WorldWideScience

Sample records for program implementation practices

  1. Translating Theory Into Practice: Implementing a Program of Assessment.

    Science.gov (United States)

    Hauer, Karen E; O'Sullivan, Patricia S; Fitzhenry, Kristen; Boscardin, Christy

    2018-03-01

    A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement. Implementation incorporated stakeholder engagement, use of multiple assessment tools, design of a coaching program, and creation of a learner performance dashboard. The assessment team monitors adherence to principles defining the program of assessment and gathers and responds to regular feedback from key stakeholders, including faculty, staff, and students. Next steps include systematically collecting evidence for validity of individual assessments and the program overall. Iterative review of student performance data informs curricular improvements. The program of assessment also highlights technology needs that will be addressed with information technology experts. The outcome ultimately will entail showing evidence of validity that the program produces physicians who engage in lifelong learning and provide high-quality patient care.

  2. Implementation of R & QA practices in Research and Development programs

    Science.gov (United States)

    Bankaitis, H.

    1983-01-01

    DOE has established a number of broad programs aimed at reducing fuel consumption. Several programs address the R&D of ground transportation propulsion alternatives to the conventional spark-ignition engine. NASA Lewis is responsible for managing the effort between the Government and industry teams involving American and foreign companies. Thus, existing NASA SR&QA procedure were modified/adapted to these R&D programs and implemented to assure that the test hardware design intent was met, the hardware was not hazardous to personnel, it would demonstrate reliable operation, and it would help establish the future R&D quality assurance and maintainability requirements. This successful low-cost approach might be applicable to other similar projects.

  3. Lessons Learned from A System-Wide Evidence-Based Practice Program Implementation

    Science.gov (United States)

    2017-04-25

    S9 MOW CRD Graduate Health Sciences Education (GHSE) (SGS O&M); SGS R&D; Tri-Service Nursing Research Program (TSNRP): Defense Medical Research...Practice Program Implementation presented at/published to 2017 Triservice Nursing Research and Evidence-Based Practice Dissemination Course, Ellicott...residency programs. 3. Please know that if you are a Graduate Health Sciences Education student and your department has told you they cannot fund your

  4. Physician practice responses to financial incentive programs: exploring the concept of implementation mechanisms.

    Science.gov (United States)

    Cohen, Genna R; Erb, Natalie; Lemak, Christy Harris

    2012-01-01

    To develop a framework for studying financial incentive program implementation mechanisms, the means by which physician practices and physicians translate incentive program goals into their specific office setting. Understanding how new financial incentives fit with the structure of physician practices and individual providers' work may shed some insight on the variable effects of physician incentives documented in numerous reviews and meta-analyses. Reviewing select articles on pay-for-performance evaluations to identify and characterize the presence of implementation mechanisms for designing, communicating, implementing, and maintaining financial incentive programs as well as recognizing participants' success and effects on patient care. Although uncommonly included in evaluations, evidence from 26 articles reveals financial incentive program sponsors and participants utilized a variety of strategies to facilitate communication about program goals and intentions, to provide feedback about participants' progress, and to assist-practices in providing recommended services. Despite diversity in programs' geographic locations, clinical targets, scope, and market context, sponsors and participants deployed common strategies. While these methods largely pertained to communication between program sponsors and participants and the provision of information about performance through reports and registries, they also included other activities such as efforts to engage patients and ways to change staff roles. This review covers a limited body of research to develop a conceptual framework for future research; it did not exhaustively search for new articles and cannot definitively link particular implementation mechanisms to outcomes. Our results underscore the effects implementation mechanisms may have on how practices incorporate new programs into existing systems of care which implicates both the potential rewards from small changes as well as the resources which may be

  5. Distributed Solar Incentive Programs: Recent Experience and Best Practices for Design and Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Reger, A.; Heeter, J.

    2012-12-01

    Based on lessons from recent program experience, this report explores best practices for designing and implementing incentives for small and mid-sized residential and commercial distributed solar energy projects. The findings of this paper are relevant to both new incentive programs as well as those undergoing modifications. The report covers factors to consider in setting and modifying incentive levels over time, differentiating incentives to encourage various market segments, administrative issues such as providing equitable access to incentives and customer protection. It also explores how incentive programs can be designed to respond to changing market conditions while attempting to provide a longer-term and stable environment for the solar industry. The findings are based on interviews with program administrators, regulators, and industry representatives as well as data from numerous incentive programs nationally, particularly the largest and longest-running programs. These best practices consider the perspectives of various stakeholders and the broad objectives of reducing solar costs, encouraging long-term market viability, minimizing ratepayer costs, and protecting consumers.

  6. The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program.

    Science.gov (United States)

    Scovil, Carol Y; Flett, Heather M; McMillan, Lan T; Delparte, Jude J; Leber, Diane J; Brown, Jacquie; Burns, Anthony S

    2014-09-01

    To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks. Quality improvement. SCI Rehabilitation Center. Inpatients admitted January 2012 to July 2013. Implementation of two PU best practices were targeted: (1) completing a comprehensive PU risk assessment and individualized interprofessional PU prevention plan (PUPP); and (2) providing patient education for PU prevention; as part of the pan-Canadian SCI Knowledge Mobilization Network. At our center, the SCI Pressure Ulcer Scale replaced the Braden risk assessment scale and an interprofessional PUPP form was implemented. Comprehensive educational programing existed, so efforts focused on improving documentation. Implementation science frameworks provided structure for a systematic approach to best practice implementation (BPI): (1) site implementation team, (2) implementation drivers, (3) stages of implementation, and (4) improvement cycles. Strategies were developed to address key implementation drivers (staff competency, organizational supports, and leadership) through the four stages of implementation: exploration, installation, initial implementation, and full implementation. Improvement cycles were used to address BPI challenges. Implementation processes (e.g. staff training) and BPI outcomes (completion rates). Following BPI, risk assessment completion rates improved from 29 to 82%. The PUPP completion rate was 89%. PU education was documented for 45% of patients (vs. 21% pre-implementation). Implementation science provided a framework and effective tools for successful pressure ulcer BPI in SCI rehabilitation. Ongoing improvement cycles will target timeliness of tool completion and documentation of patient education.

  7. Implementation of genetic conservation practices in a muskellunge propagation and stocking program

    Science.gov (United States)

    Jennings, Martin J.; Sloss, Brian L.; Hatzenbeler, Gene R.; Kampa, Jeffrey M.; Simonson, Timothy D.; Avelallemant, Steven P.; Lindenberger, Gary A.; Underwood, Bruce D.

    2010-01-01

    Conservation of genetic resources is a challenging issue for agencies managing popular sport fishes. To address the ongoing potential for genetic risks, we developed a comprehensive set of recommendations to conserve genetic diversity of muskellunge (Esox masquinongy) in Wisconsin, and evaluated the extent to which the recommendations can be implemented. Although some details are specific to Wisconsin's muskellunge propagation program, many of the practical issues affecting implementation are applicable to other species and production systems. We developed guidelines to restrict future broodstock collection operations to lakes with natural reproduction and to develop a set of brood lakes to use on a rotational basis within regional stock boundaries, but implementation will require considering lakes with variable stocking histories. Maintaining an effective population size sufficient to minimize the risk of losing alleles requires limiting broodstock collection to large lakes. Recommendations to better approximate the temporal distribution of spawning in hatchery operations and randomize selection of brood fish are feasible. Guidelines to modify rearing and distribution procedures face some logistic constraints. An evaluation of genetic diversity of hatchery-produced fish during 2008 demonstrated variable success representing genetic variation of the source population. Continued evaluation of hatchery operations will optimize operational efficiency while moving toward genetic conservation goals.

  8. Educating Social Workers for Practice in Integrated Health Care: A Model Implemented in a Graduate Social Work Program

    Science.gov (United States)

    Mattison, Debra; Weaver, Addie; Zebrack, Brad; Fischer, Dan; Dubin, Leslie

    2017-01-01

    This article introduces a curricular innovation, the Integrated Health Scholars Program (IHSP), developed to prepare master's-level social work students for practice in integrated health care settings, and presents preliminary findings related to students' self-reported program competencies and perceptions. IHSP, implemented in a…

  9. Mindfulness in Practice: Considerations for Implementation of Mindfulness-Based Programming for Adolescents in School Contexts

    Science.gov (United States)

    Lawlor, Molly Steward

    2014-01-01

    Schools are considered one of the primary settings in which prevention and intervention initiatives can be implemented successfully, reaching a large number of young people. Especially when promoting social and emotional learning (SEL), many adolescents benefit from universal programs implemented in the school context. This chapter embeds…

  10. The Implementation of One-Week-One-Article Program in a Reading Class: A Reflective Practice

    Directory of Open Access Journals (Sweden)

    Yudi Rahmatullah

    2017-07-01

    Full Text Available This article presents my reflections on the implementation of one-week-one-article program. Fifty-three students participated in this program. Every week they presented the article they had read. I found that the majority of students actively participated in this program, showing seriousness in understanding the content of the article, the pronunciation of difficult words, and the flow of the presentation. This program at least promoted three aspects: students’ motivation, cooperative learning, and their critical thinking. Even though this program was conducted for university students, it is likely to be working with students of junior and senior secondary school with some modification

  11. Teacher and Student Language Practices and Ideologies in a Third-Grade Two-Way Dual Language Program Implementation

    Science.gov (United States)

    Henderson, Kathryn I.; Palmer, Deborah K.

    2015-01-01

    This article provides an in-depth exploration of the language ecologies of two classrooms attempting to implement a two-way dual language (TWDL) program and its mediating conditions. Drawing on ethnographic methods and a sociocultural understanding of language, we examined both teachers' and students' language ideologies and language practices,…

  12. Implementing a simulated client program: bridging the gap between theory and practice.

    Science.gov (United States)

    Adams, Cindy L; Ladner, Lynda D

    2004-01-01

    This paper outlines the design and implementation of an innovative communication skills training program at the Ontario Veterinary College (OVC). Based upon the body of research in human medical education reporting effective results through the use of standardized patients (SPs) for this type of training, an experiential learning laboratory using simulated clients (SCs) and patients was introduced to first-year veterinary students. One hundred and four first-year students were assigned to 12 groups of eight or nine students plus a facilitator. Each student interacted with a simulated client and a patient while being observed by peers and a facilitator. The Calgary-Cambridge Observation Guide (CCOG) was used to guide students and facilitators with performance standards and feedback. Assessment strategies were utilized. Implementation of this program required extensive resources, including funding, expertise, facilitator training, time allotment in an already overburdened curriculum, and administrative and faculty support. Preliminary assessment revealed high student and facilitator satisfaction. The potential of this program for student education and assessment was recognized, and it will be expanded in years 2 and 3 of the DVM (Doctor of Veterinary Medicine) curriculum. Medical educators have created resources, including skills checklists and experiential learning modalities, that are highly applicable to veterinary medical education. Ongoing evaluation of the program is essential to determine whether we are meeting expectations for communication competency in veterinary medicine.

  13. Implementing Sustainable Institutional Practices

    Science.gov (United States)

    Shepard, Joseph; Johnson, Lewis

    2009-01-01

    Recent research has found that few institutions of higher education implemented the necessary strategies to make their campuses sustainable (Thompson and Green 2005). Ironically, universities are the segment of society with the most access to the intellectual capital needed to provide sound sustainable practices and measurements. Having top…

  14. Using research and education to implement practical bed bug control programs in multifamily housing.

    Science.gov (United States)

    Bennett, Gary W; Gondhalekar, Ameya D; Wang, Changlu; Buczkowski, Grzegorz; Gibb, Timothy J

    2016-01-01

    Multifamily housing facilities serving low-income populations have been at the forefront of bed bug outbreaks. Research conducted in the past 8 years has consistently proven that integrated pest management (IPM) is the best approach for successful suppression of bed bug infestations. Bed bug IPM in multifamily settings is especially dependent upon a collaborative community or building-wide effort involving residents, building staff and pest control technicians. Other components of a bed bug IPM program include regular monitoring to detect early-stage bed bug infestations and combined use of non-chemical and chemical interventions. Lastly, to reduce reinfestation rates and costs associated with bed bug control, it is critical to continue periodic monitoring and implement preventive control measures even after successful elimination of bed bugs has been achieved. © 2015 Society of Chemical Industry.

  15. Evaluation of Prerequisite Programs Implementation and Hygiene Practices at Social Food Services through Audits and Microbiological Surveillance.

    Science.gov (United States)

    Garayoa, Roncesvalles; Yánez, Nathaly; Díez-Leturia, María; Bes-Rastrollo, Maira; Vitas, Ana Isabel

    2016-04-01

    Prerequisite programs are considered the most efficient tool for a successful implementation of self-control systems to ensure food safety. The main objective of this study was to evaluate the implementation of these programs in 15 catering services located in Navarra and the Basque Country (regions in northern Spain), through on-site audits and microbiological analyses. The implementation of the prerequisite program was incomplete in 60% of the sample. The unobserved temperature control during both the storage and preparation of meals in 20% of the kitchens reveals misunderstanding in the importance of checking these critical control points. A high level of food safety and hygiene (absence of pathogens) was observed in the analyzed meals, while 27.8% of the tested surfaces exceeded the established limit for total mesophilic aerobic microorganisms (≤100 CFU/25 cm²). The group of hand-contact surfaces (oven door handles and aprons) showed the highest level of total mesophilic aerobic microorganisms and Enterobacteriaceae, and the differences observed with respect to the food-contact surfaces (work and distribution utensils) were statistically significant (P < 0.001). With regard to the food workers' hands, lower levels of microorganisms were observed in the handlers wearing gloves (that is, for Staphylococcus spp we identified 43 CFU/cm2 on average compared with 4 CFU/cm2 (P < 0.001) for those not wearing and wearing gloves, respectively). For a proper implementation of the prerequisites, it is necessary to focus on attaining a higher level of supervision of activities and better hygiene training for the food handlers, through specific activities such as informal meetings and theoretical-practical sessions adapted to the characteristics of each establishment. © 2016 Institute of Food Technologists®

  16. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    Science.gov (United States)

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

  17. Data Decision-Making and Program-Wide Implementation of the Pyramid Model. Roadmap to Effective Intervention Practices #7

    Science.gov (United States)

    Fox, Lise; Veguilla, Myrna; Perez Binder, Denise

    2014-01-01

    The Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) Roadmap on "Data Decision-Making and Program-Wide Implementation of the Pyramid Model" provides programs with guidance on how to collect and use data to ensure the implementation of the Pyramid Model with fidelity and decision-making that…

  18. Implementation of Aerobic Programs.

    Science.gov (United States)

    American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD).

    This information is intended for health professionals interested in implementing aerobic exercise programs in public schools, institutions of higher learning, and business and industry workplaces. The papers are divided into three general sections. The introductory section presents a basis for adhering to a health fitness lifestyle, using…

  19. Implementation of Best Practices in Obesity Prevention in Child Care Facilities: The Arizona Empower Program, 2013-2015.

    Science.gov (United States)

    Papa, Jillian; Agostinelli, Joan; Rodriguez, Gertrudes; Robinson, Deborah

    2017-09-07

    Obesity is a major health concern in every US age group. Approximately one in 4 children in Arizona's Special Supplemental Nutrition Program for Women, Infants, and Children is overweight or obese. The Arizona Department of Health Services developed the Empower program to promote healthy environments in licensed child care facilities. The program consists of 10 standards, including one standard for each of these 5 areas: physical activity and screen time, breastfeeding, fruit juice and water, family-style meals, and staff training. The objective of this evaluation was to determine the level of implementation of these 5 Empower standards. A self-assessment survey was completed from July 2013 through June 2015 by 1,850 facilities to evaluate the level of implementation of 5 Empower standards. We calculated the percentage of facilities that reported the degree to which they implemented each standard and identified common themes in comments recorded in the survey. All facilities reported either full or partial implementation of the 5 standards. Of 1,678 facilities, 21.7% (n = 364) reported full implementation of all standards, and 78.3% (n = 1,314) reported at least partial implementation. Staff training, which has only one component, had the highest level of implementation: 77.4% (n = 1,299) reported full implementation. Only 44.0% (n = 738) reported full implementation of the standard on a breastfeeding-friendly environment. Arizona child care facilities have begun to implement the Empower program, but facilities will need more education, technical assistance, and support in some areas to fully implement the program.

  20. Hypertension management initiative: qualitative results from implementing clinical practice guidelines in primary care through a facilitated practice program.

    Science.gov (United States)

    Tobe, Sheldon W; Moy Lum-Kwong, Margaret; Von Sychowski, Shirley; Kandukur, Kishan

    2013-05-01

    The goal of the Hypertension Management Initiative (HMI) is to improve the management and control of hypertension by both primary care providers and patients. The HMI was in effect in 11 primary care sites across the province of Ontario, Canada. This was a qualitative study. Focus groups and a lobby survey were completed with a total of 199 of the 3934 patients enrolled in the study. Interviews with 41 participating health care providers from all sites were performed. A qualitative description approach was used to give a rich description of each informant's experiences. Patients expressed motivation and engagement in their own health care and became more knowledgeable about hypertension and how to manage it with their health care providers. Most reported satisfaction with the discipline of regular appointments and ongoing monitoring and counseling of the program including identifying and working on goals for their modifiable risk factors. Their health care providers felt the HMI program had a positive impact on the treatment and management of hypertension and also that it improved the functioning of the interprofessional team. The HMI helped to improve patient self-empowerment and self-management and also improved physicians' and nurses' confidence in diagnosing accurately and in hypertension management. Physician buy-in is key to maintaining clinical hypertension management. Interprofessional collaboration was improved for physicians and nurses but less so for pharmacists. Greater confidence among the nurses to manage hypertension more independently reduced demands on physician time. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  1. Quality Oncology Practice Initiative Certification Program: measuring implementation of chemotherapy administration safety standards in the outpatient oncology setting.

    Science.gov (United States)

    Gilmore, Terry R; Schulmeister, Lisa; Jacobson, Joseph O

    2013-03-01

    The Quality Oncology Practice Initiative (QOPI) Certification Program (QCP) evaluates individual outpatient oncology practice performance in areas that affect patient care and safety and builds on the American Society of Clinical Oncology (ASCO) QOPI by assessing the compliance of a practice with certification standards based on the ASCO/Oncology Nursing Society standards for safe chemotherapy administration. To become certified, a practice must attain a benchmark quality score on certification measures in QOPI and attest that it complies with 17 QCP standards. Structured on-site reviews, initially performed in randomly selected practices, became mandatory beginning in September 2011. Of 111 practices that have undergone on-site review, only two were fully concordant with all of the standards (median, 11; range, seven to 17). Most practices were subsequently able to modify practice to become QOPI certified. The QCP addresses the call from the Institute of Medicine to close the quality gap by aligning evidence-based guidelines and consensus-driven standards with requirements for oncology practices to develop and maintain structural safety components, such as policies and procedures that ensure practice performance. On-site practice evaluation is a high-impact component of the program.

  2. The Promise and Challenge of Practice-Research Collaborations: Guiding Principles and Strategies for Initiating, Designing, and Implementing Program Evaluation Research

    Science.gov (United States)

    Secret, Mary; Abell, Melissa L.; Berlin, Trey

    2011-01-01

    The authors present a set of guiding principles and strategies to facilitate the collaborative efforts of social work researchers and practitioners as they initiate, design, and implement outcome evaluations of human service interventions and programs. Beginning with an exploration of the interpersonal barriers to practice-research collaborations,…

  3. School Administrator's Guide to Implementing Language Programming

    Science.gov (United States)

    Alberta Education, 2007

    2007-01-01

    The "School Administrator's Guide to Implementing Language Programming" serves as a starting point to plan for and implement language programming. It provides a general overview; suggests practical strategies for working with students, parents, teachers and the surrounding community; and includes details on areas to address in selecting…

  4. Evidence-based practice implementation: case report of the evolution of a quality improvement program in a multicenter physical therapy organization.

    Science.gov (United States)

    Stevans, Joel M; Bise, Christopher G; McGee, John C; Miller, Debora L; Rockar, Paul; Delitto, Anthony

    2015-04-01

    Our nation's suboptimal health care quality and unsustainable costs can be linked to the failure to implement evidence-based interventions. Implementation is the bridge between the decision to adopt a strategy and its sustained use in practice. The purpose of this case report is threefold: (1) to outline the historical implementation of an evidence-based quality improvement project, (2) to describe the program's future direction using a systems perspective to identify implementation barriers, and (3) to provide implications for the profession as it works toward closing the evidence-to-practice gap. The University of Pittsburgh Medical Center (UPMC) Centers for Rehab Services is a large, multicenter physical therapy organization. In 2005, they implemented a Low Back Initiative utilizing evidence-based protocols to guide clinical decision making. The initial implementation strategy used a multifaceted approach. Formative evaluations were used repeatedly to identify barriers to implementation. Barriers may exist outside the organization, they can be created internally, they may result from personnel, or they may be a direct function of the research evidence. Since the program launch, 3 distinct improvement cycles have been utilized to address identified implementation barriers. Implementation is an iterative process requiring evaluation, measurement, and refinement. During this period, behavior change is actualized as clinicians become increasingly proficient and committed to their use of new evidence. Successfully incorporating evidence into routine practice requires a systems perspective to account for the complexity of the clinical setting. The value the profession provides can be enhanced by improving the implementation of evidence-based strategies. Achieving this outcome will require a concerted effort in all areas of the profession. New skills will be needed by leaders, researchers, managers, and clinicians. © 2015 American Physical Therapy Association.

  5. Social network analysis for program implementation.

    Science.gov (United States)

    Valente, Thomas W; Palinkas, Lawrence A; Czaja, Sara; Chu, Kar-Hai; Brown, C Hendricks

    2015-01-01

    This paper introduces the use of social network analysis theory and tools for implementation research. The social network perspective is useful for understanding, monitoring, influencing, or evaluating the implementation process when programs, policies, practices, or principles are designed and scaled up or adapted to different settings. We briefly describe common barriers to implementation success and relate them to the social networks of implementation stakeholders. We introduce a few simple measures commonly used in social network analysis and discuss how these measures can be used in program implementation. Using the four stage model of program implementation (exploration, adoption, implementation, and sustainment) proposed by Aarons and colleagues [1] and our experience in developing multi-sector partnerships involving community leaders, organizations, practitioners, and researchers, we show how network measures can be used at each stage to monitor, intervene, and improve the implementation process. Examples are provided to illustrate these concepts. We conclude with expected benefits and challenges associated with this approach.

  6. Implementing best practice in hospital multidisciplinary nutritional care: an example of using the knowledge-to-action process for a research program.

    Science.gov (United States)

    Laur, Celia; Keller, Heather H

    2015-01-01

    Prospective use of knowledge translation and implementation science frameworks can increase the likelihood of meaningful improvements in health care practices. An example of this creation and application of knowledge is the series of studies conducted by and with the Canadian Malnutrition Task Force (CMTF). Following a cohort study and synthesis of evidence regarding best practice for identification, treatment, and prevention of malnutrition in hospitals, CMTF created an evidence-informed, consensus-based pathway for nutritional care in hospitals. The purpose of this paper is to detail the steps taken in this research program, through four studies, as an example of the knowledge-to-action (KTA) process. The KTA process includes knowledge creation and action cycles. The steps of the action cycle within this program of research are iterative, and up to this point have been informed by three studies, with a fourth underway. The first study identified the magnitude of the malnutrition problem upon admission to hospital and how it is undetected and undertreated (study 1). Knowledge creation resulted in an evidence-based pathway established to address care gaps (study 2) and the development of monitoring tools (study 3). The study was then adapted to local context: focus groups validated face validate the evidence-based pathway; during the final phase, study site implementation teams will continue to adapt the pathway (studies 2 and 4). Barriers to implementation were also assessed; focus groups and interviews were conducted to inform the pathway implementation (studies 1, 2, and 4). In the next step, specific interventions were selected, tailored, and implemented. In the final study in this research program, plan-do-study-act cycles will be used to make changes and to implement the pathway (study 4). To monitor knowledge use and to evaluate outcomes, audits, staff surveys, patient outcomes, etc will be used to record process evaluations (studies 3 and 4). Finally, a

  7. Childcare service centers' preferences and intentions to use a web-based program to implement healthy eating and physical activity policies and practices: a cross-sectional study.

    Science.gov (United States)

    Yoong, Sze Lin; Williams, Christopher Michael; Finch, Meghan; Wyse, Rebecca; Jones, Jannah; Freund, Megan; Wiggers, John Henry; Nathan, Nicole; Dodds, Pennie; Wolfenden, Luke

    2015-04-30

    Overweight and obesity is a significant public health problem that impacts a large number of children globally. Supporting childcare centers to deliver healthy eating and physical activity-promoting policies and practices is a recommended strategy for obesity prevention, given that such services provide access to a substantial proportion of children during a key developmental period. Electronic Web-based interventions represent a novel way to support childcare service providers to implement such policies and practices. This study aimed to assess: (1) childcare centers' current use of technology, (2) factors associated with intention to use electronic Web-based interventions, and (3) Web-based features that managers rated as useful to support staff with implementing healthy eating and physical activity-promoting policies and practices. A computer-assisted telephone interview (CATI) was conducted with service managers from long day care centers and preschools. The CATI assessed the following: (1) childcare center characteristics, (2) childcare centers' use of electronic devices, (3) intention to use a hypothetical electronic Web-based program-assessed using the Technology Acceptance Model (TAM) with ratings between 1 (strongly disagree) and 7 (strongly agree), and (4) features rated as useful to include in a Web-based program. Overall, 214 service centers out of 277 (77.3%) consented to participate. All service centers except 2 reported using computers (212/214, 99.1%), whereas 40.2% (86/214) used portable tablets. A total of 71.9% (151/210) of childcare service managers reported a score of 6 or more for intention to use a hypothetical electronic Web-based program. In a multivariable logistic regression analysis, intention to use the program was significantly associated with perceived ease of use (P=.002, odds ratio [OR] 3.9, 95% CI 1.6-9.2) and perceived usefulness (Pservice managers as useful or very useful for a Web-based program included decision-support tools to

  8. Implementing an Information Security Program

    Energy Technology Data Exchange (ETDEWEB)

    Glantz, Clifford S.; Lenaeus, Joseph D.; Landine, Guy P.; O' Neil, Lori Ross; Leitch, Rosalyn; Johnson, Christopher; Lewis, John G.; Rodger, Robert M.

    2017-11-01

    The threats to information security have dramatically increased with the proliferation of information systems and the internet. Chemical, biological, radiological, nuclear, and explosives (CBRNe) facilities need to address these threats in order to protect themselves from the loss of intellectual property, theft of valuable or hazardous materials, and sabotage. Project 19 of the European Union CBRN Risk Mitigation Centres of Excellence Initiative is designed to help CBRN security managers, information technology/cybersecurity managers, and other decision-makers deal with these threats through the application of cost-effective information security programs. Project 19 has developed three guidance documents that are publically available to cover information security best practices, planning for an information security management system, and implementing security controls for information security.

  9. Investigating the impact of teachers' implementation practices on academic achievement in science during a long-term professional development program on the Science Writing Heuristic

    Science.gov (United States)

    Gunel, Murat

    This study is a part of a bigger project known as the Science Writing Heuristic (SWH) Partnership Professional Development Project, conducted at Iowa State University and the University of Iowa in association with the Iowa Department of Education to help improve science teaching. Overall, the goal of the project is to help practicing science teachers understand and apply a student-oriented instructional approach, using the SWH. The purpose of this research study was to examine the link between teachers' implementation of a student-oriented teaching approach through the SWH approach with embedded non-traditional writing practices and students' performances on standardized tests over a 3-year period. This study investigated the impact of 6 teachers' (3 high school teachers and 3 middle school teachers) implementation of the SWH approach on student standardized test scores over the 3-year period. A mixed method approach was adopted as a research method. A major premise underpinning this study is that in the rate of change differs by teachers, and that change is not a linear process for teachers. Results of the study indicated a differential across teachers in terms of improvement in pedagogical skills related to the SWH approach. Further, results showed that the SWH approach in-service program did have an impact on participating teachers' pedagogical practices. The majority of the participating teachers improved their pedagogical practices of implementing science inquiry through the SWH approach over the 3-year period of the professional development program. Further, when teachers' rankings were correlated against students' standardized test scores, the results indicated that as their implementation levels increased their students' test achievements also increased.

  10. Implementing best practice in hospital multidisciplinary nutritional care: an example of using the knowledge-to-action process for a research program

    Directory of Open Access Journals (Sweden)

    Laur C

    2015-10-01

    Full Text Available Celia Laur,1 Heather H Keller1,2 1University of Waterloo, 2Schlegel-University of Waterloo, Research Institute for Aging, Waterloo, Ontario, Canada Background: Prospective use of knowledge translation and implementation science frameworks can increase the likelihood of meaningful improvements in health care practices. An example of this creation and application of knowledge is the series of studies conducted by and with the Canadian Malnutrition Task Force (CMTF. Following a cohort study and synthesis of evidence regarding best practice for identification, treatment, and prevention of malnutrition in hospitals, CMTF created an evidence-informed, consensus-based pathway for nutritional care in hospitals. The purpose of this paper is to detail the steps taken in this research program, through four studies, as an example of the knowledge-to-action (KTA process. The KTA process: The KTA process includes knowledge creation and action cycles. The steps of the action cycle within this program of research are iterative, and up to this point have been informed by three studies, with a fourth underway. The first study identified the magnitude of the malnutrition problem upon admission to hospital and how it is undetected and undertreated (study 1. Knowledge creation resulted in an evidence-based pathway established to address care gaps (study 2 and the development of monitoring tools (study 3. The study was then adapted to local context: focus groups validated face validate the evidence-based pathway; during the final phase, study site implementation teams will continue to adapt the pathway (studies 2 and 4. Barriers to implementation were also assessed; focus groups and interviews were conducted to inform the pathway implementation (studies 1, 2, and 4. In the next step, specific interventions were selected, tailored, and implemented. In the final study in this research program, plan–do–study–act cycles will be used to make changes and to implement

  11. Top-down, bottom-up, and around the jungle gym: a social exchange and networks approach to engaging afterschool programs in implementing evidence-based practices.

    Science.gov (United States)

    Smith, Emilie Phillips; Wise, Eileen; Rosen, Howard; Rosen, Alison; Childs, Sharon; McManus, Margaret

    2014-06-01

    This paper uses concepts from social networks and social exchange theories to describe the implementation of evidence-based practices in afterschool programs. The members of the LEGACY Together Afterschool Project team have been involved in conducting collaborative research to migrate a behavioral strategy that has been documented to reduce disruptive behaviors in classroom settings to a new setting-that of afterschool programs. We adapted the Paxis Institute's version of the Good Behavior Game to afterschool settings which differ from in-school settings, including more fluid attendance, multiple age groupings, diverse activities that may take place simultaneously, and differences in staff training and experience (Barrish et al. in J Appl Behav Anal 2(2):119-124, 1969; Embry et al. in The Pax Good Behavior Game. Hazelden, Center City, 2003; Hynes et al. in J Child Serv 4(3):4-20, 2009; Kellam et al. in Drug Alcohol Depend 95:S5-S28, 2008; Tingstrom et al. in Behav Modif 30(2):225-253, 2006). This paper presents the experiences of the three adult groups involved in the implementation process who give first-person accounts of implementation: (1) university-based scientist-practitioners, (2) community partners who trained and provided technical assistance/coaching, and (3) an afterschool program administrator. We introduce here the AIMS model used to frame the implementation process conceptualized by this town-gown collaborative team. AIMS builds upon previous work in implementation science using four phases in which the three collaborators have overlapping roles: approach/engagement, implementation, monitoring, and sustainability. Within all four phases principles of Social Exchange Theory and Social Network Theory are highlighted.

  12. A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs.

    Science.gov (United States)

    Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark

    2015-05-28

    The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval

  13. Integrating patient safety standards into the accreditation program: a qualitative study to assess the readiness of Lebanese hospitals to implement into routine practice.

    Science.gov (United States)

    El-Jardali, Fadi; Jaafar, Maha; Jamal, Diana; Rabbaa, Sally

    2012-09-01

    Concerns about quality of care have led to the integration of patient safety standards and goals in national and international accreditation programs. Since 2005, two national hospital accreditation surveys have been conducted in Lebanon. In 2010, the Ministry of Health integrated patient safety standards into the current program. This study is one of the first efforts in Lebanon and the region to assess hospitals' readiness to integrate patient safety standards into routine practice. This cross-sectional study sampled 6807 respondents from 68 hospitals in Lebanon. This paper will detail results from the qualitative thematic analysis of the responses on 5 open-ended questions added to the Hospital Survey on Patient Safety Culture. The emerging themes were compared across regions, accreditation status, and hospital size. Lebanese hospitals have made progress by recognizing patient safety as a major strategic goal and priority, but gaps still exist in implementation. Very few hospitals are ready for effective implementation of these standards. Staff education and training are needed. Public awareness about patient safety and integrating these concepts into health educational curricula were cited as important strategies among others for creating a culture of patient safety. Variations in responses across regions, accreditation status, and hospital size were discussed. Integrating patient safety initiatives into routine practices requires a cultural shift in health-care organizations. Before assessing whether hospitals comply with patient safety standards, it is important to provide them with sufficient training and education on how to successfully implement these standards. Study findings provide valuable lessons for Lebanon and other countries, which are in the process or currently mandating the implementation of patient safety standards and/or accreditation programs.

  14. Managing Air Quality - Program Implementation

    Science.gov (United States)

    Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.

  15. A Study on Promotion and Implementation of Cleaner Production Practices in Malaysian Industry - Development of a National Program and Action Plan for Promotion of Cleaner Production. Progress Report 1

    DEFF Research Database (Denmark)

    Wangel, Arne

    This Progress Report presents the initial findings of the research project 'A Study on Promotion and Implementation of Cleaner Production Practices in Malaysian Industry - Development of a National Program and Action Plan for Promotion of Cleaner Production. Progress Report' funded...

  16. Large program implementation on minicomputers

    CERN Document Server

    Fonti, L

    1980-01-01

    A method is described to fit a very large program (usually executed on very big mainframes, like a CDC 7600 or IBM 370/168) on a 16-bit minicomputer with memory management support. The method outlined is fully general, even if references are made to a specific example: the implementation of the CERN program HYDRA on a PDP 11/70. (2 refs).

  17. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    Science.gov (United States)

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence

  18. Implementing an Applied Science Program

    Science.gov (United States)

    Rickman, Doug; Presson, Joan

    2007-01-01

    The work implied in the NASA Applied Science Program requires a delicate balancing act for the those doing it. At the implementation level there are multiple tensions intrinsic to the program. For example each application of an existing product to a decision support process requires deep knowledge about the data and deep knowledge about the decision making process. It is highly probable no one person has this range of knowledge. Otherwise the decision making process would already be using the data. Therefore, a team is required. But building a team usually requires time, especially across agencies. Yet the program mandates efforts of relatively short duration. Further, those who know the data are scientists, which makes them essential to the program. But scientists are evaluated on their publication record. Anything which diverts a scientist from the research for his next publication is an anathema to him and potential death to their career. Trying to get another agency to use NASA data does not strike most scientists as material inherently suitable for publication. Also, NASA wishes to rapidly implement often substantial changes to another agency's process. For many reasons, such as budget and program constraints, speed is important. But the owner of a decision making process is tightly constrained, usually by law, regulation, organization and custom. Changes when made are slow, cautious, even hesitant, and always done according a process specific to the situation. To manage this work MSFC must balance these and other tensions. Some things we have relatively little control over, such as budget. These we try to handle by structural techniques. For example by insisting all of our people work on multiple projects simultaneously we inherently have diversification of funding for all of our people. In many cases we explicitly use some elements of tension to be productive. For example the need for the scientists to constantly publish is motivation to keep tasks short and

  19. Practical C++ Programming

    CERN Document Server

    Oualline, Steve

    2003-01-01

    C++ is a powerful, highly flexible, and adaptable programming language that allows software engineers to organize and process information quickly and effectively. But this high-level language is relatively difficult to master, even if you already know the C programming language. The 2nd edition of Practical C++ Programming is a complete introduction to the C++ language for programmers who are learning C++. Reflecting the latest changes to the C++ standard, this 2nd edition takes a useful down-to-earth approach, placing a strong emphasis on how to design clean, elegant code. In short, to-th

  20. Ubiquitous Pharmacogenomics (U-PGx): The Time for Implementation is Now. An Horizon2020 Program to Drive Pharmacogenomics into Clinical Practice.

    Science.gov (United States)

    Cecchin, Erika; Roncato, Rossana; Guchelaar, Hendrik J; Toffoli, Giuseppe

    2017-01-01

    Although the clinical validity of a number of pharmacogenetic markers is nowadays a matter of fact, and led authoritative scientific consortia as the Dutch Pharmacogenetic Working Group (DPWG) and the Clinical Pharmacogenomics Implementation Consortium (CPIC) to publish pharmacogenetic guidelines, the clinical implementation in real life remains challenging. Ubiquitous Pharmacogenomics (U-PGx) program is a coordinated effort that put together scientific and clinical expertise in the pharmacogenomic field, to implement the pre-emptive pharmacogenomic approach in the clinical practice in Europe, and to demonstrate its benefit in both patients' clinical outcome and quality of life, with an economic advantage for the healthcare system. The project is conceived as a clinical trial that will compare 4,000 patients, pre-emptively genotyped for a panel of pharmacogenes included in the DPWG guidelines, and treated accordingly, with 4,000 controls treated with the standard of care. All the genetic data will be prospectively collected and fully embedded into the patient's clinical record. An electronic clinical decision support system will be developed to alert physicians and pharmacists when a drug is being prescribed or dispensed to a patient with a risky genotype. U-PGx will test and harmonize this approach in seven healthcare environments (The Netherlands, Spain, UK, Italy, Austria, Greece, Slovenia) to set the basis for a future European healthcare system where an 'effective treatment optimization will be accessible to every European citizen' (www.upgx.eu). Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. FINANCIAL SUPPORT OF ENVIRONMENTAL PROGRAMS: PRACTICE OF IMPLEMENTATION IN THE REGION AND POSSIBILITIES OF ITS STUDY IN THE PROCESS OF PROFESSIONAL ENVIRONMENTAL TRAINING

    Directory of Open Access Journals (Sweden)

    A. V. Kozachek

    2015-01-01

    Full Text Available Aim. The aim is to consider the structure and practice of funding environmental projects, its implementation in the region as well as the prospects for studying the characteristics of financial support for environmental programs in the course of vocational environmental training in regional universities.Methodology. We propose the method of quantitative research for statistical documents and the method of qualitative analysis that can be used to clarify the structure of environmental financing in the regions.Results. We identified the basic quantitative parameters and made a structure of financing the regional environmental programs. The analysis showed that this structure includes the federal budget, the budget of the Russian Federation, local budgets, extra-budgetary sources. Thus, the example of the Tambov region illustrates that the main financial burden is on the enterprises, and local governments involved in such financing make up the minority. It is proved that the study of the peculiarities of financing the regional environmental programs is important for students of different specialties. We propose a list of didactic units and issues to be included in the content of professional environmental training.Main conclusions. We recommend using the structure of funding the regional ecological projects analyzed on the example of the Tambov region for other regions of Russia as well. At the same time, putting into practice the basic principles of sustainable development, it is necessary to ensure the inclusion of the study of the characteristics and structure of the financing regional environmental programs as didactic units in the process of professional environmental training.

  2. Practical biometrics from aspiration to implementation

    CERN Document Server

    Ashbourn, Julian

    2015-01-01

    This practically-focused text presents a hands-on guide to making biometric technology work in real-life scenarios. Extensively revised and updated, this new edition takes a fresh look at what it takes to integrate biometrics into wider applications. An emphasis is placed on the importance of a complete understanding of the broader scenario, covering technical, human and implementation factors. This understanding may then be exercised through interactive chapters dealing with educational software utilities and the BANTAM Program Manager. Topics and features: provides a concise introduction t

  3. Diminishing Manufacturing Sources and Material Shortages: A Guidebook of Best Practices for Implementing a Robust DMSMS Management Program

    Science.gov (United States)

    2012-08-01

    is often determined by the criticality of their function. Examples of parts with critical functions are microprocessors , microcontrollers , memory...life cycle, not just until the end of the contract. Furthermore, government and industry often have different perspectives on long-term sustainment. The... different DMT roles. The DMT lead may use this as a guide, but tailor it as necessary to meet the specific needs and constraints of the program. The

  4. ENRICH: A promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients.

    Science.gov (United States)

    Vadaparampil, Susan T; Gwede, Clement K; Meade, Cathy; Kelvin, Joanne; Reich, Richard R; Reinecke, Joyce; Bowman, Meghan; Sehovic, Ivana; Quinn, Gwendolyn P

    2016-11-01

    We describe the impact of ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare), a web-based communication-skill-building curriculum for oncology nurses regarding AYA fertility and other reproductive health issues. Participants completed an 8-week course that incorporated didactic content, case studies, and interactive learning. Each learner completed a pre- and post-test assessing knowledge and a 6-month follow-up survey assessing learner behaviors and institutional changes. Out of 77 participants, the majority (72%) scored higher on the post-test. Fifty-four participants completed the follow-up survey: 41% reviewed current institutional practices, 20% formed a committee, and 37% gathered patient materials or financial resources (22%). Participants also reported new policies (30%), in-service education (37%), new patient education materials (26%), a patient navigator role (28%), and workplace collaborations with reproductive specialists (46%). ENRICH improved nurses' knowledge and involvement in activities addressing fertility needs of oncology patients. Our study provides a readily accessible model to prepare oncology nurses to integrate American Society of Clinical Oncology guidelines and improve Quality Oncology Practice Initiative measures related to fertility. Nurses will be better prepared to discuss important survivorship issues related to fertility and reproductive health, leading to improved quality of life outcomes for AYAs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Diminishing Manufacturing Sources and Material Shortages: A Guidebook of Best Practices and Tools for Implementing a DMSMS Management Program

    Science.gov (United States)

    2009-09-01

    28 29 Table 5. Sample Cost Avoidance for Set of DMSMS Program Solutions Notes: MYB = multiyear buy, NHA = next higher assembly, PPR = Problem Part...Substitution Engineering solution complete 1 55,000 Engineering solution in work 2 94,000 Unfunded 120 0 Multiyear buy MYB complete (with PPRs) 54 1,800,000 MYB ...complete (no PPRs) 500 17,000,000 MYB on order 8 0 MYB partially received 10 340,000 MYB protected at DSCC 6 200,000 Other 1 0 Unfunded 298 0 No

  6. 2APL: a practical agent programming language

    NARCIS (Netherlands)

    Dastani, M.M.

    2008-01-01

    This article presents a BDI-based agent-oriented programming language, called 2APL (A Practical Agent Programming Language). This programming language facilitates the implementation ofmulti-agent systems consisting of individual agents thatmay share and access external environments. It realizes

  7. Practical C++ financial programming

    CERN Document Server

    Oliveira, Carlos

    2015-01-01

    Practical C++ Financial Programming is a hands-on book for programmers wanting to apply C++ to programming problems in the financial industry. The book explains those aspects of the language that are more frequently used in writing financial software, including the STL, templates, and various numerical libraries. The book also describes many of the important problems in financial engineering that are part of the day-to-day work of financial programmers in large investment banks and hedge funds. The author has extensive experience in the New York City financial industry that is now distilled in

  8. Food Safety Programs Based on HACCP Principles in School Nutrition Programs: Implementation Status and Factors Related to Implementation

    Science.gov (United States)

    Stinson, Wendy Bounds; Carr, Deborah; Nettles, Mary Frances; Johnson, James T.

    2011-01-01

    Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was…

  9. Studying the implementation of public programs

    Energy Technology Data Exchange (ETDEWEB)

    Yin, R.K.

    1980-02-01

    This report describes and critically assesses approaches that have been employed to study the implementation of public programs. Implementation is defined as the process by which new policies and/or practices are installed in organizations. The report was produced because of the increased interest among researchers and policy makers alike in the linkages between policy and outcome. The study of implementation has barely begun, and it was recognized that methodological issues of a particularly complex nature arise because of certain unique characteristics of the implementation processes: (1) they involve a series of decisions that occur over a long period of time, with no clear beginning or end points; (2) their outcomes have direct or indirect implications that are too complex for single-factor theories; (3) they involve a large number of participants; and (4) they involve situations that are rather unique in terms of agency context, historical moment in time, and other key elements. The approach employed in the report was to examine the methods that have been used in a number of exemplary studies of implementation. These studies are commonly cited in publications and informally in research circles. Descriptive material from each study was used to address three questions: (1) How is evidence collected in studies of implementation; (2) How is evidence analyzed; (3) What are the reasons for believing the conclusions from such studies. The report concludes with recomendations for the conduct of future studies of implementation.

  10. The classwide peer tutoring program: implementation factors moderating students' achievement.

    Science.gov (United States)

    Greenwood, C R; Terry, B; Arreaga-Mayer, C; Finney, R

    1992-01-01

    We conducted a study designed to assess implementation of the classwide peer tutoring program and the relationship between implementation variation and student outcome. A clinical replication design was used. Five volunteer elementary teachers were trained to implement the program; their implementation was monitored for 19 consecutive weeks during 1 school year. Overall, the results indicated that specific variations in program implementation were associated with students' responses to treatment. It was also demonstrated that different teachers' applications of the program produced differential levels of student outcome. Implementation factors related to lower spelling achievement were (a) reduced opportunities to receive program sessions, (b) reduced probabilities of students' participation in program opportunities, (c) too many students assigned unchallenging spelling words, and (d) reduced rates of daily point earning reflecting lower levels of spelling practice during tutoring sessions. The implications of these findings and methods of preventing these implementation problems are discussed in the context of quality assurance and social validity.

  11. Agile Values and Their Implementation in Practice

    Directory of Open Access Journals (Sweden)

    Eva Maria Schön

    2015-12-01

    Full Text Available Today agile approaches are often used for the development of digital products. Since their development in the 90s, Agile Methodologies, such as Scrum and Extreme Programming, have evolved. Team collaboration is strongly influenced by the values and principles of the Agile Manifesto. The values and principles described in the Agile Manifesto support the optimization of the development process. In this article, the current operation is analyzed in Agile Product Development Processes. Both, the cooperation in the project team and the understanding of the roles and tasks will be analyzed. The results are set in relation to the best practices of Agile Methodologies. A quantitative questionnaire related to best practices in Agile Product Development was developed. The study was carried out with 175 interdisciplinary participants from the IT industry. For the evaluation of the results, 93 participants were included who have expertise in the subject area Agile Methodologies. On one hand, it is shown that the collaborative development of product-related ideas brings benefits. On the other hand, it is investigated which effect a good understanding of the product has on decisions made during the implementation. Furthermore, the skillset of product managers, the use of pair programming, and the advantages of cross-functional teams are analyzed.

  12. Implementing Best Practice in Psoriasis

    DEFF Research Database (Denmark)

    Kragballe, Knud; Gniadecki, Robert; Mørk, Nils-Jørgen

    2014-01-01

    In the absence of Nordic-wide guidelines on the best practice management of psoriasis, this paper aims to provide Nordic recommendations for treatment goals, evaluation of quality of life impact and assessment/management of co-morbidities. This Delphi approach consisted of telephone interviews...... of psoriasis patients with cardio-metabolic risk factors to their general practitioner. In order to achieve the best practice management of psoriasis, Nordic dermatologists should be trained and adhere to these recommendations in conjunction with available treatment guidelines....

  13. Implementation Practice and Implementation Research: A Report from the Field

    Science.gov (United States)

    Brekke, John S.; Phillips, Elizabeth; Pancake, Laura; O, Anne; Lewis, Jenebah; Duke, Jessica

    2009-01-01

    The Interventions and Practice Research Infrastructure Program (IPRISP) funding mechanism was introduced by the National Institute of Mental Health (NIMH) to bridge the gap between the worlds of services research and the usual care practice in the community. The goal was to build infrastructure that would provide a platform for research to…

  14. Understanding biochar mechanisms for practical implementation

    Energy Technology Data Exchange (ETDEWEB)

    Glaser, Bruno [Halle-Wittenberg Univ. (Germany). Inst. fuer Agrar- und Ernaehrungeswissenschaften Bodenbiogeochemie; Kammann, Claudia [Arbeitskreis zur Nutzung von Sekundaerrohstoffen und fuer Klimaschutz (ANS) e.V., Braunschweig (Germany). Fachausschuss Biokohle; Hochschule Geisenheim Univ. (Germany). Klimafolgenforschung-Klimawandel in Spezialkulturen; Loewen, Achim (ed.) [Arbeitskreis zur Nutzung von Sekundaerrohstoffen und fuer Klimaschutz (ANS) e.V., Braunschweig (Germany); HAWK Hochschule fuer Angewandte Wissenschaft und Kunst Hildesheim, Holzminden, Goettingen (Germany). Fachgebiet Nachhaltige Energie- und Umwelttechnik NEUtec

    2015-07-01

    The conference on ''understanding biochar mechanisms for practical implementation'' 2015 at the Geisenheim University aims at understanding biochar mechanism, that are crucial for beneficial and safety biochar technology implementation. Further issues are ecotoxicology, biochar in agriculture, horticulture, and animal husbandry. Practical issues concern analysis and characterization of technological processes, sustainable uses and certification, regulation and marketing aspects. The Conference is structured in 10 sessions.

  15. Practical Maya programming with Python

    CERN Document Server

    Galanakis, Robert

    2014-01-01

    ""Practical Maya Programming with Python"" is a practical tutorial packed with plenty of examples and sample projects which guides you through building reusable, independent modules and handling unexpected errors. If you are a developer looking to build a powerful system using Python and Maya's capabilities, then this book is for you. Practical Maya Programming with Python is perfect for intermediate users with basic experience in Python and Maya who want to better their knowledge and skills.

  16. Mentoring program design and implementation in new medical schools

    Directory of Open Access Journals (Sweden)

    Alice Fornari

    2014-06-01

    Full Text Available Purpose: Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods: Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results: The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions: Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established.

  17. Mentoring program design and implementation in new medical schools

    Science.gov (United States)

    Fornari, Alice; Murray, Thomas S.; Menzin, Andrew W.; Woo, Vivian A.; Clifton, Maurice; Lombardi, Marion; Shelov, Steven

    2014-01-01

    Purpose Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established. PMID:24962112

  18. Mentoring program design and implementation in new medical schools.

    Science.gov (United States)

    Fornari, Alice; Murray, Thomas S; Menzin, Andrew W; Woo, Vivian A; Clifton, Maurice; Lombardi, Marion; Shelov, Steven

    2014-01-01

    Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established.

  19. The implementation of the Objective Structured Practical ...

    African Journals Online (AJOL)

    The implementation of the Objective Structured Practical Examination (OSPE) method: Students' and examiners' experiences. B Olivier, V Naidoo, W Mudzi, H van Aswegen, J Potterton, H Myezwa, R Roos, L Godlwana, D Maleka, S Mtshali, V Ntsiea, A Stewart, M Romm, C Humphries, B Watt ...

  20. Systematization of best practices for ecodesign implementation

    DEFF Research Database (Denmark)

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

    2014-01-01

    Despite the recognition of ecodesign potential benefits, its application has not reached companies over the last decades mainly due to difficulties in ecodesign implementation and management and lack of a systematization of existing practices. In order to support companies in dealing with those c...

  1. Awareness of evidence-based practices alone does not translate to implementation: insights from implementation research.

