projects in India and abroad. The suggested framework is based on a phased implementation approach. The first phase "Information Dissemination" is more geared towards breaking the "digital divide" across three dimensions: G2Business; G2Citizen; and G2Agent. The most advanced stage is aimed towards joining up healthcare information across the above three dimensions and drawing meaningful analytics out of it. The recommendations also include management of Policies, Scope, Process Reform, Infrastructure, Technology, Finance, Partnership and People for efficient implementation of such e-governance initiatives. The paper provides measures for continuous evaluation of systems as one passes through various stages of implementation. However, the framework can be tested on real or simulated environment to prove its worthiness. This paper can be a potential frame of reference for nation-wide e-healthcare projects not only in India but also in other developing countries. The paper also describes challenges that are most likely to be faced during implementation. Since the paper is practical in

  20. Fall Prevention Hits Stumbling Blocks.

    Science.gov (United States)

    Huff, Charlotte

    2018-03-01

    Implementation of efforts to screen older people for fall risk-and to intervene before falls occur-have been scattershot at best. Ongoing studies of fall prevention called STRIDE (Strategies to Reduce Injuries and Develop Confidence in Elders) might change that. The studies look at whether clinicians can implement a fall-prevention program across rural, urban, and suburban treatment settings.

  1. Hit size effectiveness in relation to the microdosimetric site size

    International Nuclear Information System (INIS)

    Varma, M.N.; Wuu, C.S.; Zaider, M.

    1994-01-01

    This paper examines the effect of site size (that is, the diameter of the microdosimetric volume) on the hit size effectiveness function (HSEF), q(y), for several endpoints relevant in radiation protection. A Bayesian and maximum entropy approach is used to solve the integral equations that determine, given microdosimetric spectra and measured initial slopes, the function q(y). All microdosimetric spectra have been calculated de novo. The somewhat surprising conclusion of this analysis is that site size plays only a minor role in selecting the hit size effectiveness function q(y). It thus appears that practical means (e.g. conventional proportional counters) are already at hand to actually implement the HSEF as a radiation protection tool. (Author)

  2. A generic, web-based clinical information system architecture using HL7 CDA: successful implementation in dermatological routine care.

    Science.gov (United States)

    Schuler, Thilo; Boeker, Martin; Klar, Rüdiger; Müller, Marcel

    2007-01-01

    The requirements of highly specialized clinical domains are often underrepresented in hospital information systems (HIS). Common consequences are that documentation remains to be paper-based or external systems with insufficient HIS integration are used. This paper presents a solution to overcome this deficiency in the form of a generic framework based on the HL7 Clinical Document Architecture. The central architectural idea is the definition of customized forms using a schema-controlled XML language. These flexible form definitions drive the user interface, the data storage, and standardized data exchange. A successful proof-of-concept application in a dermatologic outpatient wound care department has been implemented, and is well accepted by the clinicians. Our work with HL7 CDA revealed the need for further practical research in the health information standards realm.

  3. Issues to be resolved for the successful implementation of the Nuclear Waste Policy Act of 1982: Utilities' viewpoint

    International Nuclear Information System (INIS)

    Kauffman, J.T.; Kraft, S.P.

    1987-01-01

    This article describes issues that utility companies perceive as important for successful implementation of the NWPA. Electric utility companies with nuclear energy programs are fulfilling their commitments under the NWPA by paying over $400 million a year into the Nuclear Waste Fund as well as preparing for on-site storage of spent fuel until 1998. The current impasse in Congress over DOE's recommend second repository reprogramming is giving the industry pause to consider whether or not DOE will be allowed by Congress to live up to its 1998 obligation to the utilities. The industry is asking Congress to allow DOE to proceed with characterization of the three potential first sites, to authorize and fund the MRS, and to provide equitable payments for defense waste disposal. Also, Congress and DOE must work cooperatively to find a solution to the current impasse over the second repository program

  4. Focal point pricing: A challenge to the successful implementation of Section 10a (introduced by the Competition Amendment Act

    Directory of Open Access Journals (Sweden)

    Mike Holland

    2015-08-01

    Full Text Available The Competition Amendment Act introduced section 10A, which provides the Competition Commission with the powers to investigate complex monopoly conduct in a market and allows the Competition Tribunal, under certain conditions, to prohibit such behaviour. Although more than five years have elapsed since the Competition Amendment Act was promulgated, this provision has yet to come into force. However, when it eventually does so, it will mark a significant change in South African competition law, as it seeks to regulate firms’ consciously parallel conduct. This is coordinated conduct that occurs without communication or agreement, but results in the prevention or substantial lessening of competition. Examples of horizontal tacit coordination practices include price leadership and facilitating practices, such as information exchanges and price signaling. The successful implementation of the amendment poses problems for the competition authorities in assessing the competitive effects of complex monopoly conduct and in providing effective remedies. Oligopoly markets result in mutual interdependent decision-making by firms, which can lead to market outcomes similar to explicit collusion. However, a further and little noticed issue is that firms in oligopolistic markets have opportunities to use focal points to determine coordinated strategies. This paper explores the nature and role of focal point pricing, which can lead to prices that are above competitive levels. The South African banking industry is used as an example. We find that focal point pricing is difficult to control, making the successful implementation of section 10A even more problematic. Moreover, the proposed amendment provides scope for the imposition of structural remedies by the Competition Tribunal, a function that the Competition Tribunal is ill-suited to perform.

  5. Evaluating the effect of structural dimensions on the successful implementation of strategies in Payam-e-noor University of Iran

    Directory of Open Access Journals (Sweden)

    Hamidreza Shahhosseini

    2013-07-01

    Full Text Available This study aims to assess the relationship between structural dimensions of organization including centralization, complexity and formalization on one side and strategy effectiveness on the other side. Structural dimensions are determined based on Robbins theory, and each of them is considered as independent variables of research. Strategy effectiveness, which includes achieving strategic goals or successful implementation of strategies are the independent variable of the research, based on Noble’s strategy implementation model. One primary thesis and three secondary these are defined. This is a descriptive research of two variable correlation. The target population includes 600 senior managers of Payam-e-noor university around the country, including staff administrative managers, province and unit headmasters, of Iran at the time of data collection. Simple random sampling is used, with sample size of 120. Library resources are used for theoretical foundation data collection and note-taking. Questionnaires are used to collect data and evaluate research theses. Inferential Statistics and Pearson correlation coefficient are used to analyze the research theses. The first two theses are confirmed, at 95% and 99% respectively, but the third thesis is rejected based on the collected data. Therefore, based on this study, complexity and formalization have respectively inverse and direct effect on strategy effectiveness, but centralization does not affect strategy effectiveness in Payam-e-noor University.

  6. Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person's Pathway.

    LENUS (Irish Health Repository)

    2018-01-25

    We addressed the research question "what factors enable the successful development and implementation of a frail older person\\'s pathway within the acute setting". A rapid realist review (RRR) was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources)-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE) study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person\\'s pathway.

  7. The validation of Huffaz Intelligence Test (HIT)

    Science.gov (United States)

    Rahim, Mohd Azrin Mohammad; Ahmad, Tahir; Awang, Siti Rahmah; Safar, Ajmain

    2017-08-01

    In general, a hafiz who can memorize the Quran has many specialties especially in respect to their academic performances. In this study, the theory of multiple intelligences introduced by Howard Gardner is embedded in a developed psychometric instrument, namely Huffaz Intelligence Test (HIT). This paper presents the validation and the reliability of HIT of some tahfiz students in Malaysia Islamic schools. A pilot study was conducted involving 87 huffaz who were randomly selected to answer the items in HIT. The analysis method used includes Partial Least Square (PLS) on reliability, convergence and discriminant validation. The study has validated nine intelligences. The findings also indicated that the composite reliabilities for the nine types of intelligences are greater than 0.8. Thus, the HIT is a valid and reliable instrument to measure the multiple intelligences among huffaz.

  8. A fast online hit verification method for the single ion hit system at GSI

    International Nuclear Information System (INIS)

    Du, G.; Fischer, B.; Barberet, P.; Heiss, M.

    2006-01-01

    For a single ion hit facility built to irradiate specific targets inside biological cells, it is necessary to prove that the ions hit the selected targets reliably because the ion hits usually cannot be seen. That ability is traditionally tested either indirectly by aiming at pre-etched tracks in a nuclear track detector or directly by making the ion tracks inside cells visible using a stain coupled to special proteins produced in response to ion hits. However, both methods are time consuming and hits can be verified only after the experiment. This means that targeting errors in the experiment cannot be corrected during the experiment. Therefore, we have developed a fast online hit verification method that measures the targeting accuracy electronically with a spatial resolution of ±1 μm before cell irradiation takes place. (authors)

  9. How I treat double-hit lymphoma.

    Science.gov (United States)

    Friedberg, Jonathan W

    2017-08-03

    The 2016 revision of the World Health Organization (WHO) classification for lymphoma has included a new category of lymphoma, separate from diffuse large B-cell lymphoma, termed high-grade B-cell lymphoma with translocations involving myc and bcl-2 or bcl-6 . These lymphomas, which occur in hit lymphomas (or triple-hit lymphomas if all 3 rearrangements are present). It is important to differentiate these lymphomas from the larger group of double-expressor lymphomas, which have increased expression of MYC and BCL-2 and/or BCL-6 by immunohistochemistry, by using variable cutoff percentages to define positivity. Patients with double-hit lymphomas have a poor prognosis when treated with standard chemoimmunotherapy and have increased risk of central nervous system involvement and progression. Double-hit lymphomas may arise as a consequence of the transformation of the underlying indolent lymphoma. There are no published prospective trials in double-hit lymphoma, however retrospective studies strongly suggest that aggressive induction regimens may confer a superior outcome. In this article, I review my approach to the evaluation and treatment of double-hit lymphoma, with an eye toward future clinical trials incorporating rational targeted agents into the therapeutic armamentarium. © 2017 by The American Society of Hematology.

  10. Effective progression of nuclear magnetic resonance-detected fragment hits.

    Science.gov (United States)

    Eaton, Hugh L; Wyss, Daniel F

    2011-01-01

    Fragment-based drug discovery (FBDD) has become increasingly popular over the last decade as an alternate lead generation tool to HTS approaches. Several compounds have now progressed into the clinic which originated from a fragment-based approach, demonstrating the utility of this emerging field. While fragment hit identification has become much more routine and may involve different screening approaches, the efficient progression of fragment hits into quality lead series may still present a major bottleneck for the broadly successful application of FBDD. In our laboratory, we have extensive experience in fragment-based NMR screening (SbN) and the subsequent iterative progression of fragment hits using structure-assisted chemistry. To maximize impact, we have applied this approach strategically to early- and high-priority targets, and those struggling for leads. Its application has yielded a clinical candidate for BACE1 and lead series in about one third of the SbN/FBDD projects. In this chapter, we will give an overview of our strategy and focus our discussion on NMR-based FBDD approaches. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries

    Directory of Open Access Journals (Sweden)

    Stephen L. Hamann

    2012-03-01

    Full Text Available Transnational tobacco companies (TTCs interfere regularly in policymaking in low- and middle-income countries (LMICs. The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face ‘how to’ challenges of implementation. For more than two decades, Thailand’s public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1 doing business with ‘two faces’, (2 seeking to influence people in high places, (3 ‘buying’ advocates in grassroots organizations, (4 putting up a deceptive front, (5 intimidation, and (6 undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1 conducting vigilant surveillance, (2 excluding tobacco companies from policymaking, (3 restricting tobacco company sales, (4 sustaining pressure, and (5 dedicating resources to the effective enforcement of regulations. Policy implications from this study are

  12. From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control.

    Science.gov (United States)

    Gneiting, Uwe

    2016-04-01

    Global policy attention to tobacco control has increased significantly since the 1990 s and culminated in the first international treaty negotiated under the auspices of the World Health Organization--the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC's progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990 s, in translating countries' commitment to the FCTC into domestic policy change. By comparing the network's influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network's effectiveness around the FCTC's implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network's success than the evidence base for the effectiveness of tobacco control interventions. The network's variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

  13. Competency champions in the clinical competency committee: a successful strategy to implement milestone evaluations and competency coaching.

    Science.gov (United States)

    Ketteler, Erika R; Auyang, Edward D; Beard, Kathy E; McBride, Erica L; McKee, Rohini; Russell, John C; Szoka, Nova L; Nelson, M Timothy

    2014-01-01

    To create a clinical competency committee (CCC) that (1) centers on the competency-based milestones, (2) is simple to implement, (3) creates competency expertise, and (4) guides remediation and coaching of residents who are not progressing in milestone performance evaluations. We created a CCC that meets monthly and at each meeting reviews a resident class for milestone performance, a competency (by a faculty competency champion), a resident rotation service, and any other resident or issue of concern. University surgical residency program. The CCC members include the program director, associate program directors, director of surgical curriculum, competency champions, departmental chair, 2 at-large faculty members, and the administrative chief residents. Seven residents were placed on remediation (later renamed as coaching) during the academic year after falling behind on milestone progression in one or more competencies. An additional 4 residents voluntarily placed themselves on remediation for medical knowledge after receiving in-training examination scores that the residents (not the CCC membership) considered substandard. All but 2 of the remediated/coached residents successfully completed all area milestone performance but some chose to stay on the medical knowledge competency strategy. Monthly meetings of the CCC make milestone evaluation less burdensome. In addition, the expectations of the residents are clearer and more tangible. "Competency champions" who are familiar with the milestones allow effective coaching strategies and documentation of clear performance improvements in competencies for successful completion of residency training. Residents who do not reach appropriate milestone performance can then be placed in remediation for more formal performance evaluation. The function of our CCC has also allowed us opportunity to evaluate the required rotations to ensure that they offer experiences that help residents achieve competency performance necessary

  14. Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project.

    Science.gov (United States)

    Skoien, Wade; Page, Katie; Parsonage, William; Ashover, Sarah; Milburn, Tanya; Cullen, Louise

    2016-10-12

    The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it

  15. Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

    Science.gov (United States)

    Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A

    2015-04-01

    Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration

  16. SUCCESSFUL IMPLEMENTATION OF LEAN AS A MANAGERIAL PRINCIPLE IN HEALTH CARE: A CONCEPTUAL ANALYSIS FROM SYSTEMATIC LITERATURE REVIEW.

    Science.gov (United States)

    Maijala, Riikka; Eloranta, Sini; Reunanen, Tero; Ikonen, Tuija S

    2018-01-01

    The aim of this study was to identify and analyze the characteristics of leadership and management associated with a successful Lean thinking adaptation in healthcare. A systematic literature review was undertaken using electronic databases: PubMed, PubMed Systematic Review, ABI/INFORM, Business Source Complete, Emerald, JBI, and Cinahl. Inclusion criteria were: (i) a description of Lean management or leadership in health care, (ii) a reference to Lean thinking, (iii) a peer-reviewed original research article or a literature review, and (iv) a full text article available in English. Among the 1,754 peer-reviewed articles identified, nine original articles and three systematic reviews met the inclusion criteria. Data on informants, methods, and settings were extracted and collated. Content analysis was used to conduct a review of the nine original studies describing and analyzing the success factors of Lean adaptation. The characteristics of leadership and management were analyzed by using the concept of a managerial windshield that divides leadership and management into four ontological dimensions: activities, style, focus, and purpose, each with typical developmental stages of skills and capabilities. The current study has some limitations: some papers from the journals not indexed in the searched databases may have been overlooked and the literature searches were carried out only for a 5-year period. Considering the results using the windshield concept emphasizes the philosophy, principles, and tools of Lean thinking. Lean leadership and management factors in health care were mainly conceptualized as skills and capabilities such as problem solving, making changes occur, empowering, communicating, coaching, supporting, facilitating, being democratic, organizational learning, and organizational success, all of which represented middle-stage or advanced managerial skills and capabilities. A conceptual analysis of systematically reviewed studies of Lean leadership

  17. The critical role of nurses to the successful implementation of the National Safety and Quality Health Service Standards.

    Science.gov (United States)

    Twigg, Diane E; Duffield, Christine; Evans, Gemma

    2013-09-01

    The National Safety and Quality Health Service Standards requires health service compliance by 2013 and covers several areas including governance arrangements, partnerships with consumers and eight key clinical processes. Nurses in Australia comprise 62% of the hospital workforce, are the largest component and hence play a critical role in meeting these standards and improving the quality of patient care. Several of the standards are influenced by nursing interventions, which incorporate any direct-care treatment that the nurse performs for a patient that may be nurse or physician initiated. The ability for nurses to undertake these interventions is influenced by the hours of care available, the skill mix of the nursing workforce and the environment in which they practice. Taking into consideration the predicted nursing shortages, the challenge to successfully implement the National Safety and Quality Health Service Standards will be great. This paper examines the role of nursing in the delivery of the National Standards, analyses the evidence with regard to nursing-sensitive outcomes and discusses the implications for health service decision makers and policy.

  18. Factors Which Influenced the Success of the Implementation of the Regulation of the Minister of Home Affairs Number 59 of 2007 in North Sumatera Provincial Government

    Directory of Open Access Journals (Sweden)

    Amar Rinanda Lubis

    2016-06-01

    Full Text Available This study aimed to test empirically and analyze the influence of regulation, commitment, human resources and supporting devices to the successful implementation of the Regulation of the Minister of Home Affairs No.59 Year 2007. Population in this study is SKPD Officer of North Sumatra Province (108 people which was sampled for 93 people. Simultaneous F test and partial t test were used to studies effects of regulation, commitment, human resources and supporting facilities to the successful implementation of the Regulation of the Minister of Home Affairs No. 59, year 2007. These results prove that the regulation, commitment, human resources and supporting devices simultaneously influenced the successful implementation of the Regulation of the Minister of Home Affairs No. 59 Year 2007. In partial, regulation, commitment and human resources affected successful implementation of the Regulation of the Minister of Home Affairs No. 59 Year 2007, while the supporting facilities did not have an effect. These results showed that 48% variations of successful implementation of the Regulation of the Minister of Home Affairs No.59 Year 2007, depended on variable of regulation, commitment, human resources and supporting facilities and the remaining 52% depended on other uninvestigated variables.

  19. Insights from the design and implementation of a single-entry model of referral for total joint replacement surgery: Critical success factors and unanticipated consequences.

