Interactive Control System, Intended Strategy, Implemented Strategy dan Emergent Strategy

Directory of Open Access Journals (Sweden)

Tubagus Ismail

2012-09-01

Full Text Available The purpose of this study was to examine the relationship between management control system (MCS and strategy formation processes, namely: intended strategy, emergent strategy and impelemented strategy. The focus of MCS in this study was interactive control system. The study was based on Structural Equation Modeling (SEM as its multivariate analyses instrument. The samples were upper middle managers of manufacturing company in Banten Province, DKI Jakarta Province and West Java Province. AMOS Software 16 program is used as an additional instrument to resolve the problem in SEM modeling. The study found that interactive control system brought a positive and significant influence on Intended strategy; interactive control system brought a positive and significant influence on implemented strategy; interactive control system brought a positive and significant influence on emergent strategy. The limitation of this study is that our empirical model only used one way relationship between the process of strategy formation and interactive control system.

Simulation and RTDS Hardware Implementation of SHAF for Mitigation of Current Harmonics with p-q and Id-Iq Control Strategies Using PI Controller

Directory of Open Access Journals (Sweden)

A. K. Panda

2011-06-01

Full Text Available Control strategies for extracting the three-phase reference currents for shunt active power filters are compared, evaluating their performance under different source conditions in MATLAB/Simulink environment and also with Real Time Digital Simulator (RTDS Hardware. When the supply voltages are balanced and sinusoidal, the two control strategies are converging to the same compensation characteristics but when the supply voltages are distorted and/or un-balanced sinusoidal, these control strategies result in different degrees of compensation in harmonics. The p-q control strategy is unable to yield an adequate solution when source voltages are not ideal. Extensive Simulations are carried out with PI controller for both p-q and Id-Iq control strategies for different voltage conditions and adequate results were presented. The 3-ph 4-wire SHAF system is also implemented on RTDS Hardware to further verify its effectiveness. The detailed simulation and RTDS Hardware results are included.

Cost reducing code implementation strategies

International Nuclear Information System (INIS)

Kurtz, Randall L.; Griswold, Michael E.; Jones, Gary C.; Daley, Thomas J.

1995-01-01

Sargent and Lundy's Code consulting experience reveals a wide variety of approaches toward implementing the requirements of various nuclear Codes Standards. This paper will describe various Code implementation strategies which assure that Code requirements are fully met in a practical and cost-effective manner. Applications to be discussed includes the following: new construction; repair, replacement and modifications; assessments and life extensions. Lessons learned and illustrative examples will be included. Preferred strategies and specific recommendations will also be addressed. Sargent and Lundy appreciates the opportunity provided by the Korea Atomic Industrial Forum and Korean Nuclear Society to share our ideas and enhance global cooperation through the exchange of information and views on relevant topics

ANALYTICAL AND SCIENTIFIC REVIEW OF PROJECTS AND PROGRAMMES ON CHANGES STRATEGY IMPLEMENTATION

Directory of Open Access Journals (Sweden)

MLODETSKYY V. R.

2017-01-01

Full Text Available Formulation of the problem. Sustainable and successful functioning of the organization in today's competitive market conditions is possible if the organization is an open dynamic system capable of timely and adequately adapt to changes in the environment, this organization should initiate the implementation of innovations, both in production and organizational structure. Most suited for these conditions are project-oriented organizations, when the program's development strategy is developed with a detailed individual relatively independent stages, which are implemented as part of projects. In accordance with the development and improvement of the organization of control systems in the direction of increasing emphasis on the development strategy in relation to operating activities is an important task. Goal and tasks. Explore the hierarchical control system of project-oriented organization towards establishing information flows combine program management system with project management subsystems, included in this program. Conclusions. Concretized the concept of "program" and "project" as a result assumed that the program management is a permanent process in the organization that is adaptable to external changes, and project management (as defined is temporary, so the project management structure are subject to program management structures and are not permanent in the organization's management system.

Internal quality control: planning and implementation strategies.

Science.gov (United States)

Westgard, James O

2003-11-01

The first essential in setting up internal quality control (IQC) of a test procedure in the clinical laboratory is to select the proper IQC procedure to implement, i.e. choosing the statistical criteria or control rules, and the number of control measurements, according to the quality required for the test and the observed performance of the method. Then the right IQC procedure must be properly implemented. This review focuses on strategies for planning and implementing IQC procedures in order to improve the quality of the IQC. A quantitative planning process is described that can be implemented with graphical tools such as power function or critical-error graphs and charts of operating specifications. Finally, a total QC strategy is formulated to minimize cost and maximize quality. A general strategy for IQC implementation is recommended that employs a three-stage design in which the first stage provides high error detection, the second stage low false rejection and the third stage prescribes the length of the analytical run, making use of an algorithm involving the average of normal patients' data.

Clarkesville Green Infrastructure Implementation Strategy

Science.gov (United States)

The report outlines the 2012 technical assistance for Clarkesville, GA to develop a Green Infrastructure Implementation Strategy, which provides the basic building blocks for a green infrastructure plan:

Implementation of marketing strategy: Factor of competitive advantage

OpenAIRE

Krstić Ivan; Becić Sonja

2011-01-01

Primary objective of the company is to reach the business success. Competitors have the same objective. Only the companies that really meet the consumer's needs and demands survive in the competitive struggle. The company who succeeds in it, has the possibility to achieve the competitive advantage as well. The company has to have the adequate marketing strategy in order to fulfill the marketing objectives and achieve the competitive advantage. The marketing strategy should be flexible and pro...

Implementation strategies for collaborative primary care-mental health models.

Science.gov (United States)

Franx, Gerdien; Dixon, Lisa; Wensing, Michel; Pincus, Harold

2013-09-01

Extensive research exists that collaborative primary care-mental health models can improve care and outcomes for patients. These programs are currently being implemented throughout the United States and beyond. The purpose of this study is to review the literature and to generate an overview of strategies currently used to implement such models in daily practice. Six overlapping strategies to implement collaborative primary care-mental health models were described in 18 selected studies. We identified interactive educational strategies, quality improvement change processes, technological support tools, stakeholder engagement in the design and execution of implementation plans, organizational changes in terms of expanding the task of nurses and financial strategies such as additional collaboration fees and pay for performance incentives. Considering the overwhelming evidence about the effectiveness of primary care-mental health models, there is a lack of good studies focusing on their implementation strategies. In practice, these strategies are multifaceted and locally defined, as a result of intensive and required stakeholder engagement. Although many barriers still exist, the implementation of collaborative models could have a chance to succeed in the United States, where new service delivery and payment models, such as the Patient-Centered Medical Home, the Health Home and the Accountable Care Organization, are being promoted.

Feasibility of an implementation strategy for the integration of health promotion in routine primary care: a quantitative process evaluation.

Science.gov (United States)

Sanchez, Alvaro; Grandes, Gonzalo; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

2017-02-17

attain adequate program adoption and implementation through improved implementation strategies.

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...

The Concept of Sustainable Strategy Implementation

Directory of Open Access Journals (Sweden)

Joanna Radomska

2015-11-01

Full Text Available The idea of sustainable development has been present in the field of management for many years, yet the challenges and rules of contemporary business mean that it remains topical. At the same time, the results of much research indicates an unsatisfactory level of execution of development concepts. Due to this, the subject of the study encompasses the implementation of the idea of sustainability in the strategy execution process, lending it a holistic and balanced nature. The purpose of the paper is an examination of the relationship between strategy implementation and the effectiveness of the strategy execution process. The relationships between the perspectives defined and results obtained by organizations were investigated. The research demonstrated the existence of a positive correlation of varied intensity. It is thus possible to identify a positive influence of the integration of the idea of sustainability with strategy execution, which is reflected in the effectiveness of activities undertaken.

Impact of Strategy Implementation on Performance of Generic Strategy: Evidence from Thailand

Directory of Open Access Journals (Sweden)

Mayookapan Chaimankong

2012-04-01

Full Text Available The purpose of this paper is to examine the strategic orientation in terms of Miles and Snow typologies of the firms in emerging country and investigate their implications on performance. Unlike previous research, this paper focuses the importance of strategy implementation to the performance implications of Miles and Snow typology. Data was collected from 111 key informants from firms in Thailand’s chemical industry using probability sampling. The one-way Analysis of Variance (ANOVA results showed that prospectors performed better than the other three strategic types, whereas reactors exhibited the lowest performance scores. While the success in strategy implementation is found to be a significant predictor of firm performance, the two-way Analysis of Variance (ANOVA results revealed that the success in strategy implementation did not alter the relationship between Miles and Snow strategic type and a firm’s performance. This finding suggests that the relationship between Miles and Snow strategic type and a firm’s performance may be universal, regardless of the location where the study is conducted. However, additional studies in other contexts are required before the conclusion can be made whether the strategic type performance relationship will be contingent on strategy implementation.

Mobile Portal Implementation Strategy

DEFF Research Database (Denmark)

Gao, Ping; Damsgaard, Jan

2005-01-01

Mobile portal plays an important role in mobile commerce market. Current literature focuses on static analysis on the value chain of mobile portals. This article provides a dynamic perspective on mobile portal strategy. Drawing upon network economics, we describe mobile portal implementation...... as a fourphase process. In different phase, a portal provider has various challenges to overcome and adopt diverse strategies, and correspondingly the regulator has different foci. The conceptual framework proposed in this article offers a basis for further analyses on the market dynamics of mobile commerce......, and can be generalized to studying other networked technologies...

Towards the Implementation of the GEOSS Water Strategy

Science.gov (United States)

Lawford, R. G.; Cripe, D.

2014-12-01

Early in 2014, the Group on Earth Observations (GEO) adopted the GEOSS (Global Earth Observation System of Systems) Water Strategy as a potential guide for GEO-related water activities over the next decade. The Water Strategy outlines water-related issues and opportunities that fit within the general GEOSS framework that will be developed over the next decade (2016-2025). Implementation of a water strategy within the GEOSS framework can be complex because GEO Members and Participating Organizations contribute to GEO on a voluntary basis. In spite of these limitations efforts to consolidate an implementation plan have made significant advances during the past nine months. Progress towards the final GEOSS Water Strategy Implementation Plan will be reported and gaps in the plan will be identified. Specific responses to the strategy will address the need for user engagement, the development of integrated of data products, model hierarchies and user support systems, and the research that will be needed to expand the capabilities of GEOSS and its water services. One challenge for the implementation plan involves building a framework from the diverse and wide range of activities and opportunities presented by GEO Members and Participating Organizations. The priority themes within the GEO Water Strategy are being used to provide more focus for new initiatives. New activities related to these priority areas involving projects that link water and other GEO Societal Benefit Areas, as well as initiatives related to the Water-Energy-Food nexus and the Sustainable Development Goals will be described. The presentation will also explore the needs and opportunities for new satellites and other observational and information technologies to advance the implementation of the GEOSS water strategy objectives.

Implementation of a records management strategy at the Botswana ...

African Journals Online (AJOL)

Ngulup

University of Botswana, Department of Library and Information Studies, ... implementation of records and document management systems. .... The BURS Act further states that BURS has to maintain adequate accounting records ... organisation puts in place internal financial controls that would maintain a strong control.

Implementation of patient safety strategies in European hospitals.

Science.gov (United States)

Suñol, R; Vallejo, P; Groene, O; Escaramis, G; Thompson, A; Kutryba, B; Garel, P

2009-02-01

This study is part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project on cross-border care, investigating quality improvement strategies in healthcare systems across the European Union (EU). To explore to what extent a sample of acute care European hospitals have implemented patient safety strategies and mechanisms and whether the implementation is related to the type of hospital. Data were collected on patient safety structures and mechanisms in 389 acute care hospitals in eight EU countries using a web-based questionnaire. Subsequently, an on-site audit was carried out by independent surveyors in 89 of these hospitals to assess patient safety outputs. This paper presents univariate and bivariate statistics on the implementation and explores the associations between implementation of patient safety strategies and hospital type using the chi(2) test and Fisher exact test. Structures and plans for safety (including responsibilities regarding patient safety management) are well developed in most of the hospitals that participated in this study. The study found greater variation regarding the implementation of mechanisms or activities to promote patient safety, such as electronic drug prescription systems, guidelines for prevention of wrong patient, wrong site and wrong surgical procedure, and adverse events reporting systems. In the sample of hospitals that underwent audit, a considerable proportion do not comply with basic patient safety strategies--for example, using bracelets for adult patient identification and correct labelling of medication.

40 CFR 93.120 - Consequences of control strategy implementation plan failures.

Science.gov (United States)

2010-07-01

... Consequences of control strategy implementation plan failures. (a) Disapprovals. (1) If EPA disapproves any submitted control strategy implementation plan revision (with or without a protective finding), the... is determined. (2) If EPA disapproves a submitted control strategy implementation plan revision...

Implementation strategy for the ITER plasma control system

International Nuclear Information System (INIS)

Winter, A.; Ambrosino, G.; Bauvir, B.; De Tommasi, G.; Humphreys, D.A.; Mattei, M.; Neto, A.; Raupp, G.; Snipes, J.A.; Stephen, A.V.; Treutterer, W.; Walker, M.L.; Zabeo, L.

2015-01-01

This paper gives an overview of the scope and context of the CODAC high-level real-time applications (Supervision and Plasma Control) and presents the strategy and current state of design of the tools to support the implementation. A real-time framework, which is currently under development with strong support of the worldwide fusion community will not only support the implementation of plasma control strategies with the extensive exception handling and forecasting functionality foreseen for ITER, but also integrated commissioning, orchestration and supervision as well as the real-time needs of ITER plant system developers. A second cornerstone in the implementation strategy is the development of a powerful simulation environment (Plasma Control System Simulation Platform – PCSSP) to design and verify control strategies, event handling and orchestration and automation. The development of PCSSP is currently under contract and this paper will also give an overview of its current state of development.

Implementation strategy for the ITER plasma control system

Energy Technology Data Exchange (ETDEWEB)

Winter, A., E-mail: axel.winter@iter.org [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Ambrosino, G. [CREATE/Università di Napoli Federico II, Dip. Ingegneria Elettrica e delle Tecnologie dell’Informazione (Italy); Bauvir, B. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France); De Tommasi, G. [CREATE/Università di Napoli Federico II, Dip. Ingegneria Elettrica e delle Tecnologie dell’Informazione (Italy); Humphreys, D.A. [General Atomics, San Diego, CA (United States); Mattei, M. [CREATE/Seconda Università di Napoli, Dip. Ingegneria Industriale e dell’Informazione (Italy); Neto, A. [Fusion for Energy, Barcelona (Spain); Raupp, G. [Max Planck Institute for Plasma Physics, EURATOM Association, Garching (Germany); Snipes, J.A. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Stephen, A.V. [Culham Centre for Fusion Energy, Culham Science Centre, Abingdon (United Kingdom); Treutterer, W. [Max Planck Institute for Plasma Physics, EURATOM Association, Garching (Germany); Walker, M.L. [General Atomics, San Diego, CA (United States); Zabeo, L. [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

2015-10-15

This paper gives an overview of the scope and context of the CODAC high-level real-time applications (Supervision and Plasma Control) and presents the strategy and current state of design of the tools to support the implementation. A real-time framework, which is currently under development with strong support of the worldwide fusion community will not only support the implementation of plasma control strategies with the extensive exception handling and forecasting functionality foreseen for ITER, but also integrated commissioning, orchestration and supervision as well as the real-time needs of ITER plant system developers. A second cornerstone in the implementation strategy is the development of a powerful simulation environment (Plasma Control System Simulation Platform – PCSSP) to design and verify control strategies, event handling and orchestration and automation. The development of PCSSP is currently under contract and this paper will also give an overview of its current state of development.

A Pragmatic Approach to Guide Implementation Evaluation Research: Strategy Mapping for Complex Interventions

Directory of Open Access Journals (Sweden)

Alexis K. Huynh

2018-05-01

Full Text Available IntroductionGreater specification of implementation strategies is a challenge for implementation science, but there is little guidance for delineating the use of multiple strategies involved in complex interventions. The Cardiovascular (CV Toolkit project entails implementation of a toolkit designed to reduce CV risk by increasing women’s engagement in appropriate services. The CV Toolkit project follows an enhanced version of Replicating Effective Programs (REP, an evidence-based implementation strategy, to implement the CV Toolkit across four phases: pre-conditions, pre-implementation, implementation, and maintenance and evolution. Our current objective is to describe a method for mapping implementation strategies used in real time as part of the CV Toolkit project. This method supports description of the timing and content of bundled strategies and provides a structured process for developing a plan for implementation evaluation.MethodsWe conducted a process of strategy mapping to apply Proctor and colleagues’ rubric for specification of implementation strategies, constructing a matrix in which we identified each implementation strategy, its conceptual group, and the corresponding REP phase(s in which it occurs. For each strategy, we also specified the actors involved, actions undertaken, action targets, dose of the implementation strategy, and anticipated outcome addressed. We iteratively refined the matrix with the implementation team, including use of simulation to provide initial validation.ResultsMapping revealed patterns in the timing of implementation strategies within REP phases. Most implementation strategies involving the development of stakeholder interrelationships and training and educating stakeholders were introduced during the pre-conditions or pre-implementation phases. Strategies introduced in the maintenance and evolution phase emphasized communication, re-examination, and audit and feedback. In addition to its value

Integrated management system implementation strategy for PUSPATI TRIGA Reactor

International Nuclear Information System (INIS)

Phongsakorn Prak Tom; Shaharum Ramli; Mohamad Azman Che Mat Isa; Shahirah Abdul Rahman; Mohd Zaid Mohamed; Mat Zin Mat Husin; Nurfazila Husain; Mohamad Puad Abu

2012-01-01

Integrated Management System (IMS) designed to fulfil the requirements integrates safety, health, environmental, security, quality and economic elements. PUSPATI TRIGA Reactor (RTP) is currently implementing the Quality Assurance Program (QAP) and looking toward implementation of IMS. This paper discussed the implementation strategy of IMS for RTP. There are nine steps of IMS implementation strategy. In implementation of IMS, Gantt chart is useful project management tool in managing the project frame work. IMS is intended as a tool to enable the continuous development of safety culture and achieve higher safety levels. (author)

Strategy Implementation and Organizational Change

DEFF Research Database (Denmark)

Lynch, Susan E.; Mors, Louise

2018-01-01

. This paper considers how formal structural change affects senior managers’ ability to maintain their intraorganizational networks. The hypotheses are tested on sample of 884 work-related relationships of 96 partners in a global professional services firm. This firm had recently implemented a new strategy...

PERFORMANCE ACHIEVEMENT OF TOURISM ENTERPRISE BY IMPLEMENTING MANAGEMENT STRATEGIES

Directory of Open Access Journals (Sweden)

Nicolae PLATON

2017-04-01

Full Text Available For managerial practice it is important to know the methodology of developing a tourism business strategy, more than the theoretical concepts related to this field. The enterprise strategy is an important lever to boost and support the change of emphasis of the creative side of the organization's management. Based on these prerequisites, the author makes an overview of the need to adopt a management strategy within the enterprise, describes the defining features of the strategy in the view of some authors, classifies the strategies according to several criteria, proposes a management model specific to the tourism enterprise, carries out the comparative analysis of how to formulate and how to implement the strategy, characterizes the difficulties that arise in the process of strategy implementation.

40 CFR 51.302 - Implementation control strategies for reasonably attributable visibility impairment.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Implementation control strategies for... IMPLEMENTATION PLANS Protection of Visibility § 51.302 Implementation control strategies for reasonably... implementation of the elements of the long-term strategy as may be necessary to make reasonable progress toward...

Strategy Implementation Style and Public Service Effectiveness, Efficiency, and Equity

Directory of Open Access Journals (Sweden)

Rhys Andrews

2017-02-01

Full Text Available Strategic decision-making theories suggest that organizations that combine rational and incremental strategy implementation styles are likely to perform better than those that emphasize a single style. To assess whether these arguments apply to the public sector; we explore the strategy implementation style and perceived service effectiveness, efficiency and equity of Turkish municipal government departments. Using fuzzy cluster analysis, we identify four distinctive though inter-related styles of strategy implementation in our sample organizations: logical-incremental; mostly rational; mostly incremental; and no clear approach. A logical-incremental and mostly rational style of implementation are associated with better effectiveness, efficiency and equity; with the absence of an implementation style associated with worse performance. Theoretical and practical implications are discussed.

An empirical analysis of strategy implementation process and performance of construction companies

Science.gov (United States)

Zaidi, F. I.; Zawawi, E. M. A.; Nordin, R. M.; Ahnuar, E. M.

2018-02-01

Strategy implementation is known as action stage where it is to be considered as the most difficult stage in strategic planning. Strategy implementation can influence the whole texture of a company including its performance. The aim of this research is to provide the empirical relationship between strategy implementation process and performance of construction companies. This research establishes the strategy implementation process and how it influences the performance of construction companies. This research used quantitative method approached via questionnaire survey. Respondents were G7 construction companies in Klang Valley, Selangor. Pearson correlation analysis indicate a strong positive relationship between strategy implementation process and construction companies’ performance. The most importance part of strategy implementation process is to provide sufficient training for employees which directly influence the construction companies’ profit growth and employees’ growth. This research results will benefit top management in the construction companies to conduct strategy implementation in their companies. This research may not reflect the whole construction industry in Malaysia. Future research may be resumed to small and medium grades contractors and perhaps in other areas in Malaysia.

Strategy implemented through structuring and new structures

DEFF Research Database (Denmark)

Nielsen, Renate

Research objective: With the purpose of generating a new understanding of how development in organisations take place, an interpretive perspective at continuous processes in organisations will be applied: more specifically at how organisational interpretation forms an organisation's strategy...... and how the strategy is implemented through structuring, new structures and routines....

PLANNING THE IMPLEMENTATION OF QUALITY THROUGH STRATEGY FORMULATION AND CORPORATE GOVERNANCE

Directory of Open Access Journals (Sweden)

Nikola Stefanović

2007-09-01

Full Text Available Planning the implementation of quality is a complex process that depends on many different internal and external factors. Planning the implementation is defined by the capabilities of management to visualize the market position of the company and to evaluate the company's strengths, weaknesses, opportunities, and threats. Serving to the company's purposes, planning the implementation of quality must be integrated into the company's strategic objectives and then transferred to other parts of the organization utilizing the corporate governance system. Planning the implementation, as a part of strategy formulation, should be reflected in: 1 company's vision and mission development, 2 goals setting, 3 strategy development aimed at achieving goals, 4 implementation and execution of the strategy, and 4 monitoring, evaluation, control, and readjustment of the strategy. Finally, planning must account for all possible implementation barriers.

Canada's National Implementation Strategy on Climate Change

International Nuclear Information System (INIS)

2000-10-01

This document describes the national implementation strategy which is a part of the coordinated national response to climate change. The approach was developed from the National Climate Change process, established by the federal, provincial and territorial ministers responsible for energy and the environment, based on an examination of the impacts, costs and benefits of implementing the Kyoto Protocol, as well as the options for addressing climate change. The Strategy involves (1) taking action to reduce risks and to improve our understanding of risks associated with climate change, (2) institution of a national framework that includes individual and joint action, while recognizing jurisdictional flexibility in responding to unique circumstances, (3) adopting a phased approach, (4) progressive action in response to changing domestic and international circumstances, (5) clear understanding of the necessary relationship between international and national strategies, (6) developing an understanding of the implications of emission reduction targets and major options, including cross-cutting policy approaches such as emissions trading and allocation of responsibility for reducing emissions. The Strategy uses a risk-management approach that attempts to limit the risks of climate change while maximizing opportunities for Canada to contribute to global and national solutions. This approach incorporates improving scientific and analytical understanding and co-ordinating national and international action and a phased approach to implementation. This policy document focuses on Phase One actions which consist of five connected themes, i. e. enhancing awareness and understanding, promoting technology development and innovation, governments leading by example, investing in knowledge and building the foundation, and encouraging action. Future phases will be linked to greater international certainty based on ratification of the Kyoto Protocol, the actions of our trading partners

Formalizing Implementation Strategies for First-Class Continuations

DEFF Research Database (Denmark)

Danvy, Olivier

1999-01-01

We present the first formalization of implementation strategies for first-class continuations. The formalization hinges on abstract machines for continuation-passing style (CPS) programs with a special treatment for the current continuation, accounting for the essence of first-class continuations......-class continuations and that second-class continuations are stackable. A large body of work exists on implementing continuations, but it is predominantly empirical and implementation-oriented. In contrast, our formalization abstracts the essence of first-class continuations and provides a uniform setting...

Formalizing Implementation Strategies for First-Class Continuations

DEFF Research Database (Denmark)

Danvy, Olivier

2000-01-01

We present the first formalization of implementation strategies for first-class continuations. The formalization hinges on abstract machines for continuation-passing style (CPS) programs with a special treatment for the current continuation, accounting for the essence of first-class continuations......-class continuations and that second-class continuations are stackable. A large body of work exists on implementing continuations, but it is predominantly empirical and implementation-oriented. In contrast, our formalization abstracts the essence of first-class continuations and provides a uniform setting...

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...

Implementation of Patient Safety and Patient-Centeredness Strategies in Iranian Hospitals

Science.gov (United States)

Aghaei Hashjin, Asgar; Kringos, Dionne S.; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S.

2014-01-01

Objective To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. Methods A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009–2010. Results The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO), and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient’s diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. Conclusions Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention. PMID:25268797

Implementation of patient safety and patient-centeredness strategies in Iranian hospitals.

Directory of Open Access Journals (Sweden)

Asgar Aghaei Hashjin

Full Text Available OBJECTIVE: To examine the extent of implementation for patient safety (PS and patient-centeredness (PC strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade in Iran. METHODS: A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009-2010. RESULTS: The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO, and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient's diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. CONCLUSIONS: Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention.

Implementation of patient safety and patient-centeredness strategies in Iranian hospitals.

Science.gov (United States)

Aghaei Hashjin, Asgar; Kringos, Dionne S; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S

2014-01-01

To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. A cross-sectional study through an adapted version of the MARQuIS questionnaire, eliciting information from hospital and nursing managers in 84 Iranian hospitals on the implementation of PS and PC strategies in 2009-2010. The majority of hospitals reported to have implemented 84% of the PS and 72% of the PC strategies. In general, implementation of PS strategies was unrelated to the type of hospital, with the exception of health promotion reports, which were more common in the Social Security Organization (SSO), and MRSA testing, which was reported more often in nonprofit hospitals. MRSA testing was also more common among teaching hospitals compared to non-teaching hospitals. The higher grade hospitals reported PS strategies significantly more frequently than lower grade hospitals. Overall, there was no significant difference in the reported implementation of PC strategies across general and specialized hospitals; except for the provision of information in different languages and recording of patient's diet which were reported significantly more often by general than specialized hospitals. Moreover, patient hotel services were more common in private compared to public hospitals. Despite substantial reporting of PS and PC strategies, there is still room for strengthening standard setting on safety, patient services and patient-centered information strategies in Iranian hospitals. To assure effective implementation of PS and PC strategies, enforcing standards, creating a PS and PC culture, increasing organizational responsiveness, and partnering with patients and their families need more attention.

WHO ADOPT AND IMPLEMENT HUMAN RESOURCES STRATEGY IN AN ORGANIZATION?

Directory of Open Access Journals (Sweden)

MUNTEANU ANCA-IOANA

2016-04-01

Full Text Available The need for effective human resources strategies, which have a strong role in achieving goals has been a subject extensively treated in the literature. Thus, those interested in this field could learn about the stages of development of human resources strategy, the criteria necessary to be considered, features that should have a human resource strategy properly adopted and the modalities for its implementation. However, it has neglected an important aspect essential, namely, who should formulate strategy and human resources of an organization who is responsible for its implementation. In this paper we focused attention on identifying new aspects of the human resources strategy: people involved in adopting and implementing human resources strategy. The present study is one of the fundamental theoretical literature. The facts are not merely generalizing, but is analysis, opinion and personal conclusions. However, they can represent a focal point for business, prompting an awareness among the lead actors in a company, the need straightening attention to the foregoing. The overall conclusion is that it is not enough for an organization to have a human resources strategy. To be fair one, to adopt and implement them have involved those individuals who have the necessary capacity and not the responsibility of everyone. Pawns should be the main human resources manager and senior manager, followed by operational.

Real Time Investments with Adequate Portfolio Theory

Directory of Open Access Journals (Sweden)

Alina Kvietkauskienė

2015-02-01

Full Text Available The objective of this paper is to identify investment decision makingschemes using the adequate portfolio model. This approach can be employed to project investment in stocks, using the opportunities offered by the markets and investor intelligence. It was decided to use adequate portfolio theory for investment decision making, simulation of financial markets, and optimisation of utility function. The main conclusion of article suggests investigating return on individual portfolio level. Real investment is a way to make sure of the soundness of applicable strategies.

Reporting on the Strategies Needed to Implement Proven Interventions: An Example From a "Real-World" Cross-Setting Implementation Study.

Science.gov (United States)

Gold, Rachel; Bunce, Arwen E; Cohen, Deborah J; Hollombe, Celine; Nelson, Christine A; Proctor, Enola K; Pope, Jill A; DeVoe, Jennifer E

2016-08-01

The objective of this study was to empirically demonstrate the use of a new framework for describing the strategies used to implement quality improvement interventions and provide an example that others may follow. Implementation strategies are the specific approaches, methods, structures, and resources used to introduce and encourage uptake of a given intervention's components. Such strategies have not been regularly reported in descriptions of interventions' effectiveness, or in assessments of how proven interventions are implemented in new settings. This lack of reporting may hinder efforts to successfully translate effective interventions into "real-world" practice. A recently published framework was designed to standardize reporting on implementation strategies in the implementation science literature. We applied this framework to describe the strategies used to implement a single intervention in its original commercial care setting, and when implemented in community health centers from September 2010 through May 2015. Per this framework, the target (clinic staff) and outcome (prescribing rates) remained the same across settings; the actor, action, temporality, and dose were adapted to fit local context. The framework proved helpful in articulating which of the implementation strategies were kept constant and which were tailored to fit diverse settings, and simplified our reporting of their effects. Researchers should consider consistently reporting this information, which could be crucial to the success or failure of implementing proven interventions effectively across diverse care settings. clinicaltrials.gov Identifier: NCT02299791. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Forest Strategy in Republic of Macedonia: Barriers to Effective Implementation

Directory of Open Access Journals (Sweden)

Jana Baumgartner

2014-06-01

Full Text Available Background and Purpose: In recent years, implementation of forest strategies and programs has been acknowledged as an important phase of the forest policy process. Forest policies such as conflict management concepts between deferent interests of stakeholders, are a dynamic route that needs to be managed carefully to achieve its goals. Creation of the forest policy document entitled “Strategy for sustainable development of forestry in Republic of Macedonia” was introduced for the first time in 2005 as cooperation between the Government and United Nations Food and Agriculture Organization (FAO. Action Plan was brought in the same year including the strategy and validity until the end of the year 2009 now is out of date for undetermined reasons, due to lack of analysis of the level of implementation, monitoring and evaluation. Materials and Methods: Through exploratory qualitative method using a case study, this paper attempts to explore different stakeholders perception of the most common barriers for implementation of the Strategy for sustainable development of forests in Republic of Macedonia and ascertain if implementation variables are identified as barriers in the implementation stage. Results: The research showed that environmental and organisational barriers such as legal restrictions, political willingness, social change, control, leadership and clear responsibility are the most common barriers impeding forest strategy implementation in Macedonia. Conclusions: The paper concluded that the three year action plan was too ambitious, given the existing human and technical capacities in the forestry sector, recommending participation of all included stakeholders in the implementation as an important fact in overcoming the current barriers and moving forward the process.

A revelation principle for obviously strategy-proof implementation

NARCIS (Netherlands)

Mackenzie, Andrew

2018-01-01

We prove that if a stochastic (social choice) rule has an obviously strategy-proof (OSP) implementation (Li, 2016), then it has such an implementation through a randomized round table mechanism, where the administrator randomly selects a game form in which the agents take turns making public

Jordanian dentists' knowledge and implementation of eco-friendly dental office strategies.

Science.gov (United States)

Al Shatrat, Sabha M; Shuman, Deanne; Darby, Michele L; Jeng, Hueiwang A

2013-06-01

To investigate the implementation of eco-friendly dental office strategies by Jordanian dentists. Self-designed questionnaires were provided to 150 dentists working in private dental practices in the city of Amman, the capital of Jordan. Dentists' names and addresses were obtained from the Jordanian Dental Association. Overall, the level of knowledge about eco-friendly dental offices strategies was high for amalgam, radiology, paper waste, infection control and energy and water conservation. In terms of implementation, the majority of Jordanian dentists apply few eco-friendly dental offices strategies. The most frequently identified barriers to implementation of eco-friendly dental offices strategies were cost and lack of incentives from the government. Most Jordanian dental practices are not eco-friendly. A continued focus on the impact of dental practices on the environment is needed through formal and continuing dental education. Results of this study can guide policy development to encourage implementation of eco-friendly strategies. © 2013 FDI World Dental Federation.

Collaboration process for integrated social and health care strategy implementation

Directory of Open Access Journals (Sweden)

Jukka Korpela

2012-05-01

Full Text Available Objective:  To present collaboration process for creating a roadmap for the implementation of a strategy for integrated health and social care. The developed collaboration process includes multiple phases and uses electronic group decision support system technology (GDSS.Method: A case study done in the South Karelia District of Social and Health Services in Finland during 2010 - 2011. An expert panel of 13 participants was used in the planning process of the strategy implementation. The participants were interviewed and observed during the case study.Results: As a practical result, a roadmap for integrated health and social care strategy implementation has been developed. The strategic roadmap includes detailed plans of several projects which are needed for successful integration strategy implementation. As an academic result, a collaboration process to create such a roadmap has been developed.Conclusions: The collaboration process and technology seem to suit the planning process well. The participants of the meetings were satisfied with the collaboration process and the GDSS technology. The strategic roadmap was accepted by the participants, which indicates satisfaction with the developed process.

Collaboration process for integrated social and health care strategy implementation.

Science.gov (United States)

Korpela, Jukka; Elfvengren, Kalle; Kaarna, Tanja; Tepponen, Merja; Tuominen, Markku

2012-01-01

To present a collaboration process for creating a roadmap for the implementation of a strategy for integrated health and social care. The developed collaboration process includes multiple phases and uses electronic group decision support system technology (GDSS). A case study done in the South Karelia District of Social and Health Services in Finland during 2010-2011. An expert panel of 13 participants was used in the planning process of the strategy implementation. The participants were interviewed and observed during the case study. As a practical result, a roadmap for integrated health and social care strategy implementation has been developed. The strategic roadmap includes detailed plans of several projects which are needed for successful integration strategy implementation. As an academic result, a collaboration process to create such a roadmap has been developed. The collaboration process and technology seem to suit the planning process well. The participants of the meetings were satisfied with the collaboration process and the GDSS technology. The strategic roadmap was accepted by the participants, which indicates satisfaction with the developed process.

Implementation Strategies of Inclusive Education in Cypriot Classrooms

Science.gov (United States)

Angelides, Panayiotis; Hajisoteriou, Christina

2013-01-01

This research examined the implementation strategies used by the participant teachers in order to practice inclusion in their classrooms. To this end, we investigated the participant teachers' perceptions of their roles and the barriers faced in the implementation of inclusion. Interviews and observations were carried out with four teachers in…

Multicriteria evaluation of demand side management (DSM) implementation strategies in the Indian power sector

Energy Technology Data Exchange (ETDEWEB)

Vashishtha, Sanjay [Centre for Renewable Energy and Environmental Development (CREED), BITS, Pilani, Rajasthan 333031 (India); Ramachandran, M. [BITS Pilani Dubai Centre, Dubai (United Arab Emirates)

2006-09-15

In recent years, demand side management (DSM) has emerged as an efficient utility planning strategy for reducing capacity shortages and improving system load factors. The Indian government is adopting various policies to implement DSM programs. DSM implementation involves a variety of interests with conflicting objectives, and a range of possible implementation strategies with varying implications for effectiveness, cost, feasibility, efficiency and stakeholder acceptance. This necessitates a critical comparison of the strategies to determine a preferred strategy or combination of strategies from each specific stakeholder's point of view. The present study evaluates DSM implementation strategies from a multiobjective perspective using the Analytic Hierarchy Process (AHP). Eight strategies and six criteria were considered. Forty utility, regulator, and consumer stakeholders were surveyed. The most highly ranked strategies involved creating dedicated funds and providing technical support to end users for effective implementation of DSM. (author)

Study protocol for "Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET)": a pragmatic trial comparing implementation strategies.

Science.gov (United States)

Gold, Rachel; Hollombe, Celine; Bunce, Arwen; Nelson, Christine; Davis, James V; Cowburn, Stuart; Perrin, Nancy; DeVoe, Jennifer; Mossman, Ned; Boles, Bruce; Horberg, Michael; Dearing, James W; Jaworski, Victoria; Cohen, Deborah; Smith, David

2015-10-16

Little research has directly compared the effectiveness of implementation strategies in any setting, and we know of no prior trials directly comparing how effectively different combinations of strategies support implementation in community health centers. This paper outlines the protocol of the Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET), a trial designed to compare the effectiveness of several common strategies for supporting implementation of an intervention and explore contextual factors that impact the strategies' effectiveness in the community health center setting. This cluster-randomized trial compares how three increasingly hands-on implementation strategies support adoption of an evidence-based diabetes quality improvement intervention in 29 community health centers, managed by 12 healthcare organizations. The strategies are as follows: (arm 1) a toolkit, presented in paper and electronic form, which includes a training webinar; (arm 2) toolkit plus in-person training with a focus on practice change and change management strategies; and (arm 3) toolkit, in-person training, plus practice facilitation with on-site visits. We use a mixed methods approach to data collection and analysis: (i) baseline surveys on study clinic characteristics, to explore how these characteristics impact the clinics' ability to implement the tools and the effectiveness of each implementation strategy; (ii) quantitative data on change in rates of guideline-concordant prescribing; and (iii) qualitative data on the "how" and "why" underlying the quantitative results. The outcomes of interest are clinic-level results, categorized using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, within an interrupted time-series design with segmented regression models. This pragmatic trial will compare how well each implementation strategy works in "real-world" practices. Having a better understanding of how different

Strategy to Ensure Institutional Control Implementation at Superfund Sites

Science.gov (United States)

This document sets forth EPA’s strategy (Strategy) for ensuring that institutional controls (ICs) are successfully implemented at Superfund sites, with an emphasis on evaluating ICs at sites where all construction of all remedies is complete (construction complete sites).

Multilevel Mechanisms of Implementation Strategies in Mental Health: Integrating Theory, Research, and Practice

Science.gov (United States)

2015-01-01

A step toward the development of optimally effective, efficient, and feasible implementation strategies that increase evidence-based treatment integration in mental health services involves identification of the multilevel mechanisms through which these strategies influence implementation outcomes. This article (a) provides an orientation to, and rationale for, consideration of multilevel mediating mechanisms in implementation trials, and (b) systematically reviews randomized controlled trials that examined mediators of implementation strategies in mental health. Nine trials were located. Mediation-related methodological deficiencies were prevalent and no trials supported a hypothesized mediator. The most common reason was failure to engage the mediation target. Discussion focuses on directions to accelerate implementation strategy development in mental health. PMID:26474761

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children.