    Science.gov (United States)

    Rangachari, Pavani; Rissing, Peter; Rethemeyer, Karl

    2013-01-01

    This article offers a scholarly review and perspective on the potential of "implementation research" to generate incremental, context-sensitive, evidence-based management strategies for the successful implementation of evidence-based practices (EBPs) (such as the "central line bundle"). Many hospitals have difficulty consistently implementing EBPs at the unit level. This problem has been broadly characterized as "change implementation failure" in health care organizations. The popular hospital response to this challenge has been to raise clinician awareness of EBPs through mandated educational programs. However, this approach has not always succeeded in changing practice. The health services research literature has emphasized the role of several organizational variables (eg, leadership, safety culture, organizational learning, teamwork and communication, and physician/staff engagement) in successful change implementation. Correspondingly, this literature has developed broad frameworks and programs for change in health care organizations. While these broad change frameworks have been successfully applied by some facilities to change practice, they are not incrementally actionable. As such, several facilities have not leveraged broad change frameworks because of resource and/or contextual limitations; a majority of hospitals continue to resort to mandated clinician education (awareness-building) for change implementation. The recent impetus toward "implementation research" in health care has the potential to generate incremental, context-sensitive, evidence-based management strategies for practice change. Authors discuss specific insights from a recently completed study on central line bundle implementation in 2 intensive care units in an academic health center. The study demonstrates that awareness of EBPs alone does not translate to implementation. More importantly, the study also identifies incremental, context-sensitive, evidence-based management strategies for

  2. Implementation of a pharmacist career ladder program.

    Science.gov (United States)

    Heavner, Mojdeh S; Tichy, Eric M; Yazdi, Marina

    2016-10-01

    The implementation and outcomes of a pharmacist career ladder program (PCLP) at a tertiary care, academic medical center are described. A PCLP was developed at Yale-New Haven Hospital to guide career development, motivate staff to perform beyond their daily tasks and responsibilities, and recognize and retain high performers through professional advancement. The PCLP advancement criteria include specific requirements for excellence in five categories: level of training and experience, pharmacy practice, drug information, education and scholarship, and leadership. The PCLP is designed with four distinct tiers: clinical pharmacist, clinical pharmacist II, clinical pharmacy specialist, and clinical pharmacy specialist II. The specific criteria are increasingly challenging to achieve when moving up the ladder. Pharmacists may apply voluntarily each year for advancement. A PCLP review committee consisting of pharmacist peers and managers meets annually to discuss and vote on career advancement decisions. Since PCLP implementation, we have observed an increasing success rate for advancement (50% in 2013, 85% in 2014, and 100% in 2015) and a considerable increase in pharmacist participation in clinical and process improvement projects, as well as intervention and medication-use variance documentation. The implementation of a PCLP at a tertiary care, academic medical center provided an opportunity for frontline pharmacists to advance professionally and increased their participation and leadership in clinical and process improvement projects and drug-use policy and medication safety initiatives; the program also increased the number of pharmacists with specialty board certification and peer-reviewed publications. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. EPA LABORATORIES IMPLEMENT EMS PROGRAM

    Science.gov (United States)

    This paper highlights the breadth and magnitude of carrying out an effective Environmental Management System (EMS) program at the U.S. EPA's research and development laboratories. Federal research laboratories have unique operating challenges compared to more centralized industr...

  4. Implementing a centralized institutional peer tutoring program.

    Science.gov (United States)

    Gaughf, Natalie White; Foster, Penni Smith

    2016-01-01

    Peer tutoring has been found to be beneficial to both students and peer tutors in health sciences education programs. This article describes the implementation of a centralized, institutional peer tutoring program at the University of Mississippi Medical Center, an academic health science center in the U.S. The Program: This multispecialty peer tutoring program paired students experiencing academic difficulties with peer tutors who showed prior academic success, professionalism and effective communication skills. The program allowed students and peer tutors to coordinate their own tutoring services. Evaluations by both students and peer tutors showed satisfaction with the program. Recommendations for developing and implementing an effective peer tutoring program are presented, including utilization of an online system, consistent program policy with high professionalism expectations, funding, program evaluation and data tracking.

  5. The Veterans Choice Program (VCP): Program Implementation

    Science.gov (United States)

    2017-01-05

    to VACAA and challenges encountered during implantation of the law. Table 1 provides major highlights pertaining to the Veterans Choice Program (VCP...outpatient medical, surgical, and mental healthcare; pharmaceuticals; pregnancy and delivery services; dental care; and durable medical equipment, and

  6. Practical Implementation of Sustainable Urban Management Tools

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Jensen, Jesper Ole; Hoffmann, Birgitte

    2006-01-01

    The paper discusses how to promote the use of decision support tools for urban sustainable development. The interest in decision support tools based on indicators is increasing among practitioners and researchers. The research has so far focused on indicator types and systems of indicators...... and goals for urban sustainability whereas less focus has been on the context of implementation and even less on what we can learn from practical experiences about the usefulness of urban sustainable indicator tools. This paper explores the practical implementation of urban sustainable management tools....... It is generally agreed that in order to make indicators and other sustainability management tools work it is necessary that they are integrated in the relevant urban organisational levels, in a way that creates commitment to the subsequent goals. This includes involvement of organisations, individuals and other...

  7. Implementing human factors in clinical practice

    OpenAIRE

    Timmons, Stephen; Baxendale, Bryn; Buttery, Andrew; Miles, Giulia; Roe, Bridget; Browes, Simon

    2014-01-01

    Objectives To understand whether aviation-derived human factors training is acceptable and useful to healthcare professionals. To understand whether and how healthcare professionals have been able to implement human factors approaches to patient safety in their own area of clinical practice. Methods Qualitative, longitudinal study using semi-structured interviews and focus groups, of a multiprofessional group of UK NHS staff (from the emergency department and operating theatres) who have rece...

  8. The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA: a knowledge translation (KT randomized controlled trial (RCT: Part I: The Uptake of the Ottawa Panel clinical practice guidelines (CPGs

    Directory of Open Access Journals (Sweden)

    Brosseau Lucie

    2012-10-01

    Full Text Available Abstract Background The implementation of evidence based clinical practice guidelines on self-management interventions to patients with chronic diseases is a complex process. A multifaceted strategy may offer an effective knowledge translation (KT intervention to promote knowledge uptake and improve adherence in an effective walking program based on the Ottawa Panel Evidence Based Clinical Practice Guidelines among individuals with moderate osteoarthritis (OA. Methods A single-blind, randomized control trial was conducted. Patients with mild to moderate (OA of the knee (n=222 were randomized to one of three KT groups: 1 Walking and Behavioural intervention (WB (18 males, 57 females which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking for OA; 2 Walking intervention (W (24 males, 57 females wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3 Self-directed control (C (32 males, 52 females wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period. Results Short-term program adherence was greater in WB compared to C (p 0.05 was observed for long-term adherence (6 to 12 months, and total adherence between the three groups. The three knowledge translation strategies demonstrated equivalent long-term results for the implementation of a walking program for older individuals with moderate OA. Lower dropout rates as well as higher retention rates were observed for WB at 12 and 18 months. Conclusion The additional knowledge translation behavioural component facilitated the implementation of clinical practice guidelines

  9. Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience.

    Science.gov (United States)

    Hoyme, Derek B; Atkins, Dianne L

    2017-02-01

    To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was CPR training programs can be implemented with reasonable resource and time allocations. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Regional Traffic Incident Management Programs : implementation guide

    Science.gov (United States)

    2000-11-01

    The purpose of this document is to assist organizations and their leaders in implementing and sustaining regional traffic incident management programs, both by examining some successful models, and by considering some of the lessons learned by early ...

  11. Formulation: Implementing Successful Public Montessori Programs.

    Science.gov (United States)

    Epstein, Paul

    1994-01-01

    Draws on the experiences of the OEkos Foundation for Education in implementing successful Montessori programs in 12 public school districts to present essential elements and key decisions needed for establishing such programs. Includes a schematic for the Decision Tree developed by the foundation. (ETB)

  12. Self-assessment program implementation plan. Revision A

    Energy Technology Data Exchange (ETDEWEB)

    Quets, A.L.

    1991-10-23

    This implementation plan identifies and describes the tasks that must be completed in order to successfully implement a Self-Assessment (SA) Program. The purpose of the Self-Assessment Program is to comply with applicable Department of Energy (DOE) directives and orders, Federal, State, and local regulations, operate the Pinellas Plant according to best management practices, and achieve excellence in all operating areas. The Self-Assessment Program will be applied to the Pinellas Plant facility which includes buildings, grounds, equipment, operations, and activities under the control of line management. Furthermore, all applicable disciplines under environmental protection, safety, health and management will be covered by the program. The Self-Assessment Program has been designed to accomplish the following tasks: define the scope of the Self-Assessment Program; assign organizational roles and responsibilities; address EH and S functional elements and management issues; develop a Self-Assessment program charter and policy; identify all applicable EH and S codes, regulations and standards; develop self-assessment procedures and instructions; generate a Self-Assessment Manual; develop a master schedule for facility appraisals and audits; design checklists and report formats for recording appraisal data; implement an assessment tracking and reporting system; implement a root cause analysis and corrective action system; implement a trend analysis and lessons learned system; and establish a formal training program.

  13. Measuring implementation of a school-based violence prevention program : Fidelity and teachers' responsiveness as predictors of proximal outcomes

    NARCIS (Netherlands)

    Schultes, Marie Therese; Stefanek, Elisabeth; van de Schoot, Rens|info:eu-repo/dai/nl/304833207; Strohmeier, Dagmar; Spiel, Christiane

    2014-01-01

    When school-based prevention programs are put into practice, evaluation studies commonly only consider one indicator of program implementation. The present study investigates how two different aspects of program implementation - fidelity and participant responsiveness - jointly influence proximal

  14. Adaptive Filtering Algorithms and Practical Implementation

    CERN Document Server

    Diniz, Paulo S R

    2013-01-01

    In the fourth edition of Adaptive Filtering: Algorithms and Practical Implementation, author Paulo S.R. Diniz presents the basic concepts of adaptive signal processing and adaptive filtering in a concise and straightforward manner. The main classes of adaptive filtering algorithms are presented in a unified framework, using clear notations that facilitate actual implementation. The main algorithms are described in tables, which are detailed enough to allow the reader to verify the covered concepts. Many examples address problems drawn from actual applications. New material to this edition includes: Analytical and simulation examples in Chapters 4, 5, 6 and 10 Appendix E, which summarizes the analysis of set-membership algorithm Updated problems and references Providing a concise background on adaptive filtering, this book covers the family of LMS, affine projection, RLS and data-selective set-membership algorithms as well as nonlinear, sub-band, blind, IIR adaptive filtering, and more. Several problems are...

  15. Practical Implementation of a Graphics Turing Test

    DEFF Research Database (Denmark)

    Borg, Mathias; Johansen, Stine Schmieg; Thomsen, Dennis Lundgaard

    2012-01-01

    We present a practical implementation of a variation of the Turing Test for realistic computer graphics. The test determines whether virtual representations of objects appear as real as genuine objects. Two experiments were conducted wherein a real object and a similar virtual object is presented...... graphics. Based on the results from these experiments, future versions of the Graphics Turing Test could ease the restrictions currently necessary in order to test object telepresence under more general conditions. Furthermore, the test could be used to determine the minimum requirements to achieve object...

  16. Preadmission programs: development, implementation and evaluation.

    Science.gov (United States)

    O'Meara, K; McAuliffe, M J; Motherway, D; Dunleavy, M J

    1983-01-01

    Preparation of children for hospitalization is utilized to mitigate the stresses which may accompany the experience. Preadmission programs provide preparation for the patient and family on a prehospital basis. The authors describe the development of family-centered, developmentally based programs which foster continuity and consistency in a large, pediatric tertiary care setting. Implementation and evaluation of the programs which contribute to quality patient care are discussed.

  17. Factors influencing hospital implementation of acute pain management practice guidelines.

    Science.gov (United States)

    Jiang, H J; Lagasse, R S; Ciccone, K; Jakubowski, M S; Kitain, E M

    2001-06-01

    To identify factors that may influence the implementation of acute pain management guidelines in hospital settings. Two questionnaire surveys. Healthcare Association of New York State, Albany, NY. The surveys were administered to 220 hospitals in New York State regarding their acute pain management practices and resources available. One survey was addressed to each hospital's chief executive officer (CEO) and the second survey was addressed to the clinical director of the Department of Anesthesiology or Acute Pain Service. The barriers and incentives to guideline implementation identified by CEOs were analyzed using factor analysis. Logistic regression was employed to determine predictors of guideline implementation by linking the CEOs' survey data with the clinical directors' report of guideline usage. According to clinical directors, only 27% of the responding hospitals were using a published pain management practice guideline. Factors predictive of guideline implementation include resource availability and belief in the benefits of using guidelines to improve quality of care or to achieve economic/legal advantages. Guideline implementation, however, does not necessarily include applying all key elements recommended by the federal Agency for Healthcare Research and Quality (formerly Agency for Health Care Policy and Research) guideline. For example, a collaborative, interdisciplinary approach to pain control was used in only 42% of the hospitals, and underutilization of nonpharmacologic therapies to control pain was widespread. Resource availability, particularly staff with expertise in pain management and existence of a formal quality assurance program to monitor pain management, was significantly predictive of compliance with key guideline elements. Resource availability significantly influences the implementation of pain management practice guidelines in hospital settings. Implementation is often incomplete because various factors affect the feasibility of

  18. Practicing Technology Implementation: The Case of an Enterprise System

    Science.gov (United States)

    Awazu, Yukika

    2013-01-01

    Drawing on four theories of practice--Communities of Practice (CoP), Bourdieu's theory of practice, Pickering's mangle of practice, and Actor Network Theory (ANT), the study provides an in-depth understanding about technology implementation practice. Analysis of an Enterprise System implementation project in a software manufacturing…

  19. Implementing AORN recommended practices for prevention of transmissible infections.

    Science.gov (United States)

    Patrick, Marcia R; Hicks, Rodney W

    2013-12-01

    Preventing infection in the perioperative setting is a critical element of patient and health care worker safety. This article reviews the recommendations in the AORN "Recommended practices for prevention of transmissible infections in the perioperative practice setting." The recommended practices are intended to help perioperative nurses implement standard and transmission-based precautions (ie, contact, droplet, airborne), including use of personal protective equipment as well as interventions to prevent surgical site infections and exposure to bloodborne pathogens. Additional recommendations cover vaccination programs and how to manage personnel who require work restrictions. Hospital and ambulatory patient scenarios are included to help perioperative nurses apply the recommendations in daily practice. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  20. Multi-site implementation of health education programs for Latinas.

    Science.gov (United States)

    Sudarsan, Nora R; Jandorf, Lina; Erwin, Deborah O

    2011-04-01

    US Latinas are more likely to be diagnosed with late stage breast cancer and have nearly double the incidence of cervical cancer. A culturally customized educational program (Esperanza y Vida) was established in three locations to increase cancer awareness and screening. Educational programs (N = 159) were conducted, with participants randomized to either a breast and cervical (intervention) or diabetes (control) program. Variations in key factors, including gender, program location sites, language utilized, time/day of programs, and data collection method were detected, uncovering unique distributions across locations. Esperanza y Vida was successful in recruiting participants to health programs in three locations, each with a unique Latino population. Program site differences demonstrated educational and screening interventions can be implemented in multiple locations, with program variations reflecting local characteristics. These findings can be applied to outreach efforts to effectively increase participation and enhance screening practices and benefits in other regions.

  1. Barriers to implementation of an organized geriatric fracture program.

    Science.gov (United States)

    Kates, Stephen L; O'Malley, Natasha; Friedman, Susan M; Mendelson, Daniel A

    2012-03-01

    There has been a recent increase in interest in implementing organized geriatric fracture programs for care of older adults with fragility fractures in order to improve both the quality and costs of care. Because such programs are relatively new, there are no standardized methods for implementation and no published descriptions of barriers to implementation. An online survey tool was sent to 185 surgeons and physicians practicing in the United States, who are involved with geriatric fracture care. Sixty-eight responses were received and evaluated. Barriers identified included lack of medical and surgical leadership, need for a clinical case manager, lack of anesthesia department support, lack of hospital administration support, operating room time availability, and difficulty with cardiac clearance for surgery. Other issues important to implementation included quality improvement, cost reductions, cost to the hospital, infection prevention, readmission prevention, and dealing with competing interest groups and competing projects mandated by the government. Physicians and surgeons felt that a site visit to a functioning program was most important when considering implementing a hip fracture program. This study provides useful insights into barriers to implementing an organized hip fracture program. The authors offer suggestions on ways to mitigate or overcome these barriers.

  2. Practical database programming with Java

    CERN Document Server

    Bai, Ying

    2011-01-01

    "This important resource offers a detailed description about the practical considerations and applications in database programming using Java NetBeans 6.8 with authentic examples and detailed explanations. This book provides readers with a clear picture as to how to handle the database programming issues in the Java NetBeans environment. The book is ideal for classroom and professional training material. It includes a wealth of supplemental material that is available for download including Powerpoint slides, solution manuals, and sample databases"--

  3. Evidence-Based Practice Beliefs and Implementation in Doctor of Nursing Practice Students.

    Science.gov (United States)

    Singleton, Joanne K

    2017-10-01

    Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education. Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students. Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study. Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development. © 2017 Sigma Theta Tau International.

  4. 75 FR 48934 - Coral Reef Conservation Program Implementation Guidelines

    Science.gov (United States)

    2010-08-12

    ... National Oceanic and Atmospheric Administration RIN 0648-ZC19 Coral Reef Conservation Program... Implementation Guidelines for the Coral Reef Conservation Program. SUMMARY: This document provides NOAA's revised Grant Program Implementation Guidelines (Guidelines) for the Coral Reef Conservation Program (CRCP or...

  5. Barriers to implementation of the FUSE program.

    Science.gov (United States)

    Nguyen, Brian M; Fitzpatrick, Emilie; Jones, Daniel B

    2018-01-01

    The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) developed The Fundamental Use of Surgical Energy (FUSE) Program to promote safe use of energy devices in the operating room and endoscopy suite. Utilization of the program has been slower than anticipated. This study aims to determine the barriers to implementing FUSE. An anonymous survey was distributed to a surgery department at an academic teaching hospital (n = 256). Participants indicated their level of training. Answers were measured using a 5-point Likert scale. There were 94 (36.7%) respondents to the survey from September 7 to 20, 2016. Fifteen surveys were incomplete, leaving 79 responses for analysis. Most respondents were at the faculty level (45/79, 57.0%). The majority had heard of FUSE (62/79, 78.5%), but only 19 had completed the certification (19/62, 32.3%). There was no difference in the completion rate between faculty and trainees (26.7 vs. 20.6%, OR 1.4, 95% CI 0.49-4.06, p = 0.53). The most common reasons for not taking the exam were lack of time to study (26/43, 60.5%) and lack of time to take the exam (28/43, 62.1%); however, cost was not a barrier (12/43, 27.9%). The majority identified a personal learning gap regarding the safe use of surgical energy (30/43, 69.7%). Of the 19 FUSE-certified respondents, reasons cited for completing the exam included wanting to prevent adverse events to patients and in the operating room (17/19, 89.5% and 17/19, 89.5%), and the belief that the course would make them a safer surgeon (16/19, 84.2%). FUSE teaches the proper use of radiofrequency energy, how to prevent unnecessary injury, and promotes safe practice. Close to three out of every four surgeons self-identified a personal knowledge gap regarding the safe use of surgical energy. Time restraints were cited most commonly as the barrier to starting and completing FUSE. Integrating the FUSE program into resident educational conferences, faculty grand rounds, or national

  6. Implementing and evaluating reflective practice group sessions.

    Science.gov (United States)

    McGrath, Deidre; Higgins, Agnes

    2006-05-01

    The rapidly changing and developing arenas of biological and medical technology, coupled with a myriad of social concerns and issues affecting individual, family and societal health, necessitates that nursing practitioners engage themselves fully with patients in the pursuit of health and healing. The above factors have not only served as catalysts in the development of educational curricula in general but also nursing curricula. Reflection in these curricula is often considered an appropriate vehicle for the analysis of nursing practice, fostering not only an understanding of nurse's work but also the development of critically thoughtful approaches essential for providing nursing care in complex environments [Duke, S., Appleton, J., 2000. The use of reflection in a palliative care programme: a qualitative study of the development of reflective skills over an academic year. J. Adv. Nurs. 32 (6), 1557-1568]. Consequently, nurse educators are being called upon to develop nurses who are reflective practitioners. The focus of this paper is on an exploration of issues that arose from the implementation of reflective sessions with a group of qualified nurses undertaking a diploma in nursing. This paper addresses the challenges experienced in the introduction of reflection as a teaching method. Recommendations for other lecturers when using this approach are also provided. It is anticipated this paper will provide practical advice and guidance for educators who wish to use reflective sessions to enhance the educational experience of their nursing students.

  7. 14 CFR 1214.505 - Program implementation.

    Science.gov (United States)

    2010-01-01

    ... identify positions/duties subject to this regulation and will identify all civil service and contractor... Administrators) before implementation. 5 See footnote 1 to § 1214.502(e). (2) A management review process to... of this part) pursuant to international agreements also require certification under this program...

  8. Analysis and Implement of Broadcast Program Monitoring Data

    Directory of Open Access Journals (Sweden)

    Song Jin Bao

    2016-01-01

    Full Text Available With the rapid development of the radio and TV industry and the implementation of INT (the integration of telecommunications networks, cable TV networks and the Internet, the contents of programs and advertisements is showing massive, live and interactive trends. In order to meet the security of radio and television, the broadcast of information have to be controlled and administered. In order to master the latest information of public opinion trends through radio and television network, it is necessary research the specific industry applications of broadcast program monitoring. In this paper, the importance of broadcast monitoring in public opinion analysis is firstly analysed. The monitoring radio and television programs broadcast system architecture is proposed combining with the practice, focusing on the technical requirements and implementation process of program broadcast, advertisement broadcast and TV station broadcast monitoring. The more efficient information is generated through statistical analysis, which provides data analysis for radio and television public opinion analysis.

  9. A Hybrid III stepped wedge cluster randomized trial testing an implementation strategy to facilitate the use of an evidence-based practice in VA Homeless Primary Care Treatment Programs.

    Science.gov (United States)

    Simmons, Molly M; Gabrielian, Sonya; Byrne, Thomas; McCullough, Megan B; Smith, Jeffery L; Taylor, Thom J; O'Toole, Tom P; Kane, Vincent; Yakovchenko, Vera; McInnes, D Keith; Smelson, David A

    2017-04-04

    Homeless veterans often have multiple health care and psychosocial needs, including assistance with access to housing and health care, as well as support for ongoing treatment engagement. The Department of Veterans Affairs (VA) developed specialized Homeless Patient Alignment Care Teams (HPACT) with the goal of offering an integrated, "one-stop program" to address housing and health care needs of homeless veterans. However, while 70% of HPACT's veteran enrollees have co-occurring mental health and substance use disorders, HPACT does not have a uniform, embedded treatment protocol for this subpopulation. One wraparound intervention designed to address the needs of homeless veterans with co-occurring mental health and substance use disorders which is suitable to be integrated into HPACT clinic sites is the evidence-based practice called Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Veterans Edition, or MISSION-Vet. Despite the promise of MISSION-Vet within HPACT clinics, implementation of an evidence-based intervention within a busy program like HPACT can be difficult. The current study is being undertaken to identify an appropriate implementation strategy for MISSION-Vet within HPACT. The study will test the implementation platform called Facilitation and compared to implementation as usual (IU). The aims of this study are as follows: (1) Compare the extent to which IU or Facilitation strategies achieve fidelity to the MISSION-Vet intervention as delivered by HPACT homeless provider staff. (2) Compare the effects of Facilitation and IU strategies on the National HPACT Performance Measures. (3) Compare the effects of IU and Facilitation on the permanent housing status. (4) Identify and describe key stakeholders' (patients, providers, staff) experiences with, and perspectives on, the barriers to, and facilitators of implementing MISSION. Type III Hybrid modified stepped wedge implementation comparing IU to Facilitation

  10. Implementing best practice in hospital multidisciplinary nutritional care: an example of using the knowledge-to-action process for a research program

    National Research Council Canada - National Science Library

    Laur, Celia; Keller, Heather H

    2015-01-01

    ...-based pathway for nutritional care in hospitals. The purpose of this paper is to detail the steps taken in this research program, through four studies, as an example of the knowledge-to-action (KTA) process...

  11. On implementation of an endodontic program.

    Science.gov (United States)

    Koch, Margaretha

    2013-01-01

    It is widely accepted that the uptake of research findings by practitioners is unpredictable, yet until they are adopted, advances in technology and clinical research cannot improve health outcomes in patients. Despite extensive research there is limited knowledge of the processes by which changes occur and ways of measuring the effectiveness of change of practice. The overall aim of this thesis was to investigate aspects of an educational intervention in clinical endodontic routines and new instrumentation techniques in a Swedish County Public Dental Service. Special reference was made to the establishment of changed behaviour in practice, the process of change, and the clinical effects. Although a high level of competence in root canal treatment procedures is required in general dental practice, a number of Swedish studies have revealed inadequate root-fillings quality and associated periapical inflammation in general populations. It is suggested that the adoption of the nickel-titanium rotary instrumentation (NiTiR) technique would improve the cleaning and shaping of root canals and the quality of the root-filling. However, there is limited knowledge of the effectiveness of the technique when applied in general dental practice. In two of four consecutive studies, the subjects were employees of a county Public Dental Service. The aim was to investigate the rate of adoption of clinical routines and the NiTiR technique: the output, and the qualitative meaning of successful change in clinical practice. In the other two studies the aim was to investigate treatment effect and the cost-effectiveness of root canal treatment in a general population: the outcome. Four hundred employees (dentists, dental assistants, administrative assistants and clinical managers) of a Swedish County Public Dental Service were mandatorily enrolled in an educational and training program over two years. Change of practice was investigated in a post-education survey. The NiTiR technique was

  12. Implementation of Metal Casting Best Practices

    Energy Technology Data Exchange (ETDEWEB)

    Eppich, Robert [Eppich Technologies, Syracuse, IN (United States); Naranjo, Robert D. [BCS, Inc., Laurel, MD (United States)

    2007-01-01

    The project examined cases where metal casters had implemented ITP research results and the benefits they received due to that implementation. In cases where casters had not implemented those results, the project examined the factors responsible for that lack of implementation. The project also informed metal casters of the free tools and service offered by the ITP Technology Delivery subprogram.

  13. The Triple P Implementation Framework: the Role of Purveyors in the Implementation and Sustainability of Evidence-Based Programs.

    Science.gov (United States)

    McWilliam, Jenna; Brown, Jacquie; Sanders, Matthew R; Jones, Liz

    2016-07-01

    Evidence-based programs are considered critical in the human services field if major social and health problems are to be addressed. Despite the large number of programs that have been developed and implemented, there is much to learn about how to effectively implement these programs in community settings. One perspective that is rarely represented in the literature is that of the purveyor organization (an organization that actively works to disseminate and support the implementation of a program or practice). This paper introduces the Triple P Implementation Framework, developed by the program's purveyor organization, and discusses principles underlying the design and implementation of the Framework. The Framework incorporates two key underlying principles of the Triple P system: minimal sufficiency and self-regulation. Lessons learned from the application of these principles and the implementation process are discussed, along with directions for future research.

  14. Implementation of Prevention Programs: Lessons for Future Research and Practice--A Commentary on Social and Emotional Learning-- Promoting the Development of All Students, a Chapter by Joseph E. Zins and Maurice J. Elias

    Science.gov (United States)

    Tanyu, Manolya

    2007-01-01

    Zins and his colleagues pointed out that understanding implementation of school-based prevention programs is a critical issue as we get more sophisticated about strategies to promote children's social and emotional skill development. This commentary discusses school-based program implementation, challenges, lessons learned, and future directions…

  15. Pediatric clinical handover: a best practice implementation project.

    Science.gov (United States)

    Yu, Zhuowen; Zhang, Yuxia; Gu, Ying; Xu, Xiaofeng; McArthur, Alexa

    2017-10-01

    Communication of information between and among healthcare providers is an essential element of patient care. Poor clinical handover has been associated with inaccurate clinical assessment and diagnosis, delays in diagnosis, medication errors and decreased patient satisfaction. Effective and efficient transition of patient care information requires an evidence-based handover approach. The aim of this evidence implementation project was to make a contribution to promote evidence-based practice in clinical handover in a pediatric setting and thereby enhance patient safety and service delivery. Seven criteria identified by the Joanna Briggs Institute were used to conduct an audit in the Gastroenterology Department, Children's Hospital of Fudan University, Shanghai, People's Republic of China. Twelve nurses and 260 handover sessions were involved. The JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit tools for promoting change in health practice were used to ascertain compliance with the criteria before and after the implementation of best practice. The program included three phases and was conducted over six months. There were improvements with compliance for each criterion. Face-to-face communication, standardized documentation, identification of patients, care plan handover and transfer of responsibility reached 100% compliance. Detailed observations of the patient improved from 93% to 98%, and there was an 18% improvement for relevant history handover. This project has demonstrated that handover sessions can be more effective by translating evidence into practice through ongoing evidence-based audit. Nursing inter-shift handover requires the use of a highly valuable and important standardized tool. Further audits will need to be carried out in order to maintain the practice change, and ensure the sustainability of the project.

  16. Factors Associated With Full Implementation of Scope of Practice.

    Science.gov (United States)

    Ganz, Freda DeKeyser; Toren, Orly; Fadlon, Yafit

    2016-05-01

    To describe whether nurses fully implement their scope of practice; nurses' perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self-efficacy. A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post-basic certification from two Israeli university hospitals, from May 2012 to September 2013. Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self-Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self-efficacy were the predictors. High levels of professional autonomy, self-efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self-efficacy, and attitudes towards future practice, but not with current implementation. Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers. Even though staff nurses with post-basic certification had high levels of professional autonomy and self-efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses

  17. A simple tool for implementation of US Farm Bill Programs: Can a practice-based index predict soil function in organic and conventional farming systems?

    Science.gov (United States)

    Nationally, the focus on soil quality and soil ecosystem function as a foundation for natural resource conservation is rising in importance. The 2002 Farm Bill’s Conservation Security Program (CSP) considers soil quality a key component for good land stewardship. Similarly, the draft Senate and Hous...

  18. RAY TRACING IMPLEMENTATION IN JAVA PROGRAMMING LANGUAGE

    Directory of Open Access Journals (Sweden)

    Aybars UĞUR

    2002-01-01

    Full Text Available In this paper realism in computer graphics and components providing realism are discussed at first. It is mentioned about illumination models, surface rendering methods and light sources for this aim. After that, ray tracing which is a technique for creating two dimensional image of a three-dimensional virtual environment is explained briefly. A simple ray tracing algorithm was given. "SahneIzle" which is a ray tracing program implemented in Java programming language which can be used on the internet is introduced. As a result, importance of network-centric ray tracing software is discussed.

  19. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  20. The implementation of the counterintelligence assistant program.

    OpenAIRE

    Kloster, Martin Gilbert

    1981-01-01

    Approved for public release; distribution is unlimited The implementation of a new program within the Army's Military Intelligence Branch, the enlisted Counterintelligence career management field, is described. The creation of the duty position Counterintelligence Assistant represents a major change to the field through the introduction of an entry skill level which did not previously exist. This change was primarily a result of a chronic shortage of personnel which fo...

  1. Implementation and outcomes of a comprehensive worksite health promotion program.

    Science.gov (United States)

    Renaud, Lise; Kishchuk, Natalie; Juneau, Martin; Nigam, Anil; Téreault, Karine; Leblanc, Marie-Claude

    2008-01-01

    This paper reports on the implementation and results of a three-year comprehensive worksite health promotion program called Take care of your health!, delivered at a single branch of a large financial organization with 656 employees at the beginning of the implementation period and 905 at the end. The program included six educational modules delivered over a three-year period. A global health profile was part of the first and last modules. The decision to implement the program coincided with an overall program of organizational renewal. The data for this evaluation come from four sources: analysis of changes in employee health profiles between the first and last program sessions (n=270); questionnaires completed by participating employees at the end of the program (n=169); organizational data on employee absenteeism and turnover; and qualitative interviews with company managers (n=9). Employee participation rates in the six modules varied between 39% and 76%. The assessment of health profile changes showed a significant increase in the Global Health Score. Participants were significantly more likely to report more frequent physical activity and better nutritional practices. The proportion of smokers among participants was significantly reduced (p = 0.0147). Also reduced significantly between the two measurements were self-assessment of high stress inside and outside the workplace, stress signs, and feelings of depression. Employees were highly satisfied with the program and felt that it had impacts on their knowledge and capacities to manage their health behaviour. During the same period, absenteeism in the organization declined by 28% and turnover by 54%. From the organization's perspective, program implementation was very successful. This study's results are in line with previous findings of significant benefits to organizations and employees from worksite health promotion. The close relationship between the program outcomes and the overall process of

  2. Pressure Safety Program Implementation at ORNL

    Energy Technology Data Exchange (ETDEWEB)

    Lower, Mark [ORNL; Etheridge, Tom [ORNL; Oland, C. Barry [XCEL Engineering, Inc.

    2013-01-01

    The Oak Ridge National Laboratory (ORNL) is a US Department of Energy (DOE) facility that is managed by UT-Battelle, LLC. In February 2006, DOE promulgated worker safety and health regulations to govern contractor activities at DOE sites. These regulations, which are provided in 10 CFR 851, Worker Safety and Health Program, establish requirements for worker safety and health program that reduce or prevent occupational injuries, illnesses, and accidental losses by providing DOE contractors and their workers with safe and healthful workplaces at DOE sites. The regulations state that contractors must achieve compliance no later than May 25, 2007. According to 10 CFR 851, Subpart C, Specific Program Requirements, contractors must have a structured approach to their worker safety and health programs that at a minimum includes provisions for pressure safety. In implementing the structured approach for pressure safety, contractors must establish safety policies and procedures to ensure that pressure systems are designed, fabricated, tested, inspected, maintained, repaired, and operated by trained, qualified personnel in accordance with applicable sound engineering principles. In addition, contractors must ensure that all pressure vessels, boilers, air receivers, and supporting piping systems conform to (1) applicable American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (2004) Sections I through XII, including applicable code cases; (2) applicable ASME B31 piping codes; and (3) the strictest applicable state and local codes. When national consensus codes are not applicable because of pressure range, vessel geometry, use of special materials, etc., contractors must implement measures to provide equivalent protection and ensure a level of safety greater than or equal to the level of protection afforded by the ASME or applicable state or local codes. This report documents the work performed to address legacy pressure vessel deficiencies and comply

  3. ISO 17025: practical benefits of implementing a quality system.

    Science.gov (United States)

    Honsa, Julie D; McIntyre, Deborah A

    2003-01-01

    As a laboratory certified to ISO 9001:2000 and accredited to ISO 17025, rtech laboratories has incorporated an overall system for technical and quality management, which results in benefits observed in daily laboratory practices. Technical requirements were updated to include the addition of formal personnel training plans and detailed records, method development and validation procedures, measurement of method uncertainty, and a defined equipment calibration and maintenance program. In addition, a stronger definition of the sample preparation process was documented to maintain consistency in sampling, and a more rigorous quality control monitoring program was implemented for chemistry and microbiology. Management quality improvements focused on document control to maintain consistent analytical processes, improved monitoring of supplier performance, a contract review process for documenting customer requirements, and a system for handling customer comments and complaints, with continuous improvement through corrective and preventive action procedures and audits. Quarterly management review of corrective actions, nonconforming testing, and proficiency testing aid in determining long-term trending. The practical benefits of these technical and management quality improvements are seen on a daily basis in the laboratory. Faster identification and resolution of issues regarding methods, personnel or equipment, improved customer satisfaction, meeting quality requirements of specialized customers, and overall increased laboratory business are all the result of implementing an effective quality system.

  4. Implementing Lean Practices: Managing the Transformation Risks

    OpenAIRE

    Antony Pearce; Dirk Pons

    2013-01-01

    Insightful implementation of lean is necessary for high-value manufacturing and is complementary to strategic decision making regarding manufacture. However lean can be difficult to implement in specific organisations. One of the difficulties is deciding which of the many lean tools to apply and when to apply them. A complicating factor is change management. Lean implementation is a transformational process and needs to support organisational development alongside process improvement. We deve...

  5. Implementation: Learning Builds the Bridge between Research and Practice

    Science.gov (United States)

    Hall, Gene E.; Hord, Shirley M.

    2011-01-01

    Introducing new practices alone seldom results in new practices being incorporated into ongoing classroom practices. The Concerns-Based Adoption Model (CBAM) provides a way to transfer new practices into the classroom. This article presents the Implementation Bridge, a metaphor for moving from the earlier or less advanced stages to the later or…

  6. Design Patterns : Implementation in video game programming

    OpenAIRE

    Le Van, Cuong

    2016-01-01

    The goal of this thesis was to develop Last Planets, a social mobile game for iOS devices. The game development theory and the design patterns are portrayed in the first part of this study. The second part presents how such theories are put into practice during the development of Last Planets. The completion of the project resulted in the launch of Last Planets during spring 2016. Multiple design patterns were chosen to be implemented within the code base. Patterns such as Observer, Strat...

  7. IMPLEMENTATION OF CORPORATE VALUATION TECHNIQUES IN PRACTICE

    Directory of Open Access Journals (Sweden)

    Kiss Anita

    2015-07-01

    Full Text Available This paper focuses on the main tools and techniques of firm valuation. One of the objectives in this paper is to present the reasons for such differences in value across different models, and to help in choosing the right model for a specific task. In today's management literature there are a lot of evaluation models, which based on the different approaches. The most important dimensions in the evaluation are the past performance analysis, the current value of the firm based on the forecast period and the appraisal of future opportunities. Nowadays it is quite problematic that these concepts regarding the valuation methods used in practice are not homogeneous. In view of the major principles is equal, but the details are different. In this paper my goal is to categorize the methods in the right section and to demonstrate the characteristics, advantages and disadvantages as well. This study proceeds as follow. The first section classifies and categorizes the different valuation approaches, which are the ratios based on accounting data, the asset-based approach, the income-based approach within the discounted cash flow models and the value added methods, the relative valuation, at last the real options. The second part presents the main features and implementation of the methods. Finally, the third section concludes what might be learned from this study. Based on the related literature reviewed and my previous researches I conclude that, in the evaluation, the problem is not that there are not enough models to complete the task but on the contrary, the selection of the appropriate model is the first challenge in the work. The different approaches lead to significantly different values. The other main finding of this work that, professionals involved in the assessment task explained the reason for the differences, and selection the correct model which is the best fit for the job. Considering the models described below a best model cannot be

  8. Primer: implementation of guideline-based programs for coronary care.

    Science.gov (United States)

    Eagle, Kim A; Koelling, Todd M; Montoye, Cecelia K

    2006-03-01

    The American College of Cardiology Acute Myocardial Infarction Guidelines Applied in Practice program in Michigan, USA, was an initiative designed to improve the quality of cardiovascular care by bringing the American College of Cardiology/American Heart Association practice guidelines to the point of care. The program consisted of three different projects, involving a total of 33 hospitals. The program was implemented in five phases-planning, tool implementation, monitoring of tool use, remeasurement and reporting of results-by use of a collaborative model, which included a series of learning sessions for staff members that focused on the five phases. The goal was to identify the highest care priorities for patients with acute coronary syndromes and to incorporate these into the care itself. This aim was achieved with a standardized set of clinical-care tools, such as admission orders and discharge contracts; the use of such tools is associated with improvement in adherence to guidelines. Strategies were, however, tailored to each hospital by local teams. Performance was assessed by the use of tracking tools, which facilitate rapid improvement by enabling key performance indicators founded on the guidelines to be monitored. Using qualitative surveys of the project leaders, we identified an optimum timeline and correlations between hospital-specific attributes and greater or lesser success in achieving positive change. In this review, we describe our experience and identify the most useful strategies for future implementation of such a project.

  9. Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity

    Directory of Open Access Journals (Sweden)

    Fagan Abigail A

    2008-01-01

    Full Text Available Abstract Background Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. Methods This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Results Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers, ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence. Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage. Student behavior and use of interactive teaching techniques (quality of delivery were positively related. No variables were related to student participation (student responsiveness. Conclusion Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that

  10. AES ALGORITHM IMPLEMENTATION IN PROGRAMMING LANGUAGES

    Directory of Open Access Journals (Sweden)

    Luminiţa DEFTA

    2010-12-01

    Full Text Available Information encryption represents the usage of an algorithm to convert an unknown message into an encrypted one. It is used to protect the data against unauthorized access. Protected data can be stored on a media device or can be transmitted through the network. In this paper we describe a concrete implementation of the AES algorithm in the Java programming language (available from Java Development Kit 6 libraries and C (using the OpenSSL library. AES (Advanced Encryption Standard is an asymmetric key encryption algorithm formally adopted by the U.S. government and was elected after a long process of standardization.

  11. Implementation as transfer between policy, research and practice in care.

    NARCIS (Netherlands)

    Heiligers, P.J.M.; Niet, A. van der

    2010-01-01

    Background: Health Services Research is policy related and results have an impact on practices. Implementation of research output into practices is performed with a variety of strategies. Type of policy intentions and research output create a specific context for implementation. The main question

  12. Teachers Implementing Entrepreneurship Education: Classroom Practices

    Science.gov (United States)

    Ruskovaara, Elena; Pihkala, Timo

    2013-01-01

    Purpose: This study aims to highlight the entrepreneurship education practices teachers use in their work. Another target is to analyze how these practices differ based on a number of background factors. Design/methodology/approach: This article presents a quantitative analysis of 521 teachers and other entrepreneurship education actors. The paper…

  13. Implementation of selective prevention for cardiometabolic diseases; are Dutch general practices adequately prepared?

    Science.gov (United States)

    Stol, Daphne M; Hollander, Monika; Nielen, Markus M J; Badenbroek, Ilse F; Schellevis, François G; de Wit, Niek J

    2018-03-01

    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 practices are adequately prepared. Therefore, the aim of this study is to assess the organizational preparedness of Dutch general practices and the facilitators and barriers for performing CMD-prevention in practices currently implementing selective CMD-prevention. Observational study. Dutch primary care. General practices. Organizational characteristics. General practices implementing selective CMD-prevention are more often organized as a group practice (49% vs. 19%, p = .000) and are better organized regarding chronic disease management compared to reference practices. They are motivated for performing CMD-prevention and can be considered as 'frontrunners' of Dutch general practices with respect to their practice organization. The most important reported barriers are a limited availability of staff (59%) and inadequate funding (41%). The organizational infrastructure of Dutch general practices is considered adequate for performing most steps of selective CMD-prevention. Implementation of prevention programs including easily accessible lifestyle interventions needs attention. All stakeholders involved share the responsibility to realize structural funding for programmed CMD-prevention. Aforementioned conditions should be taken into account with respect to future implementation of selective CMD-prevention. Key Points   There is need for adequate CMD prevention. Little is known about the organization of selective CMD prevention in general practices.   • The organizational infrastructure of Dutch general practices is adequate for performing most steps of selective CMD prevention.   • Implementation of selective CMD prevention programs including easily accessible

  14. Using implementation science as the core of the doctor of nursing practice inquiry project.

    Science.gov (United States)

    Riner, Mary E

    2015-01-01

    New knowledge in health care needs to be implemented for continuous practice improvement. Doctor of nursing practice (DNP) programs are designed to increase clinical practice knowledge and leadership skills of graduates. This article describes an implementation science course developed in a DNP program focused on advancing graduates' capacity for health systems leadership. Curriculum and course development are presented, and the course is mapped to depict how the course objectives and assignments were aligned with DNP Essentials. Course modules with rational are described, and examples of how students implemented assignments are provided. The challenges of integrating this course into the life of the school are discussed as well as steps taken to develop faculty for this capstone learning experience. This article describes a model of using implementation science to provide DNP students an experience in designing and managing an evidence-based practice change project. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Gavi HPV Programs: Application to Implementation

    Directory of Open Access Journals (Sweden)

    Celina M. Hanson

    2015-05-01

    Full Text Available Developing countries disproportionately suffer from the burden of cervical cancer yet lack the resources to establish systematic screening programs that have resulted in significant reductions in morbidity and mortality in developed countries. Human Papillomavirus (HPV vaccination provides an opportunity for primary prevention of cervical cancer in low-resource settings through vaccine provision by Gavi The Vaccine Alliance. In addition to the traditional national introduction, countries can apply for a demonstration program to help them make informed decisions for subsequent national introduction. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

  16. Gavi HPV Programs: Application to Implementation.

    Science.gov (United States)

    Hanson, Celina M; Eckert, Linda; Bloem, Paul; Cernuschi, Tania

    2015-05-20

    Developing countries disproportionately suffer from the burden of cervical cancer yet lack the resources to establish systematic screening programs that have resulted in significant reductions in morbidity and mortality in developed countries. Human Papillomavirus (HPV) vaccination provides an opportunity for primary prevention of cervical cancer in low-resource settings through vaccine provision by Gavi The Vaccine Alliance. In addition to the traditional national introduction, countries can apply for a demonstration program to help them make informed decisions for subsequent national introduction. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

  17. Open innovation practices and implementation barriers

    DEFF Research Database (Denmark)

    Burcharth, Ana Luiza Lara de Araújo; Søndergaard, Helle Alsted; Knudsen, Mette Præst

    A key organizational barrier related to the implementation of open innovation strategies refers to the unwillingness of employees to undertake extra-organizational knowledge transactions. Negative attitudes against the utilization of external knowledge (i.e. the Not-invented-here (NIH) syndrome...

  18. Solar-fuel generation: Towards practical implementation

    DEFF Research Database (Denmark)

    Dahl, Søren; Chorkendorff, Ib

    2012-01-01

    Limiting reliance on non-renewable fossil fuels inevitably depends on a more efficient utilization of solar energy. Materials scientists discuss the most viable approaches to produce high-energy-density fuels from sunlight that can be implemented in existing infrastructures....

  19. Practices and challenges of implementing locally available ...

    African Journals Online (AJOL)

    The main challenges of implementing LAE in teaching chemistry are lack of skills, interest and knowledge; lack of facilities and awareness problem of school principals. Therefore, giving planned and consecutive training for chemistry teachers and creating awareness for school principals solve the problems of utilizing LAE ...

  20. Implementation Research Workshop in Argentina: Moving Research into Practice

    Science.gov (United States)

    Research on implementation science addresses the level to which health interventions can fit within real-world public health and clinical service systems. The overall goal of the Introduction to Cancer Program Planning and Implementation Research Workshop was to train a critical mass of researchers, program managers, practitioners, and policy makers that can apply the knowledge gained on implementation and dissemination research to promote evidence-based interventions to reduce the cancer burden in the country and globally.

  1. Y-12 Site environmental protection program implementation plan (EPPIP)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    The Y-12 Plant Environmental Protection Program is conducted to: (1) protect public health and the environment from chemical and radiological releases occurring from current plant operations and past waste management and operational practices; (2) ensure compliance with federal, state, and local environmental regulations and DOE directives; (3) identify potential environmental problems; (4) evaluate existing environmental contamination and determine the need for remedial actions and mitigative measures; (5) monitor the progress of ongoing remedial actions and cleanup measures; and (6) inform the public of environmental issues relating to DOE operations. DOE Order 5400.1, General Environmental Protection Program, defines the general requirements for environmental protection programs at DOE facilities. This Environmental Protection Program Implementation Plan (EPPIP) defines the methods by which the Y-12 Plant staff will comply with the order by: (1) referencing environmental protection goals and objectives and identifying strategies and timetables for attaining them; (2) providing the overall framework for the design and implementation of the Y-12 Environmental Protection Program; and (3) assigning responsibilities for complying with the requirements of the order. The EPPIP is revised and updated annually.

  2. How GPs implement clinical guidelines in everyday clinical practice

    DEFF Research Database (Denmark)

    Videbæk Le, Jette; Hansen, Helle P; Riisgaard, Helle

    2015-01-01

    . Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. RESULTS: Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective......BACKGROUND: Clinical guidelines are considered to be essential for improving quality and safety of health care. However, interventions to promote implementation of guidelines have demonstrated only partial effectiveness and the reasons for this apparent failure are not yet fully understood....... OBJECTIVE: To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. METHODS: Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form...

  3. Implementing inclusive educational practices through partnerships ...

    African Journals Online (AJOL)

    This study reports on work in progress of a partnership between the University of Stellenbosch and three rural schools in a disadvantaged community, focused on the development of inclusive educational practices such as teaching, assessment and support in inclusive education. Recognizing the changing needs of the ...

  4. Implementing Lean Practices: Managing the Transformation Risks

    Directory of Open Access Journals (Sweden)

    Antony Pearce

    2013-01-01

    Full Text Available Insightful implementation of lean is necessary for high-value manufacturing and is complementary to strategic decision making regarding manufacture. However lean can be difficult to implement in specific organisations. One of the difficulties is deciding which of the many lean tools to apply and when to apply them. A complicating factor is change management. Lean implementation is a transformational process and needs to support organisational development alongside process improvement. We develop a method based on risk management to identify which lean tools are most appropriate for a specific organisational setting. This permits the situational and contingency variables to be accommodated in the lean transformation. The method is demonstrated by application to a small manufacturing organisation with a high-variety low-volume business model. Thus it is possible, given contextual knowledge of the organisation, to predict which lean methods are most important in the situation. This enables the prioritisation of organisational effort towards lean methods that are relevant to the organisation at that particular time in its development.

  5. Organization, management, implementation and value of ehr implementation in a solo pediatric practice.

    Science.gov (United States)

    Cooper, Jeffrey D

    2004-01-01

    This case study-based on this practice's application for the 2003 HIMSS Davies Award for Primary Care-describes the processes, costs and benefits of the implementation of an EHR in a solo practice. The organization, management and value of an EHR implementation is described, as well as a description of the physician's 15 business objectives, which shows how each objective was met and to what degree and gives specific financial data. An EHR that is implemented in a small practice improves quality of patient care, office efficiency and patient safety. A small practice can realize significant ROI from an EHR.

  6. Curriculum and Practice of an Innovative Teacher Professional Development Program

    Science.gov (United States)

    Horton, Akesha; Shack, Kyle; Mehta, Rohit

    2017-01-01

    The MSUrbanSTEM fellowship program provides exemplary urban STEM teachers the opportunity to engage in transformative instructional and leadership experiences that support the advancement of their teaching practice. In this chapter, we provide a foundational examination of the development and implementation of a curriculum for this innovative…

  7. Academic Program Approval and Review Practices

    Directory of Open Access Journals (Sweden)

    Don G. Creamer

    1999-08-01

    Full Text Available This report outlines general and specific processes for both program approval and program review practices found in 50 states and eight foreign countries and regions.  Models that depict these procedures are defined and the strengths and weakness of each are discussed.  Alternatives to current practice by state agencies in the U.S. are described that might provide for greater decentralization of these practices while maintaining institutional accountability.

  8. Implementation status and barriers of good manufacturing practice ...

    African Journals Online (AJOL)

    Removal of implementation barriers could be considered, including strengthening personnel competence, improving the quality management system and enhancing the international communication with advanced GMP regulators. Keywords: good manufacturing practice, GMP, Chinese patent medicine, traditional Chinese ...

  9. Practical design control implementation for medical devices

    CERN Document Server

    Justiniano, Jose

    2003-01-01

    Bringing together the concepts of design control and reliability engineering, this book is a must for medical device manufacturers. It helps them meet the challenge of designing and developing products that meet or exceed customer expectations and also meet regulatory requirements. Part One covers motivation for design control and validation, design control requirements, process validation and design transfer, quality system for design control, and measuring design control program effectiveness. Part Two discusses risk analysis and FMEA, designing-in reliability, reliability and design verific

  10. Implementing change in primary care practices using electronic medical records: a conceptual framework

    Directory of Open Access Journals (Sweden)

    Stuart Gail W

    2008-01-01

    improvement, leading to an iterative cycle of goal setting by leaders. Conclusion This conceptual framework provides a mental model which can serve as a guide for practice leaders implementing clinical guidelines in primary care practice using electronic medical records. Using the concepts as implementation and evaluation criteria, program developers and teams can stimulate improvements in their practice settings. Investing in collaborative team development of clinicians and staff may enable the practice environment to be more adaptive to change and improvement.

  11. Functional Reactive Programming on the Web - A Practical Evaluation

    OpenAIRE

    Young, Christian Strand

    2015-01-01

    The web as an application platform is rising rapidly. With more complex solutions written in JavaScript that run client-side, as well as server-side, challenges related to JavaScript's asynchronous nature arise. This thesis explores and applies the Functional Reactive Programming paradigm (FRP) on the web as an alternative to traditional imperative programming. The potential of FRP in a context of the web is shown through case implementations of general practical real world problems that web ...