    Science.gov (United States)

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; Noseworthy, Tom; Wang, Jenney Meng Han; DeMone, Brie; Wright, Brock; Marshall, Deborah A

    2018-02-01

    Single-entry models (SEMs) in healthcare allow patients to see the next-available provider and have been shown to improve waiting times, access and patient flow for preference-sensitive, scheduled services. The Winnipeg Central Intake Service (WCIS) for hip and knee replacement surgery was implemented to improve access in the Winnipeg Regional Health Authority. This paper describes the system's design/implementation; successes, challenges, and unanticipated consequences. On two occasions, during and following implementation, we interviewed all members of the WCIS project team, including processing engineers, waiting list coordinators, administrators and policy-makers regarding their experiences. We used semi-structured telephone interviews to collect data and qualitative thematic analysis to analyze and interpret the findings. Respondents indicated that the overarching objectives of the WCIS were being met. Benefits included streamlined processes, greater patient access, improved measurement and monitoring of outcomes. Challenges included low awareness, change readiness, and initial participation among stakeholders. Unanticipated consequences included workload increases, confusion around stakeholder expectations and under-reporting of data by surgeons' offices. Critical success factors for implementation included a requirement for clear communication, robust data collection, physician leadership and patience by all, especially implementation teams. Although successfully implemented, key lessons and critical success factors were learned related to change management, which if considered and applied, can reduce unanticipated consequences, improve uptake and benefit new models of care. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation

    NARCIS (Netherlands)

    Leemans, K.; Block, L.; van der Stichele, R.; Francke, A.L.; Deliens, L.; Cohen, J.

    2015-01-01

    Purpose: There is an increasing demand for the use of quality indicators in palliative care. With previous research about implementation in this field lacking, we aimed to evaluate the barriers to and facilitators of implementation. Methods: Three focus group interviews were organized with 21

  1. How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation.

    NARCIS (Netherlands)

    Leemans, K.; Block, L. van den; Stichele, R. Vander; Francke, A.L.; Deliens, L.; Cohen, J.

    2015-01-01

    Purpose: There is an increasing demand for the use of quality indicators in palliative care.With previous research about implementation in this field lacking, we aimed to evaluate the barriers to and facilitators of implementation. Methods: Three focus group interviews were organized with 21

  2. Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. IERC 2015-3

    Science.gov (United States)

    Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

    2015-01-01

    The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

  3. Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. Executive Summary. IERC 2015-3

    Science.gov (United States)

    Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

    2015-01-01

    The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

  4. Statistical properties and pre-hit dynamics of price limit hits in the Chinese stock markets.

    Science.gov (United States)

    Wan, Yu-Lei; Xie, Wen-Jie; Gu, Gao-Feng; Jiang, Zhi-Qiang; Chen, Wei; Xiong, Xiong; Zhang, Wei; Zhou, Wei-Xing

    2015-01-01

    Price limit trading rules are adopted in some stock markets (especially emerging markets) trying to cool off traders' short-term trading mania on individual stocks and increase market efficiency. Under such a microstructure, stocks may hit their up-limits and down-limits from time to time. However, the behaviors of price limit hits are not well studied partially due to the fact that main stock markets such as the US markets and most European markets do not set price limits. Here, we perform detailed analyses of the high-frequency data of all A-share common stocks traded on the Shanghai Stock Exchange and the Shenzhen Stock Exchange from 2000 to 2011 to investigate the statistical properties of price limit hits and the dynamical evolution of several important financial variables before stock price hits its limits. We compare the properties of up-limit hits and down-limit hits. We also divide the whole period into three bullish periods and three bearish periods to unveil possible differences during bullish and bearish market states. To uncover the impacts of stock capitalization on price limit hits, we partition all stocks into six portfolios according to their capitalizations on different trading days. We find that the price limit trading rule has a cooling-off effect (object to the magnet effect), indicating that the rule takes effect in the Chinese stock markets. We find that price continuation is much more likely to occur than price reversal on the next trading day after a limit-hitting day, especially for down-limit hits, which has potential practical values for market practitioners.

  5. Statistical Properties and Pre-Hit Dynamics of Price Limit Hits in the Chinese Stock Markets

    Science.gov (United States)

    Wan, Yu-Lei; Xie, Wen-Jie; Gu, Gao-Feng; Jiang, Zhi-Qiang; Chen, Wei; Xiong, Xiong; Zhang, Wei; Zhou, Wei-Xing

    2015-01-01

    Price limit trading rules are adopted in some stock markets (especially emerging markets) trying to cool off traders’ short-term trading mania on individual stocks and increase market efficiency. Under such a microstructure, stocks may hit their up-limits and down-limits from time to time. However, the behaviors of price limit hits are not well studied partially due to the fact that main stock markets such as the US markets and most European markets do not set price limits. Here, we perform detailed analyses of the high-frequency data of all A-share common stocks traded on the Shanghai Stock Exchange and the Shenzhen Stock Exchange from 2000 to 2011 to investigate the statistical properties of price limit hits and the dynamical evolution of several important financial variables before stock price hits its limits. We compare the properties of up-limit hits and down-limit hits. We also divide the whole period into three bullish periods and three bearish periods to unveil possible differences during bullish and bearish market states. To uncover the impacts of stock capitalization on price limit hits, we partition all stocks into six portfolios according to their capitalizations on different trading days. We find that the price limit trading rule has a cooling-off effect (object to the magnet effect), indicating that the rule takes effect in the Chinese stock markets. We find that price continuation is much more likely to occur than price reversal on the next trading day after a limit-hitting day, especially for down-limit hits, which has potential practical values for market practitioners. PMID:25874716

  6. Upgrade tracking with the UT Hits

    CERN Document Server

    Gandini, P; Wang, J

    2014-01-01

    The performance of the LHCb tracking system for the upgrade on long tracks is evaluated in terms of efficiency and ghost rate reduction for several different sets of requirements. We find that the efficiency is quite high and that the ghost rate reduction is substantial. We also describe the current algorithm for adding UT hits to the tracks.

  7. Double-hit B-cell lymphomas

    NARCIS (Netherlands)

    Aukema, Sietse M.; Siebert, Reiner; Schuuring, Ed; van Imhoff, Gustaaf W.; Kluin-Nelemans, Hanneke C.; Boerma, Evert-Jan; Kluin, Philip M.

    2011-01-01

    In many B-cell lymphomas, chromosomal translocations are biologic and diagnostic hallmarks of disease. An intriguing subset is formed by the so-called double-hit (DH) lymphomas that are defined by a chromosomal breakpoint affecting the MYC/8q24 locus in combination with another recurrent breakpoint,

  8. Enterprise resource planning system implementation and success measurement : case study of a small to medium sized enterprise

    OpenAIRE

    Shaikh, N.

    2014-01-01

    It is widely believed that major financial benefits can be achieved by organisations implementing Enterprise Resource Planning software. It is also believed that such systems are a time consuming and a costly endeavour which can result in loss of resource and eventually failure of implementation. Furthermore not all companies have the technical competence or financial stability to take such a risk. Alternatively companies can be more modular in their approach in implementing...

  9. Post-hit dynamics of price limit hits in the Chinese stock markets

    Science.gov (United States)

    Wu, Ting; Wang, Yue; Li, Ming-Xia

    2017-01-01

    Price limit trading rules are useful to cool off traders short-term trading mania on individual stocks. The price dynamics approaching the limit boards are known as the magnet effect. However, the price dynamics after opening price limit hits are not well investigated. Here, we provide a detailed analysis on the price dynamics after the hits of up-limit or down-limit is open based on all A-share stocks traded in the Chinese stock markets. A "W" shape is found in the expected return, which reveals high probability of a continuous price limit hit on the following day. We also find that price dynamics after opening limit hits are dependent on the market trends. The time span of continuously hitting the price limit is found to an influence factor of the expected profit after the limit hit is open. Our analysis provides a better understanding of the price dynamics around the limit boards and contributes potential practical values for investors.

  10. 42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.

    Science.gov (United States)

    2010-10-01

    ... and strategic plan for the next 5 years. (2) A description of how the State Medicaid HIT plan will be... processes that enable improved program administration for the Medicaid enterprise; (ii) Includes business... used certified EHR technology during the EHR reporting period, and that they have adopted, implemented...

  11. Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system.

    Science.gov (United States)

    Vivanti, Angela; O'Sullivan, Therese A; Porter, Jane; Hogg, Marion

    2017-09-01

    Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved (P  0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. © 2017 State of Queensland. Nutrition and Dietetics © 2017 Dietitians Association of Australia.

  12. On the Hitting Probability of Max-Stable Processes

    OpenAIRE

    Hofmann, Martin

    2012-01-01

    The probability that a max-stable process {\\eta} in C[0, 1] with identical marginal distribution function F hits x \\in R with 0 < F (x) < 1 is the hitting probability of x. We show that the hitting probability is always positive, unless the components of {\\eta} are completely dependent. Moreover, we consider the event that the paths of standard MSP hit some x \\in R twice and we give a sufficient condition for a positive probability of this event.

  13. Simplified validation of borderline hits of database searches

    OpenAIRE

    Thomas, Henrik; Shevchenko, Andrej

    2008-01-01

    Along with unequivocal hits produced by matching multiple MS/MS spectra to database sequences, LC-MS/MS analysis often yields a large number of hits of borderline statistical confidence. To simplify their validation, we propose to use rapid de novo interpretation of all acquired MS/MS spectra and, with the help of a simple software tool, display the candidate sequences together with each database search hit. We demonstrate that comparing hit database sequences and independent de novo interpre...

  14. THE FACTORS AFFECTING ON THE SUCCESS OF IMPLEMENTING TOTAL PRODUCTIVE MAINTENANCE IN THE MANUFACTURING COMPANY (NS BLUESCOPE VIETNAM)

    OpenAIRE

    Pham Van Tai (PhD)*, Dean of International Trade, College of Foreign Economic Relations Phan Cao Huy (MBA), Technical Manager, Bosch Vietnam

    2017-01-01

    The competition in business environment becomes more strictly, manufacturers must introduce lots of new products on the high quality level with suitable price. Thus, new technologies have been applied, manufacturing systems become more complex. Therefore, a new strategy for maintenance such as Total productive maintenance (TPM) becomes really necessary. Many organizations have implemented TPM to increase the effectiveness of manufacturing system. However, implementation of TPM still meets a l...

  15. The Holistic Integrity Test (HIT - quantified resilience analysis

    Directory of Open Access Journals (Sweden)

    Dobson Mike

    2016-01-01

    Full Text Available The Holistic Integrity Test (HIT - Quantified Resilience Analysis. Rising sea levels and wider climate change mean we face an increasing risk from flooding and other natural hazards. Tough economic times make it difficult to economically justify or afford the desired level of engineered risk reduction. Add to this significant uncertainty from a range of future predictions, constantly updated with new science. We therefore need to understand not just how to reduce the risk, but what could happen should above design standard events occur. In flood terms this includes not only the direct impacts (damage and loss of life, but the wider cascade impacts to infrastructure systems and the longer term impacts on the economy and society. However, understanding the “what if” is only the first part of the equation; a range of improvement measures to mitigate such effects need to be identified and implemented. These measures should consider reducing the risk, lessening the consequences, aiding the response, and speeding up the recovery. However, they need to be objectively assessed through quantitative analysis, which underpins them technically and economically. Without such analysis, it cannot be predicted how measures will perform if the extreme events occur. It is also vital to consider all possible hazards as measures for one hazard may hinder the response to another. The Holistic Integrity Test (HIT, uses quantitative system analysis and “HITs” the site, its infrastructure, contained dangers and wider regional system to determine how it copes with a range of severe shock events, Before, During and After the event, whilst also accounting for uncertainty (as illustrated in figure 1. First explained at the TINCE 2014 Nuclear Conference in Paris, it was explained in terms of a Nuclear Facility needing to analyse the site in response to post Fukushima needs; the hit is however universally applicable. The HIT has three key risk reduction goals: The

  16. Successful Deployment of High Flow Nasal Cannula in a Peruvian Pediatric Intensive Care Unit Using Implementation Science—Lessons Learned

    Directory of Open Access Journals (Sweden)

    Katie R. Nielsen

    2018-04-01

    Full Text Available Acute lower respiratory infections are the leading cause of death outside the neonatal period for children less than 5 years of age. Widespread availability of invasive and non-invasive mechanical ventilation in resource-rich settings has reduced mortality rates; however, these technologies are not always available in many low- and middle-income countries due to the high cost and trained personnel required to implement and sustain their use. High flow nasal cannula (HFNC is a form of non-invasive respiratory support with growing evidence for use in pediatric respiratory failure. Its simple interface makes utilization in resource-limited settings appealing, although widespread implementation in these settings lags behind resource-rich settings. Implementation science is an emerging field dedicated to closing the know-do gap by incorporating evidence-based interventions into routine care, and its principles have guided the scaling up of many global health interventions. In 2016, we introduced HFNC use for respiratory failure in a pediatric intensive care unit in Lima, Peru using implementation science methodology. Here, we review our experience in the context of the principles of implementation science to serve as a guide for others considering HFNC implementation in resource-limited settings.

  17. 78 FR 29135 - HIT Standards Committee Advisory Meeting

    Science.gov (United States)

    2013-05-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting AGENCY: Office of...: HIT Standards Committee. General Function of the Committee: To provide recommendations to the National... Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT Policy Committee...

  18. All hypertopologies are hit-and-miss

    Directory of Open Access Journals (Sweden)

    Somshekhar Naimpally

    2002-04-01

    Full Text Available We solve a long standing problem by showing that all known hypertopologies are hit-and-miss. Our solution is not merely of theoretical importance. This representation is useful in the study of comparison of the Hausdorff-Bourbaki or H-B uniform topologies and the Wijsman topologies among themselves and with others. Up to now some of these comparisons needed intricate manipulations. The H-B uniform topologies were the subject of intense activity in the 1960's in connection with the Isbell-Smith problem. We show that they are proximally locally finite topologies from which the solution to the above problem follows easily. It is known that the Wijsman topology on the hyperspace is the proximal ball (hit-and-miss topology in”nice” metric spaces including the normed linear spaces. With the introduction of a new far-miss topology we show that the Wijsman topology is hit-and-miss for all metric spaces. From this follows a natural generalization of the Wijsman topology to the hyperspace of any T1 space. Several existing results in the literature are easy consequences of our work.

  19. Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

    Science.gov (United States)

    deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

    2018-03-01

    Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene

  20. Integration and acceleration of virtual microscopy as the key to successful implementation into the routine diagnostic process.

    Science.gov (United States)

    Wienert, Stephan; Beil, Michael; Saeger, Kai; Hufnagl, Peter; Schrader, Thomas

    2009-01-09

    The virtual microscopy is widely accepted in Pathology for educational purposes and teleconsultation but is far from the routine use in surgical pathology due to the technical requirements and some limitations. A technical problem is the limited bandwidth of a usual network and the delayed transmission rate and presentation time on the screen. In this study the process of secondary diagnostic was evaluated using the "T.Konsult Pathologie" service of the Professional Association of German Pathologists within the German breast cancer screening program. The characteristics of the access to the WSI (Whole Slide Images) have been analyzed to explore the possibilities of prefetching and caching to reduce the presentation and transfer time with the goal to increase user acceptance. The log files of the web server were analyzed to reconstruct the movements of the pathologist on the WSI and to create the observation path. Using a specialized tool the observation paths were extracted automatically from the log files. The attributes linearity, 3-point-linearity, changes per request, and number of consecutive requests were calculated to design, develop and evaluate different caching and prefetching strategies. The analysis of the observation paths showed that a complete accordance of two image requests is a very rare event. But more frequently a partial covering of two requested image areas can be found. In total 257 diagnostic paths from 131 WSI have been extracted and analysed. On average a diagnostic path consists of 16 image requests and takes 189 seconds between first and last image request. The mean linearity was 0,41 and the mean 3-point-linearity 0,85. Three different caching algorithms have been compared with respect to hit rate and additional image requests on the WSI server. Tests demonstrated that 95% of the diagnostic paths could be loaded without any deletion of entries in the cache (cache size 12,2 Megapixel). If the image parts are stored after JPEG compression

  1. Integration and acceleration of virtual microscopy as the key to successful implementation into the routine diagnostic process

    Directory of Open Access Journals (Sweden)

    Hufnagl Peter

    2009-01-01

    Full Text Available Abstract Background The virtual microscopy is widely accepted in Pathology for educational purposes and teleconsultation but is far from the routine use in surgical pathology due to the technical requirements and some limitations. A technical problem is the limited bandwidth of a usual network and the delayed transmission rate and presentation time on the screen. Methods In this study the process of secondary diagnostic was evaluated using the "T.Konsult Pathologie" service of the Professional Association of German Pathologists within the German breast cancer screening program. The characteristics of the access to the WSI (Whole Slide Images have been analyzed to explore the possibilities of prefetching and caching to reduce the presentation and transfer time with the goal to increase user acceptance. The log files of the web server were analyzed to reconstruct the movements of the pathologist on the WSI and to create the observation path. Using a specialized tool the observation paths were extracted automatically from the log files. The attributes linearity, 3-point-linearity, changes per request, and number of consecutive requests were calculated to design, develop and evaluate different caching and prefetching strategies. Results The analysis of the observation paths showed that a complete accordance of two image requests is a very rare event. But more frequently a partial covering of two requested image areas can be found. In total 257 diagnostic paths from 131 WSI have been extracted and analysed. On average a diagnostic path consists of 16 image requests and takes 189 seconds between first and last image request. The mean linearity was 0,41 and the mean 3-point-linearity 0,85. Three different caching algorithms have been compared with respect to hit rate and additional image requests on the WSI server. Tests demonstrated that 95% of the diagnostic paths could be loaded without any deletion of entries in the cache (cache size 12,2 Megapixel

  2. A New Track Reconstruction Algorithm suitable for Parallel Processing based on Hit Triplets and Broken Lines

    Directory of Open Access Journals (Sweden)

    Schöning André

    2016-01-01

    Full Text Available Track reconstruction in high track multiplicity environments at current and future high rate particle physics experiments is a big challenge and very time consuming. The search for track seeds and the fitting of track candidates are usually the most time consuming steps in the track reconstruction. Here, a new and fast track reconstruction method based on hit triplets is proposed which exploits a three-dimensional fit model including multiple scattering and hit uncertainties from the very start, including the search for track seeds. The hit triplet based reconstruction method assumes a homogeneous magnetic field which allows to give an analytical solutions for the triplet fit result. This method is highly parallelizable, needs fewer operations than other standard track reconstruction methods and is therefore ideal for the implementation on parallel computing architectures. The proposed track reconstruction algorithm has been studied in the context of the Mu3e-experiment and a typical LHC experiment.