Science.gov (United States)

Stevens, Bonnie J; Yamada, Janet; Promislow, Sara; Stinson, Jennifer; Harrison, Denise; Victor, J Charles

2014-11-25

Despite extensive research, institutional policies, and practice guidelines, procedural pain remains undertreated in hospitalized children. Knowledge translation (KT) strategies have been employed to bridge the research to practice gap with varying success. The most effective single or combination of KT strategies has not been found. A multifaceted KT intervention, Evidence-based Practice for Improving Quality (EPIQ), that included tailored KT strategies was effective in improving pain practices and clinical outcomes at the unit level in a prospective comparative cohort study in 32 hospital units (16 EPIQ intervention and 16 Standard Care), in eight pediatric hospitals in Canada. In a study of the 16 EPIQ units (two at each hospital) only, the objectives were to: determine the effectiveness of evidence-based KT strategies implemented to achieve unit aims; describe the KT strategies implemented and their influence on pain assessment and management across unit types; and identify facilitators and barriers to their implementation. Data were collected from each EPIQ intervention unit on targeted pain practices and KT strategies implemented, through chart review and a process evaluation checklist, following four intervention cycles over a 15-month period. Following the completion of the four cycle intervention, 78% of 23 targeted pain practice aims across units were achieved within 80% of the stated aims. A statistically significant improvement was found in the proportion of children receiving pain assessment and management, regardless of pre-determined aims (p strategies implemented was 35 and included reminders, educational outreach and materials, and audit and feedback. Units successful in achieving their aims implemented more KT strategies than units that did not. No specific type of single or combination of KT strategies was more effective in improving pain assessment and management outcomes. Tailoring KT strategies to unit context, support from unit leadership

Spent Nuclear Fuel (SNF) Project Safety Basis Implementation Strategy

International Nuclear Information System (INIS)

TRAWINSKI, B.J.

2000-01-01

The objective of the Safety Basis Implementation is to ensure that implementation of activities is accomplished in order to support readiness to move spent fuel from K West Basin. Activities may be performed directly by the Safety Basis Implementation Team or they may be performed by other organizations and tracked by the Team. This strategy will focus on five key elements, (1) Administration of Safety Basis Implementation (general items), (2) Implementing documents, (3) Implementing equipment (including verification of operability), (4) Training, (5) SNF Project Technical Requirements (STRS) database system

Implementation Analysis Services Marketing Strategy Room (Case on Kharisma Hotel Bukittinggi)

OpenAIRE

Saputriyani, Rita; Sutrisna, Endang

2016-01-01

Service marketing strategy is a set of tools that can be used marketer, which consists of various elements of a marketing program that should be considered that the implementation of the strategy defined marketers can be successful. The purpose of this study was to megetahui implementation of marketing strategy services performed charisma bukittinggi hotel.Kharisma Hotel Bukittinggi established PT. Mega Kharisma Asia Sentosa and all operating on 10 August 2002. Hotel charisma is suattu hotels...

Implementation Strategies for Gender-Sensitive Public Health Practice: A European Workshop.

Science.gov (United States)

Oertelt-Prigione, Sabine; Dalibert, Lucie; Verdonk, Petra; Stutz, Elisabeth Zemp; Klinge, Ineke

2017-11-01

Providing a robust scientific background for the focus on gender-sensitive public health and a systematic approach to its implementation. Within the FP7-EUGenMed project ( http://eugenmed.eu ) a workshop on sex and gender in public health was convened on February 2-3, 2015. The experts participated in moderated discussion rounds to (1) assemble available knowledge and (2) identify structural influences on practice implementation. The findings were summarized and analyzed in iterative rounds to define overarching strategies and principles. The participants discussed the rationale for implementing gender-sensitive public health and identified priorities and key stakeholders to engage in the process. Communication strategies and specific promotion strategies with distinct stakeholders were defined. A comprehensive list of gender-sensitive practices was established using the recently published taxonomy of the Expert Recommendations for Implementing Change (ERIC) project as a blueprint. A clearly defined implementation strategy should be mandated for all new projects in the field of gender-sensitive public health. Our tool can support researchers and practitioners with the analysis of current and past research as well as with the planning of new projects.

Marketing Strategy Implementation Process in the Creative Industry of Video Games

Directory of Open Access Journals (Sweden)

Maryangela Drumond de Abreu Negrão

2013-06-01

Full Text Available This article contributes to the understanding of marketing strategy process when it presents the organizational and human factors that support the processes of implementation, identified in a qualitative study conducted in the creative industry of video game development. The research, a case study applied to four video and computer game companies was based on the Sashittal and Jassawalla (2001 marketing strategic model, and on the concepts of the creative behavior and innovation in organizations proposed by Amabile (1997. The analysis suggests that the marketing strategy implementation is anchored in innovative administrative process, creative skills and the adoption of modern control technologies. It was observed that a vision that associates production, process, the market orientation and the delivery of value-adding is essential for the implementation of strategies in creative and innovative organizational structures. The research contributes to the marketing strategy implementation studies in creative and innovative environments under the approach of smaller organizations. It also contributes with the marketing strategy theory when it suggests that the analysis of the process, the control and the management skills be included as categories into the theoretical model in future investigations.

A four-phase strategy for the implementation of reflectance confocal microscopy in dermatology

NARCIS (Netherlands)

Hoogedoorn, L.; Gerritsen, M.J.P.; Wolberink, E.A.W.; Peppelman, M.; Kerkhof, P.C.M. van de; Erp, P.E.J. van

2016-01-01

BACKGROUND: Reflectance confocal microscopy (RCM) is gradually implemented in dermatology. Strategies for further implementation and practical 'hands on' guidelines are lacking. OBJECTIVE: The primary outcome was to conduct a general strategy for further implementation of RCM. The secondary outcome

Supporting FEI through innovation strategy implementation

DEFF Research Database (Denmark)

Aagaard, Annabeth

the ‘predictability’ of the discovery process/FEI ought to be an immediate priority area of investment for Pharma (Duyck, 2003). This paper explores how pharmaceutical front end innovation can be actively supported through the development and implementation of an innovation strategy. The empirical field......-year Ph.D. study the process of identifying, developing and integrating a targeted innovation corporate strategy and divisional action plans is examined and effects and results are evaluated and measured. The findings and key learnings from the study are presented as propositions of how innovation......, Steven & Burly, 2003, and Vernorn et al., 2008) and that innovation strategies play a central role in optimization of innovation (Clark & Wheelwright, 1995; Cottam et al., 2001; Morgan & Berthon, 2008). Cottam et al. (2001) stress that in order to maximize the benefits of previous innovations innovative...

Strategies for implementing transit priority

International Nuclear Information System (INIS)

2005-11-01

Increased urbanization in Canada has placed pressure on an eroding, ageing infrastructure and raised concerns about declining air quality. In addition to reducing emissions, well-designed transit systems can reduce traffic and improve road safety. This paper presented a set of transit best practices which addressed the need to improve supply, influence demand, and make operational improvements with the least environmental impact. The objective of this paper was to gather the best implementation strategies for urban roads from municipalities across Canada, and to focus on solutions that can be applied to bus and streetcar systems to make better use of shared facilities. Bus bulbs, signal priority, queue jumps and green waves were recommended, as well as dedicated lanes and exclusive transit facilities. Advances in technology were reviewed, as well as the use of intelligent transportation systems to improve transit with little or no impact on other road users. Case studies were presented from various municipalities across Canada. Various stages of project development, design and construction, operations and maintenance strategies for the various projects were reviewed. The most successful installations were found to be in cities that have established a clear policy on transit improvements. It was suggested that defining the need for priority and determining where it can be implemented is central to the development of a strategic program. Dedicated programs looking at transit priority were recommended, and risks arising from integrating new infrastructure were reviewed. It was suggested that the range of stakeholders involved, and the internal organization of the implementing authority bore a significant impact on overall cost and schedule of transit projects. It was concluded that appropriate planning is needed to control risks. 20 refs., 3 figs

Clinical guideline implementation strategies for common mental health disorders.

Science.gov (United States)

Moreno, Eliana María; Moriana, Juan Antonio

2016-01-01

There has been a considerable proliferation of clinical guidelines recently, but their practical application is low, and organisations do not always implement their own ones. The aim of this study is to analyse and describe key elements of strategies and resources designed by the National Institute for Health and Care Excellence for the implementation of guidelines for common mental health disorders in adults, which are some of the most prevalent worldwide. A systematic review was performed following PRISMA model. Resources, tools and implementation materials where included and categorised considering type, objectives, target and scope. A total of 212 elements were analysed, of which 33.5 and 24.5% are related to the implementation of generalized anxiety and depression guidelines, respectively. Applied tools designed to estimate costs and assess the feasibility of the setting up at local level are the most frequent type of resource. The study highlights the important variety of available materials, classified into 3 main strategies: tools targeting the professionals (30.6%), structural (26.4%), and organizational (24%). Developing guidelines is not enough; it is also necessary to promote their implementation in order to encourage their application. The resources and strategies described in this study may be potentially applicable to other contexts, and helpful to public health managers and professionals in the design of programmes and in the process of informed decision making to help increase access to efficient treatments. Copyright © 2015. Published by Elsevier España.

Marketing Strategy Implementation: A Study of Small and Medium Companies in Indonesia

Directory of Open Access Journals (Sweden)

Asmai Ishak

2009-08-01

Full Text Available A good marketing strategy does not always necessarily lead to successful marketing performance in an organization. It depends on how marketing people translate the strategy into action. A well formulated, but badly implemented strategy, will be effective (do the right things, but not efficient (do things right. While correct implementation of a badly formulated strategy will be efficient, but not effective. Firms need both effectiveness and efficiency to optimize their performance. This study, based on existing literature, identified a list of activities concerning the marketing strategy implementation, and investigated their nature in the process of the strategy implementation among small and medium companies in Indonesia. A tested structured questionnaire was used as a guidance in interviewing marketing managers -the respondents of the study. A total of 76 completed questionnaires were collected. Factor analysis was used to extract, if any, key dimensions across the data. This analysis resulted into four fundamental factors underlying 16 activities in marketing strategy implementation, namely commitment, consensus, evaluation and control, autonomy, and two factors representing 8 marketing performance that are financial, and strategic performances. Subsequently simple regression was performed to examine the impact of the four factors on the marketing performance. The study findings suggest that evaluation and control has greatest impact either on financial performance or strategic performance, followed by autonomy. Even though commitment and consensus influence the marketing performance, but their influences are not statistically significant.

Analysing the differences between theoretical and implemented supply chain strategies in selected organisations

OpenAIRE

Danie J. Nel; Johanna A. Badenhorst-Weiss

2011-01-01

Organisations can use supply chain strategies to gain a competitive advantage for the supply chain. A competitive advantage can be achieved by means of low cost or by means of differentiation. However, organisations have to implement the correct supply chain strategy. Returns on investment can be compromised if organisations implement an incorrect supply chain strategy. The objective of the article is to analyse the differences between theoretically implied and implemented supply chain strate...

Are marketing strategies implemented by SME’s in the Republic of Macedonia ?

Directory of Open Access Journals (Sweden)

Nexhbi Veseli

2012-12-01

Full Text Available Business strategies in general and marketing strategies in particular are a factor of significant importance when it comes to the success and long term growth of companies. This paper tends to test the generally accepted assumption that SME’s in the Republic of Macedonia do not have and implement well defined marketing strategies. As will be noticed, based on the opinions of the owners of 277 SME’s in the Pollog region, business entities in the Republic of Macedonia do recognize the importance of marketing and marketing strategies, but still fail when it comes to their creation and implementation. As proven by the research, SME’s in the studied region randomly implement certain elements of different types of business and marketing strategies, but not based on theoretical approaches and generally accepted literature in this field.

Implementation of a reimbursed medication review program: Corporate and pharmacy level strategies.

Science.gov (United States)

MacKeigan, Linda D; Ijaz, Nadine; Bojarski, Elizabeth A; Dolovich, Lisa

In 2006, the Ontario drug plan greatly reduced community pharmacy reimbursement for generic drugs. In exchange, a fee-for-service medication review program was introduced to help patients better understand their medication therapy and ensure that medications were taken as prescribed. A qualitative study of community pharmacy implementation strategies was undertaken to inform a mixed methods evaluation of the program. To describe strategies used by community pharmacies to implement a government-funded medication review service. Key informant interviews were conducted with pharmacy corporate executives and managers, as well as independent pharmacy owners. All pharmacy corporations in the province were approached; owners were purposively sampled from the registry of the pharmacist licensing body to obtain diversity in pharmacy attributes; and pharmacy managers were identified through a mix of snowball and registry sampling. Thematic qualitative coding and analysis were applied to interview transcripts. 42 key informants, including 14 executives, 15 managers/franchisees, and 11 owners, participated. The most common implementation strategy was software adaptation to flag eligible patients and to document the service. Human resource management (task shifting to technicians and increasing the technician complement), staff training, and patient identification and recruitment processes were widely mentioned. Motivational strategies including service targets and financial incentives were less frequent but controversial. Strategies typically unfolded over time, and became multifaceted. Apart from the use of targets in chain pharmacies only, strategies were similar across pharmacy ownership types. Ontario community pharmacies appeared to have done little preplanning of implementation strategies. Strategies focused on service efficiency and quantity, rather than quality. Unlike other jurisdictions, many managers supported the use of targets as motivators, and very few reported

76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

Science.gov (United States)

2011-06-24

... Best Practices for Community Health Needs Assessment and Implementation Strategy; Public Forum AGENCY... processes relating to community health needs assessment (CHNA) and implementation strategy/plan development... practices in CHNA and implementation strategy development and execution for improved community health...

Drivers and barriers for implementation of environmental strategies in manufacturing companies

DEFF Research Database (Denmark)

Bey, Niki; Hauschild, Michael Zwicky; McAloone, Tim C.

2013-01-01

In order for environmental strategies to come into effect in industry practice, they need to be implemented and applied in daily business routines. Based on a dedicated comprehensive international survey in product developing and manufacturing companies, this paper identifies major current drivers...... for implementing product life cycle oriented environmental strategies but also barriers and obstacles that need to be addressed. On this basis it provides a number of recommendations for manufacturing companies as well as policy makers to consider for a successful implementation of strategic environmental goals...... in manufacturing industry....

Change Strategies and Associated Implementation Challenges: An Analysis of Online Counselling Sessions.

Science.gov (United States)

Rodda, Simone N; Hing, Nerilee; Hodgins, David C; Cheetham, Alison; Dickins, Marissa; Lubman, Dan I

2017-09-01

Self-change is the most frequent way people limit or reduce gambling involvement and often the first choice of people experiencing gambling-related problems. Less well known is the range of change strategies gamblers use and how these are selected, initiated or maintained. This study examined change strategies discussed in counselling transcripts from 149 clients who accessed a national online gambling help service in Australia. Using thematic analysis, we identified the presence of six change strategies; cash control and financial management, social support, avoiding or limiting gambling, alternative activities, changing thoughts and beliefs, and self-assessment and monitoring. Four implementation issues were also identified; a mismatch between need and strategy selection or maintenance; importance and readiness versus the cost of implementation; poor or unplanned transitions between strategies; and failure to review the helpfulness of strategies resulting in premature abandonment or unhelpful prolonged application. This study is the first to identify change strategies discussed in online counselling sessions. This study suggests change strategies are frequently discussed in online counselling sessions and we identified multiple new actions associated with change strategies that had not previously been identified. However, multiple implementation issues were identified and further work is required to determine the helpfulness of change strategies in terms of their selection, initiation and maintenance.

Implementing national strategies on antimicrobial resistance in Thailand: potential challenges and solutions.

Science.gov (United States)

Sommanustweechai, A; Tangcharoensathien, V; Malathum, K; Sumpradit, N; Kiatying-Angsulee, N; Janejai, N; Jaroenpoj, S

2018-04-01

Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps. This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR. Two of six strategies are related to monitoring and surveillance of AMR and antimicrobial consumption in human and animal. Two other strategies aim to improve antibiotic stewardship and control the spread of AMR in both clinical and farm settings. The remaining two strategies aim to increase knowledge and public awareness on AMR and establish national governance for inter-sectoral actions. Strategies to overcome implementation challenges are sustaining cross-sectoral policy commitments, effective cross-sectoral coordination using One Health approach, generating evidence which guides policy implementation, and improving enforcement capacities in regulatory authorities. To address AMR, Thailand requires significant improvements in implementation capacities in two dimensions. First, technical capacities among implementing agencies are needed to translate policies into practice. Second, governance and organizational capacities enable effective multi-sectoral actions across human, animal, and environmental sectors. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Strategies for Implementing Human Rights Education in Nigeria ...

African Journals Online (AJOL)

Strategies for Implementing Human Rights Education in Nigeria. ... the social and emotional development of the child and by introducing democratic values. It helps learners to develop attitudes of solidarity across issues and nations. Human ...

Implementation of Teaching Skills and Strategies in the Schools

DEFF Research Database (Denmark)

Choeda, Choeda; Kinley, Kinley

2013-01-01

‘Teaching Skills’ and ‘Teaching Strategies’ are two core (professional) modules offered at the two colleges of education in Bhutan to develop pedagogical knowledge and skills of student teachers. However, a tracer study (in press) done by Samtse College of Education [SCE] revealed teacher graduates...... of teaching skills and strategies in the schools. Teacher graduates, both male and female having working experience of three years and above, teaching in Middle Secondary and Higher Secondary Schools, were selected as the participants in the study. Samples were drawn from the different parts of the country...... covering seventeen Dzongkhags. The study revealed adequate understanding of the concepts of professional modules. However, teachers were found to be grappling with the extra responsibilities affecting their planning to integrate skills and strategies into their teaching. Key words: Teaching skills...

Region 6: Texas Austin Adequate Letter (11/23/2016)

Science.gov (United States)

EPA letter approves the Motor Vehicle Emissions Budgets contained in the latest revision to Dallas/Fort Worth 2008 8-hour Ozone State Implementation Plan, finding them adequate for transportation conformity purposes to be announced in the Federal Register.

Integrative review of implementation strategies for translation of research-based evidence by nurses.

Science.gov (United States)

Wuchner, Staci S

2014-01-01

The purpose of this review was to synthesize and critique experimental and/or quasi-experimental research that has evaluated implementation strategies for translation of research-based evidence into nursing practice. Successfully implementing evidence-based research can improve patient outcomes. Identifying successful implementation strategies is imperative to move research-based evidence into practice. As implementation science gains popularity, it is imperative to understand the strategies that most effectively translate research-based evidence into practice. The review used the CINAHL and MEDLINE (Ovid) databases. Articles were included if they were experimental and/or quasi-experimental research designs, were written in English, and measured nursing compliance to translation of research-based evidence. An independent review was performed to select and critique the included articles. A wide array of interventions were completed, including visual cues, audit and feedback, educational meetings and materials, reminders, outreach, and leadership involvement. Because of the complex multimodal nature of the interventions and the variety of research topics, comparison across interventions was difficult. Many difficulties exist in determining what implementation strategies are most effective for translation of research-based evidence into practice by nurses. With these limited findings, further research is warranted to determine which implementation strategies most successfully translate research-based evidence into practice.

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.

Challenges of information systems strategy implementation in public hospitals: a South African experience

CSIR Research Space (South Africa)

Hwabamungu, B

2015-05-01

Full Text Available on this phenomenon in the healthcare sector. Building on previous IS strategizing research we explored the challenges of Information Systems strategy implementation. We then explored the challenges of IS strategy implementation in public hospitals in developing...

Towards an Effective Management Strategy for Passive RFID Implementation

National Research Council Canada - National Science Library

Fisch, John N; Koch, David M

2004-01-01

.... However, many issues central to passive RFID implementation remain unresolved. First and foremost, a comprehensive management strategy, including a complete redesign of business practices, must be developed...

Monitoring implementation of city development strategy: The case study of Pančevo

Directory of Open Access Journals (Sweden)

Mikavica Mihailo

2017-01-01

Full Text Available This paper is the result of the research project carried out as part of the Master program Integral Urbanism at Faculty of Architecture, University of Belgrade. The main focus of master's thesis was 'Instruments for Governing Integral Urban Development'. In year 2016, polygon used to create a master projects was the territory of the City of Pančevo, a development framework was: 'City Development Strategy of Pančevo for the Period 2014-2020'. Considering issues and potential improvement opportunities of the city, after research and analysis, we have chosen the research theme 'Implementation Monitoring of City Development Strategy - The Case Study of Pančevo'. The paper outlines the broader framework of urban development management to understand the implementation of new instruments of urban governance in local context of the City of Pančevo. The focus is on instruments that improve process of the monitoring of implementation of local development strategies - human resources, financing, institutionalization and participation. The results of this master project relate to the proposals for improving monitoring of the implementation strategy, including the manner and structure of reporting, establishing a team to implement the strategy as a permanent body, linking funding strategy with the program budget of the city and improving public participation and transparency in decision-making in the process of implementing the strategy. Results are derived from the research presented in this paper, and listed for better overview and operationalization issues in a local context. The focus of this work is on understanding the capacity of institutionalization of changes in the domain of urban governance in the local context in Serbia.

The development and implementation of a waste management strategy

International Nuclear Information System (INIS)

Fairhall, G.A.; Vickery, P.; Edmiston, L.

1999-01-01

Over the past forty years BNFL has operated 4 nuclear sites in the UK. Commercial operations on these sites span the full nuclear fuel cycle from enrichment, fuel fabrication, electricity generation, reprocessing, waste management, and decommissioning. Through the recent merger with Magnox Electric BNFL has acquired a further 8 Magnox reactor sites in the UK. Prior to 1980 BNFL adopted a policy of storing wastes generated by its activities in an unconditioned state in purpose built stores. This paper shows how BNFL's waste management strategy has developed to ensure how volume reduction technologies have been implemented for low level waste. Whilst immobilisation technologies have been implemented for high and intermediate level wastes. The paper describes how continual review of the strategy ensures waste management processes are continually monitored against progress and optimised to ensure all waste arisings are conditioned for final disposal. Finally the paper will show how the strategy can be used to develop waste management plans for customer sites. (author)

Towards our Common Future: Comparative Assessment of the Sustainable Development Strategies of the European Union, the Mediterranean and Slovenia

Directory of Open Access Journals (Sweden)

Tomaz DEŽELAN

2014-11-01

Full Text Available This paper assesses three sustainable de- velopment strategies – the European Union’s Sustainable Development Strategy in its revised version, the Mediterranean Strategy for Sustain- able Development and Slovenia’s Development Strategy – according to the level of sustainability these strategies provide. Deriving from three di- verse sustainable development regimes, select- ed strategies are scrutinised for the presence of the five general principles of effective sustainable development strategies promoted by the United Nations and the Organization for Economic Co- operation and Development. Building on George and Kirkpatrick’s (2006 framework for analysis, we concentrate on principles of strategic planning and sustainable development, and a coordinated set of measures to ensure their implementation. The results reveal that the major differences be- tween the assessed strategies are present in the sophistication of the theoretical bases and the integration of three main pillars of sustainable development (i.e. environmental, economic and social. In general, the assessed strategies re- flect a high degree of inclusiveness of a variety of interests. However, there is a common weak- ness among them in terms of implementation, be it in the provision of adequate resources, the guarantee of adequate implementing capacity of the institutions designated for implementation or the precise definition of the institutional frame- work responsible for the implementation of the strategy.

[A Matter of Balance: strategy for implementation in Dutch homecare organizations].

Science.gov (United States)

de Jonge, M C; van der Poel, A; van Haastregt, J C M; Du Moulin, M F T M; Zijlstra, G A R; Voordouw, I

2013-02-01

The Dutch version of A Matter of Balance (AMB-NL) is a cognitive behavioral group program to reduce fear of falling and related activity avoidance in community-living older persons. This paper presents the strategy for implementation of AMB-NL in Dutch homecare organizations and the outcomes of this implementation. The aim was to implement AMB-NL in at least 50 % of 64 homecare organizations in The Netherlands in 2009 and 2010. The implementation strategy was based on the four phases of the Replicating Effective Interventions: pre-conditions, pre-implementation, implementation, and maintenance and evolution. After preparing the implementation activities, such as identifying implementation barriers, consulting stakeholders, preparing the materials involved in the implementation, and training the facilitators of the program (n = 53), AMB-NL was implemented in 16 of the 64 homecare organizations (25 %). Another five homecare organizations indicated that they would shortly include AMB-NL in their care program. These organizations conducted the intervention 19 times to a total of 178 participants. After the implementation phase another 16 facilitators were trained, and program materials were successfully disseminated. The implementation of AMB-NL was well performed. The targeted aim is not fully reached within the two-year timeframe, but the program is well received by participants, trainers and homecare organizations. Further implementation and maintenance of AMB-NL in primary health care is recommended.

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.

Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

Science.gov (United States)

SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

2017-01-01

Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972

A preliminary study for the implementation of general accident management strategies

International Nuclear Information System (INIS)

Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung

1997-01-01

To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated

The Role of Ambidexterity in Marketing Strategy Implementation: Resolving the Exploration-Exploitation Dilemma

Directory of Open Access Journals (Sweden)

Christiane Prange

2009-12-01

Full Text Available Formulating consistent marketing strategies is a difficult task, but successfully implementing them is even more challenging. This is even more pertinent as marketing strategies quite often incorporate inherent conflicts between major breakthroughs and consolidation. Consequently, marketers need to balance exploratory and exploitative strategies. However, the literature lacks concrete insights for marketing managers as to how exploratory and exploitative strategies can be best combined. This paper addresses this issue by introducing a framework of multiple types of ambidexterity. Based on qualitative research, tools and procedures are identified to overcome marketing dilemmas and support strategy implementation by drawing on ambidextrous designs.

Intervention implementation research: an exploratory study of reduction strategies for occupational contact dermatitis in the printing industry.

Science.gov (United States)

Brown, Terry P; Rushton, Lesley; Williams, Hywel C; English, John S C

2007-01-01

Occupational dermatitis is a problem in the printing industry but can be avoided through adequate protective measures. Research into intervention implementation is fundamental to the success of a formal intervention effectiveness trial. The preliminary testing of four risk reduction strategies for occupationally caused dermatitis, which represent a range of approaches and cost implications. The strategies, the provision of (i) skin checks plus treatment advice; provision of (ii) gloves of the correct type/size plus use of an after-work cream; provision of (iii) information highlighting the problem of occupational dermatitis and (iv) development of a best practice skin care policy, were evaluated over 3 months in two non-randomly selected companies. A post-intervention evaluation into the effectiveness and efficacy of the intervention was also carried out. All interventions were found to be acceptable to some extent. No single intervention appeared to be completely effective. The most practical intervention appeared to be the regular use of gloves of the correct type and size. This preliminary intervention study has demonstrated an improvement in the skin condition of workers examined and points towards the need for further testing of risk reduction strategies for the prevention of dermatitis in the printing industry on a much larger scale.

Human Resource Development Issues in the Implementation of the Western China Development Strategy

Science.gov (United States)

Xiao, Mingzheng

2007-01-01

This paper systematically illustrates the value and role of human resource development in the implementation of the Western China development strategy. It analyzes in details some current human resource issues constraining the implementation of the Western China development strategy and those on the sustainable development process of economic…

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.

Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.

Science.gov (United States)

Soban, Lynn M; Kim, Linda; Yuan, Anita H; Miltner, Rebecca S

2017-09-01

To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

A preliminary study for the implementation of general accident management strategies

Energy Technology Data Exchange (ETDEWEB)

Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

1998-12-31

To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)

A preliminary study for the implementation of general accident management strategies

Energy Technology Data Exchange (ETDEWEB)

Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

1997-12-31

To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)

Implementing school nursing strategies to reduce LGBTQ adolescent suicide: a randomized cluster trial study protocol.

Science.gov (United States)

Willging, Cathleen E; Green, Amy E; Ramos, Mary M

2016-10-22

Reducing youth suicide in the United States (U.S.) is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth are at elevated risk. The Centers for Disease Control and Prevention (CDC) endorses six evidence-based (EB) strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, "RLAS" (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide), builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS) conceptual framework and the Dynamic Adaptation Process (DAP) to implement EB strategies in U.S. high schools. The DAP accounts for the multilevel context of school settings and uses Implementation Resource Teams (IRTs) to facilitate appropriate expertise, advise on acceptable adaptations, and provide data feedback to make schools implementation ready and prepared to sustain changes. Mixed methods will be used to examine individual, school, and community factors influencing both implementation process and youth outcomes. A cluster randomized controlled trial will assess whether LGBTQ students and their peers in RLAS intervention schools (n = 20) report reductions in suicidality, depression, substance use, bullying, and truancy related to safety concerns compared to those in usual care schools (n = 20). Implementation progress and fidelity for each EB strategy in RLAS intervention schools will be examined using a modified version of the Stages of Implementation Completion checklist. During the implementation and sustainment phases, annual focus groups will be conducted with the 20 IRTs to document their experiences identifying and advancing adaptation supports to facilitate use of EB strategies and their perceptions of the DAP. The DAP represents a data-informed, collaborative, multiple stakeholder approach to progress from exploration to sustainment and obtain

Implementing school nursing strategies to reduce LGBTQ adolescent suicide: a randomized cluster trial study protocol

Directory of Open Access Journals (Sweden)

Cathleen E. Willging

2016-10-01

Full Text Available Abstract Background Reducing youth suicide in the United States (U.S. is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ youth are at elevated risk. The Centers for Disease Control and Prevention (CDC endorses six evidence-based (EB strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, “RLAS” (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide, builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS conceptual framework and the Dynamic Adaptation Process (DAP to implement EB strategies in U.S. high schools. The DAP accounts for the multilevel context of school settings and uses Implementation Resource Teams (IRTs to facilitate appropriate expertise, advise on acceptable adaptations, and provide data feedback to make schools implementation ready and prepared to sustain changes. Methods/Design Mixed methods will be used to examine individual, school, and community factors influencing both implementation process and youth outcomes. A cluster randomized controlled trial will assess whether LGBTQ students and their peers in RLAS intervention schools (n = 20 report reductions in suicidality, depression, substance use, bullying, and truancy related to safety concerns compared to those in usual care schools (n = 20. Implementation progress and fidelity for each EB strategy in RLAS intervention schools will be examined using a modified version of the Stages of Implementation Completion checklist. During the implementation and sustainment phases, annual focus groups will be conducted with the 20 IRTs to document their experiences identifying and advancing adaptation supports to facilitate use of EB strategies and their perceptions of the DAP. Discussion The DAP represents a data-informed, collaborative, multiple stakeholder

A four-phase strategy for the implementation of reflectance confocal microscopy in dermatology.

Science.gov (United States)

Hoogedoorn, L; Gerritsen, M J P; Wolberink, E A W; Peppelman, M; van de Kerkhof, P C M; van Erp, P E J

2016-08-01

Reflectance confocal microscopy (RCM) is gradually implemented in dermatology. Strategies for further implementation and practical 'hands on' guidelines are lacking. The primary outcome was to conduct a general strategy for further implementation of RCM. The secondary outcome was the diagnosis of psoriasis and differentiation of stable from unstable psoriatic plaques by means of the 'hands on' protocol, derived from the strategy. We used a four-phased model; an exploring phase, a systematic literature search, a clinical approach and, finally, an integration phase to develop a clinical guideline for RCM in psoriasis. Receiver operating characteristic curve statistics was applied to define the accuracy for the diagnosis of unstable psoriasis. A general strategy for further implementation of RCM and practical approach was developed to examine psoriasis by RCM and to distinguish stable from unstable psoriasis. Unstable psoriasis was diagnosed by epidermal inflammatory cell counts with a sensitivity and specificity of 91.7% and 98.3%, respectively, and with an accuracy of 0.92 (area under the curve). In addition, a monitoring model was proposed. This is the first study that shows a method for implementation of RCM in dermatology. The strategy and hands on protocol for psoriasis may serve as a model for other dermatological entities and additionally may lead to specialized ready-to-use RCM protocols for clinical dermatological practice. © 2016 European Academy of Dermatology and Venereology.

From intervention to innovation: applying a formal implementation strategy in community primary care.

Science.gov (United States)

Wallace, Andrea S; Sussman, Andrew L; Anthoney, Mark; Parker, Edith A

2013-01-01

Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs) serving vulnerable patients. Methods. The Replicating Effective Programs (REP) framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer. Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers. Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations.

From Intervention to Innovation: Applying a Formal Implementation Strategy in Community Primary Care

Directory of Open Access Journals (Sweden)

Andrea S. Wallace

2013-01-01

Full Text Available Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs serving vulnerable patients. Methods. The Replicating Effective Programs (REP framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer. Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers. Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations.

Implementing multiple intervention strategies in Dutch public health-related policy networks.

Science.gov (United States)

Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

2017-10-13

Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

75 FR 43528 - Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan

Science.gov (United States)

2010-07-26

... National Health Security Strategy Biennial Implementation Plan AGENCY: Department of Health and Human... National Health Security Strategy (NHSS) of the United States of America (2009) and build upon the NHSS Interim Implementation Guide for the National Health Security Strategy of the United States of America...

Implementation of a records management strategy at the Botswana ...

African Journals Online (AJOL)

Implementation of a records management strategy at the Botswana Unified ... raising awareness on the importance of records; human capacity building and ... of records, appreciation of the importance of records as a strategic resource and the ...

Forest Service Global Change Research Strategy, 2009-2019 Implementation Plan

Science.gov (United States)

Allen Solomon; Richard A. Birdsey; Linda A. Joyce

2010-01-01

In keeping with the research goals of the U.S. Global Change Research Program, the climate change strategy of the U.S. Department of Agriculture (USDA), and the climate change framework of the Forest Service, this Forest Service Global Change Research Strategy, 2009-2019 Implementation Plan (hereafter called the Research Plan), was written by Forest Service Research...

Taking the UK's national LLW programme from strategy development to implementation - 59059

International Nuclear Information System (INIS)

Rossiter, David; O'Donnell, Rachel

2012-01-01

In 2008 UK Nuclear Waste Management Ltd (UKNWM) became the Parent Body Organisation (PBO) at the Low Level Waste Repository (LLWR) in the UK. LLWR is the primary disposal facility for the UK's LLW, supporting a wide range of industries across the nuclear power generation, reprocessing, defence, health care, education, and oil and gas sectors. One of the key tasks following the appointment of the new PBO was to work with the Nuclear Decommissioning Authority (NDA) to develop a national strategy for LLW generated in the UK, predominantly in the NDA estate. The new National Strategy for LLW was required to address the gap between the forecast waste arisings and predicted capacity at LLWR. The National Strategy for LLW Management was published in August 2010 following an 18 month development period. The main focus of the strategy is on three areas: - Application of the waste management hierarchy to extend the life of LLWR and ensure waste is managed in a risk-based, fit-for-purpose manner - Making best use of existing assets such as transport, packaging, treatment and disposal facilities - Opening up new fit-for-purpose waste management routes to divert waste away from LLWR Developing a robust strategy is vital to provide strategic direction to Government, waste producers, regulators, and stakeholders. Once the strategy is developed and approved, the key challenge is then to implement the strategy on a national scale in an efficient and cost-effective manner that delivers maximum value for money to the UK taxpayer. As well as developing the strategy, LLWR has been actively working to develop the enablers to implement the strategy. Since the publication of the strategy in August 2010 LLWR has been re-organised to reflect the shift in focus, from strategy development to implementation and delivery of the strategy. New resources have been brought in with international waste management experience to help integrate delivery with waste producers. This paper covers the

A 7-Step Strategy for the Implementation of Worksite Lifestyle Interventions: Helpful or Not?

Science.gov (United States)

Wierenga, Debbie; Engbers, Luuk H; Van Empelen, Pepjin; van Mechelen, Willem

2016-05-01

The aim of this study was to evaluate the use of and adherence to a 7-step strategy for the development, implementation, and continuation of a comprehensive, multicomponent lifestyle program. Strategy use and adherence was assessed with 12 performance indicators. Data were collected by combining onsite monitoring with semi-structured interviews at baseline and follow-up (6, 12, and 18 months). Not all performance indicators were met so partial strategy adherence was obtained. The strategy could be improved on the following aspects: support among management, project structure, adaptation to needs of employees, planning, and maintenance. The results of this evaluation indicate that strategy adherence facilitated structured development and implementation. On the basis of the qualitative data, this study suggests that when improvements will be made on both the content and performance, the 7-step strategy could be an effective tool to successfully implement a multicomponent WHPP.

Analytical Role of Corporate Strategy in Growth and Expansion of Unilever Pakistan

Directory of Open Access Journals (Sweden)

Hassan Abbas

2018-03-01

Full Text Available The corporate strategy plays an integral role in providing business entities with a market direction. The formulation and implementation of corporate strategy aids in providing businesses with abilities and capabilities so as to maintain and develop adequate pace with the consistently changing business environment, aids in the development of a strategic vision and focus on overall business goals and objectives, strengthens decision making and most importantly helps in the provision of a competitive edge to a business. The role of corporate strategy becomes highly significant when the business operates globally. The research undertakes the relative role, significance and overall impact of its corporate strategy in making adequate contribution towards the attainment of business growth and expansion and assessing the correlation between the corporate strategy and overall business growth.

Implementing a Redesign Strategy: Lessons from Educational Change.

Science.gov (United States)

Basom, Richard E., Jr.; Crandall, David P.

The effective implementation of school redesign, based on a social systems approach, is discussed in this paper. A basic assumption is that the interdependence of system elements has implications for a complex change process. Seven barriers to redesign and five critical issues for successful redesign strategy are presented. Seven linear steps for…

Evaluation of an effective multifaceted implementation strategy for elective single-embryo transfer after in vitro fertilization.

Science.gov (United States)

Kreuwel, I A M; van Peperstraten, A M; Hulscher, M E J L; Kremer, J A M; Grol, R P T M; Nelen, W L D M; Hermens, R P M G

2013-02-01

What is the relationship between the rate of elective single-embryo transfer (eSET) and couples' exposure to different elements of a multifaceted implementation strategy? Additional elements in a multifaceted implementation strategy do not result in an increased eSET rate. A multifaceted eSET implementation strategy with four different elements is effective in increasing the eSET rate by 11%. It is unclear whether every strategy element contributes equally to the strategy's effectiveness. An observational study was performed among 222 subfertile couples included in a previously performed randomized controlled trial. Of the 222 subfertile couples included, 109 couples received the implementation strategy and 113 couples received standard IVF care. A multivariate regression analysis assessed the effectiveness of four different strategy elements on the decision about the number embryos to be transferred. Questionnaires evaluated the experiences of couples with the different elements. Of the couples who received the implementation strategy, almost 50% (52/109) were exposed to all the four elements of the strategy. The remaining 57 couples who received two or three elements of the strategy could be divided into two further classes of exposure. Our analysis demonstrated that additional elements do not result in an increased eSET rate. In addition to the physician's advice, couples rated a decision aid and a counselling session as more important for their decision to transfer one or two embryos, compared with a phone call and a reimbursement offer (P implementation strategy does not always result in an increased effectiveness, which is in concordance with recent literature. This in-depth evaluation of a multifaceted intervention strategy could therefore help to modify strategies, by making them more effective and less expensive.

High flexibility and low cost digital implementation for modern PWM strategies

DEFF Research Database (Denmark)

Mathe, Laszlo; Sera, Dezso; Kerekes, Tamas

2011-01-01

like AZSPWM, NSPWM, or ACRPWM. By using a conventional PWM unit from a microcontroller, these modern modulation techniques are often difficult, or even impossible, to implement. The proposed method can be used to implement PWM strategies even for those microcontrollers which are not equipped...

Awareness and implementation of the regional animal welfare strategy for the Americas: a questionnaire.

Science.gov (United States)

Glass, E; Kahn, S; Arroyo Kuribreha, M

2015-12-01

The World Organisation for Animal Health (OIE) is the global standard-setting organisation for animal health and these standards are references for the World Trade Organization legal framework. In 2002, noting the relationship between animal health and welfare, the OIE accepted the mandate to develop animal welfare standards. These standards were subsequently adopted by Member Countries and have been included in the TerrestrialAnimal Health Code and the Aquatic Animal Health Code. The implementation of the OIE standards by Member Countries is continually promoted. National OIE Delegates are encouraged to nominate National Focal Points for key topics, including animal welfare. In 2012, the OIE Regional Commission of the Americas adopted a Regional Animal Welfare Strategy (Regional Strategy) to promote a coordinated approach to the implementation of the OIE animal welfare standards by the 29 Member Countries in the region. In February 2015, the OIE Regional Representation for the Americas distributed a questionnaire to determine the level of awareness and implementation of the Regional Strategy. This paper presents the results of the questionnaire. With a few exceptions, veterinary officials and stakeholders are only just becoming aware of the strategy and implementation is at an early stage. To promote the implementation of the Regional Strategy, it will be.necessary to continue building the capacity of the national Veterinary Services, strengthening public-private partnerships, modernising legislation and promoting veterinary involvement in animal welfare. Through the implementation of the Regional Strategy, the OIE will provide support to countries in establishing animal welfare standards, in line with government priorities and consumer concerns.