  12. The Implementation of Sustainability Practices in Portuguese Higher Education Institutions

    Science.gov (United States)

    Aleixo, Ana Marta; Azeiteiro, Ulisses; Leal, Susana

    2018-01-01

    Purpose: The purpose of this work is to analyze the current state of implementation of sustainability development (SD) in Portuguese higher education institutions (HEIs). Design/methodology/approach: A questionnaire was developed to measure the level of implementation of SD practices in HEIs as well as the number of rankings, certifications and…

  13. A Model for Implementing Integrative Practice in Health Care Agencies

    Directory of Open Access Journals (Sweden)

    Chris Patterson

    2008-01-01

    Full Text Available Over the last few years, there has been increased awareness and use of complementary/alternative therapies (CAM in many countries without the health care infrastructure to support it. The National Centre for Complementary and Alternative Medicine referred to the combining of mainstream medical therapies and CAM as integrative medicine. The creation of integrative health care teams will definitely result in redefining roles, but more importantly in a change in how services are delivered. The purpose of this paper is to describe a model of the necessary health care agency resources to support an integrative practice model. A logic model is used to depict the findings of a review of current evidence. Logic models are designed to show relationships between the goals of a program or initiative, the resources to achieve desired outputs and the activities that lead to outcomes. The four major resource categories necessary for implementing integrative care are within the domains of a professional and research development, b health human resource planning, c regulation and legislation and d practice and management in clinical areas. It was concluded that the system outcomes from activities within these resource categories should lead to freedom of choice in health care; a culturally sensitive health care system and a broader spectrum of services for achieving public health goals.

  14. Developmental milestones across the programmatic life cycle: implementing the CDC's Colorectal Cancer Screening Demonstration Program.

    Science.gov (United States)

    Glover-Kudon, Rebecca; DeGroff, Amy; Rohan, Elizabeth A; Preissle, Judith; Boehm, Jennifer E

    2013-08-01

    In 2005 through 2009, the Centers for Disease Control and Prevention (CDC) funded 5 sites to implement a colorectal cancer screening program for uninsured, low-income populations. These 5 sites composed a demonstration project intended to explore the feasibility of establishing a national colorectal cancer screening program through various service delivery models. A longitudinal, multiple case study was conducted to understand and document program implementation processes. Using metaphor as a qualitative analytic technique, evaluators identified stages of maturation across the programmatic life cycle. Analysis rendered a working theory of program development during screening implementation. In early stages, program staff built relationships with CDC and local partners around screening readiness, faced real-world challenges putting program policies into practice, revised initial program designs, and developed new professional skills. Midterm implementation was defined by establishing program cohesiveness and expanding programmatic reach. In later stages of implementation, staff focused on sustainability and formal program closeout, which prompted reflection about personal and programmatic accomplishments. Demonstration sites evolved through common developmental stages during screening implementation. Findings elucidate ways to target technical assistance to more efficiently move programs along their maturation trajectory. In practical terms, the time and cost associated with guiding a program to maturity may be potentially shortened to maximize return on investment for both organizations and clients receiving service benefits. © 2013 American Cancer Society.

  15. IMPLEMENTATIONS AND PRACTICAL APPLICATIONS OF HYPERBOLIC METAMATERIALS

    Directory of Open Access Journals (Sweden)

    A. V. Shchelokova

    2014-03-01

    Full Text Available The paper presents a review on hyperbolic metamaterials which are normally described by the permittivity and permeability tensors with the components of the opposite sign. Therefore, the hyperbolic metamaterials have the hyperbolic isofrequency surfaces in the wave vector space. It leads to a number of unusual properties, such as the negative refraction, the diverging density of photonic states, ultra-high rate of spontaneous emission and increasing of subwavelength fields. The presence of the unique properties mentioned above makes the concept of hyperbolic metamaterials promising for research in modern science and explains the attempts of research groups around the world to realize structures with hyperbolic isofrequency curve suitable for applications in different frequency ranges. Hyperbolic metamaterials realized as layered metal-dielectric structures, arrays of nanowires, graphene layers, as well as artificial transmission lines are considered in the paper. Possible practical applications of hyperbolic metamaterials are described including hyperlens able to increase the nanoscale objects; wire mediums applied for spectroscopy to improve the resolution and increasing the distance to the object being scanned. Hyperbolic metamaterials are noted to be extremely promising for applications in nanophotonics, including single-photon generation, sensing and photovoltaics.

  16. Understanding and Implementing Best Practices in Accountability

    Directory of Open Access Journals (Sweden)

    Raisa Deber

    2017-03-01

    Full Text Available There has been much emphasis on accountability in health care in all jurisdictions across Canada. Using document analysis and key informant interviews, we assessed the extent to which the findings from our earlier Ontario-based study, Approaches to Accountability, applied across Canada. Accountability done well improves performance, improves the patient experience and promotes efficient use of resources. If implemented poorly, it can waste valuable resources, create perverse incentives and encourage gaming in the system. The findings of this study reinforced the earlier findings. Our respondents stressed that it was important to focus on the goals being sought and transition points in the system; they emphasized that resources and stable leadership were key. Although good metrics are essential, they are not always available. Accordingly, what is easily measured tends to be what is reported. Organizations are also reluctant to be held accountable for what they cannot control. They noted that too many organizations are asking for too many indicators in too many forms. Although this is particularly problematic for small organizations, it is not exclusive to them. Moving forward, it will be important to streamline and prioritize reporting metrics, ensure adequate resources are available to support accountability and educate users as to the value of reporting accountability activities, by showing them that there is something in it for them. In addition, it is important to encourage coordination and sharing among the multiple bodies that request similar information in different forms. Finally, it is important to ensure that that which is difficult to measure is not lost in the shuffle.

  17. 36 CFR 230.21 - Implementation of the program.

    Science.gov (United States)

    2010-07-01

    ... STATE AND PRIVATE FORESTRY ASSISTANCE Urban and Community Forestry Assistance Program § 230.21 Implementation of the program. (a) The Urban and Community Forestry Assistance Program is implemented through the... Service, under the authority of the Cooperative Forestry Assistance Act of 1978 and through the Urban and...

  18. Halal Logistics Implementation in Malaysia: A Practical View

    Science.gov (United States)

    Sham, Rohana; Zuraidah Rasi, Raja; Abdamia, Noranita; Mohamed, Suhana; Thahira Bibi, TKM

    2017-08-01

    Concept of halal is not only acceptable world wide by the Muslim society but also to the non Muslim. However, the implementing of halal logistics in daily operation experience a few difficulties especially on the implementation part. Although there are many academic research paper that highlight the issue of halal logistics and the critical success factor, until today, halal logistics in Malaysia is still experiencing a hiccup. This paper try to highlight a few simple ways of implementation of halal logistics that could enhance the total implementation concept at the very least cost to create benefit to all society. The Paper deals with a few aspect of possible implementation and practice to facilitate the halal logistics approach in daily operation. The main objective is to look at the possible method of implementation and critical success factors towards the implementation of halal logistics operation in daily goods movement in Malaysia.

  19. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping.

    Science.gov (United States)

    Green, Amy E; Aarons, Gregory A

    2011-09-07

    The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

  20. Effective Practices for Evaluating Education and Public Outreach Programs

    Science.gov (United States)

    Wilkerson, S.

    2013-12-01

    Stephanie Baird Wilkerson, PhD Carol Haden EdD Magnolia Consulting,LLC Education and public outreach (EPO) program developers and providers seeking insights regarding effective practices for evaluating EPO activities programs benefit from understanding why evaluation is critical to the success of EPO activities and programs, what data collection methods are appropriate, and how to effectively communicate and report findings. Based on our extensive experience evaluating EPO programs, we will share lessons learned and examples of how these practices play out in actual evaluation studies. EPO program developers, providers, and evaluators must consider several factors that influence which evaluation designs and data collection methods will be most appropriate, given the nature of EPO programs. Effective evaluation practices of EPO programs take into account a program's phase of development, duration, and budget as well as a program's intended outcomes. EPO programs that are just beginning development will have different evaluation needs and priorities than will well-established programs. Effective evaluation practices consider the 'life' of a program with an evaluation design that supports a program's growth through various phases including development, revision and refinement, and completion. It would be premature and inappropriate to expect the attainment of longer-term outcomes of activities during program development phases or early stages of implementation. During program development, EPO providers should clearly define program outcomes that are feasible and appropriate given a program's scope and expected reach. In many respects, this directly relates to the amount of time, or duration, intended audiences participate in EPO programs. As program duration increases so does the likelihood that the program can achieve longer-term outcomes. When choosing which outcomes are reasonable to impact and measure, program duration should be considered. Effective evaluation

  1. Implementation and evaluation of a nursing home fall management program.

    Science.gov (United States)

    Rask, Kimberly; Parmelee, Patricia A; Taylor, Jo A; Green, Diane; Brown, Holly; Hawley, Jonathan; Schild, Laura; Strothers, Harry S; Ouslander, Joseph G

    2007-03-01

    To evaluate the feasibility and effectiveness of a falls management program (FMP) for nursing homes (NHs). A quality improvement project with data collection throughout FMP implementation. NHs in Georgia owned and operated by a single nonprofit organization. All residents of participating NHs. A convenience sample of 19 NHs implemented the FMP. The FMP is a multifaceted quality improvement and culture change intervention. Key components included organizational leadership buy-in and support, a designated facility-based falls coordinator and interdisciplinary team, intensive education and training, and ongoing consultation and oversight by advanced practice nurses with expertise in falls management. Process-of-care documentation using a detailed 24-item audit tool and fall and physical restraint use rates derived from quality improvement software currently used in all Georgia NHs (MyInnerView). Care process documentation related to the assessment and management of fall risk improved significantly during implementation of the FMP. Restraint use decreased substantially during the project period, from 7.9% to 4.4% in the intervention NHs (a relative reduction of 44%), and decreased in the nonintervention NHs from 7.0% to 4.9% (a relative reduction of 30%). Fall rates remained stable in the intervention NHs (17.3 falls/100 residents per month at start and 16.4 falls/100 residents per month at end), whereas fall rates increased 26% in the NHs not implementing the FMP (from 15.0 falls/100 residents/per month to 18.9 falls/100 residents per month). Implementation was associated with significantly improved care process documentation and a stable fall rate during a period of substantial reduction in the use of physical restraints. In contrast, fall rates increased in NHs owned by the same organization that did not implement the FMP. The FMP may be a helpful tool for NHs to manage fall risk while attempting to reduce physical restraint use in response to the Centers for

  2. Practical operational implementation of Teton Pass avalanche monitoring infrasound system.

    Science.gov (United States)

    2008-12-01

    Highway snow avalanche forecasting programs typically rely on weather and field observations to make road closure and hazard : evaluations. Recently, infrasonic avalanche monitoring technology has been developed for practical use near Teton Pass, WY ...

  3. STEM Intervention Programs: Funding Practices and Challenges

    Science.gov (United States)

    Rincon, Blanca E.; George-Jackson, Casey E.

    2016-01-01

    This study examines the funding practices and challenges of diversity initiatives found in the science, technology, engineering, and mathematics (STEM) fields. Interviews with 55 intervention program administrators, representing 48 unique STEM intervention programs, were conducted at nine large research-intensive universities. The interviews,…

  4. Impact of a multifaceted education program on implementing a pediatric palliative care guideline : a pilot study

    NARCIS (Netherlands)

    Jagt-van Kampen, Charissa Thari; Kremer, Leontien C. M.; Verhagen, A. A. Eduard; Schouten-van Meeteren, Antoinette Y. N.

    2015-01-01

    Background: A national clinical practice guideline for pediatric palliative care was published in 2013. So far there are only few reports available on whether an educational program fosters compliance with such a guideline implementation. We aimed to test the effect of the education program on

  5. Implementing Intervention Movement Programs for Kindergarten Children

    Science.gov (United States)

    Deli, Eleni; Bakle, Iliana; Zachopoulou, Evridiki

    2006-01-01

    The reported study aimed to identify the effects of two 10-week intervention programs on fundamental locomotor skill performance in kindergarten children. Seventy-five children with mean age 5.4 plus or minus 0.5 years participated. Experimental Group A followed a movement program, experimental Group B followed a music and movement program, and…

  6. Implementation of good manufacturing practices (GMP) on human blood irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Boghi, Claudio; Napolitano, Celia M.; Ferreira, Danilo C.; Rela, Paulo Roberto [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)]. E-mails: cboghi@uol.com.br; cmnapoli@ipen.br; dancarde@ig.com.br; prela@ipen.br; Zarate, Herman S. [Comission Chilena de Energia Nuclear, Santiago (Chile)]. E-mail: hzarate@cchen.cl

    2007-07-01

    The irradiation of human blood is used to avoid the TA-GVHD (transfusion-associated graft-versus-host-disease), a rare but devastating adverse effect of leukocytes present in blood components for a immuno-competent transfusion recipients. Usually this irradiation practice is performed to a physical elimination of lymphocytes. The implementation of the GMP will assure that the properly dose in a range of 25 Gy to 50 Gy will be delivered to the blood in the bag collected in a blood tissue bank. The studies to establish the GMP were developed under the guidelines of the standard ISO 11137 - Sterilization of health care products - Requirements for validation and routine control - Radiation sterilization. In this work, two dosimetric systems were used for dose mapping during the studies of irradiator qualification, loading pattern, irradiation process validation and auditing. The CaSO{sub 4}: Dy dosimeter presented difficulties concerning to uncertainty on dose measurement, stability, trace ability and calibration system. The PMMA and gafchromic dosimetric systems have shown a better performance and were adopted on establishment of GMP procedures. The irradiation tests have been done using a Gammacell 220 Irradiator. The developed GMP can be adapted for different types of gamma irradiators, allowing to set up a quality assurance program for blood irradiation. (author)

  7. Implementing a Hybrid Graduate Program: Lessons Learned One Year Later

    Directory of Open Access Journals (Sweden)

    Ronda Sturgill

    2016-06-01

    Full Text Available Development of any graduate program is an extensive and timely process. Once the development phase is complete the program continues into the implementation phase. The implementation phase of a hybrid delivered program can present with many challenges. The purpose of this paper is to describe the implementation and challenges of delivering a hybrid graduate program. This is a follow-up paper to "Developing a Hybrid Graduate Program," [4]. This follow-up will provide information from both a faculty and graduate student perspective. Challenges of implementation, lessons learned, and future program delivery recommendations will also be presented.[4] R. Sturgill, J. Wilson, and J.C. Andersen, "Developing a Hybrid Graduate Program," Journal of Systemics, Cybernetics, and Informatics, Vol. 12, No. 7, 2014, pp. 22-24.

  8. School wellness team best practices to promote wellness policy implementation.

    Science.gov (United States)

    Profili, Erika; Rubio, Diana S; Lane, Hannah G; Jaspers, Lea H; Lopes, Megan S; Black, Maureen M; Hager, Erin R

    2017-08-01

    Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52.4% response rate, 2012-2013 school year) was administered that included LWP implementation (17-item scale: categorized as no, low, and high implementation) and six wellness team best practices. Analyses included multi-level multinomial logistic regression. Wellness teams were present in 311/707 (44.0%) schools, with no (19.6%), low (36.0%), and high (44.4%) LWP implementation. A sum score representing active wellness teams (mean=2.6) included: setting healthy eating/physical activity goals (66.9%), informing the public of LWP activities (71.4%), meeting ≥4times/year (45.8%), and having school staff (46.9%), parent (25.4%), or student (14.8%) representation. In adjusted models, goal setting, meeting ≥4times/year, and student representation were associated with high LWP implementation. For every one-unit increase in active wellness team sum score, schools were 41% more likely to be in high versus no implementation (Likelihood Ratio=1.41, 95% C.I.=1.13, 1.76). In conclusion, wellness teams meeting best practices are more likely to implement LWPs. Interventions should focus on the formation of wellness teams with recommended composition/activities. Study findings provide support for wellness team recommendations stemming from the 2016 Healthy, Hunger-Free Kids Act final rule. Copyright © 2017. Published by Elsevier Inc.

  9. Best Practices for Robotic Surgery Programs.

    Science.gov (United States)

    Estes, Stephanie J; Goldenberg, David; Winder, Joshua S; Juza, Ryan M; Lyn-Sue, Jerome R

    2017-01-01

    Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations. Guidelines for hospitals and robotic directors that can be applied to one's own robotic surgical services are included with examples of management of all aspects of a multispecialty robotic surgery program. The use of these best practices will ensure a robotic surgery program that is successful and well positioned for a safe and productive environment for current clinical practice.

  10. A practical implementation science heuristic for organizational readiness: R = MC2

    Science.gov (United States)

    Cook, Brittany S.; Lamont, Andrea; Wandersman, Abraham; Castellow, Jennifer; Katz, Jason; Beidas, Rinad S.

    2015-01-01

    There are many challenges when an innovation (i.e., a program, process, or policy that is new to an organization) is actively introduced into an organization. One critical component for successful implementation is the organization’s readiness for the innovation. In this article, we propose a practical implementation science heuristic, abbreviated as R= MC2. We propose that organizational readiness involves: 1) the motivation to implement an innovation, 2) the general capacities of an organization, and 3) the innovation-specific capacities needed for a particular innovation. Each of these components can be assessed independently and be used formatively. The heuristic can be used by organizations to assess readiness to implement and by training and technical assistance providers to help build organizational readiness. We present an illustration of the heuristic by showing how behavioral health organizations differ in readiness to implement a peer specialist initiative. Implications for research and practice of organizational readiness are discussed. PMID:26668443

  11. A practical implementation science heuristic for organizational readiness: R = MC2.

    Science.gov (United States)

    Scaccia, Jonathan P; Cook, Brittany S; Lamont, Andrea; Wandersman, Abraham; Castellow, Jennifer; Katz, Jason; Beidas, Rinad S

    2015-04-01

    There are many challenges when an innovation (i.e., a program, process, or policy that is new to an organization) is actively introduced into an organization. One critical component for successful implementation is the organization's readiness for the innovation. In this article, we propose a practical implementation science heuristic, abbreviated as R= MC2 . We propose that organizational readiness involves: 1) the motivation to implement an innovation, 2) the general capacities of an organization, and 3) the innovation-specific capacities needed for a particular innovation. Each of these components can be assessed independently and be used formatively. The heuristic can be used by organizations to assess readiness to implement and by training and technical assistance providers to help build organizational readiness. We present an illustration of the heuristic by showing how behavioral health organizations differ in readiness to implement a peer specialist initiative. Implications for research and practice of organizational readiness are discussed.

  12. 46 CFR 16.205 - Implementation of chemical testing programs.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Implementation of chemical testing programs. 16.205 Section 16.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN CHEMICAL TESTING Required Chemical Testing § 16.205 Implementation of chemical testing programs. (a) When a...

  13. Embedding research to improve program implementation in Latin America and the Caribbean.

    Science.gov (United States)

    Tran, Nhan; Langlois, Etienne V; Reveiz, Ludovic; Varallyay, Ilona; Elias, Vanessa; Mancuso, Arielle; Becerra-Posada, Francisco; Ghaffar, Abdul

    2017-06-08

    In the last 10 years, implementation research has come to play a critical role in improving the implementation of already-proven health interventions by promoting the systematic uptake of research findings and other evidence-based strategies into routine practice. The Alliance for Health Policy and Systems Research and the Pan American Health Organization implemented a program of embedded implementation research to support health programs in Latin America and the Caribbean (LAC) in 2014-2015. A total of 234 applications were received from 28 countries in the Americas. The Improving Program Implementation through Embedded Research (iPIER) scheme supported 12 implementation research projects led by health program implementers from nine LAC countries: Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Saint Lucia. Through this experience, we learned that the "insider" perspective, which implementers bring to the research proposal, is particularly important in identifying research questions that focus on the systems failures that often manifest in barriers to implementation. This paper documents the experience of and highlights key conclusions about the conduct of embedded implementation research. The iPIER experience has shown great promise for embedded research models that place implementers at the helm of implementation research initiatives.

  14. Child Protection Program Implementations in Sport Management

    National Research Council Canada - National Science Library

    Özgün PARASIZ; Mustafa Yaşar ŞAHİN; Akın ÇELİK

    2015-01-01

    ... of the most important social responsibilites of states in this day and age. In the fight against this problem, especially developed countries promote chi ld protection policies and implement them in every sport field children take active part...

  15. Nursing best practice statements: an exploration of their implementation in clinical practice.

    Science.gov (United States)

    Ring, Nicola; Malcolm, Cari; Coull, Alison; Murphy-Black, Tricia; Watterson, Andrew

    2005-10-01

    To explore implementation of the first five Best Practice Statements from the perspective of nurses involved in their development. Best Practice Statements were introduced in Scotland to encourage consistent evidence-based nursing practice. As a new initiative, research was required to investigate their clinical implementation. In this descriptive study, semi-structured interviews of a purposive sample of nurses (n = 15) were undertaken. Content analysis was used to identify themes emerging from the interview data. Four main themes emerged from analysis of transcripts: variations in use of the Best Practice Statements; benefits to patients; benefits to practitioners; and, barriers and drivers to use. Amongst participants, personal users adopted the statements in their own practice but enablers also actively encouraged others to use the statements. Whether participants acted as enablers depended on individual, team and organizational factors. The ability of participants to act as leaders was influential in determining their ability both to facilitate local implementation and to encourage others to regard the Best Practice Statements as a priority for implementation. This exploratory study highlighted examples of patients and practitioners benefiting from the Best Practice Statements. Such findings suggest these statements could become a useful tool in promoting evidence-based nursing practice. However, implementation of the Best Practice Statements varied between participants and their organizations. Nurses who were most effective in promoting local implementation of the Best Practice Statements adopted facilitator and leadership roles within their organizations. By relating research findings to the literature on guideline and research utilization, this study gives further insight into the implementation of evidence-based practice by nurses. In particular, it supports the conclusion that to be truly effective, initiatives to promote evidence-based practice require

  16. Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

    Science.gov (United States)

    John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

    2014-04-01

    Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

  17. Material Programming: A New Interaction Design Practice

    DEFF Research Database (Denmark)

    Vallgårda, Anna; Boer, Laurens; Tsaknaki, Vasiliki

    2016-01-01

    We propose the notion of material programming as a new practice for designing future interactive artifacts. Material programming would be a way for the interaction designer to better explore the dynamics of the materials at hand and through that familiarity be able to compose more sophisticated...... and complex temporal forms in their designs. As such it would blur the boundaries between programming and crafting these new smart and computational materials. We envision a material programming practice developed around physical tools (e.g. Fig 1) that draw on bodily skills and experiences (Fig 2) while...... enabling actions performed directly on the material with immediate effects (no program vs. execution mode). Finally, the tools would enable one layer of abstraction and as such encompass the potential of the computational materials but not that of possibly adjacent computers, which could run more complex...

  18. Strengthening organizations to implement evidence-based clinical practices.

    Science.gov (United States)

    VanDeusen Lukas, Carol; Engle, Ryann L; Holmes, Sally K; Parker, Victoria A; Petzel, Robert A; Nealon Seibert, Marjorie; Shwartz, Michael; Sullivan, Jennifer L

    2010-01-01

    Despite recognition that implementation of evidence-based clinical practices (EBPs) usually depends on the structure and processes of the larger health care organizational context, the dynamics of implementation are not well understood. This project's aim was to deepen that understanding by implementing and evaluating an organizational model hypothesized to strengthen the ability of health care organizations to facilitate EBPs. CONCEPTUAL MODEL: The model posits that implementation of EBPs will be enhanced through the presence of three interacting components: active leadership commitment to quality, robust clinical process redesign incorporating EBPs into routine operations, and use of management structures and processes to support and align redesign. In a mixed-methods longitudinal comparative case study design, seven medical centers in one network in the Department of Veterans Affairs participated in an intervention to implement the organizational model over 3 years. The network was selected randomly from three interested in using the model. The target EBP was hand-hygiene compliance. Measures included ratings of implementation fidelity, observed hand-hygiene compliance, and factors affecting model implementation drawn from interviews. Analyses support the hypothesis that greater fidelity to the organizational model was associated with higher compliance with hand-hygiene guidelines. High-fidelity sites showed larger effect sizes for improvement in hand-hygiene compliance than lower-fidelity sites. Adherence to the organizational model was in turn affected by factors in three categories: urgency to improve, organizational environment, and improvement climate. Implementation of EBPs, particularly those that cut across multiple processes of care, is a complex process with many possibilities for failure. The results provide the basis for a refined understanding of relationships among components of the organizational model and factors in the organizational context

  19. Implementing a Multidisciplinary Program for Developing Learning,

    Science.gov (United States)

    Mc Goldrick, Niamh B.; Marzec, Bartosz; Scully, P. Noelle; Draper, Sylvia M.

    2013-01-01

    Since 2002, a multidisciplinary program has been used to encourage science students to build on their chemical knowledge and to appreciate how it applies to the world around them. The program is interactive and instills a new set of core learning skills that are often underrepresented in undergraduate curricula, namely, cooperative learning,…

  20. Factors influencing the implementation of evidence in Chinese nursing practice.

    Science.gov (United States)

    Cheng, Lei; Broome, Marion E; Feng, Sheng; Hu, Yan

    2017-12-01

    To explore the influencing factors from staff nurses, nurse managers, nursing directors and a physician involved in nursing evidence implementation in Mainland China. Although the need for evidence-based nursing is well recognised, continuous efforts are needed to strive for closing the gap from evidence to action. Previous studies have explored influencing factors from individual and organisational perspectives in Western countries. However, it remains unclear what the influences (i.e., context and culture) in the developing countries as China. A grounded theory design using in-depth individual interviews was conducted. Interviews with 56 participants from 24 evidence-based nursing implementation projects were conducted in Mainland China. Constant comparative analysis was used to discover the concepts describing the influencing factors during the implementation process. Factors that influenced implementation of evidence-based practice in the Chinese context were identified. These included the leaders of the projects, the nature of the evidence, practising nurses, patients involved in the projects, the system where the projects were implemented, as well as the influence from outside of the system. A variety of factors influencing evidence implementation in Chinese nursing context were identified and further explored from the perspective of different project leaders and culture influence. There is apparently a strong demand for a supportive system, targeted strategies to facilitate various evidence implementations and integrated core elements of evidence-based practice at the point care. The blurred boundaries and complexity of influencing factors call for a systematic and dynamic perspective during implementation. The competitive priorities emphasise the importance of integration between clinical nursing care and evidence-based practice. © 2017 John Wiley & Sons Ltd.

  1. Implementing Effective Educational Practices at Scales of Social Importance.

    Science.gov (United States)

    Horner, Robert H; Sugai, George; Fixsen, Dean L

    2017-03-01

    Implementing evidence-based practices is becoming both a goal and standard across medicine, psychology, and education. Initial successes, however, are now leading to questions about how successful demonstrations may be expanded to scales of social importance. In this paper, we review lessons learned about scaling up evidence-based practices gleaned from our experience implementing school-wide positive behavioral interventions and supports (PBIS) across more than 23,000 schools in the USA. We draw heavily from the work of Flay et al. (Prev Sci 6:151-175, 2005. doi: 10.1007/s11121-005-5553-y ) related to defining evidence-based practices, the significant contributions from the emerging "implementation science" movement (Fixsen et al. in Implementation research: a synthesis of the literature, University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231), Tampa 2005), and guidance we have received from teachers, family members, students, and administrators who have adopted PBIS.

  2. Responsive feeding: implications for policy and program implementation.

    Science.gov (United States)

    Engle, Patrice L; Pelto, Gretel H

    2011-03-01

    In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation.

  3. Responsive Feeding: Implications for Policy and Program Implementation12

    Science.gov (United States)

    Engle, Patrice L.; Pelto, Gretel H.

    2011-01-01

    In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation. PMID:21270361

  4. Practical Implementation of Cooperative RRM for IMT-Advanced Systems

    DEFF Research Database (Denmark)

    Mihovska, Albena D.; Tragos, Elias; Kyriazakos, Sofoklis

    2008-01-01

    This paper describes a practical implementation of a radio resource management (RRM) framework for support of cooperation between radio access networks (RANs). The platform supports the inter-working between a next generation RAN and legacy systems (i.e., WLAN, UMTS). The platform is based on rea...

  5. Implementation Fidelity Affects the Degree of Change in Teacher Practice

    Science.gov (United States)

    Killion, Joellen

    2016-01-01

    In each issue of "JSD," Joellen Killion explores a recent research study to help practitioners understand the impact of particular professional learning practices on student outcomes. In this issue, she describes Z. Kisa and R. Correnti's 2015 longitudinal study of fidelity of implementation of principles of reform-aligned professional…

  6. Implementation of measurement instruments in physical therapist practice

    NARCIS (Netherlands)

    Anita Stevens

    2010-01-01

    The use of measurement instruments has become a major issue in physical therapy, but their use in daily practice is infrequent. The aims of this case report were to develop and evaluate a plan for the systematic implementation of two measurement instruments frequently recommended in Dutch physical

  7. Creating Tesselations with Pavement Chalk: Implementing Best Practices in Mathematics

    Science.gov (United States)

    Furner, Joseph M.; Goodman, Barbara; Meeks, Shirley

    2004-01-01

    Implementing best practices like cooperative learning, using concrete manipulatives, problem solving, technology, active learning, multi-age grouping, and team teaching have shown benefits for students when learning mathematics concepts within the curriculum (Zemelman, Daniels & Hyde, 1998; NCTM, 2000). What started as a professional development…

  8. factors affecting implementation of practical activities in science

    African Journals Online (AJOL)

    Temechegn

    Academically less prepared students of secondary schools prefer humanities and social sciences than science and technology in higher education. The majority of students in schools of the study area join social science. Therefore assessing factors affecting implementation of practical activities in science education in study ...

  9. Factors affecting implementation of practical activities in science ...

    African Journals Online (AJOL)

    The implementation process of practices in science education is limited in Ethiopian schools and students in Ethiopia generally perform poorly in science subjects at secondary schools. Academically less prepared students of secondary schools prefer humanities and social sciences than science and technology in higher ...

  10. Preparing Early Interventionists to Implement Family-Centered Practices

    Science.gov (United States)

    Hile, Kimberly A.; Milagros Santos, Rosa; Hughes, Mary-alayne

    2016-01-01

    The reauthorization of IDEA in 1997 placed greater emphasis on providing early intervention services to the family unit versus solely focusing on children with disabilities or children who are at risk for disabilities. Due to the shift from child-focused services to family-focused services, the need to implement family-centered practices became…

  11. Implementing Environmental Practices for Accomplishing Sustainable Green Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Minkyun Kim

    2017-07-01

    Full Text Available With the emergence of environmental protection as a global issue, implementing environmental practices for sustaining green supply chain management (GSCM has received a lot of attention. This study investigates the impact of integration with suppliers and supply disruption risk on environmental practices. It also examines the role of supplier integration and supply disruption risk on performance. Finally, it investigates the relationship between environmental practices and performance in order to sustain green supply chains. Based on 272 survey responses from supply and purchase managers, our research results support the positive impact of integration with suppliers and the negative impact of supply disruption risk on the adoption of environmental practices. Furthermore, they provide empirical evidence that environmental practices and integration with suppliers are positively associated with performance, while supply disruption risk is negatively associated with performance. This study identifies antecedents and establishes a research framework of GSCM. More importantly, it provides meaningful insights to managers regarding the implementation of environmental practices related to other supply chain practices for sustaining green supply chains.

  12. Large-Scale Linear Optimization through Machine Learning: From Theory to Practical System Design and Implementation

    Science.gov (United States)

    2016-08-10

    AFRL-AFOSR-JP-TR-2016-0073 Large-scale Linear Optimization through Machine Learning: From Theory to Practical System Design and Implementation...2016 4.  TITLE AND SUBTITLE Large-scale Linear Optimization through Machine Learning: From Theory to Practical System Design and Implementation 5a...CONTRACT NUMBER 5b.  GRANT NUMBER FA2386-14-1-4058 5c.  PROGRAM ELEMENT NUMBER 61102F 6.  AUTHOR(S) Jinwoo Shin 5d.  PROJECT NUMBER 5e.  TASK NUMBER

  13. Evidence-Based Practice: The Psychology of EBP Implementation.

    Science.gov (United States)

    Rousseau, Denise M; Gunia, Brian C

    2016-01-01

    Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation.

  14. The layered learning practice model: Lessons learned from implementation.

    Science.gov (United States)

    Pinelli, Nicole R; Eckel, Stephen F; Vu, Maihan B; Weinberger, Morris; Roth, Mary T

    2016-12-15

    Pharmacists' views about the implementation, benefits, and attributes of a layered learning practice model (LLPM) were examined. Eligible and willing attending pharmacists at the same institution that had implemented an LLPM completed an individual, 90-minute, face-to-face interview using a structured interview guide developed by the interdisciplinary study team. Interviews were digitally recorded and transcribed verbatim without personal identifiers. Three researchers independently reviewed preliminary findings to reach consensus on emerging themes. In cases where thematic coding diverged, the researchers discussed their analyses until consensus was reached. Of 25 eligible attending pharmacists, 24 (96%) agreed to participate. The sample was drawn from both acute and ambulatory care practice settings and all clinical specialty areas. Attending pharmacists described several experiences implementing the LLPM and perceived benefits of the model. Attending pharmacists identified seven key attributes for hospital and health-system pharmacy departments that are needed to design and implement effective LLPMs: shared leadership, a systematic approach, good communication, flexibility for attending pharmacists, adequate resources, commitment, and evaluation. Participants also highlighted several potential challenges and obstacles for organizations to consider before implementing an LLPM. According to attending pharmacists involved in an LLPM, successful implementation of an LLPM required shared leadership, a systematic approach, communication, flexibility, resources, commitment, and a process for evaluation. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  15. Implementation of an Arranged Preventive Consultation in Danish General Practice

    DEFF Research Database (Denmark)

    Junge, Anne Gram; Kirkegaard, Pia; Thomsen, Janus Laust

    Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences...... with the arranged preventive consultation with focus on facilitators and barriers in the implementation of the consultation. Material & Method: Semi-structured interviews with 10 GPs and nurses in general practice. Results & Conclusions: Economically lucrative services are not an isolated motivation for the GPs....../nurses, but must be accompanied with a basic belief in the effect of preventive consultations in general practice. The better payment of the 0106-service is used to spend more time per consultation and it makes the GPs/nurses feel rewarded for the preventive work they perform. The consultation frames a social...

  16. International Mentoring Programs: Leadership Opportunities to Enhance Worldwide Pharmacy Practice.

    Science.gov (United States)

    Ubaka, Chukwuemeka; Brechtelsbauer, Erich; Goff, Debra A

    2017-07-01

    Health-system and community pharmacy practice in the United States is experiencing transformational change; however, this transformation is lagging in the international arena. As a result, efforts are being made to provide support and education to the international pharmacy leaders and practitioners. This article describes one effort, the Mandela Washington Fellows Program, and suggests areas where pharmacy leaders can be involved to help advance the practice of pharmacy on an international level. The Mandela Washington Fellows Program for young Africa leaders consists of a US-Africa pharmacy-mentoring program identified ranging from educational opportunities to collaboration for implementation of patient care programs. The specifics of the mentoring program include daily meetings, clinic and ward rounds, round table discussions with mentors, and visits to various hospital care systems. Lessons were learned and strategies for sustaining the program are discussed. These types of programs represent leadership opportunities that may not be apparent to most pharmacy directors, but expanding their view to helping international pharmacists expand their practice only strengthens the professional goal of providing patient-centered pharmacy services.

  17. National Reform Programs in Local Practices

    DEFF Research Database (Denmark)

    Hjelholt, Morten; Jensen, Tina Blegind

    with strategic intentions. First we present how the national reform program is translated into a local government by the evoking of historically produced and context dependent discourses. Next we show that locally produced discourses need to be evoked and re-attached to the national reform program in order......This paper investigates how discourse can be mobilized as a strategic resource when introducing a public sector reform program in a local government setting. We explore how actual day-to-day practices, contexts, and processes relate to the shaping and localizing of broad strategic discourses....... In particular, we emphasize the practices in which national strategic formulations are legitimized and accepted or abandoned by the actors involved. Building on a case study conducted over a two-year time span, we show how a local actor engages with and promotes a national reform program by evoking a discourse...

  18. Implementing portfolio in postgraduate general practice training. Benefits and recommendations.

    Science.gov (United States)

    Alotaibi, Fawaz S

    2012-10-01

    This paper presents a review to explore the literature focusing on portfolio in postgraduate general practice (GP) training, and to examine the impact of implementation of portfolio on learning process, as well as proposing recommendations for its implementation in postgraduate GP training. An electronic search was carried out on several databases for studies addressing portfolio in postgraduate GP training. Six articles were included to address specifically the effectiveness of portfolio in postgraduate GP training. Five of them described successful experiences of portfolio-based learning implementation. Only one article addressed portfolio-based assessment in postgraduate GP training. The existing evidence provides various benefits of professional portfolio-based learning. It does appear to have advantages of stimulating reflective learning, promoting proactive learning, and bridging the hospital experiences of the learners to GP. Moreover, the challenges to implementation of portfolio-based learning are often based on orientation and training of stakeholders.

  19. Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings.

    Science.gov (United States)

    Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P; Kravitz, Richard L; Owen, Richard R; Sullivan, J Greer; Wu, Albert W; Di Capua, Paul; Hoagwood, Kimberly Eaton

    2015-09-01

    Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context.

  20. Implementing digital preservation in repositories: Knowledge and practices

    Directory of Open Access Journals (Sweden)

    Caterina Groposo Pavão

    2016-09-01

    Full Text Available Digital preservation has to be undertaken by institutional repositories, which are responsible for the preservation of the scientific output from academic institutions. However, due to the constant evolution of the field, to gain domain knowledge and recognise best practices is a complex task for people responsible for digital preservation in those institutions. Digital preservation research, practices and solutions address specific problems, such as formats, curation, reference models, authenticity, policies and preservation plans, tools, etc., while stakeholders need an integrated, contextualized and applicable overview. This paper focuses on the implementation of digital preservation in repositories, from the perspective of the team responsible for the project, regarding the necessary knowledge and best practices. Initially, it defines and contextualizes digital preservation repositories. The following section presents a conceptual model of digital preservation, synthesized from conceptual models developed in influential projects in the field, which allows us to identify the domain knowledge in digital preservation. Finally, aspects represented in the model are discussed in the light of the performance of teams implementing digital preservation repositories. It provides recommendations, guides and examples that may be useful for the implementation of digital preservation. It points to the need to strengthen the relationship between domain knowledge in digital preservation repositories with practices developed in numerous projects developed worldwide.

  1. The chaos cookbook a practical programming guide

    CERN Document Server

    Pritchard, Joe

    2014-01-01

    The Chaos Cookbook: A Practical Programming Guide discusses the use of chaos in computer programming. The book is comprised of 11 chapters that tackle various topics relevant to chaos and programming. Chapter 1 reviews the concept of chaos, and Chapter 2 discusses the iterative functions. Chapters 3 and 4 cover differential and Lorenz equations. Chapter 5 talks about strange attractors, while Chapter 6 deals with the fractal link. The book also discusses the Mandelbrot set, and then covers the Julia sets. The other fractal systems and the cellular automata are also explained. The last chapter

  2. Implementing a Community-Oriented Policing Program.

    Science.gov (United States)

    Sumner, Dave

    2002-01-01

    Describes a successful community-oriented policing program at the University of South Alabama which has cut crime rates while not requiring extra funding. Discusses the reorganization of the police department, efforts targeting children, university services started by the deputy chief, and other new crime prevention and training initiatives. (EV)

  3. Abstract Machines for Programming Language Implementation

    NARCIS (Netherlands)

    Diehl, Stephan; Hartel, Pieter H.; Sestoft, Peter

    We present an extensive, annotated bibliography of the abstract machines designed for each of the main programming paradigms (imperative, object oriented, functional, logic and concurrent). We conclude that whilst a large number of efficient abstract machines have been designed for particular

  4. Best practice implementation: lessons learned from 20 partnerships.

    Science.gov (United States)

    Sharek, Paul J; Mullican, Charlotte; Lavanderos, Angela; Palmer, Cynthia; Snow, Vincenza; Kmetik, Karen; Antman, Mark; Knutson, David; Dembry, Louise Marie

    2007-12-01

    Partnerships can facilitate effective implementation of best practices, but literature describing effective and ineffective strategies to address barriers to implementation in partnerships is lacking. Principal investigators (PIs) were surveyed to identify barriers to best practice implementation, rank their significance, and articulate the success and failure of solutions attempted. The top four categories of barriers to implementation were partnership challenges, practitioner/local organization variables, time frame challenges, and financial concerns. Ninety-eight effective and 38 ineffective solutions used to overcome these barriers were identified. The most common categories of successful solutions were flexibility of interventions to align with unique local characteristics, schedules, and budgets (36.7% of listed successful solutions); communication strategies that emphasize frequent bidirectional information exchange in person (26.5%); and thoughtful use of personnel emphasizing sites' senior leadership and centralized quality and analytic content expertise (16.3%). Despite substantial partnership diversity, consistent themes related to barriers to implementation and solutions to these barriers emerged. The successful and unsuccessful solutions provided should be proactively assessed to enhance the likelihood of future partnership success.

  5. Implementation contexts of a Tuberculosis Control Program in Brazilian prisons

    Directory of Open Access Journals (Sweden)

    Luisa Gonçalves Dutra de Oliveira

    2015-01-01

    Full Text Available OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects.METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons.RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases.CONCLUSIONS The implementation degree and its contexts – external and political-organizational dimensions – simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons.

  6. Implementation contexts of a Tuberculosis Control Program in Brazilian prisons.

    Science.gov (United States)

    de Oliveira, Luisa Gonçalves Dutra; Natal, Sonia; Camacho, Luiz Antonio Bastos

    2015-01-01

    OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects.METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons.RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases.CONCLUSIONS The implementation degree and its contexts - external and political-organizational dimensions - simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons.

  7. The CSSP implementation plan for space plasma physics programs

    Science.gov (United States)

    Baker, D. N.; Williams, D. J.

    1985-12-01

    The Committee on Solar and Space Physics (CSSP) has provided NASA with guidance in the areas of solar, heliospheric, magnetospheric, and upper atmospheric research. The budgetary situation confronted by NASA has called for a prioritized plane for the implementation of solar and space plasma physics programs. CSSP has developed the following recommendations: (1) continue implementation of both the Upper Atmosphere Research Satellite and Solar Optical Telescope programs; (2) initiate the International Solar Terrestrial Physics program; (3) plan for later major free-flying missions and carry out the technology development they require; (4) launch an average of one solar and space physics Explorer per yr beginning in 1990; (5) enhance current Shuttle/Spacelab programs; (6) develop facility-class instrumentation; (7) augment the solar terrestrial theory program by FY 1990; (8) support a compute modeling program; (9) strengthen the research and analysis program; and (10) maintain a stable suborbital program for flexible science objectives in upper atmosphere and space plasma physics.

  8. CSSP implementation plan for space plasma physics programs

    Energy Technology Data Exchange (ETDEWEB)

    Baker, D.N.; Williams, D.J.

    1985-12-01

    The Committee on Solar and Space Physics (CSSP) has provided NASA with guidance in the areas of solar, heliospheric, magnetospheric, and upper atmospheric research. The budgetary sitation confronted by NASA has called for a prioritized plane for the implementation of solar and space plasma physics programs. CSSP has developed the following recommendations: (1) continue implementation of both the Upper Atmosphere Research Satellite and Solar Optical Telescope programs; (2) initiate the International Solar Terrestrial Physics program; (3) plan for later major free-flying missions and carry out the technology development they require; (4) launch an average of one solar and space physics Explorer per yr beginning in 1990; (5) enhance current Shuttle/Spacelab programs; (6) develop facility-class instrumentation; (7) augment the solar terrestrial theory program by FY 1990; (8) support a compute modeling program; (9) strengthen the research and analysis program; and (10) maintain a stable suborbital program for flexible science objectives in upper atmosphere and space plasma physics.

  9. Concurrent implementation of quality improvement programs.

    Science.gov (United States)

    Nyström, Monica Elisabeth; Garvare, Rickard; Westerlund, Anna; Weinehall, Lars

    2014-01-01

    Competing activities and projects can interfere with implementing new knowledge and approaches. The purpose, therefore, was to investigate processes and impact related to implementing two concurrent quality initiatives in a Swedish hospital. These were a regionally initiated, system-wide organizational learning programme called the Dynamic and Viable Organization (DVO) and a national initiative on stopping healthcare-associated and hospital-acquired infections (SHAI). Both undertakings aspired to increase staff competence in systematic improvement approaches. Multiple methods were applied including surveys, observations, interviews, process diaries, documents and organizational measurements. Respondents were unit managers, change facilitators and improvement team members. Even though both initiatives shared the same improvement approach, there was no strong indication that they were strategically combined to benefit each other. The initiatives existed side by side with some coordination and some conflict. Despite absent management strategies to utilize the national SHAI initiative, positive developments in QI culture and communication were reported. The current study illustrates the inherent difficulties coordinating change initiatives, even in favourable circumstances. This article addresses the lesser studied but common situation of coinciding and competing projects in organizations.

  10. A Case Study on the Implementation of a Positive Youth Development Program (Project P.A.T.H.S. in Hong Kong: Learning from the Experimental Implementation Phase

    Directory of Open Access Journals (Sweden)

    Tak Yan Lee

    2008-01-01

    Full Text Available This investigation of the implementation of a positive youth development program (Project P.A.T.H.S. was part of a large study undertaken comprehensively to explore how effective the Tier 1 Program was in practice and how the results can shed light on future developments. Utilizing a case study approach, individual and focus group interviews were conducted in 2007 to examine the factors that influence the process and quality of implementation of the Tier 1 Program of the Project P.A.T.H.S. The focus of this study was on how the implementers of a school made use of the experience gained in the Experimental Implementation Phase (EIP in 2005/06 to improve the program implementation quality in the Full Implementation Phase (FIP in 2006/07. Results showed that the program implementation in the FIP was generally high and the program was well received by the implementers. Factors that facilitated the implementation of the program were identified, including the adoption of an incremental change strategy, the incorporation of the program into both formal and informal curricula, positive perceptions of the program among staff and agency social workers, sufficient school administrative support, excellent cooperation between the school and the social work agency, presence of a dedicated school contact person and instructors who engaged themselves in continuous quality improvement of the implementation, and an emphasis on application of what had been learned. Difficulties encountered by the school in the process of implementation were also observed. Based on the present findings, key process variables that facilitate or impede the implementation of positive youth development programs are discussed. Implications for future program implementation are also discussed.

  11. Implementation issues in Inductive Logic Programming

    OpenAIRE

    Kolter, Robert

    2017-01-01

    We propose several algorithms for efficient Testing of logical Implication in the case of ground objects. Because the problem of Testing a set of propositional formulas for (un)satisfiability is \\(NP\\)-complete there's strong evidence that there exist examples for which every algorithm which solves the problem of testing for (un)satisfiability has a runtime that is exponential in the length of the input. So will have our algorithms. We will therefore point out classes of logic programs for wh...

  12. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping

    Directory of Open Access Journals (Sweden)

    Green Amy E

    2011-09-01

    Full Text Available Abstract Background The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP implementation in a large public mental health service system in the United States. Methods Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. Results A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding were rated among the most important and least likely to change by both groups. Conclusions EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

  13. Implementing a Dynamic Street-Children's Program: Successes and ...

    African Journals Online (AJOL)

    Implementing a Dynamic Street-Children's Program: Successes and Challenges. ... the influence that early childhood dynamics of parentchild, parent-parent and ... they can influence the child's behaviour in both positive and negative ways.

  14. Implementation of Advanced Access in general practice: postal survey of practices.

    Science.gov (United States)

    Goodall, Stephen; Montgomery, Alan; Banks, Jon; Salisbury, Chris; Sampson, Fiona; Pickin, Mark

    2006-12-01

    Advanced Access has been strongly promoted as a means of improving access to general practice. Key principles include measuring demand, matching capacity to demand, managing demand in different ways and having contingency plans. Although not advocated by Advanced Access, some practices have also restricted availability of pre-booked appointments. This study compares the strategies used to improve access by practices which do or do not operate Advanced Access. Postal survey of practices. Three hundred and ninety-one practices in 12 primary care trusts. Questionnaires were posted to practice managers to collect data on practice characteristics, supply and demand of appointments, strategies employed to manage demand, and use of Advanced Access. Two hundred and forty-five from 391 (63%) practices returned a questionnaire and 162/241(67%) claimed to be using Advanced Access. There were few differences between characteristics of practices operating Advanced Access or not. Both types of practice had introduced a wide range of measures to improve access. The proportion of doctors' appointments only available for booking on the same day was higher in Advanced Access practices (40 versus 16%, difference = 24%, 95% CI = 16% to 32%). Less than half the practices claiming to operate Advanced Access ((63/140; 45%) used all four of this model's key principles. The majority of practices in this sample claim to have introduced Advanced Access, but the degree of implementation is very variable. Advanced Access practices use more initiatives to measure and improve access than non-Advanced Access practices.

  15. Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian

    2013-01-01

    In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788

  16. A practical approach to implementing new CDC GBS guidelines.

    Science.gov (United States)

    Hill, Shawna M; Bridges, Margie A; Knudsen, Alexis L; Vezeau, Toni M

    2013-01-01

    Group beta streptococcus (GBS) is a well-documented pathogen causing serious maternal and fetal morbidity and mortality. The CDC guidelines for managing clients who test positive for GBS in pregnancy were revised and published in 2010. However, CDC and extant literature provide limited guidance on implementation strategies for these new recommendations. Although several algorithms are included in the CDC (2010) document, none combine the maternal risk factors for practical and consistent implementation from pregnancy to newborn. In response to confusion upon initial education of these guidelines, we developed an algorithm for maternal intrapartum management. In addition, we clarified the CDC (2010) newborn algorithm in response to provider request. Without altering the recommendations, both algorithms provide clarification of the CDC (2010) guidelines. The nursing process provides an organizational structure for the discussion of our efforts to translate the complex guidelines into practice. This article could provide other facilities with tools for dealing with specific aspects of the complex clinical management of perinatal GBS.

  17. Identifying critical factors for implementing good agricultural practice

    Directory of Open Access Journals (Sweden)

    Nelson Gutiérrez Guzmán

    2010-05-01

    Full Text Available This paper deals with identifying the critical factors (CFs involved in implementing a good agricultural practice (GAP programme for coffee and fruit farmers in the Huila department of Colombia. An exploratory factor analysis using principal component analy- sis (PCA factorisation was used. Data matrixes were constructed from the results of applying two defined-structure assessment tools to the populations being studied: Starbucks’ coffee and farmer equity (CAFE practices for small-scale coffee growers and coffee-producers and the EUREPGAP V2.1 Oct.2004 / checklist for fruit and vegetables, as applied to fruit-producers. This inves- tigation led to identifying 6 CFs which must be considered when implementing a GAP programme: infrastructure, established production activities, preparing and maintaining records, environmental awareness, workers’ welfare and safety and quality con- trol.

  18. Sustained Implementation Support Scale: Validation of a Measure of Program Characteristics and Workplace Functioning for Sustained Program Implementation.

    Science.gov (United States)

    Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Filus, Ania

    2017-07-01

    An evaluation measure of enablers and inhibitors to sustained evidence-based program (EBP) implementation may provide a useful tool to enhance organizations' capacity. This paper outlines preliminary validation of such a measure. An expert informant and consumer feedback approach was used to tailor constructs from two existing measures assessing key domains associated with sustained implementation. Validity and reliability were evaluated for an inventory composed of five subscales: Program benefits, Program burden, Workplace support, Workplace cohesion, and Leadership style. Exploratory and confirmatory factor analysis with a sample of 593 Triple P-Positive Parenting Program-practitioners led to a 28-item scale with good reliability and good convergent, discriminant, and predictive validity. Practitioners sustaining implementation at least 3 years post-training were more likely to have supervision/peer support, reported higher levels of program benefit, workplace support, and positive leadership style, and lower program burden compared to practitioners who were non-sustainers.