  3. Creating the Situation of Success as Implementation of the Optimism Idea: Pedagogic Interpretation of M. Seligman’s Theory

    Directory of Open Access Journals (Sweden)

    Y. V. Andreyeva

    2012-01-01

    Full Text Available The paper is devoted to the Optimism Theory by Martin Seligman that can be used for creating the model of positive emotional response aimed at improving the effectiveness of educational process. The author shares the idea of the contemporary American psychologist and philosopher regarding the optimism as the acquired skill affecting the students’ academic progress, and recommends developing students’ self-assurance by addressing a situation of success. Such situation is considered as both the leading factor and pedagogic condition, and the technological base for promoting personal optimism.The educational significance of success is based on its ability to change students’ attitude as the result of personal achievements. The lack of motivation, as the main teaching problem, can be overcome by assisting students in their academic progress and addressing the situation of success. The pedagogic techniques improving motivation to overcome learning difficulties on the way to success are given providing adolescents with effective assistance and emotional support. According to the author, the situation of success is not a temporary pedagogic tool, but rather a way of achieving optimistic outlook, which allows students themselves to solve complex learning tasks and achieve desired results without pedagogic facilitation. 

  4. Progress on FIR interferometry and Thomson Scattering measurements on HIT-SI3

    Science.gov (United States)

    Everson, Christopher; Jarboe, Thomas; Morgan, Kyle

    2017-10-01

    Spatially resolved measurements of the electron temperature (Te) and density (ne) will be fundamental in assessing the degree to which HIT-SI3 demonstrates closed magnetic flux and energy confinement. Further, electron temperature measurements have not yet been made on an inductively-driven spheromak. Far infrared (FIR) interferometer and Thomson Scattering (TS) systems have been installed on the HIT-SI3 spheromak. The TS system currently implemented on HIT-SI3 was originally designed for other magnetic confinement experiments, and progress continues toward modifying and optimizing for HIT-SI3 plasmas. Initial results suggest that the electron temperature is of order 10 eV. Plans to modify the TS system to provide more sensitivity and accuracy at low temperatures are presented. The line-integrated ne is measured on one chord by the FIR interferometer, with densities near 5x1019 m-3. Four cylindrical volumes have been added to the HIT-SI3 apparatus to enhance passive pumping. It is hoped that this will allow for more control of the density during the 2 ms discharges. Density measurements from before and after the installation of the passive pumping volumes are presented for comparison.

  5. An evaluation of health information technology outsourcing success.

    Science.gov (United States)

    Malovec, Shannon N; Borycki, Elizabeth M; Kushniruk, Andre W

    2015-01-01

    Outsourcing involves contracting out functions performed by an organization to another organization. Many healthcare organizations are exploring outsourcing as a way to address demands for health information technology (HIT). This study researches the success of outsourcing in the health informatics industry in Canada. The study is designed to help understand whether outsourcing four functions of HIT (i.e. development, implementation, operations, and maintenance) can prove successful for an organization. Findings demonstrate that outsourcing these four functions occurs in Canada; however, the research from the semi-structured interviews finds that operations and maintenance may be more commonly outsourced in Canada, over development and implementation functions. Despite this, findings from this research suggest that outsourcing development and implementation may offer more benefits and fewer challenges than outsourcing operations and maintenance. The research also finds that there can be benefits of outsourcing, such as gaining access to expertise and improving service levels. A weakness of outsourcing may be that internal knowledge is lost and having to manage the change required from outsourcing. The study proposes that there are many factors that need to be considered when outsourcing to ensure it is successful.

  6. A Study to Identify the Critical Success Factors for ERP Implementation in an Indian SME: A Case Based Approach

    Science.gov (United States)

    Upadhyay, Parijat; Dan, Pranab K.

    To achieve synergy across product lines, businesses are implementing a set of standard business applications and consistent data definitions across all business units. ERP packages are extremely useful in integrating a global company and provide a "common language" throughout the company. Companies are not only implementing a standardized application but is also moving to a common architecture and infrastructure. For many companies, a standardized software rollout is a good time to do some consolidation of their IT infrastructure across various locations. Companies are also finding that the ERP solutions help them get rid of their legacy systems, most of which may not be compliant with the modern day business requirements.

  7. Heparin-independent, PF4-dependent binding of HIT antibodies to platelets: implications for HIT pathogenesis.

    Science.gov (United States)

    Padmanabhan, Anand; Jones, Curtis G; Bougie, Daniel W; Curtis, Brian R; McFarland, Janice G; Wang, Demin; Aster, Richard H

    2015-01-01

    Antibodies specific for platelet factor 4 (PF4)/heparin complexes are the hallmark of heparin-induced thrombocytopenia and thrombosis (HIT), but many antibody-positive patients have normal platelet counts. The basis for this is not fully understood, but it is believed that antibodies testing positive in the serotonin release assay (SRA) are the most likely to cause disease. We addressed this issue by characterizing PF4-dependent binding of HIT antibodies to intact platelets and found that most antibodies testing positive in the SRA, but none of those testing negative, bind to and activate platelets when PF4 is present without any requirement for heparin (P HIT antibodies recognize PF4 in a complex with heparin, only a subset of these antibodies recognize more subtle epitopes induced in PF4 when it binds to CS, the major platelet glycosaminoglycan. Antibodies having this property could explain "delayed HIT" seen in some individuals after discontinuation of heparin and the high risk for thrombosis that persists for weeks in patients recovered from HIT. © 2015 by The American Society of Hematology.

  8. Eyewitness Identification Reforms: Are Suggestiveness-Induced Hits and Guesses True Hits?

    Science.gov (United States)

    Wells, Gary L; Steblay, Nancy K; Dysart, Jennifer E

    2012-05-01

    Research-based reforms for collecting eyewitness identification evidence (e.g., unbiased pre-lineup instructions, double-blind administration) have been proposed by psychologists and adopted in increasing numbers of jurisdictions across the United States. It is well known that reducing rates of mistaken identifications can also reduce accurate identification rates (hits). But the reforms are largely designed to reduce the suggestiveness of the procedures they are meant to replace. Accordingly, we argue that it is misleading to label any hits obtained because of suggestive procedures as "hits" and then saddle reforms with the charge that they reduce the rate of these illegitimate hits. Eyewitness identification evidence should be based solely on the independent memory of the witness, not aided by biased instructions, cues from lineup administrators, or the use of lineup fillers who make the suspect stand out. Failure to call out these hits as being illegitimate can give solace to those who are motivated to preserve the status quo. © The Author(s) 2012.

  9. PREPARING STUDENTS FOR THE TREATMENT OF A NEW TEACHER CONTENT, AN IMPORTANT PREREQUISITE FOR THE SUCCESSFUL IMPLEMENTATION OF THE TASK OF TEACHING

    Directory of Open Access Journals (Sweden)

    Zvezdan Arsić

    2013-12-01

    Full Text Available Success in any type of activity depends on thorough preparation. Processing of new teaching facilities, or the acquisition of new knowledge in the whole course of the educational process is one of the most important prerequisites for success in the implementation of the tasks of teaching. When it comes to this problem, the analysis of available pedagogical-psychological and didactic and methodical literature, indicates that it mainly talks about the preparation of teachers, which is certainly needed. However, the implementation of teaching together and actively participating teachers and students , and the modern conception of school based on the students' activities. The above observations lead us to the conclusion that preparing students for teaching is equally important as the preparation of teachers, although it is somewhat more specific, given their status in the classroom.

  10. Professionals' Perspectives on Organizational Factors that Support or Hinder the Successful Implementation of Family-Centered Practice

    Science.gov (United States)

    Wright, Alexandra; Hiebert-Murphy, Diane; Trute, Barry

    2010-01-01

    This article presents findings from an exploratory, qualitative study whose objective was to identify professionals' perceptions of organizational factors that support or hinder the implementation of family-centered practice (FCP). Two disability services organizations in Manitoba, Canada, were selected as the research sites. In 2002, all staff…

  11. A generic quality assurance model (GQAM) for successful e-health implementation in rural hospitals in South Africa

    CSIR Research Space (South Africa)

    Ruxwana, N

    2013-05-01

    Full Text Available Although e-health can potentially facilitate the management of scarce resources and improve the quality of healthcare services, implementation of e-health programs continues to fail or not fulfi l expectations. A key contributor to the failure of e...

  12. Implementation and Sustainability of an Evidence-Based Program: Lessons Learned from the Prism Applied to "First Step to Success"

    Science.gov (United States)

    Woodbridge, Michelle W.; Sumi, W. Carl; Yu, Jennifer; Rouspil, Kristen; Javitz, Harold S.; Seeley, John R.; Walker, Hill M.

    2014-01-01

    Although numerous studies address the efficacy of school-based interventions, fewer focus on how to support sustainability of interventions from the perspective of participants. To address this research gap, we use the Practical, Robust Implementation and Sustainability Model to examine how the characteristics of an evidence-based program interact…

  13. Effect of the Exclusion of Behavioral Health from Health Information Technology (HIT) Legislation on the Future of Integrated Health Care.

    Science.gov (United States)

    Cohen, Deborah

    2015-10-01

    Past research has shown abundant comorbidity between physical chronic health conditions and mental illness. The focal point of the conversation to reduce cost is better care coordination through the implementation of health information technology (HIT). At the policy level, the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) was implemented as a way to increase the implementation of HIT. However, behavioral health providers have been largely excluded from obtaining access to the funds provided by the HITECH Act. Without further intervention, disjointed care coordination between physical and behavioral health providers will continue.

  14. Using Innovative Tools to Teach Computer Application to Business Students--A Hawthorne Effect or Successful Implementation Here to Stay

    Science.gov (United States)

    Khan, Zeenath Reza

    2014-01-01

    A year after the primary study that tested the impact of introducing blended learning and guided discovery to help teach computer application to business students, this paper looks into the continued success of using guided discovery and blended learning with learning management system in and out of classrooms to enhance student learning.…

  15. The VOICES/VOCES Success Story: Effective Strategies for Training, Technical Assistance and Community-Based Organization Implementation

    Science.gov (United States)

    Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

    2006-01-01

    The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a…

  16. Health information technology knowledge and skills needed by HIT employers.

    Science.gov (United States)

    Fenton, S H; Gongora-Ferraez, M J; Joost, E

    2012-01-01

    To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey.

  17. Tracking, aiming, and hitting the UAV with ordinary assault rifle

    Science.gov (United States)

    Racek, František; Baláž, Teodor; Krejčí, Jaroslav; Procházka, Stanislav; Macko, Martin

    2017-10-01

    The usage small-unmanned aerial vehicles (UAVs) is significantly increasing nowadays. They are being used as a carrier of military spy and reconnaissance devices (taking photos, live video streaming and so on), or as a carrier of potentially dangerous cargo (intended for destruction and killing). Both ways of utilizing the UAV cause the necessity to disable it. From the military point of view, to disable the UAV means to bring it down by a weapon of an ordinary soldier that is the assault rifle. This task can be challenging for the soldier because he needs visually detect and identify the target, track the target visually and aim on the target. The final success of the soldier's mission depends not only on the said visual tasks, but also on the properties of the weapon and ammunition. The paper deals with possible methods of prediction of probability of hitting the UAV targets.

  18. Scheme for implementing N-qubit controlled phase gate of photons assisted by quantum-dot-microcavity coupled system: optimal probability of success

    International Nuclear Information System (INIS)

    Cui, Wen-Xue; Hu, Shi; Wang, Hong-Fu; Zhu, Ai-Dong; Zhang, Shou

    2015-01-01

    The direct implementation of multiqubit controlled phase gate of photons is appealing and important for reducing the complexity of the physical realization of linear-optics-based practical quantum computer and quantum algorithms. In this letter we propose a nondestructive scheme for implementing an N-qubit controlled phase gate of photons with a high success probability. The gate can be directly implemented with the self-designed quantum encoder circuits, which are probabilistic optical quantum entangler devices and can be achieved using linear optical elements, single-photon superposition state, and quantum dot coupled to optical microcavity. The calculated results indicate that both the success probabilities of the quantum encoder circuit and the N-qubit controlled phase gate in our scheme are higher than those in the previous schemes. We also consider the effects of the side leakage and cavity loss on the success probability and the fidelity of the quantum encoder circuit for a realistic quantum-dot-microcavity coupled system. (letter)

  19. Implementation of the Good School Toolkit in Uganda: a quantitative process evaluation of a successful violence prevention program.

    Science.gov (United States)

    Knight, Louise; Allen, Elizabeth; Mirembe, Angel; Nakuti, Janet; Namy, Sophie; Child, Jennifer C; Sturgess, Joanna; Kyegombe, Nambusi; Walakira, Eddy J; Elbourne, Diana; Naker, Dipak; Devries, Karen M

    2018-05-09

    The Good School Toolkit, a complex behavioural intervention designed by Raising Voices a Ugandan NGO, reduced past week physical violence from school staff to primary students by an average of 42% in a recent randomised controlled trial. This process evaluation quantitatively examines what was implemented across the twenty-one intervention schools, variations in school prevalence of violence after the intervention, factors that influence exposure to the intervention and factors associated with students' experience of physical violence from staff at study endline. Implementation measures were captured prospectively in the twenty-one intervention schools over four school terms from 2012 to 2014 and Toolkit exposure captured in the student (n = 1921) and staff (n = 286) endline cross-sectional surveys in 2014. Implementation measures and the prevalence of violence are summarised across schools and are assessed for correlation using Spearman's Rank Correlation Coefficient. Regression models are used to explore individual factors associated with Toolkit exposure and with physical violence at endline. School prevalence of past week physical violence from staff against students ranged from 7% to 65% across schools at endline. Schools with higher mean levels of teacher Toolkit exposure had larger decreases in violence during the study. Students in schools categorised as implementing a 'low' number of program school-led activities reported less exposure to the Toolkit. Higher student Toolkit exposure was associated with decreased odds of experiencing physical violence from staff (OR: 0.76, 95%CI: 0.67-0.86, p-valueEffectiveness of the Toolkit may be increased by further targeting and supporting teachers' engagement with girls and students with mental health difficulties. The trial is registered at clinicaltrials.gov , NCT01678846, August 24th 2012.

  20. Successful implementation of a packed red blood cell and fresh frozen plasma transfusion protocol in the surgical intensive care unit.

    Directory of Open Access Journals (Sweden)

    Benjamin E Szpila

    Full Text Available Blood product transfusions are associated with increased morbidity and mortality. The purpose of this study was to determine if implementation of a restrictive protocol for packed red blood cell (PRBC and fresh frozen plasma (FFP transfusion safely reduces blood product utilization and costs in a surgical intensive care unit (SICU.We performed a retrospective, historical control analysis comparing before (PRE and after (POST implementation of a restrictive PRBC/FFP transfusion protocol for SICU patients. Univariate analysis was utilized to compare patient demographics and blood product transfusion totals between the PRE and POST cohorts. Multivariate logistic regression models were developed to determine if implementation of the restrictive transfusion protocol is an independent predictor of adverse outcomes after controlling for age, illness severity, and total blood products received.829 total patients were included in the analysis (PRE, n=372; POST, n=457. Despite higher mean age (56 vs. 52 years, p=0.01 and APACHE II scores (12.5 vs. 11.2, p=0.006, mean units transfused per patient were lower for both packed red blood cells (0.7 vs. 1.2, p=0.03 and fresh frozen plasma (0.3 vs. 1.2, p=0.007 in the POST compared to the PRE cohort, respectively. There was no difference in inpatient mortality between the PRE and POST cohorts (7.5% vs. 9.2%, p=0.39. There was a decreased risk of urinary tract infections (OR 0.47, 95%CI 0.28-0.80 in the POST cohort after controlling for age, illness severity and amount of blood products transfused.Implementation of a restrictive transfusion protocol can effectively reduce blood product utilization in critically ill surgical patients with no increase in morbidity or mortality.

  1. Hype, Hope, and Hit in Movies

    DEFF Research Database (Denmark)

    Dholakia, Nikhilesh; Turcan, Romeo V.

    2012-01-01

    This paper is part of an ongoing project to develop an interdisciplinary metatheory of bubbles, relevant to the contemporary era of globalization and rapid, technology-aided communication flows. Just in the first few years of the 21st century, several bubbles have appeared – the so-called dotcom ...... cultural field where relatively small bubbles may form. Movies represent a good arena to examine cultural bubbles on a scale that is not daunting, and where the hype-hope-hit dynamics can be observed more frequently than in most other settings....

  2. Measuring the Success of E-Cargo Implementation at One of Indonesian Airlines using DeLone and McLean Model

    Science.gov (United States)

    Monika, Ruth; Lumban Gaol, Ford

    2017-06-01

    This research is aimed at measuring the success of e-cargo implementation in Indonesia. There are three analyzed districts: Tanjung Pandan (TJQ), Palembang (PLM), and Jakarta (CGK). The research uses information system’s success model proposed by Delone and McLean. The research will analyze the factors that measure the success of using DeLone & McLean model of success information systems. Data from 53 respondents were collected through a survey, then the author created a path with the Partial Least Squares (PLS) path analysis using the software SmartPLS (v.3.2.6). The results of this study proved that the information quality variable did not significantly affect use variable, the information quality variable had no significant effect on the user satisfaction variable and the service quality variable had no significant effect on the use variable, while the other variables were tested significant in measuring the success of the use of information systems with R-square value that has a moderate effect of user satisfaction variable by 0.577, the use variable by 0.396, and a net benefit variable by 0.615.

  3. Implementing the PAIN RelieveIt Randomized Controlled Trial in Hospice Care: Mechanisms for Success and Meeting PCORI Methodology Standards.

    Science.gov (United States)

    Ezenwa, Miriam O; Suarez, Marie L; Carrasco, Jesus D; Hipp, Theresa; Gill, Anayza; Miller, Jacob; Shea, Robert; Shuey, David; Zhao, Zhongsheng; Angulo, Veronica; McCurry, Timothy; Martin, Joanna; Yao, Yingwei; Molokie, Robert E; Wang, Zaijie Jim; Wilkie, Diana J

    2017-07-01

    This purpose of this article is to describe how we adhere to the Patient-Centered Outcomes Research Institute's (PCORI) methodology standards relevant to the design and implementation of our PCORI-funded study, the PAIN RelieveIt Trial. We present details of the PAIN RelieveIt Trial organized by the PCORI methodology standards and components that are relevant to our study. The PAIN RelieveIt Trial adheres to four PCORI standards and 21 subsumed components. The four standards include standards for formulating research questions, standards associated with patient centeredness, standards for data integrity and rigorous analyses, and standards for preventing and handling missing data. In the past 24 months, we screened 2,837 cancer patients and their caregivers; 874 dyads were eligible; 223.5 dyads consented and provided baseline data. Only 55 patients were lost to follow-up-a 25% attrition rate. The design and implementation of the PAIN RelieveIt Trial adhered to PCORI's methodology standards for research rigor.