The WHO-ITU national eHealth strategy toolkit as an effective approach to national strategy development and implementation.

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Hamilton, Clayton

2013-01-01

With few exceptions, national eHealth strategies are the pivotal tools upon which the launch or refocusing of national eHealth programmes is hinged. The process of their development obviates cross-sector ministerial commitment led by the Ministry of Health. Yet countries often grapple with the task of strategy development and best efforts frequently fail to address strategic components of eHealth key to ensure successful implementation and stakeholder engagement. This can result in strategies that are narrowly focused, with an overemphasis placed on achieving technical outcomes. Without a clear link to a broader vision of health system development and a firm commitment from partners, the ability of a strategy to shape development of a national eHealth framework will be undermined and crucial momentum for implementation will be lost. WHO and ITU have sought to address this issue through the development of the National eHealth Strategy Toolkit that provides a basis for the components and processes to be considered in a strategy development or refocusing exercise. We look at this toolkit and highlight those areas which the countries should consider in formulating their national eHealth strategy.

Region 10: Idaho Northern Ada County Adequate Letter (6/21/2013)

Science.gov (United States)

EPA approves motor vehicle emissions budget in the Northern Ada County PM10 State Implementation Plan, Maintenance Plan: Ten-Year Update for PM10 national ambient air quality standard, adequate for transportation conformity purposes.

Evaluation of the Strategy Management Implementation in Project- Oriented Service Organizations

Directory of Open Access Journals (Sweden)

Abolfazl Sherafat

2014-02-01

Full Text Available Although developing strategic and operational plans is a difficult and complicated process, their successful implementation is much more difficult. Many organizations fail in the full implementation of their strategies. This is not due to the partial definition of strategies and organization‘s operational plan, but this is likely due to the lack of strong framework for creating alignment between employees and operational process and the organizational goals. To implement strategies effectively and to develop a comprehensive management system and to improve the performance, Robert Kaplan and David Norton introduced a modern management system which is Balanced ScoreCard. Likewise they introduced five main criteria: leadership, translation, alignment, every day process and ongoing process for a strategy oriented organization. This paper is intended to offer a systematic approach for measuring the effectiveness and efficiency of the strategic plan performance. For this study the questionnaire was distributed in a project- orientated service organization and after collection, by the use of statistical. Analysis especially factor analysis the grouping of sub-criteria under the five main criteria was confirmed. The statistical analysis showed that, two criteria of alignment and every day work had the lowest scores in terms of both implementation and effectiveness in the organization‘s senior and executive manager‘s point of view. With deep interview, studying of scorecards and meeting of the strategic committee of the studied organization, the two dimension of alignment and every day work were further examined and after identifying upgradeable areas, some suggestions for improving the effectiveness and efficiency of the studied organization were presented.

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.

On the implementation of a ‘global’ environmental strategy: The role of absorptive capacity

NARCIS (Netherlands)

Pinkse, J.; Kuss, M.J.; Hoffmann, V.H.

2010-01-01

This paper sheds light on factors influencing to what extent MNCs are able to implement a global environmental strategy. We apply the concept of absorptive capacity to analyze what role the uptake and integration of external knowledge plays in implementing an environmental strategy and propose to

Assessment of generic accident management strategies considered for near term implementation

International Nuclear Information System (INIS)

Lehner, J.R.; Luckas, W.J.; Vandenkieboom, J.J.

1989-01-01

The US Nuclear Regulatory Commission (NRC) and the industry are both participating in the identification of measures that can prevent the progression of a severe accident or mitigate its consequences. Information important for evaluating these accident management strategies for specific plants is expected to result from the ongoing Individual Plant Evaluation (IPE) program. However, NRC staff have identified a number of generic strategies which may not have to await the results of the IPE program and therefore can be considered for earlier implementation. The NRC requested two of its contractors, Brookhaven National Laboratory (BNL) and Battelle Pacific Northwest Laboratories (PNL) to evaluate these strategies. The twenty one candidate strategies fall under three broad global strategies: (1) conserving and replenishing limited resources, (2) use of systems/components in innovative applications, and (3) defeating interlocks and component protective trips in emergencies. Some strategies apply to BWRs or PWRs only, other apply to both types of plants. This paper describes the evaluation of the strategies performed by Brookhaven National Laboratory. Brookhaven National Laboratory assessed the proposed strategies by first detailing the objective of the strategy and listing the actions involved in the implementation. A description of the plant systems associated with the strategy was given. Next, the applicability of existing rules or plant procedures to a particular strategy was investigated. This was accomplished by a fairly detailed, but by no means exhaustive review of the emergency operating procedures of several plants, as well as utility and NRC reports related to accident management

Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

Science.gov (United States)

Sperber, Nina R; Carpenter, Janet S; Cavallari, Larisa H; J Damschroder, Laura; Cooper-DeHoff, Rhonda M; Denny, Joshua C; Ginsburg, Geoffrey S; Guan, Yue; Horowitz, Carol R; Levy, Kenneth D; Levy, Mia A; Madden, Ebony B; Matheny, Michael E; Pollin, Toni I; Pratt, Victoria M; Rosenman, Marc; Voils, Corrine I; W Weitzel, Kristen; Wilke, Russell A; Ryanne Wu, R; Orlando, Lori A

2017-05-22

To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic

Towards guideline implementation for integrated local health policies : Evaluation of an experimental implementation strategy in regional health services

NARCIS (Netherlands)

Kuunders, T.J.M.; Cloin, J.C.M.; van Bon, M.J.H.; Paulussen, T.G.W.M.; van Oers, J.A.M.; van de Goor, L.A.M.

2017-01-01

To enhance implementation of a Guideline for integrated local health policy, a draft implementation strategy (DIS) was developed. It was hypothesized that the DIS would be feasible and effective to enhance the use of a Guideline for integrated local health policy. To examine its feasibility and

A Knowledge Management Approach to Support Software Process Improvement Implementation Initiatives

Science.gov (United States)

Montoni, Mariano Angel; Cerdeiral, Cristina; Zanetti, David; Cavalcanti da Rocha, Ana Regina

The success of software process improvement (SPI) implementation initiatives depends fundamentally of the strategies adopted to support the execution of such initiatives. Therefore, it is essential to define adequate SPI implementation strategies aiming to facilitate the achievement of organizational business goals and to increase the benefits of process improvements. The objective of this work is to present an approach to support the execution of SPI implementation initiatives. We also describe a methodology applied to capture knowledge related to critical success factors that influence SPI initiatives. This knowledge was used to define effective SPI strategies aiming to increase the success of SPI initiatives coordinated by a specific SPI consultancy organization. This work also presents the functionalities of a set of tools integrated in a process-centered knowledge management environment, named CORE-KM, customized to support the presented approach.

Establishing an intrapreneurial orientation as strategy: A framework for implementation

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H. Jacobs

2001-12-01

Full Text Available This paper describes a study aimed at increasing an organisation's ability to implement a strategy for establishing an intrapreneurial orientation effectively. Establishing an intrapreneurial orientation will be treated from a strategic management point of view, with the emphasis on the implementation phase of strategic management. As such, this study seeks to integrate theory and practice from the fields of strategic management and entrepreneurship.

Structured Strategy for Implementation of the Teaching Portfolio Concept in Japan

Science.gov (United States)

Kurita, Kayoko

2013-01-01

This paper describes a strategy for successfully implementing the teaching portfolio in higher education institutions in Japan. The teaching portfolio has gained recognition in Japan in the last few years as an effective instrument for improving and showcasing teaching performance. It is well known that the implementation process is very important…

To Assess Prerequisites Before an Implementation Strategy in an Orthopaedic Department in Sweden.

Science.gov (United States)

Bahtsevani, Christel; Idvall, Ewa

2016-01-01

Promoting Action on Research Implementation in Health Services (PARiHS) asserts that the success of knowledge implementation relates to multiple factors in a complex and dynamic way, and therefore the effects of implementation strategies vary by method and context. An instrument based on the PARiHS framework was developed to help assess critical factors influencing implementation strategies so that strategies can be tailored to promote implementation.The purpose of this study was to use the Evaluation Before Implementation Questionnaire (EBIQ), to describe staff perceptions in one orthopaedic department, and to investigate differences between wards.Staff members in four different wards at one orthopaedic department at a university hospital in Sweden were invited to complete a questionnaire related to planning for the implementation of a clinical practice guideline. The 23 items in the EBIQ were expected to capture staff perceptions about the evidence, context, and facilitation factors that influence the implementation process. Descriptive statistics and differences between wards were analyzed. Although the overall response rate was low (n = 49), two of the four wards accounted for most of the completed questionnaires (n = 25 and n = 12, respectively), enabling a comparison of these wards. We found significant differences between respondents' perceptions at the two wards in six items regarding context and facilitation in terms of receptiveness to change, forms of leadership, and evaluation and presence of feedback and facilitators.The EBIQ instrument requires further testing, but there appears to be initial support for pre-implementation use of the EBIQ as a means to enhance planning for implementation.

Group Coaching on Pre-School Teachers' Implementation of Pyramid Model Strategies: A Program Description

Science.gov (United States)

Fettig, Angel; Artman-Meeker, Kathleen

2016-01-01

The purpose of this article was to describe a group coaching model and present preliminary evidence of its impact on teachers' implementation of Pyramid Model practices. In particular, we described coaching strategies used to support teachers in reflecting and problem solving on the implementation of the evidence-based strategies. Preliminary…

Implementation strategies for health systems in low-income countries: an overview of systematic reviews.

Science.gov (United States)

Pantoja, Tomas; Opiyo, Newton; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Wiysonge, Charles S; Herrera, Cristian A; Rada, Gabriel; Peñaloza, Blanca; Dudley, Lilian; Gagnon, Marie-Pierre; Garcia Marti, Sebastian; Oxman, Andrew D

2017-09-12

A key function of health systems is implementing interventions to improve health, but coverage of essential health interventions remains low in low-income countries. Implementing interventions can be challenging, particularly if it entails complex changes in clinical routines; in collaborative patterns among different healthcare providers and disciplines; in the behaviour of providers, patients or other stakeholders; or in the organisation of care. Decision-makers may use a range of strategies to implement health interventions, and these choices should be based on evidence of the strategies' effectiveness. To provide an overview of the available evidence from up-to-date systematic reviews about the effects of implementation strategies for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on alternative implementation strategies and informing refinements of the framework for implementation strategies presented in the overview. We searched Health Systems Evidence in November 2010 and PDQ-Evidence up to December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of implementation strategies on professional practice and patient outcomes and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the review findings. Two overview authors independently screened reviews, extracted data and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence) and assessments of the relevance of findings to low-income countries. We identified 7272 systematic reviews and included 39 of them in this overview. An additional four

Teaching Strategies Employed by ACSE English Teachers in Implementing CBLT in Tanzania

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Wakati MALIVA

2017-12-01

Full Text Available English in Tanzania is taught as one of the major subjects at Advanced Certificate of Secondary School Education (ACSE. This paper explores the strategies employed by teachers in implementing the ACSE curriculum. The curriculum requires that the subject be taught using the competence based approach where learner-centred strategies are emphasized. The study employed mixed methods and descriptive design. Purposive sampling was used to get schools and teachers because it was only schools that had English as a major subject in the municipality that were selected. The findings reveal that the teacher-centerd strategies dominate the curriculum implementation as opposed to learner-centerd ones as required by the curriculum. The paper therefore recommends that teachers in Iringa municipality be oriented on the learner-centred strategies in the implementation of English at ACSE. It is further recommended that since oral language skills form a large part of the curriculum, these skills be assessed at both school and national based assessments if they are to be taught and learnt. This is because no teacher can waste time teaching what is not assessed and no student can take trouble to learn what is not assessed.

The association between implementation strategy use and the uptake of hepatitis C treatment in a national sample.

Science.gov (United States)

Rogal, Shari S; Yakovchenko, Vera; Waltz, Thomas J; Powell, Byron J; Kirchner, JoAnn E; Proctor, Enola K; Gonzalez, Rachel; Park, Angela; Ross, David; Morgan, Timothy R; Chartier, Maggie; Chinman, Matthew J

2017-05-11

Hepatitis C virus (HCV) is a common and highly morbid illness. New medications that have much higher cure rates have become the new evidence-based practice in the field. Understanding the implementation of these new medications nationally provides an opportunity to advance the understanding of the role of implementation strategies in clinical outcomes on a large scale. The Expert Recommendations for Implementing Change (ERIC) study defined discrete implementation strategies and clustered these strategies into groups. The present evaluation assessed the use of these strategies and clusters in the context of HCV treatment across the US Department of Veterans Affairs (VA), Veterans Health Administration, the largest provider of HCV care nationally. A 73-item survey was developed and sent to all VA sites treating HCV via electronic survey, to assess whether or not a site used each ERIC-defined implementation strategy related to employing the new HCV medication in 2014. VA national data regarding the number of Veterans starting on the new HCV medications at each site were collected. The associations between treatment starts and number and type of implementation strategies were assessed. A total of 80 (62%) sites responded. Respondents endorsed an average of 25 ± 14 strategies. The number of treatment starts was positively correlated with the total number of strategies endorsed (r = 0.43, p strategies endorsed (p strategies, compared to 15 strategies in the lowest quartile. There were significant differences in the types of strategies endorsed by sites in the highest and lowest quartiles of treatment starts. Four of the 10 top strategies for sites in the top quartile had significant correlations with treatment starts compared to only 1 of the 10 top strategies in the bottom quartile sites. Overall, only 3 of the top 15 most frequently used strategies were associated with treatment. These results suggest that sites that used a greater number of implementation

Strategies for implementing a mitigation policy for light water reactors

International Nuclear Information System (INIS)

Kastenberg, W.E.; Hammond, R.P.; Catton, I.; Dooley, J.L.; Castle, J.N.

1988-01-01

Possible strategies are considered for implementing a regulatory policy requiring that power reactor containment enclosures be modified to resist severe core-melt accidents without release of radioactive materials. Such modification was found to be feasible, reliable and cost effective in the work reported in previous studies in this NRC series. Incentives, goals, costs and sources of funding are discussed, and a series of possible implementation steps are presented. 11 refs

Lean implementation strategies: how are the Toyota way principles addressed?

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Coetzee, Rojanette

2016-11-01

Full Text Available Lean manufacturing is widely considered to be a proven organisational improvement philosophy, yet the success rate of lean implementation in industry remains relatively low. Neglect of the human aspect of lean manufacturing is often cited as the leading reason for this, despite the emphasis so clearly placed upon this aspect by the creators of the lean philosophy. This article reviews the extent to which the human dimensions of the lean philosophy, as described in the Toyota Way management principles, have been incorporated in lean implementation strategies. It is found that few of the principles feature prominently in these strategies. Notably absent are those linked to the ‘respect for people’ pillar , which forms half of the T oyota Way’s foundation. This conclusion indicates that the adoption of the lean philosophy runs contrary to the oft-repeated message from its creators that no tenet of the philosophy should be favoured at the expense of another. This may provide valuable insight into the reasons for the high implementation failure rate.

Parallel processes: using motivational interviewing as an implementation coaching strategy.

Science.gov (United States)

Hettema, Jennifer E; Ernst, Denise; Williams, Jessica Roberts; Miller, Kristin J

2014-07-01

In addition to its clinical efficacy as a communication style for strengthening motivation and commitment to change, motivational interviewing (MI) has been hypothesized to be a potential tool for facilitating evidence-based practice adoption decisions. This paper reports on the rationale and content of MI-based implementation coaching Webinars that, as part of a larger active dissemination strategy, were found to be more effective than passive dissemination strategies at promoting adoption decisions among behavioral health and health providers and administrators. The Motivational Interviewing Treatment Integrity scale (MITI 3.1.1) was used to rate coaching Webinars from 17 community behavioral health organizations and 17 community health centers. The MITI coding system was found to be applicable to the coaching Webinars, and raters achieved high levels of agreement on global and behavior count measurements of fidelity to MI. Results revealed that implementation coaches maintained fidelity to the MI model, exceeding competency benchmarks for almost all measures. Findings suggest that it is feasible to implement MI as a coaching tool.

Operations Strategy and –Innovation? -A Contractor Implementing Lean

DEFF Research Database (Denmark)

Koch, Christian; Simonsen, Rolf

2006-01-01

Traditional strategic management and operations strategy wants us to believe that the implementation of management concepts is a simple strategic choice made by top managers. In this paper we introduce the story of Lean Construction entering into the organisation of a Danish contractor. Lean...... concepts. The paper presents findings from empirical work in collaboration with a large Danish contractor. The case is analysed from the perspective of operation strategy and political process. It is observed how the management concept is socially constructed and negotiated through political action of key...

Adequate Education: Issues in Its Definition and Implementation. School Finance Project, Working Papers.

Science.gov (United States)

Tron, Esther, Ed.

Section 1203 of the Education Amendments of 1978 mandated the undertaking of studies concerning the adequate financing of elementary and secondary education in the 1980s. Created to carry out this mandate, the School Finance Project established as one of its goals reporting to Congress on issues implicit in funding educational adequacy. Several…

Using a multi-state Learning Community as an implementation strategy for immediate postpartum long-acting reversible contraception.

Science.gov (United States)

DeSisto, Carla L; Estrich, Cameron; Kroelinger, Charlan D; Goodman, David A; Pliska, Ellen; Mackie, Christine N; Waddell, Lisa F; Rankin, Kristin M

2017-11-21

Implementation strategies are imperative for the successful adoption and sustainability of complex evidence-based public health practices. Creating a learning collaborative is one strategy that was part of a recently published compilation of implementation strategy terms and definitions. In partnership with the Centers for Disease Control and Prevention and other partner agencies, the Association of State and Territorial Health Officials recently convened a multi-state Learning Community to support cross-state collaboration and provide technical assistance for improving state capacity to increase access to long-acting reversible contraception (LARC) in the immediate postpartum period, an evidence-based practice with the potential for reducing unintended pregnancy and improving maternal and child health outcomes. During 2015-2016, the Learning Community included multi-disciplinary, multi-agency teams of state health officials, payers, clinicians, and health department staff from 13 states. This qualitative study was conducted to better understand the successes, challenges, and strategies that the 13 US states in the Learning Community used for increasing access to immediate postpartum LARC. We conducted telephone interviews with each team in the Learning Community. Interviews were semi-structured and organized by the eight domains of the Learning Community. We coded transcribed interviews for facilitators, barriers, and implementation strategies, using a recent compilation of expert-defined implementation strategies as a foundation for coding the latter. Data analysis showed three ways that the activities of the Learning Community helped in policy implementation work: structure and accountability, validity, and preparing for potential challenges and opportunities. Further, the qualitative data demonstrated that the Learning Community integrated six other implementation strategies from the literature: organize clinician implementation team meetings, conduct

AHP IN IMPLEMENTATION OF BALANCED SCORECARD

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Jelena Jovanovic

2015-11-01

Full Text Available BSC as a matrix of balanced indicators gives a review of organization activities within four or more perspectives (fields (finance, users, business processes, learning and development where by necessary conditions for development and continual improvement are created. As BSC is essentially a frame for realization of defined strategy in the organization, its implementation asks for an adequate choice of measures-indicators and therefore this paper is oriented towards importance and methodology of the choice of indicators. This paper particularly emphasizes a possibility of implementation of AHP (Analytic Hierarchy Process and ANP (Analytic Network Process as methods of multi-criteria decision-making (MCDM inmplementation of BSC.

Rationale, Implementation and Evaluation of Assistive Strategies for an Active Back-Support Exoskeleton

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Stefano Toxiri

2018-05-01

Full Text Available Active exoskeletons are potentially more effective and versatile than passive ones, but designing them poses a number of additional challenges. An important open challenge in the field is associated to the assistive strategy, by which the actuation forces are modulated to the user’s needs during the physical activity. This paper addresses this challenge on an active exoskeleton prototype aimed at reducing compressive low-back loads, associated to risk of musculoskeletal injury during manual material handling (i.e., repeatedly lifting objects. An analysis of the biomechanics of the physical task reveals two key factors that determine low-back loads. For each factor, a suitable control strategy for the exoskeleton is implemented. The first strategy is based on user posture and modulates the assistance to support the wearer’s own upper body. The second one adapts to the mass of the lifted object and is a practical implementation of electromyographic control. A third strategy is devised as a generalized combination of the first two. With these strategies, the proposed exoskeleton can quickly adjust to different task conditions (which makes it versatile compared to using multiple, task-specific, devices as well as to individual preference (which promotes user acceptance. Additionally, the presented implementation is potentially applicable to more powerful exoskeletons, capable of generating larger forces. The different strategies are implemented on the exoskeleton and tested on 11 participants in an experiment reproducing the lifting task. The resulting data highlights that the strategies modulate the assistance as intended by design, i.e., they effectively adjust the commanded assistive torque during operation based on user posture and external mass. The experiment also provides evidence of significant reduction in muscular activity at the lumbar spine (around 30% associated to using the exoskeleton. The reduction is well in line with previous

Current status of RCA projects and strategies for future implementation

International Nuclear Information System (INIS)

Kim, Kyoung Pyo; Lee, Jeong Kong

1998-12-01

This report is intended to provide basic overall information about ways to promote technical cooperation within the framework of RCA to accelerate and coordinate cooperative activities in nuclear science and technology in Asia and the Pacific region through a thorough review on the current status and through suggesting future implementation strategies. The contents of this report include an overall introduction of RCA, guidelines and operating rules for RCA programmes, current status and future plans for RCA projects as well as the RCA vision for the next 25 years. By reviewing the current status and future implementation strategies for RCA projects, it will help to set up a national nuclear policy aimed at seeking maximum benefits from participation in RCA projects and to implement programmes for nuclear cooperation with Asian-Pacific countries. It is expected that as a lead country for the energy sector, which is one of five thematic areas for the year 1999 - 2000 cycle programmes, Korea will continue to make significant contributions towards the implementation of RCA programmes in the future. With this report, we plan to keep up with future developments as well as implement an effective cooperation with the countries in the region so that the opinion of Korea, one of the nuclear advanced countries in the region, can be fully reflected in the establishment of future plans for RCA programmes. (author). 3 refs., 5 tabs., 1 fig

IMPLEMENTING THE COMPUTER-BASED NATIONAL EXAMINATION IN INDONESIAN SCHOOLS: THE CHALLENGES AND STRATEGIES

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Heri Retnawati

2017-12-01

Full Text Available In line with technological development, the computer-based national examination (CBNE has become an urgent matter as its implementation faces various challenges, especially in developing countries. Strategies in implementing CBNE are thus needed to face the challenges. The aim of this research was to analyse the challenges and strategies of Indonesian schools in implementing CBNE. This research was qualitative phenomenological in nature. The data were collected through a questionnaire and a focus group discussion. The research participants were teachers who were test supervisors and technicians at junior high schools and senior high schools (i.e. Level 1 and 2 and vocational high schools implementing CBNE in Yogyakarta, Indonesia. The data were analysed using the Bogdan and Biklen model. The results indicate that (1 in implementing CBNE, the schools should initially make efforts to provide the electronic equipment supporting it; (2 the implementation of CBNE is challenged by problems concerning the Internet and the electricity supply; (3 the test supervisors have to learn their duties by themselves and (4 the students are not yet familiar with the beneficial use of information technology. To deal with such challenges, the schools employed strategies by making efforts to provide the standard electronic equipment through collaboration with the students’ parents and improving the curriculum content by adding information technology as a school subject.

Implementation of Peer Tutoring Strategies in Teaching Students with ADHD: Teachers' Attitudes in Saudi Education

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Abaoud, Abdulrahman A.

2016-01-01

This study aimed to measured teachers' attitudes toward implementation of peer tutoring strategies in teaching students with ADHD in Saudi Arabia. The study moreover examined the relationship between teachers' attitudes of implementation of peer tutoring strategies and variables of demographic characteristics. Five hundred thirty eight teachers…

Nutritional screening, assessment and implementation strategies for adults in an Australian acute tertiary hospital: a best practice implementation report.

Science.gov (United States)

Smith, Louise; Chapman, Amanda; Flowers, Kelli; Wright, Kylie; Chen, Tanghua; O'Connor, Charmaine; Astorga, Cecilia; Francis, Nevenka; Vigh, Gia; Wainwright, Craig

2018-01-01

The project aimed to improve the effectiveness of nutritional screening and assessment practices through clinical audits and the implementation of evidence-based practice recommendations. In the absence of optimal nutrition, health may decline and potentially manifest as adverse health outcomes. In a hospitalized person, poor nutrition may adversely impact on the person's outcome. If the nutritional status can be ascertained, nutritional needs can be addressed and potential risks minimized.The overall purpose of this project was to review and monitor staff compliance with nutritional screening and assessment best practice recommendations ensuring there is timely, relevant and structured nutritional therapeutic practices that support safe, compassionate and person-centered care in adults in a tertiary hospital in South Western Sydney, Australia, in the acute care setting. A baseline retrospective chart audit was conducted and measured against 10 best practice criteria in relation to nutritional screening and assessment practices. This was followed by a facilitated multidisciplinary focus group to identify targeted strategies, implementation of targeted strategies, and a post strategy implementation chart audit.The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRIP) tool, including evidence from other available supporting literature, for promoting change in healthcare practice. The baseline audit revealed deficits between current practice and best practice across the 10 criteria. Barriers for implementation of nutritional screening and assessment best practice criteria were identified by the focus group and an education strategy was implemented. There were improved outcomes across all best practice criteria in the follow-up audit. The baseline audit revealed gaps between current practice and best practice. Through the implementation of a targeted education program and

The perceived influence of diversity factors on effective strategy implementation in a higher education institution

Directory of Open Access Journals (Sweden)

K. Strydom

2018-04-01

Full Text Available Managing diversity is one of the major challenges in higher education institutions in South Africa. Additionally, effective strategy implementation is vital for an institution to be successful and sustainable. Questionnaires were distributed to the management of Walter Sisulu University, South Africa, to investigate the relationship between diversity factors and effective strategy implementation. The questionnaires interrogated the effect of the acculturation process, the degree of structural integration, the degree of informal integration, institutional bias and intergroup conflict, and how these factors influence strategy implementation. Structural equation modelling (SEM was employed as the statistical tool to confirm the hypothetical model. Results of this study revealed that there is no statistically significant relationship between diversity and strategy implementation at the institution, and imply that diversity among staff do not impact on the successful achievement of strategic objectives in the institution. The findings of the study are contrary to empirical evidence by other studies. Keywords: Education, Sociology, Political science, Psychology

The EU's New Global Strategy : Its Implementation in a Troubled International Environment

NARCIS (Netherlands)

Buitelaar, T.; Larik, J.E.; Matta, A.; Vos, de B.

2016-01-01

Executive Summary In June 2016, High Representative Mogherini presented the EU’s new Global Strategy on Foreign and Security Policy (EUGS) to the European Council. With the Strategy now finalized, attention needs to turn to its implementation in an environment mired by crises both within Europe and

Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care : A systematic review

NARCIS (Netherlands)

Suman, Arnela; Dikkers, Marije F.; Schaafsma, Frederieke G.; van Tulder, Maurits W.; Anema, Johannes R.

2016-01-01

Background: For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

Science.gov (United States)

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare

Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.

Science.gov (United States)

Aldao, Amelia; Mennin, Douglas S

2012-02-01

Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or were not given specific regulation instructions. Implementation of adaptive regulation strategies produced differential effects in the physiological (but not subjective) domain across diagnostic groups. Whereas participants with GAD demonstrated lower cardiac flexibility when implementing adaptive regulation strategies than when not given specific instructions on how to regulate, healthy controls showed the opposite pattern, suggesting they benefited from the use of adaptive regulation strategies. We discuss the implications of these findings for the delineation of emotion regulation deficits in psychopathology. Copyright © 2011 Elsevier Ltd. All rights reserved.

METHODOLOGICAL BASES OF THE OPTIMIZATION OF ORGANIZATIONAL MANAGEMENT STRUCTURE AT IMPLEMENTING THE MAJOR CONSTRUCTION ENTERPRISE STRATEGY

Directory of Open Access Journals (Sweden)

Rodionova Svetlana Vladimirovna

2015-09-01

Full Text Available Planning and implementation of innovations on the microlevel of management and on the higher levels is a process of innovative projects portfolio implementation. Project management is aimed at some goal; therefore, defining the mission and aims of implementation is of primary importance. These are the part of the notion of development strategy of an enterprise. Creating a strategy for big construction holding companies is complicated by the necessity to account for different factors effecting each business-block and subsidiary companies. The authors specify an algorithm of development and implementation of the activity strategy of a big construction enterprise. A special importance of the correspondence of organizational management structure to the implemented strategy is shown. The innovative character of organizational structure change is justified. The authors offer methods to optimize the organizational management structure based on communication approach with the use of the elements graph theory. The offered methodological provisions are tested on the example of the Russian JSC “RZhDstroy”.

Preparedness to Implement Wellness Strategies: Perceptions of School Counselors

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Burnett, Tena

2012-01-01

The purpose of this study is to survey school counselors to determine their knowledge and perceived preparedness to implement wellness strategies in school counseling programs. Wellness plans are a requirement for thousands of public school districts in the United States. There are no established standards for the training of school counselors in…

Development and implementation strategy for the of product configuration systems in engineer-to-order companies

DEFF Research Database (Denmark)

Kristjansdottir, Katrin; Shafiee, Sara; Hvam, Lars

2016-01-01

This paper will address how to develop a strategy when developing and implementing product configuration systems (PCSs) in engineer-to-order (ETO) companies. PCSs are often gradually implemented especially where there are complex products and processes in order to break down the overall project...... and reduce risk. This highlights the importance of having an overall strategy to guide the long-term development and implementation of PCSs In this paper, guideline for making the strategy are provided and supplemented with examples based on a case study. The guideline includes the main objectives...... for the development and implementation process, PCSs to be used to support the sales and /or the engineering processes, more uniform IT support for making product configurations, combining output from different PCSs and finally integrations that includes both internal and external IT systems. Based...

Implementation strategies for health systems in low-income countries: an overview of systematic reviews

Science.gov (United States)

Pantoja, Tomas; Opiyo, Newton; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Wiysonge, Charles S; Herrera, Cristian A; Rada, Gabriel; Peñaloza, Blanca; Dudley, Lilian; Gagnon, Marie-Pierre; Garcia Marti, Sebastian; Oxman, Andrew D

2017-01-01

Background A key function of health systems is implementing interventions to improve health, but coverage of essential health interventions remains low in low-income countries. Implementing interventions can be challenging, particularly if it entails complex changes in clinical routines; in collaborative patterns among different healthcare providers and disciplines; in the behaviour of providers, patients or other stakeholders; or in the organisation of care. Decision-makers may use a range of strategies to implement health interventions, and these choices should be based on evidence of the strategies' effectiveness. Objectives To provide an overview of the available evidence from up-to-date systematic reviews about the effects of implementation strategies for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on alternative implementation strategies and informing refinements of the framework for implementation strategies presented in the overview. Methods We searched Health Systems Evidence in November 2010 and PDQ-Evidence up to December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of implementation strategies on professional practice and patient outcomes and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the review findings. Two overview authors independently screened reviews, extracted data and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence) and assessments of the relevance of findings to low-income countries. Main results We identified 7272 systematic reviews and included 39 of

How CEOs use management information systems for strategy implementation in hospitals.

Science.gov (United States)

Naranjo-Gil, David; Hartmann, Frank

2007-04-01

Institutional and market changes seem to force hospitals across the Western world to revitalize their corporate strategies towards more cost efficiency on the one hand, and more flexibility towards customer demands on the other hand. Hospitals, however, apparently differ in the extent to which they are able to implement such strategies effectively. This paper explores whether these different levels of effectiveness depend on how hospitals' top managers' use of the available management information systems (MIS). Based on data obtained from the 218 CEOs of public hospitals in Spain, we analyze how CEOs' professional and educational backgrounds affect their use of MIS, and how the use of the MIS subsequently supports or inhibits the implementation of these strategic goals. The results indicate that CEOs with a predominant clinical background focus more on non-financial information for decision-making and prefer an interactive style of using MIS, which together support flexibility strategies. CEOs with a predominant administrative background seem more effective in establishing cost-reduction strategies, through their larger inclination to emphasize financial information in combination with a diagnostic use of the MIS. Implications for the strategic management of hospitals are outlined.

Decision method for optimal selection of warehouse material handling strategies by production companies

Science.gov (United States)

Dobos, P.; Tamás, P.; Illés, B.

2016-11-01

Adequate establishment and operation of warehouse logistics determines the companies’ competitiveness significantly because it effects greatly the quality and the selling price of the goods that the production companies produce. In order to implement and manage an adequate warehouse system, adequate warehouse position, stock management model, warehouse technology, motivated work force committed to process improvement and material handling strategy are necessary. In practical life, companies have paid small attantion to select the warehouse strategy properly. Although it has a major influence on the production in the case of material warehouse and on smooth costumer service in the case of finished goods warehouse because this can happen with a huge loss in material handling. Due to the dynamically changing production structure, frequent reorganization of warehouse activities is needed, on what the majority of the companies react basically with no reactions. This work presents a simulation test system frames for eligible warehouse material handling strategy selection and also the decision method for selection.

Large-scale fortification of condiments and seasonings as a public health strategy: equity considerations for implementation.

Science.gov (United States)

Zamora, Gerardo; Flores-Urrutia, Mónica Crissel; Mayén, Ana-Lucia

2016-09-01

Fortification of staple foods with vitamins and minerals is an effective approach to increase micronutrient intake and improve nutritional status. The specific use of condiments and seasonings as vehicles in large-scale fortification programs is a relatively new public health strategy. This paper underscores equity considerations for the implementation of large-scale fortification of condiments and seasonings as a public health strategy by examining nonexhaustive examples of programmatic experiences and pilot projects in various settings. An overview of conceptual elements in implementation research and equity is presented, followed by an examination of equity considerations for five implementation strategies: (1) enhancing the capabilities of the public sector, (2) improving the performance of implementing agencies, (3) strengthening the capabilities and performance of frontline workers, (3) empowering communities and individuals, and (4) supporting multiple stakeholders engaged in improving health. Finally, specific considerations related to intersectoral action are considered. Large-scale fortification of condiments and seasonings cannot be a standalone strategy and needs to be implemented with concurrent and coordinated public health strategies, which should be informed by a health equity lens. © 2016 New York Academy of Sciences.

Foreign practice of introducing conventional communicative strategy in the implementation of the functions of government

Directory of Open Access Journals (Sweden)

I. P. Zarytska

2014-10-01

Full Text Available This article describes the role of conventional communicative strategy from the standpoint of foreign practice. Depending on scientific approaches to communications, business and management strategies based conventional communicative strategy implementation functions of government. It has certain methodological features and differences in different countries: UK, Germany, Australia, USA, Spain, Holland, Finland, New Zealand. Generalization showed that each state produces its conventional communicative strategy depending on the overall state objectives. However joint is considered important not only communication, but also the ability to communicate effectively, understand how to implement the vision of an opinion on relations between the state and society. Purpose conventional communicative strategy determined by the impact on the optimization of the authorities at the national and regional level, the processes of globalization, the experience of other states, its implementation in practical activities as well as their lack of predictive scenarios of the process of optimizing the functions of government. Demonstrated the appropriateness of existing methodologies to use in domestic practice of public administration.

Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease.

Science.gov (United States)

Wolfenden, Luke; Nathan, Nicole K; Sutherland, Rachel; Yoong, Sze Lin; Hodder, Rebecca K; Wyse, Rebecca J; Delaney, Tessa; Grady, Alice; Fielding, Alison; Tzelepis, Flora; Clinton-McHarg, Tara; Parmenter, Benjamin; Butler, Peter; Wiggers, John; Bauman, Adrian; Milat, Andrew; Booth, Debbie; Williams, Christopher M

2017-11-29

A number of school-based policies or practices have been found to be effective in improving child diet and physical activity, and preventing excessive weight gain, tobacco or harmful alcohol use. Schools, however, frequently fail to implement such evidence-based interventions. The primary aims of the review are to examine the effectiveness of strategies aiming to improve the implementation of school-based policies, programs or practices to address child diet, physical activity, obesity, tobacco or alcohol use.Secondary objectives of the review are to: Examine the effectiveness of implementation strategies on health behaviour (e.g. fruit and vegetable consumption) and anthropometric outcomes (e.g. BMI, weight); describe the impact of such strategies on the knowledge, skills or attitudes of school staff involved in implementing health-promoting policies, programs or practices; describe the cost or cost-effectiveness of such strategies; and describe any unintended adverse effects of strategies on schools, school staff or children. All electronic databases were searched on 16 July 2017 for studies published up to 31 August 2016. We searched the following electronic databases: Cochrane Library including the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; Embase Classic and Embase; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); Dissertations and Theses; and SCOPUS. We screened reference lists of all included trials for citations of other potentially relevant trials. We handsearched all publications between 2011 and 2016 in two specialty journals (Implementation Science and Journal of Translational Behavioral Medicine) and conducted searches of the WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/) as well as the US National Institutes of Health registry (https://clinicaltrials.gov). We

Implementing Strategy in a Budget: A Model of the Coast Guard Reserve

OpenAIRE

Bromund, Carl Douglas

1990-01-01

Approved for public release; distribution is unlimited. This thesis discusses the managment strategy of the Coast Guard Reserve; it examines the formulation and implmentation of strateqy. A model to develop and implement strategy is proposed, which defines the role of the budget in this strategic management process. The recent strategy of the Coast Guard Reserve is analyzed using this model.. This analysis seems to indicate that the Coast Guard Reserve had no explicit strate...

Implementation of an optical diagnosis strategy saves costs and does not impair clinical outcomes of a fecal immunochemical test-based colorectal cancer screening program.

Science.gov (United States)

Vleugels, Jasper L A; Greuter, Marjolein J E; Hazewinkel, Yark; Coupé, Veerle M H; Dekker, Evelien

2017-12-01

 In an optical diagnosis strategy, diminutive polyps that are endoscopically characterized with high confidence are removed without histopathological analysis and distal hyperplastic polyps are left in situ. We evaluated the effectiveness and costs of optical diagnosis.  Using the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model, we simulated biennial fecal immunochemical test (FIT) screening in individuals aged 55 - 75 years. In this program, we compared an optical diagnosis strategy with current histopathology assessment of all diminutive polyps. Base-case assumptions included 76 % high-confidence predictions and sensitivities of 88 %, 91 %, and 88 % for endoscopically characterizing adenomas, sessile serrated polyps, and hyperplastic polyps, respectively. Outcomes were colorectal cancer burden, number of colonoscopies, life-years, and costs.  Both the histopathology strategy and the optical diagnosis strategy resulted in 21 life-days gained per simulated individual compared with no screening. For optical diagnosis, €6 per individual was saved compared with the current histopathology strategy. These cost savings were related to a 31 % reduction in colonoscopies in which histopathology was needed for diminutive polyps. Projecting these results onto the Netherlands (17 million inhabitants), assuming a fully implemented FIT-based screening program, resulted in an annual undiscounted cost saving of € 1.7 - 2.2 million for optical diagnosis.  Implementation of optical diagnosis in a FIT-based screening program saves costs without decreasing program effectiveness when compared with current histopathology analysis of all diminutive polyps. Further work is required to evaluate how endoscopists participating in a screening program should be trained, audited, and monitored to achieve adequate competence in optical diagnosis.