  19. Implementation and Effectiveness of the Response to Intervention (RTI) Program

    Science.gov (United States)

    Hite, Jessica Elaine; McGahey, James Todd

    2015-01-01

    The purpose of this research study was to determine whether or not student test scores on the Georgia Criterion-Referenced Competency Test (CRCT) were positively impacted by the implementation of the Response to Intervention (RTI) program. This paper will review the implementation and effectiveness of the RTI method.

  20. Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

    Science.gov (United States)

    Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen

    2006-01-01

    Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

  1. The Network Form of Implementing Educational Programs: Differences and Typology

    Science.gov (United States)

    Sobolev, Alexandr Borisovich

    2016-01-01

    The article describes peculiarities of implementation and major differences in network educational programs, currently introduced in Russia. It presents a general typology of models and forms for implementing interaction between educational institutions of Russia, including teacher institutes and federal universities, as well as a typology of…

  2. High levels of coach intent to integrate a ACL injury prevention program into training does not translate to effective implementation.

    Science.gov (United States)

    Frank, Barnett S; Register-Mihalik, Johna; Padua, Darin A

    2015-07-01

    Evaluate the effect of a anterior cruciate ligament injury prevention program coaching workshop on elite-level youth soccer coaches' behavioral determinants to implement a injury prevention program and describe coaches' subsequent injury prevention program implementation compliance. Descriptive study. We evaluated a soccer club's coaches' behavioral determinants regarding injury prevention programming implementation before and after a coaching workshop using pre- and post-workshop surveys. We then described the club's coaches' subsequent adoption of and implementation compliance with the injury prevention programming during the following season. The injury prevention workshop increased coaches' attitudes toward conducting a program at the beginning of practice (pinjury prevention program workshop increased coaches' perceived behavioral control; feeling more comfortable in their ability to teach their team a program (pinjury prevention program workshop increased coaches' intent to implement a program the next season (ptraining session. Only 53% of the club's teams implemented the injury prevention program, with implementers demonstrating high variability in program fidelity. Coaching workshops can effectively increase coach attitudes, perceived behavioral control, and intent to implement a injury prevention program. However, high levels of behavioral determinants do not appear to translate to high levels of implementation compliance. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Practices implemented by a Texas charter school system to overcome science teacher shortage

    Science.gov (United States)

    Yasar, Bilgehan M.

    The purpose of this study was to examine practices used by a charter school system to hire and retain science teachers. The research design for this study was a qualitative case study. This single instrumental case study explored the issue within a bounded system. Purposeful sampling strategy was used to identify the participants who were interviewed individually. Findings of the case study supported that using online resources, advertising in the newspaper, attending job fairs, using alternative certification programs, attracting alumni, contacting the college of educations and hiring internationally helped the charter school system with hiring science teachers. Improving teacher salary scale, implementing teacher mentorship programs, reimbursing teachers for certification and master's programs, providing professional development and supporting teachers helped to retain science teachers. Therefore, this study contributes to determining strategies and techniques, selecting methods and programs, training administrators, and monitoring for successful hiring and retaining science teacher implementation.

  4. Practical Implementations of Advanced Process Control for Linear Systems

    DEFF Research Database (Denmark)

    Knudsen, Jørgen K . H.; Huusom, Jakob Kjøbsted; Jørgensen, John Bagterp

    and a linearised CSTR. Advantages and disadvantages of these controllers will be discussed. All three controller types shows a set of common undesirable characteristics, which must be accounted for. At the end of the evaluation horizon the "optimal" solution has an unstable characteristics, which can be suppressed...... as function of controllers type, Model dimension and constraint type will be discussed. Finally the special requirements set by processes including a pure integration dynamics will be illustrated by a linearised CSTR process. The simulated results presented, will later on be implemented on and demonstrated......This paper describes some practical problems encountered, when implementing Advanced Process Control, APC, schemes on linear processes. The implemented APC controllers discussed will be LQR, Riccati MPC and Condensed MPC controllers illustrated by simulation of the Four Tank Process...

  5. Practical Implementation of 10 Rules for Writing REST APIs

    Directory of Open Access Journals (Sweden)

    Jiri Hradil

    2017-01-01

    Full Text Available This paper shows a practical implementation of “10 Rules for Writing REST APIs introduced in the article” (Hradil, 2016. The application is done in Invoice Home (Wikilane, 2016, an invoicing web application for small business and entrepreneurs available world-wide. The API is implemented in JSON hypermedia format (ECMA International, 2016 and with Ruby on Rails framework (Hansson, 2016. The main purpose of the API is to allow connection of Invoice Home with external systems and offer Invoice Home data in simpler format compared to the current HTML format of the full-stack web application. The paper could be also used as a basic template or pattern for any other implementation of the JSON API in any web-based application.

  6. The practical implementation of enterprise balanced scorecard analysis system

    Directory of Open Access Journals (Sweden)

    Pollack G.A.

    2017-01-01

    Full Text Available The use of balanced scorecard system requires to use some measurable key performance indicators in every part of an enterprise activity, not only for the enterprise itself and its subdivisions, but for every employee. These actions need the introduction/application of a corporate information system. In this work we suggest the most commonly used Russian software “1C: Enterprise Platform” (Accounting system of enterprise. We present the practical implementation of the system of real-time monitoring, analysis and control for the implementation of actions concerned with financial component of the enterprise-balanced scorecard. The formed module (expansion can be applied in pattern “1C: ERP” (Enterprise Recourse Planning. The conclusion is made about the possibility of the above information system expansion for the implementation of all components of the enterprise balanced scorecard system.

  7. Development and implementation of an interdisciplinary oncology program in a community hospital.

    Science.gov (United States)

    Chung, Clement; Collins, Angela; Cui, Nancy

    2011-09-15

    The development and implementation of an interdisciplinary oncology program in a community hospital are described. Before the program was established, clinical pharmacists responsible for order entry and verification did not have a defined structure and resource to effectively communicate with medical oncologists and nurses on patient care issues and oncology drug information. The practice model did not meet practice needs, departmental safety, quality, or cost-saving goals. An interdisciplinary team was established to determine where current processes and procedures were needed to decrease errors and improve efficiency associated with chemotherapy services. Three stages of practice development were planned, and an interdisciplinary oncology program involving nursing and pharmacy team members and medical oncologists was established. Standardized order forms, various pharmacy collaborative agreements, protocols, improved oncology nursing and pharmacy processes, and established standards in order writing, dispensing, administration, and monitoring were developed. An oncology pharmacist specialist position was requested, and this pharmacist played an essential role in helping the hospital realize significant cost savings and improve the quality of care provided to patients receiving chemotherapy services. Data were collected for 96 chemotherapy orders before program implementation and for 75 orders after program implementation, and a 45% reduction in total error related to chemotherapy drugs was observed (p cause of errors was missing information, typically an omitted duration or frequency, dose, route, or premedication (63% of all errors documented). The development and implementation of an interdisciplinary oncology program resulted in decreased medication-error rates, expanded pharmacy services, and cost savings.

  8. Implementation evaluation of the Telephone Lifestyle Coaching (TLC) program: organizational factors associated with successful implementation.

    Science.gov (United States)

    Damschroder, Laura J; Reardon, Caitlin M; Sperber, Nina; Robinson, Claire H; Fickel, Jacqueline J; Oddone, Eugene Z

    2017-06-01

    The Telephone Lifestyle Coaching (TLC) program provided telephone-based coaching for six lifestyle behaviors to 5321 Veterans at 24 Veterans Health Administration (VHA) medical facilities. The purpose of the study was to conduct an evaluation of the TLC program to identify factors associated with successful implementation. A mixed-methods study design was used. Quantitative measures of organizational readiness for implementation and facility complexity were used to purposively select a subset of facilities for in-depth evaluation. Context assessments were conducted using interview transcripts. The Consolidated Framework for Implementation Research (CFIR) was used to guide qualitative data collection and analysis. Factors most strongly correlated with referral rates included having a skilled implementation leader who used effective multi-component strategies to engage primary care clinicians as well as general clinic structures that supported implementation. Evaluation findings pointed to recommendations for local and national leaders to help anticipate and mitigate potential barriers to successful implementation.

  9. Status of Pharmacy Practice Experience Education Programs

    Science.gov (United States)

    Eccles, Dayl; Kwasnik, Abigail; Craddick, Karen; Heinz, Andrew K.; Harralson, Arthur F.

    2014-01-01

    Objective. To assess financial, personnel, and curricular characteristics of US pharmacy practice experiential education programs and follow-up on results of a similar survey conducted in 2001. Methods. Experiential education directors at 118 accredited US pharmacy colleges and schools were invited to participate in a blinded, Web-based survey in 2011. Aggregate responses were analyzed using descriptive statistics and combined with data obtained from the American Association of Colleges of Pharmacy to assess program demographics, faculty and administrative organizational structure, and financial support. Results. The number of advanced pharmacy practice experience (APPE) sites had increased by 24% for medium, 50% for large, and 55% for very large colleges and schools. Introductory pharmacy practice experience (IPPE) sites outnumbered APPEs twofold. The average experiential education team included an assistant/associate dean (0.4 full-time equivalent [FTE]), a director (1.0 FTE), assistant/associate director (0.5 FTE), coordinator (0.9 FTE), and multiple administrative assistants (1.3 FTE). Most faculty members (63%-75%) were nontenure track and most coordinators (66%) were staff members. Estimated costs to operate an experiential education program represented a small percentage of the overall expense budget of pharmacy colleges and schools. Conclusion. To match enrollment growth, pharmacy practice experiential education administrators have expanded their teams, reorganized responsibilities, and found methods to improve cost efficiency. These benchmarks will assist experiential education administrators to plan strategically for future changes. PMID:24850934

  10. Program and Teacher Characteristics Predicting the Implementation of Banking Time with Preschoolers Who Display Disruptive Behaviors.

    Science.gov (United States)

    Williford, Amanda P; Wolcott, Catherine Sanger; Whittaker, Jessica Vick; Locasale-Crouch, Jennifer

    2015-11-01

    This study examined the relationship among baseline program and teacher characteristics and subsequent implementation of Banking Time. Banking Time is a dyadic intervention intended to improve a teacher's interaction quality with a specific child. Banking Time implementation was examined in the current study using a sample of 59 teachers and preschool children displaying disruptive behaviors in the classroom (~three children per classroom). Predictors included preschool program type, teacher demographic characteristics (personal and professional), and teacher beliefs (self-efficacy, authoritarian beliefs, and negative attributions about child disruptive behavior). Multiple measures and methods (i.e., teacher report, consultant report, independent observations) were used to assess implementation. We created three implementation composite measures (dosage, quality, and generalized practice) that had high internal consistencies within each composite but were only modestly associated with one another, suggesting unique constructs of implementation. We found that type of preschool program was associated with dosage and quality. Aspects of teacher demographics related to all three implementation composites. Teacher beliefs predicted dosage and generalized practice. Results suggest that the factors that predict the implementation of Banking Time vary as a function of the type of implementation being assessed.

  11. Implementing sustainable development programs in Chicago

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, H.

    1994-12-31

    Achieving sustainable development requires a revision of the present view of the nature of the city as an environment, and its relation to a larger ecosystem of which it is an essential part. The environmental health of a wilderness area is inextricably related to the environmental, and economic, health of the great urban centers. The vitality of dense metropolitan areas, where population and economic activities are concentrated, is key to the preservation of productive farm lands, wildlife habitat, and open spaces. The social and economic crisis which grips many metropolitan centers, with attendant flight of industry and development to the so-called {open_quotes}greenfields,{close_quotes} fundamentally spreads a broader crisis to our common ecosystem. This crisis is marked by the obliteration of habitat necessary for biodiversity, loss of fertile farm land, and the contamination of air, water and land, as an unescapable effect of the sprawl created by flight from the urban centers. The removal of false conceptual distinctions between the city and nature, distinctions that are unfortunately at the heart of so much of American environmental philosophy, is key to the concept of `sustainable development.` This article sets forth how the City of Chicago is implementing this understanding of the nature of the urban environment, in pursuit of sustainable development within the city.

  12. Management Involvement--A Decisive Condition When Implementing Evidence-Based Practice.

    Science.gov (United States)

    Aasekjaer, Katrine; Waehle, Hilde Valen; Ciliska, Donna; Nordtvedt, Monica Wammen; Hjälmhult, Esther

    2016-02-01

    Even though health professionals have a positive attitude toward evidence-based practice (EBP), they have limited skills when it comes to implementation of EBP. A postprofessional program in EPB has been offered at Bergen University College since 2004. To date, there is limited knowledge of how the graduates of the program implement and make use of the EBP principles in their working environment in different healthcare settings. The aim of the study was to explore the facilitators and strategies to successful implementation of the steps of EBP as experienced by health professionals who had completed a postgraduate program in EBP. Grounded theory was used in gathering and analyzing data from single and focus group interviews of 20 health professionals who had attended a postprofessional program in EBP. Inclusion criteria also required current clinical practice. This study identified a specific set of activities used by health professionals when implementing EBP within their service organization. Creating an interest and understanding of EBP amongst their colleagues appeared to be a challenge, which they addressed by using the generated grounded theory of "tailoring principles." The dominant condition of this theory was management involvement. This study highlighted the importance of middle-range managers' coordinating and supporting role as a decisive component in the process of implementing EBP to clinical settings in Norway. Moreover, the dynamic complex process of "tailoring principles" also showed how the production of a clinical protocol became an outcome of implementation effectiveness as well as input for further intervention effectiveness. Tailoring the principle of EBP to the organizational and cultural context facilitated the implementation of EBP. © 2016 Sigma Theta Tau International.

  13. Implementation of Industrial Work Practice management at vocational high school

    Science.gov (United States)

    Widodo, Joko; Samsudi, Sunyoto

    2017-03-01

    The purpose of this study was to develop a management model of entrepreneurship-based Industrial Work Practice (Prakerin) at Vocational High School. This research was planned for three years under Research and Development design. The respondents were public and private Vocational High Schools in Semarang, Salatiga and District of Demak, Central Java, Indonesia. Data were collected through interviews, questionnaires, observation, and documentation. The data were analyzed qualitatively and quantitatively. Preliminary study shows that the implementation of Industrial Work Practice at Vocational High School, which has been carried out, was only to prepare the graduates to become an employee of the industry instead of entrepreneur. Further study is needed to develop a management model of entrepreneurship-based Industrial Work Practice at Vocational High School.

  14. [Marketing in hospitals and practices: from theory to implementation].

    Science.gov (United States)

    Mattmüller, R; Gebauer, J

    2011-12-01

    Although hospitals and medical practices are typical service providers from a marketing perspective, only very few engage in topics relevant to marketing. Best practice examples do, however, show how important and meaningful the implementation of marketing tools can be for medical service providers. This article thus deals with the question of how the service of hospitals and practices may be improved by marketing initiatives. As a first step, the particular challenges these service providers face need to be analyzed. A significant focus will therefore be put on the examination of service-related quality and will then be applied to medical services. Thus it becomes evident that the path to success is based on adapting to patients' needs. Possibilities to minimize the uncertainties and risks experienced by the patients need to be identified. At the same time, the perceived service quality needs to be maximized.

  15. A distributed implementation of a mode switching control program

    DEFF Research Database (Denmark)

    Holdgaard, Michael; Eriksen, Thomas Juul; Ravn, Anders P.

    1995-01-01

    A distributed implementation of a mode switched control program for a robot is described. The design of the control program is given by a set of real-time automatons. One of them plans a schedule for switching between a fixed set of control functions, another dispatches the control functions...

  16. Implementation of Evidence-Based Practice From a Learning Perspective.

    Science.gov (United States)

    Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin

    2017-06-01

    For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.

  17. Investigation into Practical Implementations of a Zero Knowledge Protocol.

    Energy Technology Data Exchange (ETDEWEB)

    Marleau, Peter [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Krentz-Wee, Rebecca E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-02-01

    In recent years, the concept of Zero Knowledge Protocols (ZKP) as a useful approach to nuclear warhead verification has become increasingly popular. Several implementations of ZKP have been proposed, driving technology development toward proof of concept demonstrations. Whereas proposed implementations seem to fall within the general class of template-based techniques, all physical implementations of ZKPs proposed to date have a complication: once the instrumentation is prepared, it is no longer authenticatable; the instrument physically contains sensitive information. In this work we explore three different concepts that may offer more authenticatable and practical ZKP implementations and evaluate the sensitive information that may be at risk when doing so: sharing a subset of detector counts in a preloaded image (with spatial information removed), real-time image subtraction, and a new concept, CONfirmation using a Fast-neutron Imaging Detector with Anti-image NULL-positive Time Encoding (CONFIDANTE). CONFIDANTE promises to offer an almost ideal implementation of ZKP: a positive result is indicated by a constant rate at all times enabling the monitoring party the possibility of full access to the instrument before, during, and after confirmation. A prototype of CONFIDANTE was designed, built, and its performance evaluated in a series of measurements of several objects including a set of plutonium dioxide Hemispheres. Very encouraging results proving feasibility are presented. 1 Rebecca is currently a graduate student in Nuclear Engineering at UC Berkeley

  18. Program development: role of the clinical nurse specialist in implementing a fast-track postanesthesia care unit.

    Science.gov (United States)

    Harrington, Linda

    2005-01-01

    Advanced practice nurses are involved in many aspects of program development as part of their roles. This can involve such things as developing programs for staff and family education, organizing system-wide quality assurance programs, or implementing new care programs. One unique aspect of the advanced practice nurse's role is the ability to serve as a change agent and implement new models of care. Although all advanced practice nurses can be involved in program development, the role of the Clinical Nurse Specialist lends itself to devoting dedicated services for implementing programmatic change in the clinical setting. This article describes the role of the Clinical Nurse Specialist in implementing an evidence-based, fast-track postanesthesia care unit.

  19. Issues associated with energy efficiency programs implementation at the housing and utility enterprises

    Directory of Open Access Journals (Sweden)

    Borisova Natalia

    2017-01-01

    Full Text Available Energy saving potential is quite huge in the most sectors of the national economy, particularly in housing and utilities and industry. Due to this, energy efficiency increase at the enterprises of housing and utilities and industry through the energy efficiency programs implementation, is one of the priorities in the modern economy of Russia and its regions, and requires radical measures to improve the effectiveness of its implementation. The purpose of the authors is the scientific and practical study of the main problems of energy efficiency programs implementation at the enterprises of housing and utilities services and industry in modern conditions. To achieve this purpose the authors solved the following problems: the current state of the housing and utilities sector and industry, the relevance and the need for energy saving policy at the enterprises of housing and utilities services and industry are studied; the main problems impeding to implement the energy-saving program effectively at the enterprises of housing and utilities services and industry are determined; the possible ways of solving the problems identified in the energy efficiency programs implementation at the enterprises of housing and industry are offered. The team of authors focuses in this study on the problems of the energy audit using in practice as a basic tool for the energy saving programs development at the enterprises of housing and utilities services, industry and their subsequent implementation. The subject of author's researches is the factors that determine the energy efficiency programs implementation at the enterprises of housing and utilities services and industry at the level of individual region and the whole country, and the object is the enterprises of housing and utilities services and industry. Methodologically the scientific and practical research is based on the complex approach using the methods of comparative, statistical and logical analysis.

  20. The Wildlife Habitat Education Program: Moving from Contest Participation to Implementation

    Science.gov (United States)

    Allen, Kevin; Elmore, R. Dwayne; Harper, Craig

    2013-01-01

    Do members participating in the Wildlife Habitat Education Program (WHEP) apply knowledge gained by implementing wildlife management practices at the local level? 4-H members who participated in the National WHEP Contest from 2003-2005 and 2007-2011 completed an evaluation at the end of each contest. The evaluation asked participants if they…

  1. Sporting programs for inactive population groups: factors influencing implementation in the organized sports setting.

    Science.gov (United States)

    Ooms, Linda; Veenhof, Cindy; Schipper-van Veldhoven, Nicolette; de Bakker, Dinny H

    2015-01-01

    The organized sports sector has received increased attention as a setting to promote health-enhancing physical activity (HEPA) to the general population. For significant public health impact, it is important that successful HEPA programs are widely adopted, implemented and continued as ongoing practice. The importance of evaluating the context in which programs are implemented has been identified as critical. However, little research has focused on understanding the organized sports implementation context, including factors facilitating and impeding implementation. In this study, the main factors influencing implementation of HEPA programs in the organized sports setting were studied. Fourteen sporting programs in the Netherlands aimed at increasing participation in sports by inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were investigated. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands over a 3-year implementation period (June 2008-June 2011). The qualitative research component involved yearly face-to-face interviews (i.e. fourteen interviews each year, n = 12 program coordinators) and a group meeting with the program coordinators of the NSFs (n = 8). Cross-case comparisons and thematic analyses were performed to identify and categorize important facilitating and impeding factors respectively. The quantitative research component, used to identify the most important facilitating and impeding factors across all sporting programs, consisted of ranking of factors according to importance by the program coordinators (n = 12). Different factors act during six identified (implementation) phases. When comparing factors across phases, several key learnings were evident. Successful implementation relied, for example, on program design and enthusiastic individuals within sporting organizations. On the other hand, inactive

  2. Teachers' Reflective Practice in Lifelong Learning Programs

    DEFF Research Database (Denmark)

    Jensen, Annie Aarup; Thomassen, Anja Overgaard

    2018-01-01

    This chapter explores teachers' reflective practice in lifelong learning programs based on a qualitative study of five teachers representing three part-time Master's programs. The theoretical framework for analysis of the interview data is Ellström's (1996) model for categorizing levels of action......, knowledge and learning, activity theory (Engeström, 1987) and expansive learning (Engeström & Sannino, 2010). The results show a divergence between what the teachers perceive as the Master students' learning goals and the teachers' goals and objectives. This is highlighted through the teachers' experience...... with the students' understandings of the theories they are introduced to and how they apply them in relation to their practice context. The insights and the issues raised by the study are relevant for teachers in Higher Education....

  3. Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean.

    Science.gov (United States)

    Oldenburger, David; De Bortoli Cassiani, Silvia Helena; Bryant-Lukosius, Denise; Valaitis, Ruta Kristina; Baumann, Andrea; Pulcini, Joyce; Martin-Misener, Ruth

    2017-06-08

    SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.

  4. [Evaluation of tools for the implementation of clinical practice guidelines on sexually transmitted infections].

    Science.gov (United States)

    Moreno, Jaime Hernán Rodríguez; Romero Vergara, Antonio José; De Moya, Danilo De Jesús De Alba; Jaramillo Rojas, Hernán Javier; Díaz Rojas, Claudia Milena; Ciapponi, Agustín

    2017-05-25

    Determine the acceptability, perceived usefulness, and adoption of implementation tools and technical assistance provided by the Health Technology Assessment Institute (IETS) in hospitals in two regions of Colombia. Assistance was provided for implementation of clinical practice guidelines (CPGs) in 24 hospitals (17 in Antioquia and seven in Cundinamarca) in areas with high prevalence of sexually transmitted infections, and for use of the implementation tools. Health professionals were given surveys and medical specialists were interviewed. Overall, 86% of respondents are familiar with the GPGs, 86% with the tracer recommendations, 79% with the interactive flow charts, and 82% with the evidence sheets, while 41% never used the implementation tools. Of the respondents who used the tools, 55% did so on their work computer, while 24% used their personal telephone. The most useful tools were the evidence sheets and flow charts (98%) and the tracer recommendations (92%). The least useful were the budgetary impact tools (81%). The implementation tools and technical assistance provided in hospitals in two regions of Colombia are perceived as useful and acceptable, although the degree of implementation is low. The findings of this research will help the different actors, such as the Ministry of Health and Social Protection, the IETS, and the Administrative Department of Science, Technology and Innovation (Colciencias), among others, improve their programs for the implementation of clinical practice guidelines.

  5. Development and implementation of a writing program to improve resident authorship rates.

    Science.gov (United States)

    Clemmons, Amber Bradley; Hoge, Stephanie C; Cribb, Ashley; Manasco, Kalen B

    2015-09-01

    The development, implementation, and evaluation of a writing program with a formalized writing project as a component of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residencies are described. The writing program at Georgia Regents Medical Center/University of Georgia College of Pharmacy, a collaborative and jointly funded program, was initiated in the 2010-11 residency year. The goals of the program are to teach residents to communicate effectively, apply leadership skills, employ project management skills, and provide medication- and practice- related education and training. The program combines both writing experiences and mentorship. At the beginning of the residency year, trainees are presented with opportunities to participate in both research projects and writing projects. Specifically, opportunities within the writing program include involvement in review articles, case reports, drug information rounds, book chapters, letters to the editor, and high-quality medication-use evaluations for potential publication. The writing project is highly encouraged, and completion of a manuscript to be submitted for publication is expected by graduation. Nine papers were published by 8 of 18 PGY1 and PGY2 residents in the four years before program implementation. A total of 23 publications were published by 18 (72%) of the 25 PGY1 and PGY2 residents in the four years after implementation of the writing program. Implementation of a formal writing program increased the overall publication rate of residents. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Characteristics of Combined Family Practice-Psychiatry Residency Programs

    Science.gov (United States)

    Rachal, James; Lacy, Timothy J.; Warner, Christopher H.; Whelchel, Jennifer

    2005-01-01

    Objective: To evaluate how family practice-psychiatry residency programs meet the challenges of rigorous accreditation demands, clinical supervision, and boundaries of practice. Method: A 54-question survey of program directors of family practice-psychiatry residency programs outlining program demographic data, curricula, coordination, resident…

  7. Advancing patient care through innovative practice: the Clinical Partners Program.

    Science.gov (United States)

    Mehta, Bella H; Rodis, Jennifer L; Nahata, Milap C; Bennett, Marialice S

    2005-12-01

    The development, implementation, and outcomes assessment of an innovative pharmacist-managed ambulatory care and community pharmacy practice clinic are described. The Clinical Partners Program at The Ohio State University (OSU) provides an active learning environment for students and residents, offers a patient-focused practice model based on pharmaceutical care principles, and serves as an arena for applied research in pharmacy practice. The program offers multiple services, including anticoagulation management, diabetes self-management, cholesterol management, hepatitis C education, herbal product and dietary supplement consultations, medication management, smoking cessation, and wellness. The practice is currently staffed by two faculty members from the college of pharmacy, with a 0.8 full-time-equivalent (FTE) pharmacist and a 0.65 FTE community pharmacy resident. It has served as a training site for 17 pharmacy residents, 28 bachelor of science (B.S.) in pharmacy students, 30 post-B.S. doctor of pharmacy (Pharm.D.) students, and 132 entry-level Pharm.D. students at various levels of training. The most successful methods of reimbursement for programs have been contracted services with OSU Managed Health Care Systems, Inc., which serves OSU faculty and staff and fee-for-service billing, charged directly to non-OSU patients. Numerous studies have shown that Clinical Partners has consistently demonstrated improved therapeutic outcomes over those achieved in traditional practice. Faculty are exploring outreach services, including the development of advanced practice community sites for the college, establishing patient care services within physician offices, and providing disease management services for self-insured employers. The Clinical Partners Program has improved patient care and provided education and training opportunities for pharmacy students and residents.

  8. A practical communication strategy to improve implementation of evidence-based practice.

    Science.gov (United States)

    Diedrick, Lee A; Schaffer, Marjorie A; Sandau, Kristin E

    2011-11-01

    The purpose of this study was to determine if a consistent communication strategy for implementation of evidence-based practice (EBP), developed with input from staff nurses, improved staff nurse satisfaction with communication of practice changes. Integration of EBP knowledge into clinical practice supports optimal nursing care. Awareness of a practice change and the ability to reference the information may be problematic. A quasi-experimental single group before-after design was used to survey all RNs of a level III neonatal ICU for satisfaction before and after implementation of the EBP communication strategy. Registered nurse satisfaction improved regarding the amount of communication (P strategy can improve nurse satisfaction with communication of EBP changes. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

  9. Implementation of evidence-based practices for children in four countries: a project of the World Psychiatric Association.

    Science.gov (United States)

    Hoagwood, Kimberly E; Kelleher, Kelly; Murray, Laura K; Jensen, Peter S

    2006-03-01

    The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.

  10. Enhanced implementation of low back pain guidelines in general practice

    DEFF Research Database (Denmark)

    Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming

    2013-01-01

    BACKGROUND: Evidence-based clinical practice guidelines may improve treatment quality, but the uptake of guideline recommendations is often incomplete and slow. Recently new low back pain guidelines are being launched in Denmark. The guidelines are considered to reduce personal and public costs....... The aim of this study is to evaluate whether a complex, multifaceted implementation strategy of the low back pain guidelines will reduce secondary care referral and improve patient outcomes compared to the usual simple implementation strategy. METHODS/DESIGN: In a two-armed cluster randomised trial, 100...... visits, stratification tools, and quality reports on low back pain treatment. Primary outcome is referral to secondary care. Secondary outcomes are pain, physical function, health-related quality of life, patient satisfaction with care and treatment outcome, employment status, and sick leave. Primary...

  11. Practical Team-Based Learning from Planning to Implementation.

    Science.gov (United States)

    Whitley, Heather P; Bell, Edward; Eng, Marty; Fuentes, David G; Helms, Kristen L; Maki, Erik D; Vyas, Deepti

    2015-12-25

    Team-based learning (TBL) helps instructors develop an active teaching approach for the classroom through group work. The TBL infrastructure engages students in the learning process through the Readiness Assessment Process, problem-solving through team discussions, and peer feedback to ensure accountability. This manuscript describes the benefits and barriers of TBL, and the tools necessary for developing, implementing, and critically evaluating the technique within coursework in a user-friendly method. Specifically, the manuscript describes the processes underpinning effective TBL development, preparation, implementation, assessment, and evaluation, as well as practical techniques and advice from authors' classroom experiences. The paper also highlights published articles in the area of TBL in education, with a focus on pharmacy education.

  12. Development and Implementation of a Program Management Maturity Model

    Energy Technology Data Exchange (ETDEWEB)

    Hartwig, Laura; Smith, Matt

    2008-12-15

    In 2006, Honeywell Federal Manufacturing & Technologies (FM&T) announced an updatedvision statement for the organization. The vision is “To be the most admired team within the NNSA [National Nuclear Security Administration] for our relentless drive to convert ideas into the highest quality products and services for National Security by applying the right technology, outstanding program management and best commercial practices.” The challenge to provide outstanding program management was taken up by the Program Management division and the Program Integration Office (PIO) of the company. This article describes how Honeywell developed and deployed a program management maturity model to drive toward excellence.

  13. Barriers to implementation of opioid overdose prevention programs in Ohio.

    Science.gov (United States)

    Winstanley, Erin L; Clark, Angela; Feinberg, Judith; Wilder, Christine M

    2016-01-01

    Nationally, overdose fatalities have reached epidemic proportions. Ohio has one of the highest overdose death rates in the country, as well as high rates of prescription opioid trafficking. A cross-sectional self-report survey of opioid overdose prevention programs (OOPPs) in Ohio was conducted between August and October 2014 to characterize programs and ascertain barriers to successful implementation. A 91% response rate was achieved with 18 programs participating in the study. The first Ohio OOPP opened in August 2012, a second program opened in 2013, and the remaining programs began in 2014. All of the programs distribute nasal naloxone and provide overdose prevention education, and 89% (n = 16) provide overdose kits for free. Six OOPPs are funded by the Ohio Department of Health, 3 programs are funded by a local health foundation, and several other public and private funding sources were reported. The OOPPs have funding to distribute a combined total of 8,670 overdose kits and had distributed 1998 kits by October 2014. The OOPPs reported 149 overdose reversals. Fifteen programs (83%) reported implementation barriers that were categorized as stigma-, cost-, staffing-, legal, regulatory, and client-related problems. Legislative changes aimed at removing some of the obstacles to distribution and lay administration of naloxone have recently been enacted in Ohio. OOPPs have rapidly expanded in Ohio during the past 3 years. Although recent legislative changes have addressed some of the reported implementation barriers, stigma and the cost of naloxone remain significant problems.

  14. Policy implementation in practice: the case of national service frameworks in general practice.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2004-10-01

    National Service Frameworks are an integral part of the government's drive to 'modernise' the NHS, intended to standardise both clinical care and the design of the services used to deliver that clinical care. This article uses evidence from qualitative case studies in three general practices to illustrate the difficulties associated with the implementation of such top-down guidelines and models of service. In these studies it was found that, while there had been little explicit activity directed at implementation overall, the National Service Framework for coronary heart disease had in general fared better than that for older people. Gunn's notion of 'perfect implementation' is used to make sense of the findings.

  15. Development and Validation of a Principal Implementation Practices Measure: The Principal Implementation Questionnaire

    Science.gov (United States)

    Nettles, Stephen M.; Petscher, Yaacov

    2015-01-01

    Measurement of principal implementation behaviors has proved difficult to researchers in educational leadership due to a lack of consensus on the operational definitions of leadership constructs. The Principal Implementation Questionnaire (PIQ) was developed and validated with the intention of providing clarity in the assessment of principal leadership behaviors in the implementation of effective reading programs. Constructs were operationally defined within the context of the population of interest, with subsequent item writing centered around the constructs. A resulting calibration sample of principals from Florida Reading First schools was used to test the hypothesized measurement model to determine how well the items were described by the proposed factors. Results from LISREL analyses revealed a well-fitted model, based on numerous fit indices. PMID:26366043

  16. Efforts to Increase Implementation of Evidence-Based Clinical Practices to Improve Adolescent-Friendly Reproductive Health Services.

    Science.gov (United States)

    Romero, Lisa M; Olaiya, Oluwatosin; Hallum-Montes, Rachel; Varanasi, Balalakshmi; Mueller, Trisha; House, L Duane; Schlanger, Karen; Middleton, Dawn

    2017-03-01

    The purposes of this study were to describe changes in implementation of evidence-based clinical practices among health center partners as part of a multicomponent, community-wide teen pregnancy prevention initiative; to better understand the barriers to and facilitators of implementation of the evidence-based clinical practices; and to describe the technical assistance and training provided to the health center partners and key lessons learned. Health center data from the second and third years (2012 and 2013) of the teen pregnancy prevention community-wide initiative were analyzed from 10 communities (the first year was a planning year; program implementation began in the second year). Data were analyzed from 48 health center partners that contributed data in both years to identify evidence-based clinical practices that were being implemented and opportunities for improvement. In addition, data were analyzed from a purposive sample of 30 health center partners who were asked to describe their experiences in implementing evidence-based clinical practices in adolescent reproductive health care and barriers and facilitators to implementation. Across 48 health centers in the 10 communities, 52% reported an increase in the implementation of evidence-based clinical practices from 2012 to 2013, mostly in providing contraceptive access (23%) and offering Quick Start (19%). Among health centers that reported no change (13%), the majority reported that practices were already being implemented before the initiative. Finally, among health centers that reported a decrease in implementation of evidence-based clinical practices (35%), most reported a decrease in having either hormonal contraception or intrauterine devices available at every visit (15%), having HIV rapid testing available (10%), or participating in the federal 340B Drug Discount Program (2%). In addition, health systems and community-level factors influence health center implementation of evidence

  17. IMPLEMENTATION OF SERVICE ORIENTED ARCHITECTURE USING ITIL BEST PRACTICES

    Directory of Open Access Journals (Sweden)

    A. WAHAB

    2015-06-01

    Full Text Available Service Oriented Architecture (SOA principles normally allows the software applications to integrate with other software applications by means of a service in order to achieve the reusability, interoperability and this can also reduce the time of the other applications, which results in the support of new or changed business processes. However the expectation with SOA based applications in enterprise system was quite extensive and which hasn’t been completely fulfilled for both IT and business. This paper proposes guidance in the implementation of SOA using the Information Technology Infrastructure Library (ITIL best practices and from this a realization will come about the planning, designing and operating the SOA.

  18. BIM IMPLEMENTATION IN A NEW ZEALAND CONSULTING QUANTITY SURVEYING PRACTICE

    OpenAIRE

    Curtis Harrison; Derek Thurnell

    2015-01-01

    5D BIM – generating cost data via the building information modelling (BIM) process- has the potential to be used by quantity surveyors (QSs) to streamline their workflows and increase their provision of quality service. Consultant QSs experienced in the use 5D BIM, from the New Zealand office of one large global practice, were interviewed on their perceptions of the benefits of, and barriers to, 5D BIM implementation within their firm. Findings suggest that 5D BIM has numerous benefits over t...

  19. Developing an active implementation model for a chronic disease management program

    Directory of Open Access Journals (Sweden)

    Margrethe Smidth

    2013-06-01

    Full Text Available Background: Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council’s model for complex interventions and the Chronic Care Model.Methods: We used the Medical Research Council’s five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model.Results: The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council’s model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active

  20. Developing an active implementation model for a chronic disease management program

    Directory of Open Access Journals (Sweden)

    Margrethe Smidth

    2013-06-01

    Full Text Available Background: Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council’s model for complex interventions and the Chronic Care Model.Methods: We used the Medical Research Council’s five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. Results: The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council’s model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active

  1. Developing an active implementation model for a chronic disease management program.

    Science.gov (United States)

    Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

    2013-04-01

    Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council's model for complex interventions and the Chronic Care Model. We used the Medical Research Council's five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council's model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial

  2. Maintenance Management in Network Utilities Framework and Practical Implementation

    CERN Document Server

    Gómez Fernández, Juan F

    2012-01-01

    In order to satisfy the needs of their customers, network utilities require specially developed maintenance management capabilities. Maintenance Management information systems are essential to ensure control, gain knowledge and improve-decision making in companies dealing with network infrastructure, such as distribution of gas, water, electricity and telecommunications. Maintenance Management in Network Utilities studies specified characteristics of maintenance management in this sector to offer a practical approach to defining and implementing  the best management practices and suitable frameworks.   Divided into three major sections, Maintenance Management in Network Utilities defines a series of stages which can be followed to manage maintenance frameworks properly. Different case studies provide detailed descriptions which illustrate the experience in real company situations. An introduction to the concepts is followed by main sections including: • A Literature Review: covering the basic concepts an...

  3. SOFTWARE TRAINING AIDS DEVELOPMENT AND IMPLEMENTATION IN PROFESSIONAL PREPARATION PRACTICE OF TECHNOLOGICAL EDUCATION TEACHER

    Directory of Open Access Journals (Sweden)

    Anatoliy G. Gritchenko

    2013-03-01

    Full Text Available The article outlines the theoretical and practical aspects of software training aids development and implementation in professional preparation practice of technological education teacher. The myriad opportunities of new information technologies are described; the characteristic features of modern software training tool (STT are revealed; the main algorithmic structure circuits of training programs construction (linear, cyclic, with hyperlinks, to the labels, which enable the development of STT variety and functionality are given; the methodology of STT creating is described based on the analysis of the technology teacher preparation in HEE content, MITE didactic functions and selection criteria of educational software for this area of specialist’s preparation.

  4. Effect of care management program structure on implementation: a normalization process theory analysis.

    Science.gov (United States)

    Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

    2016-08-15

    Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice. Data collection involved semi-structured interviews and observations conducted at 25 practices in five physician organizations in Michigan, USA. Practices were selected to reflect variation in physician organizations, type of care management program, and degree of normalization. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with NPT as a guiding framework. Seventy interviews and 25 observations were completed. Two key structures for care management organization emerged: practice-based care management where the care managers were embedded in the practice as part of the practice team; and centralized care management where the care managers worked independently of the practice work flow and was located outside the practice. There were differences in normalization of care management across practices. Practice-based care management was generally better normalized as compared to centralized care management. Differences in normalization were well explained by the NPT, and in particular the collective action construct. When care managers had multiple and flexible opportunities for communication (interactional workability), had the requisite knowledge, skills, and personal characteristics (skill set workability), and the organizational support and resources (contextual integration), a trusting professional relationship

  5. Toward a policy ecology of implementation of evidence-based practices in public mental health settings

    Directory of Open Access Journals (Sweden)

    Bright Charlotte

    2008-05-01

    Full Text Available Abstract Background Mental health policymaking to support the implementation of evidence-based practices (EBPs largely has been directed toward clinicians. However, implementation is known to be dependent upon a broader ecology of service delivery. Hence, focusing exclusively on individual clinicians as targets of implementation is unlikely to result in sustainable and widespread implementation of EBPs. Discussion Policymaking that is informed by the implementation literature requires that policymakers deploy strategies across multiple levels of the ecology of implementation. At the organizational level, policies are needed to resource the added marginal costs of EBPs, and to assist organizational learning by re-engineering continuing education units. At the payor and regulatory levels, policies are needed to creatively utilize contractual mechanisms, develop disease management programs and similar comprehensive care management approaches, carefully utilize provider and organizational profiling, and develop outcomes assessment. At the political level, legislation is required to promote mental health parity, reduce discrimination, and support loan forgiveness programs. Regulations are also needed to enhance consumer and family engagement in an EBP agenda. And at the social level, approaches to combat stigma are needed to ensure that individuals with mental health need access services. Summary The implementation literature suggests that a single policy decision, such as mandating a specific EBP, is unlikely to result in sustainable implementation. Policymaking that addresses in an integrated way the ecology of implementation at the levels of provider organizations, governmental regulatory agencies, and their surrounding political and societal milieu is required to successfully and sustainably implement EBPs over the long term.

  6. From Implementation to Outcomes to Impacts: Designing a Comprehensive Program Evaluation

    Science.gov (United States)

    Shebby, S.

    2015-12-01

    Funders are often interested in learning about the impact of program activities, yet before the impacts are determined, educational evaluations should first examine program implementation and outcomes. Implementation evaluation examines how and the extent to which program activities are delivered as intended, including the extent to which activities reached the targeted participants. Outcome evaluation is comprised of a systematic examination of the effects that a program has on program participants, such as changes in knowledge, attitudes, beliefs, values, and behaviors. In this presentation, presenters will share insights on evaluating the implementation, outcomes, and impacts associated with an online science curriculum for K-2 students. The science curriculum was designed to provide students with access to science concepts and skills in an interactive and innovative environment, and teachers with embedded, aligned, and on-demand professional development. One of the most important—and challenging—steps in this evaluation was to select outcomes that were well-defined, measurable, and aligned to program activities, as well as relevant to program stakeholders. An additional challenge was to measure implementation given limited access to the classroom environment. This presentation will include a discussion of the process evaluators used to select appropriate implementation indicators and outcomes (teacher and student), design an evaluation approach, and craft data collection instruments. Although examples provided are specific to the K-2 science intervention, the best practices discussed are pertinent to all program and event evaluations. Impact evaluation goes beyond implementation and outcome evaluation to inform whether a program is working or not. It requires a comparison group to inform what outcomes would have been in the absence of the intervention. As such, this presentation will also include a discussion of impacts, including how impacts are defined

  7. Do Program Implementation Factors or Fidelity Affect Chronic Disease Self-Management Education Programs' Outcomes?

    Science.gov (United States)

    Brady, Teresa J; Murphy, Louise B; O'Colmain, Benita J; Hobson, Reeti Desai

    2017-09-01

    To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. Community. N = 10 792. Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. Meta-analysis using pooled effect sizes. Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.

  8. Statistical coordinates of the LEADER Program implementation process in Romania

    Directory of Open Access Journals (Sweden)

    Klára - Dalma POLGÁR (DESZKE

    2015-12-01

    Full Text Available The LEADER program, the fourth priority direction for financing through European Agricultural Fund for Rural Development – EAFRD, consists in implementing local development strategies for improving administrative governance in rural areas. This paper presents the management of rural development by the National Network for Rural Development and the status of implementation of the LEADER program in Romania, until December 2014. The funded projects of rural development meet the requirements of local communities identified by the operational structures of type LAG - Local Action Group, through appropriate measures, specific to each county.

  9. Prevention of neonatal unplanned extubations in the neonatal intensive care unit: a best practice implementation project.

    Science.gov (United States)

    Hu, Xiaojing; Zhang, Yuxia; Cao, Yun; Huang, Guoying; Hu, Yan; McArthur, Alexa

    2017-11-01

    Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital. Evidence-based audit criteria were used to conduct an audit in the neonatal intensive care unit, Children's Hospital of Fudan University, Shanghai. The program included three phases and was conducted from May 2016 to October 2016. The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tools for promoting change in health practice were used to ascertain compliance with the criteria before and after the implementation of best practice. Compared with the baseline audit, the follow-up audit results demonstrated increased compliance rates for securement procedures, documentation of position and security of the endotracheal tube. Compliance for standardized care practice documentation increased from 0% to 100%; compliance for standard care practice implementation increased from 0% to 54.9%; and compliance for staff education increased from 66.7% to 100%. The neonatal intensive care unit also achieved the benchmark of less than one UE per 100 intubation days. This implementation project achieved a significant improvement in establishing evidence-based prevention of unplanned extubations in the neonatal intensive care unit of Children's Hospital of Fudan University, China. Standardizing the procedures represented an important step toward refining the quality improvement process.

  10. How to Implement a Geriatric Assessment in Your Clinical Practice

    Science.gov (United States)

    Sattar, Schroder; Alibhai, Shabbir M.H.; Wildiers, Hans

    2014-01-01

    Cancer is a disease that mostly affects older adults. Other health conditions, changes in functional status, and use of multiple medications change the risks and benefits of cancer treatment for older adults. Several international organizations, such as the International Society of Geriatric Oncology, the European Organization for Research and Treatment of Cancer, recommend the conduct of a geriatric assessment (GA) for older adults with cancer to help select the most appropriate treatment and identify any underlying undetected medical, functional, and psychosocial issues that can interfere with treatment. The aim of this review is to describe what a GA is and how to implement it in daily clinical practice for older adults with cancer in the oncology setting. We provide an overview of commonly used tools. Key considerations in performing the GA include the resources available (staff, space, and time), patient population (who will be assessed), what GA tools to use, and clinical follow-up (who will be responsible for using the GA results for developing care plans and who will provide follow-up care). Important challenges in implementing GA in clinical practice include not having easy and timely access to geriatric expertise, patient burden of the additional hospital visits, and establishing collaboration between the GA team and oncologists regarding expectations of the population referred for GA and expected outcomes of the GA. Finally, we provide some possible interventions for problems identified during the GA. PMID:25187477

  11. Applying Best Practices to Florida Local Government Retrofit Programs

    Energy Technology Data Exchange (ETDEWEB)

    McIlvaine, J. [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Sutherland, K. [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States)

    2013-12-01

    In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annual energy savings of 15%-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.

  12. Applying Best Practices to Florida Local Government Retrofit Programs

    Energy Technology Data Exchange (ETDEWEB)

    McIlvaine, J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sutherland, K. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-12-01

    In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annual energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the 'current best practices.' A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.

  13. Developing programs for homeless veterans: understanding driving forces in implementation.

    Science.gov (United States)

    Nakashima, John; McGuire, Jim; Berman, Stephen; Daniels, William

    2004-01-01

    Between 1992 and 2003, services for homeless veterans at the Veterans Affairs Greater Los Angeles Healthcare System went from inappropriate utilization of hospital medical and psychiatric beds, to a continuum of residential treatment, transitional housing, and employment programs through arrangements with private agencies. The authors use elements of Hasenfeld and Brock's Political Economy Model (1991) to explain this transformation in service delivery that was spearheaded by a VA social work leadership team. It is argued that three driving forces crucial to program implementation were present: technological certainty, economic stability, and concentration of power. Evidence of the implementation's impact includes creation of new homeless program beds, a reduction in use of medical/psychiatric beds, and a large number of formerly homeless veterans with housing and employment at program discharge. Study limitations and implications for future studies are discussed.

  14. A discharge planning program in orthopaedics: experiences in implementation and evaluation.

    Science.gov (United States)

    Matt-Hensrud, N; Severson, M; Hansen, D C; Holland, D E

    2001-01-01

    The acute care orthopaedic registered nurse plays a key role in assessing and communicating the continuing care needs of patient's and their families, coordinating community resources, and formulating a timely discharge plan to maximize rehabilitation and recovery. Developing and maintaining a staff nurse's discharge planning knowledge and skills can be a challenging endeavor. Discharge Planning Coordinators at a tertiary medical center developed and implemented a Discharge Planning Mentorship Program, an educational pilot program designed to enhance the knowledge and skill level of select nurses in the orthopaedic specialty practice, thus maximizing expert resources at the bedside. Program implementation and evaluation of role preparation, practice changes, and actualization challenges are discussed in this article. Overall, participants demonstrated increased skill in articulating and problem solving a patient's postdischarge needs, devised creative strategies to enhance communication between multiple levels of care, and developed a greater knowledge of community resources and reimbursement mechanisms for continuing care.

  15. Implementation of a health care policy: An analysis of barriers and facilitators to practice change

    Directory of Open Access Journals (Sweden)

    Sword Wendy

    2005-08-01

    Full Text Available Abstract Background Governments often create policies that rely on implementation by arms length organizations and require practice changes on the part of different segments of the health care system without understanding the differences in and complexities of these agencies. In 2000, in response to publicity about the shortening length of postpartum hospital stay, the Ontario government created a universal program offering up to a 60-hour postpartum stay and a public health follow-up to mothers and newborn infants. The purpose of this paper is to examine how a health policy initiative was implemented in two different parts of a health care system and to analyze the barriers and facilitators to achieving practice change. Methods The data reported came from two studies of postpartum health and service use in Ontario Canada. Data were collected from newly delivered mothers who had uncomplicated vaginal deliveries. The study samples were drawn from the same five purposefully selected hospitals for both studies. Questionnaires prior to discharge and structured telephone interviews at 4-weeks post discharge were used to collect data before and after policy implementation. Qualitative data were collected using focus groups with hospital and community-based health care practitioners and administrators at each site. Results In both studies, the respondents reflected a population of women who experienced an "average" or non-eventful hospital-based, singleton vaginal delivery. The findings of the second study demonstrated wide variance in implementation of the offer of a 60-hour stay among the sites and focus groups revealed that none of the hospitals acknowledged the 60-hour stay as an official policy. The uptake of the offer of a 60-hour stay was unrelated to the rate of offer. The percentage of women with a hospital stay of less than 25 hours and the number with the guideline that the call be within 48 hours of hospital discharge. Public health

  16. BIM IMPLEMENTATION IN A NEW ZEALAND CONSULTING QUANTITY SURVEYING PRACTICE

    Directory of Open Access Journals (Sweden)

    Curtis Harrison

    2015-07-01

    Full Text Available 5D BIM – generating cost data via the building information modelling (BIM process- has the potential to be used by quantity surveyors (QSs to streamline their workflows and increase their provision of quality service. Consultant QSs experienced in the use 5D BIM, from the New Zealand office of one large global practice, were interviewed on their perceptions of the benefits of, and barriers to, 5D BIM implementation within their firm. Findings suggest that 5D BIM has numerous benefits over traditional methods, chiefly through the increased efficiency and visualization that BIM provides, along with the rapid identification of design changes. However, realization of these perceived benefits limited to date, due to several barriers hindering 5D BIM implementation: incomplete design and insufficient model object data in the BIM model; a lack of standards to facilitate electronic measurement; legal issues, and a lack of government support. However, participants perceived that 5D BIM implementation will achieve these benefits to a far greater extent in the future. Further research is recommended to identify the BIM skills which QSs will need in the future to reach the full potential of 5D BIM

  17. School Gardens: A Qualitative Study on Implementation Practices

    Directory of Open Access Journals (Sweden)

    Nele Huys

    2017-11-01

    Full Text Available School gardens have beneficial effects on children’s dietary behaviors but information on its implementation is scarce. The current study aimed to gain insight in implementation practices of school gardens and in perceptions of key members and children towards a school garden. We conducted twelve interviews involving 14 key members and five focus groups with 38 children from fifth to sixth grade (10–13 years old in four primary schools in Ghent (Flanders, Belgium. We analyzed the interviews and focus groups in NVivo, using thematic analysis. School gardens were mainly initiated to involve children in nature, not to improve vegetable consumption. Participants were positive about having a school garden, experienced facilitating factors (e.g., adaptability of the garden, having a person responsible for the garden, but also various barriers (e.g., difficulties with startup, maintenance during summer holidays and integration in the school curriculum and suggested some solutions (e.g., involving external organizations and parents, expanding the garden and motivating factors for children (e.g., colorful plants, use of gloves. In order to improve implementation and to contribute to children’s health, future school gardening projects should take the recommendations of key members and children into account.