  4. The Rock that Hit New York

    Energy Technology Data Exchange (ETDEWEB)

    Meade, Roger Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Keksis, August Lawrence [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-10-03

    On January 12, 1975, a rock seemed to fall from the sky over New York State’s Schoharie County hitting the tractor of a local farmer, who was “preparing his fields for spring planting.” As the farmer later described the event to a reporter from the UFO INVESTIGATOR, the object glanced off the tractor, fell to the ground, and melted its way through a patch of ice that was two and one half inches thick. The farmer, Leonard Tillapaugh, called the county sheriff, Harvey Stoddard, who recovered the rock, noting that it “was still warm.” Why and how a sample of the rock came to Los Alamos is not known. However, it captivated a wide Laboratory audience, was subjected to rigorous testing and evaluation. Los Alamos used the scientific method in the manner promoted by Hynek. Did Los Alamos solve the mystery of the rock’s origin? Not definitively. Although the exact origin could not be determined, it was shown conclusively that the rock was not from outer space. With that said, the saga of Rock that hit New York came to an end. Nothing more was said or written about it. The principals involved have long since passed from the scene. The NICAP ceased operations in 1980. And, the rock, itself, has disappeared.

  5. Career Counseling as a Tool for Successful Implementation of Managerial Competencies of Secondary School Graduates in the Slovak Republic

    Directory of Open Access Journals (Sweden)

    Droppa Milan

    2017-11-01

    Full Text Available The object of this paper is the issue of career counseling for secondary school students using the "Model career counseling" (hereinafter MCC. The aim of this paper is to demonstrate the contribution of the MCC for students while deciding about the choice of their further education and career choices with the implementation of abilities, interests and personal abilities of the student. The method is an analysis of personality preconditions, general, specific abilities and interests of students by using standardized tests and non-standardized author's questionnaires. Consequently, comparison is realized of the collected data about students with graduate profiles in the study program. Based on the observed results, the focus of their further study is recommended to the students.

  6. Successful social environmental management model, implemented in Ecuador to overcome impacts from a heavy crude oil spill

    Energy Technology Data Exchange (ETDEWEB)

    Aleman, Miguel Angel; Bermeo, Ramiro; Mendizabal, Andres; Loon, Wong [ENTRIX Inc. Branch, Quito (Ecuador)

    2010-07-01

    An oil spill of 11,700 barrels of heavy crude oil occurred at an OCP Ecuador S.A. pipeline in a high biodiversity area in eastern Ecuador on February 25, 2009. The pipeline breakage was due to stress caused by an earth movement. The aim of this paper is to present the methodology used by the company for the emergency response. First of all, medical assistance was provided to the inhabitants of the area as a safety precaution and water was distributed to them while other workers contained the spill and cleaned the area. Residents were then offered temporary jobs participating in the cleaning efforts. Throughout the cleanup process, the media and the population were kept informed of how the process was progressing in an open and transparent manner. This methodology ensured the success of the cleanup and restoration work in a timely manner and this methodology can now be used and further developed for handling future events.

  7. Successful social environmental management model, implemented in Ecuador to overcome impacts from a heavy crude oil spill

    International Nuclear Information System (INIS)

    Aleman, Miguel Angel; Bermeo, Ramiro; Mendizabal, Andres; Loon, Wong

    2010-01-01

    An oil spill of 11,700 barrels of heavy crude oil occurred at an OCP Ecuador S.A. pipeline in a high biodiversity area in eastern Ecuador on February 25, 2009. The pipeline breakage was due to stress caused by an earth movement. The aim of this paper is to present the methodology used by the company for the emergency response. First of all, medical assistance was provided to the inhabitants of the area as a safety precaution and water was distributed to them while other workers contained the spill and cleaned the area. Residents were then offered temporary jobs participating in the cleaning efforts. Throughout the cleanup process, the media and the population were kept informed of how the process was progressing in an open and transparent manner. This methodology ensured the success of the cleanup and restoration work in a timely manner and this methodology can now be used and further developed for handling future events.

  8. Multiple-hit parameter estimation in monolithic detectors.

    Science.gov (United States)

    Hunter, William C J; Barrett, Harrison H; Lewellen, Tom K; Miyaoka, Robert S

    2013-02-01

    We examine a maximum-a-posteriori method for estimating the primary interaction position of gamma rays with multiple interaction sites (hits) in a monolithic detector. In assessing the performance of a multiple-hit estimator over that of a conventional one-hit estimator, we consider a few different detector and readout configurations of a 50-mm-wide square cerium-doped lutetium oxyorthosilicate block. For this study, we use simulated data from SCOUT, a Monte-Carlo tool for photon tracking and modeling scintillation- camera output. With this tool, we determine estimate bias and variance for a multiple-hit estimator and compare these with similar metrics for a one-hit maximum-likelihood estimator, which assumes full energy deposition in one hit. We also examine the effect of event filtering on these metrics; for this purpose, we use a likelihood threshold to reject signals that are not likely to have been produced under the assumed likelihood model. Depending on detector design, we observe a 1%-12% improvement of intrinsic resolution for a 1-or-2-hit estimator as compared with a 1-hit estimator. We also observe improved differentiation of photopeak events using a 1-or-2-hit estimator as compared with the 1-hit estimator; more than 6% of photopeak events that were rejected by likelihood filtering for the 1-hit estimator were accurately identified as photopeak events and positioned without loss of resolution by a 1-or-2-hit estimator; for PET, this equates to at least a 12% improvement in coincidence-detection efficiency with likelihood filtering applied.

  9. High energy ion hit technique to local area using microbeam

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Ryuichi; Kamiya, Tomihiro; Suda, Tamotsu; Sakai, Takuro; Hirao, Toshio; Kobayashi, Yasuhiko; Watanabe, Hiroshi [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment

    1997-03-01

    Single energetic ion hit technique has been developed as an application of ion microbeam technique, in order to study the effect of local damage or injury to materials and living organisms. The overall performance is basically defined by those of separate techniques: microbeam formation, microbeam positioning, single ion detection, detection signal processing, hit timing control, and hit verification. Recent progress on the developments of these techniques at JAERI-TIARA facility are reviewed. (author)

  10. Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature.

    Science.gov (United States)

    Simons, Sereh M J; Cillessen, Felix H J M; Hazelzet, Jan A

    2016-08-02

    A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing with the multiplicity of patient problems. The problem list as a precondition is the centerpiece of the problem-oriented medical record (POMR) also called problem-oriented record (POR). Prior to the digital era, paper records presented a flat list of medical problems to the healthcare professional without the features that are possible with current technology. In modern EHRs a POMR based on a structured problem list can be used for clinical decision support, registries, order management, population health, and potentially other innovative functionality in the future, thereby providing a new incentive to the implementation and use of the POMR. On both 12 May 2014 and 1 June 2015 a systematic literature search was conducted. From the retrieved articles statements regarding the POMR and related to successful or non-successful implementation, were categorized. Generic determinants were extracted from these statements. In this research 38 articles were included. The literature analysis led to 12 generic determinants: clinical practice/reasoning, complete and accurate problem list, data structure/content, efficiency, functionality, interoperability, multi-disciplinary, overview of patient information, quality of care, system support, training of staff, and usability. Two main subjects can be distinguished in the determinants: the system that the problem list and POMR is integrated in and the organization using that system. The combination of the two requires a sociotechnical approach and both are equally important for successful implementation of a POMR. All the determinants have to be taken into account, but the weight given to each of the determinants depends on the organizationusing

  11. Early Warning System Ghana: how to successfully implement a disaster early warning system in a data scarce region

    Science.gov (United States)

    Udo, Job; Jungermann, Nicole

    2016-04-01

    Ghana is a country frequently struck by natural disasters like floods and droughts. Timely warning or detection of such disasters will mitigate the negative impact on lives and property. However, local data and monitoring systems necessary to provide such a warning are hardly available. The availability and improvement of internet, mobile phones and satellites has provided new possibilities for disaster warning systems in data scarce regions such as Ghana. Our presentation describes the development of an early warning system (EWS) in Ghana completely based on satellite based open data. The EWS provides a flood or drought hazard warning on sub-catchment level and links the warning to a more detailed flood or drought risk map, to enable the disaster coordinator to send warnings or relieve more efficiently to areas that have the highest risk. This is especially relevant because some areas for which the system is implemented are very remote. The system is developed and tested to be robust and operational especially in remote areas. This means that the necessary information is also available under limited internet conditions and not dependent on local computer facilities. In many rural areas in Ghana communities rely on indigenous knowledge when it comes to flood or drought disaster forecasting. The EWS has a feature that allows indigenous knowledge indicators to be taken into account in the warning and makes easy comparison possible with the satellite based warnings.

  12. Advancing haemostasis automation--successful implementation of robotic centrifugation and sample processing in a tertiary service hospital.

    Science.gov (United States)

    Sédille-Mostafaie, Nazanin; Engler, Hanna; Lutz, Susanne; Korte, Wolfgang

    2013-06-01

    Laboratories today face increasing pressure to automate operations due to increasing workloads and the need to reduce expenditure. Few studies to date have focussed on the laboratory automation of preanalytical coagulation specimen processing. In the present study, we examined whether a clinical chemistry automation protocol meets the preanalytical requirements for the analyses of coagulation. During the implementation of laboratory automation, we began to operate a pre- and postanalytical automation system. The preanalytical unit processes blood specimens for chemistry, immunology and coagulation by automated specimen processing. As the production of platelet-poor plasma is highly dependent on optimal centrifugation, we examined specimen handling under different centrifugation conditions in order to produce optimal platelet deficient plasma specimens. To this end, manually processed models centrifuged at 1500 g for 5 and 20 min were compared to an automated centrifugation model at 3000 g for 7 min. For analytical assays that are performed frequently enough to be targets for full automation, Passing-Bablok regression analysis showed close agreement between different centrifugation methods, with a correlation coefficient between 0.98 and 0.99 and a bias between -5% and +6%. For seldom performed assays that do not mandate full automation, the Passing-Bablok regression analysis showed acceptable to poor agreement between different centrifugation methods. A full automation solution is suitable and can be recommended for frequent haemostasis testing.

  13. Successful implementation of diabetes audits in Australia: the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative.

    Science.gov (United States)

    Lee, A S; Colagiuri, S; Flack, J R

    2018-04-06

    We developed and implemented a national audit and benchmarking programme to describe the clinical status of people with diabetes attending specialist diabetes services in Australia. The Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative was established as a quality audit activity. De-identified data on demographic, clinical, biochemical and outcome items were collected from specialist diabetes services across Australia to provide cross-sectional data on people with diabetes attending specialist centres at least biennially during the years 1998 to 2011. In total, 38 155 sets of data were collected over the eight ANDIAB audits. Each ANDIAB audit achieved its primary objective to collect, collate, analyse, audit and report clinical diabetes data in Australia. Each audit resulted in the production of a pooled data report, as well as individual site reports allowing comparison and benchmarking against other participating sites. The ANDIAB initiative resulted in the largest cross-sectional national de-identified dataset describing the clinical status of people with diabetes attending specialist diabetes services in Australia. ANDIAB showed that people treated by specialist services had a high burden of diabetes complications. This quality audit activity provided a framework to guide planning of healthcare services. © 2018 Diabetes UK.

  14. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa.

    Science.gov (United States)

    Allegranzi, Benedetta; Sax, Hugo; Bengaly, Loséni; Richet, Hervé; Minta, Daouda K; Chraiti, Marie-Noelle; Sokona, Fatoumata Maiga; Gayet-Ageron, Angèle; Bonnabry, Pascal; Pittet, Didier

    2010-02-01

    To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country. A before-and-after study from December 2006 through June 2008, with a 6-month baseline evaluation period and a follow-up period of 8 months from the beginning of the intervention. University Hospital, Bamako, Mali. Participants. Two hundred twenty-four healthcare workers. The intervention consisted of introducing a locally produced, alcohol-based handrub; monitoring hand hygiene compliance; providing performance feedback; educating staff; posting reminders in the workplace; and promoting an institutional safety climate according to the World Health Organization multimodal hand hygiene improvement strategy. Hand hygiene infrastructure, compliance, healthcare workers' knowledge and perceptions, and handrub consumption were evaluated at baseline and at follow-up. Severe deficiencies in the infrastructure for hand hygiene were identified before the intervention. Local handrub production and quality control proved to be feasible, affordable, and satisfactory. At follow-up, handrubbing was the quasi-exclusive hand hygiene technique (93.3%). Compliance increased from 8.0% at baseline to 21.8% at follow-up (P appreciation of each strategy component by staff. Multimodal hand hygiene promotion is feasible and effective in a low-income country. Access to handrub was critical for its success. These findings motivated the government of Mali to expand the intervention nationwide. This experience represents a significant advancement for patient safety in developing countries.

  15. Recent Improvements in the SHIELD-HIT Code

    DEFF Research Database (Denmark)

    Hansen, David Christoffer; Lühr, Armin Christian; Herrmann, Rochus

    2012-01-01

    Purpose: The SHIELD-HIT Monte Carlo particle transport code has previously been used to study a wide range of problems for heavy-ion treatment and has been benchmarked extensively against other Monte Carlo codes and experimental data. Here, an improved version of SHIELD-HIT is developed concentra......Purpose: The SHIELD-HIT Monte Carlo particle transport code has previously been used to study a wide range of problems for heavy-ion treatment and has been benchmarked extensively against other Monte Carlo codes and experimental data. Here, an improved version of SHIELD-HIT is developed...

  16. Successful implementation of ageing management exemplified at the cooling tower of the Emsland nuclear power plant; Erfolgreiche Umsetzung von Alterungsmanagement am Beispiel Kuehlturm des Kernkraftwerks Emsland

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Alexander [Hochtief Solutions AG, Consult IKS Energy, Frankfurt am Main (Germany). Design Kraftwerke; Dueweling, Carsten [Kernkraftwerke Lippe-Ems GmbH, Lingen (Germany). Abschnitt Bautechnik

    2013-09-01

    The paper describes the successful implementation of the restoration of water distribution channels at the cooling tower of the Emsland nuclear power plant under the aspect of ageing management. The main challenge of ageing management is the determination of potential ageing mechanism and to avoid systematically and effectively their damaging influences. In the course of the annual site inspections, abnormalities at the lower side of the water-distribution channels of the cooling tower were detected, analysed, and repaired. The procedures conserve the load bearing reinforcement only for a certain period. Therefore permanent structural monitoring is needed. (orig.)

  17. Case study on the role of socio-technical influences on the implementation and success of nuclear power in France

    International Nuclear Information System (INIS)

    Jedani, T.

    2004-01-01

    To fully understand a technological development one must appreciate social, political and economic factors in addition to the technological components (Hughes, 1991). The systems perspective, asserted by Hughes, implies that technologies cannot be understood in isolation, but only in their contexts, especially in their systemic contexts. This theory is illustrated through an examination of France's implementation of its nuclear power program in the early 1970's. Nuclear power provided France with the opportunity to achieve energy independence and, as a result, political control over its energy supply. The scope of this case study is limited to consideration of the socio-technical influences on the rise of nuclear power in France and includes an examination of the technical aspects of the innovation. In considering the socio-technical system encompassing France's adoption of nuclear power, this case study will contemplate: how France was able to persuade its people to accept nuclear power; what it is about French culture and politics that allowed them to succeed where most other countries have failed; the breakthroughs that led to the broad commercialization of nuclear power in France in the 1970's; and how France achieved its status as one of the world's top producers of nuclear energy. The time period during which this study is based is limited to the early 1970's, when France was reliant upon external energy supplies, up until the present day, where nuclear power has become France's main source of energy, thus contributing to France's autonomy in terms of its energy supply. This study will not address the issue of nuclear waste or the nuclear power safety debate which is also beyond the scope of this study. (author)

  18. Developing and testing an instrument to measure the presence of conditions for successful implementation of quality improvement collaboratives.

    Science.gov (United States)

    Dückers, Michel L A; Wagner, Cordula; Groenewegen, Peter P

    2008-08-11

    In quality improvement collaboratives (QICs) teams of practitioners from different health care organizations are brought together to systematically improve an aspect of patient care. Teams take part in a series of meetings to learn about relevant best practices, quality methods and change ideas, and share experiences in making changes in their own local setting. The purpose of this study was to develop an instrument for measuring team organization, external change agent support and support from the team's home institution in a Dutch national improvement and dissemination programme for hospitals based on several QICs. The exploratory methodological design included two phases: a) content development and assessment, resulting in an instrument with 15 items, and b) field testing (N = 165). Internal consistency reliability was tested via Cronbach's alpha coefficient. Principal component analyses were used to identify underlying constructs. Tests of scaling assumptions according to the multi trait/multi-item matrix, were used to confirm the component structure. Three components were revealed, explaining 65% of the variability. The components were labelled 'organizational support', 'team organization' and 'external change agent support'. One item not meeting item-scale criteria was removed. This resulted in a 14 item instrument. Scale reliability ranged from 0.77 to 0.91. Internal item consistency and divergent validity were satisfactory. On the whole, the instrument appears to be a promising tool for assessing team organization and internal and external support during QIC implementation. The psychometric properties were good and warrant application of the instrument for the evaluation of the national programme and similar improvement programmes.