Analyzing the United States Department of Transportation's Implementation Strategy for High Speed Rail: Three Case Studies

Science.gov (United States)

Robinson, Ryan

High-speed rail (HSR) has become a major contributor to the transportation sector with a strong push by the Obama Administration and the Department of Transportation to implement high-speed rail in the United States. High-speed rail is a costly transportation alternative that has the potential displace some car and airport travel while increase energy security and environmental sustainability. This thesis will examine the United States high-speed rail implementation strategy by comparing it to the implementation strategies of France, Japan, and Germany in a multiple case study under four main criteria of success: economic profitability, reliability, safety, and ridership. Analysis will conclude with lessons to be taken away from the case studies and applied to the United States strategy. It is important to understand that this project has not been established to create a comprehensive implementation plan for high-speed rail in the United States; rather, this project is intended to observe the depth and quality of the current United States implementation strategy and make additional recommendations by comparing it with France, Japan, and Germany.

Multichannel strategy - the dominant approach in modern retailing

Directory of Open Access Journals (Sweden)

Stojković Dragan

2016-01-01

Full Text Available The purpose of this paper is to thoroughly analyse the concept of multichannel strategy, focussing on retail, to enable the academic community and marketers to better understand its advantages and disadvantages. This paper presents a comprehensive literature review and financial data analysis. The authors have analysed the financial data of 88 retail companies in the 2007 to 2014 period, and have proven that the importance of multichannel strategy has grown with the emergence of e-commerce. The main hypothesis is that the multichannel concept dominates modern marketing channels because it is widely accepted and provides superior financial performance. Multichannel retailing is definitely a winning concept, if adequately implemented. However, wrongly implemented it can negatively influence business performance.

Political benchmarking as part of anti-crisis strategy of the state

Directory of Open Access Journals (Sweden)

S. V. Stavchenko

2014-11-01

Growth Risk and crisis situations in modern Ukraine involves the use of specific technologies in the development and implementation of reforms. In practice, this means that the state must not only adequately respond to the crisis, but also to carry out continuous training such action is to develop anti-crisis strategy.

DEVELOPMENT AND IMPLEMENTATION OF CREATIVITY-ORIENTED TEACHING STRATEGY

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S. N. Degtyarev

2014-01-01

Full Text Available The research investigates the principles of creativity-oriented teaching (COT, substantiates its strategy based on developing the didactic structure of creative educational environment, and looks for the invariant of pedagogical activity guaranteeing the creativity development. The methodology involves a theoretical analysis and specification of COT principles, and empirical methods of identifying the creative teaching invariant.The paper describes the content of COT principles, and provides recommendations for their implementation; the concepts of creative teaching invariant and creative potential being defined. The author supplements the theory of heuristic teaching and applies the methods of logical and graphical structuring of information to foster students’ creative activity.The research findings can be implemented in the system of school education for developing the students’ intellectual potential and creative abilities.

Evaluation of an effective multifaceted implementation strategy for elective single-embryo transfer after in vitro fertilization

NARCIS (Netherlands)

Kreuwel, I.A.M.; Peperstraten, A.M. van; Hulscher, M.E.J.L.; Kremer, J.A.M.; Grol, R.P.T.M.; Nelen, W.L.D.M.; Hermens, R.P.M.G.

2013-01-01

STUDY QUESTION: What is the relationship between the rate of elective single-embryo transfer (eSET) and couples' exposure to different elements of a multifaceted implementation strategy? SUMMARY ANSWER: Additional elements in a multifaceted implementation strategy do not result in an increased eSET

Unlocking the “black box” of practice improvement strategies to implement surgical safety checklists: a process evaluation

Directory of Open Access Journals (Sweden)

Gillespie BM

2017-04-01

Full Text Available Brigid M Gillespie,1–3 Kyra Hamilton,4 Dianne Ball,5 Joanne Lavin,6 Therese Gardiner,6 Teresa K Withers,7 Andrea P Marshall1–3 1School of Nursing & Midwifery, Griffith University, Gold Coast, 2Gold Coast University Hospital and Health Service, Southport, 3Nursing & Midwifery Education & Research Unit (NMERU, National Centre of Research Excellence in Nursing, Menzies Health Institute of Queensland, Griffith University, Gold Coast, 4School of Applied Psychology, Griffith University, Mt Gravatt, 5Communio Pty Ltd, Sydney, 6Nursing & Midwifery Education & Research Unit, 7Surgical and Procedural Services, Gold Coast University Hospital and Health Service, Southport, Australia Background: Compliance with surgical safety checklists (SSCs has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve.Objectives: The objective of this study was to undertake a process evaluation of four knowledge translation (KT strategies used to implement the Pass the Baton (PTB intervention which was designed to improve utilization of the SSC. Methods: As part of the process evaluation, a logic model was generated to explain which KT strategies worked well (or less well in the operating rooms of a tertiary referral hospital in Queensland, Australia. The KT strategies implemented included change champions/opinion leaders, education, audit and feedback, and reminders. In evaluating the implementation of these strategies, this study considered context, intervention and underpinning assumptions, implementation, and mechanism of impact. Observational and interview data were collected to assess implementation of the KT strategies relative to fidelity, feasibility, and acceptability. Results: Findings from 35 structured observations and 15 interviews with 96 intervention participants suggest that all of the KT strategies were consistently

Development and testing of an implementation strategy for a complex housing intervention: protocol for a mixed methods study.

Science.gov (United States)

Watson, Dennis P; Young, Jeani; Ahonen, Emily; Xu, Huiping; Henderson, Macey; Shuman, Valery; Tolliver, Randi

2014-10-17

There is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes. Drawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes. This project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general.

Strategies to manage barriers in policy formation and implementation of road pricing packages

DEFF Research Database (Denmark)

Sørensen, Claus Hedegaard; Isaksson, Karolina; Macmillen, James

2014-01-01

Fee scheme implemented in 2001, this paper identifies a selection of strategies which appear to have supported the policymakers' capacity to implement effective road pricing schemes. Together, these three examples offer a sound empirical basis from which to infer a set of strategies......In the transport policy domain, as in other highly-contested spheres of public policy, it is commonplace for certain policy measures to emerge as promising only to then remain unimplemented. Road pricing is one example of a theoretically well-developed transport policy measure that has proven...... for the formulation and implementation of politically-contentious road pricing packages-addressing issues of measure combination, flexibility, legitimacy, communication, timing and organisational dynamics. While acknowledging the primacy of broader external and contextual issues, the conclusion is that taking...

The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada.

Science.gov (United States)

Jaglal, S B; Hawker, G; Cameron, C; Canavan, J; Beaton, D; Bogoch, E; Jain, R; Papaioannou, A

2010-06-01

In the last decade, there have been a number of action plans published to highlight the importance of preventing osteoporosis and related fractures. In the province of Ontario Canada, the Ministry of Health provided funding for the Ontario Osteoporosis Strategy. The goal is to reduce morbidity, mortality, and costs from osteoporosis and related fractures through an integrated and comprehensive approach aimed at health promotion and disease management. This paper describes the components of the Ontario Osteoporosis Strategy and progress on implementation efforts as of March 2009. There are five main components: health promotion; bone mineral density testing, access, and quality; postfracture care; professional education; and research and evaluation. Responsibility for implementation of the initiatives within the components is shared across a number of professional and patient organizations and academic teaching hospitals with osteoporosis researchers. The lessons learned from each phase of the development, implementation, and evaluation of the Ontario Osteoporosis Strategy provides a tremendous opportunity to inform other jurisdictions embarking on implementing similar large-scale bone health initiatives.

Examining the feasibility of implementing behavioural economics strategies that encourage home dinner vegetable intake among low-income children.

Science.gov (United States)

Leak, Tashara M; Swenson, Alison; Rendahl, Aaron; Vickers, Zata; Mykerezi, Elton; Redden, Joseph P; Mann, Traci; Reicks, Marla

2017-06-01

To examine the feasibility of implementing nine behavioural economics-informed strategies, or 'nudges', that aimed to encourage home dinner vegetable intake among low-income children. Caregivers were assigned six of nine strategies and implemented one new strategy per week (i.e. 6 weeks) during three dinner meals. Caregivers recorded child dinner vegetable intake on the nights of strategy implementation and rated the level of difficulty for assigned strategies. Baseline data on home vegetable availability and child vegetable liking were collected to assess overall strategy feasibility. Participants' homes in a large Midwestern metropolitan area, USA. Low-income caregiver/child (aged 9-12 years) dyads (n 39). Pairwise comparisons showed that child dinner vegetable intake for the strategy 'Serve at least two vegetables with dinner meals' was greater than intake for each of two other strategies: 'Pair vegetables with other foods the child likes' and 'Eat dinner together with an adult(s) modelling vegetable consumption'. Overall, caregivers' mean rating of difficulty for implementing strategies was 2·6 (1='not difficult', 10='very difficult'). Households had a mean of ten different types of vegetables available. Children reported a rating ≥5 for seventeen types of vegetable on a labelled hedonic scale (1='hate it', 5-6='it's okay', 10='like it a lot'). Behavioural economics-informed strategies are feasible to implement during dinner meals, with some strategies differing by how much they influence vegetable intake among low-income children in the home.

Die Face Engineering based Springback Compensation Strategy and Implementation

International Nuclear Information System (INIS)

Tang, Arthur; Lee Wing; He, Jeanne; Xu Jinbo; Liu Kesu; Chen Chinchun

2005-01-01

Springback or shape change has been one of the major challenges in sheet metal fabrication, particularly with increase application of high strength steel (HSS) and aluminum alloys in automotive stamping. Springback, an elastic material recovery after the unloading of stamping tools, causes variations and inconsistencies of final part dimensions. Minor or mild springback usually can be corrected in the re-strike process. Excessive springback must be corrected so the part will be produced within the given design tolerance and dimension. The commonly used Spring Forward approaches and shape compensations such as over-crown and over-bending are proven effective to alleviate excessive springback. To enhance these approaches, a new strategy of Die Face Engineering (DFE) based processing is proposed to quickly and easily to achieve the maximum allowable compensation using the under cut (or die lock) as the primary criteria. The implementation of the die face compensation through iterative FEA calculation, automatic surface mapping, projection and manual morphing are crucial to meet production environment requirements in terms of generating NC quality CAD surfaces of the compensated or morphed die face. In this paper, the strategy of the die face compensation with the consideration of the under cut criteria is presented. The implementation of various processes to enable user to perform the die face compensation task in a production environment is also discussed. Finally, two examples are shown to demonstrate the implementation of the proposed springback compensation scheme based on the combined CAE/CAD methodology

Early Childhood Educators' Meta-Cognitive Knowledge of Problem-Solving Strategies and Quality of Childcare Curriculum Implementation

Science.gov (United States)

Kim, Yeon Ha

2016-01-01

This study aims to explore the impact of early childhood educators' meta-cognitive knowledge on the quality of their childcare curriculum implementation, and to gain insights regarding successful problem-solving strategies associated with early education and care. Early childhood educators' implementation of general problem-solving strategies in…

Influence network linkages across implementation strategy conditions in a randomized controlled trial of two strategies for scaling up evidence-based practices in public youth-serving systems.

Science.gov (United States)

Palinkas, Lawrence A; Holloway, Ian W; Rice, Eric; Brown, C Hendricks; Valente, Thomas W; Chamberlain, Patricia

2013-11-14

Given the importance of influence networks in the implementation of evidence-based practices and interventions, it is unclear whether such networks continue to operate as sources of information and advice when they are segmented and disrupted by randomization to different implementation strategy conditions. The present study examines the linkages across implementation strategy conditions of social influence networks of leaders of youth-serving systems in 12 California counties participating in a randomized controlled trial of community development teams (CDTs) to scale up use of an evidence-based practice. Semi-structured interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. A web-based survey collected additional quantitative data on information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) to examine linkages between treatment and standard conditions. Of those network members who were affiliated with a county (n = 137), only 6 (4.4%) were directly connected to a member of the opposite implementation strategy condition; 19 (13.9%) were connected by two steps or fewer to a member of the opposite implementation strategy condition; 64 (46.7%) were connected by three or fewer steps to a member of the opposite implementation strategy condition. Most of the indirect steps between individuals who were in different implementation strategy conditions were connections involving a third non-county organizational entity that had an important role in the trial in keeping the implementation strategy conditions separate. When these entities were excluded, the CDT network exhibited fewer components and significantly higher betweenness centralization than did the standard condition network. Although the integrity of the RCT in this instance was not compromised by study participant influence

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services.

Science.gov (United States)

Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A

2016-05-14

Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members

An interoperable architecture and principles for implementing strategy and policy in operational processes

NARCIS (Netherlands)

Gong, Y.; Janssen, M.

2013-01-01

In today's economy managers expect new strategies and policies to be implemented quickly. Yet practice shows that current systems are not able to implement changes within a short time frame. Nowadays a variety of technologies including semantic web services, business rules and software agents are

The Implementation of Physics Problem Solving Strategy Combined with Concept Map in General Physics Course

Science.gov (United States)

Hidayati, H.; Ramli, R.

2018-04-01

This paper aims to provide a description of the implementation of Physic Problem Solving strategy combined with concept maps in General Physics learning at Department of Physics, Universitas Negeri Padang. Action research has been conducted in two cycles where each end of the cycle is reflected and improved for the next cycle. Implementation of Physics Problem Solving strategy combined with concept map can increase student activity in solving general physics problem with an average increase of 15% and can improve student learning outcomes from 42,7 in the cycle I become 62,7 in cycle II in general physics at the Universitas Negeri Padang. In the future, the implementation of Physic Problem Solving strategy combined with concept maps will need to be considered in Physics courses.

Strategy Implementation through Hierarchical Couplings in a Management Control Package: An Explorative Case Study

OpenAIRE

van der Kolk, Berend; Schokker, Tom

2016-01-01

We examine how couplings of management control (MC) elements help to implement an organization’s strategy. Despite prior research stating that couplings between MC elements form fruitful soil for further research, empirical studies in this area are still scarce. We draw on coupling theory to explore three hierarchical relations between MC elements, and examine how these couplings help to implement the organization’s strategy. We conducted a single case study in a medium-sized Dutch municipali...

Is the high-risk strategy to prevent cardiovascular disease equitable?

DEFF Research Database (Denmark)

Wallach Kildemoes, Helle; Diderichsen, Finn; Krasnik, Allan

2012-01-01

ABSTRACT: BACKGROUND: Statins are increasingly prescribed to prevent cardiovascular disease (CVD) in asymptomatic individuals. Yet, it is unknown whether those at higher CVD risk - i.e. individuals in lower socio-economic position (SEP) - are adequately reached by this high-risk strategy. Aim......: To examine whether the Danish implementation of the strategy to prevent cardiovascular disease (CVD) by initiating statin (HMG-CoA reductase inhibitor) therapy in high-risk individuals is equitable across socioeconomic groups. METHODS: Design: Cohort study. Setting and participants: Applying individual...

Assessing implementation of evidence-based childhood obesity prevention strategies in schools

Directory of Open Access Journals (Sweden)

Christine M.W. Totura

2015-01-01

Conclusion: Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place.

"One-Size-Does-Not-Fit-All": Teaching MBA Students Different ERP Implementation Strategies

Science.gov (United States)

Venkatesh, Viswanath

2008-01-01

This teaching tip discusses an approach to educating MBA students regarding strategies to select, design, and implement enterprise resource planning (ERP) systems. The teaching approach presented here discusses how to teach students about different strategies based success stories from three different organizations, namely Cisco, Tektronix, and…

Coding Strategies and Implementations of Compressive Sensing

Science.gov (United States)

Tsai, Tsung-Han

This dissertation studies the coding strategies of computational imaging to overcome the limitation of conventional sensing techniques. The information capacity of conventional sensing is limited by the physical properties of optics, such as aperture size, detector pixels, quantum efficiency, and sampling rate. These parameters determine the spatial, depth, spectral, temporal, and polarization sensitivity of each imager. To increase sensitivity in any dimension can significantly compromise the others. This research implements various coding strategies subject to optical multidimensional imaging and acoustic sensing in order to extend their sensing abilities. The proposed coding strategies combine hardware modification and signal processing to exploiting bandwidth and sensitivity from conventional sensors. We discuss the hardware architecture, compression strategies, sensing process modeling, and reconstruction algorithm of each sensing system. Optical multidimensional imaging measures three or more dimensional information of the optical signal. Traditional multidimensional imagers acquire extra dimensional information at the cost of degrading temporal or spatial resolution. Compressive multidimensional imaging multiplexes the transverse spatial, spectral, temporal, and polarization information on a two-dimensional (2D) detector. The corresponding spectral, temporal and polarization coding strategies adapt optics, electronic devices, and designed modulation techniques for multiplex measurement. This computational imaging technique provides multispectral, temporal super-resolution, and polarization imaging abilities with minimal loss in spatial resolution and noise level while maintaining or gaining higher temporal resolution. The experimental results prove that the appropriate coding strategies may improve hundreds times more sensing capacity. Human auditory system has the astonishing ability in localizing, tracking, and filtering the selected sound sources or

Analytical Role of Corporate Strategy in Growth and Expansion of Unilever Pakistan

OpenAIRE

Hassan Abbas

2018-01-01

The corporate strategy plays an integral role in providing business entities with a market direction. The formulation and implementation of corporate strategy aids in providing businesses with abilities and capabilities so as to maintain and develop adequate pace with the consistently changing business environment, aids in the development of a strategic vision and focus on overall business goals and objectives, strengthens decision making and most importantly helps in the provision of a compe...

Evaluating the implementation of "managing the risk of suicide: a suicide prevention strategy for the ACT 2009-2014".

Science.gov (United States)

Sheehan, Johann; Griffiths, Kathleen; Rickwood, Debra; Carron-Arthur, Bradley

2015-01-01

Over the past two decades, governments have invested significantly in policies and strategies to prevent the tragic loss of life to suicide. However, there has been little focus on evaluating the implementation of such policies. This paper reports on the evaluation of the implementation of "Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009-2014," the Australian Capital Territory's (ACT) suicide prevention strategy. We sought to answer two questions: (1) Could agencies provide data reporting on their progress in implementing the activities for which they were responsible?; and (2) Could a judgment about implementation progress be made and, if so, to what extent was the activity implemented? Individually tailored electronic surveys were sent to 18 ACT agencies annually over 4 years to measure their progress in implementing activities for which they had responsibility. By year four, full data were provided for 64% of activities, maximal partial data for 9%, and minimal partial data for 27%. Forty-two per cent of activities were fully implemented, 20% were partially implemented, and 38% were not implemented or could not be measured. It is possible to measure implementation of suicide prevention strategies, but appropriate processes and dedicated resources must be in place at the outset.

Gaps and strategies in developing health research capacity: experience from the Nigeria Implementation Science Alliance.

Science.gov (United States)

Ezeanolue, Echezona E; Menson, William Nii Ayitey; Patel, Dina; Aarons, Gregory; Olutola, Ayodotun; Obiefune, Michael; Dakum, Patrick; Okonkwo, Prosper; Gobir, Bola; Akinmurele, Timothy; Nwandu, Anthea; Khamofu, Hadiza; Oyeledun, Bolanle; Aina, Muyiwa; Eyo, Andy; Oleribe, Obinna; Ibanga, Ikoedem; Oko, John; Anyaike, Chukwuma; Idoko, John; Aliyu, Muktar H; Sturke, Rachel

2018-02-12

Despite being disproportionately burdened by preventable diseases than more advanced countries, low- and middle-income countries (LMICs) continue to trail behind other parts of the world in the number, quality and impact of scholarly activities by their health researchers. Our strategy at the Nigerian Implementation Science Alliance (NISA) is to utilise innovative platforms that catalyse collaboration, enhance communication between different stakeholders, and promote the uptake of evidence-based interventions in improving healthcare delivery. This article reports on findings from a structured group exercise conducted at the 2016 NISA Conference to identify (1) gaps in developing research capacity and (2) potential strategies to address these gaps. A 1-hour structured group exercise was conducted with 15 groups of 2-9 individuals (n = 94) to brainstorm gaps for implementation, strategies to address gaps and to rank their top 3 in each category. Qualitative thematic analysis was used. First, duplicate responses were merged and analyses identified emerging themes. Each of the gaps and strategies identified were categorised as falling into the purview of policy-makers, researchers, implementing partners or multiple groups. Participating stakeholders identified 98 gaps and 91 strategies related to increasing research capacity in Nigeria. A total of 45 gaps and an equal number of strategies were ranked; 39 gaps and 43 strategies were then analysed, from which 8 recurring themes emerged for gaps (lack of sufficient funding, poor research focus in education, inadequate mentorship and training, inadequate research infrastructure, lack of collaboration between researchers, research-policy dissonance, lack of motivation for research, lack of leadership buy-in for research) and 7 themes emerged for strategies (increased funding for research, improved research education, improved mentorship and training, improved infrastructure for research, increased collaboration between

Designing, implementing and monitoring social impact mitigation strategies: Lessons from Forest Industry Structural Adjustment Packages

International Nuclear Information System (INIS)

Loxton, Edwina A.; Schirmer, Jacki; Kanowski, Peter

2013-01-01

Social impact mitigation strategies are implemented by the proponents of policies and projects with the intent of reducing the negative, and increasing the positive social impacts of their activities, and facilitating the achievement of policy/project goals. Evaluation of mitigation strategies is critical to improving their future success and cost-effectiveness. This paper evaluates two Forest Industry Structural Adjustment Packages (FISAP) implemented in Australia in the 1990s to 2000s as part of broader policy changes that reduced access to timber from publicly owned native forests. It assesses the effectiveness of the structure, design, implementation and monitoring of the FISAPs, and highlights the interactions between these four elements and their influence on social impacts. The two FISAPs were found to be effective in terms of reducing negative impacts, encouraging positive impacts and contributing towards policy goals, although they did not mitigate negative impacts in all cases, and sometimes interacted with external factors and additional policy changes to contribute to significant short and long term negative impacts. -- Highlights: ► Mitigation strategies aim to reduce negative and enhance positive social impacts ► Mitigation strategy design, implementation, and monitoring are critical to success ► Effective mitigation enhanced the capacity of recipients to respond to change ► Mitigation strategies influenced multiple interacting positive and negative impacts ► Success required good communication, transparency, support, resources and timing

Earth Science Futuristic Trends and Implementing Strategies

Science.gov (United States)

Habib, Shahid

2003-01-01

For the last several years, there is a strong trend among the science community to increase the number of space-based observations to get a much higher temporal and spatial resolution. Such information will eventually be useful in higher resolution models that can provide predictability with higher precision. Such desirability puts a tremendous burden on any single implementing entity in terms of budget, technology readiness and compute power. The health of planet Earth is not governed by a single country, but in reality, is everyone's business living on this planet. Therefore, with this notion, it is becoming an impractical problem by any single organization/country to undertake. So far, each country per their means has proceeded along satisfactorily in implementing or benefiting directly or indirectly from the Earth observation data and scientific products. However, time has come that this is becoming a humongous problem to be undertaken by a single country. Therefore, this paper gives some serious thoughts in what options are there in undertaking this tremendous challenge. The problem is multi-dimensional in terms of budget, technology availability, environmental legislations, public awareness, and communication limitations. Some of these issues are introduced, discussed and possible implementation strategies are provided in this paper to move out of this predicament. A strong emphasis is placed on international cooperation and collaboration to see a collective benefit for this effort.

A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

Directory of Open Access Journals (Sweden)

Adang Eddy

2011-03-01

Full Text Available Abstract Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service, have been allocated randomly to either the intervention group (CI strategy or the control group (ED strategy. The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

Science.gov (United States)

Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam; Jensen, Martin Bach; Pedersen, Kjeld Møller

2017-05-01

In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.

Deployment and Implementation Strategies for Massive MIMO in 5G

DEFF Research Database (Denmark)

Panzner, Berthold; Zirwas, Wolfgang; Dierks, Stefan

2015-01-01

for 5G is a successful and cost-efficient integration in the overall network concept. This work highlights deployment and implementation strategies for massive MIMO in the context of 5G indoor small cell scenarios. Different massive MIMO deployment scenarios are analyzed for a standard 3GPP indoor...... to spatial streams is varied stepwise from equality to a factor of ten. For implementation of massive MIMO in 5G networks trends in beamforming techniques, mutually coupled subarrays, over the calibration procedure and estimated ADC performance in 2020 time-frame are discussed. Based on the debate the paper...

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

Science.gov (United States)

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana

Directory of Open Access Journals (Sweden)

Lucia U. Mupara

2016-02-01

Full Text Available Background: Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. Design: A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. Results: The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. Conclusions: The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Implementing multiple intervention strategies in Dutch public health-related policy networks

NARCIS (Netherlands)

Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

2017-01-01

Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to

School Age Center Connections: Site-Based Management Strategies for Implementation of Quality Programs.

Science.gov (United States)

Willis, Dahna R.

This paper describes the outcomes of a practicum that initiated site-based-management strategies to support the consistent implementation of a quality school-age child-care program. Implemented at a multisite child-care center, the program sought to enhance staff members' job satisfaction and maximize their opportunities for professional growth…

Implementing an Open Source Learning Management System: A Critical Analysis of Change Strategies

Science.gov (United States)

Uys, Philip M.

2010-01-01

This paper analyses the change and innovation strategies that Charles Sturt University (CSU) used from 2007 to 2009 during the implementation and mainstreaming of an open source learning management system (LMS), Sakai, named locally as "CSU Interact". CSU was in January 2008 the first Australian University to implement an open source…

A systematic review of the implementation of recommended psychological interventions for schizophrenia: Rates, barriers, and improvement strategies.

Science.gov (United States)

Ince, Paul; Haddock, Gillian; Tai, Sara

2016-09-01

A systematic review of the literature exploring if the UK recommendations for psychological interventions for schizophrenia were being met was carried out. Rates of implementation for cognitive behavioural therapy (CBT) and family intervention (FI) were compared. The barriers against implementation and described strategies aimed at improving implementation were reviewed. A literature search of electronic bibliography databases (Psychinfo, Medline, Pubmed, AMED, CINHAL, and EMBASE), reference and citation lists, the Evaluation and Review of NICE Implementation (ERNIE) database, a manual search of Clinical Psychology Forum, governmental reports, charity, and service user group reports was conducted. Twenty-six articles met the inclusion criteria, 11 provided data on implementation rates, 13 explored the barriers to implementation, and 10 gave information about improvement strategies. Rates of implementation varied from 4% to 100% for CBT and 0% to 53% for FI, and studies varied in the methodology used and quality of the articles. Previously reported barriers to implementation were found, with organisational barriers being most commonly followed by barriers met by staff members and service users. Implementation strategies discovered included training packages for CBT, FI, and psychosocial interventions as well as empirical evidence suggesting methods for engagement with service users. Rates of implementation for CBT and FI are still below recommended levels with wide variation of rates found. This suggests inequalities in the provision of psychological interventions for schizophrenia are still present. Previously identified barriers to implementation were confirmed. Attempted implementation strategies have been met with modest success. Inequalities in the provision of psychological therapies for schizophrenia persist. Good quality cognitive behavioural therapy and FI training do not ensure implementation. Collaboration at all levels of healthcare is needed for

Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients.

Science.gov (United States)

Montecucco, Fabrizio; Carbone, Federico; Dini, Frank Lloyd; Fiuza, Manuela; Pinto, Fausto J; Martelli, Antonietta; Palombo, Domenico; Sambuceti, Gianmario; Mach, François; De Caterina, Raffaele

2014-11-01

Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

A methodology for the sustainable design and implementation strategy of CO2 utilization processes

DEFF Research Database (Denmark)

Roh, Kosan; Frauzem, Rebecca; Nguyen, Tuan B. H.

2016-01-01

design and analysis is discussed as only limited amounts of process data is available for determining the optimal processing path and in the third stage the issue of implementation strategy is considered. As examples, two CO2 utilization methods for methanol production, combined reforming and direct...... synthesis are considered. Methanol plants employing such methods are developed using synthesis-design and simulation tools and their evaluation indicators are calculated under various implementation strategies. It is demonstrated that integrating or replacing an existing conventional methanol plant...

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

Energy Technology Data Exchange (ETDEWEB)

Singh, Ravindra [Argonne National Lab. (ANL), Argonne, IL (United States); Reilly, James T. [Reilly Associates, Pittston, PA (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States)

2017-03-01

Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to common barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.

Implementation of Enterprise Imaging Strategy at a Chinese Tertiary Hospital.

Science.gov (United States)

Li, Shanshan; Liu, Yao; Yuan, Yifang; Li, Jia; Wei, Lan; Wang, Yuelong; Fei, Xiaolu

2018-01-04

Medical images have become increasingly important in clinical practice and medical research, and the need to manage images at the hospital level has become urgent in China. To unify patient identification in examinations from different medical specialties, increase convenient access to medical images under authentication, and make medical images suitable for further artificial intelligence investigations, we implemented an enterprise imaging strategy by adopting an image integration platform as the main tool at Xuanwu Hospital. Workflow re-engineering and business system transformation was also performed to ensure the quality and content of the imaging data. More than 54 million medical images and approximately 1 million medical reports were integrated, and uniform patient identification, images, and report integration were made available to the medical staff and were accessible via a mobile application, which were achieved by implementing the enterprise imaging strategy. However, to integrate all medical images of different specialties at a hospital and ensure that the images and reports are qualified for data mining, some further policy and management measures are still needed.

Implementation of patient safety and patient-centeredness strategies in Iranian hospitals

NARCIS (Netherlands)

Aghaei Hashjin, Asgar; Kringos, Dionne S.; Manoochehri, Jila; Ravaghi, Hamid; Klazinga, Niek S.

2014-01-01

To examine the extent of implementation for patient safety (PS) and patient-centeredness (PC) strategies and their association with hospital characteristics (type, ownership, teaching status, annual evaluation grade) in Iran. A cross-sectional study through an adapted version of the MARQuIS

Best strategies to implement clinical pathways in an emergency department setting: study protocol for a cluster randomized controlled trial.

Science.gov (United States)

Jabbour, Mona; Curran, Janet; Scott, Shannon D; Guttman, Astrid; Rotter, Thomas; Ducharme, Francine M; Lougheed, M Diane; McNaughton-Filion, M Louise; Newton, Amanda; Shafir, Mark; Paprica, Alison; Klassen, Terry; Taljaard, Monica; Grimshaw, Jeremy; Johnson, David W

2013-05-22

The clinical pathway is a tool that operationalizes best evidence recommendations and clinical practice guidelines in an accessible format for 'point of care' management by multidisciplinary health teams in hospital settings. While high-quality, expert-developed clinical pathways have many potential benefits, their impact has been limited by variable implementation strategies and suboptimal research designs. Best strategies for implementing pathways into hospital settings remain unknown. This study will seek to develop and comprehensively evaluate best strategies for effective local implementation of externally developed expert clinical pathways. We will develop a theory-based and knowledge user-informed intervention strategy to implement two pediatric clinical pathways: asthma and gastroenteritis. Using a balanced incomplete block design, we will randomize 16 community emergency departments to receive the intervention for one clinical pathway and serve as control for the alternate clinical pathway, thus conducting two cluster randomized controlled trials to evaluate this implementation intervention. A minimization procedure will be used to randomize sites. Intervention sites will receive a tailored strategy to support full clinical pathway implementation. We will evaluate implementation strategy effectiveness through measurement of relevant process and clinical outcomes. The primary process outcome will be the presence of an appropriately completed clinical pathway on the chart for relevant patients. Primary clinical outcomes for each clinical pathway include the following: Asthma--the proportion of asthmatic patients treated appropriately with corticosteroids in the emergency department and at discharge; and Gastroenteritis--the proportion of relevant patients appropriately treated with oral rehydration therapy. Data sources include chart audits, administrative databases, environmental scans, and qualitative interviews. We will also conduct an overall process

Improving occupational physicians' adherence to a practice guideline: feasibility and impact of a tailored implementation strategy.

Science.gov (United States)

Joosen, Margot C W; van Beurden, Karlijn M; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P M; van der Klink, Jac J L

2015-04-24

Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived by occupational physicians (OPs). Feasibility and impact on OPs' barriers were evaluated. OPs received 8 training-sessions in small peer-learning groups, aimed at discussing the content of the guideline and their perceived barriers to adhere to guideline recommendations; finding solutions to overcome these barriers; and implementing solutions in practice. The training had a plan-do-check-act (PDCA) structure and was guided by a trainer. Protocol compliance and OPs' experiences were qualitatively and quantitatively assessed. Using a questionnaire, impact on knowledge, attitude, and external barriers to guideline adherence was investigated before and after the training. The training protocol was successfully conducted; guideline recommendations and related barriers were discussed with peers, (innovative) solutions were found and implemented in practice. The participating 32 OPs were divided into 6 groups and all OPs attended 8 sessions. Of the OPs, 90% agreed that the peer-learning groups and the meetings spread over one year were highly effective training components. Significant improvements (p implementation strategy focusing on perceived barriers and tailor-made implementation interventions is a feasible method to enhance guideline adherence. Moreover, the strategy contributed to OPs' knowledge, attitudes, and skills in using the guideline. As a generic approach to overcome barriers perceived in specific situations, this strategy provides a useful method to guideline implementation for other health care professionals too.

The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs.

Science.gov (United States)

Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris

2013-07-01

The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc

Implementing a WIC-Based Intervention to Promote Exclusive Breastfeeding: Challenges, Facilitators, and Adaptive Strategies.

Science.gov (United States)

Eldridge, Johanna D; Hartnett, Josette O; Lee, Furrina F; Sekhobo, Jackson P; Edmunds, Lynn S

Understand factors that contributed to the implementation of a successful multicomponent intervention to promote exclusive breastfeeding (EBF) within Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC) clinics. Qualitative study of staff implementers' experiences using implementation status reports, facilitated group discussion immediately after implementation, and WIC administrative data. WIC staff from 12 clinics participated in an EBF Learning Community composed of 8 intervention trainings and ongoing support from trainers and peers. A total of 47 WIC staff including 11 directors, 20 other administrators, 8 nutritionists, and 6 peer counselors. A WIC-integrated EBF promotion initiative, supported through a Learning Community, composed of prenatal screening, tailored trimester-specific counseling, and timely postpartum follow-up. Challenges and facilitators to implementation within clinics. Iterative qualitative analysis using directed, emergent, and thematic coding. Implementation experiences were characterized by (1) perceived benefits of implementation, including improved EBF knowledge and counseling confidence among staff; and (2) managing implementation, including responding to challenges posed by clinic settings (resources, routine practices, values, and perceptions of mothers) through strategies such as adapting clinic practices and intervention components. Implementation was shaped by clinic setting and adaptive strategies. Future WIC interventions may benefit from formal consideration of intervention fit with local clinic setting and allowable adaptations. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Implementing a learning technology strategy: top–down strategy meets bottom–up culture

Directory of Open Access Journals (Sweden)

Bernard Lisewski

2004-12-01

Full Text Available Using interview-based ‘insider case study' research, this paper outlines why the University of Salford has adopted a Learning Technologies Strategy and examines the factors which are likely to lead to its successful implementation. External reasons for the adoption focused on the need to: respond to ‘increased Higher Education (HE competition', meet student expectations of learning technology use, provide more flexibility and access to the curriculum, address the possible determining effect of technology and establish a Virtual Learning Environment (VLE presence in this ‘particular area of the HE landscape'. Internal drivers centred on the need to: continue a ‘bottom– up' e-learning pilot project initiative, particularly given that a VLE is a ‘complex tool' which requires effective strategic implementation, and promote the idea that learning technology will play an important role in determining the type of HE institution that the University of Salford wishes to become. Likely success factors highlighted the need to: create ‘time and space' for innovation, maintain effective communication and consultation at all levels of the organization, emphasize the operational aspects of the strategy, establish a variety of staff development processes and recognize the negotiatory processes involved in understanding the term ‘web presence' in local teaching cultures. Fundamentally, the paper argues that policy makers should acknowledge the correct ‘cultural configuration' of HE institutions when seeking to manage and achieve organizational change. Thus, it is not just a question of establishing ‘success factors' per se but also whether they are contextualized appropriately within a ‘correct' characterization of the organizational culture.

Implementing a Standardized Social Networks Testing Strategy in a Low HIV Prevalence Jurisdiction.

Science.gov (United States)

Schumann, Casey; Kahn, Danielle; Broaddus, Michelle; Dougherty, Jacob; Elderbrook, Megan; Vergeront, James; Westergaard, Ryan

2018-05-15

Alternative HIV testing strategies are needed to engage individuals not reached by traditional clinical or non-clinical testing programs. A social networks recruitment strategy, in which people at risk for or living with HIV are enlisted and trained by community-based agencies to recruit individuals from their social, sexual, or drug-using networks for HIV testing, demonstrates higher positivity rates compared to other non-clinical recruitment strategies in some jurisdictions. During 2013-2015, a social networks testing protocol was implemented in Wisconsin to standardize an existing social networks testing program. Six community-based, non-clinical agencies with multiple sites throughout the state implemented the protocol over the 2-year period. Both quantitative and qualitative data were collected. The new positivity rate (0.49%) through social networks testing did not differ from that of traditional counseling, testing, and referral recruitment methods (0.48%). Although social networks testing did not yield a higher new positivity rate compared to other testing strategies, it proved to be successful at reaching high risk individuals who may not otherwise engage in HIV testing.

Smart Specialisation in European Regions: Issues of Strategy, Institutions and Implementation

NARCIS (Netherlands)

McCann, Philip; Ortega Argiles, Raquel

2014-01-01

After reviewing some of the key features of the smart specialisation approach this paper examines issues of strategy and implementation which arise in the light of institutional and macroeconomic context in regional examples from four EU countries. The specific insights provided by this comparative

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

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

Strategies for developing and implementing specialized training

International Nuclear Information System (INIS)

Pate, M.C.

1991-01-01

Numerous strategies can be used to develop and implement specialized training. In order to achieve effective specialized training, however, two items are especially critical: use of a systematic approach and sensitiwity towards a good needs analysis. Sensitivity towards these items includes involving representatives of the target population in all phases of training, identifying student characteristics and their impact on training setting and delivery, preparing a scope document that addresses the terminal and enabling objectives of training in terms understandable to the customer, and emphasizing flexibility in the use of alternative training delivery methods and training resources. Increasing sensitivity towards these factors will increase participant satisfaction and the ultimate use of the training provided

ENTREPRENEURIAL STRATEGIES AND USE OF STRATEGIC IMPLEMENTATION MECHANISMS: A SURVEY WITH MICRO AND SMALL ENTREPRENEURS

Directory of Open Access Journals (Sweden)

Pedro Melo

2010-07-01

Full Text Available The aim of this article is to comprehend the mechanisms of strategic implementation used by entrepreneurs in the processes of establishing new functional strategies (production and marketing in their companies. A survey with 169 micro and small entrepreneurs was accomplished. The results showed that the relation between the use of strategic process by micro and small entrepreneurs is middling, but the use of implementation mechanisms, in general terms, is low and the correlation when the entrepreneurs strategies are adopted is weak. So, the possibility of justifying the use of these strategies is fragile whilst associated to a stronger holding of the strategic management techniques by the entrepreneurs.

Implementing a university e-learning strategy: levers for change within academic schools

Directory of Open Access Journals (Sweden)

Rhona Sharpe

2006-12-01

Full Text Available This paper describes the implementation of an e-learning strategy at a single higher education institution in terms of the levers used to promote effective uptake and ensure sustainable embedding. The focus of this work was at the level of the academic school using a range of change practices including the appointment of school-based learning technologists and e-learning champions, supporting schools to write their own strategies, a pedagogical framework of engaging with e-learning, and curriculum development and evaluation of school-supported projects. It is clear that the implementation of the e-learning strategy has led to a large and increasing proportion of our students experiencing blended learning. In addition, there are initial indications that this has enhanced some learning and teaching processes. Where there has been sustainable embedding of effective e-learning, the following levers were identified as particularly important: flexibility in practices that allow schools to contextualise their plans for change, the facilitation of communities of key staff and creating opportunities for staff to voice and challenge their beliefs about e-learning.