  18. Design and implementation of modular software for programming mobile robots

    Directory of Open Access Journals (Sweden)

    Luca Iocchi

    2008-11-01

    Full Text Available This article describes a software development toolkit for programming mobile robots, that has been used on different platforms and for different robotic applications. We address design choices, implementation issues and results in the realization of our robot programming environment, that has been devised and built from many people since 1998. We believe that the proposed framework is extremely useful not only for experienced robotic software developers, but also for students approaching robotic research projects.

  19. Design and Implementation of Modular Software for Programming Mobile Robots

    Directory of Open Access Journals (Sweden)

    Alessandro Farinelli

    2006-03-01

    Full Text Available This article describes a software development toolkit for programming mobile robots, that has been used on different platforms and for different robotic applications. We address design choices, implementation issues and results in the realization of our robot programming environment, that has been devised and built from many people since 1998. We believe that the proposed framework is extremely useful not only for experienced robotic software developers, but also for students approaching robotic research projects.

  20. Organizational attributes of practices successful at a disease management program.

    Science.gov (United States)

    Cloutier, Michelle M; Wakefield, Dorothy B; Tsimikas, John; Hall, Charles B; Tennen, Howard; Brazil, Kevin

    2009-02-01

    To assess the contribution of organizational factors to implementation of 3 asthma quality measures: enrollment in a disease management program, development of a written treatment plan, and prescription of severity-appropriate anti-inflammatory therapy. A total of 138 pediatric clinicians and 247 office staff in 13 urban clinics and 23 nonurban private practices completed questionnaires about their practice's organizational characteristics (eg, leadership, communication, perceived effectiveness, job satisfaction). 94% of the clinicians and 92% of the office staff completed questionnaires. When adjusted for confounders, greater practice activity and perceived effectiveness in meeting family needs were associated with higher rates of enrollment in the Easy Breathing program, whereas higher scores for 3 organizational characteristics--communication timeliness, decision authority, and job satisfaction--were associated with both higher enrollment and a greater number of written treatment plans. None of the organizational characteristics was associated with greater use of anti-inflammatory therapy. Three organizational characteristics predicted 2 quality asthma measures: use of a disease management program and creation of a written asthma treatment plan. If these organizational characteristics were amenable to change, then our findings could help focus interventions in areas of effective and acceptable organizational change.

  1. Developing evidence-based librarianship: practical steps for implementation.

    Science.gov (United States)

    Crumley, Ellen; Koufogiannakis, Denise

    2002-06-01

    Evidence-based librarianship (EBL) is a relatively new concept for librarians. This paper lays out a practical framework for the implementation of EBL. A new way of thinking about research in librarianship is introduced using the well-built question process and the assignment of librarian research questions to one of six domains specific to librarianship. As a profession, librarianship tends to reflect more qualitative, social sciences/humanities in its research methods and study types which tend to be less rigorous and more prone to bias. Randomised controlled trials (RCT) do not have to be placed at the top of an evidence 'hierarchy' for librarianship. Instead, a more encompassing model reflecting librarianship as a whole and the kind of research likely to be done by librarians is proposed. 'Evidence' from a number of disciplines including health sciences, business and education can be utilized by librarians and applied to their practice. However, access to and availability of librarianship literature needs to be further studied. While using other disciplines (e.g. EBHC) as a model for EBL has been explored in the literature, the authors develop models unique to librarianship. While research has always been a minor focus in the profession, moving research into practice is becoming more important and librarians need to consider the issues surrounding research in order to move EBL forward.

  2. Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs.

    Science.gov (United States)

    Main, Chris J; Nicholas, Michael K; Shaw, William S; Tetrick, Lois E; Ehrhart, Mark G; Pransky, Glenn

    2016-12-01

    Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision

  3. Impact of quality assurance program: providing practice assessment.

    Science.gov (United States)

    Saporito, R A; Feldman, C A; Stewart, D C; Echoldt, H; Buchanan, R N

    1994-05-01

    Participation in a self-administered quality assessment (SAQA) program led to changes in New Jersey dentists' perceptions of practice quality. Ninety-four percent indicated they discovered practice deficiencies. This study suggests that using a self-administered quality assessment program, such as the SAQA program, can lead to a better understanding of a practice's strengths and weaknesses.

  4. Practical applications approach to design, development and implementation of an integrated management system.

    Science.gov (United States)

    Holdsworth, Rodger

    2003-11-14

    The introduction of quality, risk, safety, health and environmental management philosophies has significantly changed industry's view of company organization and controlling processes. Quality, risk, safety, health and environmental programs and systems, such as ISO 9000, ISO 14000, process safety, and risk management are impacting the way industry will meet the challenges of safety and environmental risks and the needs of the customer in the future.A wealth of knowledge has been extracted from practical application case studies, which would otherwise be unobtainable without years of experience related to management systems design, development, implementation and control. This paper discusses a practical applications approach to design, develop and implement an integrated management system encompassing quality (ISO 9000), process safety management (CFR 29 1910.119), risk management programs (CFR 40 part 68), environmental management (ISO 14000), and safety and health. This paper includes a discussion of management systems integration and an overview of management systems standards that apply to the petrochemical and chemical manufacturers industries. The paper also provides an overview on integrating management systems, including issues related to the following topics: Establishing a management system team and objectives. Assessing and knowing your organization. Designing the management system to meet site objectives. Developing system documentation. Implementing effective management systems. Measuring program performance. Continuous improvement.

  5. Practical applications approach to design, development and implementation of an integrated management system

    Energy Technology Data Exchange (ETDEWEB)

    Holdsworth, Rodger

    2003-11-14

    The introduction of quality, risk, safety, health and environmental management philosophies has significantly changed industry's view of company organization and controlling processes. Quality, risk, safety, health and environmental programs and systems, such as ISO 9000, ISO 14000, process safety, and risk management are impacting the way industry will meet the challenges of safety and environmental risks and the needs of the customer in the future. A wealth of knowledge has been extracted from practical application case studies, which would otherwise be unobtainable without years of experience related to management systems design, development, implementation and control. This paper discusses a practical applications approach to design, develop and implement an integrated management system encompassing quality (ISO 9000), process safety management (CFR 29 1910.119), risk management programs (CFR 40 part 68), environmental management (ISO 14000), and safety and health. This paper includes a discussion of management systems integration and an overview of management systems standards that apply to the petrochemical and chemical manufacturers industries. The paper also provides an overview on integrating management systems, including issues related to the following topics: - Establishing a management system team and objectives. - Assessing and knowing your organization. - Designing the management system to meet site objectives. - Developing system documentation. - Implementing effective management systems. - Measuring program performance. - Continuous improvement.

  6. Purposeful and timely nursing rounds: a best practice implementation project.

    Science.gov (United States)

    Daniels, Juli F

    2016-01-01

    Purposeful and timely rounding is a best practice intervention to routinely meet patient care needs, ensure patient safety, decrease the occurrence of patient preventable events, and proactively address problems before they occur. The Institute for Healthcare Improvement (IHI) endorsed hourly rounding as the best way to reduce call lights and fall injuries, and increase both quality of care and patient satisfaction. Nurse knowledge regarding purposeful rounding and infrastructure supporting timeliness are essential components for consistency with this patient centred practice. The project aimed to improve patient satisfaction and safety through implementation of purposeful and timely nursing rounds. Goals for patient satisfaction scores and fall volume were set. Specific objectives were to determine current compliance with evidence-based criteria related to rounding times and protocols, improve best practice knowledge among staff nurses, and increase compliance with these criteria. For the objectives of this project the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool were used. Direct observation of staff nurses on a medical surgical unit in the United States was employed to assess timeliness and utilization of a protocol when rounding. Interventions were developed in response to baseline audit results. A follow-up audit was conducted to determine compliance with the same criteria. For the project aims, pre- and post-intervention unit-level data related to nursing-sensitive elements of patient satisfaction and safety were compared. Rounding frequency at specified intervals during awake and sleeping hours nearly doubled. Use of a rounding protocol increased substantially to 64% compliance from zero. Three elements of patient satisfaction had substantive rate increases but the hospital's goals were not reached. Nurse communication and pain management scores increased modestly (5% and 11

  7. A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice

    DEFF Research Database (Denmark)

    Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming

    2016-01-01

    BACKGROUND: Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from......IS including outreach visits, quality reports, and the STarT Back Tool for subgrouping patients with LBP. Both groups were offered the usual dissemination of guidelines, guideline-concordant structuring of the medical record, and a new referral opportunity for patients with psycho-social problems...

  8. Community-Level Successes and Challenges to Implementing Adolescent Sex Education Programs

    Science.gov (United States)

    Rouse, Maura; Resseguie, Jamie; Smith, Hannah; Woodcox, Stephanie

    2010-01-01

    Best practices for adolescent sex education recommend science-based approaches. However, little is known about the capacity and needs of organizations who implement sex education programs on the local level. The purpose of this research was to describe successes and challenges of community organizations in implementing science-based sex education. Using qualitative methods, we interviewed program directors and educators in 17 state-funded adolescent pregnancy prevention/sex education programs as part of a larger mixed methods evaluation. Semi-structured interviews focused on success and challenges faced in implementing science-based approaches to program design, implementation and evaluation. Interviews were audio-recorded, transcribed and analyzed using a thematic approach. Grantees included a range of programs, from short programs on puberty and HIV for late elementary students, to skills-based curricular sex education programs for high schools, to year-long youth development programs. Key aspects of curricular choice included meeting the needs of the population, and working within time constraints of schools and other community partners. Populations presenting specific challenges included rural youth, youth in juvenile justice facilities, and working with Indiana's growing Latino population. Programs self-developing curricula described challenges related to assessment and evaluation of impact. Programs using commercial curricula described challenges related to curricular selection and adaptation, in particularly shortening curricula, and adapting to different cultural or social groups. A remarkable degree of innovation was observed. The use of qualitative methods permitted the identification of key challenges and successes in a state-sponsored small grants program. Information can be used to enhance program capacity and quality. PMID:20180004

  9. Status of Satellite Television Broadcast Programs Implementation in ...

    African Journals Online (AJOL)

    (classroom interaction) is conducive for effective implementation of the satellite plasma television program? • What are the possible advantages and limitations of the plasma instruction? .... classroom teachers' use of lesson introduction. Accordingly, only 65.3% of .... 4 It decreases teachers creativity. 53. 47. 428. 5 It reduces ...

  10. Implementing a Moral Education Program through Attitude Change Theory.

    Science.gov (United States)

    Hughes, Richard L.; Casper, Daniel

    1979-01-01

    Major theories of attitude change are explained: stimulus-response and reinforcement theory, functional theory, social judgment theory, and consistency theory. These theories are applied to the problems of influencing staff toward implementing a program of moral education. (Author/SJL)

  11. A Framework for Implementing TQM in Higher Education Programs

    Science.gov (United States)

    Venkatraman, Sitalakshmi

    2007-01-01

    Purpose: This paper aims to provide a TQM framework that stresses continuous improvements in teaching as a plausible means of TQM implementation in higher education programs. Design/methodology/approach: The literature survey of the TQM philosophies and the comparative analysis of TQM adoption in industry versus higher education provide the…

  12. Learning Computer Programming: Implementing a Fractal in a Turing Machine

    Science.gov (United States)

    Pereira, Hernane B. de B.; Zebende, Gilney F.; Moret, Marcelo A.

    2010-01-01

    It is common to start a course on computer programming logic by teaching the algorithm concept from the point of view of natural languages, but in a schematic way. In this sense we note that the students have difficulties in understanding and implementation of the problems proposed by the teacher. The main idea of this paper is to show that the…

  13. Implementing Quality Service-Learning Programs in Community Colleges

    Science.gov (United States)

    Vaknin, Lauren Weiner; Bresciani, Marilee J.

    2013-01-01

    This cross-case comparative study at Western Community College and the University of the Coast explored through a constructive lens the characteristics that lead to sustainable, high quality service-learning programs and how they are implemented at institutions of higher education. The researchers determined that both Western Community College and…

  14. Implementation of a proton pump inhibitor stewardship program.

    Science.gov (United States)

    Davis, Kelly W; Hanners, Rachel E; Lockwood, Sean M

    2017-06-15

    The development and implementation of a proton pump inhibitor (PPI) stewardship program at a single institution are described. Due to the overuse of PPIs and the increasing awareness of the adverse drug events associated with long-term PPI therapy, the pharmacy and internal medicine services of a medical center implemented a PPI stewardship program. All patients admitted to the internal medicine service were evaluated by the PPI stewardship team to determine if they had an appropriate indication for PPI continuation in the hospital as well as after discharge. If patients did not meet specified criteria for continuation of PPI use during hospitalization, PPI therapy was suspended and replaced by as-needed acid suppressive therapy, and the patients received discharge counseling regarding the implemented medication regimen changes. Challenges encountered during program development included establishing appropriate criteria for PPI continuation and determining the best method for discontinuing PPIs in order to reduce the risk of rebound hyperacidity. In an effort to reduce unnecessary PPI use, a PPI stewardship program was developed and implemented to ensure appropriate continuation of PPIs for patients admitted and discharged from an internal medicine service. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  15. Designing and Implementing Effective Adapted Physical Education Programs

    Science.gov (United States)

    Kelly, Luke E.

    2011-01-01

    "Designing and Implementing Effective Adapted Physical Education Programs" was written to assist adapted and general physical educators who are dedicated to ensuring that the physical and motor needs of all their students are addressed in physical education. While it is anticipated that adapted physical educators, where available, will typically…

  16. NIF Programs Directorate: Integrated Safety Management System Implementation Plan October 2000

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, L

    2001-09-17

    Lawrence Livermore National Laboratory (LLNL) has developed a work structure that serves to ensure work is performed safely and in compliance with applicable environment, safety, and health (ES&H) requirements. Safety begins and ends with the worker ''on the floor'' conducting the work activity. The primary focus of the NIF Programs Integrated Safety Management System (ISMS) is to provide the worker with a sound work environment, necessary resources to perform the job, and adequate procedures and controls to ensure the work is performed safely. It is to this end that the ES&H roles, responsibilities, and authorities are developed and practiced. NIF Programs recognizes and understands the Department of Energy (DOE)/University of California (UC) Contract requirements for ISMS at LLNL and the opportunities and values of the system. NIF Programs understands and supports the DOE Integrated Safety Management (ISM) objective, guiding principles, core functions, and the institutional requirements contained in the LLNL ISMS Description document. NIF Programs is committed to implementing and utilizing ISMS in all of its programs, operations, facilities, and activities and to continuing to assess its successful implementation and use. NIF Programs ISMS has been developed consistent with the requirements of the ''LLNL Integrated Safety Management System Description'' document and specific ISMS implementation needs of NIF Programs. The purpose of this document is to define for NIF Programs' workers and communicate to both senior LLNL management and DOE how and where NIF Programs satisfies the institutional ISM requirements. This document consists of: (1) A NIF Programs document hierarchy that illustrates the flow of ES&H requirements from the directorate level to the worker. (2) A roles, responsibilities, and authorities section for ES&H management chain positions, (3) An ISM implementation matrix that references specific

  17. Evaluating the Implementation of an Olympic Education Program in Greece

    Science.gov (United States)

    Grammatikopoulos, Vasilios; Tsigilis, Nikolaos; Koustelios, Athanasios; Theodorakis, Yannis

    2005-11-01

    The aim of this study was to develop an instrument for evaluating how an education program has been implemented. Such evaluation can provide insight into the effectiveness of a program. Examined here was the Olympic Education Program used in Greek schools since 2000. In it, students learn the history of the Olympic games and the importance of exercise for health along with the principles and values of sports and volunteerism. The evaluation instrument underlying this study addressed the following six factors: `facilities', `administration', `educational material', `student-teacher relationships', `educational procedures', and `training'. Results indicate that the instrument, while adequate for assessing effectiveness, should be combined with advanced statistical methods.

  18. Implementing Probabilistic Abductive Logic Programming with Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning

    2008-01-01

    A class of Probabilistic Abductive Logic Programs (PALPs) is introduced and an implementation is developed in CHR for solving abductive problems, providing minimal explanations with their probabilities. Both all-explanations and most-probable-explanations versions are given. Compared with other...... probabilistic versions of abductive logic programming, the approach is characterized by higher generality and a flexible and adaptable architecture which incorporates integrity constraints and interaction with external constraint solvers. A PALP is transformed in a systematic way into a CHR program which serves...

  19. Indicators of successful implementation of programs to promote healthy weight among women.

    Science.gov (United States)

    Drayton, V L C; Walker, D K; Mikolowsky, K

    2015-03-01

    Obesity rates have steadily increased over the past two decades. To address the epidemic in women, the Health Resources and Services Administration's Maternal and Child Health Bureau, Division of Healthy Start and Perinatal Services (HRSA/MCHB/DHSPS) awarded 14 demonstration grants to community health centers, health departments, universities and community-based organizations in 12 states to develop innovative approaches aimed at reducing the prevalence of overweight and obesity, specifically in women of childbearing age. Grantees implemented modified or existing evidence-based programs (EBP) or promising practices tailored to the geographic locations, cultures and traditional values of the communities. A review of the 15 programs implemented from 2004 to 2007 was conducted using the methodology outlined in the Transparent Reporting of Evaluations with Nonrandomized Designs Statement to identify indicators of successful program implementation. The six indicators identified were: (1) supportive organizational culture with adequate resources and appropriate staff; (2) attention to the needs of the service population; (3) a referral system that links participants to appropriate services; (4) flexible schedules; (5) support for child care and transportation; and (6) formal and informal support systems to keep participants engaged and motivated. Two of the programs that reported improved participant outcomes are available for replication: La Vida Sana, La Vida Feliz in Illinois was designated as a promising practice by the Association of Maternal and Child Health Programs and Sisters in Action in Michigan was rated as a moderate evidence-based program by the Agency for Healthcare Research and Quality.

  20. 75 FR 63480 - Medicaid Program: Implementation of Section 614 of the Children's Health Insurance Program...

    Science.gov (United States)

    2010-10-15

    ... HUMAN SERVICES Medicaid Program: Implementation of Section 614 of the Children's Health Insurance... Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-3. Section 614... Security Act and for child health assistance expenditures under the Children's Health Insurance Program...

  1. Acceptance and perceived barriers of implementing a guideline for managing low back in general practice

    Directory of Open Access Journals (Sweden)

    Pfingsten Michael

    2008-02-01

    Full Text Available Abstract Background Implementation of guidelines in clinical practice is difficult. In 2003, the German College of General Practitioners and Family Physicians (DEGAM released an evidence-based guideline for the management of low back pain (LBP in primary care. The objective of this study is to explore the acceptance of guideline content and perceived barriers to implementation. Methods Seventy-two general practitioners (GPs participating in quality circles within the framework of an educational intervention study for guideline implementation evaluated the LBP-guideline and its practicability with a standardised questionnaire. In addition, statements of group discussions were recorded using the metaplan technique and were incorporated in the discussion. Results Most GPs agree with the guideline content but believe that guideline stipulations are not congruent with patient wishes. Non-adherence to the guideline and contradictory information for patients by other professionals (e.g., GPs, orthopaedic surgeons, physiotherapists are important barriers to guideline adherence. Almost half of the GPs have no access to recommended multimodal pain programs for patients with chronic LBP. Conclusion Promoting adherence to the LBP guideline requires more than enhancing knowledge about evidence-based management of LBP. Public education and an interdisciplinary consensus are important requirements for successful guideline implementation into daily practice. Guideline recommendations need to be adapted to the infrastructure of the health care system. Trial registration BMBF Grant Nr. 01EM0113. FORIS (database for research projects in social science Reg #: 20040116 25.

  2. Steps to a HealthierUS Cooperative Agreement Program: foundational elements for program evaluation planning, implementation, and use of findings.

    Science.gov (United States)

    MacDonald, Goldie; Garcia, Danyael; Zaza, Stephanie; Schooley, Michael; Compton, Don; Bryant, Terry; Bagnol, Lulu; Edgerly, Cathy; Haverkate, Rick

    2006-01-01

    The Steps to a HealthierUS Cooperative Agreement Program (Steps Program) enables funded communities to implement chronic disease prevention and health promotion efforts to reduce the burden of diabetes, obesity, asthma, and related risk factors. At both the national and community levels, investment in surveillance and program evaluation is substantial. Public health practitioners engaged in program evaluation planning often identify desired outcomes, related indicators, and data collection methods but may pay only limited attention to an overarching vision for program evaluation among participating sites. We developed a set of foundational elements to provide a vision of program evaluation that informs the technical decisions made throughout the evaluation process. Given the diversity of activities across the Steps Program and the need for coordination between national- and community-level evaluation efforts, our recommendations to guide program evaluation practice are explicit yet leave room for site-specific context and needs. Staff across the Steps Program must consider these foundational elements to prepare a formal plan for program evaluation. Attention to each element moves the Steps Program closer to well-designed and complementary plans for program evaluation at the national, state, and community levels.

  3. Implementing incentivized practice to improve patient care in developing countries.

    Science.gov (United States)

    Mohiuddin, Zia; Sanchez, Laura Rosemary; Alcantra, Jose Manuel; Shuaib, Waqas

    2014-01-01

    Faculty awards provide an incentive to encourage higher standards of personal performance, which closely reflects the quality of health care. We report the development and implementation of the first medical faculty award program in the region. Anonymous preaward survey evaluated responses to understand the overall state of our institution. Five awards were celebrated. An anonymous postaward survey gathered responses to evaluate the effectiveness of the program. A total of 60% (307/509) of preaward survey responses were collected. Among those, 92% (283/307) felt that employee recognition was important and 78% (240/307) felt that performance should be the deciding criteria for employee recognition. A 24% (20/85) of the faculty received the decade of excellence award and 13% (11/85) received the compassionate physician award. Best service award was granted to 7% (6/85) of the nominees. Postaward survey showed 68% (170/250) agreed that the award ceremony incentivized them to increase quality of personal performance. In summary, we feel that this transparent, objective, and peer-nominated awards program could serve as an incentivized model for health care providers to elevate the standards of personal performance, which in turn will benefit the advancement of patient care.

  4. ERP implementation and organizational performance. A Romanian case study of best practices

    Directory of Open Access Journals (Sweden)

    Valentin Florentin Dumitru

    2013-06-01

    Full Text Available Best practices are conceived in management as improvement programs leading to higher organizational performance. We hereby take an interest in the effects of Enterprise Resource Planning (ERP, systems implementation as managerial tools on firm performance, in connection with the organizational processes, and accounting and controlling systems. The aim of this paper is to investigate how the mutual evolution of both organizations and systems transforms the case of ERP implementation in best practices in management and accounting in an emerging economy. This research comes in the context of a slowly developing research based on empirical data in Romania in this area. However, best practices need to be promoted in order to stimulate change, in an increasingly complex and competitive environment, and with fewer resources available to organizations. By an in-depth longitudinal case study, we illustrate how both the ERP system and the case organization evolved, triggering a fit which consequently led to improving organizational performance. The paper has practical contributions for the Romanian business environment, in that Romanian managers and IT employees might become aware how they can leverage their ERP system to exploit its fuller potential, and regarding the importance of the organizational context for the implementation and postimplementation processes.

  5. Emissions Scenarios, Costs, and Implementation Considerations of REDD Programs

    Energy Technology Data Exchange (ETDEWEB)

    Sathaye, Jayant; Andrasko, Ken; Chan, Peter

    2011-04-11

    Greenhouse gas emissions from the forestry sector are estimated to be 8.4 GtCO2-eq./year or about 17percent of the global emissions. We estimate that the cost forreducing deforestation is low in Africa and several times higher in Latin America and Southeast Asia. These cost estimates are sensitive to the uncertainties of how muchunsustainable high-revenue logging occurs, little understood transaction and program implementation costs, and barriers to implementation including governance issues. Due to lack of capacity in the affected countries, achieving reduction or avoidance of carbon emissions will require extensive REDD-plus programs. Preliminary REDD-plus Readiness cost estimates and program descriptions for Indonesia, Democratic Republic of the Congo, Ghana, Guyana and Mexico show that roughly one-third of potential REDD-plus mitigation benefits might come from avoided deforestation and the rest from avoided forest degradation and other REDD-plus activities.

  6. Savannah River Site Environmental Implementation Plan. Volume 2, Protection programs

    Energy Technology Data Exchange (ETDEWEB)

    1989-08-01

    Formal sitewide environmental planning at the . Savannah River Site (SRS) began in 1986 with the development and adoption of the Strategic Environmental Plan. The Strategic Environmental Plan describes the philosophy, policy, and overall program direction of environmental programs for the operation of the SRS. The Strategic Environmental Plan (Volume 2) provided the basis for development of the Environmental Implementation Plan (EIP). The EIP is the detailed, comprehensive environmental master plan for operating contractor organizations at the SRS. The EIP provides a process to ensure that all environmental requirements and obligations are being met by setting specific measurable goals and objectives and strategies for implementation. The plan is the basis for justification of site manpower and funding requests for environmental projects and programs over a five-year planning period.

  7. Implementation of SQLite database support in program gama-local

    Directory of Open Access Journals (Sweden)

    Vaclav Petras

    2012-03-01

    Full Text Available The program gama-local is a part of GNU Gama project and allows adjustment of local geodetic networks. Before realization of this project the program gama-local supported only XML as an input. I designed and implemented support for the SQLite database and thanks to this extension gama-local can read input data from the SQLite database. This article is focused on the specifics of the use of callback functions in C++ using the native SQLite C/C++ Application Programming Interface. The article provides solution to safe calling of callback functions written in C++. Callback functions are called from C library and C library itself is used by C++ program. Provided solution combines several programing techniques which are described in detail, so this article can serve as a cookbook even for beginner programmers.  This project was accomplished within my bachelor thesis.

  8. Practical Implementations of Advanced Process Control for Linear Systems

    DEFF Research Database (Denmark)

    Knudsen, Jørgen K . H.; Huusom, Jakob Kjøbsted; Jørgensen, John Bagterp

    2013-01-01

    Most advanced process control systems are based on Model Predictive Control (MPC). In this paper we discuss three critical issues for the practical implementation of linear MPC for process control applications. The rst issue is related to oset free control and disturbance models; the second issue...... implications for process control. If the control and evaluation intervals are chosen too short, the predicted behaviour of the controllers may have unstable characteristics. Depending of the degrees of freedom, oset-free control of a number of the controlled variables can be achieved by introduction of noise...... models and integration of the innovation errors. If the disturbances increases, oset-free control cannot be achieved without violation of process constraints. A target calculation function is used to calculate the optimal achievable target for the process. The use of soft constraints for process output...

  9. Program Monitoring Practices for Teachers of the Deaf and Hard of Hearing in Early Intervention

    Science.gov (United States)

    Thomas, Anne E.; Marvin, Christine A.

    2016-01-01

    Program monitoring is an important and necessary assessment practice within the field of early childhood deaf education. Effective program monitoring requires a focus on both the consistent implementation of intervention strategies (fidelity) and the assessment of children's ongoing progress in response to interventions (progress monitoring).…

  10. A benchmarking program to reduce red blood cell outdating: implementation, evaluation, and a conceptual framework.

    Science.gov (United States)

    Barty, Rebecca L; Gagliardi, Kathleen; Owens, Wendy; Lauzon, Deborah; Scheuermann, Sheena; Liu, Yang; Wang, Grace; Pai, Menaka; Heddle, Nancy M

    2015-07-01

    Benchmarking is a quality improvement tool that compares an organization's performance to that of its peers for selected indicators, to improve practice. Processes to develop evidence-based benchmarks for red blood cell (RBC) outdating in Ontario hospitals, based on RBC hospital disposition data from Canadian Blood Services, have been previously reported. These benchmarks were implemented in 160 hospitals provincewide with a multifaceted approach, which included hospital education, inventory management tools and resources, summaries of best practice recommendations, recognition of high-performing sites, and audit tools on the Transfusion Ontario website (http://transfusionontario.org). In this study we describe the implementation process and the impact of the benchmarking program on RBC outdating. A conceptual framework for continuous quality improvement of a benchmarking program was also developed. The RBC outdating rate for all hospitals trended downward continuously from April 2006 to February 2012, irrespective of hospitals' transfusion rates or their distance from the blood supplier. The highest annual outdating rate was 2.82%, at the beginning of the observation period. Each year brought further reductions, with a nadir outdating rate of 1.02% achieved in 2011. The key elements of the successful benchmarking strategy included dynamic targets, a comprehensive and evidence-based implementation strategy, ongoing information sharing, and a robust data system to track information. The Ontario benchmarking program for RBC outdating resulted in continuous and sustained quality improvement. Our conceptual iterative framework for benchmarking provides a guide for institutions implementing a benchmarking program. © 2015 AABB.

  11. Children and Residential Experiences: A Comprehensive Strategy for Implementing a Research-Informed Program Model for Residential Care

    Science.gov (United States)

    Holden, Martha J.; Izzo, Charles; Nunno, Michael; Smith, Elliott G.; Endres, Thomas; Holden, Jack C.; Kuhn, Frank

    2010-01-01

    This paper describes an effort to bridge research and practice in residential care through implementing a program model titled Children and Residential Experiences (CARE). The strategy involves consulting at all levels of the organization to guide personnel to incorporate CARE evidence-based principles into daily practice, and fostering an…

  12. Compressive sensing scalp EEG signals: implementations and practical performance.

    Science.gov (United States)

    Abdulghani, Amir M; Casson, Alexander J; Rodriguez-Villegas, Esther

    2012-11-01

    Highly miniaturised, wearable computing and communication systems allow unobtrusive, convenient and long term monitoring of a range of physiological parameters. For long term operation from the physically smallest batteries, the average power consumption of a wearable device must be very low. It is well known that the overall power consumption of these devices can be reduced by the inclusion of low power consumption, real-time compression of the raw physiological data in the wearable device itself. Compressive sensing is a new paradigm for providing data compression: it has shown significant promise in fields such as MRI; and is potentially suitable for use in wearable computing systems as the compression process required in the wearable device has a low computational complexity. However, the practical performance very much depends on the characteristics of the signal being sensed. As such the utility of the technique cannot be extrapolated from one application to another. Long term electroencephalography (EEG) is a fundamental tool for the investigation of neurological disorders and is increasingly used in many non-medical applications, such as brain-computer interfaces. This article investigates in detail the practical performance of different implementations of the compressive sensing theory when applied to scalp EEG signals.

  13. Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services.

    Science.gov (United States)

    Romero, Lisa M; Middleton, Dawn; Mueller, Trisha; Avellino, Lia; Hallum-Montes, Rachel

    2015-11-01

    The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement. Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy. Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were "always" available to adolescents. The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities. Published by Elsevier Inc.

  14. Oil program implementation plan FY 1996--2000

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    This document reaffirms the US Department of Energy (DOE) Office of Fossil Energy commitment to implement the National Oil Research Program in a way to maximize assurance of energy security, economic growth, environmental protection, jobs, improved economic competitiveness, and improved US balance of trade. There are two sections and an appendix in this document. Section 1 is background information that guided its formulation and a summary of the Oil Program Implementation Plan. This summary includes mission statements, major program drivers, oil issues and trends, budget issues, customers/stakeholders, technology transfer, measures of program effectiveness, and benefits. Section 2 contains more detailed program descriptions for the eight technical areas and the NIPER infrastructure. The eight technical areas are reservoir characterization; extraction research; exploration, drilling, and risk-based decision management; analysis and planning; technology transfer; field demonstration projects; oil downstream operations; and environmental research. Each description contains an overview of the program, descriptions on main areas, a discussion of stakeholders, impacts, planned budget projections, projected schedules with Gantt charts, and measures of effectiveness. The appendix is a summary of comments from industry on an earlier draft of the plan. Although changes were made in response to the comments, many of the suggestions will be used as guidance for the FY 1997--2001 plan.

  15. Cabo Verde telemedicine program: initial results of nationwide implementation.

    Science.gov (United States)

    Latifi, Rifat; Dasho, Erion; Merrell, Ronald C; Lopes, Miguel; Azevedo, Vanda; Bekteshi, Flamur; Osmani, Kalterina L; Qesteri, Orland; Kucani, Julian; Lecaj, Ismet

    2014-11-01

    Telemedicine and e-health have been suggested as one solution for closing the health disparity gap between the developed world and the developing world. Yet evidence is lacking from current successful programs in the developing world and, in particular, from sub-Saharan Africa. The primary objective of our study was to present the preliminary results of our efforts in building the Integrated Telemedicine and e-Health Program for Cabo Verde (ITeHP-CV), with an emphasis on initial utilization and results. This is a prospective study of data collected while we worked to establish a fully functional, integrated national telemedicine network and virtual education network in Cabo Verde. We used the International Virtual e-Hospital Foundation strategic approach known as "initiate-build-operate-transfer" over a 26-month period (November 2011-December 2013). We describe herein the five main pillars of this process that have been implemented: (1) capacity building; (2) network development and deployment of equipment; (3) implementation of clinical telemedicine; (4) implementation of activities related to continuing medical education, delivered from within the country and from abroad; and (5) establishment and use of the electronic virtual library. Based on comprehensive technical and medical assessment of the country's needs, 10 fully functional telemedicine centers in all nine inhabited islands of the Republic of Cabo Verde have been established. RESULTS are presented under the five main pillars of capacity building, network deployment, implementation of clinical telemedicine, implementation of continuing medical education activities, and establishment of the electronic virtual library. The ITeHP-CV has been successfully launched, and the initial results are encouraging. The continuity of the program and sustainability are primary goals once the program is transferred fully to the Ministry of Health of Cabo Verde. A long-term follow-up study is required in order to ensure

  16. Avoid costly litigation: ten steps to implementing lawful hiring practices.

    Science.gov (United States)

    Holmes, Judith H

    2004-01-01

    employment-related disputes that lead to costly litigation would never have arisen if the employer had implemented more effective employment practices. Hiring mistakes in particular cause many costly legal battles. This article identifies legal issues that precipitate litigation and suggests ten steps physicians can take to implement lawful hiring practices that will reduce the risk of costly employment suits while improving office efficiency, morale, and productivity. NOTE: This article is intended as an overview of lawful hiring strategies, and is not a substitute for legal advice from experienced employment counsel. Applicable laws vary from state to state and appropriate procedures may depend on specific factual situations. This article is not, and should not be construed as, legal advice.

  17. Standard Review Plan Update and Development Program. Implementing Procedures Document

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-01

    This implementing procedures document (IPD) was prepared for use in implementing tasks under the standard review plan update and development program (SRP-UDP). The IPD provides comprehensive guidance and detailed procedures for SRP-UDP tasks. The IPD is mandatory for contractors performing work for the SRP-UDP. It is guidance for the staff. At the completion of the SRP-UDP, the IPD will be revised (to remove the UDP aspects) and will replace NRR Office Letter No. 800 as long-term maintenance procedures.

  18. Implementation of the parametric variation method in an EMTP program

    DEFF Research Database (Denmark)

    Holdyk, Andrzej; Holbøll, Joachim

    2013-01-01

    The paper presents an algorithm for- and shows the implementation of a method to perform parametric variation studies using electromagnetic transients programs applied to an offshore wind farm. Those kind of studies are used to investigate the sensitivity of a given phenomena to variation...... of parameters in an electric system. The proposed method allows varying any parameter of a circuit, including the simulation settings and exploits the specific structure of the ATP-EMTP software. In the implementation of the method, Matlab software is used to control the execution of the ATP solver. Two...

  19. Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

    Science.gov (United States)

    Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

    2016-02-29

    There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

  20. Attitudinal Perspectives: A Factor to Implementation of a Dual Language Program

    Directory of Open Access Journals (Sweden)

    Michael Whitacre

    2015-01-01

    Full Text Available The central focus of this study was to determine the overall perceptions of school administrators, and the district bilingual coordinator on transferring theory to classroom practice, implementation, as viewed by those involved in the implementation process of the Gómez and Gómez Model of Dual Language Education. Responses were solicited from administrative personnel involved in the implementation of the Gómez and Gómez Model of Dual Language. Results revealed overall administrative attitudes were positive to the theoretical ideology and mixed as related to the actual implementation of the dual language program. The greatest areas of concern were; what to do when students enter the program who are either not Spanish dominant or who have not been in a dual language program. The second area of concern was with how to effectively evaluate teachers as they are observed for implementation of the dual langue program. Lastly, most administrators felt there was a lack of faculty proficient in Spanish.

  1. Implementing an Assessment Clinic in a Residential PTSD Program

    Directory of Open Access Journals (Sweden)

    Joan McDowell

    2014-08-01

    Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

  2. The Practice of Health Program Evaluation.

    Science.gov (United States)

    Lewis, Sarah R

    2017-11-01

    The Practice of Health Program Evaluation provides an overview of the evaluation process for public health programs while diving deeper to address select advanced concepts and techniques. The book unfolds evaluation as a three-phased process consisting of identification of evaluation questions, data collection and analysis, and dissemination of results and recommendations. The text covers research design, sampling methods, as well as quantitative and qualitative approaches. Types of evaluation are also discussed, including economic assessment and systems research as relative newcomers. Aspects critical to conducting a successful evaluation regardless of type or research design are emphasized, such as stakeholder engagement, validity and reliability, and adoption of sound recommendations. The book encourages evaluators to document their approach by developing an evaluation plan, a data analysis plan, and a dissemination plan, in order to help build consensus throughout the process. The evaluative text offers a good bird's-eye view of the evaluation process, while offering guidance for evaluation experts on how to navigate political waters and advocate for their findings to help affect change.

  3. Using planned change to implement a pressure sore program.

    Science.gov (United States)

    Walsh, K C

    1989-08-01

    The establishment of a hospital-wide wound care program is a monumental endeavor requiring mobilization of all available resources. The clinical nurse specialist in a community hospital acted as a change agent to facilitate the formation of a wound care task force, development of wound care protocols and the purchase of wound care products to address the problem of pressure ulcers. With the theory of planned change as a framework, the driving and resisting forces at work are depicted and unanticipated events that speeded and impeded the change process are revealed. Collaboration between nursing and other disciplines is discussed with recommendations offered to other practitioners considering implementation of a wound care program.

  4. Standard Review Plan Maintenance Program implementing procedures document

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    The implementing Procedures Document (IPD) was developed by the Inspection Program Projects Branch, Office of Nuclear Reactor Regulation, with assistance from Pacific Northwest National Laboratory, for the Standard Review Plan Maintenance Program (SRP-MP). The SRP-MP was established to maintain the Standard Review Plan (SRP) on an on-going basis. The IPD provides guidance, including an overall approach and procedures, for SRP-MP tasks. The objective of the IPD is to ensure that modifications to SRP need to reflect current NRC requirements and guidance are identified and that a consistent methodology is used to develop and revise SRP sections.

  5. Final report on implementation of energy conservation practices training in selected public housing developments

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    This report on the implementation of energy conservation practices training in selected public housing developments represents an initiative of the Research and Education Division, Office of Minority Economic Impact, US Department of Energy. The Office of Minority Economic Impact (MI) was created by Congress in 1979, within the US Department of Energy, to afford the Secretary advice on the effect policies, regulations and other actions of DOE respecting minority participation in energy programs. The Director of MI is responsible for the conduct of ongoing research into the effects, including socio-economic and environmental, of national energy programs, policies, and regulations of the Department of minorities. Public housing in the United States is dominated by minorities, public housing is a large consumer of residential energy. Consequently, this project is a logical merging of these two factors and an attempt to somehow influence energy savings through improving public housing residents' energy-consumption practices. This final report attempts to capture the results of this current demonstration, and incorporate the historical basis for today's results by renewing the efforts that preceded the implementation of energy conservation practices training in selected public housing developments.

  6. Final report on implementation of energy conservation practices training in selected public housing developments

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    This report on the implementation of energy conservation practices training in selected public housing developments represents an initiative of the Research and Education Division, Office of Minority Economic Impact, US Department of Energy. The Office of Minority Economic Impact (MI) was created by Congress in 1979, within the US Department of Energy, to afford the Secretary advice on the effect policies, regulations and other actions of DOE respecting minority participation in energy programs. The Director of MI is responsible for the conduct of ongoing research into the effects, including socio-economic and environmental, of national energy programs, policies, and regulations of the Department of minorities. Public housing in the United States is dominated by minorities, public housing is a large consumer of residential energy. Consequently, this project is a logical merging of these two factors and an attempt to somehow influence energy savings through improving public housing residents` energy-consumption practices. This final report attempts to capture the results of this current demonstration, and incorporate the historical basis for today`s results by renewing the efforts that preceded the implementation of energy conservation practices training in selected public housing developments.

  7. Defense programs beryllium good practice guide

    Energy Technology Data Exchange (ETDEWEB)

    Herr, M.

    1997-07-01

    Within the DOE, it has recently become apparent that some contractor employees who have worked (or are currently working) with and around beryllium have developed chronic beryllium disease (CBD), an occupational granulomatous lung disorder. Respiratory exposure to aerosolized beryllium, in susceptible individuals, causes an immunological reaction that can result in granulomatous scarring of the lung parenchyma, shortness of breath, cough, fatigue, weight loss, and, ultimately, respiratory failure. Beryllium disease was originally identified in the 1940s, largely in the fluorescent light industry. In 1950, the Atomic Energy Commission (AEC) introduced strict exposure standards that generally curtailed both the acute and chronic forms of the disease. Beginning in 1984, with the identification of a CBD case in a DOE contractor worker, there was increased scrutiny of both industrial hygiene practices and individuals in this workforce. To date, over 100 additional cases of beryllium-specific sensitization and/or CBD have been identified. Thus, a disease previously thought to be largely eliminated by the adoption of permissible exposure standards 45 years ago is still a health risk in certain workforces. This good practice guide forms the basis of an acceptable program for controlling workplace exposure to beryllium. It provides (1) Guidance for minimizing worker exposure to beryllium in Defense Programs facilities during all phases of beryllium-related work, including the decontamination and decommissioning (D&D) of facilities. (2) Recommended controls to be applied to the handling of metallic beryllium and beryllium alloys, beryllium oxide, and other beryllium compounds. (3) Recommendations for medical monitoring and surveillance of workers exposed (or potentially exposed) to beryllium, based on the best current understanding of beryllium disease and medical diagnostic tests available. (4) Site-specific safety procedures for all processes of beryllium that is likely to

  8. Implementing a farmers' market incentive program: perspectives on the New York City Health Bucks Program.

    Science.gov (United States)

    Payne, Gayle Holmes; Wethington, Holly; Olsho, Lauren; Jernigan, Jan; Farris, Rosanne; Walker, Deborah Klein

    2013-08-29

    One strategy for lowering the prevalence of obesity is to increase access to and affordability of fruits and vegetables through farmers' markets. However, little has been documented in the literature on the implementation of such efforts. To address this gap, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) sponsored an evaluation of the New York City Health Bucks program, a farmers' market coupon incentive program intended to increase access to fresh fruits and vegetables in underserved neighborhoods while supporting local farmers. We conducted a process evaluation of Health Bucks program implementation. We interviewed 6 farmer/vendors, 3 market managers, and 4 program administrators, and collected data on site at 86 farmers' markets, including surveys of 81 managers and 141 farmer/vendors on their perspectives on promotion and redemption of the incentive coupons; knowledge and attitudes regarding the program; experiences with markets and products; and facilitators and barriers to program participation. Results indicate that respondents view Health Bucks as a positive program model. Farmers' market incentive coupon programs like Health Bucks are one strategy to address the problem of obesity and were associated with higher fruit and vegetable access and purchases in low-income communities. This evaluation identified some areas for improving implementation of the Health Bucks program. Farmers' market incentive programs like Health Bucks may be one avenue to increase access to and affordability of fruits and vegetables among low-income persons. Further research is needed to assess the potential effects of these programs on access and health outcomes.

  9. Practice Characteristics of Graduates of Postdoctoral General Dentistry Programs.

    Science.gov (United States)

    Gatlin, Lonny J.; And Others

    1993-01-01

    A survey of 391 dentists completing a postdoctoral general dentistry program and 369 not participating in such a program revealed 75% of program participants were trained in civilian programs and the remainder in either military or Veterans Administration training programs. Employment patterns, treatment settings, and patterns of practice or…

  10. The SBIRT program matrix: a conceptual framework for program implementation and evaluation.

    Science.gov (United States)

    Del Boca, Frances K; McRee, Bonnie; Vendetti, Janice; Damon, Donna

    2017-02-01

    Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of services to those at risk for the adverse consequences of alcohol and other drug use, and for those with probable substance use disorders. Research on successful SBIRT implementation has lagged behind studies of efficacy and effectiveness. This paper (1) outlines a conceptual framework, the SBIRT Program Matrix, to guide implementation research and program evaluation and (2) specifies potential implementation outcomes. Overview and narrative description of the SBIRT Program Matrix. The SBIRT Program Matrix has five components, each of which includes multiple elements: SBIRT services; performance sites; provider attributes; patient/client populations; and management structure and activities. Implementation outcomes include program adoption, acceptability, appropriateness, feasibility, fidelity, costs, penetration, sustainability, service provision and grant compliance. The Screening, Brief Intervention and Referral to Treatment Program Matrix provides a template for identifying, classifying and organizing the naturally occurring commonalities and variations within and across SBIRT programs, and for investigating which variables are associated with implementation success and, ultimately, with treatment outcomes and other impacts. © 2017 Society for the Study of Addiction.

  11. Implementing secure laptop-based testing in an undergraduate nursing program: a case study.

    Science.gov (United States)

    Tao, Jinyuan; Lorentz, B Chris; Hawes, Stacey; Rugless, Fely; Preston, Janice

    2012-07-01

    This article presents the implementation of secure laptop-based testing in an undergraduate nursing program. Details on how to design, develop, implement, and secure tests are discussed. Laptop-based testing mode is also compared with the computer-laboratory-based testing model. Five elements of the laptop-based testing model are illustrated: (1) it simulates the national board examination, (2) security is achievable, (3) it is convenient for both instructors and students, (4) it provides students hands-on practice, (5) continuous technical support is the key.

  12. Improving Service Quality of Rusunawa Implementation Program in Kudus

    Directory of Open Access Journals (Sweden)

    Septiana Pancawati

    2014-02-01

    Full Text Available Development of housing and settlements are still faced the main problems as follows: the limited supply of homes, inadequate housing that is not supported by infrastructure, environmental facilities and public utilities, as well as the growing slums widespread. Government issues Rusunawa Implementation Program to overcome those problems. However some problems arose in its implementation, such as poor environmental condition, poor building quality, inadequate infrastructure and public services. The objectives of the research are to describe, to analyze, and to interpret things as follows: (1 The management of Rusunawa implementation program in order to improve service quality, (2 Improving service quality of Rusunawa program by the authorities. This research used qualitative method with descriptive approach. Information can be obtained byinterview stakeholders, field observations and documentation. From research findings, there are some records that should be highlighted as follows: (1 Rusunawa construction and its supervision influence the building quality. Low performance of those service providers will result in low building quality and vice versa. (2 Rent arrears are higher, an indication of dissatisfaction Rusunawa residents during they stay there. Keywords: Rusunawa, building condition, service quality

  13. Obesity Prevention in Early Child Care Settings: A Bistate (Minnesota and Wisconsin) Assessment of Best Practices, Implementation Difficulty, and Barriers

    Science.gov (United States)

    Nanney, Marilyn S.; LaRowe, Tara L.; Davey, Cynthia; Frost, Natasha; Arcan, Chrisa; O'Meara, Joyce

    2017-01-01

    Background: Long-term evaluation studies reveal that high-quality early care and education (ECE) programs that include a lifestyle component predict later adult health outcomes. The purpose of this article is to characterize the nutrition and physical activity (PA) practices, including implementation difficulty and barriers, of licensed center-…

  14. Consultation and Collaboration to Develop and Implement Restorative Practices in a Culturally and Linguistically Diverse Elementary School

    Science.gov (United States)

    Ingraham, Colette L.; Hokoda, Audrey; Moehlenbruck, Derek; Karafin, Monica; Manzo, Caroline; Ramirez, Daniel

    2016-01-01

    Through an embedded single-case study design and qualitative methods, this article describes the school-wide implementation and preliminary results of a restorative practices (RP) program within a culturally and linguistically diverse (CLD) elementary school. Located in an urban area with high rates of crime, violence, and poverty, the three-year…

  15. Pile Structure Program, Projected Start Date : January 1, 2010 (Implementation).

    Energy Technology Data Exchange (ETDEWEB)

    Collins, Chris; Corbett, Catherine [Lower Columbia River Estuary Partnership; Ebberts, Blaine [U.S. Army Corps of Engineers

    2009-07-27

    The 2008 Federal Columbia River Power System Biological Opinion includes Reasonable and Prudent Alternative 38-Piling and Piling Dike Removal Program. This RPA directs the Action Agencies to work with the Estuary Partnership to develop and implement a piling and pile dike removal program. The program has since evolved to include modifying pile structures to enhance their habitat value and complexity by adding large woody debris. The geographic extent of the Pile Structure Program (PSP) includes all tidally-influenced portions of the lower Columbia River below Bonneville Dam; however, it will focus on the mainstem. The overarching goal of the PSP is to enhance and restore ecosystem structure and function for the recovery of federally listed salmonids through the active management of pile structures. To attain this goal, the program team developed the following objectives: (1) Develop a plan to remove or modify pile structures that have lower value to navigation channel maintenance, and in which removal or modification will present low-risk to adjacent land use, is cost-effective, and would result in increased ecosystem function. (2) Determine program benefits for juvenile salmonids and the ecosystem through a series of intensively monitored pilot projects. (3) Incorporate best available science and pilot project results into an adaptive management framework that will guide future management by prioritizing projects with the highest benefits. The PSP's hypotheses, which form the basis of the pilot project experiments, are organized into five categories: Sediment and Habitat-forming Processes, Habitat Conditions and Food Web, Piscivorous Fish, Piscivorous Birds, and Toxic Contaminant Reduction. These hypotheses are based on the effects listed in the Estuary Module (NOAA Fisheries in press) and others that emerged during literature reviews, discussions with scientists, and field visits. Using pilot project findings, future implementation will be adaptively managed

  16. Linking Postdoctoral General Dentistry Programs with Private Practice Settings.

    Science.gov (United States)

    Weaver, Richard G.; And Others

    1997-01-01

    Reports on a small work group that met to discuss experiences with establishing and conducting dental education programs that had significant affiliation with private practice settings. Five programs in diverse areas were represented. Discussion covered program goals and objectives, support and commitment, practice/practitioner selection,…

  17. Implementing a Health System-wide Patient Blood Management Program with a Clinical Community Approach.

    Science.gov (United States)

    Frank, Steven M; Thakkar, Rajiv N; Podlasek, Stanley J; Ken Lee, K H; Wintermeyer, Tyler L; Yang, Will W; Liu, Jing; Rotello, Leo C; Fleury, Thomas A; Wachter, Pat A; Ishii, Lisa E; Demski, Renee; Pronovost, Peter J; Ness, Paul M

    2017-11-01

    Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals. This physician-led, multidisciplinary, collaborative, quality-improvement team (the clinical community) worked to implement best practices for patient blood management, which we describe in detail. Changes in blood utilization and blood acquisition costs were compared for the pre- and post-patient blood management time periods. Across the health system, multiunit erythrocyte transfusion orders decreased from 39.7 to 20.2% (by 49%; P clinical community approach substantially reduced blood utilization and blood acquisition costs.

  18. Higher Education Military and Veteran Student Program Success: A Qualitative Study of Program Administration Best Practice Application

    Science.gov (United States)

    Murillo, Rose L.

    2017-01-01

    Purpose: The purpose of this study was to determine how Southern California community colleges have implemented best practices based on the 8 Keys to Veterans' Success as identified by the U.S. Departments of Education, Defense, and Veterans Affairs to effectively support and retain military and veteran students in higher education programs. The…

  19. Practical Formal Verification of MPI and Thread Programs

    Science.gov (United States)

    Gopalakrishnan, Ganesh; Kirby, Robert M.