  19. Developing and testing an instrument to measure the presence of conditions for successful implementation of quality improvement collaboratives

    Directory of Open Access Journals (Sweden)

    Wagner Cordula

    2008-08-01

    Full Text Available Abstract Background In quality improvement collaboratives (QICs teams of practitioners from different health care organizations are brought together to systematically improve an aspect of patient care. Teams take part in a series of meetings to learn about relevant best practices, quality methods and change ideas, and share experiences in making changes in their own local setting. The purpose of this study was to develop an instrument for measuring team organization, external change agent support and support from the team's home institution in a Dutch national improvement and dissemination programme for hospitals based on several QICs. Methods The exploratory methodological design included two phases: a content development and assessment, resulting in an instrument with 15 items, and b field testing (N = 165. Internal consistency reliability was tested via Cronbach's alpha coefficient. Principal component analyses were used to identify underlying constructs. Tests of scaling assumptions according to the multi trait/multi-item matrix, were used to confirm the component structure. Results Three components were revealed, explaining 65% of the variability. The components were labelled 'organizational support', 'team organization' and 'external change agent support'. One item not meeting item-scale criteria was removed. This resulted in a 14 item instrument. Scale reliability ranged from 0.77 to 0.91. Internal item consistency and divergent validity were satisfactory. Conclusion On the whole, the instrument appears to be a promising tool for assessing team organization and internal and external support during QIC implementation. The psychometric properties were good and warrant application of the instrument for the evaluation of the national programme and similar improvement programmes.

  20. A Two-Hit Model of Autism: Adolescence as the Second Hit

    Science.gov (United States)

    Picci, Giorgia; Scherf, K. Suzanne

    2015-01-01

    Adolescence brings dramatic changes in behavior and neural organization. Unfortunately, for some 30% of individuals with autism, there is marked decline in adaptive functioning during adolescence. We propose a two-hit model of autism. First, early perturbations in neural development function as a “first hit” that sets up a neural system that is “built to fail” in the face of a second hit. Second, the confluence of pubertal hormones, neural reorganization, and increasing social demands during adolescence provides the “second hit” that interferes with the ability to transition into adult social roles and levels of adaptive functioning. In support of this model, we review evidence about adolescent-specific neural and behavioral development in autism. We conclude with predictions and recommendations for empirical investigation about several domains in which developmental trajectories for individuals with autism may be uniquely deterred in adolescence. PMID:26609500

  1. Barriers to successful implementation of care in home haemodialysis (BASIC-HHD):1. Study design, methods and rationale.

    Science.gov (United States)

    Jayanti, Anuradha; Wearden, Alison J; Morris, Julie; Brenchley, Paul; Abma, Inger; Bayer, Steffen; Barlow, James; Mitra, Sandip

    2013-09-17

    Ten years on from the National Institute of Health and Clinical Excellence' technology appraisal guideline on haemodialysis in 2002; the clinical community is yet to rise to the challenge of providing home haemodialysis (HHD) to 10-15% of the dialysis cohort. The renal registry report, suggests underutilization of a treatment type that has had a lot of research interest and several publications worldwide on its apparent benefit for both physical and mental health of patients. An understanding of the drivers to introducing and sustaining the modality, from organizational, economic, clinical and patient perspectives is fundamental to realizing the full benefits of the therapy with the potential to provide evidence base for effective care models. Through the BASIC-HHD study, we seek to understand the clinical, patient and carer related psychosocial, economic and organisational determinants of successful uptake and maintenance of home haemodialysis and thereby, engage all major stakeholders in the process. We have adopted an integrated mixed methodology (convergent, parallel design) for this study. The study arms include a. patient; b. organization; c. carer and d. economic evaluation. The three patient study cohorts (n = 500) include pre-dialysis patients (200), hospital haemodialysis (200) and home haemodialysis patients (100) from geographically distinct NHS sites, across the country and with variable prevalence of home haemodialysis. The pre-dialysis patients will also be prospectively followed up for a period of 12 months from study entry to understand their journey to renal replacement therapy and subsequently, before and after studies will be carried out for a select few who do commence dialysis in the study period. The process will entail quantitative methods and ethnographic interviews of all groups in the study. Data collection will involve clinical and biomarkers, psychosocial quantitative assessments and neuropsychometric tests in patients. Organizational

  2. Successful implementation of the National Environmental Policy Act (NEPA) at a US Department of Energy (DOE) site: Environmental assessment preparation - a case study

    International Nuclear Information System (INIS)

    Haagenstad, T.; Ladino, A.

    1997-01-01

    The U.S. Department of Energy (DOE) at Los Alamos National Laboratory (LANL) implements the requirements of the National Environmental Policy Act (NEPA) using a NEPA Compliance Team. The NEPA Compliance Team (Team) is composed of DOE Los Alamos Area Office (LAAO) and LANL employees that combine to create quality improvements in the DOE NEPA compliance process at both LAAO and LANL. A major focus of quality improvement has been in the area of Environmental Assessment (EA) documentation preparation. The NEPA Team within LANL's Ecology Group (ESH-20) is the organization responsible for preparing the EA documentation on behalf of DOE. DOE and LANL team in an interdisciplinary process to prepare review, and complete EAs using the technical expertise of individuals throughout the DOE and LANL. This approach has demonstrated significant time and cost savings as well as EA document quality improvements. The process used to prepare an EA for the Low Energy Demonstration Accelerator (LEDA) is presented as an example of a successful approach to implementing NEPA. The LEDA EA is used as a case study example to demonstrate how an integrated and interdisciplinary approach to conducting a NEPA analysis yields extremely successful results. The LEDA EA was prepared on an extremely aggressive schedule with tight cost constraints. The ESH-20 NEPA Team was successful in providing a critical link between the DOE decision-makers and the LEDA project representatives within LANL. As the technical scope of the LEDA project changed during the preparation of the EA, by emphasizing an interdisciplinary approach, the Team was able to quickly assess the implications and potential impacts through open communications with the various subject matter experts while maintaining a pace consistent with the EA schedule demands

  3. Current insights into the laboratory diagnosis of HIT.

    Science.gov (United States)

    Bakchoul, T; Zöllner, H; Greinacher, A

    2014-06-01

    Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction and prothrombotic disorder caused by immunization against platelet factor 4 (PF4) after complex formation with heparin or other polyanions. After antibody binding to PF4/heparin complexes, HIT antibodies are capable of intravascular platelet activation by cross-linking Fc gamma receptor IIa (FcγRIIa) on the platelet surface leading to a platelet count decrease and/or thrombosis. In contrast to most other immune-mediated disorders, the currently available laboratory tests for anti-PF4/heparin antibodies show a high sensitivity also for clinically irrelevant antibodies. This makes the diagnosis of HIT challenging and bears the risk to substantially overdiagnose HIT. The strength of the antigen assays for HIT is in ruling out HIT when the test is negative. Functional assays have a higher specificity for clinically relevant antibodies, but they are restricted to specialized laboratories. Currently, a Bayesian approach combining the clinical likelihood estimation for HIT with laboratory tests is the most appropriate approach to diagnose HIT. In this review, we give an overview on currently available diagnostic procedures and discuss their limitations. © 2014 John Wiley & Sons Ltd.

  4. Reduction of multiple hits in atom probe tomography

    International Nuclear Information System (INIS)

    Thuvander, Mattias; Kvist, Anders; Johnson, Lars J.S.; Weidow, Jonathan; Andrén, Hans-Olof

    2013-01-01

    The accuracy of compositional measurements using atom probe tomography is often reduced because some ions are not recorded when several ions hit the detector in close proximity to each other and within a very short time span. In some cases, for example in analysis of carbides, the multiple hits result in a preferential loss of certain elements, namely those elements that frequently field evaporate in bursts or as dissociating molecules. In this paper a method of reducing the effect of multiple hits is explored. A fine metal grid was mounted a few millimeters behind the local electrode, effectively functioning as a filter. This resulted in a decrease in the overall detection efficiency, from 37% to about 5%, but also in a decrease in the fraction of multiple hits. In an analysis of tungsten carbide the fraction of ions originating from multiple hits decreased from 46% to 10%. As a result, the measured carbon concentration increased from 48.2 at%to 49.8 at%, very close to the expected 50.0 at%. The characteristics of the multiple hits were compared for analyses with and without the grid filter. - Highlights: ► APT experiments have been performed with a reduced amount of multiple hits. ► The multiple hits were reduced by placing a grid behind the electrode. ► This resulted in improved carbon measurement of WC

  5. Hitting your foothills target the first time

    Energy Technology Data Exchange (ETDEWEB)

    Ewanek, J. [MI Drilling Fluids Canada, Calgary, AB (Canada); Young, S. [M-I L.L.C., Calgary, AB (Canada)

    2001-07-01

    As the demand for gas increases, operators are exploring for more long-term gas reserves in the foothills and in more complex structural traps and reservoirs. The high tectonic activity in the foothills has rendered the structural geology complex, making it difficult to hit an exploration target the first time. Costly sidetracking operations are common. The use of oil based fluids is often necessary for drilling in such technically challenging environments. However, dips/structural evaluation tools such as the Formation Micro Imager (FMI) and the GeoVision 675 Logging While Drilling (LWD) tool cannot be used because of the non-conductive nature of oil based fluids. Therefore, a conductive oil based fluid was developed with the recent advances in oil based mud technology, and it is now available. This new conductive oil based fluid allows LWD tools to transmit structural information in real time and FMI logs to give detailed structural information while wireline logging the hole. The combination of LWD and FMI data plus a conductive oil based fluid makes it possible to gather better structural information while drilling. This minimizes sidetracks and leads to a better understanding of the structural geology in that field. It was concluded that the use of this technology well enable better pre-planning on future well sites and will make it possible to reduce costs associated with drilling and oilfield operations in the foothills. 9 refs., 2 tabs., 13 figs.

  6. The first neutron beam hits EAR2

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    On 25 July 2014, about a year after construction work began, the Experimental Area 2 (EAR2) of CERN’s neutron facility n_TOF recorded its first beam. Unique in many aspects, EAR2 will start its rich programme of experimental physics this autumn.   The last part of the EAR2 beamline: the neutrons come from the underground target and reach the top of the beamline, where they hit the samples. Built about 20 metres above the neutron production target, EAR2 is in fact a bunker connected to the n_TOF underground facilities via a duct 80 cm in diameter, where the beamline is installed. The feet of the bunker support pillars are located on the concrete structure of the n_TOF tunnel and part of the structure lies above the old ISR building. A beam dump located on the roof of the building completes the structure. Neutrons are used by physicists to study neutron-induced reactions with applications in a number of fields, including nuclear waste transmutation, nuclear technology, nuclear astrop...

  7. A study of how to implement a successful CRM by identifying challenges using DEMATEL method: An empirical study on small to medium business units

    Directory of Open Access Journals (Sweden)

    Bahman Saeidipour

    2012-01-01

    Full Text Available This paper identifies and analyzes barriers of customer relationship management (CRM implementation in SMEs. Hence, based on a comprehensive review of the literature and gathering the viewpoint of experts, the influencing barriers are identified. In order to analyze the identified barriers, DEMATEL methodology is applied and a causal model of the relationships between barriers is developed. Furthermore, based on the DEMATEL results the barriers are also categorized into two groups of driver and dependent. The results of study show that inadequate budget, organization culture, obligation of major management to CRM and inadequate access to modern technical knowledge are among effective impediments and play important role in successful establishment of customer relationship management system.

  8. Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway

    Directory of Open Access Journals (Sweden)

    Éidín Ní Shé

    2018-01-01

    Full Text Available We addressed the research question “what factors enable the successful development and implementation of a frail older person’s pathway within the acute setting”. A rapid realist review (RRR was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person’s pathway.

  9. [Factors of success in the implementation of the technologies of the information and the communication in the health systems. The human factor].

    Science.gov (United States)

    Roman-Viñas, Ramón

    2010-02-01

    In this work some of the fundamentals of change management techniques to ensure the introduction of information and communication technologies in health organizations are analized. Managing change is aimed at redirecting the impact of any transformation process in the organizations towards a positive attitude and enthusiasm of those involved. That is, this paper analyzes the most important of all factors that must be managed in any project for change: the human factor. If a proper change management is a critical success factor in implementing new processes and systems of information and communication technologies (ICT) in an organization, when we faced with the introduction of new processes and interoperability systems between different organizations, cooperation, leadership and motivation of individuals focused on a common goal is absolutely imperative. This is the case of the new ICT systems being introduced in the Catalan Health System. Indeed, by definition of the model itself, in Catalonia, continuity of care, increased efficiency and effectiveness and quality improvement of projects as the clinical history shared, electronic prescriptions, or scanning medical imaging, require necessarily the definition of processes in which a large number of different health organizations, different in their law status, and whose own interests should converge towards the ICT systems and processes of health care so that the contribution of all parties can make a whole. The success of these projects, a reality nowadays, is due largely to the management of the human factor conducted continuously since its inception. 2010 Elsevier España S.L. All rights reserved.

  10. B-HIT - A Tool for Harvesting and Indexing Biodiversity Data.

    Directory of Open Access Journals (Sweden)

    Patricia Kelbert

    Full Text Available With the rapidly growing number of data publishers, the process of harvesting and indexing information to offer advanced search and discovery becomes a critical bottleneck in globally distributed primary biodiversity data infrastructures. The Global Biodiversity Information Facility (GBIF implemented a Harvesting and Indexing Toolkit (HIT, which largely automates data harvesting activities for hundreds of collection and observational data providers. The team of the Botanic Garden and Botanical Museum Berlin-Dahlem has extended this well-established system with a range of additional functions, including improved processing of multiple taxon identifications, the ability to represent associations between specimen and observation units, new data quality control and new reporting capabilities. The open source software B-HIT can be freely installed and used for setting up thematic networks serving the demands of particular user groups.

  11. Hit and lead criteria in drug discovery for infectious diseases of the developing world.

    Science.gov (United States)

    Katsuno, Kei; Burrows, Jeremy N; Duncan, Ken; Hooft van Huijsduijnen, Rob; Kaneko, Takushi; Kita, Kiyoshi; Mowbray, Charles E; Schmatz, Dennis; Warner, Peter; Slingsby, B T

    2015-11-01

    Reducing the burden of infectious diseases that affect people in the developing world requires sustained collaborative drug discovery efforts. The quality of the chemical starting points for such projects is a key factor in improving the likelihood of clinical success, and so it is important to set clear go/no-go criteria for the progression of hit and lead compounds. With this in mind, the Japanese Global Health Innovative Technology (GHIT) Fund convened with experts from the Medicines for Malaria Venture, the Drugs for Neglected Diseases initiative and the TB Alliance, together with representatives from the Bill &Melinda Gates Foundation, to set disease-specific criteria for hits and leads for malaria, tuberculosis, visceral leishmaniasis and Chagas disease. Here, we present the agreed criteria and discuss the underlying rationale.

  12. "Hits" emerge through self-organized coordination in collective response of free agents

    Science.gov (United States)

    Chakrabarti, Anindya S.; Sinha, Sitabhra

    2016-10-01

    Individuals in free societies frequently exhibit striking coordination when making independent decisions en masse. Examples include the regular appearance of hit products or memes with substantially higher popularity compared to their otherwise equivalent competitors or extreme polarization in public opinion. Such segregation of events manifests as bimodality in the distribution of collective choices. Here we quantify how apparently independent choices made by individuals result in a significantly polarized but stable distribution of success in the context of the box-office performance of movies and show that it is an emergent feature of a system of noninteracting agents who respond to sequentially arriving signals. The aggregate response exhibits extreme variability amplifying much smaller differences in individual cost of adoption. Due to self-organization of the competitive landscape, most events elicit only a muted response but a few stimulate widespread adoption, emerging as "hits".

  13. SUCCESS OF IMPLEMENTATION OF COMPUTER CRIME ACT (UU ITE NO.11 2008 (A Case Study in the Higher Education Institution in Indonesia

    Directory of Open Access Journals (Sweden)

    Rizki Yudhi Dewantara

    2017-06-01

    Full Text Available Computer crime rate grow rapidly along with the development of the digital world that has touched almost all aspects of human life. Institutions of higher education cannot be separated from the problem of computer crime activities. The paper analyses the implementation of Indonesia Computer Crime Act (UU ITE NO.11 2008 in the Higher Education Institution in Indonesia. It aims to investigate the level of computer crimes that occurred in the higher education institution environment and the act (UU ITE 11, 2008 successfully applied to prevent the crime that would arise. In this research, the analysis using Descriptive Statistics, Binary logistic regression. This paper also describes the success implementation of the Information System Security Policy (ISSP as a computer crime prevention policy in higher education institution in Indonesia. In factor of act, clarity of objectives and purpose of the UU ITE 11, 2008 was low, the communication and socialization activities are still low to the society especially to the higher education institution, moreover the control process has been running on UU ITE 11, 2008, but at a low level. Keywords: computer crime, computer crime act, public policy implementation  ABSTRAK  Kejahatan Komputer berkembang pesat sejalan dengan perkembangan dunia digital, pada institusi perguruan tinggi tidak dapat dipisahkan dari bagian kejahatan computer. Penelitian ini merupakan analisis kesuksesan penerapan undang-undang kejahatan komputer (UU ITE 11, 2008 di institusi perguruan tinggi di Indonesia. Penelitian ini bertujuan untuk mengetahui tingkat kejahatan komputer yang terjadi pada lingkungan institusi perguruan tinggi dan kesuksesan penerapan undang-undang kejahatan komputer untuk mencegah tindakan kejahatan komputer yang mungkin dapat terjadi maupun menangani kejahatan yang sedang terjadi. Berdasarkan tujuan penelitian, digunakan pendekatan quantitative dengan beberapa uji statistic antara lain analisis statistic

  14. The average number of alpha-particle hits to the cell nucleus required to eradicate a tumour cell population

    International Nuclear Information System (INIS)

    Roeske, John C; Stinchcomb, Thomas G

    2006-01-01

    Alpha-particle emitters are currently being considered for the treatment of micrometastatic disease. Based on in vitro studies, it has been speculated that only a few alpha-particle hits to the cell nucleus are considered lethal. However, such estimates do not consider the stochastic variations in the number of alpha-particle hits, energy deposited, or in the cell survival process itself. Using a tumour control probability (TCP) model for alpha-particle emitters, we derive an estimate of the average number of hits to the cell nucleus required to provide a high probability of eradicating a tumour cell population. In simulation studies, our results demonstrate that the average number of hits required to achieve a 90% TCP for 10 4 clonogenic cells ranges from 18 to 108. Those cells that have large cell nuclei, high radiosensitivities and alpha-particle emissions occurring primarily in the nuclei tended to require more hits. As the clinical implementation of alpha-particle emitters is considered, this type of analysis may be useful in interpreting clinical results and in designing treatment strategies to achieve a favourable therapeutic outcome. (note)

  15. Do pigeons prefer alternatives that include near-hit outcomes?

    Science.gov (United States)

    Stagner, Jessica P; Case, Jacob P; Sticklen, Mary F; Duncan, Amanda K; Zentall, Thomas R

    2015-07-01

    Pigeons show suboptimal choice on a gambling-like task similar to that shown by humans. Humans also show a preference for gambles in which there are near hits (losses that come close to winning). In the present research, we asked if pigeons would show a preference for alternatives with near-hit-like trials. In Experiment 1, we included an alternative that presented a near hit, in which a stimulus associated with reinforcement (a presumed conditioned reinforcer) changed to a stimulus associated with the absence of reinforcement (a presumed conditioned inhibitor). The pigeons tended to avoid this alternative. In Experiment 2, we varied the duration of the presumed conditioned reinforcer (2 vs. 8 s) that changed to a presumed conditioned inhibitor (8 vs. 2 s) and found that the longer the conditioned reinforcer was presented, the more the pigeons avoided it. In Experiment 3, the near-hit alternative involved an ambiguous stimulus for 8 s that changed to a presumed conditioned reinforcer (or a presumed conditioned inhibitor) for 2 s, but the pigeons still avoided it. In Experiment 4, we controlled for the duration of the conditioned reinforcer by presenting it first for 2 s followed by the ambiguous stimulus for 8 s. Once again, the pigeons avoided the alternative with the near-hit trials. In all 4 experiments, the pigeons tended to avoid alternatives that provided near-hit-like trials. We concluded that humans may be attracted to near-hit trials because near-hit trials give them the illusion of control, whereas this does not appear to be a factor for pigeons. (c) 2015 APA, all rights reserved).

