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.

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

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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

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

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

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

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

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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.

The promise and challenge of practice-research collaborations: Guiding principles and strategies for initiating, designing, and implementing program evaluation research.

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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, and building on their experiences in successfully completing a community-based research evaluation, the authors identify specific relationship-focused principles and strategies and illustrate how these approaches can guide practice-research teams through the various sequential activities of the evaluation research process. In particular, it is suggested that practice-research collaborations can be formed, strengthened, and sustained by emphasis on a spirit of discovery and shared leadership at the start of the relationship, use of a comprehensive evaluation model to clarify and frame the evaluation and program goals, beginning where the client is when selecting research methodology and measurement tools, commitment to keeping the program first and recording everything during the implementation and data-collection stages, discussion of emerging findings and presentation of findings in graphic format at the data-analysis stage, and a total team approach at the dissemination stage.

Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.

Science.gov (United States)

McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D

2018-04-01

Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.

Paid maternity leave and breastfeeding practice before and after California's implementation of the nation's first paid family leave program.

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Huang, Rui; Yang, Muzhe

2015-01-01

California was the first state in the United States to implement a paid family leave (PFL) program in 2004. We use data from the Infant Feeding Practices Study to examine the changes in breastfeeding practices in California relative to other states before and after the implementation of PFL. We find an increase of 3-5 percentage points for exclusive breastfeeding and an increase of 10-20 percentage points for breastfeeding at several important markers of early infancy. Our study supports the recommendation of the Surgeon General to establish paid leave policies as a strategy for promoting breastfeeding. Copyright © 2014 Elsevier B.V. All rights reserved.

Factors Impacting Program Delivery: The Importance of Implementation Research in Extension

Directory of Open Access Journals (Sweden)

Ryan J. Gagnon

2015-06-01

Full Text Available Cooperative Extension is in a unique position, given its relationship with research-based, Land-Grant Universities, to advance the scholarship of implementation research. A stronger shift towards evidence-based practice has been occurring, oriented towards the assessment of programs for outcomes. This paper explores core concepts related to program implementation and delves into factors that influence successful implementation of Extension programs and services. The importance of implementation within the Extension Program Development Model is explored, along with emerging issues and trends.

An e-learning supported Train-the-Trainer program to implement a suicide practice guideline. Rationale, content and dissemination in Dutch mental health care.

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Groot, M. de; Beurs, D.P. de; Keijser, J. de; Kerkhof, A.F.J.M.

2015-01-01

An e-learning supported Train-the-Trainer program was developed to implement the Dutch suicide practice guideline inmental health care. Literature on implementation strategies has been restricted to the final reporting of studieswith little opportunity to describe relevant contextual, developmental

Solar Ready: An Overview of Implementation Practices

Energy Technology Data Exchange (ETDEWEB)

Watson, A.; Guidice, L.; Lisell, L.; Doris, L.; Busche, S.

2012-01-01

This report explores three mechanisms for encouraging solar ready building design and construction: solar ready legislation, certification programs for solar ready design and construction, and stakeholder education. These methods are not mutually exclusive, and all, if implemented well, could contribute to more solar ready construction. Solar ready itself does not reduce energy use or create clean energy. Nevertheless, solar ready building practices are needed to reach the full potential of solar deployment. Without forethought on incorporating solar into design, buildings may be incompatible with solar due to roof structure or excessive shading. In these cases, retrofitting the roof or removing shading elements is cost prohibitive. Furthermore, higher up-front costs due to structural adaptations and production losses caused by less than optimal roof orientation, roof equipment, or shading will lengthen payback periods, making solar more expensive. With millions of new buildings constructed each year in the United States, solar ready can remove installation barriers and increase the potential for widespread solar adoption. There are many approaches to promoting solar ready, including solar ready legislation, certification programs, and education of stakeholders. Federal, state, and local governments have the potential to implement programs that encourage solar ready and in turn reduce barriers to solar deployment. With the guidance in this document and the examples of jurisdictions and organizations already working to promote solar ready building practices, federal, state, and local governments can guide the market toward solar ready implementation.

HIV Pre-exposure Prophylaxis Program Implementation Using Intervention Mapping.