    Large-scale simulation codes in science and engineering are written using the Message Passing Interface (MPI). Shared memory threads are widely used directly, or to implement higher level programming abstractions. Traditional debugging methods for MPI or thread programs are incapable of providing useful formal guarantees about coverage. They get bogged down in the sheer number of interleavings (schedules), often missing shallow bugs. In this tutorial we will introduce two practical formal verification tools: ISP (for MPI C programs) and Inspect (for Pthread C programs). Unlike other formal verification tools, ISP and Inspect run directly on user source codes (much like a debugger). They pursue only the relevant set of process interleavings, using our own customized Dynamic Partial Order Reduction algorithms. For a given test harness, DPOR allows these tools to guarantee the absence of deadlocks, instrumented MPI object leaks and communication races (using ISP), and shared memory races (using Inspect). ISP and Inspect have been used to verify large pieces of code: in excess of 10,000 lines of MPI/C for ISP in under 5 seconds, and about 5,000 lines of Pthread/C code in a few hours (and much faster with the use of a cluster or by exploiting special cases such as symmetry) for Inspect. We will also demonstrate the Microsoft Visual Studio and Eclipse Parallel Tools Platform integrations of ISP (these will be available on the LiveCD).

  20. International Review of the Development and Implementation of Energy Efficiency Standards and Labeling Programs

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Zheng, Nina; Fridley, David

    2012-02-28

    Appliance energy efficiency standards and labeling (S&L) programs have been important policy tools for regulating the efficiency of energy-using products for over 40 years and continue to expand in terms of geographic and product coverage. The most common S&L programs include mandatory minimum energy performance standards (MEPS) that seek to push the market for efficient products, and energy information and endorsement labels that seek to pull the market. This study seeks to review and compare some of the earliest and most well-developed S&L programs in three countries and one region: the U.S. MEPS and ENERGY STAR, Australia MEPS and Energy Label, European Union MEPS and Ecodesign requirements and Energy Label and Japanese Top Runner programs. For each program, key elements of S&L programs are evaluated and comparative analyses across the programs undertaken to identify best practice examples of individual elements as well as cross-cutting factors for success and lessons learned in international S&L program development and implementation. The international review and comparative analysis identified several overarching themes and highlighted some common factors behind successful program elements. First, standard-setting and programmatic implementation can benefit significantly from a legal framework that stipulates a specific timeline or schedule for standard-setting and revision, product coverage and legal sanctions for non-compliance. Second, the different MEPS programs revealed similarities in targeting efficiency gains that are technically feasible and economically justified as the principle for choosing a standard level, in many cases at a level that no product on the current market could reach. Third, detailed survey data such as the U.S. Residential Energy Consumption Survey (RECS) and rigorous analyses provide a strong foundation for standard-setting while incorporating the participation of different groups of stakeholders further strengthen the process

  1. Prerequisite programs and food hygiene in hospitals: food safety knowledge and practices of food service staff in Ankara, Turkey.

    Science.gov (United States)

    Bas, Murat; Temel, Mehtap Akçil; Ersun, Azmi Safak; Kivanç, Gökhan

    2005-04-01

    Our objective was to determine food safety practices related to prerequisite program implementation in hospital food services in Turkey. Staff often lack basic food hygiene knowledge. Problems of implementing HACCP and prerequisite programs in hospitals include lack of food hygiene management training, lack of financial resources, and inadequate equipment and environment.

  2. Integrating research and education into clinical practice: the multi-organ transplant student research training program.

    Science.gov (United States)

    Famure, Olusegun; Li, Anna; Ross, Heather; Kim, S Joseph

    2012-01-01

    Given the increased student interest in health research and the need to implement health research initiatives, the Multi-Organ Transplant Student Research Training Program provides student trainees with the opportunity to contribute to health research initiatives in transplant care. Program quality initiatives achieved include the development of a clinical research database, knowledge exchange, performance measurement tools, and health research projects. The program promotes collaboration between academic and healthcare institutions to integrate research and education into clinical practice.

  3. Barriers of implementation of environmental management accounting in business practice

    Directory of Open Access Journals (Sweden)

    Petra Mísařová

    2010-01-01

    Full Text Available Environmental management accounting is a very important source of information for decision-making management of the company. In many companies there were created a detailed and dynamic system of recording and processing of data on environmental costs that companies mistakenly issued for environmental management accounting. And also today for environmental accounting in the CR it is characteristic that in organizations is not normal monitoring of the environmental costs con­si­de­red as part of an integrated system for monitoring and evaluation of material, energy and financial flows. Companies do not use a wide range of options that the environmental management accounting provides. Why do not companies introduce environmental management accounting into its information system and do not use all the opportunities that EMA provides? In practice there are many barriers that prevent full-fledged process of implementation of environmental management accounting in the information system of companies. Many barriers were identified and were therefore subjected to cluster analysis. Clusters filled by identified barriers under the rules of cluster analysis are the result of cluster analysis.

  4. Sustainable port infrastructure, practical implementation of the green port concept

    Directory of Open Access Journals (Sweden)

    Pavlic Bostjan

    2014-01-01

    Full Text Available The overall idea and research interest related with the development of sustainable port infrastructure evolved around the core requirements of continuous reduction of negative environmental impacts without jeopardising economic growth. The growth of trade activities and need for competitiveness on the global market are forcing ports around the world to systematically and continuously evaluate all possibilities for the optimisation and related costs reduction. On the implementation level, the greatest challenge is how to empower workers, who operate machines and work on the shop floor, to achieve enduring performance improvements. Presented research work provides a methodological approach for finding realistic solutions to the problem of the future development challenges of seaports. The case study shown in this research represents a practical application of the green port concept with the emphasis on the overall energy efficiency improvement based on testing, deployment and demonstration of energy efficient solutions. Additional emphasis was placed on the state-of-the-art technologies and developing pilot initiatives based on modern energy solutions designed to improve efficiency in fuel consumption and emissions reduction in rubber tired gantry cranes.

  5. Implementation of a new advanced graduate education program in oral implantology.

    Science.gov (United States)

    Gallucci, German O; Weber, Hans Peter; Kalenderian, Elsbeth

    2012-10-01

    The academic program for the Harvard School of Dental Medicine's Advanced Graduate Program in Oral Implantology is based on scientific evidence applied to educational quality, translational research, patient care, and service. The objective of the program is to enable highly motivated individuals with proven scholarship and excellence in patient care to achieve academic leadership in the clinical and scientific fields of implant dentistry and tissue regeneration. A detailed curriculum describing the academic program, as well as a business plan (which included a management plan describing the organizational structure, financial implications, and market forces) and implementation and communication plans, were developed before moving forward. With careful academic and business planning, the result was a vibrant implant program, in which all placements and restorations of implants are coordinated with regard to practice management. The program is integrated into the existing clinical care model and has been financially self-sustaining from its inception. Six students have participated in the last two years. On average, each student performed seventy-nine procedures on twenty-nine patients, generating over $46,000 in production. The curriculum includes didactics, hands-on clinical learning, and research activities. Research is a critical component as well. The results demonstrate that the time taken to develop a detailed curriculum and business plan for a new academic program, which anticipated and resolved potential barriers to success, was instrumental in the successful implementation of an oral implantology residency program.

  6. Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting.

    Science.gov (United States)

    Smith, Katherine; Firth, Kimberly; Smeeding, Sandra; Wolever, Ruth; Kaufman, Joanna; Delgado, Roxana; Bellanti, Dawn; Xenakis, Lea

    2016-01-01

    Research suggests that the development of mind-body skills can improve individual and family resilience, particularly related to the stresses of illness, trauma, and caregiving. To operationalize the research evidence that mind-body skills help with health and recovery, Samueli Institute, in partnership with experts in mind-body programming, created a set of guidelines for developing and evaluating mind-body programs for service members, veterans, and their families. The Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting outline key strategies and issues to consider when developing, implementing, and evaluating a mind-body focused family empowerment approach in a military healthcare setting. Although these guidelines were developed specifically for a military setting, most of the same principles can be applied to the development of programs in the civilian setting as well. The guidelines particularly address issues unique to mind-body programs, such as choosing evidence-based modalities, licensure and credentialing, safety and contraindications, and choosing evaluation measures that capture the holistic nature of these types of programs. The guidelines are practical, practice-based guidelines, developed by experts in the fields of program development and evaluation, mind-body therapies, patient- and family-centered care, as well as, experts in military and veteran's health systems. They provide a flexible framework to create mind-body family empowerment programs and describe important issues that program developers and evaluators are encouraged to address to ensure the development of the most impactful, successful, evidence-supported programs possible. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Implementation of psychiatric-focused lifestyle medicine programs in Asia.

    Science.gov (United States)

    Sarris, Jerome; Nishi, Daisuke; Xiang, Yu-Tao; Su, Kuan-Pin; Bannatyne, Amy; Oliver, Georgina; Kua, Ee-Heok; Ng, Chee Hong

    2015-12-01

    Lifestyle-focused health programs are growing in interest throughout Western society, and a range of lifestyle factors are known to enhance both physical and mental health. However, it remains largely unknown as to whether this approach is salient for the Asian context. The major components of integrative lifestyle-focused health programs to enhance mental and physical health are considered to include the evidence-based adoption of physical activity and exercise, dietary modification, general psychoeducation, adequate relaxation/sleep and social interaction, use of mindfulness techniques, the reduction of substance use, attention of intersecting environmental factors, and the potential use of motivation and goal-setting techniques. This paper outlines an overview of the evidence underpinning these elements, and discusses potential barriers and challenges, and what logistical considerations may need to be addressed in the implementation of such programs within the context of Asian cultures. © 2015 Wiley Publishing Asia Pty Ltd.

  8. Implementation of a Psychosocial Intervention Program for Working Caregivers.

    Science.gov (United States)

    Jimenez, Daniel E; Schulz, Richard; Perdomo, Dolores; Lee, Chin Chin; Czaja, Sara J

    2017-12-01

    The overall aim of this pilot study was to examine the feasibility and acceptability of a multicomponent, psychosocial intervention specifically designed to meet the unique needs of caregivers who are balancing caregiving duties with work responsibilities. Seventy-one family caregivers employed at a private, nonprofit institution in South Florida were randomized to either the Caregiver Workstation condition ( n = 35) or a control condition ( n = 36). Sixty-two caregivers completed the 5-month follow-up. Our results indicate that an intervention tailored to the time demands of a working caregiver is feasible, acceptable to caregivers, and has the potential to have positive long-term effects. Currently, there are limited data available regarding the benefits of employer programs for caregivers or the type of programs caregivers find most useful. This pilot study is the first step in developing a working caregiver intervention program that can be implemented on a broad-scale basis.

  9. Mesonet Programs - Needs and Best Practices

    Science.gov (United States)

    Usher, J.; Doherty, J.

    2010-09-01

    Authors: Jeremy Usher Managing Director, Europe WeatherBug® Professional John Doherty Senior Vice President Sales & Marketing WeatherBug® Professional There are many well documented and compelling needs for significant improvements in mesoscale meteorological observations throughout many parts of the world. This is evidenced by the fact that the vast majority of severe weather impacts and related life, property and economic losses are associated with mesoscale events such as tornados, thunderstorms, fronts, squall lines, etc. Additionally, the looming impacts of climate change are likely to vary substantially on a regional basis requiring more detailed information on a finer scale. Hence, development of comprehensive densely spaced observing systems can establish the critical information repositories needed to improve: short- and medium-term weather and wind forecasting down to local scales, climate monitoring on a regional basis, as well as decision support capabilities including plume dispersion modeling and air quality forecasting, to name a few. It is imperative that governmental/public/private/academic partnerships are formed to leverage the collective expertise, assets and technological know-how of each sector. Collaboration of this type is particularly germane given that many existing mesonets (weather networks) have been deployed by local organizations with local considerations in mind. These stakeholders maintain the capacity to react quickly and efficiently and are best positioned to recommend future network evolution within their domains. Additionally, coordination will go a long way toward avoiding duplication of effort and promote both a robust private sector and wise expenditure of public funds. This presentation will outline the major building blocks of a mesonet program and discuss best practices for a multi-tiered, multi-faceted "network of networks" approach that maximizes the value derived from leveraging existing assets and serves multiple

  10. Doctor of Nursing Practice programs: opportunities for faculty development.

    Science.gov (United States)

    Sebastian, Juliann G; White Delaney, Connie

    2013-08-01

    This article examines development opportunities for faculty teaching in Doctor of Nursing Practice (DNP) programs. Although faculty development for DNP programs is similar to that of other academic programs, faculty may need different strategies for teaching, scholarship, and service because DNP programs focus on translation of science into practice, systems-level changes, clinical scholarship, and the highest levels of advanced nursing practice. Faculty and student collaboration across DNP and PhD programs provide new approaches for translating research into practice and generating practice questions in need of further scientific development. Specific faculty development strategies for facilitating this collaboration are essential. Capstone projects pose special opportunities for faculty development due to the integration of these projects within diverse practice environments, with differing expectations, regulations, and pacing compared with research. Linking new care delivery models with health informatics is expected to facilitate rapid translation of research and development of improvements in practice. Copyright 2013, SLACK Incorporated.

  11. Utility Green Pricing Programs: Design, Implementation, and Consumer Response

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Swezey, B.; Aabakken, J.

    2004-02-01

    The term green pricing refers to programs offered by utilities in traditionally regulated electricity markets, which allow customers to support the development of renewable energy sources by paying a small premium on their electric bills. Since the introduction of the concept in the United States, the number of unique utility green pricing programs has expanded from just a few programs in 1993 to more than 90 in 2002. About 10% of U.S. utilities offered a green pricing option to about 26 million consumers by the end of 2002. This report provides: (1) aggregate industry data on consumer response to utility programs, which indicate the collective impact of green pricing on renewable energy development nationally; and (2) market data that can be used by utilities as a benchmark for gauging the relative success of their green pricing programs. Specifically, the paper presents current data and trends in consumer response to green pricing, as measured by renewable energy sales, participants, participation rates, and new renewable energy capacity supported. It presents data on various aspects of program design and implementation, such as product pricing, ownership of supplies, retention rates, marketing costs, the effectiveness of marketing techniques, and methods of enrolling and providing value to customers.

  12. Implementation a Medical Simulation Curriculum in Emergency Medicine Residency Program

    Directory of Open Access Journals (Sweden)

    Amirhossein Jahanshir

    2017-10-01

    Full Text Available Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks. Our plan was to induct simulation in emergency medicine residency program in order to ameliorate our defects in clinical bedside training. Our residents believed that simulation could be effective in their real medical practice. They mentioned that facilitators’ expertise and good medical knowledge, was the strongest point of the program and lack of proper facilities was the weakest.

  13. Implementing the MOVE! weight-management program in the Veterans Health Administration, 2007-2010: a qualitative study.

    Science.gov (United States)

    Weiner, Bryan J; Haynes-Maslow, Lindsey; Kahwati, Leila C; Kinsinger, Linda S; Campbell, Marci K

    2012-01-01

    One-third of US veterans receiving care at Veterans Health Administration (VHA) medical facilities are obese and, therefore, at higher risk for developing multiple chronic diseases. To address this problem, the VHA designed and nationally disseminated an evidence-based weight-management program (MOVE!). The objective of this study was to examine the organizational factors that aided or inhibited the implementation of MOVE! in 10 VHA medical facilities. Using a multiple, holistic case study design, we conducted 68 interviews with medical center program coordinators, physicians formally appointed as program champions, managers directly responsible for overseeing the program, clinicians from the program's multidisciplinary team, and primary care physicians identified by program coordinators as local opinion leaders. Qualitative data analysis involved coding, memorandum writing, and construction of data displays. Organizational readiness for change and having an innovation champion were most consistently the 2 factors associated with MOVE! implementation. Other organizational factors, such as management support and resource availability, were barriers to implementation or exerted mixed effects on implementation. Barriers did not prevent facilities from implementing MOVE! However, they were obstacles that had to be overcome, worked around, or accepted as limits on the program's scope or scale. Policy-directed implementation of clinical weight-management programs in health care facilities is challenging, especially when no new resources are available. Instituting powerful, mutually reinforcing organizational policies and practices may be necessary for consistent, high-quality implementation.

  14. CDC Best Practices for Comprehensive Tobacco Control Programs - 2007

    Data.gov (United States)

    U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...

  15. CDC Best Practices for Comprehensive Tobacco Control Programs - 2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...

  16. Impact of a tailored program on the implementation of evidence-based recommendations for multimorbid patients with polypharmacy in primary care practices-results of a cluster-randomized controlled trial

    NARCIS (Netherlands)

    Jager, C.; Freund, T.; Steinhauser, J.; Stock, C.; Krisam, J.; Kaufmann-Kolle, P.; Wensing, M.; Szecsenyi, J.

    2017-01-01

    BACKGROUND: Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previously identified determinants of practice. The aim of this study was to assess the

  17. A review of diabetes prevention program translations: use of cultural adaptation and implementation research.

    Science.gov (United States)

    Tabak, Rachel G; Sinclair, Kàimi A; Baumann, Ana A; Racette, Susan B; Sebert Kuhlmann, Anne; Johnson-Jennings, Michelle D; Brownson, Ross C

    2015-12-01

    The Diabetes Prevention Program (DPP) has been shown to prevent type 2 diabetes through lifestyle modification. The purpose of this study was to describe the literature on DPP translation, synthesizing studies using cultural adaptation and implementation research. A systematic search was conducted. Original studies evaluating DPP implementation and/or cultural adaptation were included. Data about cultural adaptation, implementation outcomes, and translation strategies was abstracted. A total of 44 were included, of which 15 reported cultural adaptations and 38 explored implementation. Many studies shortened the program length and reported a group format. The most commonly reported cultural adaptation (13 of 15) was with content. At the individual level, the most frequently assessed implementation outcome (n = 30) was adoption. Feasibility was most common (n = 32) at the organization level. The DPP is being tested in a variety of settings and populations, using numerous translational strategies and cultural adaptations. Implementation research that identifies, evaluates, and reports efforts to translate the DPP into practice is crucial.

  18. [The intervention mapping protocol: A structured process to develop, implement and evaluate health promotion programs].

    Science.gov (United States)

    Fassier, J-B; Lamort-Bouché, M; Sarnin, P; Durif-Bruckert, C; Péron, J; Letrilliart, L; Durand, M-J

    2016-02-01

    Health promotion programs are expected to improve population health and reduce social inequalities in health. However, their theoretical foundations are frequently ill-defined, and their implementation faces many obstacles. The aim of this article is to describe the intervention mapping protocol in health promotion programs planning, used recently in several countries. The challenges of planning health promotion programs are presented, and the six steps of the intervention mapping protocol are described with an example. Based on a literature review, the use of this protocol, its requirements and potential limitations are discussed. The intervention mapping protocol has four essential characteristics: an ecological perspective (person-environment), a participative approach, the use of theoretical models in human and social sciences and the use of scientific evidence. It comprises six steps: conduct a health needs assessment, define change objectives, select theory-based change techniques and practical applications, organize techniques and applications into an intervention program (logic model), plan for program adoption, implementation, and sustainability, and generate an evaluation plan. This protocol was used in different countries and domains such as obesity, tobacco, physical activity, cancer and occupational health. Although its utilization requires resources and a critical stance, this protocol was used to develop interventions which efficacy was demonstrated. The intervention mapping protocol is an integrated process that fits the scientific and practical challenges of health promotion. It could be tested in France as it was used in other countries, in particular to reduce social inequalities in health. Copyright © 2016. Published by Elsevier Masson SAS.

  19. Teachers' implementation of reform-oriented instructional strategies in science: Lessons from two professional development programs

    Science.gov (United States)

    Cook, Nicole D.

    This dissertation reports findings from two studies that investigated the relationship between professional development and teachers' instructional practices in Science,Technology, Engineering, and Mathematics (STEM). The first program, the Indiana Science Initiative (ISI) focused on K-8 teachers and their use of inquiry-based science instruction in conjunction with curricular modules provided by the ISI program. The second program, Research Goes to School (RGS), focused on high school STEM teachers and their use of problem-based learning (PBL) as they implemented curricular units that they developed themselves at the RGS summer workshop. In-service teachers were recruited from both programs. They were observed teaching their respective curricular materials and interviewed about their experiences in order to investigate the following research questions: 1. How do teachers implement the reform-oriented instructional strategies promoted by their professional development experiences with the ISI or RGS? 2. What are the challenges and supports that influence teachers' use of the reform-oriented instructional strategies promoted by their professional development experiences with the ISI or RGS? To investigate these questions the fidelity of implementation was it was conceptualized by Century, Rudnick, and Freeman (2010) was used as a theoretical framework. The study of the ISI program was conducted during the program's pilot year (2010-11). Five teachers of grades 3 through 6 were recruited from three different schools. Participants were observed as they taught lessons related to the modules and they were interviewed about their experiences. Based on analysis of the data from the observations, using a modified version of the Science Teacher Inquiry Rubric (STIR) (Bodzin & Beerer, 2003), the participants were found to exhibit partial fidelity of implementation to the model of inquiry-based instruction promoted by the ISI. Based on data from the interviews, the

  20. Programming principles and practice using C++

    CERN Document Server

    Stroustrup, Bjarne

    2014-01-01

    An Introduction to Programming by the Inventor of C++ Preparation for Programming in the Real World The book assumes that you aim eventually to write non-trivial programs, whether for work in software development or in some other technical field. Focus on Fundamental Concepts and Techniques The book explains fundamental concepts and techniques in greater depth than traditional introductions. This approach will give you a solid foundation for writing useful, correct, maintainable, and efficient code. Programming with Today's C++ (C++11 and C++14) The book is an introduction to programming in general, including object-oriented programming and generic programming. It is also a solid introduction to the C++ programming language, one of the most widely used languages for real-world software. The book presents modern C++ programming techniques from the start, introducing the C++ standard library and C++11 and C++14 features to simplify programming tasks. For Beginners-And Anyone Who Wants to Learn Something New The...

  1. Implementing embedded artificial intelligence rules within algorithmic programming languages

    Science.gov (United States)

    Feyock, Stefan

    1988-01-01

    Most integrations of artificial intelligence (AI) capabilities with non-AI (usually FORTRAN-based) application programs require the latter to execute separately to run as a subprogram or, at best, as a coroutine, of the AI system. In many cases, this organization is unacceptable; instead, the requirement is for an AI facility that runs in embedded mode; i.e., is called as subprogram by the application program. The design and implementation of a Prolog-based AI capability that can be invoked in embedded mode are described. The significance of this system is twofold: Provision of Prolog-based symbol-manipulation and deduction facilities makes a powerful symbolic reasoning mechanism available to applications programs written in non-AI languages. The power of the deductive and non-procedural descriptive capabilities of Prolog, which allow the user to describe the problem to be solved, rather than the solution, is to a large extent vitiated by the absence of the standard control structures provided by other languages. Embedding invocations of Prolog rule bases in programs written in non-AI languages makes it possible to put Prolog calls inside DO loops and similar control constructs. The resulting merger of non-AI and AI languages thus results in a symbiotic system in which the advantages of both programming systems are retained, and their deficiencies largely remedied.

  2. Development, implementation and management of a drug testing program in the workplace

    Energy Technology Data Exchange (ETDEWEB)

    Burtis, C.A.

    1990-01-01

    To combat the rising use of drugs in the workplace many American companies have implemented drug testing programs and are testing employees and job applicants for use of illegal drugs. In addition, on September 15, 1986, Executive Order No.12564 was issued by President Reagan, which requires all federal agencies to develop programs and policies, one of the goals of which is to achieve a drug-free federal workplace. Included in this Executive Order is the requirement that federal agencies implement drug testing has become a prevalent practice as a means to detect and deter drug use in the workplace. Before a drug testing program is implemented, it is imperative that policies and procedures are developed that (1) ensure the accuracy of test results, (2) protect the validity and integrity of the specimen, (3) guarantee due process, and (4) maintain confidentiality. To make certain that these prerequisites were met in the government drug testing programs, the US Department of Health and Human Services (HHS) was directed to develop technical and scientific guidelines for conducting such programs. 15 refs., 1 fig., 2 tabs.

  3. Theory versus practice at implementation of inquiry-based approaches into physics education

    Science.gov (United States)

    Pfefferová, Miriam Spodniaková; Raganová, Janka; Hruška, Martin; Holec, Stanislav

    2017-01-01

    At present a lot of ideas for student inquiry-based activities accompanied with methodical remarks and instructions for teachers exist and can be used at physics lessons at lower and upper secondary levels. A need of the use of the teaching methods that support an independent student work as well as active learning approaches has been reflected also in the Slovak state educational program at various educational levels. Experiences of teachers who have used inquiry-based approaches in the classrooms are often in the contrary with expectations of these didactical trends. The paper aims to compare the theory and the practice of the implementation of inquiry-based activities in physics teaching. Practical experience was gained implementing activities for science education developed within the Chain Reaction project running at Matej Bel University Banska Bystrica. Opinions of teachers were investigated with the help of questionnaires, evaluation meetings and structured interviews. Their analysis identified many problems that the teachers had met during the implementation of the inquiry-based approaches in their teaching, as well as benefits of those activities for development of student competences.

  4. Quality improvement educational practices in pediatric residency programs: survey of pediatric program directors.

    Science.gov (United States)

    Mann, Keith J; Craig, Mark S; Moses, James M

    2014-01-01

    The Accreditation Council for Graduate Medical Education requires residents to learn quality improvement (QI) methods to analyze, change, and improve their practice. Little is known about how pediatric residency programs design, implement, and evaluate QI curricula to achieve this goal. We sought to describe current QI educational practices, evaluation methods, and program director perceptions through a national survey. A survey of QI curricula was developed, pilot tested, approved by the Association of Pediatric Program Directors (APPD), and distributed to pediatric program directors. Descriptive statistics were used to analyze the data. The response rate was 53% (104 of 197). Most respondents reported presence of a QI curriculum (85%, 88 of 104), including didactic sessions (83%) and resident QI projects (88%). Continuous process improvement was the most common methodology addressed (65%). The most frequent topics taught were "Making a Case for QI" (68%), "PDSA [plan-do-study-act] Cycles" (66%), and "Measurement in QI" (60%). Projects were most frequently designed to improve clinical care (90%), hospital operations (65%), and the residency (61%). Only 35% evaluated patient outcomes, and 17% had no formal evaluation. Programs had a mean of 6 faculty members (standard deviation 4.4, range 2-20) involved in teaching residents QI. Programs with more faculty involved were more likely to have had a resident submit an abstract to a professional meeting about their QI project (9, 92%; P = .003). Barriers to teaching QI included time (66%), funding constraints (39%), and absent local QI expertise (33%). Most PPDs (65%) believed that resident input in hospital QI was important, but only 24% reported resident involvement. Critical factors for success included an experiential component (56%) and faculty with QI expertise (50%). QI curricular practices vary greatly across pediatric residency programs. Although pediatric residency programs commit a fair number of resources to

  5. Implementation of a professional portfolio: a tool to demonstrate professional development for advanced practice.

    Science.gov (United States)

    Chamblee, Tracy B; Dale, Juanita Conkin; Drews, Barbie; Spahis, Joanna; Hardin, Teri

    2015-01-01

    The literature has a gap related to professional development for APRNs. In the United States, many health care organizations use clinical advancement programs for registered nurses, but APRNs are not often included in these programs. If APRNs are included, advancement opportunities are very limited. At CMC, implementation of a professional portfolio resulted in increased satisfaction among APPs regarding their ability to showcase professional growth and expertise, as well as the uniqueness of their advanced practice. Use of the professional portfolio led to improved recognition by APS and organizational leaders of APP performance excellence during the annual performance evaluation, as well as improved recognition among APP colleagues in terms of nominations for honors and awards.

  6. Defense Programs benchmarking in Chicago, April 1994: Identifying best practices in the pollution prevention programs of selected private industries

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The Office of Defense Programs (DP) was the first US Department of Energy (DOE) Cognizant Secretarial Office (CSO) to attempt to benchmark private industries for best-in-class practices in the field of pollution prevention. Defense Programs` intent in this effort is to identify and bring to DOE field offices strategic and technological tools that have helped private companies minimize waste and prevent pollution. Defense Programs` premier benchmarking study focused on business practices and process improvements used to implement exceptional pollution prevention programs in four privately owned companies. The current interest in implementing partnerships information exchange, and technology transfer with the private sector prompted DP to continue to seek best practices in the area of pollution prevention through a second benchmarking endeavor in May 1994. This report presents the results of that effort. The decision was made to select host facilities that own processes similar to those at DOE plants and laboratories, that have programs that have been recognized on a local or national level, that have an interest in partnering with the Department on an information-sharing basis, and that are located in proximity to each other. The DP benchmarking team assessed the pollution prevention programs of five companies in the Chicago area--GE Plastics, Navistar, Northrop Corporation, Sundstrand and Caterpillar. At all facilities visited, Ozone Depleting Compounds (ODCs), hazardous wastes, releases under the Superfund Amendments and Reauthorization Act (SARA), waste water and non-hazardous wastes are being eliminated, replaced, reduced, recycled and reused whenever practicable.

  7. An exploration of participants' experience of an intensive care nursing transition to specialty practice program.

    Science.gov (United States)

    Madhuvu, Auxillia E; Plummer, Virginia; Morphet, Julia

    2017-09-26

    Transition to specialty practice programs were developed to support, educate and facilitate recruitment and retention of nurses in specialised areas of practice. The intensive care nursing transition to specialty practice program in this study was implemented in 2000. To date, in Australia there are no published studies which focus on intensive care nursing transition to specialty practice programs. The study aimed to explore the effects of an intensive care nursing transition to specialty practice program offered in two intensive care units in a single Australian health service. A cross-sectional survey design was used. Quantitative data were collected from nurses who participated in the transition to specialty practice program from 2005 to 2015 using an anonymous online survey. Summary statistics and Chi-square tests were used to analyse the data. The response rate was 51.8% (n=86). Most of the transition to specialty practice program participants had medical nursing experience (n=35, 40.7%) or surgical nursing experience (n=35, 40.7%) prior to enrolling into the program. More than half (n=46, 53.5%) of the participants had worked in the intensive care units for more than two years post program. The majority of the participants (n=60, 69.8%) undertook post graduate education after the transition to specialty practice program. Significant numbers of experienced nurses undertook transition to specialty practice program into intensive care and majority of the participants reported positive results of the program. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Implementation of the Danish return-to-work program

    DEFF Research Database (Denmark)

    Aust, Birgit; D. Nielsen, Maj Britt; Grundtvig, Gry

    2015-01-01

    (defined as implementation consistent with the principles of the interdisciplinary RTW process). Five municipalities had high and eight had low fidelity scores. Similar large differences were found with regard to dose-delivered, particularly in the quality of cooperation with beneficiaries, employers...... of the Danish RTW program, however, large variations existed between municipalities. Establishment of well-functioning interdisciplinary RTW teams might require more time and resources, while ensuring early assessment and more frequent cooperation with employers might need more general adjustments in the Danish...

  9. Implementing a UDL Framework: A Study of Current Personnel Preparation Practices.

    Science.gov (United States)

    Scott, LaRon A; Thoma, Colleen A; Puglia, Lauren; Temple, Peter; D'Aguilar, Allison

    2017-02-01

    Young adults with intellectual disability (ID) continue to experience the least successful postschool outcomes among transition-aged youth ( Sanford et al., 2011 ). Experts disagree on the most effective approach to improve outcomes such as employment, postsecondary education, and community living. In 2015, the National Goals Conference brought together educational researchers to set an agenda to guide the field in terms of research, practice, and policy ( Thoma, Cain, & Walther-Thomas, 2015 ). One of their recommendations, based on promising research and practices, urged the field to identify effective personnel preparation and professional development practices that ensure general and special educators can implement a UDL framework ( Thoma, Cain, et al., 2015 ). This study surveyed program coordinators at accredited universities to determine what is currently being done to prepare educators to implement a Universal Design for Learning (UDL) framework, the extent to which a UDL framework is being incorporated into preservice courses in higher education, and how a UDL framework is being used to improve postschool outcomes for youth with ID.

  10. Dynamics of the public concern and risk communication program implementation.

    Science.gov (United States)

    Zaryabova, Victoria; Israel, Michel

    2015-09-01

    The public concern about electromagnetic field (EMF) exposure varies due to different reasons. A part of them are connected with the better and higher quality of information that people receive from science, media, Internet, social networks, industry, but others are based on good communication programs performed by the responsible institutions, administration and persons. Especially, in Bulgaria, public concern follows interesting changes, some of them in correlation with the European processes of concern, but others following the economic and political processes in the country. Here, we analyze the dynamics of the public concern over the last 10 years. Our explanation of the decrease of the people's complaints against EMF exposure from base stations for mobile communication is as a result of our risk communication program that is in implementation for >10 years.

  11. Implementation impediments to institutionalising the practice of sustainable urban water management.

    Science.gov (United States)

    Brown, R R; Sharp, L; Ashley, R M

    2006-01-01

    It is now well accepted that there are significant challenges to realising the widespread and self-sustaining implementation of sustainable urban water management. It is argued that these challenges are entrenched within the broader socio-political framework, yet often unsuccessfully addressed within the more narrow scope of improving technical knowledge and design capacity. This hypothesis is investigated through a comparative analysis of three independent research projects investigating different dimensions of the water cycle, including stormwater management in Australia and sanitary waste management and implementation of innovative technologies in the U.K. The analysis reveals significant and common socio-political impediments to improved practice. It was evident that the administrative regime, including implementing professionals and institutions, appears to be largely driven by an implicit expectation that there is a technical solution to solve water management issues. This is in contrast to addressing the issues through broader strategies such as political leadership, institutional reform and social change. It is recognised that this technocratic culture is inadvertently underpinned by the need to demonstrate implementation success within short-term political cycles that conflict with both urban renewal and ecological cycles. Addressing this dilemma demands dedicated socio-technical research programs to enable the much needed shift towards a more sustainable regime.

  12. Implementation fidelity in adolescent family-based prevention programs: relationship to family engagement.

    Science.gov (United States)

    Byrnes, Hilary F; Miller, Brenda A; Aalborg, Annette E; Plasencia, Ana V; Keagy, Carolyn D

    2010-08-01

    Reliability and validity of intervention studies are impossible without adequate program fidelity, as it ensures that the intervention was implemented as designed and allows for accurate conclusions about effectiveness (Bellg AJ, Borrelli B, Resnick B et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH behavior change consortium. Health Psychol 2004; 23: 443-51). This study examines the relation between program fidelity with family engagement (i.e. satisfaction and participation) in family-based prevention programs for adolescent alcohol, tobacco or other drug use. Families (n = 381) were those with an 11- to 12-year-old child enrolled in Kaiser Permanente in the San Francisco area. Families participated in one of two programs: Strengthening Families Program: For Parents and Youth 10-14 (SFP) (Spoth R, Redmond C, Lepper H. Alcohol initiation outcomes of universal family-focused preventive interventions: one- and two-year follow-ups of a controlled study. J Stud Alcohol Suppl 1999; 13: 103-11) or Family Matters (FM) (Bauman KE, Ennett ST. On the importance of peer influence for adolescent drug use: commonly neglected considerations. Addiction 1996; 91: 185-98). Fidelity was assessed by: (i) adherence to the program manual and (ii) quality of implementation. No relationships were found for FM, a self-directed program. For SFP, higher quality scores were related to higher parent satisfaction. Higher adherence scores were related to higher satisfaction for youth, yet surprisingly to lower satisfaction for parents. Parent sessions involve much discussion, and to obtain high adherence scores, health educators were often required to limit this to implement all program activities. Findings highlight a delivery challenge in covering all activities while allowing parents to engage in mutually supportive behavior.

  13. Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program

    Directory of Open Access Journals (Sweden)

    R. Laws

    2016-08-01

    Full Text Available Abstract Background While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT, an obesity prevention program for parents with infants aged 3–18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers. Methods Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4, policy makers (n = 2 and implementers (n = 22, contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking. Results Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however

  14. [Implementation of a Clinical Practice Guidelines for the Management of Adults With Schizophrenia in Colombia].

    Science.gov (United States)

    Sánchez Díaz, Natalia; Duarte Osorio, Andrés; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia

    2016-01-01

    To present overall strategies and activities for the implementation process of the recommendations contained in the clinical practice guideline for the management of adults with schizophrenia (GPC_E) published by the Colombian Ministry of Health and Welfare (MSPS). Prioritize the proposed recommendations, identify barriers and solving strategies to implement the GPC_E, and develop a monitoring and evaluation system for the key recommendations. The Guideline Developer Group (GDG) included professionals with primary dedication to implementation issues that accompanied the entire process. During the GDG meetings implementation topics were identified and discussed, and later complemented by literature reviews concerning the experience of mental health guidelines implementation at national and international level. Additionally, feedback from the discussions raised during the socialization meetings, and joint meetings with the MSPS and the Institute of Technology Assessment in Health (IETS) were included. The prioritization of recommendations was made in conjunction with the GDG, following the proposed steps in the methodological guide for the development of Clinical Practice Guidelines with Economic Evaluation in the General System of Social Security in Colombian Health (GMEGPC) using the tools 13 and 14. the conclusions and final adjustments were discussed with the GPC_E leaders. The implementation chapter includes a description of the potential barriers, solution strategies, facilitators and monitoring indicators. The identified barriers were categorized in the following 3 groups: Cultural context, health system and proposed interventions. The issues related to solving strategies and facilitating education programs include community mental health, mental health training for health workers in primary care, decentralization and integration of mental health services at the primary care level, use of technologies information and communication and telemedicine. To monitor

  15. Scaling Up a Water, Sanitation, and Hygiene Program in Rural Bangladesh: The Role of Program Implementation.

    Science.gov (United States)

    Benjamin-Chung, Jade; Sultana, Sonia; Halder, Amal K; Ahsan, Mohammed Ali; Arnold, Benjamin F; Hubbard, Alan E; Unicomb, Leanne; Luby, Stephen P; Colford, John M

    2017-05-01

    To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. SHEWA-B did not meet UNICEF's ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B's design was suboptimal for improving these outcomes.

  16. Enabling pathways to health equity: developing a framework for implementing social capital in practice.

    Science.gov (United States)

    Putland, Christine; Baum, Fran; Ziersch, Anna; Arthurson, Kathy; Pomagalska, Dorota

    2013-05-29

    Mounting evidence linking aspects of social capital to health and wellbeing outcomes, in particular to reducing health inequities, has led to intense interest in social capital theory within public health in recent decades. As a result, governments internationally are designing interventions to improve health and wellbeing by addressing levels of social capital in communities. The application of theory to practice is uneven, however, reflecting differing views on the pathways between social capital and health, and divergent theories about social capital itself. Unreliable implementation may restrict the potential to contribute to health equity by this means, yet to date there has been limited investigation of how the theory is interpreted at the level of policy and then translated into practice. The paper outlines a collaborative research project designed to address this knowledge deficit in order to inform more effective implementation. Undertaken in partnership with government departments, the study explored the application of social capital theory in programs designed to promote health and wellbeing in Adelaide, South Australia. It comprised three case studies of community-based practice, employing qualitative interviews and focus groups with community participants, practitioners, program managers and policy makers, to examine the ways in which the concept was interpreted and operationalized and identify the factors influencing success. These key lessons informed the development of practical resources comprising a guide for practitioners and briefing for policy makers. Overall the study showed that effective community projects can contribute to population health and wellbeing and reducing health inequities. Of specific relevance to this paper, however, is the finding that community projects rely for their effectiveness on a broader commitment expressed through policies and frameworks at the highest level of government decision making. In particular this

  17. Productive ward 2: practical advice to facilitators implementing the programme.

    Science.gov (United States)

    Allsopp, Pete; Faruqi, Joe; Gascoigne, Laura; Tennyson, Rachel

    This is the second in a two-part series looking at the implementation of Productive Ward. Part one looked at roll-out of the initiative across a hospital This part offers advice to facilitators involved in implementing the programme.

  18. The Implementation of Best Practices: Process and Performance Effects

    DEFF Research Database (Denmark)

    Laugen, Bjørge Timenes; Boer, Harry

    2007-01-01

    companies showed that a broad and incremental implementation approach initially leads to reduced performance followed by a gradual improvement as larger parts of the programmes are institutionalized. A ‘big bang' implementation approach does not seem to lead to deterioration in performance....

  19. OWL representation of the geologic timescale implementing stratigraphic best practice

    Science.gov (United States)

    Cox, S. J.

    2011-12-01

    The geologic timescale is a cornerstone of the earth sciences. Versions are available from many sources, with the following being of particular interest: (i) The official International Stratigraphic Chart (ISC) is maintained by the International Commission for Stratigraphy (ICS), following principles developed over the last 40 years. ICS provides the data underlying the chart as part of a specialized software package, and the chart itself as a PDF using the standard colours; (ii) ITC Enschede has developed a representation of the timescale as a thesaurus in SKOS, used in a Web Map Service delivery system; (iii) JPL's SWEET ontology includes a geologic timescale. This takes full advantage of the capabilities of OWL. However, each of these has limitations - The ISC falls down because of incompatibility with web technologies; - While SKOS supports multilingual labelling, SKOS does not adequately support timescale semantics, in particular since it does not include ordering relationships; - The SWEET version (as of version 2) is not fully aligned to the model used by ICS, in particular not recognizing the role of the Global Boundary Stratotype Sections and Point (GSSP). Furthermore, it is distributed as static documents, rather than through a dynamic API using SPARQL. The representation presented in this paper overcomes all of these limitations as follows: - the timescale model is formulated as an OWL ontology - the ontology is directly derived from the UML representation of the ICS best practice proposed by Cox & Richard [2005], and subsequently included as the Geologic Timescale package in GeoSciML (http://www.geosciml.org); this includes links to GSSPs as per the ICS process - key properties in the ontology are also asserted to be subProperties of SKOS properties (topConcept and broader/narrower relations) in order to support SKOS-based queries; SKOS labelling is used to support multi-lingual naming and synonyms - the International Stratigraphic Chart is implemented

  20. 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

  1. How feasible are lifestyle modification programs for disease prevention in general practice?

    Science.gov (United States)

    Schütze, Heike; Rix, Elizabeth F; Laws, Rachel A; Passey, Megan; Fanaian, Mahnaz; Harris, Mark F

    2012-01-01

    Vascular disease is a leading cause of death and disability. While it is preventable, little is known about the feasibility or acceptability of implementing interventions to prevent vascular disease in Australian primary health care. We conducted a cluster randomised controlled trial assessing prevention of vascular disease in patients aged 40-65 by providing a lifestyle modification program in general practice. Interviews with 13 general practices in the intervention arm of this trial examined their views on implementing the lifestyle modification program in general practice settings. Qualitative study, involving thematic analysis of semi-structured interviews with 11 general practitioners, four practice nurses and five allied health providers between October 2009 and April 2010. Providing brief lifestyle intervention fitted well with routine health-check consultations; however, acceptance and referral to the program was dependent on the level of facilitation provided by program coordinators. Respondents reported that patients engaged with the advice and strategies provided in the program, which helped them make lifestyle changes. Practice nurse involvement was important to sustaining implementation in general practice, while the lack of referral services for people at risk of developing vascular disease threatens maintenance of lifestyle changes as few respondents thought patients would continue lifestyle changes without long-term follow up. Lifestyle modification programs to prevent vascular disease are feasible in general practice but must be provided in a flexible format, such as being offered out of hours to facilitate uptake, with ongoing support and follow up to assist maintenance. The newly formed Medicare Locals may have an important role in facilitating lifestyle modification programs for this target group.

  2. The urology residency matching program in practice.

    Science.gov (United States)

    Teichman, J M; Anderson, K D; Dorough, M M; Stein, C R; Optenberg, S A; Thompson, I M

    2000-06-01

    We evaluate behaviors and attitudes among resident applicants and program directors related to the American Urological Association (AUA) residency matching program and recommend changes to improve the match. Written questionnaires were mailed to 519 resident applicants and 112 program directors after the 1999 American Urological Association match. Subjects were asked about their observations, behaviors and opinions towards the match. Questionnaires were returned by 230 resident applicants and 94 program directors (44% and 83% response rates, respectively.) Of the resident applicants 75% spent $1,001 to $5,000 for interviewing. Of the program directors 47% recalled that applicants asked how programs would rank the applicant and 61% of applicants recalled that program directors asked applicants how they would rank programs. Dishonesty was acknowledged by 31% of program directors and 44% of resident applicants. Of program directors 82% thought applicants "lied", while 67% of applicants thought that programs "lied" (quotations indicate questionnaire language). Participants characterized their own dishonesty as "just playing the game" or they "did not feel badly." Of program directors 81% and of applicants 61% were "skeptical" or "did not believe" when informed they were a "high" or "number 1" selection. Being asked about marital status was recalled by 91% of male and 100% of female (p = 0. 02), if they had children by 53% of male and 67% of female, (p = 0. 03), and intent to have children by 25% of male and 62% of female (p gender. Interviews are costly for applicants. We recommend that 1) programs adopt policies to enhance fairness, 2) applications be filed electronically, 3) programs assist resident applicants with interview accommodation to reduce financial burden and 4) a post-interview code of limited or noncommunication be adopted.

  3. Implementation of parental feeding practices: does parenting style matter?

    Science.gov (United States)

    Kiefner-Burmeister, Allison; Hoffmann, Debra; Zbur, Samantha; Musher-Eizenman, Dara

    2016-09-01

    To combat childhood obesity, researchers have focused on parental feeding practices that promote child health. The current study investigated how parenting style relates to twelve parental feeding practices. Data on parenting style and parental feeding practices were obtained for a correlational study from users of Amazon's Mechanical Turk, an online survey system. USA. Mothers of children aged 7-11 years (n 193). Parenting style related differentially to eleven out of the twelve measured practices. Authoritative mothers displayed more feeding practices that promote child health and fewer practices that impede child health. Authoritarian and permissive mothers displayed more unhealthy practices than authoritative mothers, but differed from each other on the practices they employed. Parenting style may relate to more aspects of feeding than previously realized. The inclusion of numerous healthy feeding practices along with unhealthy practices in the current study provides suggestions for the application of healthy feeding behaviours. Instruction on feeding behaviours and parenting style should be a focus of future educational programmes.

  4. Interprofessional development and implementation of a pharmacist professional advancement and recognition program.

    Science.gov (United States)

    Hager, David; Chmielewski, Eric; Porter, Andrea L; Brzozowski, Sarah; Rough, Steve S; Trapskin, Philip J

    2017-11-15

    The interprofessional development, implementation, and outcomes of a pharmacist professional advancement and recognition program (PARP) at an academic medical center are described. Limitations of the legacy advancement program, in combination with low rates of employee engagement in peer recognition and professional development, at the UW Health department of pharmacy led to the creation of a task force comprising pharmacists from all practice areas to develop a new pharmacist PARP. Senior leadership within the organization expanded the scope of the project to include an interprofessional work group tasked to develop guidelines and core principles that other professional staff could use to reduce variation across advancement and recognition programs. Key program design elements included a triennial review of performance against advancement standards and the use of peer review to supplement advancement decisions. The primary objective was to meaningfully improve pharmacists' engagement as measured through employee engagement surveys. Secondary outcomes of interest included the results of pharmacist and management satisfaction surveys and the program's impact on the volume and mix of pharmacist professional development activities. Of the 126 eligible pharmacists, 93 participated in the new program. The majority of pharmacists was satisfied with the program. For pharmacists who were advanced as part of the program, meaningful increases in employee engagement scores were observed, and a mean of 95 hours of professional development and quality-improvement activities was documented. Implementation of a PARP helped increase pharmacist engagement through participation in quality-improvement and professional development activities. The program also led to the creation of organizationwide interprofessional guidelines for advancement programs within various healthcare disciplines. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Tan LD

    2017-07-01

    Full Text Available Laren D Tan,1 Nicholas Kenyon,2 Ken Y Yoneda,2 Samuel Louie2 1Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA; 2Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, USA Abstract: 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. Keywords: asthma, severe asthma, severe refractory asthma, biologic resistant asthma, BT

  6. Policies and Practices regarding Students with Accents in Speech-Language Pathology Training Programs

    Science.gov (United States)

    Levy, Erika S.; Crowley, Catherine J.

    2012-01-01

    Speech-language pathology (SLP) training programs are the initial gateway for nonnative speakers of English to join the SLP profession. An anonymous web-based survey in New York State examined policies and practices implemented when SLP students have foreign accents in English or in other languages. Responses were elicited from 530 students and 28…

  7. Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

    Science.gov (United States)

    Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

    2016-01-01

    To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

  8. Optimization and practical implementation of ultrafast 2D NMR experiments

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz Junior, Luiz H. K., E-mail: professorkeng@gmail.com [Universidade Federal de Sao Carlos (UFSC), SP (Brazil). Departamento de Quimica; Universidade Federal de Goias (UFGO), Goiania, GO (Brazil). Inst. de Quimica; Ferreira, Antonio G. [Universidade Federal de Sao Carlos (UFSC), SP (Brazil). Departamento de Quimica; Giraudeau, Patrick [Universite de Nantes (France). CNRS, Chimie et Interdisciplinarite: Synthese, Analyse, Modelisation

    2013-09-01

    Ultrafast 2D NMR is a powerful methodology that allows recording of a 2D NMR spectrum in a fraction of second. However, due to the numerous non-conventional parameters involved in this methodology its implementation is no trivial task. Here, an optimized experimental protocol is carefully described to ensure efficient implementation of ultrafast NMR. The ultrafast spectra resulting from this implementation are presented based on the example of two widely used 2D NMR experiments, COSY and HSQC, obtained in 0.2 s and 41 s, respectively. (author)

  9. Implementation and Outcomes of a Comprehensive Type 2 Diabetes Program in Rural Guatemala.

    Directory of Open Access Journals (Sweden)

    David Flood

    Full Text Available The burden of chronic, non-communicable diseases such as diabetes is growing rapidly in low- and middle-income countries. Implementing management programs for diabetes and other chronic diseases for underserved populations is thus a critical global health priority. However, there is a notable dearth of shared programmatic and outcomes data from diabetes treatment programs in these settings.We describe our experiences as a non-governmental organization designing and implementing a type 2 diabetes program serving Maya indigenous people in rural Guatemala. We detail the practical challenges and solutions we have developed to build and sustain diabetes programming in this setting.We conduct a retrospective chart review from our electronic medical record to evaluate our program's performance. We generate a cohort profile, assess cross-sectional indicators using a framework adapted from the literature, and report on clinical longitudinal outcomes.A total of 142 patients were identified for the chart review. The cohort showed a decrease in hemoglobin A1C from a mean of 9.2% to 8.1% over an average of 2.1 years of follow-up (p <0.001. The proportions of patients meeting glycemic targets were 53% for hemoglobin A1C < 8% and 32% for the stricter target of hemoglobin A1C < 7%.We first offer programmatic experiences to address a gap in resources relating to the practical issues of designing and implementing global diabetes management interventions. We then present clinical data suggesting that favorable diabetes outcomes can be attained in poor areas of rural Guatemala.

  10. A Survey of E-Learning Implementation Best Practices in Jordanian Government Universities

    Science.gov (United States)

    Al-Tarawneh, Haroon Salem; Allahawiah, Sattam

    2011-01-01

    The objective of the research reported in this article is to understand the extent of e-learning implementation practices currently in use in Jordanian government universities. In order to achieve this objective, a survey of e-learning implementation practice in Jordanian universities was conducted. A detailed description of the survey procedures…

  11. Training Teachers to Use Evidence-Based Practices for Autism: Examining Procedural Implementation Fidelity

    Science.gov (United States)

    Stahmer, Aubyn C.; Rieth, Sarah; Lee, Ember; Reisinger, Erica M.; Mandell, David S.; Connell, James E.