  16. Combined hit theory-microdosimetric explanation of cellular radiobiological action

    International Nuclear Information System (INIS)

    Bond, V.P.; Varma, M.N.

    1983-01-01

    Hit theory is combined with microdosimetry in a stochastic approach that explains the observed responses of cell populations exposed in radiation fields of different qualities. The central thesis is that to expose a population of cells in a low-level radiation field is to subject the cells to the potential for interaction with charged particles in the vicinity of the cells, quantifiable in terms of the charged particle fluence theta. When such an interaction occurs there is a resulting stochastic transfer of energy to a critical volume (CV) of cross section sigma, within the cell(s). The severity of cell injury is dependent on the amount of energy thus imparted, or the hit size. If the severity is above some minimal level, there is a non-zero probability that the injury will result in a quantal effect (e.g., a mutational or carcinogenic initial event, cell transformation). A microdosimetric proportional counter, viewed here as a phantom cell CV that permits measurements not possible in the living cell, is used to determine the incidence of hit cells and the spectrum of hit sizes. Each hit is then weighted on the basis of an empirically-determined function that provides the fraction of cells responding quantally, as a function of hit size. The sum of the hits so weighted provides the incidence of quantally-responding cells, for any amount of exposure theta in a radiation field of any quality or mixture qualities. The hit size weighting function for pink mutations in Tradescantia is discussed, as are its implications in terms of a replacement for RBE and dose equivalent. 14 references, 9 figures

  17. A fast DSP-based calorimeter hit scanning system

    International Nuclear Information System (INIS)

    Sekikawa, S.; Arai, I.; Suzuki, A.; Watanabe, A.; Marlow, D.R.; Mindas, C.R.; Wixted, R.L.

    1997-01-01

    A custom made digital signal processor (DSP) based system has been developed to scan calorimeter hits read by a 32-channel FASTBUS waveform recorder board. The scanner system identifies hit calorimeter elements by surveying their discriminated outputs. This information is used to generate a list of addresses, which guides the read-out process. The system is described and measurements of the scan times are given. (orig.)

  18. Rare transformation to double hit lymphoma in Waldenstrom's macroglobulinemia.

    Science.gov (United States)

    Okolo, Onyemaechi N; Johnson, Ariel C; Yun, Seongseok; Arnold, Stacy J; Anwer, Faiz

    2017-08-01

    Waldenström macroglobulinemia (WM) is a lymphoproliferative lymphoma that is characterized by monoclonal immunoglobulin M (IgM) protein and bone marrow infiltration. Its incidence is rare and rarer still is its ability to transform to a B-cell lymphoma, particularly the aggressive diffuse large B-cell lymphoma, which bodes a poor prognosis. When transformation includes mutations of MYC, BCL-2 and/or BCL-6, it is known as a 'double hit' or 'triple hit' lymphoma respectively. This paper presents a rare case of WM with mutations positive for MYC and BCL2, making it a case of double hit B-cell lymphoplasmacytic lymphoma with plasmatic differentiation without morphological transformation to aggressive histology like DLBCL. The paper also broadens to include discussions on current topics in the classification, diagnosis, possible causes of transformation, and treatment of WM, including transformation to double hit lymphoma. The significance of this case lies in that the presence of double hit lymphoma-like genetic mutations in WM have not been previously described in the literature and potentially such changes are harbinger of extra-nodal presentation, aggressive growth, and possibly poor prognosis, if data from other double-hit lymphoma are extrapolated.

  19. Overview of the HIT-SI3 spheromak experiment

    Science.gov (United States)

    Hossack, A. C.; Jarboe, T. R.; Chandra, R. N.; Morgan, K. D.; Sutherland, D. A.; Everson, C. J.; Penna, J. M.; Nelson, B. A.

    2017-10-01

    The HIT-SI and HIT-SI3 spheromak experiments (a = 23 cm) study efficient, steady-state current drive for magnetic confinement plasmas using a novel method which is ideal for low aspect ratio, toroidal geometries. Sustained spheromaks show coherent, imposed plasma motion and low plasma-generated mode activity, indicating stability. Analysis of surface magnetic fields in HIT-SI indicates large n = 0 and 1 mode amplitudes and little energy in higher modes. Within measurement uncertainties all the n = 1 energy is imposed by the injectors, rather than being plasma-generated. The fluctuating field imposed by the injectors is sufficient to sustain the toroidal current through dynamo action whereas the plasma-generated field is not (Hossack et al., Phys. Plasmas, 2017). Ion Doppler spectroscopy shows coherent, imposed plasma motion inside r 10 cm in HIT-SI and a smaller volume of coherent motion in HIT-SI3. Coherent motion indicates the spheromak is stable and a lack of plasma-generated n = 1 energy indicates the maximum q is maintained below 1 for stability during sustainment. In HIT-SI3, the imposed mode structure is varied to test the plasma response (Hossack et al., Nucl. Fusion, 2017). Imposing n = 2, n = 3, or large, rotating n = 1 perturbations is correlated with transient plasma-generated activity. Work supported by the U.S. Department of Energy, Office of Science, Office of Fusion Energy Sciences, under Award Number DE-FG02-96ER54361.

  20. Verbs in the lexicon: Why is hitting easier than breaking?

    Science.gov (United States)

    McKoon, Gail; Love, Jessica

    2011-11-01

    Adult speakers use verbs in syntactically appropriate ways. For example, they know implicitly that the boy hit at the fence is acceptable but the boy broke at the fence is not. We suggest that this knowledge is lexically encoded in semantic decompositions. The decomposition for break verbs (e.g. crack, smash) is hypothesized to be more complex than that for hit verbs (e.g. kick, kiss). Specifically, the decomposition of a break verb denotes that "an entity changes state as the result of some external force" whereas the decomposition for a hit verb denotes only that "an entity potentially comes in contact with another entity." In this article, verbs of the two types were compared in a lexical decision experiment - Experiment 1 - and they were compared in sentence comprehension experiments with transitive sentences (e.g. the car hit the bicycle and the car broke the bicycle) - Experiments 2 and 3. In Experiment 1, processing times were shorter for the hit than the break verbs and in Experiments 2 and 3, processing times were shorter for the hit sentences than the break sentences, results that are in accord with the complexities of the postulated semantic decompositions.

  1. The successful implementation of a licensed data management interface between a Sunquest(®) laboratory information system and an AB SCIEX™ mass spectrometer.

    Science.gov (United States)

    French, Deborah; Terrazas, Enrique

    2013-01-01

    Interfacing complex laboratory equipment to laboratory information systems (LIS) has become a more commonly encountered problem in clinical laboratories, especially for instruments that do not have an interface provided by the vendor. Liquid chromatography-tandem mass spectrometry is a great example of such complex equipment, and has become a frequent addition to clinical laboratories. As the testing volume on such instruments can be significant, manual data entry will also be considerable and the potential for concomitant transcription errors arises. Due to this potential issue, our aim was to interface an AB SCIEX™ mass spectrometer to our Sunquest(®) LIS. WE LICENSED SOFTWARE FOR THE DATA MANAGEMENT INTERFACE FROM THE UNIVERSITY OF PITTSBURGH, BUT EXTENDED THIS WORK AS FOLLOWS: The interface was designed so that it would accept a text file exported from the AB SCIEX™ × 5500 QTrap(®) mass spectrometer, pre-process the file (using newly written code) into the correct format and upload it into Sunquest(®) via file transfer protocol. The licensed software handled the majority of the interface tasks with the exception of converting the output from the Analyst(®) software to the required Sunquest(®) import format. This required writing of a "pre-processor" by one of the authors which was easily integrated with the supplied software. We successfully implemented the data management interface licensed from the University of Pittsburgh. Given the coding that was required to write the pre-processor, and alterations to the source code that were performed when debugging the software, we would suggest that before a laboratory decides to implement such an interface, it would be necessary to have a competent computer programmer available.

  2. The successful implementation of a licensed data management interface between a Sunquest® laboratory information system and an AB SCIEX TM mass spectrometer

    Directory of Open Access Journals (Sweden)

    Deborah French

    2013-01-01

    Full Text Available Background: Interfacing complex laboratory equipment to laboratory information systems (LIS has become a more commonly encountered problem in clinical laboratories, especially for instruments that do not have an interface provided by the vendor. Liquid chromatography-tandem mass spectrometry is a great example of such complex equipment, and has become a frequent addition to clinical laboratories. As the testing volume on such instruments can be significant, manual data entry will also be considerable and the potential for concomitant transcription errors arises. Due to this potential issue, our aim was to interface an AB SCIEX TM mass spectrometer to our Sunquest® LIS. Materials and Methods: We licensed software for the data management interface from the University of Pittsburgh, but extended this work as follows: The interface was designed so that it would accept a text file exported from the AB SCIEX TM × 5500 QTrap® mass spectrometer, pre-process the file (using newly written code into the correct format and upload it into Sunquest® via file transfer protocol. Results: The licensed software handled the majority of the interface tasks with the exception of converting the output from the Analyst® software to the required Sunquest® import format. This required writing of a "pre-processor" by one of the authors which was easily integrated with the supplied software. Conclusions: We successfully implemented the data management interface licensed from the University of Pittsburgh. Given the coding that was required to write the pre-processor, and alterations to the source code that were performed when debugging the software, we would suggest that before a laboratory decides to implement such an interface, it would be necessary to have a competent computer programmer available.

  3. Spontaneous HIT syndrome post-knee replacement surgery with delayed recovery of thrombocytopenia: a case report and literature review.

    Science.gov (United States)

    Poudel, Dilli Ram; Ghimire, Sushil; Dhital, Rashmi; Forman, Daniel A; Warkentin, Theodore E

    2017-09-01

    associated with seroreversion to a negative SRA (documented at POD151). Our literature review identified joint replacement surgery, specifically knee replacement, to be a relatively common trigger of spontaneous HIT syndrome. Further, including our patient case, 5 of 7 patients with spontaneous HIT syndrome post-orthopedic surgery who received treatment with argatroban developed new and/or progressive lower-limb DVT or recurrent PE despite anticoagulation with this parenteral direct thrombin inhibitor, suggesting that this patient population is at high risk of breakthrough thrombotic events despite treatment with this HIT treatment-approved anticoagulant. Our case also illustrates successful outcome with rivaroxaban for treatment of spontaneous HIT syndrome, consistent with emerging literature supporting safety and efficacy of direct oral anticoagulant therapy for treatment of acute HIT.

  4. 77 FR 55217 - Health Information Technology Implementation

    Science.gov (United States)

    2012-09-07

    ... Information Technology Implementation AGENCY: Health Resources and Services Administration (HRSA), Department... effective use of Health Information Technology (HIT). SUPPLEMENTARY INFORMATION: Former Grantee of Record... advance information technology resources of Virginia's medically underserved communities, HCHC has...

  5. A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue.

    Science.gov (United States)

    Behkami, Nima A; Dorr, David A; Morrice, Stuart

    2010-01-01

    The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis.

  6. Developing Proper Systems for Successful Cloud Computing Implementation Using Fuzzy ARAS Method (Case Study: University of Tehran Faculty of New Science and Technology

    Directory of Open Access Journals (Sweden)

    Jalil Heidaryd Dahooie

    2017-12-01

    Full Text Available Given the increasing requirements of communication and the need for advanced network-based technologies, cloud computing has been suggested as a perfect strategy to achieve these objectives. Yet, despite the development of computing applications and the increased number of alternatives, it is quite a difficult task to select the exact software platform for the implementation of cloud computing arrangements. In this line, the present paper aimed to develop a scientific framework as how to select the proper software for successful cloud computing implantation at the infrastructure level. First through a review on the related literature and using experts’ opinions, the software selection criteria were extracted. Based on the framework proposed here, the interval-valued fuzzy ARAS method was then employed for weighting and prioritizing specified alternatives. This model was applied by the Faculty of New Sciences and Technologies of Tehran University in order to select proper software platforms from among five alternatives. The results revealed that the OpenStack cloud operating system has been selected as the best alternative, most probably because this platform demonstrates significant achievement for its merits such as high level of performance, reliability and security, stability, and usability.

  7. Successful implementation of ageing management exemplified at the cooling tower of Emsland nuclear power plant; Erfolgreiche Umsetzung von Alterungsmanagement am Beispiel Kuehlturm des Kernkraftwerkes Emsland

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Alexander [Hochtief Solutions AG, Consult IKS Energy, Frankfurt am Main (Germany). Design Kraftwerke; Dueweling, Carsten [Kernkraftwerke Lippe-Ems GmbH, Lingen (Germany). Abschnitt Bautechnik

    2013-07-15

    The present paper describes the successful implementation of the restoration of water-distribution channels at the cooling tower of the Emsland nuclear power plant under the aspect of ageing management. The main challenge of aging management is the determination of potential aging mechanism and to avoid systematically and effectively their damaging influences. In the course of the annual site inspections abnormalities at the lower side of the water-distribution channels of the cooling tower were detected, analysed, and repaired. The extraordinary high chlorine equivalent of the cooling water was identified as main reason of the damages located. Due to extensive infiltration into the concrete structure, chloride-induced corrosion generates a volume expansion of the reinforcement and thereby to a blast off of the concrete covering. According to the restoration concept, the damaged concrete was removed by maximum pressure water jet blasting; where necessary the reinforcement was retrofitted and a layered concrete substitution was applied by synthetic cement mortar. The realised procedures conserve the load bearing reinforcement only for a certain period, because the permanent chloride infiltration could not be stopped. Therefore, the structure has to be monitored permanently. (orig.)

  8. The successful accomplishment of nutritional and clinical outcomes via the implementation of a multidisciplinary nutrition support team in the neonatal intensive care unit.

    Science.gov (United States)

    Jeong, Eurim; Jung, Young Hwa; Shin, Seung Han; Kim, Moon Jin; Bae, Hye Jung; Cho, Yoon Sook; Kim, Kwi Suk; Kim, Hyang Sook; Moon, Jin Soo; Kim, Ee-Kyung; Kim, Han-Suk; Ko, Jae Sung

    2016-07-28

    Nutritional support is critical for preterm infants in the neonatal intensive care unit (NICU). A multidisciplinary nutritional support team (NST) that focuses on providing optimal and individualized nutrition care could be helpful. We conducted a thorough evaluation of clinical and nutritional outcomes in a tertiary NICU following the implementation of an NST. This study used a retrospective approach with historical comparisons. Preterm neonates nutritional outcomes were compared before and after the establishment of the NST. Medical records were reviewed, and clinical and nutritional outcomes were compared between the two groups. In total, 107 patients from the pre-NST period and 122 patients from the post-NST period were included. The cumulative energy delivery during the first week of life improved during the post-NST period (350.17 vs. 408.62 kcal/kg, p nutrition to preterm infants in the first week of life. There were also favorable clinical outcomes, such as increased weight gain and reduced length of ICU stay. Evaluable data remain sparse in the NICU setting with premature neonatal populations; therefore, the successful outcomes identified in this study may provide support for NST practices.

  9. Network analysis of metabolite GWAS hits

    DEFF Research Database (Denmark)

    Matone, Alice; Scott-Boyer, Marie-Pier; Carayol, Jerome

    2016-01-01

    BACKGROUND AND SCOPE: Weight loss success is dependent on the ability to refrain from regaining the lost weight in time. This feature was shown to be largely variable among individuals, and these differences, with their underlying molecular processes, are diverse and not completely elucidated. Al...

  10. Single-hit mechanism of tumour cell killing by radiation.

    Science.gov (United States)

    Chapman, J D

    2003-02-01

    To review the relative importance of the single-hit mechanism of radiation killing for tumour response to 1.8-2.0 Gy day(-1) fractions and to low dose-rate brachytherapy. Tumour cell killing by ionizing radiation is well described by the linear-quadratic equation that contains two independent components distinguished by dose kinetics. Analyses of tumour cell survival curves that contain six or more dose points usually provide good estimates of the alpha- and beta-inactivation coefficients. Superior estimates of tumour cell intrinsic radiosensitivity are obtained when synchronized populations are employed. The characteristics of single-hit inactivation of tumour cells are reviewed and compared with the characteristics of beta-inactivation. Potential molecular targets associated with single-hit inactivation are discussed along with strategies for potentiating cell killing by this mechanism. The single-hit mechanism of tumour cell killing shows no dependence on dose-rate and, consequently, no evidence of sublethal damage repair. It is uniquely potentiated by high linear-energy-transfer radiation, exhibits a smaller oxygen enhancement ratio and exhibits a larger indirect effect by hydroxyl radicals than the beta-mechanism. alpha-inactivation coefficients vary slightly throughout interphase but mitotic cells exhibit extremely high alpha-coefficients in the range of those observed for lymphocytes and some repair-deficient cells. Evidence is accumulating to suggest that chromatin in compacted form could be a radiation-hypersensitive target associated with single-hit radiation killing. Analyses of tumour cell survival curves demonstrate that it is the single-hit mechanism (alpha) that determines the majority of cell killing after doses of 2Gy and that this mechanism is highly variable between tumour cell lines. The characteristics of single-hit inactivation are qualitatively and quantitatively distinct from those of beta-inactivation. Compacted chromatin in tumour cells

  11. 75 FR 21629 - HIT Standards Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2010-04-26

    ... Technology; HIT Standards Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National... only. Name of Committees: HIT Standards Committee's Workgroups: Clinical Operations Vocabulary... developed by the HIT Policy Committee. Date and Time: The HIT Standards Committee Workgroups will hold the...