[Development and implementation of the Chronicity Strategy for the Basque Country (Spain): lessons learned].

Science.gov (United States)

Nuño-Solinís, Roberto

2016-11-01

Public healthcare in the Basque Country (Spain) faces high rates of ageing and chronicity, which stress the sustainability of the system. In response to this situation, the Basque Chronicity Strategy was launched in 2010. This large-scale and far-reaching transformation initiative focused on changing the healthcare provision model towards integrated care of chronicity. Developed in the context of economic and financial crisis, strong political opposition and resistance or passivity of many relevant stakeholders, the design and implementation of the Strategy introduced some noteworthy elements, such as: a narrative of change different to the austerity discourse, which was the dominant narrative at that time; a strategic approach supported by an evidence base and solid theoretical references; and an implementation strategy that favoured local innovation and the "bottom up" approach. In spite of this, it was not possible to overcome the political barriers or bureaucratic immobility, which limited the implementation and scope of the changes, especially those related to the scalability of successful local innovations. However, some changes in the healthcare integration culture at clinical and managerial level have been introduced as a result of the Strategy, as well as organisational progression towards a chronicity-targeted healthcare model. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

An Analysis of Implementation Strategies in a School-Wide Vocabulary Intervention

Science.gov (United States)

Roskos, Katheen A.; Moe, Jennifer Randazzo; Rosemary, Catherine

2017-01-01

From an improvement research perspective, this study explores strategies used to implement a school-wide vocabulary intervention into language arts instruction at an urban elementary school. Academic language time, an innovative change in the instructional delivery system, allots time and structure for deliberate teaching of cross-disciplinary…

Leadership Strategies in Implementation of High-School Standards-Based Grading Systems

Science.gov (United States)

Pritzl, Jerome

2016-01-01

This multi-site case study examined leadership strategies used during successful implementation of standards-based grading systems in three Wisconsin high schools. It found that leaders' reported commitment, patience, and persistence showed evidence of sustainable, high-functioning systems. It drew two main conclusions: first, school leaders need…

Value-based integrated (renal) care: setting a development agenda for research and implementation strategies.

Science.gov (United States)

Valentijn, Pim P; Biermann, Claus; Bruijnzeels, Marc A

2016-08-02

Integrated care services are considered a vital strategy for improving the Triple Aim values for people with chronic kidney disease. However, a solid scholarly explanation of how to develop, implement and evaluate such value-based integrated renal care services is limited. The aim of this study was to develop a framework to identify the strategies and outcomes for the implementation of value-based integrated renal care. First, the theoretical foundations of the Rainbow Model of Integrated Care and the Triple Aim were united into one overarching framework through an iterative process of key-informant consultations. Second, a rapid review approach was conducted to identify the published research on integrated renal care, and the Cochrane Library, Medline, Scopus, and Business Source Premier databases were searched for pertinent articles published between 2000 and 2015. Based on the framework, a coding schema was developed to synthesis the included articles. The overarching framework distinguishes the integrated care domains: 1) type of integration, 2) enablers of integration and the interrelated outcome domains, 3) experience of care, 4) population health and 5) costs. The literature synthesis indicated that integrated renal care implementation strategies have particularly focused on micro clinical processes and physical outcomes, while little emphasis has been placed on meso organisational as well as macro system integration processes. In addition, evidence regarding patients' perceived outcomes and economic outcomes has been weak. These results underscore that the future challenge for researchers is to explore which integrated care implementation strategies achieve better health and improved experience of care at a lower cost within a specific context. For this purpose, this study's framework and evidence synthesis have set a developmental agenda for both integrated renal care practice and research. Accordingly, we plan further work to develop an implementation

Patient-centred and professional-directed implementation strategies for diabetes guidelines: a cluster-randomized trial-based cost-effectiveness analysis.

NARCIS (Netherlands)

Dijkstra, R.F.; Niessen, L.W.; Braspenning, J.C.C.; Adang, E.M.M.; Grol, R.P.T.M.

2006-01-01

AIMS: Economic evaluations of diabetes interventions do not usually include analyses on effects and cost of implementation strategies. This leads to optimistic cost-effectiveness estimates. This study reports empirical findings on the cost-effectiveness of two implementation strategies compared with

Implementation strategies to promote community-engaged efforts to counter tobacco marketing at the point of sale.

Science.gov (United States)

Leeman, Jennifer; Myers, Allison; Grant, Jennifer C; Wangen, Mary; Queen, Tara L

2017-09-01

The US tobacco industry spends $8.2 billion annually on marketing at the point of sale (POS), a practice known to increase tobacco use. Evidence-based policy interventions (EBPIs) are available to reduce exposure to POS marketing, and nationwide, states are funding community-based tobacco control partnerships to promote local enactment of these EBPIs. Little is known, however, about what implementation strategies best support community partnerships' success enacting EBPI. Guided by Kingdon's theory of policy change, Counter Tools provides tools, training, and other implementation strategies to support community partnerships' performance of five core policy change processes: document local problem, formulate policy solutions, engage partners, raise awareness of problems and solutions, and persuade decision makers to enact new policy. We assessed Counter Tools' impact at 1 year on (1) partnership coordinators' self-efficacy, (2) partnerships' performance of core policy change processes, (3) community progress toward EBPI enactment, and (4) salient contextual factors. Counter Tools provided implementation strategies to 30 partnerships. Data on self-efficacy were collected using a pre-post survey. Structured interviews assessed performance of core policy change processes. Data also were collected on progress toward EBPI enactment and contextual factors. Analysis included descriptive and bivariate statistics and content analysis. Following 1-year exposure to implementation strategies, coordinators' self-efficacy increased significantly. Partnerships completed the greatest proportion of activities within the "engage partners" and "document local problem" core processes. Communities made only limited progress toward policy enactment. Findings can inform delivery of implementation strategies and tests of their effects on community-level efforts to enact EBPIs.

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

Science.gov (United States)

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and

Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial.

Science.gov (United States)

Garner, Bryan R; Zehner, Mark; Roosa, Mathew R; Martino, Steve; Gotham, Heather J; Ball, Elizabeth L; Stilen, Patricia; Speck, Kathryn; Vandersloot, Denna; Rieckmann, Traci R; Chaple, Michael; Martin, Erika G; Kaiser, David; Ford, James H

2017-11-17

Improving the extent to which evidence-based practices (EBPs)-treatments that have been empirically shown to be efficacious or effective-are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness-implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS service organizations (ASOs) as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF) as an adjunct to the Addiction Technology Transfer Center (ATTC) model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition) or the ATTC + ISF strategy (experimental condition). The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation). The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change). Building upon the exploration-preparation-implementation-sustainment (EPIS) framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1) time-to-proficiency (i.e., preparation phase outcome), (2) implementation effectiveness (i.e., implementation phase outcome), and (3) level of sustainment (i.e., sustainment phase outcome). Although not without limitations, the ISF

Authentic Leadership: Strategy of the Implementation of Madrasah Management of Change

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Aan Komariah

2017-12-01

Full Text Available Implementing the management of madrasah change starts from an authentic leadership. Authentic leadership is the identity of a head of madrasah in developing value-based educational system. His identity is seen from his sincerity in working, his kindness in treating people and the sharpness of his mind in determining the future of the organization. The authentic leadership of madrasah should represent the identity of moslem morality with work orientation on the sincerity of being a STAF+B (Siddiq, Tablig, Amanah, Fathonah + Brave leader. Leading the madrasah in the context of implementing management of change is not enough to be pious but it requires courage to take strategic and innovative decisions in realizing a qualified madrasah. This research aims to find an authentic leadership strategy model for management of change by head of madrasah. The research was conducted on the head of madrasah in Pangandaran Regency. The results show that the application of authentic leadership can build madrasah changes by empowering the Professional Learning Community (PLC in which 4CS strategy is implemented in a reciprocal (cumsuis-Casing, Communicating, Competencies, Contribution, Sample. The followers can identify who the authentic leader is by finding the integrity of identity that represents in: his mind is vision; his heart is good and his legs work hard.

A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes.

Science.gov (United States)

Trogrlić, Zoran; van der Jagt, Mathieu; Bakker, Jan; Balas, Michele C; Ely, E Wesley; van der Voort, Peter H J; Ista, Erwin

2015-04-09

Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strategies have been tested to improve ICU clinicians' ability to effectively assess, prevent and treat delirium and to evaluate the effect of these strategies on clinical outcomes. We searched PubMed, Embase, PsychINFO, Cochrane and CINAHL (January 2000 and April 2014) for studies on implementation strategies that included delirium-oriented interventions in adult ICU patients. Studies were suitable for inclusion if implementation strategies' efficacy, in terms of a clinical outcome, or process outcome was described. We included 21 studies, all including process measures, while 9 reported both process measures and clinical outcomes. Some individual strategies such as "audit and feedback" and "tailored interventions" may be important to establish clinical outcome improvements, but otherwise robust data on effectiveness of specific implementation strategies were scarce. Successful implementation interventions were frequently reported to change process measures, such as improvements in adherence to delirium screening with up to 92%, but relating process measures to outcome changes was generally not possible. In meta-analyses, reduced mortality and ICU length of stay reduction were statistically more likely with implementation programs that employed more (six or more) rather than less implementation strategies and when a framework was used that either integrated current evidence on pain, agitation and delirium management (PAD) or when a strategy of early awakening, breathing, delirium screening and early exercise (ABCDE bundle) was employed. Using implementation strategies aimed at organizational change, next to behavioral change, was also associated with reduced mortality

Implementing the Marine Strategy Framework Directive: A policy perspective on regulatory, institutional and stakeholder impediments to effective implementation

NARCIS (Netherlands)

Leeuwen, van J.; Raakjaer, J.; Hoof, van L.J.W.; Tatenhove, van J.P.M.; Long, R.; Ounanian, K.

2014-01-01

The implementation of the European Union (EU) Marine Strategy Framework Directive (MSFD) requires EU Member States to draft a program of measures to achieve Good Environmental Status (GES). Central argument of this paper, based on an analysis of the unique, holistic character of the MSFD, is that

Innovative Agro-food Technologies Implementation through Instructional Communication Mechanisms

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Gianita BLEOJU

2012-04-01

Full Text Available The current research represents the valorization of the dissemination the design framework of an interdisciplinary area of research, validated through SPAS European FP6 project and a national BIOSIG- PN2 and has as objective to channel communication on target market, through personalized solution of instructional communication mechanisms. The main objective of the national research grant being the implementation of innovative biotechnology on agro-food market, in order to improve the fish diet’s benefits, the prospects must be provided with valuable explicit information. This paper is about the commitment to embedding the actual consumer experience from PN2 fish market research and agro-food agents’ capitalization knowledge behavior from SPAS virtual platform, through designing the adequate communication framework, in order to support and accelerate the implementation of the innovation biotechnology, through improving the target market experience. The projected solution is mainly concerning to offer adequate solutions to insure against current consumers fragilities, but we also underline the vulnerabilities of the whole agro food value chain, in terms of communication strategy, which is lacking of adequate common interest coordination. The current research solution is regarding the rising awareness about the translation from consumer preferences to perceived detriment by integrating previous validated solution of agro food market analysis.

Do Teacher Attitudes Impact Literacy Strategy Implementation in Content Area Classrooms?

Science.gov (United States)

McCoss-Yergian, Tanya; Krepps, Loddie

2010-01-01

The purpose of this study was to identify beliefs about content area literacy commonly held by teachers and to evaluate whether or not these collective professional convictions and suppositions affect disciplinary instructors' implementation of content area reading strategies in their classrooms. A mixed methodology was applied to gather both…

Interactive Control System, Intended Strategy, Implemented Strategy dan Emergent Strategy

OpenAIRE

Tubagus Ismail; Darjat Sudrajat

2012-01-01

The purpose of this study was to examine the relationship between management control system (MCS) and strategy formation processes, namely: intended strategy, emergent strategy and impelemented strategy. The focus of MCS in this study was interactive control system. The study was based on Structural Equation Modeling (SEM) as its multivariate analyses instrument. The samples were upper middle managers of manufacturing company in Banten Province, DKI Jakarta Province and West Java Province. AM...

Rollout Strategy to Implement Interoperable Traceability in the Seafood Industry.

Science.gov (United States)

Gooch, Martin; Dent, Benjamin; Sylvia, Gilbert; Cusack, Christopher

2017-08-01

Verifying the accuracy and rigor of data exchanged within and between businesses for the purposes of traceability rests on the existence of effective and efficient interoperable information systems that meet users' needs. Interoperability, particularly given the complexities intrinsic to the seafood industry, requires that the systems used by businesses operating along the supply chain share a common technology architecture that is robust, resilient, and evolves as industry needs change. Technology architectures are developed through engaging industry stakeholders in understanding why an architecture is required, the benefits provided to the industry and individual businesses and supply chains, and how the architecture will translate into practical results. This article begins by reiterating the benefits that the global seafood industry can capture by implementing interoperable chain-length traceability and the reason for basing the architecture on a peer-to-peer networked database concept versus more traditional centralized or linear approaches. A summary of capabilities that already exist within the seafood industry that the proposed architecture uses is discussed; and a strategy for implementing the architecture is presented. The 6-step strategy is presented in the form of a critical path. © 2017 Institute of Food Technologists®.

Strategies from a nationwide health information technology implementation: the VA CART story.

Science.gov (United States)

Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S

2010-01-01

The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

[The implementation of strategy of medicinal support in multi-type hospital].

Science.gov (United States)

Ludupova, E Yu

2016-01-01

The article presents brief review of implementation of strategy of medicinal support of population of the Russian Federation and experience of application of at the level of regional hospital. The necessity and importance of implementation into practice of hospitals of methodology of pharmaco-economical management of medicinal care using modern technologies of XYZ-, ABC and VEN-analysis is demonstrated. The stages of development and implementation of process of medicinal support of multifield hospital applying principles of system of quality management (processing and systemic approaches, risk management) on the basis of standards ISO 9001 are described. The significance of monitoring of results ofprocess of medicinal support of the basis of implementation of priority target programs (prevention of venous thrombo-embolic complications, system od control of anti-bacterial therapy) are demonstrated in relation to multi-field hospital using technique of ATC/DDD-analysis for evaluating indices of effectiveness and efficiency.

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

Science.gov (United States)

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The

Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy.

NARCIS (Netherlands)

Bekkering, Geertruida E; van Tulder, Maurits W; Hendriks, Erik J M; Koopmanschap, Marc a; Knol, Dirk L; Bouter, Lex M; Oostendorp, Rob a B

2005-01-01

BACKGROUND AND PURPOSE: An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied.

Implementing Competency-Based Education: Challenges, Strategies, and a Decision-Making Framework

Science.gov (United States)

Dragoo, Amie; Barrows, Richard

2016-01-01

The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…

Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia.

Science.gov (United States)

Semba, Richard D; de Pee, Saskia; Hess, Sonja Y; Sun, Kai; Sari, Mayang; Bloem, Martin W

2008-02-01

Salt iodization is the main strategy for reducing iodine deficiency disorders worldwide. Characteristics of families not using iodized salt need to be known to expand coverage. The objective was to determine whether families who do not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using iodized salt. Use of adequately iodized salt (>or =30 ppm), measured by rapid test kits, was assessed between January 1999 and September 2003 in 145 522 and 445 546 families in urban slums and rural areas, respectively, in Indonesia. Adequately iodized salt was used by 66.6% and 67.2% of families from urban slums and rural areas, respectively. Among families who used adequately iodized salt, mortality in neonates, infants, and children aged urban slums; among families who did not use adequately iodized salt, the respective values were 4.2% compared with 6.3%, 7.1% compared with 11.2%, and 8.5% compared with 13.3% (P rural areas. Families not using adequately iodized salt were more likely to have children who were stunted, underweight, and wasted. In multivariate analyses that controlled for potential confounders, low maternal education was the strongest factor associated with not using adequately iodized salt. In Indonesia, nonuse of adequately iodized salt is associated with a higher prevalence of child malnutrition and mortality in neonates, infants, and children aged <5 y. Stronger efforts are needed to expand salt iodization in Indonesia.

The importance of organizational climate and implementation strategy at the introduction of a new working tool in primary health care.

Science.gov (United States)

Carlfjord, S; Andersson, A; Nilsen, P; Bendtsen, P; Lindberg, M

2010-12-01

The transmission of research findings into routine care is a slow and unpredictable process. Important factors predicting receptivity for innovations within organizations have been identified, but there is a need for further research in this area. The aim of this study was to describe contextual factors and evaluate if organizational climate and implementation strategy influenced outcome, when a computer-based concept for lifestyle intervention was introduced in primary health care (PHC). The study was conducted using a prospective intervention design. The computer-based concept was implemented at six PHC units. Contextual factors in terms of size, leadership, organizational climate and political environment at the units included in the study were assessed before implementation. Organizational climate was measured using the Creative Climate Questionnaire (CCQ). Two different implementation strategies were used: one explicit strategy, based on Rogers' theories about the innovation-decision process, and one implicit strategy. After 6 months, implementation outcome in terms of the proportion of patients who had been referred to the test, was measured. The CCQ questionnaire response rates among staff ranged from 67% to 91% at the six units. Organizational climate differed substantially between the units. Managers scored higher on CCQ than staff at the same unit. A combination of high CCQ scores and explicit implementation strategy was associated with a positive implementation outcome. Organizational climate varies substantially between different PHC units. High CCQ scores in combination with an explicit implementation strategy predict a positive implementation outcome when a new working tool is introduced in PHC. © 2010 Blackwell Publishing Ltd.

Testing the implementation and sustainment facilitation (ISF strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC strategy: study protocol for a cluster randomized trial

Directory of Open Access Journals (Sweden)

Bryan R. Garner

2017-11-01

Full Text Available Abstract Background Improving the extent to which evidence-based practices (EBPs—treatments that have been empirically shown to be efficacious or effective—are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness–implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI for substance use as an adjunct to usual care within AIDS service organizations (ASOs as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF as an adjunct to the Addiction Technology Transfer Center (ATTC model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition or the ATTC + ISF strategy (experimental condition. The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation. The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change. Building upon the exploration–preparation–implementation–sustainment (EPIS framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1 time-to-proficiency (i.e., preparation phase outcome, (2 implementation effectiveness (i.e., implementation phase outcome, and (3 level of sustainment (i.e., sustainment phase outcome

Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

Science.gov (United States)

Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

2018-01-01

Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

Science.gov (United States)

Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

2008-01-01

To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p prevention and control (p support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

Implementing Knowledge Translation Strategies in Funded Research in Canada and Australia: A Case Study

Directory of Open Access Journals (Sweden)

Gabriel Moore

2016-09-01

Full Text Available There is an emerging literature describing the use of knowledge translation strategies to increase the relevance and usability of research, yet there are few real-world examples of how this works in practice. This case study reports on the steps taken to embed knowledge translation strategies in the Movember Foundation's Men’s Mental Health Grant Rounds in 2013–14, which were implemented in Australia and Canada, and on the support provided to the applicants in developing their knowledge translation plans. It identifies the challenges faced by the Men’s Mental Health Program Team and how these were resolved. The strategies explored include articulating knowledge translation requirements, ensuring a common understanding of knowledge translation, assessing knowledge translation plans, methods of engaging end users, and building capacity with applicants. An iterative approach to facilitating knowledge translation planning within project development was rolled out in Australia just prior to Canada so that lessons learned were immediately available to refine the second roll out. Implementation included the use of external knowledge translation expertise, the development of knowledge translation plans, and the need for internal infrastructure to support monitoring and reporting. Differences in the Australian and Canadian contexts may point to differential exposure to the concepts and practices of knowledge translation. This case study details an example of designing and implementing an integrated knowledge translation strategy that moves beyond traditional dissemination models. Lessons learned point to the importance of a long lead-up time, the use of knowledge translation expertise for capacity building, the need for flexible implementation, and the need for efficiencies in supporting applicants.

Mechanism of realization economic strategy of transport organization

Science.gov (United States)

Palkina, E. S.

2017-10-01

In modern conditions of economic globalization, high dynamism of external environment, economic strategy of transport organization plays an important role in maintaining its competitive advantages, long-term development. For effective achievement of set strategic goals it is necessary to use an adequate mechanism based on completeness and interrelation of its constituent instruments. The main objective of the study presented in this paper is to develop methodological provisions on formation the mechanism of realization economic strategy for transport organizations. The principles of its construction have been proposed, the key components have been defined. Finally, an attempt to implementation this mechanism into the transport organization management system has been realized.

Defense Logistics. Preliminary Observations on the Army's Implementation of Its Equipment Reset Strategies

National Research Council Canada - National Science Library

Solis, William M

2007-01-01

.... In order to provide effective oversight of the Army's implementation of its equipment reset strategies and to plan for future reset initiatives, the Congress needs to be assured that the funds...

Do Online Bicycle Routing Portals Adequately Address Prevalent Safety Concerns?

Directory of Open Access Journals (Sweden)

Martin Loidl

2018-03-01

Full Text Available Safety concerns are among the most prevalent deterrents for bicycling. The provision of adequate bicycling infrastructure is considered as one of the most efficient means to increase cycling safety. However, limited public funding does not always allow agencies to implement cycling infrastructure improvements at the desirable level. Thus, bicycle trip planners can at least partly alleviate the lack of adequate infrastructure by recommending optimal routes in terms of safety. The presented study provides a systematic review of 35 bicycle routing applications and analyses to which degree they promote safe bicycling. The results show that most trip planners lack corresponding routing options and therefore do not sufficiently address safety concerns of bicyclists. Based on these findings, we developed recommendations on how to better address bicycling safety in routing portals. We suggest employing current communication technology and analysis to consider safety concerns more explicitly.

Implementation of Energy Strategies in Communities (Annex 63) Volume 2: Development of strategic measures

DEFF Research Database (Denmark)

Kellenberger, Daniel; Schmid, Christian; Quitzau, Maj-Britt

This report describes the further development of the analysed measures from Volume 1 into strategic measures. As with the term measure, a strategic measure refers to an essential measure in concept that can be used to develop individual implementation strategies on a local level for part...... or the whole life cycle of a project (from the first vision to monitoring of the implemented solution). The developed strategic measures deal with the following topics: Setting Vision and Targets Developing Renewable Energy Strategies Making Full use of Legal Frameworks Designing an Urban Competition Processes...... a summary of each strategic measure supported by nine appendices, each a detailed description of each strategic measure....

Autonomous Flight Rules Concept: User Implementation Costs and Strategies

Science.gov (United States)

Cotton, William B.; Hilb, Robert

2014-01-01

The costs to implement Autonomous Flight Rules (AFR) were examined for estimates in acquisition, installation, training and operations. The user categories were airlines, fractional operators, general aviation and unmanned aircraft systems. Transition strategies to minimize costs while maximizing operational benefits were also analyzed. The primary cost category was found to be the avionics acquisition. Cost ranges for AFR equipment were given to reflect the uncertainty of the certification level for the equipment and the extent of existing compatible avionics in the aircraft to be modified.

Global oral health inequalities: task group--implementation and delivery of oral health strategies

DEFF Research Database (Denmark)

Sheiham, A; Alexander, D; Cohen, L

2011-01-01

This paper reviews the shortcomings of present approaches to reduce oral diseases and inequalities, details the importance of social determinants, and links that to research needs and policies on implementation of strategies to reduce oral health inequalities. Inequalities in health...... their environment. There is a dearth of oral health research on social determinants that cause health-compromising behaviors and on risk factors common to some chronic diseases. The gap between what is known and implemented by other health disciplines and the dental fraternity needs addressing. To re-orient oral...... strategies tailored to determinants and needs of each group along the social gradient. Approaches focusing mainly on downstream lifestyle and behavioral factors have limited success in reducing health inequalities. They fail to address social determinants, for changing people's behaviors requires changing...

Strategies in disability management. Corporate disability management programs implemented at the work site.

Science.gov (United States)

Kalina, C M

1999-10-30

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

Experience measuring performance improvement in multiphase picture archiving and communications systems implementations.

Science.gov (United States)

Reed, G; Reed, D H

1999-05-01

When planning a picture archiving and communications system (PACS) implementation and determining which equipment will be implemented in earlier and later phases, collection and analysis of selected data will aid in setting implementation priorities. If baseline data are acquired relative to performance objectives, the same information used for implementation planning can be used to measure performance improvement and outcomes. The main categories of data to choose from are: (1) financial data; (2) productivity data; (3) operational parameters; (4) clinical data; and (5) information about customer satisfaction. In the authors' experience, detailed workflow data have not proved valuable in measuring PACS performance and outcomes. Reviewing only one category of data in planning will not provide adequate basis for targeting operational improvements that will lead to the most significant gains. Quality improvement takes into account all factors in production: human capacity, materials, operating capital and assets. Once we have identified key areas of focus for quality improvement in each phase, we can translate objectives into implementation requirements and finally into detailed functional and performance requirements. Here, Integration Resources reports its experience measuring PACS performance relative to phased implementation strategies for three large medical centers. Each medical center had its own objectives for overcoming image management, physical/geographical, and functional/technical barriers. The report outlines (1) principal financial and nonfinancial measures used as performance indicators; (2) implementation strategies chosen by each of the three medical centers; and (3) the results of those strategies as compared with baseline data.

Implementing an anti-smoking program in rural-remote communities: challenges and strategies.

Science.gov (United States)

Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C

2015-01-01

Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

Teachers' implementation of gender-inclusive instructional strategies in single-sex and mixed-sex science classrooms

Science.gov (United States)

Parker, Lesley H.; Rennie, Léonie J.

2002-09-01

Debate continues over the benefits, or otherwise, of single-sex classes in science and mathematics, particularly for the performance of girls. Previous research and analyses of the circumstances surrounding the implementation of single-sex classes warn that the success of the strategy requires due consideration of the nature of the instructional environment for both boys and girls, together with appropriate support for the teachers involved. This article reports the circumstances under which teachers were able to implement gender-inclusive strategies in single-sex science classes in coeducational high schools and documents some of the difficulties faced. The study was part of the Single-Sex Education Pilot Project (SSEPP) in ten high schools in rural and urban Western Australia. Qualitative and quantitative data were gathered during the project from teachers, students and classroom observations. Overall, it was apparent that single-sex grouping created environments in which teachers could implement gender-inclusive science instructional strategies more readily and effectively than in mixed-sex settings. Teachers were able to address some of the apparent shortcomings of the students' previous education (specifically, the poor written and oral communication of boys and the limited experience of girls with 'hands-on' activities and open-ended problem solving). Further, in same-sex classrooms, sexual harassment which inhibited girls' learning was eliminated. The extent to which teachers were successful in implementing gender-inclusive instructional strategies, however, depended upon their prior commitment to the SSEPP as a whole, and upon the support or obstacles encountered from a variety of sources, including parents, the community, students, and non-SSEPP teachers.

Ergonomics in the development and implementation of organisational strategy for sustainability.

Science.gov (United States)

Ryan, Brendan; Wilson, John R

2013-01-01

This is the first phase of an ergonomics study of sustainability in a rail organisation, particularly environmental sustainability. The main emphasis has been on the use of a qualitative approach to carry out in-depth consultation with those in influential and policy setting roles in the organisation, collecting and analysing perceptions on sustainability policy and related business processes. The study identified factors affecting implementation of policy on sustainability and these have been developed to produce a list of requirements for implementing the policy. The findings are valuable in understanding the range of attitudes, aspirations and perceived constraints, from the perspective of those in senior roles in the company, and development of a sustainability strategy for a rail infrastructure owner. There is need for wider consultation, both within the organisation and externally, to validate and refine the understanding of barriers to the implementation of the policy. The role of ergonomics in supporting the work on sustainability is discussed. The study collects in-depth views from senior managers on the challenges of implementing a policy on sustainability in a rail organisation. Outputs include a list of factors affecting implementation of policy and requirements for better implementation of policy in this area. Potential contributions of ergonomics to sustainability in organisational contexts are discussed.

Implementing acquisition strategies

International Nuclear Information System (INIS)

Montgomery, G. K.

1997-01-01

The objective of this paper is to address some of the strategies necessary to effect a successful asset or corporate acquisition. Understanding the corporate objective, the full potential of the asset, the specific strategies to be employed, the value of time, and most importantly the interaction of all these are crucial, for missed steps are likely to result in missed opportunities. The amount of factual information that can be obtained and utilized in a timely fashion is the largest single hurdle to the capture of value in the asset or corporate acquisition. Fact, familiarity and experience are key in this context. The importance of the due diligence process prior to title or data transfer cannot be overemphasized. Some of the most important assets acquired in a merger may be the people. To maximize effectiveness, it is essential to merge both existing staff and those that came with the new acquisition as soon as possible. By thinking together as a unit, knowledge and experience can be applied to realize the potential of the asset. Hence team building is one of the challenges, doing it quickly is usually the most effective. Developing new directions for the new enlarged company by combining the strengths of the old and the new creates more value, as well as a more efficient operation. Equally important to maximizing the potential of the new acquisition is the maintenance of the momentum generated by the need to grow that gave the impetus to acquiring new assets in the first place. In brief, the right mix of vision, facts and perceptions, quick enactment of the post-close strategies and keeping the momentum alive, are the principal ingredients of a focused strategy

Implementation of a clinical dementia guideline. A controlled study on the effect of a multifaceted strategy

DEFF Research Database (Denmark)

Waldorff, Frans Boch; Almind, Gert; Mäkelä, Marjukka

2003-01-01

OBJECTIVE: To assess the impact of a multifaceted implementation strategy aiming to improve GP adherence to a clinical guideline on dementia. DESIGN: Controlled before and after study using data records from regional laboratories. The guideline was mailed to all GPs. The multifaceted implementation...... strategy was planned with local GPs, and consisted of seminars, outreach visits, reminders and continuing medical education (CME) small group training. SETTING: Primary health care. SUBJECTS: 535 GP practices with 727 physicians in Denmark. MAIN OUTCOME MEASURES: The diffusion and use of the guideline...... of dementia in general practice. CONCLUSION: Although GPs regarded the guideline applicable in primary care, no change in practice adherence to guideline recommendations was detected after a multifaceted implementation....

Implementation Planning and Progress on Physical Activity Goals: The Mediating Role of Life-Management Strategies

Science.gov (United States)

Dugas, Michelle; Gaudreau, Patrick; Carraro, Natasha

2012-01-01

This 4-week prospective study examined whether the use of life-management strategies mediates the relationship between implementation planning and short-term progress on physical activity goals. In particular, the strategies of elective selection, compensation, and loss-based selection were disentangled to assess their specific mediating effects.…

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services.

Science.gov (United States)

Wolfenden, Luke; Jones, Jannah; Williams, Christopher M; Finch, Meghan; Wyse, Rebecca J; Kingsland, Melanie; Tzelepis, Flora; Wiggers, John; Williams, Amanda J; Seward, Kirsty; Small, Tameka; Welch, Vivian; Booth, Debbie; Yoong, Sze Lin

2016-10-04

Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to:1. describe the impact of such strategies on childcare service staff knowledge, skills or attitudes;2. describe the cost or cost-effectiveness of such strategies;3. describe any adverse effects of such strategies on childcare services, service staff or children;4. examine the effect of such strategies on child diet, physical activity or weight status. We searched the following electronic databases on 3 August 2015: the Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, ERIC, CINAHL and SCOPUS. We also searched reference lists of included trials, handsearched two international implementation science journals and searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). We included any study (randomised or non-randomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. The review authors independently screened abstracts and titles, extracted trial data and assessed risk of bias in pairs; we resolved discrepancies via consensus. Heterogeneity across studies precluded pooling of data and undertaking quantitative

Implementing thinking aloud pair and Pólya problem solving strategies in fractions

Science.gov (United States)

Simpol, N. S. H.; Shahrill, M.; Li, H.-C.; Prahmana, R. C. I.

2017-12-01

This study implemented two pedagogical strategies, the Thinking Aloud Pair Problem Solving and Pólya’s Problem Solving, to support students’ learning of fractions. The participants were 51 students (ages 11-13) from two Year 7 classes in a government secondary school in Brunei Darussalam. A mixed method design was employed in the present study, with data collected from the pre- and post-tests, problem solving behaviour questionnaire and interviews. The study aimed to explore if there were differences in the students’ problem solving behaviour before and after the implementation of the problem solving strategies. Results from the Wilcoxon Signed Rank Test revealed a significant difference in the test results regarding student problem solving behaviour, z = -3.68, p = .000, with a higher mean score for the post-test (M = 95.5, SD = 13.8) than for the pre-test (M = 88.9, SD = 15.2). This implied that there was improvement in the students’ problem solving performance from the pre-test to the post-test. Results from the questionnaire showed that more than half of the students increased scores in all four stages of the Pólya’s problem solving strategy, which provided further evidence of the students’ improvement in problem solving.

An Action Research to Optimize the Well-Being of Older People in Nursing Homes: Challenges and Strategies for Implementing a Complex Intervention.

Science.gov (United States)

Bourbonnais, Anne; Ducharme, Francine; Landreville, Philippe; Michaud, Cécile; Gauthier, Marie-Andrée; Lavallée, Marie-Hélène

2018-03-01

Few studies have been conducted on strategies to promote the implementation of complex interventions in nursing homes (NHs). This article presents a pilot study intended to assess the strategies that would enable the optimal implementation of a complex intervention approach in NHs based on the meanings of screams of older people living with Alzheimer's disease. An action research approach was used with 19 formal and family caregivers from five NHs. Focus groups and individual interviews were held to assess different implementation strategies. A number of challenges were identified, as were strategies to overcome them. These latter included interactive training, intervention design, and external support. This study shows the feasibility of implementing a complex intervention to optimize older people's well-being. The article shares strategies that may promote the implementation of these types of interventions in NHs.

Invited Reaction: The Strategic Value of HRD in Lean Strategy Implementation

Science.gov (United States)

Yorks, Lyle; Barto, Jody

2013-01-01

This study by Meera Alagaraja and Toby Egan provides a case study of a Lean strategy implementation in which HRD was an integrated part of the process and offers a model that can give direction for both future research and strategic advocacy on behalf of HRD practice. The case is actually more a study of the importance of cross-functional and…

Improvements in Students' Understanding from Increased Implementation of Active Learning Strategies

Science.gov (United States)

Hayes-Gehrke, Melissa N.; Prather, E. E.; Rudolph, A. L.; Collaboration of Astronomy Teaching Scholars CATS

2011-01-01

Many instructors are hesitant to implement active learning strategies in their introductory astronomy classrooms because they are not sure which techniques they should use, how to implement those techniques, and question whether the investment in changing their course will really bring the advertised learning gains. We present an example illustrating how thoughtful and systematic implementation of active learning strategies into a traditionally taught Astro 101 class can translate into significant increases in students' understanding. We detail the journey of one instructor, over several years, as she changes the instruction and design of her course from one that focuses almost exclusively on lecture to a course that provides an integrated use of several active learning techniques such as Lecture-Tutorials and Think-Pair-Share questions. The students in the initial lecture-only course achieved a low normalized gain score of only 0.2 on the Light and Spectroscopy Concept Inventory (LSCI), while the students in the re-designed learner-centered course achieved a significantly better normalized gain of 0.43. This material is based upon work supported by the National Science Foundation under Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS), and Grant No. 0847170, a PAARE Grant for the Calfornia-Arizona Minority Partnership for Astronomy Research and Education (CAMPARE). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

Improving occupational physicians' adherence to a practice guideline : feasibility and impact of a tailored implementation strategy

NARCIS (Netherlands)

Joosen, Margot C. W.; van Beurden, Karlijn M.; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P. M.; van der Klink, Jac J. L.

2015-01-01

Background: Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived

Summary of Gaps and Barriers for Implementing Residential Building Energy Efficiency Strategies

Energy Technology Data Exchange (ETDEWEB)

2010-08-01

This report presents the key gaps and barriers to implementing residential energy efficiency strategies in the U.S. market, as identified in sessions at the U.S. Department of Energy's Building America 2010 Residential Energy Efficiency Meeting held in Denver, Colorado, on July 20-22, 2010.

Assessing the ERP-SAP implementation strategy from cultural perspectives

Science.gov (United States)

Wang, Gunawan; Syaiful, Bakhri; Sfenrianto; Nurul, Fajar Ahmad

2017-09-01

Implementing ERP-SAP projects in Indonesian large enterprises frequently create headaches for the consultants, since there are always be a large gap between the outcomes of the SAP with the expected results. Indonesian enterprises have experience with a huge amount of investments and ended up with minor benefits. Despite its unprecedented benefits, the SAP strategy is still considered as a mandatory enterprise system for every enterprise to compete in the marketplaces. The article examines the SAP implementation from cultural perspectives to present new horizon that commonly ignored by major Indonesian enterprises. The article applies the multiple case studies with three large Indonesia enterprises, such as KS, the largest steel producer; GEM, a subsidiary of conglomerate enterprise operates in the mining industry, and HS, a subsidiary of the largest retailer in Asia with more than 700 stores in Indonesia. The outcome of the article is expected to provide a comprehensive analysis from cultural perspectives regarding to common problems faced by SAP consultants.

SUPPLY CHAIN MANAGEMENT AS AN ELEMENT OF COMPANY STRATEGY

OpenAIRE

SEBASTIAN KOT; DANUTA PLUTA; IWONA STASIAK; WIOLETTA STRUZIK

2014-01-01

: The process of supply chain management is a huge challenge for managers of many companies. In today's market situation more and more often it is the effective supply of products at minimum cost and a guarantee of an adequate level of customer service which determine the competitiveness of organizations. As a result, companies implement strategies for supply chain management. The constantly increasing role of logistics and supply chain management results, among others, from the fact that bot...

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.

Orbital prefrontal cortex is required for object-in-place scene memory but not performance of a strategy implementation task.

Science.gov (United States)

Baxter, Mark G; Gaffan, David; Kyriazis, Diana A; Mitchell, Anna S

2007-10-17

The orbital prefrontal cortex is thought to be involved in behavioral flexibility in primates, and human neuroimaging studies have identified orbital prefrontal activation during episodic memory encoding. The goal of the present study was to ascertain whether deficits in strategy implementation and episodic memory that occur after ablation of the entire prefrontal cortex can be ascribed to damage to the orbital prefrontal cortex. Rhesus monkeys were preoperatively trained on two behavioral tasks, the performance of both of which is severely impaired by the disconnection of frontal cortex from inferotemporal cortex. In the strategy implementation task, monkeys were required to learn about two categories of objects, each associated with a different strategy that had to be performed to obtain food reward. The different strategies had to be applied flexibly to optimize the rate of reward delivery. In the scene memory task, monkeys learned 20 new object-in-place discrimination problems in each session. Monkeys were tested on both tasks before and after bilateral ablation of orbital prefrontal cortex. These lesions impaired new scene learning but had no effect on strategy implementation. This finding supports a role for the orbital prefrontal cortex in memory but places limits on the involvement of orbital prefrontal cortex in the representation and implementation of behavioral goals and strategies.

Outcomes of a systematically designed strategy for the implementation of sex education in Dutch secondary schools

NARCIS (Netherlands)

Wiefferink, C.H.; Poelman, J.; Linthorst, M.; Vanwesenbeeck, I.; Wijngaarden, J.C.M. van; Paulussen, T.G.W.M.

2005-01-01

This study examines the effects of a systematically designed innovation strategy on teachers' implementation of a sex education curriculum and its related determinants. A quasi-experimental group design was used to assess the effectiveness of the innovation strategy. Teachers filled in

Strategies of employees in the construction industry to increase their sustainable employability.