    2015-01-01

    The purpose of this study was to examine the extent to which public school teachers implemented evidence-based interventions for students with autism in the way these practices were designed. Evidence-based practices for students with autism are rarely incorporated into community settings, and little is known about the quality of implementation.…

  12. Project Hanford Management Contract (PHMC) pollution prevention program implementation plan

    Energy Technology Data Exchange (ETDEWEB)

    Place, B.G., Westinghouse Hanford

    1996-12-31

    This plan documents the Project Hanford Management Contract (PHMC) Pollution Prevention/Waste Minimization (P2/WMin) Program. The subject implementation plan has been updated to reflect the Fiscal Year (FY) 1997 contract structure in which Fluor Daniel Hanford, Inc. (FDH) is the management and integration contractor. The P2/WMin Program scope includes FDH as the principal PHMC contractor, and B&W Hanford Company (BWHC), Duke Engineering & Services Hanford, Inc. (DESH), Lockheed Martin Hanford Corporation, (LMHC), Numatec Hanford Corporation (NHC), Rust Federal Services of Hanford, Inc. (RFSH), and DynCorp Tri-Cities Services, Inc. (DYN) as PHMC contractors, as well as subcontracting enterprise companies, such as Fluor Daniel Northwest, Inc. (FDNW), Lockheed Martin Services, Inc. (LMSI), and Rust Federal Services Northwest (RFS), which provide engineering, operation, construction, maintenance, and computer services for the Hanford Site. The P2/WMin Program scope also includes all other subcontractor-affiliated enterprise companies, such as B&W Protec, Inc. (BWP), DE&S Northwest, Inc. (DESNW), and SGN Eurisys Services Corp. (SESC).

  13. Development and Implementation of An Administrative Internship Program

    Directory of Open Access Journals (Sweden)

    Esther Wermuth

    2017-04-01

    Full Text Available This article describes the development and implementation of a pilot program to prepare teachers seeking New York state certification as school district administrators, by assigning them as administrative interns to a school district. The superintendent of a large urban school district and the director of a college program to prepare school district administrators partnered to design a pilot experiential course in which candidates for a master’s degree and state certificate would have an opportunity to develop skills and learn by experiencing situations that support new learning (Kolb, 1984, to take the place of an existing internship course for eight candidates. The dual purpose was to provide an authentic learning experience for the candidates and to provide actionable information for the superintendent for improvement of the district instructional program. To identify areas of academic concern, the candidates reviewed the New York State District Report Card1, conducted research, and interviewed district personnel in order to be able tomake actionable suggestions and recommendations to the superintendent that might result in academic improvement. Findings and recommendations to inform district improvement efforts and for improvement of the existing course were presented to the superintendent and his administrative staff. Recommendations are included.

  14. Implementing the NPDES program: An update on the WET ...

    Science.gov (United States)

    The U.S. EPA has utilized the Clean Water Act - National Pollutant Discharge Elimination System permitting program to protect waters of the U.S for over 40 years. NPDES permit effluent limitations serve as the primary mechanism for controlling discharges of pollutants to receiving waters. When developing effluent limitations for an NPDES permit, a permit writer must consider limits based on both the technology available to control the pollutants (i.e., technology-based effluent limits) and limits that are protective of the water quality standards of the receiving water (i.e., water quality-based effluent limits). WET testing is one of the water quality-based effluent limitation mechanisms available to permit writers that is useful in determining how the additive, synergistic and compounding effects of toxic effluents effect streams. This presentation will provide an overview of the current EPA NPDES permit program direction for increasing the efficacy of NPDES permits program administered by the U.S. EPA and States. The training implementation plan is expected to provide permit writers with a clearer understanding of WET requirements as established via the U.S. EPA WET test manuals, NPDES permitting regulatory authorities, and the WET science which has been long established. not applicable

  15. Open Groups: Adaptations in Implementing a Parent Training Program

    Directory of Open Access Journals (Sweden)

    Donna-Jean P. Brock

    2013-12-01

    Full Text Available Background: Programs that focus on positive parenting have been shown to improve parental attitudes, knowledge, and behaviors, and increase parent and child bonding. These programs are typically conducted in a closed group format. However, when individual or community needs are more immediate, programmers sometimes opt for an open group format. To determine the effectiveness of this adaptation to an open group format, the present study compared both groups on parental outcomes. Methods: Both closed and open group formats were offered and implemented between January 2009 and December 2012. Participants for both formats were recruited through similar means and the format placement for each family was determined by the immediacy of the need for an intervention, the time lapse until a new cycle would begin, and scheduling flexibility. Chi-Square analyses were conducted to determine demographic differences between the two groups and gain scores were calculated from the pre- and post-test AAPI-2 scales within a mixed MANOVA to determine group for-mat effectiveness. Results: Though open groups contained higher risk families; parental out-come improvements were significant for both groups. All participants, regardless of group membership, demonstrated the same statistically significant improvements following completion of the program. Conclusion: Findings provide support for adapting group formats when necessary to fit community and individual needs.

  16. Collaborative Benchmarking: Discovering and Implementing Best Practices to Strengthen SEAs

    Science.gov (United States)

    Building State Capacity and Productivity Center, 2013

    2013-01-01

    To help state educational agencies (SEAs) learn about and adapt best practices that exist in other SEAs and other organizations, the Building State Capacity and Productivity Center (BSCP Center) working closely with the Regional Comprehensive Centers will create multi-state groups, through a "Collaborative Benchmarking Best Practices Process" that…

  17. Contingency Factors Influencing Implementation of Physical Asset Management Practices

    Directory of Open Access Journals (Sweden)

    Maletič Damjan

    2017-02-01

    Full Text Available Purpose: The purpose of this empirical study is to examine the role of two contingency factors, i.e. uncertainty and competitiveness in relation to physical asset management (PAM practices as well as to maintenance key performance indicators. The research is based on a premise that PAM, which was defined by risk management practices, performance assessment practices, life cycle management practices, and policy & strategy practices, has become an indispensable element of strategic thinking of asset owners as well as maintenance and asset managers. The purpose of this study is to advance the understanding of how organizations that face high or low level of uncertainty and competitiveness respond in terms of PAM deployment.

  18. Programming languages for MIS concepts and practice

    CERN Document Server

    Wang, Hai

    2014-01-01

    Introduction Computers Computer Programming Languages     Role of Computer Programming Language      Software Systems     Taxonomies of Computer Programming LanguagesComputing Architecture in the Internet Environment Key Characteristics Shared by All Procedural Programming Languages      Syntax, Sentence, and Word     Variable     Arithmetic Operation     Execution Sequence      If-Then-Else Logic      Loop      Module C++ Introduction to Function-Oriented and Object-Oriented Programming A Tour of C Language      C and C++ Keyword and User-Defined Word      Comment Statements      Preprocessor

  19. Implementing web-scale discovery services a practical guide for librarians

    CERN Document Server

    Thompson, JoLinda

    2014-01-01

    Implementing Web-Scale Discovery Services: A Practical Guide for Librarians is a source for librarians seeking to evaluate, purchase, and implement a web-scale discovery service. The book breaks down each phase of the project into decision points and action plans to help librarians select and implement a system that meets their specific needs.

  20. Implementation of information technology in nursing practice - challenge for management in psychiatric nursing.

    Science.gov (United States)

    Koivunen, Marita; Hätönen, Heli; Välimäki, Maritta

    2009-01-01

    The implementation of information technology (IT) applications in nursing practice requires systematic investments and guidance. A collaborative organisational culture, and systematic and close clinical and administrative cooperation during the implementation process support the acceptance of IT among users in organisation. Although knowledge of IT projects management exists, there is a lack of knowledge about nursing management in IT implementation processes in psychiatric nursing.

  1. Implementation and Outcomes of a Comprehensive Type 2 Diabetes Program in Rural Guatemala.

    Science.gov (United States)

    Flood, David; Mux, Sandy; Martinez, Boris; García, Pablo; Douglas, Kate; Goldberg, Vera; Lopez, Waleska; Rohloff, Peter

    2016-01-01

    The burden of chronic, non-communicable diseases such as diabetes is growing rapidly in low- and middle-income countries. Implementing management programs for diabetes and other chronic diseases for underserved populations is thus a critical global health priority. However, there is a notable dearth of shared programmatic and outcomes data from diabetes treatment programs in these settings. We describe our experiences as a non-governmental organization designing and implementing a type 2 diabetes program serving Maya indigenous people in rural Guatemala. We detail the practical challenges and solutions we have developed to build and sustain diabetes programming in this setting. We conduct a retrospective chart review from our electronic medical record to evaluate our program's performance. We generate a cohort profile, assess cross-sectional indicators using a framework adapted from the literature, and report on clinical longitudinal outcomes. A total of 142 patients were identified for the chart review. The cohort showed a decrease in hemoglobin A1C from a mean of 9.2% to 8.1% over an average of 2.1 years of follow-up (p Guatemala.

  2. Implementation of Next Generation Science Standards Through Museum Geoscience Outreach Program

    Science.gov (United States)

    Moclock, L.; O'Dwyer Brown, L.

    2015-12-01

    Museums can play a pivotal role in helping school instructors transition to the Next Generation Science Standards (NGSS), as they can (1) provide large numbers of schools and students access to existing resources and specialized education, (2) implement standards faster as their programming is more focused; and (3) leverage family involvement in learning through their intrinsic informal nature. We present the Rice Mineral Museum's Family Earth Science Night (FESN), our hands-on earth science outreach program. The program utilizes the educational vision of the NGSS, providing practical activities to engage in core ideas in minerals, rocks, fossils and earth systems and to place these experiences in a crosscutting framework. FESN has already reached 1100 students and families in nine schools in Oregon and Washington during the 2014-2015 academic year.

  3. The Cascading Effects of Multiple Dimensions of Implementation on Program Outcomes: a Test of a Theoretical Model.

    Science.gov (United States)

    Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks

    2017-12-14

    This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.

  4. Implementation of a primary care physician network obesity management program.

    Science.gov (United States)

    Bowerman, S; Bellman, M; Saltsman, P; Garvey, D; Pimstone, K; Skootsky, S; Wang, H J; Elashoff, R; Heber, D

    2001-11-01

    Most primary care physicians do not treat obesity, citing lack of time, resources, insurance reimbursement, and knowledge of effective interventions as significant barriers. To address this need, a 10-minute intervention delivered by the primary care physician was coupled with individual dietary counseling sessions delivered by a registered dietitian via telephone with an automated calling system (House-Calls, Mobile, AL). Patients were seen for follow-up by their physician at weeks 4, 12, 24, 36 and 52. A total of 252 patients (202 women and 50 men) were referred by 18 primary care physicians to the program. The comorbid conditions reported for all patients at baseline included low back pain, 29% (n = 72); hypertension, 45% (n = 113); hypercholesterolemia, 41% (n = 104); type 2 diabetes, 10% (n = 26); and sleep apnea, 5% (n = 12). When offered a choice of meal plans based on foods or meal replacements, two-thirds of patients (n = 166) chose to use meal replacements (Ultra Slim-Fast; Slim-Fast Foods Co., West Palm Beach, FL) at least once daily. Baseline weights of subjects averaged 200 +/- 46 lb for women (n = 202) and 237 +/- 45 lb for men (n = 50). Patients completing 6 months in the program lost an average of 19.0 +/- 4.0 lb for women (n = 94) and 15.5 +/- 8.2 lb for men (n = 26). Physicians reported a high degree of satisfaction with the program, suggesting that a brief, effective physician-directed program with nutritionist support by telephone can be implemented in a busy primary care office.

  5. Implementation of Client Incentives within a Recovery Navigation Program.

    Science.gov (United States)

    Brolin, Mary; Torres, Maria; Hodgkin, Dominic; Horgan, Constance; Lee, Margaret; Merrick, Elizabeth; Ritter, Grant; Panas, Lee; DeMarco, Natasha; Hopwood, Jonna; Gewirtz, Andrea; Straus, John; Harrington, Janice; Lane, Nancy

    2017-01-01

    Multiple detoxification admissions among clients with substance use disorders (SUD) are costly to the health care system. This study explored the impact on behavior and cost outcomes of recovery support navigator (RSN) services delivered with and without a contingent incentive intervention. New intakes at four detoxification programs were offered RSN-only (N=1116) or RSN plus incentive (RSN+I; N=1551) services. The study used a group-level cross-over design with the intervention in place at each clinic reversed halfway through the enrollment period. RSN+I clients could earn up to $240 in gift cards for accomplishing 12 different recovery-oriented target behaviors. All eligible clients entering the detoxification programs were included in the analyses, regardless of actual service use. Among RSN+I clients, 35.5% accessed any RSN services compared to 22.3% in the RSN-only group (p<.01). Of RSN+I clients, 19% earned one, 12% earned two and 18% earned three or more incentives; 51% did not earn any incentives. The majority of incentives earned were for meeting with the RSN either during or after detoxification. Adjusted average monthly health care costs among clients in the RSN-only and RSN+I groups increased at a similar rate over 12 months post-detoxification. Possible explanations for limited uptake of the incentive program discussed include features of the incentive program itself, navigator-client communication, organizational barriers and navigator bias. The findings provide lessons to consider for future design and implementation of multi-target contingency management interventions in real-world settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Material Programming: a Design Practice for Computational Composites

    DEFF Research Database (Denmark)

    Vallgårda, Anna; Boer, Laurens; Tsaknaki, Vasiliki

    2016-01-01

    In this paper we propose the notion of material programming as a future design practice for computational composites. Material programming would be a way for the interaction designer to better explore the dynamic potential of computational materials at hand and through that familiarity be able...... to compose more sophisticated and complex temporal forms in their designs. The contribution of the paper is an analysis of qualities that we find a material programming practice would and should support: designs grounded in material properties and experiences, embodied programming practice, real-time on......-site explorations, and finally a reasonable level of complexity in couplings between input and output. We propose material programming knowing that the technology and materials are not entirely ready to support this practice yet, however, we are certain they will be and that the interaction design community...

  7. Design and Implementation of the Futhark Programming Language

    DEFF Research Database (Denmark)

    Henriksen, Troels

    reasoning. Fifth, we perform an evaluation on 21 benchmarks that demonstrates the impact of the language and compiler features, and shows application-level performance that is in many cases competitive with hand-written GPU code. Sixth, we make the Futhark compiler freely available with full source code......In this thesis we describe the design and implementation of Futhark, a small data-parallel purely functional array language that offers a machine-neutral programming model, and an optimising compiler that generates efficient OpenCL code for GPUs. The overall philosophy is based on seeking a middle...... sequentialised, while keeping access patterns intact, which then permits further locality-of-reference optimisations. We demonstrate this capability by showing instances of automatic loop tiling, as well as optimising memory access patterns. Second, to support the flattening transformation, we present...

  8. Implementing communities of practice in the Georgia Department of Transportation.

    Science.gov (United States)

    2014-12-01

    This study explored strategies through which the Georgia Department of Transportation (GDOT) can develop communities of : practice to help managers facilitate critical exchanges of knowledge, support organization learning, and ultimately achieve : im...

  9. Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos.

    Science.gov (United States)

    Schmidt, S; Bounnack, S; Hoehn, T

    2018-01-01

    Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

    Science.gov (United States)

    Hardesty, Lara A

    2015-03-01

    OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION. When appropriate attention is given to image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dose, and marketing, implementation of DBT into a breast imaging practice can be successful.

  11. Genetic programming theory and practice XII

    CERN Document Server

    Riolo, Rick; Kotanchek, Mark

    2015-01-01

    These contributions, written by the foremost international researchers and practitioners of Genetic Programming (GP), explore the synergy between theoretical and empirical results on real-world problems, producing a comprehensive view of the state of the art in GP. Topics in this volume include: gene expression regulation, novel genetic models for glaucoma, inheritable epigenetics, combinators in genetic programming, sequential symbolic regression, system dynamics, sliding window symbolic regression, large feature problems, alignment in the error space, HUMIE winners, Boolean multiplexer funct

  12. How GPs implement clinical guidelines in everyday clinical practice--a qualitative interview study.

    Science.gov (United States)

    Le, Jette V; Hansen, Helle P; Riisgaard, Helle; Lykkegaard, Jesper; Nexøe, Jørgen; Bro, Flemming; Søndergaard, Jens

    2015-12-01

    Clinical guidelines are considered to be essential for improving quality and safety of health care. However, interventions to promote implementation of guidelines have demonstrated only partial effectiveness and the reasons for this apparent failure are not yet fully understood. To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form. Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective implementation activities and organized their everyday practice to support these activities. In other practices GPs discussed guidelines collectively but left the application up to the individual GP whilst others again saw no need for discussion or collective activities depending entirely on the individual GP's decision on whether and how to manage implementation. Approaches to implementation of clinical guidelines vary substantially between practices. Supporting activities should take this into account. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Sustainable practice improvements: impact of the Comprehensive Advanced Palliative Care Education (CAPCE) program.

    Science.gov (United States)

    Harris, Diane; Hillier, Loretta M; Keat, Nancy

    2007-01-01

    This paper describes an education program designed to improve palliative care practice through the development of workplace hospice palliative care resources (PCRs), and its impact on knowledge transfer and longer-term changes to clinical practice. Evaluation methods included pre- and post-program questionnaires, and a survey of learners' (n=301) perceptions of program learning strategies. Interviews (n=21) were conducted with a purposeful sample of PCRs and representatives from their work sites. Ratings of the sessions indicated that they were relevant to learners' clinical practice. At follow up, the majority of learners (83%) continued to serve as PCRs. Many positive effects were identified, including enhanced pain and symptom management, staff education, and development of care policies and guidelines. Management support, particularly the prioritization of palliative care and staff development, were factors facilitating sustained implementation. These findings highlight the importance of multimodal learning strategies and supportive work environments in the development of PCRs to enhance palliative care practice.

  14. Implementing a collaborative return-to-work program: Lessons from a qualitative study in a large Canadian healthcare organization.

    Science.gov (United States)

    Skivington, Kathryn; Lifshen, Marni; Mustard, Cameron

    2016-11-22

    Comprehensive workplace return-to-work policies, applied with consistency, can reduce length of time out of work and the risk of long-term disability. This paper reports on the findings from a qualitative study exploring managers' and return-to-work-coordinators' views on the implementation of their organization's new return-to-work program. To provide practical guidance to organizations in designing and implementing return-to-work programs for their employees. Semi-structured qualitative interviews were undertaken with 20 managers and 10 return-to-work co-ordinators to describe participants' perspectives on the progress of program implementation in the first 18 months of adoption. The study was based in a large healthcare organization in Ontario, Canada. Thematic analysis of the data was conducted. We identified tensions evident in the early implementation phase of the organization's return-to-work program. These tensions were attributed to uncertainties concerning roles and responsibilities and to circumstances where objectives or principles appeared to be in conflict. The implementation of a comprehensive and collaborative return-to-work program is a complex challenge. The findings described in this paper may provide helpful guidance for organizations embarking on the development and implementation of a return-to-work program.

  15. The Work Disability Prevention CIHR Strategic Training Program: program performance after 5 years of implementation.

    Science.gov (United States)

    Loisel, Patrick; Hong, Quan Nha; Imbeau, Daniel; Lippel, Katherine; Guzman, Jaime; Maceachen, Ellen; Corbière, Marc; Santos, Brenda R; Anema, Johannes R

    2009-03-01

    The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and attitudes regarding WDP. The purpose of this paper is to present a descriptive portrait of the program's performance over the past 5 years, as well as the trainees' and alumni's perspectives on the WDP CIHR Training Program. Data on the program's performance were collected from documents in the program records. The trainees' opinions on the WDP training program were obtained through focus groups and telephone interviews. The data collected were compiled and divided into themes to summarize the qualitative findings pertaining to each question. From 2003 to 2007, five successive summer sessions have been offered, involving 44 high-caliber applicants from nine countries, 34 mentors and collaborators, 29 guest speakers and 15 stakeholders. Overall, trainees appreciated the networking, the opportunity to interact with people from different disciplines and countries, the openness, and the international perspective and uniqueness of the program. The least appreciated aspects concerned mainly the e-learning course, evaluations and information on optional courses. The coordination and logistics were judged appropriate and several topics were suggested to improve the program quality. In general, the program implementation went well, with good participation from mentors, speakers and stakeholders; the program was appreciated by the trainees and alumni. This paper underscores the importance of the international perspective, the transdisciplinarity and the scientific networking established through the program.

  16. Dissecting Delirium: Phenotypes, Consequences, Screening, Diagnosis, Prevention, Treatment, and Program Implementation.

    Science.gov (United States)

    Flaherty, Joseph H; Yue, Jirong; Rudolph, James L

    2017-08-01

    Delirium is an acute change in attention and awareness that preferentially occurs in older patients with acute illness. This review provides an overview for clinicians with descriptions of the presentations (phenotypes), consequences, diagnosis, and screening of delirium. In addition, this review provides guidance for the challenges posed by delirium in a health care system, including implementation of delirium programs, tools to address the diagnosis and differential diagnosis of delirium, and a review of preventive and treatment studies with a goal of improving clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. State-of-the-practice and lessons learned on implementing open data and open source policies.

    Science.gov (United States)

    2012-05-01

    This report describes the current government, academic, and private sector practices associated with open data and open source application development. These practices are identified; and the potential uses with the ITS Programs Data Capture and M...

  18. Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

    Science.gov (United States)

    Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

    2014-10-08

    comprising the composite index include the following: process measures, referral/treatment measures, and target/change outcome measures related to cardiovascular disease, diabetes, cancer and associated lifestyle factors. The BETTER 2 program is a collaborative approach grounded in practice and built from existing work (i.e., integration not creation). The program evaluation is designed to provide an understanding of issues impacting the implementation of an effective approach for CDPS within primary care that may be adapted to become sustainable in the non-research setting.

  19. Using implementation facilitation to foster clinical practice quality and adherence to evidence in challenged settings: a qualitative study.

    Science.gov (United States)

    Ritchie, Mona J; Parker, Louise E; Edlund, Carrie N; Kirchner, JoAnn E

    2017-04-20

    We evaluated a facilitation strategy to help clinical sites likely to experience challenges implement evidence-based Primary Care-Mental Health Integration (PC-MHI) care models within the context of a Department of Veterans Affairs (VA) initiative. This article describes our assessment of whether implementation facilitation (IF) can foster development of high quality PC-MHI programs that adhere to evidence, are sustainable and likely to improve clinical practices and outcomes. Utilizing a matched pair design, we conducted a qualitative descriptive evaluation of the IF strategy in sixteen VA primary care clinics. To assess program quality and adherence to evidence, we conducted one-hour structured telephone interviews, at two time points, with clinicians and leaders who knew the most about the clinics' programs. We then created structured summaries of the interviews that VA national PC-MHI experts utilized to rate the programs on four dimensions (overall quality, adherence to evidence, sustainability and level of improvement). At first assessment, seven of eight IF sites and four of eight comparison sites had implemented a PC-MHI program. Our qualitative assessment suggested that experts rated IF sites' programs higher than comparison sites' programs with one exception. At final assessment, all eight IF but only five comparison sites had implemented a PC-MHI program. Again, experts rated IF sites' programs higher than their matched comparison sites with one exception. Over time, all ratings improved in five of seven IF sites and two of three comparison sites. Implementing complex evidence-based programs, particularly in settings that lack infrastructure, resources and support for such efforts, is challenging. Findings suggest that a blend of external expert and internal regional facilitation strategies that implementation scientists have developed and tested can improve PC-MHI program uptake, quality and adherence to evidence in primary care clinics with these

  20. A Survey of Asthma Management Practices and Implementation of ...

    African Journals Online (AJOL)

    2017-09-14

    Sep 14, 2017 ... and implementation of Global Initiative for Asthma guidelines among doctors in a resource-limited setting in Nigeria. Niger J Clin Pract. 2017;20:984-91. This is an open access article distributed under the terms of the Creative Commons. Attribution-NonCommercial-ShareAlike 3.0 License, which allows ...

  1. Creating Positive Environments in Skilled Nursing Facilities to Support Best Practice Implementation: An Overview and Practical Suggestions.

    Science.gov (United States)

    Douglas, Natalie F; Hickey, Ellen

    2015-08-01

    The purpose of this article is to discuss various types of organizational cultures and climates in relationship to best practice implementation. Although not specific to speech-language pathology, positive organizational cultures and climates are associated with better clinician and patient outcomes in health care services than dysfunctional and/or hierarchical organizational cultures and climates. A goal of this article is to help the practicing speech-language pathologist (SLP) promote positive culture change in the skilled nursing facility (SNF) setting. Recommendations to improve the organizational culture and climate of SNFs will be presented through practical examples of collaborative practice. Further suggestions will be surmised from the organizational psychology and interprofessional education literature. The connection between organizational culture and climate, interprofessional education, collaborative practice, and SLPs' best practice implementation in the SNF setting will be discussed. Avenues for future work are suggested. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Blended Learning Implementation in “Guru Pembelajar” Program

    Science.gov (United States)

    Mahdan, D.; Kamaludin, M.; Wendi, H. F.; Simanjuntak, M. V.

    2018-02-01

    The rapid development of information and communication technology (ICT), especially the internet, computers and communication devices requires the innovation in learning; one of which is Blended Learning. The concept of Blended Learning is the mixing of face-to-face learning models by learning online. Blended learning used in the learner teacher program organized by the Indonesian department of education and culture that a program to improve the competence of teachers, called “Guru Pembelajar” (GP). Blended learning model is perfect for learning for teachers, due to limited distance and time because online learning can be done anywhere and anytime. but the problems that arise from the implementation of this activity are many teachers who do not follow the activities because teachers, especially the elderly do not want to follow the activities because they cannot use computers and the internet, applications that are difficult to understand by participants, unstable internet connection in the area where the teacher lives and facilities and infrastructure are not adequate.

  3. How to Switch to the Switch: Implementation of Biliopancreatic Diversion with Duodenal Switch into Practice.

    Science.gov (United States)

    Halawani, Hamzeh M; Antanavicius, Gintaras; Bonanni, Fernando

    2017-09-01

    The biliopancreatic diversion with duodenal switch (BPD/DS), a modification of the classic Scopinaro procedure, carries the highest rate of success in terms of weight loss, comorbid resolution, and maintenance of weight loss. The substantial challenges, technical complexity, and expected roadblocks of adding BPD/DS option to the bariatric surgeon's resources are reflected in the number of BPD/DS procedure performed in the USA, being less than 1% of all bariatric surgeries. Adjustments to the length of the common channel and the size of the vertical sleeve would increase the pool of candidates for BPD/DS and offer comprehensive management of obesity and metabolic comorbidities. Proper educational programs and multiple proctoring to bariatric surgeons aid to implement BPD/DS to their practice.

  4. Tobacco cessation Clinical Practice Guideline use by rural and urban hospital nurses: a pre-implementation needs assessment

    OpenAIRE

    Smith Patricia M; Sellick Scott M; Spadoni Michelle M

    2012-01-01

    Abstract Background This study was a pre-program evaluation of hospital-based nurses' tobacco intervention beliefs, confidence, training, practice, and perceived intervention barriers and facilitators. It was designed to identify relevant information prior to implementing tobacco cessation guidelines across a large northern rural region, home to 1 urban and 12 rural hospitals. Methods This cross-sectional survey was distributed by nurse managers to nurses in the 13 hospitals and returned by n...

  5. Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

    Science.gov (United States)

    McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina

    2015-12-01

    Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).

  6. The EDUCATE Study: a continuing education exemplar for Clinical Practice Guideline Implementation.

    Science.gov (United States)

    Friedman, Lyssa; Engelking, Constance; Wickham, Rita; Harvey, Catherine; Read, Martha; Whitlock, Kimberly Bardel

    2009-04-01

    Cancer care is evolving from a solo practitioner care delivery system based on tradition and anecdotal experience to a multidisciplinary, collaborative, science-driven paradigm. Evidence-based practice facilitates optimal care quality for patients with cancer and is effected for medical and nursing practitioners through clinical practice guideline implementation. Clinician education based on principles of adult learning is one method of implementing clinical practice guidelines in clinical practice. However, research demonstrates that conventional static methods of education do little to change behavior; instead, effective education incorporates interactive formats, provides feedback, and includes reminder and reinforcement strategies. The EDUCATE (Educating Clinicians to Achieve Treatment Guideline Effectiveness) Study offers one model for clinical practice guideline implementation using educational methods. A faculty of nurse educators, together with practice champions, carried out an intensive educational intervention comprised of multiple teaching/learning activities during a 12-month period in community oncology practices throughout the United States. In addition to an overview of clinical practice guidelines and educational methods that can be used for implementation of clinical practice guidelines, the obstacles faced and lessons learned through the EDUCATE Study are presented, along with recommendations for implementation in the practice setting.

  7. Best Practices in Montessori Secondary Programs

    Science.gov (United States)

    Donahoe, Marta

    2013-01-01

    This article is the result of years of study, both formal and informal; hundreds of hours of traditional and Montessori classroom observations; reading and digesting articles and books on secondary education, Montessori education, adolescent brain research, leadership, and best practices in education; and most enlightening of all, 20 years of…

  8. Exploring Community Radio Programming Practices to Inform ...

    African Journals Online (AJOL)

    ... engagement in environment and sustainability concerns. Preliminary research on museum education practices established that these are primarily expert-led and centred on exhibitions and outreach, with limited participation by the community. The study was initiated after a brief experience of working on community radio ...

  9. Implementation of Strategic Management Practices in the Malaysian Construction Industry

    Directory of Open Access Journals (Sweden)

    Abu Hassan Abu Bakar

    2011-09-01

    Full Text Available Strategic Management is a concept that concerns with making decisions and taking corrective actions to achieve long term targets and goals of an organization. The importance of strategic management in a firm can be answered by analyzing relationship between strategic management and organizational performance. Generally strategic management practices can improve efficiency in various organizations. The objective of this paper is to study the practice of strategic management in construction companies in Malaysia. Questionnaires were distributed to 300 large construction companies listed under G7 groups classified by Construction Industry Development Board (CIDB. The response rate of the survey is 26% or that 78 construction companies replied. The findings of the research showed that most of the firms practicing strategic managementhave a clear objective, a winning strategy to achieve the objective and a sound mission statement to guide the organization towards success.

  10. Nursing clinical handover improvement practices among acute inpatients in a tertiary hospital in Sydney: a best practice implementation project.

    Science.gov (United States)

    Wainwright, Craig; Wright, Kylie M

    2016-10-01

    The nursing handover normally occurs at the beginning of a nurse's shift and is considered essential for continuity of care. Nursing handovers have the potential to communicate accurate information about a patient's condition, treatment and anticipated needs but also to be ineffective or even harmful if information is incomplete or omitted. The Australian Commission on Safety and Quality in Health Care has recognized clinical handover as a National Standard, thus reinforcing its importance. This project aimed to conduct an audit of nursing clinical handover practices to implement evidence-based best practice recommendations to assess the effectiveness of these strategies to maximize the effectiveness of clinical handover across 11 units in a large tertiary hospital. The project used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting change in healthcare practice. A baseline audit of 330 observations of nursing clinical handover was conducted and measured against seven best practice recommendations, followed by the implementation of targeted strategies and a follow-up audit. The baseline audit revealed significant deficits between current practice and best practice in all but one criterion. Barriers for implementation of nursing clinical handover best practice criteria were identified by the project team, and a bundled education strategy was implemented. There were significantly improved outcomes across all best practice criteria in the follow-up audit. The findings showed how audits may be used to promote best practice in healthcare and that focused education and provision of relevant resources can have an immediate and positive impact on clinical practice. Some of the measured criteria improved to a moderate degree, leaving room for improvement; however, by the end of the project attitudes toward nursing clinical handover had been "transformed" from a passive routine "must do

  11. An automated competency-based student performance assessment program for advanced pharmacy practice experiential programs.

    Science.gov (United States)

    Ried, L Douglas; Nemire, Ruth; Doty, Randell; Brickler, Mildred P; Anderson, Holly H; Frenzel-Shepherd, Elizabeth; Larose-Pierre, Margareth; Dugan, Dee

    2007-12-15

    To describe the development and preliminary outcomes of the System of Universal Clinical Competency Evaluation in the Sunshine State (SUCCESS) for preceptors to assess students' clinical performance in advanced pharmacy practice experiences (APPEs). An Internet-based APPE assessment tool was developed by faculty members from colleges of pharmacy in Florida and implemented. Numeric scores and grades derived from the SUCCESS algorithm were similar to preceptors' comparison grades. The average SUCCESS GPA was slightly higher compared to preceptors' scores (0.02 grade points). The SUCCESS program met its goals, including establishing a common set of forms, standardized assessment criteria, an objective document that is accessible on the Internet, and standardized grading, and reducing pressure on preceptors from students concerning their grades.

  12. Delivering stepped care: an analysis of implementation in routine practice

    Directory of Open Access Journals (Sweden)

    Richards David A

    2012-01-01

    Full Text Available Abstract Background In the United Kingdom, clinical guidelines recommend that services for depression and anxiety should be structured around a stepped care model, where patients receive treatment at different 'steps,' with the intensity of treatment (i.e., the amount and type increasing at each step if they fail to benefit at previous steps. There are very limited data available on the implementation of this model, particularly on the intensity of psychological treatment at each step. Our objective was to describe patient pathways through stepped care services and the impact of this on patient flow and management. Methods We recorded service design features of four National Health Service sites implementing stepped care (e.g., the types of treatments available and their links with other treatments, together with the actual treatments received by individual patients and their transitions between different treatment steps. We computed the proportions of patients accessing, receiving, and transiting between the various steps and mapped these proportions visually to illustrate patient movement. Results We collected throughput data on 7,698 patients referred. Patient pathways were highly complex and very variable within and between sites. The ratio of low (e.g., self-help to high-intensity (e.g., cognitive behaviour therapy treatments delivered varied between sites from 22:1, through 2.1:1, 1.4:1 to 0.5:1. The numbers of patients allocated directly to high-intensity treatment varied from 3% to 45%. Rates of stepping up from low-intensity treatment to high-intensity treatment were less than 10%. Conclusions When services attempt to implement the recommendation for stepped care in the National Institute for Health and Clinical Excellence guidelines, there were significant differences in implementation and consequent high levels of variation in patient pathways. Evaluations driven by the principles of implementation science (such as targeted planning

  13. The Lions Quest Program in Turkey: Teachers’ Views and Classroom Practices.

    Directory of Open Access Journals (Sweden)

    Mine Gol-Guven

    2016-11-01

    Full Text Available This is a pilot study to explore the classroom implementation of the Lions Quest Program in Turkey. Teachers of first through eighth grades at two elementary schools who applied the program were interviewed about the program and their classroom practices while they were also observed and their classrooms were also observed. Considerable program implementation differences were found within and between the schools. Three main issues were raised in the interviews, namely that the teachers were not clear about whether social emotional learning (SEL skills should be taught to students as a separate lesson or not; they seemed to doubt whether school personnel should be responsible for SEL implementation; and although they had positive views of the implementation, they underlined that students’ social and emotional wellbeing is dependent on family background and the developing maturity of the child. In conclusion, the teachers expressed positive views about the Lions Quest Program, yet lacked strong opinions about when, where, and by whom the program needed to be included in the curriculum. Limitations, implementation challenges, and implications for SEL in the Turkish context were also identified.

  14. International Mentoring Programs: Leadership Opportunities to Enhance Worldwide Pharmacy Practice

    National Research Council Canada - National Science Library

    Ubaka, Chukwuemeka; Brechtelsbauer, Erich; Goff, Debra A

    2017-01-01

    .... This article describes one effort, the Mandela Washington Fellows Program, and suggests areas where pharmacy leaders can be involved to help advance the practice of pharmacy on an international level...

  15. Approximate Dynamic Programming by Practical Examples

    NARCIS (Netherlands)

    Mes, Martijn R.K.; Perez Rivera, Arturo Eduardo; Boucherie, Richard; van Dijk, Nico M.

    2017-01-01

    Computing the exact solution of an MDP model is generally difficult and possibly intractable for realistically sized problem instances. A powerful technique to solve the large scale discrete time multistage stochastic control processes is Approximate Dynamic Programming (ADP). Although ADP is used

  16. Implementing Response to Intervention in Context. A Center Practice Brief

    Science.gov (United States)

    Center for Mental Health in Schools at UCLA, 2011

    2011-01-01

    Response to intervention is meant to be broad-based and preventative. However, as formulated and practiced the approach often is too limited in how it frames what needs to go on to enable learning, engage students, and keep them engaged. In particular, it pays too little attention to the need to strengthen the classroom and schoolwide context in…

  17. Implementing Best Practices and Validation of Cryopreservation Techniques for Microorganisms

    Directory of Open Access Journals (Sweden)

    David Smith

    2012-01-01

    Full Text Available Authentic, well preserved living organisms are basic elements for research in the life sciences and biotechnology. They are grown and utilized in laboratories around the world and are key to many research programmes, industrial processes and training courses. They are vouchers for publications and must be available for confirmation of results, further study or reinvestigation when new technologies become available. These biological resources must be maintained without change in biological resource collections. In order to achieve best practice in the maintenance and provision of biological materials for industry, research and education the appropriate standards must be followed. Cryopreservation is often the best preservation method available to achieve these aims, allowing long term, stable storage of important microorganisms. To promulgate best practice the Organisation for Economic Development and Co-operation (OECD published the best practice guidelines for BRCs. The OECD best practice consolidated the efforts of the UK National Culture Collections, the European Common Access to Biological Resources and Information (CABRI project consortium and the World Federation for Culture Collections. The paper discusses quality management options and reviews cryopreservation of fungi, describing how the reproducibility and quality of the technique is maintained in order to retain the full potential of fungi.

  18. HR practices for enhancing sustainable employability : implementation, use, and outcomes

    NARCIS (Netherlands)

    Ybema, Jan Fekke; van Vuuren, Tinka; van Dam, Karen

    2017-01-01

    With the aging of the workforce, organizations need to maintain or improve the sustainable employability of their workforce throughout their working life. This raises the question which HR practices increase workers’ sustainable employability at work. The aim of this study is to investigate the

  19. Planning and implementing electronic records management a practical guide

    CERN Document Server

    Smith, Kelvin

    2007-01-01

    Many organizations are moving away from managing records and information in paper form to setting up electronic records management (ERM) systems. Whatever the whyfor in your organization, this book provides straightforward, practical guidance on how to prepare for and enable ERM.

  20. Implementing Restorative Justice Practice in Schools: What Pedagogy Reveals

    Science.gov (United States)

    Vaandering, Dorothy

    2014-01-01

    In the ongoing pursuit for creating safe, nurturing and relational school cultures, educators continue to turn to restorative justice (rj) principles and practice. Predominantly, schools begin to engage with rj in an effort to address harm done, causing its discourse to be situated in literature tied to classroom management and behaviour. However,…

  1. A survey of asthma management practices and implementation of ...

    African Journals Online (AJOL)

    Background: Bronchial asthma is a global health problem that causes significant morbidity and mortality in all age groups. Global Initiative for Asthma (GINA) seeks to standardize the care asthma patients receive. We assessed the knowledge, attitude, and practices of doctors in Umuahia, Southeast Nigeria, regarding ...

  2. Discovering and Implementing Best Practices to Strengthen SEAs: Collaborative Benchmarking

    Science.gov (United States)

    Building State Capacity and Productivity Center, 2013

    2013-01-01

    This paper is written for state educational agency (SEA) leaders who are considering the benefits of collaborative benchmarking, and it addresses the following questions: (1) What does benchmarking of best practices entail?; (2) How does "collaborative benchmarking" enhance the process?; (3) How do SEAs control the process so that "their" needs…

  3. Practical Implementation of Various Public Key Infrastructure Models

    Directory of Open Access Journals (Sweden)

    Dmitriy Anatolievich Melnikov

    2016-03-01

    Full Text Available The paper proposes a short comparative analysis of the contemporary models of public key infrastructure (PKI and the issues of the PKI models real implementation. The Russian model of PKI is presented. Differences between the North American and West Europe models of PKI and Russian model of PKI are described. The problems of creation and main directions of further development and improvement of the Russian PKI and its integration into the global trust environment are defined.

  4. Practical approach to knowledge management implementation in historic buildings restoration

    Directory of Open Access Journals (Sweden)

    Katayoun Taghizadeh

    2014-12-01

    Full Text Available The aim of this investigation is to establish an applicable model for knowledge management implementation that works suitably in organizations involved in projects defined for a historic building such as restoration. Based on a peer review on general approaches in literature, some main improvement potentials are recognized to enable the model to meet with the especial objectives, which shall be considered in such projects. Content analysis was applied to ascertain the new presented model capabilities and improvement in each of three main core components of knowledge management implementation model including peoples, processes, and technologies. We came up with a new conceptual model named as Finger Frame Model with four individual tiers connected with an intelligent communication medium. It is concluded that three main components of KM block diagrams consist of knowledge identification, acquisition, and prevention are appropriately covered in basic tier. The other three components of inner cycle of KM basic diagram consist of using, development, and distribution are also covered in an interface between operators and basic tiers, which together with make lower frame of new presented model. The model is in a continuous improving stage considering self-monitoring processes in an individual tier with the same name, which is located in the upper frame. An upper layer named as goal tier is also located in top frame in which, the main quantitative goals of KM implementation in the project organization are considered. The conceptual diagrams as well as internal processes of each main tier are also presented and discussed. Based on the overall explanations, some main benefits and risks are highlighted for new presented model and outlooks are debated. The model is applied in a real case study and the results are compared with the previous knowledge management implementation model. The results show that the model works efficiently in projects organization

  5. Lessons from a pilot program to induce stove replacements in Chile: design, implementation and evaluation

    Science.gov (United States)

    Gómez, Walter; Chávez, Carlos; Salgado, Hugo; Vásquez, Felipe

    2017-11-01

    We present the design, implementation, and evaluation of a subsidy program to introduce cleaner and more efficient household wood combustion technologies. The program was conducted in the city of Temuco, one of the most polluted cities in southern Chile, as a pilot study to design a new national stove replacement initiative for pollution control. In this city, around 90% of the total emissions of suspended particulate matter is caused by households burning wood. We created a simulated market in which households could choose among different combustion technologies with an assigned subsidy. The subsidy was a relevant factor in the decision to participate, and the inability to secure credit was a significant constraint for the participation of low-income households. Due to several practical difficulties and challenges associated with the implementation of large-scale programs that encourage technological innovation at the household level, it is strongly advisable to start with a small-scale pilot that can provide useful insights into the final design of a fuller, larger-scale program.

  6. A Practical Approach to Implementing Real-Time Semantics

    Science.gov (United States)

    Luettgen, Gerald; Bhat, Girish; Cleaveland, Rance

    1999-01-01

    This paper investigates implementations of process algebras which are suitable for modeling concurrent real-time systems. It suggests an approach for efficiently implementing real-time semantics using dynamic priorities. For this purpose a proces algebra with dynamic priority is defined, whose semantics corresponds one-to-one to traditional real-time semantics. The advantage of the dynamic-priority approach is that it drastically reduces the state-space sizes of the systems in question while preserving all properties of their functional and real-time behavior. The utility of the technique is demonstrated by a case study which deals with the formal modeling and verification of the SCSI-2 bus-protocol. The case study is carried out in the Concurrency Workbench of North Carolina, an automated verification tool in which the process algebra with dynamic priority is implemented. It turns out that the state space of the bus-protocol model is about an order of magnitude smaller than the one resulting from real-time semantics. The accuracy of the model is proved by applying model checking for verifying several mandatory properties of the bus protocol.

  7. Design and Implementation of Practical Constraint Logic Programming Systems

    Science.gov (United States)

    1992-08-24

    Jonathan Ostroff and Jeff Klein, is described in [135]. It reasons about discrete event processes, and the query used to obtain these results is the...274, 1988. [91 Arvind and D.E. Culler . Dataflow architectures. In Annual Reviews in Computer Science, volume 1, pages 225-253. Annual Reviews Inc

  8. Mobilizing communities to implement evidence-based practices in youth violence prevention: the state of the art.

    Science.gov (United States)

    Backer, Thomas E; Guerra, Nancy G

    2011-09-01

    Community mobilization can increase the effective implementation of evidence-based practices (EBPs) in youth violence prevention. These strategies bring together people and organizations in a community to try to solve or reduce a problem. They help communities address the challenges of identifying EBPs, disseminating them to local decision-makers, and then implementing and sustaining them if they are successful. Science-based systems for implementing EBPs such as PROSPER and Communities That Care can help to integrate this complex work in communities. Further insight about implementing EBPs in youth violence prevention is being developed through the CDC-funded Academic Centers for Excellence in Youth Violence Prevention. Community mobilization approaches for seven of these programs are discussed, highlighting successful approaches and challenges encountered.

  9. Teaching Reflective Practice: Implementation in the Teacher-Education Setting

    Science.gov (United States)

    Jones, Jennifer L.; Jones, Karrie A.

    2013-01-01

    Over the past several decades a growing amount of research has considered the role, challenges, and complexities of teaching reflective inquiry to preservice teachers. Generally accepted as a valuable component of a teacher education program, there are persistent levels of ambiguity regarding how reflective inquiry can be intentionally fostered…

  10. Key Informants' Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran.

    Science.gov (United States)

    Ghodsi, Delaram; Omidvar, Nasrin; Rashidian, Arash; Raghfar, Hossein; Eini-Zinab, Hassan; Ebrahimi, Marziyeh

    2016-01-01

    Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children. This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation. Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants. Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition. Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

  11. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

    Directory of Open Access Journals (Sweden)

    Alexander Jeffery A

    2009-08-01

    Full Text Available Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality, four constructs were identified related to outer setting (e.g., patient needs and resources, 12 constructs were identified related to inner setting (e.g., culture

  12. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.

    Science.gov (United States)

    Damschroder, Laura J; Aron, David C; Keith, Rosalind E; Kirsh, Susan R; Alexander, Jeffery A; Lowery, Julie C

    2009-08-07

    Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were

  13. Genetic programming theory and practice X

    CERN Document Server

    Riolo, Rick; Ritchie, Marylyn D; Moore, Jason H

    2013-01-01

    These contributions, written by the foremost international researchers and practitioners of Genetic Programming (GP), explore the synergy between theoretical and empirical results on real-world problems, producing a comprehensive view of the state of the art in GP. Topics in this volume include: evolutionary constraints, relaxation of selection mechanisms, diversity preservation strategies, flexing fitness evaluation, evolution in dynamic environments, multi-objective and multi-modal selection, foundations of evolvability, evolvable and adaptive evolutionary operators, foundation of  injecting

  14. Product and Release Planning Practices for Extreme Programming

    NARCIS (Netherlands)

    van Valkenhoef, Gert; Tervonen, T.P.; de Brock, E.O.; Postmus, D.; Sillitti, A; Martin, A; Wang, XF; Whitworth, E

    2010-01-01

    Extreme Programming (XP) is an agile software development methodology defined through a set of practices and values. Although the value of XP is well-established through various real-life case studies, it lacks practices for project management. In order to enable XP for larger projects, we provide

  15. [Implementation and evaluation of quality circles in general practice].

    Science.gov (United States)

    Tausch, B; Härter, M; Niebling, W; Dieter, G; Berger, M

    1995-08-01

    In the beginning of 1993, society of panel doctors Südbaden, Germany, has constituted a group of experts from the Department of General Medicine of the university hospital and practising general practitioners (GPs) to develop an organisational and conceptional framework for setting up quality circles. At present, 23 quality circles with 6-12 participants are holding regular meetings every 4 to 8 weeks in the region of Südbaden. The group members, who are all physicians working in primary health care, are selecting and discussion topics which are important in general practice. In order to facilitate the discussions, the research group has developed predefined guidelines covering a wide range of common and important conditions in general practice (Hypertension, sleeping disorders, diabetes mellitus, COPD, dementia, lower back pain, cardio-vascular disease, depression, headache, vertigo etc). In presenting these structurized guidelines, the moderator prompts and encourage the group members to identify common problems in their own practices. The use of these guidelines in, quality circles and research may provide a starting point for developing consensus guidelines. The quality circle projects is given as systematic evaluation for both participants and moderators at different levels. Main objectives of the assessment are the recruitment, motivation and the specific goals of general practitioners to participate in quality circles. Currently, we are evaluating the development of quality circle for a period of 18 months.

  16. A multifaceted implementation strategy versus passive implementation of low back pain guidelines in general practice: a cluster randomised controlled trial.

    Science.gov (United States)

    Riis, Allan; Jensen, Cathrine Elgaard; Bro, Flemming; Maindal, Helle Terkildsen; Petersen, Karin Dam; Bendtsen, Mette Dahl; Jensen, Martin Bach

    2016-10-21

    Guidelines are often slowly adapted into clinical practice. However, actively supporting healthcare professionals in evidence-based treatment may speed up guideline implementation. Danish low back pain (LBP) guidelines focus on primary care treatment of LBP, to reduce referrals from primary care to secondary care. The primary aim of this project was to reduce secondary care referral within 12 weeks by a multifaceted implementation strategy (MuIS). In a cluster randomised design, 189 general practices from the North Denmark Region were invited to participate. Practices were randomised (1:1) and stratified by practice size to MuIS (28 practices) or a passive implementation strategy (PaIS; 32 practices). Included were patients with LBP aged 18 to 65 years who were able to complete questionnaires, had no serious underlying pathology, and were not pregnant. We developed a MuIS including outreach visits, quality reports, and the STarT Back Tool for subgrouping patients with LBP. Both groups were offered the usual dissemination of guidelines, guideline-concordant structuring of the medical record, and a new referral opportunity for patients with psycho-social problems. In an intention-to-treat analysis, the primary and secondary outcomes pertained to the patient, and a cost-effectiveness analysis was performed from a healthcare sector perspective. Patients and the assessment of outcomes were blinded. Practices and caregivers delivering the interventions were not blinded. Between January 2013 and July 2014, 60 practices were included, of which 54 practices (28 MuIS, 26 PaIS) included 1101 patients (539 MuIS, 562 PaIS). Follow-up data for the primary outcome were available on 100 % of these patients. Twenty-seven patients (5.0 %) in the MuIS group were referred to secondary care vs. 59 patients (10.5 %) in the PaIS group. The adjusted odds ratio (AOR) was 0.52 [95 % CI 0.30 to 0.90; p = 0.020]. The MuIS was cost-saving £-93.20 (£406.51 vs. £499.71 per patient

  17. A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

    Science.gov (United States)

    Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

    2008-04-01

    The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

  18. OJPOT: Online Judge & Practice Oriented Teaching Idea in Programming Courses

    Science.gov (United States)

    Wang, Gui Ping; Chen, Shu Yu; Yang, Xin; Feng, Rui

    2016-01-01

    Practical abilities are important for students from majors including Computer Science and Engineering, and Electrical Engineering. Along with the popularity of ACM International Collegiate Programming Contest (ACM/ICPC) and other programming contests, online judge (OJ) websites achieve rapid development, thus providing a new kind of programming…

  19. Introduction of handheld computing to a family practice residency program.

    Science.gov (United States)

    Rao, Goutham

    2002-01-01

    Handheld computers are valuable practice tools. It is important for residency programs to introduce their trainees and faculty to this technology. This article describes a formal strategy to introduce handheld computing to a family practice residency program. Objectives were selected for the handheld computer training program that reflected skills physicians would find useful in practice. TRGpro handheld computers preloaded with a suite of medical reference programs, a medical calculator, and a database program were supplied to participants. Training consisted of four 1-hour modules each with a written evaluation quiz. Participants completed a self-assessment questionnaire after the program to determine their ability to meet each objective. Sixty of the 62 participants successfully completed the training program. The mean composite score on quizzes was 36 of 40 (90%), with no significant differences by level of residency training. The mean self-ratings of participants across all objectives was 3.31 of 4.00. Third-year residents had higher mean self-ratings than others (mean of group, 3.62). Participants were very comfortable with practical skills, such as using drug reference software, and less comfortable with theory, such as knowing the different types of handheld computers available. Structured training is a successful strategy for introducing handheld computing to a residency program.