  12. 76 FR 46297 - HIT Standards Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-08-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Standards Committee's... developed by the HIT Policy Committee. Date and Time: The HIT Standards Committee Workgroups will hold the...

  13. 75 FR 62399 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-10-08

    ... Technology; HIT Standards Committee Schedule for the Assessment of HIT Policy Committee Recommendations.... SUMMARY: Section 3003(b)(3) of the American Recovery and Reinvestment Act of 2009 mandates that the HIT Standards Committee develop a schedule for the assessment of policy recommendations developed by the HIT...

  14. 77 FR 66617 - HIT Policy and Standards Committees; Workgroup Application Database

    Science.gov (United States)

    2012-11-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy and Standards Committees; Workgroup Application... of New ONC HIT FACA Workgroup Application Database. The Office of the National Coordinator (ONC) has.... Name of Committees: HIT Standards Committee and HIT Policy Committee. General Function of the...

  15. Global programme to demonstrate the viability and removal of barriers that impede adoption and successful implementation of available, non-combustion technologies for destroying persistent organic pollutants (POPs)

    International Nuclear Information System (INIS)

    2005-01-01

    The objective of the Global Programme, in line with the strategic priorities of GEF Business Plan FY04-06, is to demonstrate the viability and removal of barriers that impede adoption and successful implementation of available non-combustion technologies for use in the destruction of obsolete Persistent Organic Pollutants (POPs) stockpiles and wastes, more specifically PCBs wastes in developing countries and countries with economies in transition. This specific Project (Slovakia Project), part of the Global Programme, will introduce and apply such technologies to destroy significant obsolete PCBs wastes in Slovakia, and will help remove barriers to the further adoption and effective implementation of available non-combustion technologies and meet the Stockholm Convention requirement to ensure the use of Best Available Techniques (BAT) and Best Environmental Practices (BEP). The [final draft of the] National Implementation Plan (NIP) in Slovakia favors the application of non-combustion technologies to destroy POPs. The Project will make available all technical, economic and financial parameters of the selected technology in a comparative, open and transparent way that would facilitate and provide further incentive to the global diffusion of innovative alternative non-combustion technologies. The GEF Council has approved (May 2004) a Project Brief for a similar activity in the Philippines. The GEF Slovakia Project will last 70 months. The first twenty-four months will be committed to parallel activities of a tendering process, obtaining necessary operating permits, including conducting necessary environmental impact analyses; designing, constructing and testing of the non-combustion technology to be deployed; and generally planning and organizing, among other things, such activities as a comprehensive public participation and involvement plan, and a comprehensive, participatory monitoring and evaluation plan. The next eighteen months of Project time would involve the

  16. Referral management centres as a means of reducing outpatients attendances: how do they work and what influences successful implementation and perceived effectiveness?

    Science.gov (United States)

    Ball, Sarah L; Greenhalgh, Joanne; Roland, Martin

    2016-03-24

    The rising volume of referrals to secondary care is a continuing concern in the NHS in England, with considerable resource implications. Referral management centres (RMCs) are one of a range of initiatives brought in to curtail this rise, but there is currently limited evidence for their effectiveness, and little is known about their mechanisms of action. This study aimed to gain a better understanding of how RMCs operate and the factors contributing to the achievement of their goals. Drawing on the principles of realist evaluation, we sought to elicit programme theories (the ideas and assumptions about how a programme works) and to identify the key issues to be considered when establishing or evaluating such schemes. Qualitative study with a purposive sample of health professionals and managers involved in the commissioning, set-up and running of four referral management centres in England and with GPs referring through these centres. Semi-structured interviews were conducted with 18 participants. Interviews were audio-recorded and transcribed. Data were analysed thematically. Interview data highlighted the diverse aims and functions of RMCs, reflecting a range of underlying programme theories. These included the overarching theory that RMCs work by ensuring the best use of limited resources and three sub-theories, relating to how this could be achieved, namely, improving the quality of referrals and patient care, reducing referrals, and increasing efficiency in the referral process. The aims of the schemes, however, varied between sites and between stakeholders, and evolved significantly over time. Three themes were identified relating to the context in which RMCs were implemented and managed: the impact of practical and administrative difficulties; the importance and challenge of stakeholder buy-in; and the dependence of perceived effectiveness on the aims and priorities of the scheme. Many RMCs were described as successful by those involved, despite limited

  17. A success story of regional projects implemented for the management of marine environment. Turkish experience related to the black sea and the mediterranean sea

    International Nuclear Information System (INIS)

    Goktepe, B.G.; Gungor, N.; Gungor, E.; Karakelle, B.

    2004-01-01

    Full text: A wide scope Regional Technical Co-operation Project RER/2/003 'Marine Environmental Assessment of the Black Sea Region' is implemented by the International Atomic Energy Agency (IAEA) in the period 1995-2001. This project was initiated in response to the needs of participating Member States - the six Black Sea coastal countries (Bulgaria, Romania, Ukraine, Russian Federation, Georgia and Turkey) to establish capabilities for reliably assessing radionuclides in the Black Sea environment and applying tracer techniques to marine pollution studies The project has various important aspects: Scientifically; one of the major environmental issue radioactivity pollution is addressed. Technically; laboratory capability for transuranic analysis is being developed. Economically; the reversing the ecological deterioration and developing sustainable uses of the Black Sea and its natural resources is one of the major interests. Politically; responsibility of pollution control and rehabilitation plans of six Black Sea countries are addressed through various convention and declarations. Socio-economically, fisheries and tourism sectors are expected to benefit. Highlights from the joint radioactivity-monitoring program of the project among six Black Sea countries are outlined. Examples from the Turkish monitoring work consist of the routine sampling of seawater, algae, mussels, fish samples and beach sand from the selected stations along the Black Sea coast are presented for illustration. The success of the Black Sea regional project has given rise to a new regional project 'Marine Environmental Assessment of the Mediterranean Region' based on the request of the member countries, which will be initiated in 2005 by the IAEA. The initial phase the project, its objectives and the schedule will be summarized. Key words: marine radioactivity, environmental management, Black Sea, Mediterranean Sea, regional cooperation

  18. What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.

    Science.gov (United States)

    Gjestsen, Martha Therese; Wiig, Siri; Testad, Ingelin

    2017-09-07

    To identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care. A single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality's perspective. The data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis. The main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this. Aligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  19. How to hit HIV where it hurts

    Science.gov (United States)

    Chakraborty, Arup

    No medical procedure has saved more lives than vaccination. But, today, some pathogens have evolved which have defied successful vaccination using the empirical paradigms pioneered by Pasteur and Jenner. One characteristic of many pathogens for which successful vaccines do not exist is that they present themselves in various guises. HIV is an extreme example because of its high mutability. This highly mutable virus can evade natural or vaccine induced immune responses, often by mutating at multiple sites linked by compensatory interactions. I will describe first how by bringing to bear ideas from statistical physics (e.g., maximum entropy models, Hopfield models, Feynman variational theory) together with in vitro experiments and clinical data, the fitness landscape of HIV is beginning to be defined with explicit account for collective mutational pathways. I will describe how this knowledge can be harnessed for vaccine design. Finally, I will describe how ideas at the intersection of evolutionary biology, immunology, and statistical physics can help guide the design of strategies that may be able to induce broadly neutralizing antibodies.

  20. Influence of Running on Pistol Shot Hit Patterns.

    Science.gov (United States)

    Kerkhoff, Wim; Bolck, Annabel; Mattijssen, Erwin J A T

    2016-01-01

    In shooting scene reconstructions, risk assessment of the situation can be important for the legal system. Shooting accuracy and precision, and thus risk assessment, might be correlated with the shooter's physical movement and experience. The hit patterns of inexperienced and experienced shooters, while shooting stationary (10 shots) and in running motion (10 shots) with a semi-automatic pistol, were compared visually (with confidence ellipses) and statistically. The results show a significant difference in precision (circumference of the hit patterns) between stationary shots and shots fired in motion for both inexperienced and experienced shooters. The decrease in precision for all shooters was significantly larger in the y-direction than in the x-direction. The precision of the experienced shooters is overall better than that of the inexperienced shooters. No significant change in accuracy (shift in the hit pattern center) between stationary shots and shots fired in motion can be seen for all shooters. © 2015 American Academy of Forensic Sciences.

  1. Recent results from the HIT-II and HIT-SI helicity injection current drive experiments

    International Nuclear Information System (INIS)

    Jarboe, T.R.; Hamp, W.T.; Izzo, V.A.; Nelson, B.A.; O'Neill, R.G.; Raman, R.; Redd, A.J.; Sieck, P.E.; Smith, R.J.

    2005-01-01

    Three important results are reported. 1) CHI startup has produced 100 kA of closed current without using poloidal field (PF) coils or any transformer action. The initial equilibrium is then driven to 240 kA with a 3 V transformer loop voltage, indicating high quality plasma. 2) For the first time CHI alone has produced toroidal currents (350 kA) that far exceed q a I inj , and with I p /I tf as high as 1.2. The key to these new results appears to be having the toroidal field small enough that relaxation will occur. 3) The steady inductive helicity injection spheromak experiment has operated at 5 kHz for 6 ms with current amplitudes up to 11 kA in each injector. The helicity injection rate is nearly constant with the ExB flow always into the plasma and not into the walls. NIMROD simulations of HIT-SI show a buildup of spheromak fields. (author)

  2. Multi-hit time-to-amplitude CAMAC module (MTAC)

    International Nuclear Information System (INIS)

    Kang, H.

    1980-10-01

    A Multi-Hit Time-to-Amplitude Module (MTAC) for the SLAC Mark III drift chamber system has been designed to measure drift time by converting time-proportional chamber signals into analog levels, and converting the analog data by slow readout via a semi-autonomous controller in a CAMAC crate. The single width CAMAC module has 16 wire channels, each with a 4-hit capacity. An externally generated common start initiates an internal precision ramp voltage which is then sampled using a novel shift register gating scheme and CMOS sampling switches. The detailed design and performance specifications are described

  3. Does ′heparin-induced thrombocytopenia′ hit our minds?

    Directory of Open Access Journals (Sweden)

    Arun R Thangavel

    2016-01-01

    Full Text Available Unfractionated heparin is a widely used drug to prevent deep vein thrombosis and pulmonary emboli in patients at risk. With the advent of newer anticoagulants having lesser side effects, its use has diminished but not out of service. Here, we report a case of deep venous thrombosis, in a patient on prophylactic dose of heparin, which was later found to be a manifestation of heparin-induced thrombocytopenia (HIT. Thrombosis in the presence of heparin prophylaxis should be considered as HIT rather than a failure of anticoagulation.

  4. Direct determination of the hit locations from experimental HPGe pulses

    Energy Technology Data Exchange (ETDEWEB)

    Désesquelles, P., E-mail: Pierre.Desesquelles@in2p3.fr [Univ. Paris-Sud, CSNSM CNRS/IN2P3, 15 rue G. Clémenceau, 91405 Orsay (France); Boston, A.J.; Boston, H.C.; Cresswell, J.R.; Dimmock, M.R. [Oliver Lodge Laboratory, The University of Liverpool, Oxford Street, Liverpool L69 7ZE (United Kingdom); Lazarus, I.H. [STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD (United Kingdom); Ljungvall, J. [Univ. Paris-Sud, CSNSM CNRS/IN2P3, 15 rue G. Clémenceau, 91405 Orsay (France); Nelson, L. [Oliver Lodge Laboratory, The University of Liverpool, Oxford Street, Liverpool L69 7ZE (United Kingdom); Nga, D.-T. [Univ. Paris-Sud, CSNSM CNRS/IN2P3, 15 rue G. Clémenceau, 91405 Orsay (France); Nolan, P.J.; Rigby, S.V. [Oliver Lodge Laboratory, The University of Liverpool, Oxford Street, Liverpool L69 7ZE (United Kingdom); Simpson, J. [STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD (United Kingdom); Van-Oanh, N.-T. [Univ. Paris-Sud, LCP UMR8000 CNRS, 15 rue G. Clémenceau, 91405 Orsay (France)

    2013-11-21

    The gamma-tracking technique optimises the determination of the energy and emission angle of gamma-rays detected by modern segmented HPGe detectors. This entails the determination, using the delivered pulse shapes, of the interaction points of the gamma-ray within the crystal. The direct method presented here allows the localisation of the hits using only a large sample of pulses detected in the actual operating conditions. No external crystal scanning system or pulse shape simulation code is needed. In order to validate this method, it is applied to sets of pulses obtained using the University of Liverpool scanning system. The hit locations are determined by the method with good precision.

  5. Possilibity of estimating payoff matrix from model for hit phenomena

    International Nuclear Information System (INIS)

    Ishii, Akira; Sakaidani, Shota; Iwanaga, Saori

    2016-01-01

    The conflicts of topics on social media is considered using an extended mathematical model based on the mathematical model for hit phenomena that has been used to analyze entertainment hits. The social media platform used in this study was blog. The calculation results shows examples of strong conflict, weak conflict, and no conflict cases. Since the conflict of two topics can be considered in the framework of game theory, the results can be used to determine each matrix element of the payoff matrix of game theory.

  6. The New HIT: Human Health Information Technology.

    Science.gov (United States)

    Leung, Tiffany I; Goldstein, Mary K; Musen, Mark A; Cronkite, Ruth; Chen, Jonathan H; Gottlieb, Assaf; Leitersdorf, Eran

    2017-01-01

    Humanism in medicine is defined as health care providers' attitudes and actions that demonstrate respect for patients' values and concerns in relation to their social, psychological and spiritual life domains. Specifically, humanistic clinical medicine involves showing respect for the patient, building a personal connection, and eliciting and addressing a patient's emotional response to illness. Health information technology (IT) often interferes with humanistic clinical practice, potentially disabling these core aspects of the therapeutic patient-physician relationship. Health IT has evolved rapidly in recent years - and the imperative to maintain humanism in practice has never been greater. In this vision paper, we aim to discuss why preserving humanism is imperative in the design and implementation of health IT systems.

  7. Physikshow is a hit in the Globe

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Students from the University of Bonn put on three highly successful performances of their "Physikshow", a theatrical journey into the world of particles.   All you need is a bit of imagination and stage management for even the most abstract of physics to become entertaining and intelligible, a principle demonstrated by 20 students from the University of Bonn and their teachers who gave three performances of their "Physikshow" in the Globe of Science and Innovation. The students quickly won over their audience using an array of amazing experiments and wacky sketches to illustrate the world of particles, the principle of forces and the evolution of the cosmos. More than 370 pupils from local secondary schools in France and the Cantons of Geneva and Vaud travelled to CERN for the two performances specially reserved for schools. The audience for the public performance numbered no fewer than 250. Physikshow was first performed in 2002 and has evolved over the years th...

  8. Single Hit Energy-resolved Laue Diffraction

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Shamim; Suggit, Matthew J.; Stubley, Paul G.; Ciricosta, Orlando; Wark, Justin S.; Higginbotham, Andrew [Clarendon Laboratory, Department of Physics, University of Oxford, Parks Road, Oxford OX1 3PU (United Kingdom); Hawreliak, James A.; Collins, Gilbert W.; Eggert, Jon H. [Lawrence Livermore National Laboratory, Livermore, California 94550 (United States); Comley, Andrew J.; Foster, John M. [Atomic Weapons Establishment, Aldermaston, Reading RG7 4PR (United Kingdom)

    2015-05-15

    In situ white light Laue diffraction has been successfully used to interrogate the structure of single crystal materials undergoing rapid (nanosecond) dynamic compression up to megabar pressures. However, information on strain state accessible via this technique is limited, reducing its applicability for a range of applications. We present an extension to the existing Laue diffraction platform in which we record the photon energy of a subset of diffraction peaks. This allows for a measurement of the longitudinal and transverse strains in situ during compression. Consequently, we demonstrate measurement of volumetric compression of the unit cell, in addition to the limited aspect ratio information accessible in conventional white light Laue. We present preliminary results for silicon, where only an elastic strain is observed. VISAR measurements show the presence of a two wave structure and measurements show that material downstream of the second wave does not contribute to the observed diffraction peaks, supporting the idea that this material may be highly disordered, or has undergone large scale rotation.

  9. Single Hit Energy-resolved Laue Diffraction

    International Nuclear Information System (INIS)

    Patel, Shamim; Suggit, Matthew J.; Stubley, Paul G.; Ciricosta, Orlando; Wark, Justin S.; Higginbotham, Andrew; Hawreliak, James A.; Collins, Gilbert W.; Eggert, Jon H.; Comley, Andrew J.; Foster, John M.

    2015-01-01

    In situ white light Laue diffraction has been successfully used to interrogate the structure of single crystal materials undergoing rapid (nanosecond) dynamic compression up to megabar pressures. However, information on strain state accessible via this technique is limited, reducing its applicability for a range of applications. We present an extension to the existing Laue diffraction platform in which we record the photon energy of a subset of diffraction peaks. This allows for a measurement of the longitudinal and transverse strains in situ during compression. Consequently, we demonstrate measurement of volumetric compression of the unit cell, in addition to the limited aspect ratio information accessible in conventional white light Laue. We present preliminary results for silicon, where only an elastic strain is observed. VISAR measurements show the presence of a two wave structure and measurements show that material downstream of the second wave does not contribute to the observed diffraction peaks, supporting the idea that this material may be highly disordered, or has undergone large scale rotation

  10. Hit Identification and Optimization in Virtual Screening: Practical Recommendations Based Upon a Critical Literature Analysis

    Science.gov (United States)

    Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B.; Szukala, Richard; Johnson, Michael E.; Hevener, Kirk E.

    2013-01-01

    A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, drug-like, and ADMET filters were applied to the reported hits to assess the quality of compounds reported and a careful analysis of a subset of the studies which presented hit optimization was performed. This data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, defining hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria. PMID:23688234

  11. Hit identification and optimization in virtual screening: practical recommendations based on a critical literature analysis.