Science.gov (United States)

Tonnon, Susanne C; van der Veen, Rozan; de Kruif, Anja Th C M; Robroek, Suzan J W; van der Ploeg, Hidde P; Proper, Karin I; van der Beek, Allard J

2018-01-01

The aging work force makes sustainable employability (SE) of workers a priority. However, it is unknown to what extent employees use implemented SE measures. To determine the utilization of 1) SE measures offered by employers, 2) employee SE strategies, and 3) to identify barriers and facilitators of SE strategies. Survey data were collected among 731 blue collar and 879 white collar workers to determine the utilization of employer SE measures. Focus groups were held with 16 blue collar and 17 white collar workers to identify employee SE strategies and their barriers and facilitators. Utilization of employer SE measures was highest for personal development measures. Strategies applied by blue collar workers included using equipment, suggesting improvements of their working conditions, and seeking promotion to a less physically demanding job. White collar workers named engaging in leisure time physical activity and seeking an adequate work-life balance. Implementation of these strategies was influenced by employee awareness and self-efficacy, the accessibility and costs and benefits of the strategy, management support and company culture. Usage of employer SE measures was generally low and recommendations are given for both blue and white collar workers to improve SE strategies.

An Implementation Strategy to Improve the Guideline Adherence of Insurance Physicians: A Process Evaluation Alongside an Experiment in a Controlled Setting

Science.gov (United States)

Zwerver, Feico; Bonefaas-Groenewoud, Karin; Schellart, Antonius J. M.; Anema, Johannes R.; van der Beek, Allard J.

2013-01-01

Background: We developed an implementation strategy for the insurance medicine guidelines for depression, which we implemented via a post-graduate course for insurance physicians (IPs). In this study we evaluate the physicians' experiences of the implementation strategy by measuring the following aspects: recruitment and reach, dose delivered and…

Meta-regression analyses to explain statistical heterogeneity in a systematic review of strategies for guideline implementation in primary health care.

Directory of Open Access Journals (Sweden)

Susanne Unverzagt

Full Text Available This study is an in-depth-analysis to explain statistical heterogeneity in a systematic review of implementation strategies to improve guideline adherence of primary care physicians in the treatment of patients with cardiovascular diseases. The systematic review included randomized controlled trials from a systematic search in MEDLINE, EMBASE, CENTRAL, conference proceedings and registers of ongoing studies. Implementation strategies were shown to be effective with substantial heterogeneity of treatment effects across all investigated strategies. Primary aim of this study was to explain different effects of eligible trials and to identify methodological and clinical effect modifiers. Random effects meta-regression models were used to simultaneously assess the influence of multimodal implementation strategies and effect modifiers on physician adherence. Effect modifiers included the staff responsible for implementation, level of prevention and definition pf the primary outcome, unit of randomization, duration of follow-up and risk of bias. Six clinical and methodological factors were investigated as potential effect modifiers of the efficacy of different implementation strategies on guideline adherence in primary care practices on the basis of information from 75 eligible trials. Five effect modifiers were able to explain a substantial amount of statistical heterogeneity. Physician adherence was improved by 62% (95% confidence interval (95% CI 29 to 104% or 29% (95% CI 5 to 60% in trials where other non-medical professionals or nurses were included in the implementation process. Improvement of physician adherence was more successful in primary and secondary prevention of cardiovascular diseases by around 30% (30%; 95% CI -2 to 71% and 31%; 95% CI 9 to 57%, respectively compared to tertiary prevention. This study aimed to identify effect modifiers of implementation strategies on physician adherence. Especially the cooperation of different health

Active implementation strategy of CONSORT adherence by a dental specialty journal improved randomized clinical trial reporting.

Science.gov (United States)

Pandis, Nikolaos; Shamseer, Larissa; Kokich, Vincent G; Fleming, Padhraig S; Moher, David

2014-09-01

To describe a novel CONsolidated Standards of Reporting Trials (CONSORT) adherence strategy implemented by the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO) and to report its impact on the completeness of reporting of published trials. The AJO-DO CONSORT adherence strategy, initiated in June 2011, involves active assessment of randomized clinical trial (RCT) reporting during the editorial process. The completeness of reporting CONSORT items was compared between trials submitted and published during the implementation period (July 2011 to September 2013) and trials published between August 2007 and July 2009. Of the 42 RCTs submitted (July 2011 to September 2013), 23 were considered for publication and assessed for completeness of reporting, seven of which were eventually published. For all published RCTs between 2007 and 2009 (n = 20), completeness of reporting by CONSORT item ranged from 0% to 100% (Median = 40%, interquartile range = 60%). All published trials in 2011-2013, reported 33 of 37 CONSORT (sub) items. Four CONSORT 2010 checklist items remained problematic even after implementation of the adherence strategy: changes to methods (3b), changes to outcomes (6b) after the trial commenced, interim analysis (7b), and trial stopping (14b), which are typically only reported when applicable. Trials published following implementation of the AJO-DO CONSORT adherence strategy completely reported more CONSORT items than those published or submitted previously. Copyright © 2014 Elsevier Inc. All rights reserved.

Deployment and implementation of the Grundfos' sustainability strategy by means of the ecodesign maturity model

DEFF Research Database (Denmark)

Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.; Rozenfeld, Henrique

2014-01-01

Companies are increasingly realizing the needs and opportunities for implementing sustainability into their business processes and corporate culture. This paper describes the approach followed by Grundfos to deploy its Sustainability Strategy for the development of Sustainable Product Solutions......, by means of the Ecodesign Maturity Model (EcoM2), which included the diagnosis of their current maturity profile, the definition of a strategic roadmap for ecodesign implementation and the implementation of the defined projects....

[Physical projects atelier: strategy for physical resources administration learning on nursing].

Science.gov (United States)

Draganov, Patricia Bover; Sanna, Maria Cristina

2011-09-01

The success of learning involves adequate strategies. Those inspired on andragogy, which is the science of teaching adults, seem to be ideal for the nursing undergraduate subject "projects", with a focus on the administration of physical resources for nursing. This study reports teaching strategies that try to estimulate the acquisition of competences that make the nurse capable of a dialogue on projects with a multiprofessional team. The strategy involved a workshop composed by four stages: reading of projects, health assistance institute (HAI) attributions, notions on physical scaling strategies and development of a glossary. The strategy, proposed by a graduate student in the subject "Strategies to the teaching of Administration", was tested through practical application, evaluated and approved by graduate students and teachers. The conditions for its implementation are working with few students, availability of proper classrooms and equipment, and partnership with HAIs.

Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city.

Science.gov (United States)

Lavôr, Débora Cristina Brasil da Silva; Pinheiro, Jair Dos Santos; Gonçalves, Maria Jacirema Ferreira

2016-04-01

To assess the degree of implementation of the Directly Observed Treatment, Short-course - DOTS for tuberculosis (TB) in a large city. Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program. Avaliar o grau de implantação da estratégia de tratamento diretamente observado (Directly Observed Treatment, Short-course - DOTS) para tuberculose (TB) em um município de grande porte. Avaliação de implantação por meio de modelo lógico, cujos casos novos de TB pulmonar bacilífera foram recrutados em ambulatórios especializados e acompanhados nas unidades básicas de saúde. Utilizou-se matriz de julgamento que abrange os cinco componentes da estratégia DOTS. O resultado do modelo lógico indica DOTS implantada parcialmente. Nos contextos externo, organizacional e de implantação, a estratégia DOTS está implantada parcialmente; e, na efetividade não está implantada. A implantação parcial da estratégia DOTS, na cidade de Manaus, reflete na não conformidade do controle da TB, levando à baixa efetividade do programa.

Strategies for establishing networking with partner schools for implementing lesson study in Indonesia

Directory of Open Access Journals (Sweden)

Nurwidodo Nurwidodo

2018-03-01

Full Text Available Lesson Study for Learning Community (LSLC contains two terminologies underpinning one another. There are many difficult challenges when the plan to create LSLC surfaces. Therefore, strong motivation and precise implementation strategies are of urgency. One of the ways is by developing networking of LSLC between universities and partner schools. The LSLC program will become powerful when it is done collaboratively in a form of strong partnership connected by networks. Writing this article aims to describe strategies for establishing networking with partner schools for implementing lesson study in Indonesia. This review article uses literature comparison study methods and use content analysis. In order for LSLC to manifest and become successful, resourcing and utilizing the partnership with schools are required. In a partnership with schools in order to implement LSLC, both parties must share the same need, which is facing the challenge with the willingness to cooperate for solving the problem. Cooperation with partner schools needs to be nurtured to become networking so that the benefits and the spirit of cooperation in solving problem double fold. Networking with partner schools can be implemented and can function well when the management of this networking conforms to shared needs, nurtures cooperation and mutual respect, gives and takes equally, and also promotes fair acceptance, support, independence, and discipline.

The Implementation of hydrogen mitigation techniques: summary and conclusions: OECD Workshop

International Nuclear Information System (INIS)

1996-01-01

The OECD Workshop on the Implementation of Hydrogen Mitigation Techniques was held in Winnipeg, Canada from 1996 May 13 to 15. Sixty-five experts from twelve OECD Member countries and the Russian Federation attended the meeting. Thirty-five papers were presented in six sessions: accident management and analyses, relevant aspects of hydrogen production, distribution and mixing, engineering, technology, possible side-effects and consequences, new designs. The objectives of the Workshop were to establish the state-of-the-art of hydrogen mitigation techniques, with emphasis on igniters and catalytic recombiners, to exchange information on Member countries' strategies in managing hydrogen mitigation and to establish dialogue as to differences in approach, to determine whether there is now an adequate technical basis for such strategies or whether more work - in which areas - is desirable, and to exchange information on future plans for implementation of hydrogen mitigation techniques

Implementation of selective prevention for cardiometabolic diseases; is general practice adequately prepared ?

NARCIS (Netherlands)

Stol, D.M.; Hollander, M.; Nielen, M.M.J.; Badenbroek, I.F.; Schellevis, F.G.; Wit, N.J. de

2018-01-01

Objective: Current guidelines acknowledge the need for cardiometabolic disease (CMD) prevention and recommend five-yearly screening of a targeted population. In recent years programs for selective CMD-prevention have been developed, but implementation is challenging. The question arises if general

Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

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Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

2017-03-10

This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

STRATEGY IMPLEMENTATION STYLES OF MALAYSIAN, THAI AND HUNGARIAN MIDDLE MANAGERS

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Maheshkumar P. Joshi

2004-01-01

Full Text Available There is a need for more comparative empirical research that examines middle manager roles in strategic change. This paper reports a study of middle managers in two dynamic settings: the Asia/Pacific region – Malaysia and Thailand; and Central/Eastern Europe – Hungary. Results of 213 respondents across three countries indicate that middle managers from all three tend toward use of authoritarian management styles even in proactive strategic change situations. However, Hungarians are less likely to use these styles than Thai and Malaysian middle managers. For all three countries, managers with less work experience were found to have lower tendencies to use an authoritarian style of implementation. When top managers exhibit an aggressive strategic posture, middle-managers from all three countries are also less likely to use an authoritarian style.Firms that want to stay competitive in the global market place must continuously evolve by successfully accomplishing strategic change (Struckman & Yammarino 2003. Although senior managers are critical in leading the strategic change process, even the best-planned strategic changes will not achieve their full potential unless they are well implemented. Part of the strategic leadership responsibility, therefore, includes establishing a climate in which the organization's rank and file will experience both a positive attitude about change and the confidence to actively seek change opportunities (Kanter 2003. Research attention is bringing more insight into the important roles of middle-managers in this process of implementing strategic change (Balogun & Jenkins 2003; Floyd & Wooldridge, 1992, 1994; Wooldridge & Floyd 1990. Although there is little doubt that active support by middle managers is critical for the strategies to be well implemented (Guth & MacMillan 1986, there remain many important questions with regard to how middle managers participate in this process (Balogun 2003.The need for research

Results of implementation of a hospital-based strategy to reduce cesarean delivery among low-risk women in Canada.

Science.gov (United States)

Shoemaker, Esther S; Bourgeault, Ivy L; Cameron, Carol; Graham, Ian D; Hutton, Eileen K

2017-11-01

To assess the cesarean delivery (CD) rate among low-risk pregnancies before and after implementation of a hospital-based program in Canada. A prospective before-and-after study was conducted to assess the effects of the CARE (CAesarean REduction) strategy, which was developed and implemented at Markham Stouffville Hospital, Toronto, ON, Canada, in 2010 to reduce CD among low-risk women. Hospital records were reviewed to identify changes in the proportions of CD performed during 12 months (April 2009-March 2010) before implementation of the CARE strategy versus 12 months after implementation (April 2012-March 2013) at Markham Stouffville Hospital and 36 hospitals of the same level in the same province. At the intervention hospital, 30.3% (964/3181) of women underwent CD in 2009-2010, compared with 26.4% (803/3045) in 2012-2013 (difference -3.9%, PImplementation of the CARE strategy reduced rates of CD among the target population. © 2017 International Federation of Gynecology and Obstetrics.

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

Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review.

Science.gov (United States)

Salloum, Ramzi G; Shenkman, Elizabeth A; Louviere, Jordan J; Chambers, David A

2017-11-23

One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. We conducted a systematic literature search (up to December 2016) of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s), healthcare setting, and implementation outcome. Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1) characterizing demand for therapies and treatment technologies (n = 32), (2) comparing implementation strategies (n = 22), (3) incentivizing workforce participation (n = 11), and (4) prioritizing interventions (n = 10). Stakeholders included providers (n = 27), patients (n = 25), caregivers (n = 5), and administrators (n = 2). The remaining studies (n = 16) engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators). The following implementation outcomes were discussed: acceptability (n = 75), appropriateness (n = 34), adoption (n = 19), feasibility (n = 16), and fidelity (n = 3). The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the past decade. As DCEs are more widely used as a

[Evidence-based clinical oral healthcare guidelines 4. Adherence requires an implementation strategy].

Science.gov (United States)

Braspenning, J C C; Mettes, T G P H; van der Sanden, W J M; Wensing, M J P

2015-03-01

Adherence to clinical guidelines requires support in practice. However, systematic implementation of evidence-based guidelines is not common practice in oral healthcare. The Knowledge Institute Oral Care (KiMo) offers the opportunity to take into account potential barriers and facilitators during the development of evidence-based clinical practice guidelines. These factors which are relevant to the guideline and the oral healthcare practice provide the ingredients for a tailor-made programme of implementation that has a scientific basis. Elements of any implementation programme are the quality indicators derived from the oral healthcare guidelines. These indicators should fit, on the one hand, the specific goals of the guidelines (patient safety, effectiveness, efficiency, patient-centred, timeliness, accessibility) and, onthe other hand, the various perspectives of the different stakeholders, such as patients, caregivers, health insurers and inspectorate. These quality indicators provide information on adherence to the guidelines, the results of a certain treatment and the success of the implementation strategy, all with the aim to improve the quality of oral healthcare.

Environmental management practices in the Lebanese pharmaceutical industries: implementation strategies and challenges.

Science.gov (United States)

Massoud, May A; Makarem, N; Ramadan, W; Nakkash, R

2015-03-01

This research attempts to provide an understanding of the Lebanese pharmaceutical industries' environmental management strategies, priorities, and perceptions as well as drivers, barriers, and incentives regarding the implementation of the voluntary ISO 14001 Environmental Management System. Accordingly, a semistructured in-depth interview was conducted with the pharmaceutical industries. The findings revealed a significant lack of knowledge about the standard among the industries. The main perceived drivers for adopting the ISO 14001 are improving the companies' image and overcoming international trade. The main perceived barriers for acquiring the standard are the lack of government support and the fact that ISO 14001 is not being legally required or enforced by the government. Moreover, results revealed that adopting the ISO 14001 standard is not perceived as a priority for the Lebanese pharmaceutical industries. Although the cost of certification was not considered as a barrier for the implementation of ISO 14001, the majority of the pharmaceutical industries are neither interested nor willing to adopt the Standard if they are not exposed to any regulatory pressure or external demand. They are more concerned with quality and safety issues with the most adopted international standard among the industries being the ISO 9001 quality management system. This study highlights the aspect that financial barriers are not always the hurdles for implementing environmental management strategies in developing countries and underscores the need for regulatory frameworks and enforcement.

Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province.

Science.gov (United States)

Vhuromu, E N; Davhana-Maselesele, M

2009-09-01

Treatment of the under five years is a national priority as an attempt in curbing deaths and deformities affecting children. Primary health care was implemented in the clinics in order to help in the treatment of illnesses affecting the community, including children. As a result of childhood illnesses; the World Health Organization (WHO) and United Nation Children's Fund (UNICEF) came up with Integrated Management of Childhood illnesses (IMCI) strategy to enhance treatment of such illnesses in developing countries. Primary health care nurses (PHCNS) in Limpopo Province were also trained to implement the strategy. This study is intended to explore and describe the experiences of PHCNS in implementing the IMCI strategy at selected clinics in Vhembe District in the Limpopo Province. A qualitative, explorative, descriptive and contextual design was used. In-depth interviews were conducted with PHCNS who are IMCI trained and have implemented the strategy for a period of not less than two years. Data analysis was done through using Tesch 's method of open coding for qualitative analysis. Findings revealed that PHCNS had difficulty in rendering IMCI services due to lack of resources and poor working conditions. Recommendations address the difficulties experienced by PHCNS when implementing the IMCI strategy.

THE MECHANISM FOR IMPLEMENTING THE STRATEGY OF COMPETITIVENESS INCREASE OF THE ORGANIZATION

Directory of Open Access Journals (Sweden)

Николай Петрович ГРИНЧЕНКО

2017-03-01

Full Text Available The mechanism of the organizational competitiveness increase, which is employed to enhance the organizational structure, has been performed in the research. The principles ensuring the product competitiveness have been pointed out. The involvement of the strategic marketing service organizational structure which aims to optimize the information flows for the development of the managerial decisions has been proved.  The generalized structure of strategic marketing services focused on medium-sized and large enterprises has been proposed. The proposed strategic marketing service develops strategic standards for all production parameters on the first stage of organizational product life cycle. Employing the innovation management methods, it prepares the exclusive values for all production parameters to turn them into an organizational competitiveness according to the following scheme: exclusive value, competitive advantages of products, competitiveness of products and organization competitiveness. Strategic Marketing Service together with top managers performs: the strategic vision and organization mission development, the tree of long-term objectives development, the strategy of the organization competitiveness improvement development, projects formation, control, and implementation. The Strategic Marketing Service Management is based on the strategic management functions implementation while performing the strategy of organizational competitiveness increase. The mechanism structure of the strategy of organizational competitiveness increase that will effectively perform the strategic management decisions and convert the exclusive values into the organizational competitiveness has been proposed.

Strategies for Exploiting Independent Cloud Implementations of Biometric Experts in Multibiometric Scenarios

Directory of Open Access Journals (Sweden)

P. Peer

2014-01-01

Full Text Available Cloud computing represents one of the fastest growing areas of technology and offers a new computing model for various applications and services. This model is particularly interesting for the area of biometric recognition, where scalability, processing power, and storage requirements are becoming a bigger and bigger issue with each new generation of recognition technology. Next to the availability of computing resources, another important aspect of cloud computing with respect to biometrics is accessibility. Since biometric cloud services are easily accessible, it is possible to combine different existing implementations and design new multibiometric services that next to almost unlimited resources also offer superior recognition performance and, consequently, ensure improved security to its client applications. Unfortunately, the literature on the best strategies of how to combine existing implementations of cloud-based biometric experts into a multibiometric service is virtually nonexistent. In this paper, we try to close this gap and evaluate different strategies for combining existing biometric experts into a multibiometric cloud service. We analyze the (fusion strategies from different perspectives such as performance gains, training complexity, or resource consumption and present results and findings important to software developers and other researchers working in the areas of biometrics and cloud computing. The analysis is conducted based on two biometric cloud services, which are also presented in the paper.

Analysis and implementation of a World Health Organization health report: methodological concepts and strategies.

Science.gov (United States)

von Groote, Per Maximilian; Giustini, Alessandro; Bickenbach, Jerome Edmond

2014-01-01

A long-standing scientific discourse on the use of health research evidence to inform policy has come to produce multiple implementation theories, frameworks, models, and strategies. It is from this extensive body of research that the authors extract and present essential components of an implementation process in the health domain, gaining valuable guidance on how to successfully meet the challenges of implementation. Furthermore, this article describes how implementation content can be analyzed and reorganized, with a special focus on implementation at different policy, systems and services, and individual levels using existing frameworks and tools. In doing so, the authors aim to contribute to the establishment and testing of an implementation framework for reports such as the World Health Organization World Report on Disability, the World Health Organization International Perspectives on Spinal Cord Injury, and other health policy reports or technical health guidelines.

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.

Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program.

Science.gov (United States)

Kilbourne, Amy M; Almirall, Daniel; Eisenberg, Daniel; Waxmonsky, Jeanette; Goodrich, David E; Fortney, John C; Kirchner, JoAnn E; Solberg, Leif I; Main, Deborah; Bauer, Mark S; Kyle, Julia; Murphy, Susan A; Nord, Kristina M; Thomas, Marshall R

2014-09-30

Despite the availability of psychosocial evidence-based practices (EBPs), treatment and outcomes for persons with mental disorders remain suboptimal. Replicating Effective Programs (REP), an effective implementation strategy, still resulted in less than half of sites using an EBP. The primary aim of this cluster randomized trial is to determine, among sites not initially responding to REP, the effect of adaptive implementation strategies that begin with an External Facilitator (EF) or with an External Facilitator plus an Internal Facilitator (IF) on improved EBP use and patient outcomes in 12 months. This study employs a sequential multiple assignment randomized trial (SMART) design to build an adaptive implementation strategy. The EBP to be implemented is life goals (LG) for patients with mood disorders across 80 community-based outpatient clinics (N = 1,600 patients) from different U.S. regions. Sites not initially responding to REP (defined as implementation costs, and organizational change. This study design will determine whether an off-site EF alone versus the addition of an on-site IF improves EBP uptake and patient outcomes among sites that do not respond initially to REP. It will also examine the value of delaying the provision of EF/IF for sites that continue to not respond despite EF. ClinicalTrials.gov identifier: NCT02151331.

An innovative cross-sectoral method for implementation of trade-off adaptation strategy assessment under climate change

Science.gov (United States)

Tsao, Jung-Hsuan; Tung, Ching-Pin; Liu, Tzu-Ming

2014-05-01

Climate change will increase sharp risks to the water and food supply in coming decades. Although impact assessment and adaptation evaluation has been discussed a lot in recent years, the importance of adaptation implement should not be ignored. In Taiwan, and elsewhere, fallow is an option of adaptation strategy under climate change. Fallow would improve the water scarcity of domestic use, but the food security might be threatened. The trade-off effects of adaptation actions are just like the side effects of medicine which cannot be avoided. Thus, managing water resources with an integrated approach will be urgent. This study aims to establish a cross-sectoral framework for implementation the trade-off adaptation strategy. Not only fallow, but also other trade-off strategy like increasing the percentage of national grain self-sufficiency would be analyzed by a rational decision process. The recent percentage of grain self-sufficiency in Taiwan is around 32, which was decreasing from 53 thirty years ago. Yet, the goal of increasing grain self-sufficiency means much more water must be used in agriculture. In that way, domestic users may face the water shortage situation. Considering the conflicts between water supply and food security, the concepts from integrative negotiation are appropriate to apply. The implementation of trade-off adaptation strategies needs to start by quantifying the utility of water supply and food security were be quantified. Next, each side's bottom line can be found by BATNA (Best Alternative to a Negotiated Agreement) and ZOPA (Zone of Possible Agreement). ZOPA provides the entire possible outcomes, and BATNA ensures the efficiency of adaptation actions by moving along with Pareto frontier. Therefore, the optimal percentage of fallow and grain self-sufficiency can be determined. Furthermore, BATNA also provides the pathway step by step which can be a guideline of adaptation strategies. This framework allows analysts and stakeholder to

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

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…

Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial.

Science.gov (United States)

Vlemmix, Floortje; Rosman, Ageeth N; Rijnders, Marlies E; Beuckens, Antje; Opmeer, Brent C; Mol, Ben W J; Kok, Marjolein; Fleuren, Margot A H

2015-05-01

To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech presentation from 32 weeks of gestation onwards. We randomized clusters to a client strategy (written information leaflets and decision aid), a care-provider strategy (1-day counseling course focused on knowledge and counseling skills), a combined client and care-provider strategy and care-as-usual strategy. We performed an intention-to-treat analysis. Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt. The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8-95%. Neither the client strategy (OR 0.8, 95% CI 0.4-1.5) nor the care-provider strategy (OR 1.2, 95% CI 0.6-2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3-1.4 and OR 2.0, 95% CI 0.7-4.5). Neither a client nor a care-provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

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.

KUNCI SUKSES DAN PERAN STRATEGIS IMPLEMENTASI AKUNTANSI BERBASIS AKRUAL

Directory of Open Access Journals (Sweden)

S. Surepno

2015-10-01

Full Text Available Penelitian dilakukan untuk menganalisis kesuksesan Pemerintah Kota Semarang dalam implementasi akuntansi berbasis akrual. Penelitian ini juga menganalisis respon pelaku implementasi terhadap peran strategis akuntansi berbasis akrual dalam transparansi dan akuntabilitas. Metode penelitian menggunakan pendekatan kualitatif dengan melalukan studi kasus pada Dinas Pengelolaan Keuangan dan Aset Daerah (DPKAD Kota Semarang dengan cara mewancarai aktor kunci impelementasi. Hasil penelitian menunjukkan, keberhasilan implementasi akuntansi berbasis akrual Pemerintah Kota Semarang didukung oleh empat strategi utama yaitu komitmen pimpinan, pengembangan regulasi, pengembangan sistem informasi dan pengembangan sumber daya manusia. Adapun hambatannya dalam proses implementasi adalah SDM masih terbatas, dukungan teknologi informasi belum memadai, permasalahan aset tetap dan belum adanya petunjuk teknis bagi Pemda. Kesimpulan penelitian menunjukkan bahwa pelaku implementasi menunjukkan akuntansi berbasis akrual memiliki peran strategis dalam peningkatan transparansi dan akuntabilitas melalui pelaporan keuangan.The study focused on analysis of Semarang City Government's success 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 Dinas Pengelolaan Keuangan dan Aset Daerah (DPKAD Semarang by means of interviewing the key actors of implementation. The results showed that the successful implementation of accrual accounting Semarang city government is supported by four main strategies, namely management commitment, regulatory development, information systems development and human resource development. While the obstacles that occur in the implementation process is still limited human resources, information technology support is not

Perspectives of key stakeholders and experts in infant feeding on the implementation of the Australian National Breastfeeding Strategy 2010-2015.

Science.gov (United States)

Hull, Naomi S; Schubert, Lisa C; Smith, Julie P

2017-03-01

Breastfeeding is widely accepted as an important public health issue for babies and their mothers. Yet, despite this, Australia continues to struggle with reaching global targets for breastfeeding indicators. In 2007, the Best Start Parliamentary Inquiry Report was released and set the stage for the Australian National Breastfeeding Strategy [2010-2015), which was announced in November 2009, with the vision to increase Australia's breastfeeding rates of infants at 6 months of age and beyond. The aim of this research project was to explore the perspectives of key stakeholders in the field of infant feeding in Australia on the implementation of the strategy, barriers and enablers to its successful implementation and actions that were still needed. Using qualitative research methods of in-depth, semi-structured interviews and thematic analysis, this study identifies main themes of these perceptions about the strategy implementation and some recommendations for future strategies and further research. The main themes identified were initial opinions of the strategy as a blueprint for action, the strategy as a driver for action, lessons learned and recommendations for the future. For success in improving implementation of national breastfeeding strategies, it is recommended that Australia establish an independent breastfeeding/infant feeding committee, increase the political prioritisation of issues surrounding infant feeding and strengthen the regulation of the marketing of breastmilk substitutes.

Implementation strategies for load center automation on the space station module/power management and distribution testbed

Science.gov (United States)

Watson, Karen

1990-01-01

The Space Station Module/Power Management and Distribution (SSM/PMAD) testbed was developed to study the tertiary power management on modules in large spacecraft. The main goal was to study automation techniques, not necessarily develop flight ready systems. Because of the confidence gained in many of automation strategies investigated, it is appropriate to study, in more detail, implementation strategies in order to find better trade-offs for nearer to flight ready systems. These trade-offs particularly concern the weight, volume, power consumption, and performance of the automation system. These systems, in their present implementation are described.

The Pitzer-Lee-Kesler-Teja (PLKT) Strategy and Its Implementation by Meta-Computing Software

Czech Academy of Sciences Publication Activity Database

Smith, W. R.; Lísal, Martin; Missen, R. W.

2001-01-01

Roč. 35, č. 1 (2001), s. 68-73 ISSN 0009-2479 Institutional research plan: CEZ:AV0Z4072921 Keywords : The Pitzer -Lee-Kesler-Teja (PLKT) strategy * implementation Subject RIV: CF - Physical ; Theoretical Chemistry

Recommendations on Problematic Issues Solution of the Customs Development Strategy Until the Year 2020 Implementation

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Konstantin A. Bromberg

2016-12-01

Full Text Available In the present article author offers recommendations for solving problematic issues of the Customs development strategy until the year 2020 implementing. In the process of research author notes that in the new conditions, not only the tasks are transformed but also the functions and powers of the Federal Customs Service, priority issues are the issues of improving information technologies, reducing the time for customs control, and creating favorable conditions for doing business. In the conclusion author concludes that the current stage of implementation of the administrative reform and the Customs development strategy until the year 2020 in Russia involves a qualitative transformation of the customs regulation of foreign trade activities.

Life Cycle Management at Brødrene Hartmann A/S - strategy,- organisation and implementation

DEFF Research Database (Denmark)

Pedersen, Claus Stig; Alting, Leo; Mortensen, Anna Lise

1997-01-01

decisionmaking is under development.The implementation of life cycle management in Hartmann is organised with respect to the divisional areas: strategic management, product development, purchase, production, sale and distribution. The implementation of life cycle managment is assisted by tools to support...... decision making. The tools are developed in coorporation with the Department of Manufacturing Engineering at the Technical University of Denmark.This paper presents- The Hartmann environmental strategy, based on the life cycle concept- Experiences and results from developing a life cycle orientated...... organisation- Experiences and results from developing and implementing tools for life cycle management...

Major Differences in Implementation Strategies of the European Resuscitation Council Guidelines 2015 in Danish Hospitals - A Nationwide Study

DEFF Research Database (Denmark)

Stærk, Mathilde; Glerup Lauridsen, Kasper; Mygind-Klausen, Troels

2016-01-01

Introduction: Implementation of guidelines into clinical practice is important to provide quality of care. Implementation of clinical guidelines is known to be poor. This study aimed to investigate awareness, expected time frame and strategy for implementation of the European Resuscitation Council...... 2015 and time frame and strategy for implementation.Results: In total, 41 hospitals replied (response rate: 87%) between October 22nd and December 22nd 2015. Overall, 37% of hospital resuscitation committees were unaware of the content of the guidelines. The majority of hospitals (80%) expected...... completion of guideline implementation within 6 months and 93% of hospitals expected the staff to act according to the ERC Guidelines 2015 within 6 months. In contrast, 78% of hospitals expected it would take between 6 months to 3 years for all staff to have completed a resuscitation course based on ERC...

Non-governmental organisations and rural poverty reduction strategies in Zimbabwe: A case of Binga rural district

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Stephen Mago

2015-09-01

Full Text Available The purpose of this paper is to evaluate the effectiveness of strategies implemented by Non-governmental organisation (NGOs for poverty alleviation in Zimbabwe with specific reference to Zimbabwe’s Binga Rural District. The qulitative research methodology was employed in the article. Data were collected using questionnaires and interviews. Findings indicated that NGOs do not adequately fulfil the needs of the poor due to ineffective strategies that they implement. There is insufficient understanding of the livelihoods of the poor in Binga, hence the need for participatory development approaches. Deepening and widening poverty in the rural areas that are currently served by NGOs is an indicator that their poverty alleviation strategies are inadequate and ineffective to deal with poverty in these rural areas. The paper recommends a policy shift by both NGOs and the government to improve the poverty reduction strategies used by NGOs.

Teachers' Reported Knowledge and Implementation of Research-Based Classroom and Behavior Management Strategies

Science.gov (United States)

Moore, Tara C.; Wehby, Joseph H.; Oliver, Regina M.; Chow, Jason C.; Gordon, Jason R.; Mahany, Laura A.

2017-01-01

Teachers' reported knowledge about and implementation of research-based classroom and behavior management strategies were examined. A total of 160 elementary teachers from two districts in different regions of the same state completed the researcher-developed "Survey of Classroom and Behavior Management." On average, teachers reported to…

Northeast Florida Regional Sediment Management: Implementation Strategies and Recommendations for Nassau County and Duval County, Florida

Science.gov (United States)

2016-03-01

management strategies and alternatives are actively coordinated. DISCLAIMER: The contents of this report are not to be used for advertising , publication... Strategies and Recommendations for Nassau County and Duval County, Florida Co as ta l a nd H yd ra ul ic s La bo ra to ry Kevin C. Hodgens, Michael...Sediment Management Implementation Strategies and Recommendations for Nassau County and Duval County, Florida Kevin C. Hodgens and Michael P

Strategy and field implementation for determining a dangerous waste mixture in Washington State

International Nuclear Information System (INIS)

Cowan, Steve; Foster, Rick; Wright, Jamie

1992-01-01

Under the Resource Conservation and Recovery Act (RCRA), states rather than the Environmental Protection Agency (EPA) maybe authorized to implement RCRA regulations. Under RCRA, environmental regulations implemented by an authorized state must be at least as stringent as those contained in RCRA. Compared to RCRA, the corresponding regulations of the State of Washington regarding the determination of characteristic wastes are more stringent and complex. This paper discusses the complexities of the regulations and presents a strategy for successfully managing diverse waste streams. This strategy was used during the cleanup of contaminated areas and equipment at the Albany Research Center (ARC) in Albany, Oregon, which processed uranium and thorium for the Manhattan Engineer District and the Atomic Energy Commission during the early days of the nation's atomic energy program. Wastes from the cleanup of ARC were shipped to the Department of Energy (DOE) Hanford Reservation. Because the DOE Hanford Reservation is located in Washington, this paper should be of interest to DOE waste generators. (author)

Implementation and comparative study of control strategies for an isolated DFIG based WECS

Science.gov (United States)

Bouchiba, Nouha; Barkia, Asma; Sallem, Souhir; Chrifi-Alaoui, Larbi; Drid, Saïd; Kammoun, M. B. A.

2017-10-01

Nowadays, a global interest for renewable energy sources has been growing intensely. In particular, a wind energy has become the most popular. In case of autonomous systems, wind energy conversion system (WECS) based on a double fed induction generator (DFIG) is widely used. In this paper, in order to control the stand-alone system outputs under wind speed and load variations, three kinds of nonlinear control strategies have been proposed, applied and compared, such as: Classical PI controller, Back-Stepping and Sliding Mode controllers. A series of experiments have been conducted to evaluate and to compare the developed controllers' dynamic performances under load demand and speed variations. The design and the implementation of different control strategies to a 1.5kW doubly fed induction machine is carried out using a dSpace DS1104 card based on MATLAB/Simulink environment. Experimental results are presented to show the validity of the implemented controllers and demonstrate the effectiveness of each controller compared with others.

A Study on the Use of the Balanced Scorecard for Strategy Implementation in a Large Brazilian Mixed Economy Company

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Ricardo Vinícius Dias Jordão

2013-09-01

Full Text Available The research described in this paper has analyzed the use of the balanced scorecard (BSC as part of a management control system for implementing strategies in a large mixed economy company. The shareholder structure of the company combines traditional shareholder interests with those of the government. Based on a case study in Brazil, the research innovates on analyzing BSC use and contributions to translate a company’s strategy (which requires bringing together different views into objectives and goals aligned to the four BSC perspectives: financial, learning and growth, improvement of internal processes and customer. The results point out that: (1 BSC, when used as part of a MCS, provides effective improvement of the strategy implementation process and its diffusion across the different organizational levels; (2 in the company under analysis, the performance evaluation integrated qualitative, financial and productive dimensions; (3 BSC appeared as an important tool in strategy conception and implementation; and (4 BSC enables to translate the company’s strategy into objectives and goals aligned to the financial, learning and growth, improvement of internal processes and customer perspectives.

The strategy of the shelter implementation plan (SIP) performance

International Nuclear Information System (INIS)

Geras'ko, V.N.; Nosovskij, A.V.

1999-01-01

In 1997 the 'Shelter Implementation Plan' (SIP) was developed it's purpose was to transform Unit 4 of the Chernobyl NPP into the ecologically safe system. The Plan was developed by common efforts of the Ukrainian scientists, CES representatives and experts from the United States of America. The fact that there are no nuclear and radiation safety criteria for the projects will result into the situation when different designers might use within the various project tasks various design criteria. Till now o exact date for the constructions stabilization activities has been defined, and it creates a kind of on definiteness while developing the Radioactive Waste Management strategy and Safe Confinement

Cost-effectiveness analysis of optimal strategy for tumor treatment

International Nuclear Information System (INIS)

Pang, Liuyong; Zhao, Zhong; Song, Xinyu

2016-01-01

We propose and analyze an antitumor model with combined immunotherapy and chemotherapy. Firstly, we explore the treatment effects of single immunotherapy and single chemotherapy, respectively. Results indicate that neither immunotherapy nor chemotherapy alone are adequate to cure a tumor. Hence, we apply optimal theory to investigate how the combination of immunotherapy and chemotherapy should be implemented, for a certain time period, in order to reduce the number of tumor cells, while minimizing the implementation cost of the treatment strategy. Secondly, we establish the existence of the optimality system and use Pontryagin’s Maximum Principle to characterize the optimal levels of the two treatment measures. Furthermore, we calculate the incremental cost-effectiveness ratios to analyze the cost-effectiveness of all possible combinations of the two treatment measures. Finally, numerical results show that the combination of immunotherapy and chemotherapy is the most cost-effective strategy for tumor treatment, and able to eliminate the entire tumor with size 4.470 × 10"8 in a year.

Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan.

Science.gov (United States)

Pradhan, Nousheen Akber; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

2013-07-05

Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition - the main targets of the strategy. The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities' survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies

Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan

Directory of Open Access Journals (Sweden)

Nousheen Akber Pradhan

2013-07-01

Full Text Available Background: Integrated management of childhood illnesses (IMCI strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition – the main targets of the strategy. Objective: The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC facilities in Matiari district, Sindh, Pakistan. Design: An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs with stakeholders which included planners and policy makers at a provincial level (n=5, implementers and managers at a district level (n=3, and IMCI-trained physicians posted at PHC facilities (n=8. Quantitative part included PHC facility survey (n=16 utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. Results: The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities’ survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all

Disclosure, apology, and offer programs: stakeholders' views of barriers to and strategies for broad implementation.

Science.gov (United States)

Bell, Sigall K; Smulowitz, Peter B; Woodward, Alan C; Mello, Michelle M; Duva, Anjali Mitter; Boothman, Richard C; Sands, Kenneth

2012-12-01

The Disclosure, Apology, and Offer (DA&O) model, a response to patient injuries caused by medical care, is an innovative approach receiving national attention for its early success as an alternative to the existing inherently adversarial, inefficient, and inequitable medical liability system. Examples of DA&O programs, however, are few. Through key informant interviews, we investigated the potential for more widespread implementation of this model by provider organizations and liability insurers, defining barriers to implementation and strategies for overcoming them. Our study focused on Massachusetts, but we also explored themes that are broadly generalizable to other states. We found strong support for the DA&O model among key stakeholders, who cited its benefits for both the liability system and patient safety. The respondents did not perceive any insurmountable barriers to broad implementation, and they identified strategies that could be pursued relatively quickly. Such solutions would permit a range of organizations to implement the model without legislative hurdles. Although more data are needed about the outcomes of DA&O programs, the model holds considerable promise for transforming the current approach to medical liability and patient safety. © 2012 Milbank Memorial Fund.

How to implement a new strategy without disrupting your organization.