  20. Practical implementation of nonlinear time series methods The TISEAN package

    CERN Document Server

    Hegger, R; Schreiber, T; Hegger, Rainer; Kantz, Holger; Schreiber, Thomas

    1998-01-01

    Nonlinear time series analysis is becoming a more and more reliable tool for the study of complicated dynamics from measurements. The concept of low-dimensional chaos has proven to be fruitful in the understanding of many complex phenomena despite the fact that very few natural systems have actually been found to be low dimensional deterministic in the sense of the theory. In order to evaluate the long term usefulness of the nonlinear time series approach as inspired by chaos theory, it will be important that the corresponding methods become more widely accessible. This paper, while not a proper review on nonlinear time series analysis, tries to make a contribution to this process by describing the actual implementation of the algorithms, and their proper usage. Most of the methods require the choice of certain parameters for each specific time series application. We will try to give guidance in this respect. The scope and selection of topics in this article, as well as the implementational choices that have ...

  1. DEVELOPMENT AND IMPLEMENTATION OF CLUSTER POLICY: RUSSIAN AND INTERNATIONAL PRACTICE

    Directory of Open Access Journals (Sweden)

    Yu. Vertakova

    2015-06-01

    Full Text Available The cluster policy is one of popular instruments of state regulation of regional development. Its main advantage – possibility of creation (on the ba-sis of clusters the “growth poles” in region economy. Feature of process of a clustering of economy both in Russia, and in other countries of the world, is the active role of the state in identification of clusters, maintenance of cluster initiatives, stimulation of their development and carrying out monitoring of efficiency of the clustering processes. As a result of the analysis of cluster policy in the certain countries, two main models of implementation of cluster policy are revealed: dirigisme and liberal. They differ in extent of the state intervention. The cluster policy has to be implemented taking into account specifics of spatial structure of economy of the countries and regions. Studying of experience of various countries allowed to allocate two main directions of modern cluster policy: ascending and descending. The ascending approach concentrates on ensuring effective functioning of the market and elimination of market deficiency. At the descending approach the government establishes regional and national priorities, formulates the stimulat-ing vision for the future. The structure of economy of Russia differs from economies of other countries therefore direct loan of institutes of cluster pol-icy is impossible. It is necessary to select the foreign experience with the use of benchmarking.

  2. Tools for Implementing Science Practice in a Large Introductory Class

    Science.gov (United States)

    Prothero, W. A.

    2008-12-01

    Scientists must have in-depth background knowledge of their subject area and know where current knowledge can be advanced. They perform experiments that gather data to test new or existing theories, present their findings at meetings, publish their results, critically review the results of others, and respond to the reviews of their own work. In the context of a course, these activities correspond to learning the background material by listening to lectures or reading a text, formulating a problem, exploring data using student friendly data access and plotting software, giving brief talks to classmates in a small class or lab setting, writing a science paper or lab report, reviewing the writing of their peers, and receiving feedback (and grades) from their instructors and/or peers. These activities can be supported using course management software and online resources. The "LearningWithData" software system allows solid Earth (focused on plate tectonics) data exploration and plotting. Ocean data access, display, and plotting are also supported. Background material is delivered using animations and slide show type displays. Students are accountable for their learning through included homework assignments. Lab and small group activities provide support for data exploration and interpretation. Writing is most efficiently implemented using the "Calibrated Peer Review" method. This methodology is available at http://cpr.molsci.ucla.edu/. These methods have been successfully implemented in a large oceanography class at UCSB.

  3. Does Implementation Follow Design? A Case Study of a Workplace Health Promotion Program Using the 4-S Program Design and the PIPE Impact Metric Evaluation Models.

    Science.gov (United States)

    Äikäs, Antti Hermanni; Pronk, Nicolaas P; Hirvensalo, Mirja Hannele; Absetz, Pilvikki

    2017-08-01

    The aim of this study was to describe the content of a multiyear market-based workplace health promotion (WHP) program and to evaluate design and implementation processes in a real-world setting. Data was collected from the databases of the employer and the service provider. It was classified using the 4-S (Size, Scope, Scalability, and Sustainability) and PIPE Impact Metric (Penetration, Implementation) models. Data analysis utilized both qualitative and quantitative methods. Program design covered well the evidence-informed best practices except for clear path toward sustainability, cooperation with occupational health care, and support from middle-management supervisors. The penetration rate among participants was high (99%) and majority (81%) of services were implemented as designed. Study findings indicate that WHP market would benefit the use of evidence-based design principles and tendentious decisions to anticipate a long-term implementation process already during the planning phase.

  4. Translating clinical training into practice in complex mental health systems: Toward opening the 'Black Box' of implementation

    Directory of Open Access Journals (Sweden)

    Blevins Dean

    2008-06-01

    Full Text Available Abstract Background Implementing clinical training in a complex health care system is challenging. This report describes two successive trainings programs in one Veterans Affairs healthcare network and the lessons we drew from their success and failures. The first training experience led us to appreciate the value of careful implementation planning while the second suggested that use of an external facilitator might be an especially effective implementation component. We also describe a third training intervention in which we expect to more rigorously test our hypothesis regarding the value of external facilitation. Results Our experiences appear to be consonant with the implementation model proposed by Fixsen. In this paper we offer a modified version of the Fixsen model with separate components related to training and implementation. Conclusion This report further reinforces what others have noted, namely that educational interventions intended to change clinical practice should employ a multilevel approach if patients are to truly benefit from new skills gained by clinicians. We utilize an implementation research model to illustrate how the aims of the second intervention were realized and sustained over the 12-month follow-up period, and to suggest directions for future implementation research. The present report attests to the validity of, and contributes to, the emerging literature on implementation research.

  5. Barriers and enablers to the implementation of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Darshini R Ayton

    Full Text Available Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702, and 12 focus groups (n = 96 nurses and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment. Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and

  6. Computer based learning in general practice--options and implementation.

    Science.gov (United States)

    Mills, K A; McGlade, K

    1992-01-01

    A survey of the 30 departments of general practice in the UK revealed that only three are currently making use of any form of computer based learning materials for teaching their undergraduate students. One of the reasons for the low level of usage is likely to be the relatively poor availability of suitable courseware and lack of guidance as to how to utilise what is available. This short paper describes the types of courseware that are available and the advantages and disadvantages of using acquired courseware as opposed to writing your own. It also considers alternative strategies for making computer based learning (CBL) courseware available to students.

  7. Needs Analysis of Blind Students in Teaching Practice Program

    OpenAIRE

    *, Iswahyuni; Junining, Esti; Dewi, Dian Novita; Linta, Alies Poetri; Suwarso, Pratnyawati Nuridi

    2015-01-01

    As an inclusive university, Brawijaya University has accepted students with special needs in some differentstudy programs. Two of those are blind / visually impaired students who enrol English Language EducationStudy Program in which the program prepares the students to be English teachers. As a consequence, thestudents must be ready to do teaching practice in a public school when they are in the seventh semester. Thisstudy is going to find out the problems of the visually impaired students i...

  8. Vending Assessment and Program Implementation in Four Iowa Worksites.

    Science.gov (United States)

    Lillehoj, Catherine J; Nothwehr, Faryle; Shipley, Kala; Voss, Carol

    2015-11-01

    The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites. © 2015 Society for Public Health Education.

  9. Video streaming: implementation and evaluation in an undergraduate nursing program.

    Science.gov (United States)

    Bennett, Paul N; Glover, Pauline

    2008-02-01

    Video streaming technology enables video content, held on the web sites, to be streamed via the web. We report the implementation and evaluation of video streaming in an undergraduate nursing program in a metropolitan university in Australia. Students (n=703) were emailed a survey with a 15% response rate. We found that 91% (n=74) of respondents stated that video streaming assisted their learning. Forty-six percent(n=50) of students had difficulty accessing video streaming (particularly at the beginning of the study period). Over a 97-day period there were 8440 "hits" to the site from 1039 different internet protocol (IP) addresses. There were 4475 video streaming sessions undertaken by users. Video streaming was used for reviewing previously attended lectures (52%, n=56), examination preparation (34%, n=37), viewing missed lectures (27%, n=29) and class preparation (9%, n=10). Our experience with the introduction of video streaming has met with general enthusiasm from both students and teaching staff. Video streaming has particular relevance for rural students.

  10. Implementing Practice Guidelines: A Workshop on Guidelines Dissemination and Implementation with a Focus on Asthma and COPD

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    2006-01-01

    Full Text Available The present supplement summarizes the proceedings of the symposium “Implementing practice guidelines: A workshop on guidelines dissemination and implementation with a focus on asthma and COPD”, which took place in Quebec City, Quebec, from April 14 to 16, 2005. This international symposium was a joint initiative of the Laval University Office of Continuing Medical Education (Bureau de la Formation Médicale Continue, the Canadian Thoracic Society and the Canadian Network for Asthma Care, and was supported by many other organizations and by industrial partners. The objectives of this meeting were to examine the optimal implementation of practice guidelines, review current initiatives for the implementation of asthma and chronic obstructive pulmonary disease (COPD guidelines in Canada and in the rest of the world, and develop an optimal strategy for future guideline implementation. An impressive group of scientists, physicians and other health care providers, as well as policy makers and representatives of patients’ associations, the pharmaceutical industry, research and health networks, and communications specialists, conveyed their perspectives on how to achieve these goals.

  11. Implementation of the Air Program Information Management System (APIMS) Inspection Module

    Science.gov (United States)

    2009-05-01

    7 5 T H A I R B A S E W I N G Implementation of the Air Program Information Management System (APIMS) Inspection Module 2009 Environment...Implementation of the Air Program Information Management System (APIMS) Inspection Module 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER

  12. Some Practical Issues in the Design and Implementation of Group Communication Services

    National Research Council Canada - National Science Library

    Mishra, Shivakant

    2000-01-01

    The main objective of the proposed research was to investigate four important practical issues in the understanding, design, and implementation of group communication services. These issues were (1) Performance...

  13. Quantum customer CERN wins computerworld's prestigious 'best practices in storage' award for systems implementation

    CERN Multimedia

    2007-01-01

    "Quantum Corp., the leading global specialist in backup, recovery and archive, today announced that its customer, European-based nuclear research organization CERN, was awarded Computerworld's prestigious "Best Practices in Storage" award for Systems Implementation.

  14. A systematic review of prerequisites for implementing assessment for learning in classroom practice

    NARCIS (Netherlands)

    Heitink, Maaike Christine; van der Kleij, Fabienne; Veldkamp, Bernard P.; Schildkamp, Kim; Kippers, Wilma Berdien

    2016-01-01

    Although many researchers acknowledge that Assessment for Learning can significantly enhance student learning, the factors facilitating or hindering its implementation in daily classroom practice are unclear. A systematic literature review was conducted to reveal prerequisites needed for Assessment

  15. Development and feasibility of a mobile experience sampling application for tracking program implementation in youth well-being programs.

    Science.gov (United States)

    Chin, TanChyuan; Rickard, Nikki S; Vella-Brodrick, Dianne A

    Well-being program evaluations mostly focus on identifying effective outcomes rather than measuring the actual extent to which program participants may apply learned skills in subsequent everyday lives. This study examined the feasibility of using a newly developed mobile experience sampling app called Wuzzup to study program implementation in young people participating in well-being programs. Ninety-six participants (60 females; 36 males) between the ages of 13 and 15 years (M = 13.87, SD = 0.71) were recruited to respond to two random prompts each day, for 7 days, at each of the three data collection time-points. Responses from 69 participants (72 % of initial sample) that met study criteria were retained for analysis. The average response rate was 92.89 %, with an average of 85.92 s to complete each ESM survey. Significant associations between first and second halves of the ESM week, and their respective positive affect and negative affect survey responses, demonstrate internal reliability and construct validity of the Wuzzup app to capture momentary affect and activation states of young people. This study also demonstrated the feasibility and practical utility of the Wuzzup app to profile and track an individual's learning over time.

  16. Implementation of New Test Methods into Practical Testing.

    Science.gov (United States)

    Curren, Rodger D; Poth, Albrecht; Raabe, Hans A

    New toxicology test methods, especially those using in vitro methods, are continually being developed. Some are used by industry for screening purposes; others are eventually validated for regulatory use. However, for a new test method to be firmly adopted by industry it must be readily available, generally through an in-house industry laboratory, an academic laboratory, or a contract research organization. Regardless of the type of laboratory which intends to implement the test method, certain steps must be taken to ascertain that the method that is put into place is reproducible and performs identically to the test method that was published or has undergone validation. This involves developing protocols and standard operating procedures, training staff, developing historic positive and negative control data, establishing acceptable performance with proficiency chemicals, and addressing all the safety concerns that may accompany the assay. From experience within a contract research laboratory, we provide guidance on how to most efficiently accomplish these tasks.

  17. Applying best practices from digital control systems to BMI implementation.

    Science.gov (United States)

    Matlack, Charlie; Moritz, Chet; Chizeck, Howard

    2012-01-01

    Many brain-machine interface (BMI) algorithms, such as the population vector decoder, must estimate neural spike rates before transforming this information into an external output signal. Often, rate estimation is performed via the selection of a bin width corresponding to the effective sampling rate of the decoding algorithm. Here, we implement real-time rate estimation by extending prior work on the optimization of Gaussian filters for offline rate estimation. We show that higher sampling rates result in improved spike rate estimation. We further show that the choice of sampling rate need not dictate the number of parameters which must be used in an autoregressive decoding algorithm. Multiple studies in other neural signal processing contexts suggest that BMI performance could be improved substantially via careful choice of smoothing filter, discrete-time decoder representation, and sampling rate. Together, these ensure minimal deviation from the behavior of the modeled continuous-time systems.

  18. Implementing high-performance work practices in healthcare organizations: qualitative and conceptual evidence.

    Science.gov (United States)

    McAlearney, Ann Scheck; Robbins, Julie; Garman, Andrew N; Song, Paula H

    2013-01-01

    Studies across industries suggest that the systematic use of high-performance work practices (HPWPs) may be an effective but underused strategy to improve quality of care in healthcare organizations. Optimal use of HPWPs depends on how they are implemented, yet we know little about their implementation in healthcare. We conducted 67 key informant interviews in five healthcare organizations, each considered to have exemplary work practices in place and to deliver high-quality care, as part of an extensive study of HPWP use in healthcare. We analyzed interview transcripts inductively and deductively to examine why and how organizations implement HPWPs. We used an evidence-based model of complex innovation adoption to guide our exploration of factors that facilitate HPWP implementation. We found considerable variability in interviewees' reasons for implementing HPWPs, including macro-organizational (strategic level) and micro-organizational (individual level) reasons. This variability highlighted the complex context for HPWP implementation in many organizations. We also found that our application of an innovation implementation model helped clarify and categorize facilitators of HPWP implementation, thus providing insight on how these factors can contribute to implementation effectiveness. Focusing efforts on clarifying definitions, building commitment, and ensuring consistency in the application of work practices may be particularly important elements of successful implementation.

  19. Implementation of renal key performance indicators: promoting improved clinical practice.

    Science.gov (United States)

    Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Soding, Jenny; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A

    2015-03-01

    In the Australian state of Victoria, the Renal Health Clinical Network (RHCN) of the Department of Health Victoria established a Renal Key Performance Indicator (KPI) Working Group in 2011. The group developed four KPIs related to chronic kidney disease and dialysis. A transplant working group of the RHCN developed two additional KPIs. The aim was to develop clinical indicators to measure performance of renal services to drive service improvement. A data collection and benchmarking programme was established, with data provided monthly to the Department using a purpose-designed website portal. The KPI Working Group is responsible for analysing data each quarter and ensuring indicators remain accurate and relevant. Each indicator has clear definitions and targets, and assess (i) patient education, (ii) timely creation of vascular access for haemodialysis, (iii) proportion of patients dialysing at home, (iv) incidence of dialysis-related peritonitis, (v) incidence of pre-emptive renal transplantation, and (vi) timely listing of patients for deceased donor transplantation. Most KPIs have demonstrated improved performance over time with limited gains notably in two: the proportion of patients dialysing at home (KPI 3) and timely listing patients for transplantation (KPI 6). KPI implementation has been established in Victoria for 2 years, providing performance data without additional funding. The six Victorian KPIs are measurable, relevant and modifiable, and implementation relies on enthusiasm and goodwill of physicians and nurses involved in collecting data. The KPIs require further evaluation, but adoption of a similar programme by other jurisdictions could lead to improved national outcomes. © 2014 Asian Pacific Society of Nephrology.

  20. Comparing written programs and self-reported respiratory protection practices in acute care hospitals.

    Science.gov (United States)

    Sietsema, Margaret; Conroy, Lorraine M; Brosseau, Lisa M

    2015-01-01

    Airborne biological hazards in hospitals require the use of respiratory protection. A well-implemented respiratory protection program can protect health care workers from these exposures. This study examines the relationship between written respiratory programs and reported practices in health care settings. Twenty-eight hospitals in Illinois and Minnesota were recruited to a study of respiratory protection programs and practices in acute care settings. Interviews were conducted with hospital managers, unit managers, and health care workers from departments where respirators are commonly required. Each hospital's written respiratory protection program was scored for the 11 elements required by the Occupational Safety and Health Administration (OSHA), using a standardized tool, for a maximum possible score of 22 (2 pts. per element). Twenty interview questions associated with program practices were also scored by percent correct responses. Written program scores ranged from 2-17 with an average of 9.2. Hospital and unit managers scored on average 82% and 81%, respectively, when compared to the OSHA standard; health care workers scored significantly lower, 71% (p respiratory protection programs in the study sites did not provide the level of detail required OSHA. Interview responses representing hospital practices surrounding respiratory protection indicated that hospitals were aware of and following regulatory guidelines.

  1. Implementing Machine Learning in Radiology Practice and Research.

    Science.gov (United States)

    Kohli, Marc; Prevedello, Luciano M; Filice, Ross W; Geis, J Raymond

    2017-04-01

    The purposes of this article are to describe concepts that radiologists should understand to evaluate machine learning projects, including common algorithms, supervised as opposed to unsupervised techniques, statistical pitfalls, and data considerations for training and evaluation, and to briefly describe ethical dilemmas and legal risk. Machine learning includes a broad class of computer programs that improve with experience. The complexity of creating, training, and monitoring machine learning indicates that the success of the algorithms will require radiologist involvement for years to come, leading to engagement rather than replacement.

  2. 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

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

    Science.gov (United States)

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

    2009-02-23

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

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

    Directory of Open Access Journals (Sweden)

    Detmer Don E

    2009-02-01

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

  5. How implementation of bibliometric practice affects the role of academic libraries

    OpenAIRE

    Åström, Fredrik; Hansson, Joacim

    2013-01-01

    This article discusses the potential consequences of implementing bibliometrics as an institutionalized practice in academic libraries. Results are reported from a survey distributed among academic libraries in Sweden with organized bibliometric activities. Incorporating bibliometric activities is seen as a way of redefining and widening of the role of the library. Implementation of bibliometric practice is motivated by ambitions to provide more complete services in the scholarly communicatio...

  6. Nursing care of transradial angiography and intervention in a tertiary hospital in Shanghai: a best practice implementation project.

    Science.gov (United States)

    Zhu, Li; Xu, Jianming; Wang, Qibing; Xu, Fei; Chen, Jun

    2016-05-01

    Coronary heart disease is common in the general population and is estimated to cause as many deaths worldwide as cancer. Percutaneous coronary angiography and intervention is the most common method in the diagnosis and treatment of coronary heart disease. To achieve best practice in the nursing care of transradial angiography and intervention, there is an urgent need for clinical knowledge. This aim of this project was to improve clinical nursing care for transradial angiography and intervention in Zhongshan Hospital, Shanghai. Seven criteria identified from evidence by the Joanna Briggs Institute were audited in the coronary care unit of Zhongshan Hospital, Shanghai. Twenty-three nurses and 80 patients were involved. The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tools for promoting change in health practice were used to examine compliance with the criteria before and after the implementation of best practice. The program included three phases and was conducted over six months. This best practice implementation project improved the rates of written discharge instructions and radial artery patency assessment at the first post-procedure from 0% to 100%. Implementation rates for pre-procedural checklist as well as the radial artery patency assessment before discharge were 100% at baseline. Pre-procedural checklists including adequate criteria reached 78%, up from 0%. The implementation rate for regular monitoring of vital signs recorded for the first two hours post-procedure reached 22% from 0%. The implementation rate for details of discharge instructions, including procedure review, limitation of physical activity, general physical status, comorbidities, medication reconciliation and follow-up appointment improved from 36.6% to 100%. Barriers to implementation were identified as: (1) the structured pre-procedural checklist not being ready, (2) nurses lacking knowledge regarding discharge

  7. Effects of the implementation of a breastfeeding best practice guideline in a Canadian public health agency.

    Science.gov (United States)

    Rempel, Lynn A; McCleary, Lynn

    2012-10-01

    Several strategies were used to implement a breastfeeding best practice guideline (BPG) in a Canadian public health agency. Nurses surveyed before and 1 year after implementation reported increased BPG-related knowledge and stronger beliefs regarding breastfeeding duration beyond 1 year. Telephone surveys also were conducted with mothers; 90 before BPG implementation and another cohort of 141 mothers following implementation. Post-implementation mothers were more knowledgeable about sources of breastfeeding help, obtained more help from public health nurses, and reported more breastfeeding-related discussion with healthcare providers. Compared to the pre-implementation cohort, mothers in the post-implementation cohort who were still breastfeeding at 6 months intended to continue breastfeeding longer. Implementing a breastfeeding BPG can affect breastfeeding-related experiences at a population level. Copyright © 2012 Wiley Periodicals, Inc.

  8. Using organization theory to understand the determinants of effective implementation of worksite health promotion programs

    National Research Council Canada - National Science Library

    Weiner, Bryan J; Lewis, Megan A; Linnan, Laura A

    .... However, no integrated theory of implementation has emerged from this research. This article describes a theory of the organizational determinants of effective implementation of comprehensive worksite health promotion programs...

  9. A practical implementation of BICS for safety-critical applications

    Energy Technology Data Exchange (ETDEWEB)

    SMITH,PATRICIA A.; CAMPBELL,DAVID V.

    2000-02-09

    This paper presents the challenges and solutions of applying Built-In-Current Sensors (BICS) to a safety-critical IC design for the purpose of in-situ state-of-health monitoring. The developed Quiscent Current Monitor (QCM) system consists of multiple BISC and digital control logic. The QCM BICS can detect leakage current as low as 4 {micro}A, run at system speed, and has relatively low real estate overhead. The QCM digital logic incorporates extensive debug capability and Built-In-Self-Test (BIST). The authors performed analog and digital simulations of the integrated BICS, and performed layout and tapeout of the design. Silicon is now in fabrication. Results to date show that, for some systems, BICS can be a practical and relatively inexpensive method for providing state-of-health monitoring of safety-critical microelectronics.

  10. Development and implementation of a reduced risk peach arthropod management program in New Jersey.

    Science.gov (United States)

    Atanasso, Atanas; Shearer, Peter W; Hamilton, George; Polk, Dean

    2002-08-01

    We implemented a 2-yr program to reduce organophosphorus and carbamate insecticide use and mitigate their associated risks as they relate to peach production in New Jersey and elsewhere. The main thrust integrated mating disruption with ground cover management practices to reduce oriental fruit moth, Grapholita molesta (Busck) (Lepidoptera: Tortricidae), and tarnished plant bug, Lygus lineolaris (Palisot de Beauvois) (Heteroptera: Miridae), abundance and damage. This Reduced Risk Peach Arthropod Management Program was compared with adjacent conventionally managed peach orchards. In 1999, we found 2.3 times fewer L. lineolaris and stink bugs (Euschistus servus (Say), E. tristigmus (Say), Acrostemum hilare (Say) (Heteroptera: Pentatomidae) and 2.0 times less heteropteran damaged peaches in reduced-risk orchards when compared with conventionally managed orchards. In 2000, we observed 4.9 times fewer heteropteran insects in reduced-risk orchards but damage levels were not significantly different between the two programs. In both years, G. molesta mating disruption gave at least 4 mo of noninsecticidal control of this major pest. The reduced-risk program provided a level of pest control that was equal to or better than conventional peach pest management programs while using fewer organophosporus and carbamate insecticides.

  11. Barriers and facilitators to the implementation of orthodontic mini implants in clinical practice: a systematic review

    NARCIS (Netherlands)

    Meursinge Reynders, Reint; Ronchi, Laura; Ladu, Luisa; Di Girolamo, Nicola; de Lange, Jan; Roberts, Nia; Mickan, Sharon

    2016-01-01

    Numerous surveys have shown that orthodontic mini implants (OMIs) are underused in clinical practice. To investigate this implementation issue, we conducted a systematic review to (1) identify barriers and facilitators to the implementation of OMIs for all potential stakeholders and (2) quantify

  12. USDA Snack Policy Implementation: Best Practices From the Front Lines, United States, 2013-2014.

    Science.gov (United States)

    Asada, Yuka; Chriqui, Jamie; Chavez, Noel; Odoms-Young, Angela; Handler, Arden

    2016-06-16

    The Smart Snacks in Schools interim final rule was promulgated by the US Department of Agriculture (USDA) as authorized by the Healthy, Hunger-Free Kids Act of 2010 (PL 111-296) and implementation commenced beginning July 1, 2014; however, in the years leading up to this deadline, national studies suggested that most schools were far from meeting the USDA standards. Evidence to guide successful implementation of the standards is needed. This study examined snack policy implementation in exemplary high schools to learn best practices for implementation. Guided by a multiple case study approach, school professionals (n = 37) from 9 high schools across 8 states were recruited to be interviewed about perceptions of school snack implementation; schools were selected using criterion sampling on the basis of the HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) database. Interview transcripts and internal documents were organized and coded in ATLAS.Ti v7; 2 researchers coded and analyzed data using a constant comparative analysis method to identify best practice themes. Best practices for snack policy implementation included incorporating the HUSSC: SL award's comprehensive wellness approach; leveraging state laws or district policies to reinforce snack reform initiatives; creating strong internal and external partnerships; and crafting positive and strategic communications. Implementation of snack policies requires evidence of successful experiences from those on the front lines. As federal, state, and local technical assistance entities work to ensure implementation of the Smart Snacks standards, these best practices provide strategies to facilitate the process.

  13. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

    Science.gov (United States)

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur

    2006-01-01

    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  14. Systematic reviews examining implementation of research into practice and impact on population health are needed.

    Science.gov (United States)

    Yoong, Sze Lin; Clinton-McHarg, Tara; Wolfenden, Luke

    2015-07-01

    To examine the research translation phase focus (T1-T4) of systematic reviews published in the Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE). Briefly, T1 includes reviews of basic science experiments; T2 includes reviews of human trials leading to guideline development; T3 includes reviews examining how to move guidelines into policy and practice; and T4 includes reviews describing the impact of changing health practices on population outcomes. A cross-sectional audit of randomly selected reviews from CDSR (n = 500) and DARE (n = 500) was undertaken. The research translation phase of reviews, overall and by communicable disease, noncommunicable disease, and injury subgroups, were coded by two researchers. A total of 898 reviews examined a communicable, noncommunicable, or injury-related condition. Of those, 98% of reviews within CDSR focused on T2, and the remaining 2% focused on T3. In DARE, 88% focused on T2, 8.7% focused on T1, 2.5% focused on T3, and 1.3% focused on T4. Almost all reviews examining communicable (CDSR 100%, DARE 93%), noncommunicable (CDSR 98%, DARE 87%), and injury (CDSR 95%, DARE 88%) were also T2 focused. Few reviews exist to guide practitioners and policy makers with implementing evidence-based treatments or programs. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Exploring the boundaries: A study of a physics faculty community of practice engaged in implementing innovation

    Science.gov (United States)

    Enderle, Patrick

    Undergraduate science education continues to develop new ways of improving the teaching and learning of science. This study describes the efforts of four science faculty members involved in developing and teaching an innovative sequence of introductory physics courses. These courses were designed in a studio format using the SCALE-UP course model, previously developed by other researchers in physics education. These four faculty members developed a cooperative group structure among themselves that was critical in sustaining these innovative courses. Using Wenger's Communities of Practice framework, the interactions of this faculty group with each other and with students through different pedagogical practices were explored for their impacts on the teaching and learning of physics. Further investigation explored the impact of multiple contextual forces operating at several levels on the development and maintenance of the studio physics program. The findings that emerged provide insight into necessary social elements for helping faculty to implement pedagogical change and offer evidence for their impact on a specific effort.

  16. Implementation of a community pharmacy-based falls prevention program.

    Science.gov (United States)

    Casteel, Carri; Blalock, Susan J; Ferreri, Stefanie; Roth, Mary T; Demby, Karen B

    2011-10-01

    Falls are the leading cause of fatal and nonfatal unintentional injury among older adults in the United States. Multifaceted falls prevention programs, which have been reported to reduce the risk for falls among older adults, usually include a medication review and modification component. Based on a literature search, no randomized trials that have examined the effectiveness of this component have been published. The aim of this article was to report on a retrospective process evaluation of data from a randomized, controlled trial conducted to examine the effectiveness of a medication review intervention, delivered through community pharmacies, on the rate of falls among community-dwelling older adults. Patients were recruited through 32 pharmacies in North Carolina. Participants were community-dwelling older adults at high risk for falls based on age (≥ 65 years), number of concurrent medications (≥ 4), and medication classes (emphasis on CNS-active agents). The process evaluation measured the recruitment of patients into the study, the process through which the intervention was delivered, the extent to which patients implemented the recommendations for intervention, and the acceptance of pharmacists' recommendations by prescribing physicians. Of the 7793 patients contacted for study participation, 981 (12.6%) responded to the initial inquiry. A total of 801 (81.7%) participated in an eligibility interview, of whom 342 (42.7%) were eligible. Baseline data collection was completed in 186 of eligible patients (54.4%), who were randomly assigned to the intervention group (n = 93) or the control group (n = 93). Pharmacists delivered a medication review to 73 of the patients (78.5%) in the intervention group, with 41 recommendations for changes in medication, of which 10 (24.4%) were implemented. Of the 31 prescribing physicians contacted with pharmacists' recommendations, 14 (45.2%) responded, and 10 (32.3%) authorized the changes. Based on the findings from the

  17. A national survey of medical risk assessment instruction in general practice residency programs (Part I).

    Science.gov (United States)

    Napholz, L; Kelly, W H

    1992-01-01

    Formal and structured training in medical risk assessment (MRA) has been a requirement in general practice residency (GPR) programs since their inception in 1972. Institutions offering GPR programs frequently differ in the levels and types of available resources necessary to implement this training. Program directors have expressed significant concerns that this training is difficult to provide, especially in the area of physical examination. The literature has not yet established how or if programs have organized their curricula to conform to accreditation standards in MRA established by the American Dental Association's Commission on Dental Accreditation. The purpose of this study was to conduct a nationwide survey of all GPR programs to identify program characteristics and resources, didactic and clinical educational methods, and perceived achievement of ADA Standard Fourteen for MRA training. Recommendations for further research are also given. Results will be reported in this paper, the paper following in this issue, and an additional paper to be published in a forthcoming issue.

  18. Translating policies into practice: a framework to prevent childhood obesity in afterschool programs.

    Science.gov (United States)

    Beets, Michael W; Webster, Collin; Saunders, Ruth; Huberty, Jennifer L

    2013-03-01

    Afterschool programs (3-6 p.m.) are positioned to play a critical role in combating childhood obesity. To this end, state and national organizations have developed policies related to promoting physical activity and guiding the nutritional quality of snacks served in afterschool programs. No conceptual frameworks, however, are available that describe the process of how afterschool programs will translate such policies into daily practice to reach eventual outcomes. Drawing from complex systems theory, this article describes the development of a framework that identifies critical modifiable levers within afterschool programs that can be altered and/or strengthened to reach policy goals. These include the policy environment at the national, state, and local levels; individual site, afterschool program leader, staff, and child characteristics; and existing outside organizational partnerships. Use of this framework and recognition of its constituent elements have the potential to lead to the successful and sustainable adoption and implementation of physical activity and nutrition policies in afterschool programs nationwide.

  19. Organizational factors that support the implementation of a nursing best practice guideline.

    Science.gov (United States)

    Marchionni, Caroline; Ritchie, Judith

    2008-04-01

    The context of the healthcare setting may play a crucial role in influencing the implementation of best practice guidelines in nursing. Further study is required to understand these organizational factors. Two variables, organizational culture and leadership, are thought to influence the adoption of best practice guidelines. A discussion of organizational factors that influence best practice guideline adoption is presented. A small pilot study is provided as an example of methods for further research. A quantitative survey of nursing staff was conducted. Results from the pilot study reveal variability in best practice guideline implementation despite the presence of a culture of organizational learning and transformational leadership. There is beginning evidence in the literature that culture and leadership are key elements influencing guideline implementation. In this pilot work on two inpatient units where a nursing best practice guideline was implemented, a supportive organizational culture and key people leading change were present. Implications for further studies are offered. Nursing leaders interested in promoting the use of best practice guidelines must pay attention to the organizational context in which nursing care occurs. A supportive culture where learning is valued coupled with transformational leadership may be key factors in the implementation and the sustainability of best practice guidelines.

  20. Best practices of Building Information Modelling (BIM) implementation in design phase for construction project

    Science.gov (United States)

    Kasim, N.; Zainal Abidin, N. A.; Zainal, R.; Sarpin, N.; Rahim, M. H. I. Abd; Saikah, M.

    2017-11-01

    Implementation of Building Information Modelling (BIM) was expected to bring improvement in current practices of Malaysian construction industry. In the design phase, there is a lack of a ready pool of skilled workers who are able to develop BIM strategic plan and effectively utilise it. These create boundaries for BIM nature in Malaysian construction industry specifically in the design phase to achieve its best practices. Therefore, the objectives of this research are to investigate the current practices of BIM implementation in the design phase as well as the best practices factors of BIM implementation in the design phase. The qualitative research approach is carried out through semi-structured interviews with the designers of different organisations which adopt BIM in the design phase. Data collection is analysed by executing content analysis method. From the findings, the best practices factors of BIM implementation in design phase such as the incentive for BIM training, formal approach to monitoring automated Level of Detailing (LOD), run a virtual meeting and improve Industry Foundation Class (IFC). Thus, best practices factors which lead to practices improvements in the design phase of project development which subsequently improves the implementation of BIM in the design phase of Malaysian construction industry.

  1. Implementation and execution of military forward resuscitation programs.

    Science.gov (United States)

    Hooper, Timothy J; Nadler, Roy; Badloe, John; Butler, Frank K; Glassberg, Elon

    2014-05-01

    Through necessity, military medicine has been the driver of medical innovation throughout history. The battlefield presents challenges, such as the requirement to provide care while under threat, resource limitation, and prolonged evacuation times, which must be overcome to improve casualty survival. Focus must also be placed on identifying the causes, and timing, of death within the battlefield. By doing so, military medical doctrine can be shaped, appropriate goals set, new concepts adopted, and relevant technologies investigated and implemented. The majority of battlefield casualties still die in the prehospital environment, before reaching a medical treatment facility, and hemorrhage remains the leading cause of potentially survivable death. Many countries have adopted policies that push damage control resuscitation forward into the prehospital setting, while understanding the need for timely medical evacuation. Although these policies vary according to country, the majority share many common principles. These include the need for early catastrophic hemorrhage control at point-of-wounding, judicious use of fluid resuscitation, use of blood products as far forward as possible, and early evacuation to a surgical facility. Some countries place medical providers with the ability, and resources, for advanced resuscitation with the forward fighting units (perhaps at company level), whereas others have established en route resuscitation capabilities. If we are to continue to improve battlefield casualty survival, we must continue to work together and learn from each other. We must also carry on working alongside our civilian colleagues so that the benefits of translational experience are not lost. This review describes several countries current military approaches to prehospital trauma care. These approaches, refined through a decade of experience, merit consideration for integration into civilian prehospital care practice.

  2. Teaching Today in the Practice Setting of the Future: Implementing Innovations in Graduate Medical Education.

    Science.gov (United States)

    Kim, Jung G; Morris, Carl G; Ford, Paul

    2017-05-01

    Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters). The authors report GHFMR residents' continuity clinic encounters, specifically volume, from 2006 through 2013 via pre- and post-PCMH implementation. They discuss the implications for leaders of high-performing practices who desire to innovate while maintaining accreditation. Post-PCMH residents had 20% more overall patient contact. The largest change in care delivery method included a large increase in secure messages between patients and residents. Pre-PCMH residents had more face-to-face encounters; however, post-PCMH residents had more contact for all types of patient care encounters (face-to-face, secure messaging, and telephone) per hour of clinic time. The ACGME PEIP exception, allowing the incorporation of the PCMH, facilitated an increase in patient access and immersed residents in primary care innovation (namely, practicing in a PCMH model during graduate medical education training). The next steps are to assess the effect of the PCMH on resident learning and clinical outcomes and to continue residents' access to training that keeps pace with today's health care delivery needs.

  3. Adoption, adaptation, and fidelity of implementation of sexual violence prevention programs.

    Science.gov (United States)

    Noonan, Rita K; Emshoff, James G; Mooss, Angela; Armstrong, Michael; Weinberg, Joanna; Ball, Barbara

    2009-01-01

    Little research examines the organizational and contextual dynamics that affect decisions to adopt evidence-based programs as well as the feasibility of implementation with fidelity to the original model when new users adopt established programs. To understand how promising strategies can be disseminated widely, this study examines the adoption and implementation of two sexual violence prevention programs in new settings. Interviews were conducted with stake-holders to investigate the factors and dynamics related to the adoption and implementation of these programs. Additionally, the research team worked with the program developers to create measures of the fidelity of implementation, which were then administered at each site. The findings suggest that adoption decisions were based on perceived fit between the program and the adopting organization's values, goals, and local setting. After adoption, new sites were able to implement the program with fairly high levels of fidelity, given moderate investments in training and technical assistance.

  4. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  5. Practical solutions to implementing "Born Semantic" data systems

    Science.gov (United States)

    Leadbetter, A.; Buck, J. J. H.; Stacey, P.

    2015-12-01

    The concept of data being "Born Semantic" has been proposed in recent years as a Semantic Web analogue to the idea of data being "born digital"[1], [2]. Within the "Born Semantic" concept, data are captured digitally and at a point close to the time of creation are annotated with markup terms from semantic web resources (controlled vocabularies, thesauri or ontologies). This allows heterogeneous data to be more easily ingested and amalgamated in near real-time due to the standards compliant annotation of the data. In taking the "Born Semantic" proposal from concept to operation, a number of difficulties have been encountered. For example, although there are recognised methods such as Header, Dictionary, Triples [3] for the compression, publication and dissemination of large volumes of triples these systems are not practical to deploy in the field on low-powered (both electrically and computationally) devices. Similarly, it is not practical for instruments to output fully formed semantically annotated data files if they are designed to be plugged into a modular system and the data to be centrally logged in the field as is the case on Argo floats and oceanographic gliders where internal bandwidth becomes an issue [2]. In light of these issues, this presentation will concentrate on pragmatic solutions being developed to the problem of generating Linked Data in near real-time systems. Specific examples from the European Commission SenseOCEAN project where Linked Data systems are being developed for autonomous underwater platforms, and from work being undertaken in the streaming of data from the Irish Galway Bay Cable Observatory initiative will be highlighted. Further, developments of a set of tools for the LogStash-ElasticSearch software ecosystem to allow the storing and retrieval of Linked Data will be introduced. References[1] A. Leadbetter & J. Fredericks, We have "born digital" - now what about "born semantic"?, European Geophysical Union General Assembly, 2014

  6. Implementation status of self-assessment/peer-group discussion program: a bottom-up approach of monitoring/supervision in improving quality of health services.

    Science.gov (United States)

    Kafle, K K; Bhuju, G B; Karkee, S B; Prasad, R R; Shrestha, N; Shrestha, A D; Das, P L; Chataut, B D; Shrestha, A; Suvedi, B K

    2014-01-01

    Monitoring/supervision is an essential component for improving the quality of health services including rational use of medicines. A new bottom-up approach of monitoring/supervision consisting of self-assessment/ peer-group discussion was found to be effective in improving prescribing practices. The new strategy significantly improved the prescribing practices based on standard treatment guidelines. The government has implemented it as a Program in primary health care services of Nepal. This article aims to share the implementation status of the self-assessment/peer-group discussion Program for improving the prescribing practices of common health problems and availability of drugs in the district health system. Concurrent mixed research design was applied for data collection. The data were collected at different levels of health care system using in-depth interviews, participatory observations and documentary analysis. The Management Division, Department of Health Services implemented the Program in 2009-10 and the PHC Revitalization Division, DoHs is the implementation division since 2010-11. The Program comprised revision of participant's and trainer's manuals, training of trainers and prescribers, finalisation of health conditions and indicators, distribution of carbon copy prescription pads, and conduction of peer-group discussions.The Program was implemented in number of districts. The government made the policy decision to implement the Program for monitoring prescribing practices and the availability of free drugs in districts. However, it has covered only few districts and needs escalation to cover all 75 districts of the country.

  7. The Convergence of Two Methodologies: Implementing Programmed Instruction.

    Science.gov (United States)

    Blankmeyer, Harrison C.; Williams, Jerome

    The applicability of a programmed methodology to a non-programmed text can result in a new approach to and definition of programmed learning. In seeking to resolve the present conflict between grammar and foreign language instruction by making the grammatical elements implicit to both student and teacher through a logically ordered program of…

  8. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  9. Implementation of solar-reflective surfaces: Materials and utility programs

    Energy Technology Data Exchange (ETDEWEB)

    Bretz, S.; Akbari, H.; Rosenfeld, A.; Taha, H.

    1992-06-01

    This report focuses on implementation issues for using solar-reflective surfaces to cool urban heat islands, with specific examples for Sacramento, California. Advantages of solar-reflective surfaces for reducing energy use are: (1) they are cost-effective if albedo is increased during routine maintenance; (2) the energy savings coincide with peak demand for power; (3) there are positive effects on environmental quality; and (4) the white materials have a long service life. Important considerations when choosing materials for mitigating heat islands are identified as albedo, emissivity, durability, cost, pollution and appearance. There is a potential for increasing urban albedo in Sacramento by an additional 18%. Of residential roofs, we estimate that asphalt shingle and modified bitumen cover the largest area, and that built-up roofing and modified bitumen cover the largest area of commercial buildings. For all of these roof types, albedo may be increased at the time of re-roofing without any additional cost. When a roof is repaired, a solar-reflective roof coating may be applied to significantly increase albedo and extend the life of the root Although a coating may be cost-effective if applied to a new roof following installation or to an older roof following repair, it is not cost-effective if the coating is applied only to save energy. Solar-reflective pavement may be cost-effective if the albedo change is included in the routine resurfacing schedule. Cost-effective options for producing light-colored pavement may include: (1) asphalt concrete, if white aggregate is locally available; (2) concrete overlays; and (3) newly developed white binders and aggregate. Another option may be hot-rolled asphalt, with white chippings. Utilities could promote solar-reflective surfaces through advertisement, educational programs and cost-sharing of road resurfacing.

  10. IMPLEMENTATION OF A SAFETY PROGRAM FOR THE WORK ACCIDENTS’ CONTROL. A CASE STUDY IN THE CHEMICAL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Edison Cesar de Faria Nogueira

    2015-03-01

    Full Text Available This article presents a case study related to the implementation of a Work Safety Program in a chemical industry, based on the Process Safety Program, PSP, of a huge energy company. The research was applied, exploratory, qualitative and with and data collection method through documentary and bibliographical research. There will be presented the main practices adopted in order to make the Safety Program a reality inside a chemical industry, its results and contributions for its better development. This paper proposes the implementation of a Safety Program must be preceded by a diagnosis of occupational safety and health management system and with constant critical analysis in order to make the necessary adjustments.

  11. Supporting Students with Severe Disabilities in Inclusive Schools: A Descriptive Account From Schools Implementing Inclusive Practices

    Science.gov (United States)

    Kurth, Jennifer A.; Lyon, Kristin J.; Shogren, Karrie A.

    2015-01-01

    The purpose of the present study was to investigate practices that support the inclusion of students with severe disabilities in the learning and social activities of inclusive K-8 schools to inform inclusive school reform research and practice. Eighteen K-8 students with severe disabilities in six schools recognized for their implementation of…

  12. Sharing Best Practices in Barbados and Trinidad and Tobago: Patterns of Policy Implementation and Resistance

    Science.gov (United States)

    Lam, Elaine

    2011-01-01

    This article outlines policies from multilateral organisations that advocate sharing best practices between developing nations. The article discusses the degree to which these best practices are implemented by small states as indicated by teachers, academics and policymakers in Barbados and Trinidad and Tobago. For the purpose of this article, a…

  13. Implementing Evidence-Based Practice Education in Social Work: A Transdisciplinary Approach

    Science.gov (United States)

    Bellamy, Jennifer L.; Mullen, Edward J.; Satterfield, Jason M.; Newhouse, Robin P.; Ferguson, Molly; Brownson, Ross C.; Spring, Bonnie

    2013-01-01

    Evidence based practice (EBP) is reflected in social work publications, accreditation standards, research, and funding opportunities. However, implementing EBP in social work practice and education has proven challenging, highlighting the need for additional resources. This paper describes the Transdisciplinary Model of EBP, a model based on…

  14. Interactive Read-Alouds: Is There a Common Set of Implementation Practices?

    Science.gov (United States)

    Fisher, Douglas; Flood, James; Lapp, Diane; Frey, Nancy

    2004-01-01

    Read-alouds are a common component of literacy instruction. However, research on the method for providing read-alouds is limited. To determine if there was a common set of implementation practices, the authors examined the read-aloud practices of 25 teachers who were nominated by their administrators as experts. From these data, the authors…

  15. Pelvic floor muscle training for the prevention of urinary incontinence in antenatal and postnatal women: a best practice implementation project.

    Science.gov (United States)

    Xing, Weijie; Zhang, Yu; Gu, Chunyi; Lizarondo, Lucylynn

    2017-02-01

    Pregnancy and vaginal delivery may cause urinary incontinence (UI) in some women, which can impact on their quality of life. Pelvic floor muscles training (PFMT) is a safe and effective intervention for preventing UI associated with pregnancy. The aim of this evidence-implementation project was to promote PFMT to prevent UI among antenatal and postnatal women in an obstetric and gynecological hospital in China. A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Six audit criteria that represent best practice recommendations for PFMT were used. A baseline audit was conducted followed by the implementation of multiple strategies and finalized with a follow-up audit to determine change in practice. Results from pre- and post-implementation audits indicated that compliance rates for Criterion 1 (nurse education), Criterion 2 (information providing), Criterion 3 (needs and precautions identifying), Criterion 4 (assessment of pelvic floor function and referral suggestion) reached 100% in the follow-up audit. The compliance rate for Criteria 5 (women education) and Criteria 6 (follow-up providing) attained 90 and 63%, respectively, in the follow-up audit. The project was successful in improving women's knowledge and skills around UI and PFMT. A variety of strategies, such as an effective education program, simple and clear instruments, multiple educational materials can facilitate implementation of evidence in clinical practice. Future plans for continuous improvements in practice and outcomes should be discussed. Further audits will need to be carried out to monitor practice and effect change as required.

  16. An Interdisciplinary Approach to Implementing a Best Practice Guideline in Public Health.

    Science.gov (United States)

    Prowd, Lisa; Leach, Denna; Lynn, Hazel; Tao, May

    2017-12-01

    This article describes how one Ontario Public Health Unit implemented a best practice guideline throughout the organization and across disciplines to achieve best practice outcomes in the delivery of client-centered care. Integration of evidence-informed practice presents challenges for both implementation and sustainability. Applying a best practice guideline in the public health setting can add to the challenge. To address this, a variety of interventions were applied: building an interdisciplinary team, adapting a Registered Nurses' Association of Ontario Best Practice Guideline to reflect public health practice for nursing and other disciplines, developing a working definition of "client," engaging staff in knowledge translation, developing policy to support practice change, and incorporating client-centered care principles into daily practice. Outcomes indicate that nursing best practice guidelines, specific to client-centered care, can be successfully adapted and applied in public health practice. Considerations include the varied definitions of a "client," the various roles of public health professionals, and engagement of both internal and external clients. Moreover, interdisciplinary staff can apply the principles of client-centered care when working with clients and when engaging in education-, practice-, and policy-level initiatives to support evidence-informed practice.

  17. MOLECULAR GASTRONOMY IN FUNCTION OF SCIENTIFIC IMPLEMENTATION IN PRACTICE

    Directory of Open Access Journals (Sweden)

    Ivanovic Slobodan

    2011-12-01

    Full Text Available Modern culinary direction - molecular gastronomy is very complex, and the relative youth of that direction affects the ignorance of the matter by a large number of professionals and the general public. It is precisely this lack of matter which causes a number of disagreements between chefs and scientists, while there is a number of related debates about aspects of molecular gastronomy, especially in connection with a change in its gastronomic cuisine. The main focus of disagreement lies in the name of ''molecular'', which mostly leads to a misunderstanding, because of the identification with something microscopic. A very common mistake is to address this branch of gastronomy as a style of cooking, which she doesn't represent. The second mistake is naming its practical application of molecular cooking, molecular cuisine. Molecular gastronomy is a scientific discipline that studies food and asks questions and gives answers so far unanswered questions about gastronomy. Simply put, molecular gastronomy can be understood as a process of application of science in everyday cooking, and the application of molecular gastronomy in the kitchen. Modern man with his awareness made some chefs to reconsider the adoption of these radical ideas to accomplish the fusion of science and gastronomy. This idea is established as a full hit, because today the best restaurants in the world, the vast majority of those who have seen the benefits of these two joints before incompatible branches of human activity. As a culinary direction it quickly spread to Western Europe and North America, and it later spread to other parts of the world, but Croatia and neighboring countries are not one of them. Molecular gastronomy shows the trends of further progress, and in the future molecular gastronomy will be more prevalent and popular.

  18. Views on and Practices of Integrating Theory and Practice in Teacher Education Programs in Atlantic Canada

    Science.gov (United States)

    Falkenberg, Thomas; Goodnough, Karen; MacDonald, Ronald J.

    2014-01-01

    The need for and lack of integration of theory and practice in initial teacher education programs has been discussed as a central issue for teacher education. This article reports on a study that surveyed university-based teacher educators in Atlantic Canada on their perspectives regarding how theory and practice can be integrated, how they and…

  19. Using structural equation modelling to integrate human resources with internal practices for lean manufacturing implementation

    Directory of Open Access Journals (Sweden)

    Protik Basu

    2018-01-01

    Full Text Available The purpose of this paper is to explore and integrate the role of human resources with the internal practices of the Indian manufacturing industries towards successful implementation of lean manu-facturing (LM. An extensive literature survey is carried out. An attempt is made to build an ex-haustive list of all the input manifests related to human resources and internal practices necessary for LM implementation, coupled with a similar exhaustive list of the benefits accrued from its suc-cessful implementation. A structural model is thus conceptualized, which is empirically validated based on the data from the Indian manufacturing sector. Hardly any survey based empirical study in India has been found to integrate human resources with the internal processes towards success-ful LM implementation. This empirical research is thus carried out in the Indian manufacturing in-dustries. The analysis reveals six key input constructs and three output constructs, indicating that these constructs should act in unison to maximize the benefits of implementing lean. The structural model presented in this paper may be treated as a guide to integrate human resources with internal practices to successfully implement lean, leading to an optimum utilization of resources. This work is one of the very first researches to have a survey-based empirical analysis of the role of human resources and internal practices of the Indian manufacturing sector towards an effective lean im-plementation.

  20. An empirical identification and categorisation of training best practices for ERP implementation projects

    Science.gov (United States)

    Esteves, Jose Manuel

    2014-11-01

    Although training is one of the most cited critical success factors in Enterprise Resource Planning (ERP) systems implementations, few empirical studies have attempted to examine the characteristics of management of the training process within ERP implementation projects. Based on the data gathered from a sample of 158 respondents across four stakeholder groups involved in ERP implementation projects, and using a mixed method design, we have assembled a derived set of training best practices. Results suggest that the categorised list of ERP training best practices can be used to better understand training activities in ERP implementation projects. Furthermore, the results reveal that the company size and location have an impact on the relevance of training best practices. This empirical study also highlights the need to investigate the role of informal workplace trainers in ERP training activities.