    Science.gov (United States)

    Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B; Szukala, Richard; Johnson, Michael E; Hevener, Kirk E

    2013-09-12

    A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses, and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, druglike, and ADMET filters were applied to the reported hits to assess the quality of compounds reported, and a careful analysis of a subset of the studies that presented hit optimization was performed. These data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, definition of hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria.

  12. Do repeated rumble strip hits improve driver alertness?

    NARCIS (Netherlands)

    Watling, C.N.; Akerstedt, T.; Kecklund, L.G.; Anund, A.

    2016-01-01

    Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective

  13. Madoff Debacle Hits Colleges and Raises Questions about Trustee Conflicts

    Science.gov (United States)

    Fain, Paul

    2009-01-01

    Several colleges and universities lost millions in the alleged $50-billion Ponzi scheme run by the Wall Street trader Bernard L. Madoff. The losses include institutions' endowment holdings in hedge funds that were invested with Madoff as well as hits taken by supporting foundations and donors. Several foundations that have been active in higher…

  14. The probability of a tornado missile hitting a target

    International Nuclear Information System (INIS)

    Goodman, J.; Koch, J.E.

    1983-01-01

    It is shown that tornado missile transportation is a diffusion Markovian process. Therefore, the Green's function method is applied for the estimation of the probability of hitting a unit target area. This propability is expressed through a joint density of tornado intensity and path area, a probability of tornado missile injection and a tornado missile height distribution. (orig.)

  15. Concentrated Hitting Times of Randomized Search Heuristics with Variable Drift

    DEFF Research Database (Denmark)

    Lehre, Per Kristian; Witt, Carsten

    2014-01-01

    Drift analysis is one of the state-of-the-art techniques for the runtime analysis of randomized search heuristics (RSHs) such as evolutionary algorithms (EAs), simulated annealing etc. The vast majority of existing drift theorems yield bounds on the expected value of the hitting time for a target...

  16. COPD: A stepwise or a hit hard approach?

    Directory of Open Access Journals (Sweden)

    A.J. Ferreira

    2016-07-01

    Full Text Available Current guidelines differ slightly on the recommendations for treatment of Chronic Obstructive Pulmonary Disease (COPD patients, and although there are some undisputed recommendations, there is still debate regarding the management of COPD. One of the hindrances to deciding which therapeutic approach to choose is late diagnosis or misdiagnosis of COPD. After a proper diagnosis is achieved and severity assessed, the choice between a stepwise or “hit hard” approach has to be made. For GOLD A patients the stepwise approach is recommended, whilst for B, C and D patients this remains debatable. Moreover, in patients for whom inhaled corticosteroids (ICS are recommended, a step-up or “hit hard” approach with triple therapy will depend on the patient's characteristics and, for patients who are being over-treated with ICS, ICS withdrawal should be performed, in order to optimize therapy and reduce excessive medications.This paper discusses and proposes stepwise, “hit hard”, step-up and ICS withdrawal therapeutic approaches for COPD patients based on their GOLD group. We conclude that all approaches have benefits, and only a careful patient selection will determine which approach is better, and which patients will benefit the most from each approach. Keywords: COPD, Stepwise, Hit hard, Step-up, ICS withdrawal, Bronchodilators, ICS

  17. Biophysics: for HTS hit validation, chemical lead optimization, and beyond.

    Science.gov (United States)

    Genick, Christine C; Wright, S Kirk

    2017-09-01

    There are many challenges to the drug discovery process, including the complexity of the target, its interactions, and how these factors play a role in causing the disease. Traditionally, biophysics has been used for hit validation and chemical lead optimization. With its increased throughput and sensitivity, biophysics is now being applied earlier in this process to empower target characterization and hit finding. Areas covered: In this article, the authors provide an overview of how biophysics can be utilized to assess the quality of the reagents used in screening assays, to validate potential tool compounds, to test the integrity of screening assays, and to create follow-up strategies for compound characterization. They also briefly discuss the utilization of different biophysical methods in hit validation to help avoid the resource consuming pitfalls caused by the lack of hit overlap between biophysical methods. Expert opinion: The use of biophysics early on in the drug discovery process has proven crucial to identifying and characterizing targets of complex nature. It also has enabled the identification and classification of small molecules which interact in an allosteric or covalent manner with the target. By applying biophysics in this manner and at the early stages of this process, the chances of finding chemical leads with novel mechanisms of action are increased. In the future, focused screens with biophysics as a primary readout will become increasingly common.

  18. Markov chains with quasitoeplitz transition matrix: first zero hitting

    Directory of Open Access Journals (Sweden)

    Alexander M. Dukhovny

    1989-01-01

    Full Text Available This paper continues the investigation of Markov Chains with a quasitoeplitz transition matrix. Generating functions of first zero hitting probabilities and mean times are found by the solution of special Riemann boundary value problems on the unit circle. Duality is discussed.

  19. First hitting probabilities for semi markov chains and estimation

    DEFF Research Database (Denmark)

    Georgiadis, Stylianos

    2017-01-01

    We first consider a stochastic system described by an absorbing semi-Markov chain with finite state space and we introduce the absorption probability to a class of recurrent states. Afterwards, we study the first hitting probability to a subset of states for an irreducible semi-Markov chain...

  20. Assessing the lipophilicity of fragments and early hits

    Science.gov (United States)

    Mortenson, Paul N.; Murray, Christopher W.

    2011-07-01

    A key challenge in many drug discovery programs is to accurately assess the potential value of screening hits. This is particularly true in fragment-based drug design (FBDD), where the hits often bind relatively weakly, but are correspondingly small. Ligand efficiency (LE) considers both the potency and the size of the molecule, and enables us to estimate whether or not an initial hit is likely to be optimisable to a potent, druglike lead. While size is a key property that needs to be controlled in a small molecule drug, there are a number of additional properties that should also be considered. Lipophilicity is amongst the most important of these additional properties, and here we present a new efficiency index (LLEAT) that combines lipophilicity, size and potency. The index is intuitively defined, and has been designed to have the same target value and dynamic range as LE, making it easily interpretable by medicinal chemists. Monitoring both LE and LLEAT should help both in the selection of more promising fragment hits, and controlling molecular weight and lipophilicity during optimisation.

  1. Stories from the Front Lines of Student Success: The Implementation and Progress of Near Peer Mentoring Programs in Alaska and Idaho. Western Policy Exchanges

    Science.gov (United States)

    Krueger, Carl

    2016-01-01

    This brief provides an overview of the implementation and impact of near peer mentoring programs in Alaska and Idaho from the standpoint of both existing research and the near peers themselves. While progress is being monitored as part of state College Access Challenge Grant (CACG) program implementation and activity, only limited data on the…

  2. Nedley Depression Hit Hypothesis: Identifying Depression and Its Causes.

    Science.gov (United States)

    Nedley, Neil; Ramirez, Francisco E

    2016-11-01

    Depression is often diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. We propose how certain lifestyle choices and non-modifiable factors can predict the development of depression. We identified 10 cause categories (hits or "blows" to the brain) and theorize that four or more active hits could trigger a depression episode. Methods. A sample of 4271 participants from our community-based program (70% female; ages 17-94 years) was assessed at baseline and at the eighth week of the program using a custom test. Ten cause categories were examined as predictors of depression are (1) Genetic, (2)Developmental, (3)Lifestyle, (4)Circadian Rhythm, (5)Addiction, (6)Nutrition, (7)Toxic, (8)Social/Complicated Grief, (9)Medical Condition, and (10)Frontal Lobe. Results. The relationship between the DSM-5 score and a person having four hits categories in the first program week showed a sensitivity of 89.98 % (95% CI: 89.20 % - 90.73%), specificity 48.84% (CI 45.94-51.75) and Matthew Correlation Coefficient (MCC) .41 . For the eight-week test, the results showed a sensitivity 83.6% (CI 81.9-85.5), specificity 53.7% (CI 51.7-55.6) and MCC .38. Overall, the hits that improved the most from baseline after the eighth week were: Nutrition (47%), Frontal lobe (36%), Addiction (24%), Circadian rhythm (24%), Lifestyle (20%), Social (12%) and Medical (10%). Conclusions. The Nedley four-hit hypothesis seems to predict a depressive episode and correlates well with the DSM-5 criteria with good sensitivity and MCC but less specificity. Identifying these factors and applying lifestyle therapies could play an important role in the treatment of depressed individuals.

  3. Target Immobilization as a Strategy for NMR-Based Fragment Screening: Comparison of TINS, STD, and SPR for Fragment Hit Identification

    NARCIS (Netherlands)

    Kobayashi, M.; Retra, K.; Figaroa, F.; Hollander, J.G.; Ab, E.; Heetebrij, R.J.; Irth, H.; Siegal, G.

    2010-01-01

    Fragment-based drug discovery (FBDD) has become a widely accepted tool that is complementary to high-throughput screening (HTS) in developing small-molecule inhibitors of pharmaceutical targets. Because a fragment campaign can only be as successful as the hit matter found, it is critical that the

  4. Identifying and Synchronizing Health Information Technology (HIT) Events from FDA Medical Device Reports.

    Science.gov (United States)

    Kang, Hong; Wang, Frank; Zhou, Sicheng; Miao, Qi; Gong, Yang

    2017-01-01

    Health information technology (HIT) events, a subtype of patient safety events, pose a major threat and barrier toward a safer healthcare system. It is crucial to gain a better understanding of the nature of the errors and adverse events caused by current HIT systems. The scarcity of HIT event-exclusive databases and event reporting systems indicates the challenge of identifying the HIT events from existing resources. FDA Manufacturer and User Facility Device Experience (MAUDE) database is a potential resource for HIT events. However, the low proportion and the rapid evolvement of HIT-related events present challenges for distinguishing them from other equipment failures and hazards. We proposed a strategy to identify and synchronize HIT events from MAUDE by using a filter based on structured features and classifiers based on unstructured features. The strategy will help us develop and grow an HIT event-exclusive database, keeping pace with updates to MAUDE toward shared learning.

  5. Hitting a High Note on Math Tests: Remembered Success Influences Test Preferences

    Science.gov (United States)

    Finn, Bridgid; Miele, David B.

    2016-01-01

    Remembered utility is the retrospective evaluation about the pleasure and pain associated with a past experience. It can influence choices about repeating or avoiding similar situations in the future (Kahneman, 2000). A set of 5 experiments explored the remembered utility of effortful test episodes and how it impacted future test choices.…

  6. The Challenges and Success of Implementing Climate Studies Lessons for Pre-Professional Teachers at a Small Historically Black College to Engage Student Teaching of Science Pedagogy and Content Skill Based Learning.

    Science.gov (United States)

    Arnold, J.; Wider-Lewis, F.; Miller-Jenkins, A.

    2017-12-01

    This poster is a description of the challenges and success of implementing climate studies lessons for pre-service teachers to engage student teaching pedagogy and content skill based learning. Edward Waters College is a historical black college with an elementary education teacher program focused on urban elementary school teaching and learning. Pre-Service Elementary Educator Students often have difficulty with science and mathematics content and pedagogy. This poster will highlight the barriers and successes of using climate studies lessons to develop and enhance pre-service teachers' knowledge of elementary science principles particularly related to climate studies, physical and earth space science.

  7. DEPDC5 takes a second hit in familial focal epilepsy.

    Science.gov (United States)

    Anderson, Matthew P

    2018-04-30

    Loss-of-function mutations in a single allele of the gene encoding DEP domain-containing 5 protein (DEPDC5) are commonly linked to familial focal epilepsy with variable foci; however, a subset of patients presents with focal cortical dysplasia that is proposed to result from a second-hit somatic mutation. In this issue of the JCI, Ribierre and colleagues provide several lines of evidence to support second-hit DEPDC5 mutations in this disorder. Moreover, the authors use in vivo, in utero electroporation combined with CRISPR-Cas9 technology to generate a murine model of the disease that recapitulates human manifestations, including cortical dysplasia-like changes, focal seizures, and sudden unexpected death. This study provides important insights into familial focal epilepsy and provides a preclinical model for evaluating potential therapies.

  8. Tolosa-Hunt Syndrome in Double-Hit Lymphoma

    Directory of Open Access Journals (Sweden)

    Prakash Peddi

    2015-01-01

    Full Text Available Tolosa-Hunt syndrome (THS is a painful condition characterized by hemicranial pain, retroorbital pain, loss of vision, oculomotor nerve paralysis, and sensory loss in distribution of ophthalmic and maxillary division of trigeminal nerve. Lymphomas rarely involve cavernous sinus and simulate Tolosa-Hunt syndrome. Here we present a first case of double-hit B cell lymphoma (DHL relapsing and masquerading as Tolosa-Hunt syndrome. The neurological findings were explained by a lymphomatous infiltration of the right Gasserian ganglion which preceded systemic relapse. As part of this report, the diagnostic criteria for Tolosa-Hunt syndrome and double-hit lymphoma are reviewed and updated treatment recommendations are presented.

  9. Exploring the Success Factors of E-crm Implementation on B2c E-commerce: Satisfaction and Loyalty a Conceptual Framework

    OpenAIRE

    Zatalini, Malicha Aulia; Pamungkas, Trisna Nugraha

    2017-01-01

    E-CRM has an important role in addressing the challenges that exist in the e-commerce industry and certainly affect the success of e-commerce. One measure of the success of e-commerce is the customer satisfaction. The purpose of this study was to determine the factors that influence the achievement of satisfaction of existing customers in the industry e-commerce, Business to Consumer (B2C) in particular, so customer will be loyal. The researchers used meta-analysis to integrate the findings o...

  10. Heparin- induced thrombocytopenia (HIT: a case report of CABG patient

    Directory of Open Access Journals (Sweden)

    Alireza Jahangirifard

    2016-08-01

    Full Text Available Heparin- induced thrombocytopenia (HIT is an antibody mediated adverse effect of heparin therapy which is classified into two subtypes, HITI which is non-immune, spontaneously reversible thrombocytopenia and; HITII which is an autoimmune-mediated adverse effect of heparin therapy. In this case report, we described a 65-year old male patient with HITII after coronary artery bypass grafting.Key words: Heparin- induced thrombocytopenia, Heparin- induced thrombosis, coronary artery bypass grafting.

  11. 76 FR 46298 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-08-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held virtually on August 17, 2011...

  12. 77 FR 16035 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-03-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on March 27, 2012, from 9 a.m...

  13. 75 FR 65636 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-10-26

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards... Strategic Plan, and in accordance with policies developed by the HIT Policy Committee. Date and Time: The...

  14. 76 FR 79684 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-12-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on January 25, 2012, from 9 a...

  15. 76 FR 50734 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-08-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on September 28, 2011, from 9...

  16. 77 FR 2727 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-01-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on February 29, 2012, from 9...

  17. 77 FR 15760 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-03-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on April 18, 2012, from 9 a.m...

  18. 76 FR 14976 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-03-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on April 20, 2011, from 9 a.m...

  19. 76 FR 70455 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-11-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on December 14, 2011, from 9...

  20. 75 FR 5595 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2010-02-03

    ... Technology HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National... Health Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT... Federal Health IT Strategic Plan, and in accordance with policies developed by the HIT Policy Committee...

  1. 76 FR 39109 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-07-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on July 20, 2011, from 9 a.m...

  2. 77 FR 73661 - HIT Standards Committee Advisory Meetings; Notice of Meetings

    Science.gov (United States)

    2012-12-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meetings; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: These meetings will be held on the following dates and...

  3. 76 FR 70454 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2011-11-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Policy Committee's Workgroup Meetings; Notice of... be open to the public via dial-in access only. Name of Committees: HIT Policy Committee's Workgroups... certification criteria are needed. Date and Time: The HIT Policy Committee Workgroups will hold the following...

  4. 75 FR 57027 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-09-17

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards... Strategic Plan, and in accordance with policies developed by the HIT Policy Committee. Date and Time: The...

  5. 76 FR 28782 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on June 22, 2011, from 9 a.m...

  6. 77 FR 27459 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-05-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on June 20, 2012, from 9 a.m...

  7. 75 FR 29762 - HIT Policy Committee's Workgroup Meetings; Notice of Meetings

    Science.gov (United States)

    2010-05-27

    ... Technology HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National... only. Name of Committees: HIT Policy Committee's Workgroups: Meaningful Use, Privacy & Security Policy... specifications, and certification criteria are needed. Date and Time: The HIT Policy Committee Workgroups will...

  8. 77 FR 37408 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-06-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... be open to the public. Name of Committee: HIT Standards Committee. General Function of the Committee... with policies developed by the HIT Policy Committee. Date and Time: The meeting will be held on July 19...

  9. 77 FR 22787 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-04-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on May 24, 2012, from 9 a.m...

  10. 77 FR 65691 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-10-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on November 13, 2012, from 9...

  11. 77 FR 50690 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-08-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on September 19, 2012, from 9...

  12. 75 FR 21628 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2010-04-26

    ... Technology HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards... Strategic Plan, and in accordance with policies developed by the HIT Policy Committee. Date and Time: The...

  13. 76 FR 22396 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-04-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on May 18, 2011, from 9 a.m...

  14. 76 FR 55913 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-09-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: to provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held virtually on October 21, 2011...

  15. 77 FR 60438 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-10-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on October 17, 2012, from 9 a...

  16. 75 FR 3906 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-01-25

    ... Technology; HIT Policy Committee's Workgroup Meetings; Notice of Meetings AGENCY: Office of the National... only. Name of Committees: HIT Policy Committee's Workgroups: Meaningful Use, Privacy & Security Policy... specifications, and certification criteria are needed. Date and Time: The HIT Policy Committee Workgroups will...

  17. 77 FR 65690 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-10-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on December 19, 2012, from 9...

  18. 76 FR 9783 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2011-02-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on March 29, 2011, from 9 a.m...

  19. 77 FR 45353 - HIT Standards Committee Advisory Meeting; Notice of Meeting

    Science.gov (United States)

    2012-07-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES HIT Standards Committee Advisory Meeting; Notice of... public. Name of Committee: HIT Standards Committee. General Function of the Committee: To provide... developed by the HIT Policy Committee. Date and Time: The meeting will be held on August 15, 2012, from 9:00...

  20. 75 FR 42090 - Office of the National Coordinator for Health Information Technology; HIT Standards Committee...

    Science.gov (United States)

    2010-07-20

    ... Technology; HIT Standards Committee Advisory Meeting; Notice of Meeting AGENCY: Office of the National... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Standards... Strategic Plan, and in accordance with policies developed by the HIT Policy Committee. Date and Time: The...