Science.gov (United States)

Kaplan, Robert S; Norton, David P

2006-03-01

Throughout most of modern busi ness history, corporations have attempted to unlock value by matching their structures to their strategies: Centralization by function. Decentralization by product category or geographic region. Matrix organizations that attempt both at once. Virtual organizations. Networked organizations. Velcro organizations. But none of these approaches has worked very well. Restructuring churn is expensive, and new structures often create new organizational problems that are as troublesome as the ones they try to solve. It takes time for employees to adapt to them, they create legacy systems that refuse to die, and a great deal of tacit knowledge gets lost in the process. Given the costs and difficulties involved in finding structural ways to unlock value, it's fair to raise the question: Is structural change the right tool for the job? The answer is usually no, Kaplan and Norton contend. It's far less disruptive to choose an organizational design that works without major conflicts and then design a customized strategic system to align that structure to the strategy. A management system based on the balanced scorecard framework is the best way to align strategy and structure, the authors suggest. Managers can use the tools of the framework to drive their unit's performance: strategy maps to define and communicate the company's value proposition and the scorecard to implement and monitor the strategy. In this article, the originators of the balanced scorecard describe how two hugely different organizations--DuPont and the Royal Canadian Mounted Police-used corporate scorecards and strategy maps organized around strategic themes to realize the enormous value that their portfolios of assets, people, and skills represented. As a result, they did not have to endure a painful series of changes that simply replaced one rigid structure with another.

Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review

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Ramzi G. Salloum

2017-11-01

Full Text Available Abstract Background One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. Methods We conducted a systematic literature search (up to December 2016 of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s, healthcare setting, and implementation outcome. Results Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1 characterizing demand for therapies and treatment technologies (n = 32, (2 comparing implementation strategies (n = 22, (3 incentivizing workforce participation (n = 11, and (4 prioritizing interventions (n = 10. Stakeholders included providers (n = 27, patients (n = 25, caregivers (n = 5, and administrators (n = 2. The remaining studies (n = 16 engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators. The following implementation outcomes were discussed: acceptability (n = 75, appropriateness (n = 34, adoption (n = 19, feasibility (n = 16, and fidelity (n = 3. Conclusions The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the

Implementing marketing strategy (Part four).

Science.gov (United States)

Dodson, D C; Dotson, M; McIlwain, T F; Young, D

1993-01-01

Every organization must monitor and evaluate the performance of its marketing strategies. The health care marketer must continually develop effective measures related to outcomes so that marketing efforts can be justified and garnish the support and resources they deserve. A major task for the marketing executive for the next decade is to develop marketing strategies and prove that those strategies are being met and that they help the health care organization carry out its objective to meet its mission.

Identifying and ranking of strategies to implement green supply chain management in Indian manufacturing industry using Analytical Hierarchy Process

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Sunil Luthra

2013-09-01

Full Text Available Purpose – The study aims to identify and rank the major strategies that help achieve successful implementation of Green Supply Chain Management (GSCM in Indian manufacturing industry.Design/methodology/approach – Strategies to implement GSCM have been identified thorough extensive literature review and then experts’ opinion is sought for categorizing them into four representative dimensions which are then ranked using Analytic Hierarchy Process (AHP.Findings – The study categorizes the GSCM implementation strategies into four dimensions - Non members of supply chain, downward stream supply chain Members, Organizational members of supply chain and upward stream supply chain members. These dimensions are found to play an important role in greening the supply chains enabling the practicing firms achieve enhanced operational performances.Research limitations/implications- AHP is used for ranking the GSCM implementation strategies in Indian manufacturing scenario. The pair-wise comparisons are made on the basis of the opinion of the experts drawn from academia and industry. As is natural, opinions of experts may not always be free from bias or prejudices. Moreover, the study relied more on the GSCM practices literature in developed nations as only limited literature related to the undertaken work in the Indian context was available.Practical implications – This paper may play important role in understanding various strategies and ranking them in order of importance. This facilitates firms prioritize different actions for achieving high GSCM performances in Indian manufacturing industry. Strategic implementation of green supply chain management will help Indian manufacturing enterprises enjoy cost and efficiency benefits.Originality/value – GSCM is a relatively new topic for majority of Indian manufacturing industries. This work is likely to help GSCM practitioners select suitable strategies in consonance with the government regulations

What Mathematics Teachers Say about the Teaching Strategies in the Implementation of Tasks

Science.gov (United States)

Enríquez, Jakeline Amparo Villota; de Oliveira, Andréia María Pereira; Valencia, Heriberto González

2018-01-01

In this article we will discuss, through the explanations given by teachers who teach Mathematics, the importance of using teaching strategies in the implementation of tasks. Teachers who participated in it belong to the group "Observatory Mathematics Education" (OME-Bahia). This study was framed in a qualitative approach and data were…

Relationships between the implementation of quality management strategies and clinical outcomes in European hospitals.

NARCIS (Netherlands)

Suñol, R.; Arah, O.A.; Wagner, C.; Groene, O.

2013-01-01

Objectives: Considerable resources are spent on implementing hospital and departmental quality management strategies. Yet, the evidence on the factors associated with the uptake of hospitals of quality management and the impact of quality management systems on clinical outcomes is limited. We

Signal Processing Implementation and Comparison of Automotive Spatial Sound Rendering Strategies

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Bai MingsianR

2009-01-01

Full Text Available Design and implementation strategies of spatial sound rendering are investigated in this paper for automotive scenarios. Six design methods are implemented for various rendering modes with different number of passengers. Specifically, the downmixing algorithms aimed at balancing the front and back reproductions are developed for the 5.1-channel input. Other five algorithms based on inverse filtering are implemented in two approaches. The first approach utilizes binaural (Head-Related Transfer Functions HRTFs measured in the car interior, whereas the second approach named the point-receiver model targets a point receiver positioned at the center of the passenger's head. The proposed processing algorithms were compared via objective and subjective experiments under various listening conditions. Test data were processed by the multivariate analysis of variance (MANOVA method and the least significant difference (Fisher's LSD method as a post hoc test to justify the statistical significance of the experimental data. The results indicate that inverse filtering algorithms are preferred for the single passenger mode. For the multipassenger mode, however, downmixing algorithms generally outperformed the other processing techniques.

Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial.

Science.gov (United States)

van Gaalen, Johanna L; Bakker, Moira J; van Bodegom-Vos, Leti; Snoeck-Stroband, Jiska B; Assendelft, Willem J J; Kaptein, Ad A; van der Meer, Victor; Taube, Christian; Thoonen, Bart P; Sont, Jacob K

2012-11-21

Internet-based self-management (IBSM) support cost-effectively improves asthma control, asthma related quality of life, number of symptom-free days, and lung function in patients with mild to moderate persistent asthma. The current challenge is to implement IBSM in clinical practice. This study is a three-arm cluster randomized trial with a cluster pre-randomisation design and 12 months follow-up per practice comparing the following three IBSM implementation strategies: minimum strategy (MS): dissemination of the IBSM program; intermediate strategy (IS): MS + start-up support for professionals (i.e., support in selection of the appropriate population and training of professionals); and extended strategy (ES): IS + additional training and ongoing support for professionals. Because the implementation strategies (interventions) are primarily targeted at general practices, randomisation will occur at practice level.In this study, we aim to evaluate 14 primary care practices per strategy in the Leiden-The Hague region, involving 140 patients per arm. Patients aged 18 to 50 years, with a physician diagnosis of asthma, prescription of inhaled corticosteroids, and/or montelukast for ≥3 months in the previous year are eligible to participate. Primary outcome measures are the proportion of referred patients that participate in IBSM, and the proportion of patients that have clinically relevant improvement in the asthma-related quality of life. The secondary effect measures are clinical outcomes (asthma control, lung function, usage of airway treatment, and presence of exacerbations); self-management related outcomes (health education impact, medication adherence, and illness perceptions); and patient utilities. Process measures are the proportion of practices that participate in IBSM and adherence of professionals to implementation strategies. Cost-effective measurements are medical costs and healthcare consumption. Follow-up is six months per patient. This study

Implementation strategies of internet-based asthma self-management support in usual care. Study protocol for the IMPASSE cluster randomized trial

Directory of Open Access Journals (Sweden)

van Gaalen Johanna L

2012-11-01

Full Text Available Abstract Background Internet-based self-management (IBSM support cost-effectively improves asthma control, asthma related quality of life, number of symptom-free days, and lung function in patients with mild to moderate persistent asthma. The current challenge is to implement IBSM in clinical practice. Methods/design This study is a three-arm cluster randomized trial with a cluster pre-randomisation design and 12 months follow-up per practice comparing the following three IBSM implementation strategies: minimum strategy (MS: dissemination of the IBSM program; intermediate strategy (IS: MS + start-up support for professionals (i.e., support in selection of the appropriate population and training of professionals; and extended strategy (ES: IS + additional training and ongoing support for professionals. Because the implementation strategies (interventions are primarily targeted at general practices, randomisation will occur at practice level. In this study, we aim to evaluate 14 primary care practices per strategy in the Leiden-The Hague region, involving 140 patients per arm. Patients aged 18 to 50 years, with a physician diagnosis of asthma, prescription of inhaled corticosteroids, and/or montelukast for ≥3 months in the previous year are eligible to participate. Primary outcome measures are the proportion of referred patients that participate in IBSM, and the proportion of patients that have clinically relevant improvement in the asthma-related quality of life. The secondary effect measures are clinical outcomes (asthma control, lung function, usage of airway treatment, and presence of exacerbations; self-management related outcomes (health education impact, medication adherence, and illness perceptions; and patient utilities. Process measures are the proportion of practices that participate in IBSM and adherence of professionals to implementation strategies. Cost-effective measurements are medical costs and healthcare consumption

Quality of diabetes care worldwide and feasibility of implementation of the Alphabet Strategy: GAIA project (Global Alphabet Strategy Implementation Audit).

Science.gov (United States)

Lee, James D; Saravanan, Ponnusamy; Varadhan, Lakshminarayanan; Morrissey, John R; Patel, Vinod

2014-10-11

The Alphabet Strategy (AS) is a diabetes care checklist ensuring "important, simple things are done right all the time." Current audits of diabetes care in developed countries reveal wide variations in quality with performance of care processes frequently sub-optimal. This study had three components:• an audit to assess diabetes care quality worldwide,• a questionnaire study seeking opinions on the merits of the AS,• a pilot study to assess the practicality of implementation of the AS in a low socioeconomic setting. Audit data was collected from 52 centres across 32 countries. Data from 4537 patients were converted to Quality and Outcome Framework (QOF) scores to enable inter-centre comparison. These were compared to each country's Gross Domestic Product (GDP), and Total Health Expenditure percentage per capita (THE%). The opinions of diabetes patients and healthcare professionals from the diabetes care team at each of these centres were sought through a structured questionnaire. A retrospective audit on 100 randomly selected case notes was conducted prior to AS implementation in a diabetes outpatient clinic in India, followed by a prospective audit after four months to assess its impact on care quality. QOF scores showed wide variation across the centres (mean 49.0, range 10.2-90.1). Although there was a positive relationship between GDP and THE% to QOF scores, there were exceptions. 91% of healthcare professionals felt the AS approach was practical. Patients found the checklist to be a useful education tool. Significant improvements in several aspects of care as well as 36% improvement in QOF score were seen following implementation. International centres observed large variations in care quality, with standards frequently sub-optimal. 71% of health care professionals would consider adopting the AS in their daily practice. Implementation in a low resource country resulted in significant improvements in some aspects of diabetes care. The AS checklist for

Building Nation-Wide Information Infrastructures in Healthcare through Modular Implementation Strategies

DEFF Research Database (Denmark)

Aanestad, Margunn; Jensen, Tina Blegind

2011-01-01

initiatives, where a national project failed to deliver interoperable Electronic Patient Record (EPR) systems while a small, local solution grew and now offers a nation-wide solution for sharing patient record information. We apply II theory, specifically the five design principles proposed by Hanseth...... of the installed base, which current II theory advocates. Here we articulate and exemplify a modular implementation strategy as an approach that also addresses the challenges related to mobilization and organization of multiple stakeholders....

Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care.

Science.gov (United States)

Grandes, Gonzalo; Sanchez, Alvaro; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Balagué, Laura; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

2017-12-06

Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care. Between 10 and 13 discussion and consensus sessions were performed in four highly-motivated primary health care centers involving 80% of the primary care staff and 21 community-based organizations. All four centers chose to address physical activity, diet, and smoking. They selected the 5 A's evidence-based clinical intervention to be adapted to the context of the health centers. The planned implementation strategy worked at multiple levels: bottom-up primary care organizational change, top-down support from managers, community involvement, and the development of innovative e-health information and communication tools. Shared decision making and practice facilitation were perceived as the most positive aspects of the collaborative modeling process, which took more time than expected, especially the development of the new e-health tools integrated into electronic health records. Collaborative modeling of an implementation strategy for the integration of health promotion in primary and community care was feasible in motivated centers. However, it was difficult, being hindered by the heavy workload in primary care and generating uncertainty inherent to a bottom-up decision making processes. Lessons from this experience could be useful in diverse settings and for other clinical interventions. Two companion papers report the evaluation of its feasibility and assess quantitatively and qualitatively the implementation process.

Prehospital evaluation and economic analysis of different coronary syndrome treatment strategies - PREDICT - Rationale, Development and Implementation

Directory of Open Access Journals (Sweden)

Craig Alan

2011-03-01

Full Text Available Abstract Background A standard of prehospital care for patients presenting with ST-segment elevation myocardial infarction (STEMI includes prehospital 12-lead and advance Emergency Department notification or prehospital bypass to percutaneous coronary intervention centres. Implementation of either care strategies is variable across communities and neither may exist in some communities. The main objective is to compare prehospital care strategies for time to treatment and survival outcomes as well as cost effectiveness. Methods/Design PREDICT is a multicentre, prospective population-based cohort study of all chest pain patients 18 years or older presenting within 30 mins to 6 hours of symptom onset and treated with nitroglycerin, transported by paramedics in a number of different urban and rural regions in Ontario. The primary objective of this study is to compare the proportion of study subjects who receive reperfusion within the target door-to-reperfusion times in subjects obtained after four prehospital strategies: 12-lead ECG and advance emergency department (ED notification or 3-lead ECG monitoring and alert to dispatch prior to hospital arrival; either with or without the opportunity to bypass to a PCI centre. Discussion We anticipate four challenges to successful study implementation and have developed strategies for each: 1 diversity in the interpretation of the ethical and privacy issues across 47 research ethics boards/commiittees covering 71 hospitals, 2 remote oversight of data guardian abstraction, 3 timeliness of implementation, and 4 potential interference in the study by concurrent technological advances. Research ethics approvals from academic centres were obtained initially and submitted to non academic centre applications. Data guardians were trained by a single investigator and data entry is informed by a detailed data dictionary including variable definitions and abstraction instrucations and subjected to error and logic

Aurally-adequate time-frequency analysis for scattered sound in auditoria

Science.gov (United States)

Norris, Molly K.; Xiang, Ning; Kleiner, Mendel

2005-04-01

The goal of this work was to apply an aurally-adequate time-frequency analysis technique to the analysis of sound scattering effects in auditoria. Time-frequency representations were developed as a motivated effort that takes into account binaural hearing, with a specific implementation of interaural cross-correlation process. A model of the human auditory system was implemented in the MATLAB platform based on two previous models [A. Härmä and K. Palomäki, HUTear, Espoo, Finland; and M. A. Akeroyd, A. Binaural Cross-correlogram Toolbox for MATLAB (2001), University of Sussex, Brighton]. These stages include proper frequency selectivity, the conversion of the mechanical motion of the basilar membrane to neural impulses, and binaural hearing effects. The model was then used in the analysis of room impulse responses with varying scattering characteristics. This paper discusses the analysis results using simulated and measured room impulse responses. [Work supported by the Frank H. and Eva B. Buck Foundation.

A mixed methods protocol for developing and testing implementation strategies for evidence-based obesity prevention in childcare: a cluster randomized hybrid type III trial.

Science.gov (United States)

Swindle, Taren; Johnson, Susan L; Whiteside-Mansell, Leanne; Curran, Geoffrey M

2017-07-18

Despite the potential to reach at-risk children in childcare, there is a significant gap between current practices and evidence-based obesity prevention in this setting. There are few investigations of the impact of implementation strategies on the uptake of evidence-based practices (EBPs) for obesity prevention and nutrition promotion. This study protocol describes a three-phase approach to developing and testing implementation strategies to support uptake of EBPs for obesity prevention practices in childcare (i.e., key components of the WISE intervention). Informed by the i-PARIHS framework, we will use a stakeholder-driven evidence-based quality improvement (EBQI) process to apply information gathered in qualitative interviews on barriers and facilitators to practice to inform the design of implementation strategies. Then, a Hybrid Type III cluster randomized trial will compare a basic implementation strategy (i.e., intervention as usual) with an enhanced implementation strategy informed by stakeholders. All Head Start centers (N = 12) within one agency in an urban area in a southern state in the USA will be randomized to receive the basic or enhanced implementation with approximately 20 classrooms per group (40 educators, 400 children per group). The educators involved in the study, the data collectors, and the biostastician will be blinded to the study condition. The basic and enhanced implementation strategies will be compared on outcomes specified by the RE-AIM model (e.g., Reach to families, Effectiveness of impact on child diet and health indicators, Adoption commitment of agency, Implementation fidelity and acceptability, and Maintenance after 6 months). Principles of formative evaluation will be used throughout the hybrid trial. This study will test a stakeholder-driven approach to improve implementation, fidelity, and maintenance of EBPs for obesity prevention in childcare. Further, this study provides an example of a systematic process to develop

Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

Science.gov (United States)

Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

2017-08-04

The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

Health workers’ perspectives on implementation of an integrated medical male circumcision strategy in KwaZulu-Natal, South Africa

Directory of Open Access Journals (Sweden)

Rogerio Phili

2014-11-01

Full Text Available Background: KwaZulu-Natal province began implementation of voluntary medical male circumcision (VMMC as an integral part of its HIV infection prevention strategy that includes other programmes such as HIV counselling and testing (HCT, screening and treatment of sexually transmitted infections and tuberculosis, and other sexual and reproductive health services. This followed randomised controlled trials that showed up to 60% HIV infection risk reduction amongst circumcised men. Implementation of the strategy occurred despite absence of knowledge of operational barriers and its acceptability to health care workers (HCWs. Objectives: The study aimed to explore HCWs’ perspectives of and barriers to strategy implementation at public sector health facilities to inform implementation policy. Method: A purposive quota sampling method was used to select HCWs for focus group discussions at three study sites. Participants were asked open-ended questions using an interview schedule based on a literature review to explore acceptability of and perceptions regarding provision of the strategy. Thematic analysis was conducted. Results: Acceptability of the strategy was high amongst the participants; however, there was limited knowledge of some key concepts of the strategy, personnel role confusion, missed opportunities for client recruitment, and infrastructural constraints. Negative perceptions included beliefs that VMMC would discourage condom use and cause stigma associated with non-circumcision of HIV-positive males, with perceptions of sexual behavioural disinhibition in circumcised men. Conclusion: There is a need to engage further with stakeholders if implementation of VMMC is to be successful. More training and support needs to be provided to HCWs at public sector facilities. Agtergrond: Die implementering van vrywillige mediese manlike besnyding (VMMC is ’n integrale deel van KwaZulu-Natal provinsie se MIV-voorkomingstrategie, wat

[The human right to adequate food: an urban vision].

Science.gov (United States)

Casemiro, Juliana Pereira; Valla, Victor Vincent; Guimarães, Maria Beatriz Lisboa

2010-07-01

The human right to adequate food is comprehended in two dimensions: being free of hunger and denutrition and having access to an adequate food. The urban context, in which the possession of food is done primarily through merchandising because of its strong consuming appealing, became a big challenge to debate this topic in poor districts today. Here we combine considerations of a qualitative study carried out in São João de Meriti, Rio de Janeiro State, joining leaders from Pastoral da Criança in focal group sessions. The unemployment, the sub-employment and the difficulty in reaching the public health system, the social assistance and basic sanitation were presented as the major obstacles to bring into effect the human right to food. It was possible to determine that, among the strategies to fight the poverty and hunger, a big highlight is the establishment of mutual help mechanisms. The social support, generosity and religiousness were presented as the most important categories among the thoughts of the leaders. Facing a reality in which poverty and hunger appear as something inherent or become a mechanism of change during elections, the issue of the clienteles appears as a huge concern and challenge for those leaders.

Bronchial thermoplasty: implementing best practice in the era of cost containment

Science.gov (United States)

Tan, Laren D; Kenyon, Nicholas; Yoneda, Ken Y; Louie, Samuel

2017-01-01

Increasing dependence on advanced technologies in the 21st century has created a dilemma between the practice and business of medicine. From information technology to robotic surgery, new technologies have expanded treatment possibilities and have potentially improved patient outcomes and safety. Simultaneously, their escalating costs limit access for certain patients and health care facilities. Nevertheless, medical decisions should not simply be based on cost. Input from physicians and other health care specialists as well as adherence to best practice position statements, are vital to implementing truly cost-effective strategies in medicine. Bronchial thermoplasty (BT), a US Food and Drug Administration approved bronchoscopy procedure in difficult-to-control persistent asthma, is a prime example of a new technology facing cost and implementation challenges. We discuss the specific indications and contraindications for BT and review recent real-world experiences that can provide the foundation for building a comprehensive asthma program that provides BT for difficult-to-control asthma patients who fail national guideline treatment recommendations after an adequate clinical trial of one. We also offer insight into the barriers to implementing a successful BT program and strategies for overcoming them. PMID:28794646

Applying theories to better understand socio-political challenges in implementing evidence-based work disability prevention strategies.

Science.gov (United States)

Ståhl, Christian; Costa-Black, Katia; Loisel, Patrick

2018-04-01

This article explores and applies theories for analyzing socio-political aspects of implementation of work disability prevention (WDP) strategies. For the analysis, theories from political science are explained and discussed in relation to case examples from three jurisdictions (Sweden, Brazil and Québec). Implementation of WDP strategies may be studied through a conceptual framework that targets: (1) the institutional system in which policy-makers and other stakeholders reside; (2) the ambiguity and conflicts regarding what to do and how to do it; (3) the bounded rationality, path dependency and social systems of different stakeholders; and (4) coalitions formed by different stakeholders and power relations between them. In the case examples, the design of social insurance systems, the access to and infrastructure of healthcare systems, labor market policies, employers' level of responsibility, the regulatory environment, and the general knowledge of WDP issues among stakeholders played different roles in the implementation of policies based on scientific evidence. Future research may involve participatory approaches focusing on building coalitions and communities of practice with policy-makers and stakeholders, in order to build trust, facilitate cooperation, and to better promote evidence utilization. Implications for Rehabilitation Implementation of work disability prevention policies are subject to contextual influences from the socio-political setting and from relationships between stakeholders Stakeholders involved in implementing strategies are bound to act based on their interests and previous courses of action To promote research uptake on the policy level, stakeholders and researchers need to engage in collaboration and translational activities Political stakeholders at the government and community levels need to be more directly involved as partners in the production and utilization of evidence.

The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review.

Science.gov (United States)

Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Lane, Haylee; Haines, Terry P

2017-11-14

It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1

Optimizing Implementation of Hepatitis C Birth-Cohort Screening and Treatment Strategies

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Yuankun Li MS

2017-01-01

Full Text Available Background: Chronic hepatitis C (HCV is a significant public health problem affecting more than three million Americans. The US health care systems are ramping up costly HCV screening and treatment efforts with limited budget. We determine the optimal implementation of HCV birth-cohort screening and treatment strategies under budget constraints and health care payer’s perspective. Methods: Markov model and scenario-based simulation optimization. The target population is birth cohort born between 1945 and 1975. The interventions are allocating annual budget to screen a proportion of the target population and treat a proportion of the identified chronic HCV-positive patients over 10 years. Outcomes measure is to maximize lifetime discounted quality-adjusted life-years. Results: Allocate a percentage of the annual budget to screening, then treat patients with the remaining budget and prioritize the sickest patients. When the budget is $1 billion/year, the best strategy is to allocate the entire budget to treatment. When the budget is $5 billion/year, it is optimal to allocate 60% of the budget to screening in the first 2 years and 0% thereafter for age cohort 40 to 49; and allocate 20% of the budget to screening starting in year 3 for age cohorts 50 to 59 and 60 to 69. Health benefits are sensitive to budget in the first 2 years. Results are not sensitive to distribution of fibrosis stages by awareness of HCV. Conclusion: When budget is limited, all efforts should be focused on early treatment. With higher budget, better population health outcomes are achieved by reserving some budget for HCV screening while implementing a priority-based treatment strategy. This work has broad applicability to diverse health care systems and helps determine how much effort should be devoted to screening versus treatment under resource limitations.

Developing implementation strategies for firearm safety promotion in paediatric primary care for suicide prevention in two large US health systems: a study protocol for a mixed-methods implementation study.

Science.gov (United States)

Wolk, Courtney Benjamin; Jager-Hyman, Shari; Marcus, Steven C; Ahmedani, Brian K; Zeber, John E; Fein, Joel A; Brown, Gregory K; Lieberman, Adina; Beidas, Rinad S

2017-06-24

The promotion of safe firearm practices, or firearms means restriction, is a promising but infrequently used suicide prevention strategy in the USA. Safety Check is an evidence-based practice for improving parental firearm safety behaviour in paediatric primary care. However, providers rarely discuss firearm safety during visits, suggesting the need to better understand barriers and facilitators to promoting this approach. This study, Adolescent Suicide Prevention In Routine clinical Encounters, aims to engender a better understanding of how to implement the three firearm components of Safety Check as a suicide prevention strategy in paediatric primary care. The National Institute of Mental Health-funded Mental Health Research Network (MHRN), a consortium of 13 healthcare systems across the USA, affords a unique opportunity to better understand how to implement a firearm safety intervention in paediatric primary care from a system-level perspective. We will collaboratively develop implementation strategies in partnership with MHRN stakeholders. First, we will survey leadership of 82 primary care practices (ie, practices serving children, adolescents and young adults) within two MHRN systems to understand acceptability and use of the three firearm components of Safety Check (ie, screening, brief counselling around firearm safety and provision of firearm locks). Then, in collaboration with MHRN stakeholders, we will use intervention mapping and the Consolidated Framework for Implementation Research to systematically develop and evaluate a multilevel menu of implementation strategies for promoting firearm safety as a suicide prevention strategy in paediatric primary care. Study procedures have been approved by the University of Pennsylvania. Henry Ford Health System and Baylor Scott & White institutional review boards (IRBs) have ceded IRB review to the University of Pennsylvania IRB. Results will be submitted for publication in peer-reviewed journals. © Article

Valuation of Human Resource During the Implementation of Resource Strategy of Sport Club

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Polyakov Konstantin, L

2017-06-01

Full Text Available This study deals with the practice of human resource valuation in the professional command football during the implementation of sport club resource strategy. The choice of the direction of research is not random. Resource view in the analysis of strategy and strategy shaping (Barney, 1991 is an effective long term success tool. There are many costs in the process of resource allocation, in particular during resource valuation, in the market economy in connection, e.g. costs related to information collection and negotiating. Costs rise with the globalization of the economy. Therefore, it is important to create and maintain various institutions to control the level of costs and to study the most common practice of the resource strategy implementation. Particularly, it is important to study resource valuation in the context of institutional environment given the heterogeneity of markets. Human resource is the most important strategic resource on the market of professional command sport. At the same time, solving the problem of human resource allocation on this market leads to serious practical problems. Specifics of economic component of command sport results in the inevitability of labor market failure (Downward, Dawson, 2002 for sustainable development of the sector. Therefore, the need for institution which is to regulate the labor market occurs. Institute of transfer plays this role in some kinds of command sport, such as football. It is the system of concepts and rules, which regulate the transfer of athlete from one sport club to another prior to the expiration of the contract. The number of requirements exist due to the institute of transfer to the practice of athlete’s valuation, which determine the sum and the order of payment of compensation for prior sporting club management. The latter should correlate with the value of the athletes, which they are interest in, with the existing restrictions, which is the reason of the strongly

An Evaluation of Strategies for Training Staff to Implement the Picture Exchange Communication System

Science.gov (United States)

Barnes, Clarissa S.; Dunning, Johnna L.; Rehfeldt, Ruth Anne

2011-01-01

The picture exchange communication system (PECS) is a functional communication system frequently used with individuals diagnosed with autism spectrum disorders who experience severe language delays (Frost & Bondy, 2002). Few empirical investigations have evaluated strategies for training direct care staff how to effectively implement PECS with…

A stochastic assessment of cavity flooding strategy involving operator action for Yonggwang 3 and 4 units

International Nuclear Information System (INIS)

Kim, J.; Yu, D.; Ha, J.

1997-01-01

The author presents a new approach to the evaluation of an accident management strategy when an operator action is involved. This approach classifies the failure in implementing a given strategy into 4 possible states, and provides their corresponding quantification methods: 1) the failure of a diagnosis and decision-making by operators, 2) the failure of taking an action following a correct diagnosis, 3) the failure of a system operation following an adequate action, and 4) the failure due to a delayed action. The proposed methods were applied to assess a cavity flooding strategy that uses containment spray system (CSS), and the result shows that the methods are more appropriate in evaluating accident management strategies when human actions are involved

The Strategy Blueprint : A Strategy Process Computer-Aided Design Tool

NARCIS (Netherlands)

Aldea, Adina Ioana; Febriani, Tania Rizki; Daneva, Maya; Iacob, Maria Eugenia

2017-01-01

Strategy has always been a main concern of organizations because it dictates their direction, and therefore determines their success. Thus, organizations need to have adequate support to guide them through their strategy formulation process. The goal of this research is to develop a computer-based

Strategies implemented by the textile industry in response to natural-gas curtailments

Energy Technology Data Exchange (ETDEWEB)

Schreibeis, R.L.

1980-01-01

An examination is made of specific activities undertaken by textile firms in North and South Carolina and Georgia to insulate themselves against production losses resulting from natural gas curtailments. Results of the research effort focusing on investigating patterns or trends of precautionary activities undertaken by the textile industry in response to fuel interruptions are presented. Chapter II delineates the scope of the project, research design, and nature of the textile industry. One hundred candidate firms for detailed study were identified and 34 discussed their alternate fuel strategies. Information obtained was analyzed by means of two statistical analysis techniques. Methods employed and results are described in Chapter III. Overall results are presented in Chapter IV. Variations in the strategies implemented by various concerns were accounted for in terms of geographic location, plant size, plant type, and the duration and extent of curtailment impacts. Ranges of expenditures for short- and long-term strategies are identified.

Different regulatory strategies in regulation of nuclear power projects: An Indian experience

International Nuclear Information System (INIS)

Khan, Sohail Ahmad

2002-01-01

Regulatory strategy needed for management of safety and safety culture involves careful planning and use of engineering concepts keeping in mind feasibility to implement certain safety requirements. It also requires adequate attention on working environment and mental conditions of designers, operating and maintenance staff and regulators. Different strategies followed during safety review and regulatory inspection of nuclear power projects for improving status of safety management and safety cultures have given certain results. The present paper brings out certain experience gained during regulation of Indian Nuclear Power Projects by Atomic Energy Regulatory Board of India in the area of management of safety and safety culture. (author)

Conceptual framework in creating and selecting the performance measurement system for marketing strategy control

Directory of Open Access Journals (Sweden)

Krstić Bojan

2011-01-01

Full Text Available Performance measurement in modern conditions is one of the most important business requirements since enterprises face the need to exhibit returns for stockholders and investors, but also contribution of management to those returns, as well as contribution of certain business units, functional departments and activities within them. Hence, it is particularly important to assess marketing successfulness as a business function according to return on investment in marketing activities, but also according to the set of indicators from following performance groups - marketing effectiveness and marketing efficiency. Core issue is which measures to select and use in the marketing performance measurement system of certain enterprise so that it could be able to assess how effective and efficient its marketing is. In other words, adequate performance measurement system ought to contain performance measures that will be used to monitor effects and marketing strategy implementation process (controlling while implementing, and performance measures that can be applied to overall effect monitoring after the strategy implementation period. Otherwise, creating the marketing performance measurement system is a complex task for marketing managers. Therefore, the aim of this paper is to explore key principles and develop conceptual framework for creating and selecting performance measurement system for marketing strategy control which is based on characteristics and key success factors of marketing strategy, that is activities and actions for its operationalizing and effective implementing.

The relevance of team characteristics and team directed strategies in the implementation of nursing innovations : A literature review

NARCIS (Netherlands)

Theo van Achterberg; Joke Mintjes; G. Holleman; E. Poot

2009-01-01

Implementation of innovations is a complex and intensive procedure in which different strategies can be successful. In nursing, strategies often focus on intrinsic motivation, competencies and attitudes of individual nurses while ignoring the social context. Since nurses often work in teams,

Implementation of the Integrated Management of Childhood Illness strategy in Peru and its association with health indicators: an ecological analysis.

Science.gov (United States)

Huicho, Luis; Dávila, Miguel; Gonzales, Fernando; Drasbek, Christopher; Bryce, Jennifer; Victora, Cesar G

2005-12-01

The Multi-Country Evaluation of Integrated Management of Childhood Illness (IMCI) Effectiveness, Cost and Impact (MCE) was launched to assess the global effectiveness of this strategy. Impact evaluations were started in five countries. The objectives of the Peru MCE were: (1) to document trends in IMCI implementation in the 24 departments of Peru from 1996 to 2000; (2) to document trends in indicators of health services coverage and impact (mortality and nutritional status) for the same period; (3) to correlate changes in these two sets of indicators, and (4) to attempt to rule out contextual factors that may affect the observed trends and correlations. An ecological analysis was performed in which the units of study were the 24 departments. By 2000, 10.2% of clinical health workers were trained in IMCI, but some districts showed considerably higher rates. There were no significant associations between clinical IMCI training coverage and indicators of outpatient utilization, vaccine coverage, mortality or malnutrition. The lack of association persisted after adjustment for several contextual factors including socioeconomic and environmental indicators and the presence of other child health projects. Community health workers were also trained in IMCI, and training coverage was not associated with any of the process or impact indicators, except for a significant positive correlation with mean height for age. According to the MCE impact model, IMCI implementation must be sufficiently strong to lead to an impact on health and nutrition. Health systems support for IMCI implementation in Peru was far from adequate. This finding, along with low training coverage level and a relatively low child mortality rate, may explain why the expected impact was not documented. Nevertheless, even districts with high levels of training coverage failed to show an impact. Further national effectiveness studies of IMCI and other child interventions are warranted as these interventions are

Social Medie-strategi og implementering

DEFF Research Database (Denmark)

2017-01-01

20 arbejdsark bygget på en strategimodel for arbejdet med sociale medier. Fra målgruppeudvælgelse til implementering i praksis og måling.......20 arbejdsark bygget på en strategimodel for arbejdet med sociale medier. Fra målgruppeudvælgelse til implementering i praksis og måling....

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.

The Strategy Blueprint: A Strategy Process Computer-Aided Design Tool

OpenAIRE

Aldea, Adina Ioana; Febriani, Tania Rizki; Daneva, Maya; Iacob, Maria Eugenia

2017-01-01

Strategy has always been a main concern of organizations because it dictates their direction, and therefore determines their success. Thus, organizations need to have adequate support to guide them through their strategy formulation process. The goal of this research is to develop a computer-based tool, known as ‘the Strategy Blueprint’, consisting of a combination of nine strategy techniques, which can help organizations define the most suitable strategy, based on the internal and external f...

Strategy of formation and training for the basic units of cooperative production. Actions for their implementation

Directory of Open Access Journals (Sweden)

Iriadna Marín de León

2014-06-01

The implementation of the strategy of Formation and Training had great importance since applying the same one, they could get rich our cooperatives, of elements that contribute to the obtaining of a bigger level of efficiency and effectiveness of the human resources, given by the knowledge that they can acquire the same ones.   The article approaches the topics of Administration of human resources, formation and training theoretically, the elements of the functional strategy, and lastly a journey for the Cooperative Sector leaving of its emergence until specifying the characteristics of the Basic Units of Cooperative Production as part of the same one.   He is also carried out a valuation of the current situation as for Formation and Training of the human resources in the UBPC of the County of Pinar del Ro. This is made going to different diagnosis techniques. Later on they intend the actions that allow the implementation of this strategy.

Implementing the United Kingdom Government's 10-Year Teenage Pregnancy Strategy for England (1999-2010): Applicable Lessons for Other Countries.

Science.gov (United States)

Hadley, Alison; Chandra-Mouli, Venkatraman; Ingham, Roger

2016-07-01

Teenage pregnancy is an issue of inequality affecting the health, well-being, and life chances of young women, young men, and their children. Consequently, high levels of teenage pregnancy are of concern to an increasing number of developing and developed countries. The UK Labour Government's Teenage Pregnancy Strategy for England was one of the very few examples of a nationally led, locally implemented evidence-based strategy, resourced over a long duration, with an associated reduction of 51% in the under-18 conception rate. This article seeks to identify the lessons applicable to other countries. The article focuses on the prevention program. Drawing on the detailed documentation of the 10-year strategy, it analyzes the factors that helped and hindered implementation against the World Health Organization (WHO) ExpandNet Framework. The Framework strives to improve the planning and management of the process of scaling-up of successful pilot programs with a focus on sexual and reproductive health, making it particularly suited for an analysis of England's teenage pregnancy strategy. The development and implementation of the strategy matches the Framework's key attributes for successful planning and scaling up of sexual and reproductive health programs. It also matched the attributes identified by the Centre for Global Development for scaled up approaches to complex public health issues. Although the strategy was implemented in a high-income country, analysis against the WHO-ExpandNet Framework identifies many lessons which are transferable to low- and medium-income countries seeking to address high teenage pregnancy rates. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Use of a mixed-method approach to evaluate the implementation of retention promotion strategies in the New York State WIC program.

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Sekhobo, Jackson P; Peck, Sanya R; Byun, Youjung; Allsopp, Marie A K; Holbrook, MaryEllen K; Edmunds, Lynn S; Yu, Chengxuan

2017-08-01

This research assessed the implementation of strategies piloted at 10 Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics aimed at increasing retention in the program, by enhancing participants' shopping experiences. Under WIC Retention Promotion Study: Keep, Reconnect, Thrive (WIC RPS), clinics were recruited and assigned to implement one or a combination of strategies: a standardized Shopping Orientation (SO) curriculum, a Guided Shopping Tour (GST), and a Pictorial Foods Card (PFC) from November 2012 through August 2013. This paper presents results from the process evaluation of the retention strategies, using a mixed-methods comparative case study design employing WIC administrative data, interviews, and focus groups. Qualitative data were inductively coded, analyzed and mapped to the following implementation constructs: organizational capacity, fidelity, allowable adaptations, implementation challenges, and participant responsiveness, while quantitative data were analyzed using SAS to assess reach and dose. Several sites implemented the SO and PFC interventions with the necessary fidelity and dose needed to assess impact on participants' shopping experiences. Sites that were assigned the GST strategy struggled to implement this strategy. However, use of the standardized SO enabled staff to use a "consistent list of shopping tips" to educate participants about the proper use of checks, while use of the PFC increased participants' awareness of the variety of WIC-allowable foods. During follow-up telephone calls, 91 percent of participants reported the shopping tips as helpful. Future analyses will assess the impact of enhanced shopping experience on retention at intervention sites. Copyright © 2017 Elsevier Ltd. All rights reserved.

Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

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Higgins, P; Murray, M L; Williams, E M

1994-03-01

This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.

Implementing exertional heat illness prevention strategies in US high school football.

Science.gov (United States)

Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

2014-01-01

Approximately 6500 high school football athletes are treated annually for exertional heat illness (EHI). In 2009, the National Athletic Trainers Association (NATA)-led Inter-Association Task Force (NATA-IATF) released preseason heat acclimatization guidelines to help athletes become accustomed to environmental factors contributing to EHI. This study examines compliance with NATA-IATF guidelines and related EHI prevention strategies. The study used a cross-sectional survey completed by 1142 certified athletic trainers (AT), which captured compliance with 17 NATA-IATF guidelines and EHI prevention strategies in high school football during the 2011 preseason. On average, AT reported football programs complying with 10.4 NATA-IATF guidelines (SD = 3.2); 29 AT (2.5%) reported compliance with all 17. Guidelines with the lowest compliance were as follows: "Single-practice days consisted of practice no more than three hours in length" (39.7%); and "During days 3-5 of acclimatization, only helmets and shoulder pads should be worn" (39.0%). An average of 7.6 EHI prevention strategies (SD = 2.5) were used. Common EHI prevention strategies were as follows: having ice bags/cooler available (98.5%) and having a policy with written instructions for initiating emergency medical service response (87.8%). Programs in states with mandated guidelines had higher levels of compliance with guidelines and greater prevalence of EHI prevention strategies. A low proportion of surveyed high school football programs fully complied with all 17 NATA-IATF guidelines. However, many EHI prevention strategies were voluntarily implemented. State-level mandated EHI prevention guidelines may increase compliance with recognized best practices recommendations. Ongoing longitudinal monitoring of compliance is also recommended.

Strategy Implementation through Hierarchical Couplings in a Management Control Package : An Explorative Case Study

NARCIS (Netherlands)

van der Kolk, Berend; Schokker, Tom

2016-01-01

We examine how couplings of management control (MC) elements help to implement an organization’s strategy. Despite prior research stating that couplings between MC elements form fruitful soil for further research, empirical studies in this area are still scarce. We draw on coupling theory to explore

Concentrated Language Encounter Approach in Practice for Global Teaching of Literacy: Lighthouse Strategy Implementation

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Rattanavich, Saowalak

2015-01-01

This article presents the lighthouse literacy strategies model using the concentrated language encounter (CLE) approach that has been successfully replicated in many countries in different languages and cultures. A review of CLE research studies and the project implementation in Thailand showed highly significant results in students' literacy…

Stress Prevention@Work : A study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

NARCIS (Netherlands)

Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-vlasveld, M.C.; Anema, J.R.; van der Beek, A.J.; Boot, C.R.L.

2018-01-01

Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative

Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

NARCIS (Netherlands)

Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-Vlasveld, M.C.; Anema, J.R.; Beek, A.J. van der; Boot, C.R.L.

2017-01-01

Background. Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and

Developing a Web-Based Advisory Expert System for Implementing Traffic Calming Strategies

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Amir Falamarzi

2014-01-01

Full Text Available Lack of traffic safety has become a serious issue in residential areas. In this paper, a web-based advisory expert system for the purpose of applying traffic calming strategies on residential streets is described because there currently lacks a structured framework for the implementation of such strategies. Developing an expert system can assist and advise engineers for dealing with traffic safety problems. This expert system is developed to fill the gap between the traffic safety experts and people who seek to employ traffic calming strategies including decision makers, engineers, and students. In order to build the expert system, examining sources related to traffic calming studies as well as interviewing with domain experts have been carried out. The system includes above 150 rules and 200 images for different types of measures. The system has three main functions including classifying traffic calming measures, prioritizing traffic calming strategies, and presenting solutions for different traffic safety problems. Verifying, validating processes, and comparing the system with similar works have shown that the system is consistent and acceptable for practical uses. Finally, some recommendations for improving the system are presented.

Implementation and evaluation of critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses.

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Simpson, Elaine; Courtney, Mary

2008-12-01

The purpose of this study was to develop, implement and evaluate critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses. Critical thinking strategies such as questioning, debate, role play and small group activity were developed and used in a professional development programme, which was trialled on a sample of Middle Eastern nurses (n = 20), to promote critical thinking skills, encourage problem solving, development of clinical judgment making and care prioritization in order to improve patient care and outcomes. Classroom learning was transformed from memorization to interaction and active participation. The intervention programme was successful in developing critical thinking skills in both the nurse educators and student nurses in this programme. This programme successfully integrated critical thinking strategies into a Middle Eastern nursing curriculum. Recommendations are as follows: (1) utilize evidence-based practice and stem questions to encourage the formulation of critical thinking questions; (2) support the needs of nurse educators for them to effectively implement teaching strategies to foster critical thinking skills; and (3) adopt creative approaches to (i) transform students into interactive participants and (ii) open students' minds and stimulate higher-level thinking and problem-solving abilities.

Implementation of strategies to increase adolescents' access to fruit and vegetables at school

DEFF Research Database (Denmark)

Aarestrup, Anne Kristine; Jørgensen, Thea Suldrup; Jørgensen, Sanne Ellegaard

2015-01-01

schools. METHODS: We used data from 20 intervention schools involved in the school-based multicomponent Boost trial targeting 13-year-olds' FV consumption. The environmental components at school included daily provision of free FV and promotion of a pleasant eating environment. Questionnaire data......BACKGROUND: Access to fruit and vegetables (FV) is associated with adolescents' FV consumption. However, little is known about implementation of strategies to increase access to FV at schools. We examined the implementation of two environmental components designed to increase access to FV at Danish...... was collected by the end of the nine-month intervention period among 1,121 pupils (95%), from all school principals (n = 20) and half way through the intervention period and by the end of the intervention among 114 teachers (44%). The implementation of the components was examined descriptively using...

Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies.

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Nathan, Nicole; Wolfenden, Luke; Butler, Michelle; Bell, Andrew Colin; Wyse, Rebecca; Campbell, Elizabeth; Milat, Andrew J; Wiggers, John

2011-08-01

School-based vegetable and fruit programs can increase student consumption of vegetables and fruit and have been recommended for adoption by Australian schools since 2005. An understanding of the prevalence and predictors of and the barriers to the adoption of school-based vegetable and fruit programs is necessary to maximize their adoption by schools and ensure that the health benefits of such programs to children are realized. The aim of this study was to determine Australian primary school Principals' attitudes and barriers to the implementation of vegetable and fruit breaks; the prevalence of vegetable and fruit breaks in schools and the implementation strategies used and associated with their recommended adoption (daily in at least 80% of classes). A random sample of 384 school Principals completed a 20-min telephone interview. While Principals were highly supportive of vegetable and fruit breaks, only 44% were implementing these to a recommended level. When controlling for all school characteristics, recommended vegetable and fruit break adoption was 1.9 and 2.2 times greater, respectively, in schools that had parent communication strategies and teachers trained. A substantial opportunity exists to enhance the health of children through the adoption of vegetable and fruit breaks in schools.

Tuberculosis deaths averted by implementation of the DOTS strategy in Kazakhstan.

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Favorov, M; Belilovsky, E; Aitmagambetova, I; Ismailov, S; White, M E; Chorba, T

2010-12-01

Kazakhstan began implementing the DOTS strategy for tuberculosis (TB) in 1998. Data were analyzed 1) to determine if changes in TB mortality rate (MR) and case fatality rate (CFR) in Kazakhstan for 1998-2003 differed from those of Uzbekistan and four adjacent Russian Federation (RF) oblasts that had not yet implemented DOTS, and 2) to estimate the number of deaths averted in Kazakhstan as a result of DOTS. Observed MRs were calculated, and predicted MRs for Kazakhstan were approximated by linear regression based on average slope of MRs from 1998 through 2003 in adjacent non-DOTS-implementing territories. Deaths averted were calculated by comparing predicted MRs to actual MRs by converting rate differences to numbers of deaths. TB MRs in Kazakhstan decreased markedly, but remained stable or increased in the neighboring territories. CFRs decreased markedly in Kazakhstan and marginally in Uzbekistan, and increased in the neighboring RF oblasts. From 1998 to 2004, DOTS appears to have helped avert approximately 17,800 deaths in Kazakhstan. DOTS has contributed markedly to a decrease in TB mortality in Kazakhstan. In settings where mortality data are relatively complete, deaths averted can be another indicator of DOTS effectiveness.

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care

OpenAIRE

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-01

Background Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy ? systems consultation ?intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy ? translation of a clinical practice guideline into a checklist-based im...

Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study

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Hofstede Stefanie N

2012-06-01

Full Text Available Abstract Background Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs after prolonged conservative treatment or surgery at one year follow-up. Guidelines recommend that the team of professionals involved in sciatica care and patients jointly decide about treatment options, so-called interprofessional shared decision making (SDM. However, there are strong indications that SDM for sciatica patients is not integrated in daily practice. We designed a study aiming to explore the barriers and facilitators associated with the everyday embedding of SDM for sciatica patients. All related relevant professionals and patients are involved to develop a tailored strategy to implement SDM for sciatica patients. Methods The study consists of two phases: identification of barriers and facilitators and development of an implementation strategy. First, barriers and facilitators are explored using semi-structured interviews among eight professionals of each (paramedical discipline involved in sciatica care (general practitioners, physical therapists, neurologists, neurosurgeons, and orthopedic surgeons. In addition, three focus groups will be conducted among patients. Second, the identified barriers and facilitators will be ranked using a questionnaire among a representative Dutch sample of 200 GPs, 200 physical therapists, 200 neurologists, all 124 neurosurgeons, 200 orthopedic surgeons, and 100 patients. A tailored team-based implementation strategy will be developed based on the results of the first phase using the principles of intervention mapping and an expert panel. Discussion Little is known about effective strategies to increase the uptake of SDM. Most implementation strategies only target a single discipline, whereas

Designing an implementation strategy to improve interprofessional shared decision making in sciatica: study protocol of the DISC study.

Science.gov (United States)

Hofstede, Stefanie N; Marang-van de Mheen, Perla J; Assendelft, Willem J J; Vleggeert-Lankamp, Carmen L A; Stiggelbout, Anne M; Vroomen, Patrick C A J; van den Hout, Wilbert B; Vliet Vlieland, Thea P M; van Bodegom-Vos, Leti

2012-06-15

Sciatica is a common condition worldwide that is characterized by radiating leg pain and regularly caused by a herniated disc with nerve root compression. Sciatica patients with persisting leg pain after six to eight weeks were found to have similar clinical outcomes and associated costs after prolonged conservative treatment or surgery at one year follow-up. Guidelines recommend that the team of professionals involved in sciatica care and patients jointly decide about treatment options, so-called interprofessional shared decision making (SDM). However, there are strong indications that SDM for sciatica patients is not integrated in daily practice. We designed a study aiming to explore the barriers and facilitators associated with the everyday embedding of SDM for sciatica patients. All related relevant professionals and patients are involved to develop a tailored strategy to implement SDM for sciatica patients. The study consists of two phases: identification of barriers and facilitators and development of an implementation strategy. First, barriers and facilitators are explored using semi-structured interviews among eight professionals of each (para)medical discipline involved in sciatica care (general practitioners, physical therapists, neurologists, neurosurgeons, and orthopedic surgeons). In addition, three focus groups will be conducted among patients. Second, the identified barriers and facilitators will be ranked using a questionnaire among a representative Dutch sample of 200 GPs, 200 physical therapists, 200 neurologists, all 124 neurosurgeons, 200 orthopedic surgeons, and 100 patients. A tailored team-based implementation strategy will be developed based on the results of the first phase using the principles of intervention mapping and an expert panel. Little is known about effective strategies to increase the uptake of SDM. Most implementation strategies only target a single discipline, whereas multiple disciplines are involved in SDM among sciatica

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

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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.

Implementing the Integrated Strategy for the Cultural Adaptation of Evidence-Based Interventions: An Illustration.

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Sidani, Souraya; Ibrahim, Sarah; Lok, Jana; Fan, Lifeng; Fox, Mary

2018-01-01

Background Persons' cultural beliefs about a health problem can affect their perceived acceptability of evidence-based interventions, undermining evidence-based interventions' adherence, and uptake to manage the problem. Cultural adaptation has the potential to enhance the acceptability, uptake, and adherence to evidence-based interventions. Purpose To illustrate the implementation of the first two phases of the integrated strategy for cultural adaptation by examining Chinese Canadians' perceptions of chronic insomnia and evidence-based behavioral therapies for insomnia. Methods Chinese Canadians ( n = 14) with chronic insomnia attended a group session during which they completed established instruments measuring beliefs about sleep and insomnia, and their perceptions of factors that contribute to chronic insomnia. Participants rated the acceptability of evidence-based behavioral therapies and discussed their cultural perspectives regarding chronic insomnia and its treatment. Results Participants actively engaged in the activities planned for the first two phases of the integrated strategy and identified the most significant factor contributing to chronic insomnia and the evidence-based intervention most acceptable for their cultural group. Conclusions The protocol for implementing the two phases of the integrated strategy for cultural adaptation of evidence-based interventions was feasible, acceptable, and useful in identifying culturally relevant evidence-based interventions.

[Implementing Inter-Professional Education (IPE): Challenges and Strategies].

Science.gov (United States)

Lee, Chia-Lun; Hung, Chich-Hsiu

2017-12-01

Inter-professional practice (IPP), necessary in today's healthcare environment, should be guided and practiced through inter-professional education (IPE). Within the context of an effective IPE program, collaborative medical professionals must be cognizant of the demands of patients' integrated care, organize a collaborative inter-professional team, and achieve the objectives of patient-centered care. However, the many challenges of IPE include insufficient understanding of inter-professional care, occupational culture-related boundary issues, lack of a college education, and insufficient support from academic and medical institutions. This article suggests adopting effective strategies to promote inter-professional recognition, create a harmonious medical culture, eliminate barriers to education, and enhance support for academic and medical institutions. Inter-professional collaboration between academic and clinical institutions must provide resources and substantive professional training. Effectively implementing IPE and IPP is expected to elicit trust, respect, and efficient communication from team members.

Evaluation of Two CEDA Weatherization Pilot Implementations of an Exterior Insulation and Over-Clad Retrofit Strategy for Residential Masonry Buildings in Chicago

Energy Technology Data Exchange (ETDEWEB)

Neuhauser, K.

2013-08-01

This project examines the implementation of an exterior insulation and over-clad strategy for brick masonry buildings in Chicago. The strategy was implemented at a free-standing two story two-family dwelling and a larger free-standing multifamily building. The test homes selected for this research represent predominant housing types for the Chicago area. High heating energy use typical in these buildings threaten housing affordability. Uninsulated mass masonry wall assemblies also have a strongly detrimental impact on comfort. Significant changes to the performance of masonry wall assemblies is generally beyond the reach of typical weatherization (Wx) program resources. The Community and Economic Development Association of Cook County, Inc. (CEDA) has secured a Sustainable Energy Resources for Consumers (SERC) innovation grant sponsored by the United States Department of Energy (DOE). This grant provides CEDA the opportunity to pursue a pilot implementation of innovative approaches to retrofit in masonry wall enclosures. The exterior insulation and over-clad strategy implemented through this project was designed to allow implementation by contractors active in CEDA weatherization programs and using materials and methods familiar to these contractors. The retrofit measures are evaluated in terms of feasibility, cost and performance. Through observations of the strategies implemented, the research described in this report identifies measures critical to performance as well as conditions for wider adoption. The research also identifies common factors that must be considered in determining whether the exterior insulation and over-clad strategy is appropriate for the building.

Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

Science.gov (United States)

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS

A guide to understanding and implementing risk evaluation and mitigation strategies in organ transplantation.

Science.gov (United States)

Gabardi, Steven; Tichy, Eric M

2013-03-01

To review the components of the Congressional mandate for risk evaluation and mitigation strategies (REMS) managed by the Food and Drug Administration and assess their impact on health care providers practicing within the organ transplant arena. A non-date-limited search of MEDLINE and EMBASE (January 2007-June 2012) was conducted by using the following search terms: risk evaluation and mitigation strategies, REMS, and organ transplant, including a query of the individual organs. Information from the Federal Register and the Food and Drug Administration was also evaluated. REMS are strategies implemented to manage known or potential risks associated with medications and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product. Elements of REMS programs may consist of 3 levels: a medication guide, communication plan, and elements to assure safe use. A medication guide is used to help prevent serious adverse events, aid in patients' decision making, and enhance medication adherence. Communication plans help educate health care providers and encourage adherence with REMS. The elements to assure safe use is a restrictive process implemented when it is deemed necessary to ensure safe access for patients to products with known serious risks. In transplant medicine, REMS currently exist for belatacept (medication guide and communication plan) and the mycophenolic acid derivatives (medication guide and elements to assure safe use). REMS are another step in the evolution of the development and marketing of pharmaceutical agents. Use of REMS in solid-organ transplant is becoming common. Transplant clinicians must provide required patient education and become involved with other aspects of REMS implementation to reduce the serious risks of pharmaceuticals and to improve patients' outcomes.

Implementation and Validation of a Self-Consumption Maximization Energy Management Strategy in a Vanadium Redox Flow BIPV Demonstrator

Directory of Open Access Journals (Sweden)

Luis Fialho

2016-06-01

Full Text Available This paper presents the results of the implementation of a self-consumption maximization strategy tested in a real-scale Vanadium Redox Flow Battery (VRFB (5 kW, 60 kWh and Building Integrated Photovoltaics (BIPV demonstrator (6.74 kWp. The tested energy management strategy aims to maximize the consumption of energy generated by a BIPV system through the usage of a battery. Whenever possible, the residual load is either stored in the battery to be used later or is supplied by the energy stored previously. The strategy was tested over seven days in a real-scale VRF battery to assess the validity of this battery to implement BIPV-focused energy management strategies. The results show that it was possible to obtain a self-consumption ratio of 100.0%, and that 75.6% of the energy consumed was provided by PV power. The VRFB was able to perform the strategy, although it was noticed that the available power (either to charge or discharge varied with the state of charge.

Addressing the challenges to health sector decentralization in Nepal: an inquiry into the policy and implementation processes.

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Dhakal, R; Ratanawijitrasin, S; Srithamrongsawat, S

2009-09-01

The objective of the study was to analyze the status and explore the challenges to decentralization policy implementation in Nepal. Thirty seven key informants rich in experience and knowledge, seven focus group discussions, observation of six health facilities and analysis of about 25 key policy documents provided the data for this study. The study identified the challenges to the implementation of decentralization reforms in the public health sector as: (i) centralised and weak management and programming practices of the government; (ii) weak legal and institutional framework; (iii) conflicting policy objectives; (iv) lack of implementation strategy; (v) poor financial and human resource management system; (vi) lack of adequate preparation for managing the reform; (vii) weak capacity at all levels; (viii) political instability. It was revealed that the implementation of the policy in Nepal was extremely poor as many of the important policy measures were either never initiated or they were only partially implemented. The challenges lie both at - policy design and implementation phase. Clear policy objectives, appropriate structure, sound planning, financing and human resources policy, adequate capacity, responsive information system, defined service packages, active participation of stakeholders and a conducive socio-political environment are considered imperative for successful implementation of the policy. Preparation for managing reform implementation at national and district levels is prerequisite for decentralization to work. Pushing for decentralization in a politically fragile environment may rather lead to further fragmentation, instead of strengthening government legitimacy.

Barriers to adequate prenatal care utilization in American Samoa

Science.gov (United States)

Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

2013-01-01

Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; Pprenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

Multi-faceted implementation strategy to increase use of a clinical guideline for the diagnosis of deep venous thrombosis in primary care.

Science.gov (United States)

Kingma, Anna E C; van Stel, Henk F; Oudega, Ruud; Moons, Karel G M; Geersing, Geert-Jan

2017-08-01

A clinical decision rule (CDR), combined with a negative D-dimer test, can safely rule out deep venous thrombosis (DVT) in primary care. This strategy is recommended by guidelines, yet uptake by GPs is low. To evaluate a multi-faceted implementation strategy aimed at increased use of the guideline recommended CDR plus D-dimer test in primary care patients with suspected DVT. This multi-faceted implementation strategy consisted of educational outreach visits, financial reimbursements and periodical newsletters. 217 Dutch GPs (implementation group) received this strategy and included patients. Effectiveness was measured through the following patient-level outcomes: (i) proportion of non-referred patients, (ii) proportion of missed DVT cases within this group and (iii) the proportion of patients in whom the guideline was applied incorrectly. Implementation outcomes ('acceptability', 'feasibility', 'fidelity' and 'sustainability') were assessed with an online questionnaire. Patient-level outcomes were compared with those of patients included by 450 GPs, uninformed about the study's purposes providing information about usual care. 336 (54%) of 619 analyzable implementation group patients were not referred, missing 6 [1.8% (95% confidence interval 0.7% to 3.9%)] DVT cases. Incorrect guideline use was observed in 199 patients (32%). Self-reported acceptability, feasibility and expected sustainability were high. Guideline use increased from 42% to an expected continuation of use of 91%. Only 32 usual care GPs included 62 patients, making formal comparison unreliable. This multi-faceted implementation strategy safely reduced patient referral to secondary care, despite frequently incorrect application of the guideline and resulted in high acceptability, feasibility and expected sustainability. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Design, Implementation and Evaluation of Innovative Science Teaching Strategies for Non-Formal Learning in a Natural History Museum

Science.gov (United States)

Çil, Emine; Maccario, Nihal; Yanmaz, Durmus

2016-01-01

Background: Museums are useful educational resources in science teaching. Teaching strategies which promote hands-on activities, student-centred learning, and rich social interaction must be designed and implemented throughout the museum visit for effective science learning. Purpose: This study aimed to design and implement innovative teaching…

Exploring K-3 Teachers' Implementation of Comprehension Strategy Instruction (CSI) Using Expectancy-Value Theory

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Foley, Laura S.

2011-01-01

This research investigated factors that influence the implementation levels of evidence-based comprehension strategy instruction (CSI) among K-3 teachers. An explanatory design was chosen to gather and probe the data. Quantitative data were gathered via a mailed survey distributed through a representative sample of the 40 school districts (through…

Technical basis, supporting information, and strategy for development and implementation of DOE policy for natural phenomena hazards

Energy Technology Data Exchange (ETDEWEB)

Murray, R.C.

1991-09-01

Policy for addressing natural phenomenon comprises a hierarchy of interrelated documents. The top level of policy is contained in the code of Federal Regulations which establishes the framework and intent to ensure overall safety of DOE facilities when subjected to the effects of natural phenomena. The natural phenomena to be considered include earthquakes and tsunami, winds, hurricanes and tornadoes, floods, volcano effects and seiches. Natural phenomena criteria have been established for design of new facilities; evaluation of existing facilities; additions, modifications, and upgrades to existing facilities; and evaluation criteria for new or existing sites. Steps needed to implement these four general criteria are described. The intent of these criteria is to identify WHAT needs to be done to ensure adequate protection from natural phenomena. The commentary provides discussion of WHY this is needed for DOE facilities within the complex. Implementing procedures identifying HOW to carry out these criteria are next identified. Finally, short and long term tasks needed to identify the implementing procedure are tabulated. There is an overall need for consistency throughout the DOE complex related to natural phenomena including consistent terminology, policy, and implementation. 1 fig, 6 tabs.

Developmental origins of metabolic disorders: The need for biomarker candidates and therapeutic targets from adequate preclinical models

Directory of Open Access Journals (Sweden)

Antonio Gonzalez-Bulnes

2016-03-01

Full Text Available The investigation on obesity and associated disorders have changed from an scenario in which genome drove the phenotype to a dynamic setup in which prenatal and early-postnatal conditions are determinant. However, research in human beings is difficult due to confounding factors (lifestyle and socioeconomic heterogeneity plus ethical issues. Hence, there is currently an intensive effort for developing adequate preclinical models, aiming for an adequate combination of basic studies in rodent models and specific preclinical studies in large animals. The results of these research strategies may increase the identification and development of contrasted biomarkers and therapeutic targets.

Implementation of a cost-effective strategy to prevent neonatal early-onset group B haemolytic streptococcus disease in the Netherlands.

Science.gov (United States)

Kolkman, Diny G E; Rijnders, Marlies E B; Wouters, Maurice G A J; van den Akker-van Marle, M Elske; van der Ploeg, Cpb Kitty; de Groot, Christianne J M; Fleuren, Margot A H

2013-07-30

Early-onset Group B haemolytic streptococcus infection (EOGBS) is an important cause of neonatal morbidity and mortality in the first week of life. Primary prevention of EOGBS is possible with intra-partum antibiotic prophylaxis (IAP.) Different prevention strategies are used internationally based on identifying pregnant women at risk, either by screening for GBS colonisation and/or by identifying risk factors for EOGBS in pregnancy or labour. A theoretical cost-effectiveness study has shown that a strategy with IAP based on five risk factors (risk-based strategy) or based on a positive screening test in combination with one or more risk factors (combination strategy) was the most cost-effective approach in the Netherlands. IAP for all pregnant women with a positive culture in pregnancy (screening strategy) and treatment in line with the current Dutch guideline (IAP after establishing a positive culture in case of pre-labour rupture of membranes or preterm birth and immediate IAP in case of intra-partum fever, previous sibling with EOGBS or GBS bacteriuria), were not cost-effective. Cost-effectiveness was based on the assumption of 100% adherence to each strategy. However, adherence in daily practice will be lower and therefore have an effect on cost-effectiveness. The aims are to: a.) implement the current Dutch guideline, the risk-based strategy and the combination strategy in three pilot regions and b.) study the effects of these strategies in daily practice. Regions where all the care providers in maternity care implement the allocated strategy will be randomised. Before the introduction of the strategy, there will be a pre-test (use of the current guideline) involving 105 pregnant women per region. This will be followed by a post-test (use of the allocated strategy) involving 315 women per region. The outcome measures are: 1.) adherence to the specific prevention strategy and the determinants of adherence among care providers and pregnant women, 2.) outcomes

Quasi-adequate semigroups

International Nuclear Information System (INIS)

El-Qallali, A.

1987-11-01

The least fundamental adequate good congruence on an arbitrary type W semigroup S is described as well as the largest superabundant full subsemigroup of S and the largest full subsemigroup of S which is a band of cancellative monoids. Weak type W semigroups are defined by replacing the idempotent-connected property in type W by one of its consequences and a structure theorem is obtained for such semigroups. (author). 12 refs

Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines.

Science.gov (United States)

Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

2016-01-01

to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.

Designing Multidimensional Policing Strategy And Organization: Towards A Synthesis Of Professional And Community Police Models

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Suve Priit

2015-06-01

Full Text Available In this article we analyse professional police and community policing in view of professionalism, strategy and structures. We aim to find ways for synthesizing these models that are usually seen as incompatible. Unlike many earlier studies of police organizations or strategies, we view strategies in the organization at the corporate, functional and operational levels, and argue that by combining them with functional and divisional principles of structuring, it is possible to place professional strategy at the core of policing, while using the community policing strategy mainly as a component part of the strategy in the framework of divisional organization. This way it is possible to avoid the risk of alienating police from the community and to ensure the successful implementation of corporate strategy through providing professional police units that perform the narrow functions, with quick and adequate information from the community.

[Thoughts on optimizing the breast cancer screening strategies and implementation effects].

Science.gov (United States)

Wu, K J

2018-02-01

Reasonable and effective breast cancer screening can make early diagnosis of breast cancer, improve the cure rate, prolong survival and improve the patients' quality of life. China has made preliminary exploration and attempt in breast cancer screening, however, there are still some problems that have not been solved in terms of the proportion of opportunistic screening, the selection of screening targets, methods and frequency, and the judgment of screening results. Therefore, this article analyzes the above problems in details, and presents some thoughts and recommendations on how to optimize the breast cancer screening strategies and implementation effects in China, from the experience of clinical practice, under the background of constantly emerging new research results and techniques and the rapid development of artificial intelligence, that is, to adjust measures to local conditions, provide personalized strategies, achieve precise screening, preach and educate, ensure health insurance coverage, improve quality control, offer technical support and employ artificial intelligence.

Implementation of Technology-based Patient Engagement Strategies within Practice-based Research Networks.

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Careyva, Beth; Shaak, Kyle; Mills, Geoffrey; Johnson, Melanie; Goodrich, Samantha; Stello, Brian; Wallace, Lorraine S

2016-01-01

Technology-based patient engagement strategies (such as patient portals) are increasingly available, yet little is known about current use and barriers within practice-based research networks (PBRNs). PBRN directors have unique opportunities to inform the implementation of patient-facing technology and to translate these findings into practice. PBRN directors were queried regarding technology-based patient engagement strategies as part of the 2015 CAFM Educational Research Alliance (CERA) survey of PBRN directors. A total of 102 PBRN directors were identified via the Agency for Healthcare Research and Quality's registry; 54 of 96 eligible PBRN directors completed the survey, for a response rate of 56%. Use of technology-based patient engagement strategies within PBRNs was limited, with less than half of respondents reporting experience with the most frequently named tools (risk assessments/decision aids). Information technology (IT) support was the top barrier, followed by low rates of portal enrollment. For engaging participant practices, workload and practice leadership were cited as most important, with fewer respondents noting concerns about patient privacy. Given limited use of patient-facing technologies, PBRNs have an opportunity to clarify the optimal use of these strategies. Providing IT support and addressing clinician concerns regarding workload may facilitate the inclusion of innovative technologies in PBRNs. © Copyright 2016 by the American Board of Family Medicine.

Implementation of a clinical dementia guideline. A controlled study on the effect of a multifaceted strategy

DEFF Research Database (Denmark)

Waldorff, Frans Boch; Almind, Gert; Mäkelä, Marjukka

2003-01-01

OBJECTIVE: To assess the impact of a multifaceted implementation strategy aiming to improve GP adherence to a clinical guideline on dementia. DESIGN: Controlled before and after study using data records from regional laboratories. The guideline was mailed to all GPs. The multifaceted implementation...... strategy was planned with local GPs, and consisted of seminars, outreach visits, reminders and continuing medical education (CME) small group training. SETTING: Primary health care. SUBJECTS: 535 GP practices with 727 physicians in Denmark. MAIN OUTCOME MEASURES: The diffusion and use of the guideline...... was measured by a mailed survey. Adherence to guideline recommendations was monitored by data on laboratory tests from general practice in patient's > or = 65 years: thyroid stimulating hormone requested with vitamin B12 or methylmalonate. The use of these tests as part of a diagnostic evaluation of dementia...

The Causality Study of External Environment Analysis (EEA), Internal Environment Analysis (IEA), Strategy Implementation on Study Program Performance at Vocational High School (VHS) in Nias Archipelago, Indonesia

Science.gov (United States)

Waruwu, Binahati; Sitompul, Harun; Manullang, Belferik

2016-01-01

The purposes of this study are to find out the significant effect of: (1) EEA on strategy implementation, (2) IEA on strategy implementation, (3) EEA on study program performance, (4) IEA on study program performance, and (5) strategy implementation on study program performance of Vocational High School (VHS) in Nias Archipelago. The population of…

East Midlands healthcare and bioscience sector strategy appendix 1: healthcare and bioscience res implementation plan

OpenAIRE

East Midlands Development Agency

2007-01-01

The healthcare and bioscience sector is one of four priority sectors identified in the regional economic strategy, A Flourishing Region. This document sets out the implementation plan for maximising the contribution of the healthcare and biosciences sector to the economic development of the East Midlands.

Proceedings of the OECD/NEA/CSNI workshop on the implementation of hydrogen mitigation techniques

International Nuclear Information System (INIS)

Koroll, G.W.; Rohde, J.; Royen, J.

1997-03-01

The Workshop on the Implementation of Hydrogen Mitigation Techniques was held in Winnipeg, Manitoba,Canada from 1996 May 13 to 15. It was organized in collaboration with the Whiteshell Laboratories of Atomic Energy of Canada Limited (AECL), Ontario Hydro and the CANDU Owner's Group (COG). Sixty-five experts from twelve OECD Member countries and the Russian Federation attended the meeting. Papers presented in the sessions included topics: accident management and analysis, relevant aspects of hydrogen production, distribution and mixing, engineering, technology, possible side-effects consequences and new designs. The objectives of the Workshop were the following: to establish the state of the art of hydrogen mitigation techniques, with emphasis on igniters and catalytic recombiners; to exchange information on Member countries' strategies in managing hydrogen mitigation, and to establish dialogue as to differences in approach; to determine whether there is now an adequate technical basis for such strategies or whether more work is needed; to exchange information on future plans for implementation of hydrogen mitigation techniques

Policy and Strategies for Environmental Remediation

International Nuclear Information System (INIS)

2015-01-01

In the environmental remediation of a given site, concerned and interested parties have diverse and often conflicting interests with regard to remediation goals, the time frames involved, reuse of the site, the efforts necessary and cost allocation. An environmental remediation policy is essential for establishing the core values on which remediation is to be based. It incorporates a set of principles to ensure the safe and efficient management of remediation situations. Policy is mainly established by the national government and may become codified in the national legislative system. An environmental remediation strategy sets out the means for satisfying the principles and requirements of the national policy. It is normally established by the relevant remediation implementer or by the government in the case of legacy sites. Thus, the national policy may be elaborated in several different strategies. To ensure the safe, technically optimal and cost effective management of remediation situations, countries are advised to formulate an appropriate policy and strategies. Situations involving remediation include remediation of legacy sites (sites where past activities were not stringently regulated or adequately supervised), remediation after emergencies (nuclear and radiological) and remediation after planned ongoing operation and decommissioning. The environmental policy involves the principles of justification, optimization of protection, protection of future generations and the environment, efficiency in the use of resources, and transparent interaction with stakeholders. A typical policy will also take into account the national legal framework and institutional structure and applicable international conventions while providing for the allocation of responsibilities and resources, in addition to safety and security objectives and public information and participation in the decision making process. The strategy reflects and elaborates the goals and requirements set

Changes in insurance physicians' attitudes, self-efficacy, intention, and knowledge and skills regarding the guidelines for depression, following an implementation strategy.

Science.gov (United States)

Zwerver, Feico; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2013-03-01

To improve guideline adherence by insurance physicians (IPs), an implementation strategy was developed and investigated in a randomized controlled trial. This implementation strategy involved a multifaceted training programme for a group of IPs in applying the guidelines for depression. In this study we report the impact of the implementation strategy on the physicians' attitude, intention, self-efficacy, and knowledge and skills as behavioural determinants of guideline adherence. Any links between these self-reported behavioural determinants and levels of guideline adherence were also determined. Just before and 3 months after the implementation of the multifaceted training, a questionnaire designed to measure behavioural determinants on the basis of the ASE (attitude, social norm, self-efficacy) model was completed by the intervention (n = 21) and the control group (n = 19). Items of the questionnaire were grouped to form scales of ASE determinants. Internal consistency of the scales was calculated using Cronbach's alphas. Differences between groups concerning changes in ASE determinants, and the association of these changes with improvements in guideline adherence, were analyzed using analysis of covariance. The internal consistency of the scales of ASE determinants proved to be sufficiently reliable, with Cronbach's alphas of at least 0.70. At follow-up after 3 months, the IPs given the implementation strategy showed significant improvement over the IPs in the control group for all ASE determinants investigated. Changes in knowledge and skills were only weakly associated with improvements in guideline adherence. The implementation strategy developed for insurance physicians can increase their attitude, intention, self-efficacy, and knowledge and skills when applying the guidelines for depression. These changes in behavioural determinants might indicate positive changes in IPs' behaviour towards the use of the guidelines for depression. However, only changes in

Testing the Andrews Framework of Strategy Formulation and Implementation: Case Study of the University of Cape Coast Digital Library in Ghana

Directory of Open Access Journals (Sweden)

Nesba Yaa Anima Adzobu

2014-12-01

Full Text Available This paper investigates how strategy formulation and implementation processes used by the University of Cape Coast (UCC in building its digital collections compare with the Andrew’s strategic formulation and implementation theoretical framework. Theory-testing case study methodology was used. The data collection instruments were the key informant interview technique and document reviews. During the formulation phase, two aspects (resources and aspirations of senior management were emergent. During the implementation phase, five aspects (achieving results, processes and behaviour, standards, motivation, personal were emergent. All other elements of building the UCC digital collections were planned during both the formulation and implementation phases. Although the emphasis on students and learning is laudable and apt, there seems to be lack of focus on research support beyond digital collection building, despite the fact that research excellence is one of the UCC’s key priorities. Opportunities exist for improving feedback mechanisms between the users, digital library staff and the university management; and inclusion of social media tools in the digital library project. Since only the experience of a single institution of higher learning is considered, it cannot be definitively stated that strategy formulation and implementation will be similar in every institutional context. However, the results provide a basis for academic digital libraries to draw lessons from this case. In African public universities, there is little earlier research on strategy formulation and implementation in digital library management. Strategy formulation and implementation is a critical issue for higher education academic libraries especially in developing countries like Ghana, due to limited financial resources and the rapid change in the information environment during the last several decades.

Evaluation of wetland implementation strategies on phosphorus reduction at a watershed scale

Science.gov (United States)

Abouali, Mohammad; Nejadhashemi, A. Pouyan; Daneshvar, Fariborz; Adhikari, Umesh; Herman, Matthew R.; Calappi, Timothy J.; Rohn, Bridget G.

2017-09-01

Excessive nutrient use in agricultural practices is a major cause of water quality degradation around the world, which results in eutrophication of the freshwater systems. Among the nutrients, phosphorus enrichment has recently drawn considerable attention due to major environmental issues such as Lake Erie and Chesapeake Bay eutrophication. One approach for mitigating the impacts of excessive nutrients on water resources is the implementation of wetlands. However, proper site selection for wetland implementation is the key for effective water quality management at the watershed scale, which is the goal of this study. In this regard, three conventional and two pseudo-random targeting methods were considered. A watershed model called the Soil and Water Assessment Tool (SWAT) was coupled with another model called System for Urban Stormwater Treatment and Analysis IntegratioN (SUSTAIN) to simulate the impacts of wetland implementation scenarios in the Saginaw River watershed, located in Michigan. The inter-group similarities of the targeting strategies were investigated and it was shown that the level of similarity increases as the target area increases (0.54-0.86). In general, the conventional targeting method based on phosphorus load generated per unit area at the subwatershed scale had the highest average reduction among all the scenarios (44.46 t/year). However, when considering the total area of implemented wetlands, the conventional method based on long-term impacts of wetland implementation showed the highest amount of phosphorus reduction (36.44 t/year).

Implementing practice management strategies to improve patient care: the EPIC project.

Science.gov (United States)

Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

2012-01-01

Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

Managing price risk - setting and implementing strategies

International Nuclear Information System (INIS)

Haines, D.

1999-01-01

The three hedging strategies for price risk management within the natural gas industry are described. The three strategies are: (1) speculative trader (characterized by 'trading for profit, i.e. small margin/large volumes); (2) price optimizer (the objective here is to outperform the market in the establishment of a price); and (3) strategic hedger( the characteristic concern in this strategy is to manage long-term company goals, i.e. balance sheet orientation). The strategies are not mutually exclusive, but overlapping areas can be the source of considerable confusion. Any firm can enter into more than one of these strategies. Integrated companies will adopt very different strategies for upstream versus downstream operations. Details of the three strategies are provided

The Pull Model as the E-Commerce Strategy For Business-To-Consumer Sites

OpenAIRE

Guillermo Reyes González; Ralf Eder Lange

2013-01-01

One of the solutions to stabilize the bullwhip effect is to provide the supply chain with the adequate mechanisms to make the information flow upstream (to the supplier) and downstream (to the consumer). This has led the e-commerce companies to implement a distribution model known as the Pull Model. This paper provides a literature review of the main characteristics of the Pull model and a comparison with the E-Commerce strategies and benefitsJournal: Revista de Administración, Finanzas y Eco...

Consultation as an implementation strategy for evidence-based practices across multiple contexts: unpacking the black box.

Science.gov (United States)

Nadeem, Erum; Gleacher, Alissa; Beidas, Rinad S

2013-11-01

There is great interest in the dissemination and implementation of evidence-based treatments and practices for children across schools and community mental health settings. A growing body of literature suggests that the use of one-time workshops as a training tool is ineffective in influencing therapist behavior and patient outcomes and that ongoing expert consultation and coaching is critical to actual uptake and quality implementation. Yet, we have very limited understanding of how expert consultation fits into the larger implementation support system, or the most effective consultation strategies. This commentary reviews the literature on consultation in child mental health, and proposes a set of core consultation functions, processes, and outcomes that should be further studied in the implementation of evidence-based practices for children.