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Flash, Charlene A; Frost, Elizabeth L T; Giordano, Thomas P; Amico, K Rivet; Cully, Jeffrey A; Markham, Christine M

2018-04-01

HIV pre-exposure prophylaxis has been proven to be an effective tool in HIV prevention. However, numerous barriers still exist in pre-exposure prophylaxis implementation. The framework of Intervention Mapping was used from August 2016 to October 2017 to describe the process of adoption, implementation, and maintenance of an HIV prevention program from 2012 through 2017 in Houston, Texas, that is nested within a county health system HIV clinic. Using the tasks outlined in the Intervention Mapping framework, potential program implementers were identified, outcomes and performance objectives established, matrices of change objectives created, and methods and practical applications formed. Results include the formation of three matrices that document program outcomes, change agents involved in the process, and the determinants needed to facilitate program adoption, implementation, and maintenance. Key features that facilitated successful program adoption and implementation were obtaining leadership buy-in, leveraging existing resources, systematic evaluation of operations, ongoing education for both clinical and nonclinical staff, and attention to emergent issues during launch. The utilization of Intervention Mapping to delineate the program planning steps can provide a model for pre-exposure prophylaxis implementation in other settings. Copyright © 2018. Published by Elsevier Inc.

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

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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.

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

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Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

[The German program for disease management guidelines--implementation with pathways and quality management].

Science.gov (United States)

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2007-07-15

In Germany, physicians enrolled in disease management programs are legally obliged to follow evidence-based clinical practice guidelines. That is why a Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 aiming at implementation of best-practice evidence-based recommendations for nationwide as well as regional disease management programs. Against this background the article reviews programs, methods and tools for implementing DM-CPGs via clinical pathways as well as regional guidelines for outpatient care. Special reference is given to the institutionalized program of adapting DM-CPGs for regional use by primary-care physicians in the State of Hesse.

Mentoring program design and implementation in new medical schools

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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

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.

Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

Science.gov (United States)

Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

2016-08-01

Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

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

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

Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation.

Science.gov (United States)

Padek, Margaret; Allen, Peg; Erwin, Paul C; Franco, Melissa; Hammond, Ross A; Heuberger, Benjamin; Kasman, Matt; Luke, Doug A; Mazzucca, Stephanie; Moreland-Russell, Sarah; Brownson, Ross C

2018-03-23

Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with

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

Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

Science.gov (United States)

Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

2014-01-01

To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

Implementing the Comprehensive Unit-Based Safety Program (CUSP) to Improve Patient Safety in an Academic Primary Care Practice.

Science.gov (United States)

Pitts, Samantha I; Maruthur, Nisa M; Luu, Ngoc-Phuong; Curreri, Kimberly; Grimes, Renee; Nigrin, Candace; Sateia, Heather F; Sawyer, Melinda D; Pronovost, Peter J; Clark, Jeanne M; Peairs, Kimberly S

2017-11-01

While there is growing awareness of the risk of harm in ambulatory health care, most patient safety efforts have focused on the inpatient setting. The Comprehensive Unit-based Safety Program (CUSP) has been an integral part of highly successful safety efforts in inpatient settings. In 2014 CUSP was implemented in an academic primary care practice. As part of CUSP implementation, staff and clinicians underwent training on the science of safety and completed a two-question safety assessment survey to identify safety concerns in the practice. The concerns identified by team members were used to select two initial safety priorities. The impact of CUSP on safety climate and teamwork was assessed through a pre-post comparison of results on the validated Safety Attitudes Questionnaire. Ninety-six percent of staff completed science of safety training as part of CUSP implementation, and 100% of staff completed the two-question safety assessment. The most frequently identified safety concerns were related to medications (n = 11, 28.2), diagnostic testing (n = 9, 25), and communication (n = 5, 14). The CUSP team initially prioritized communication and infection control, which led to standardization of work flows within the practice. Six months following CUSP implementation, large but nonstatistically significant increases were found for the percentage of survey respondents who reported knowledge of the proper channels for questions about patient safety, felt encouraged to report safety concerns, and believed that the work setting made it easy to learn from the errors of others. CUSP is a promising tool to improve safety climate and to identify and address safety concerns within ambulatory health care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

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.

Perceived benefits and barriers of implementing nursing residency programs in Jordan.

Science.gov (United States)

AbuAlRub, R F; Abu Alhaija'a, M G

2018-03-02

To explore the challenges that face Jordanian nurses in the first year of employment; and understand the benefits and barriers of implementing a Nursing Residency Program from the perspectives of nurses and key informants. Many researchers reported that novice nurses do not have an adequate level of competence needed in the real clinical practice to meet the increasing demands of healthcare systems. A descriptive qualitative approach using individual interviews and focus group discussions was utilized. The sample was a purposive one that consisted of 30 Jordanian nurses and six key informants. Data were recorded and then transcribed. Content analysis was used to analyze the data. The results revealed several challenges that face nurses in their first year of experience such as reality shock, lack of self-confidence, and burnout and intent to leave. Some of the perceived barriers of implementing the Program were issues concerned with the responsible regulatory body, payment, and monitoring and evaluation. The findings asserted that the implementation of the Nursing Residency Program for new practicing nurses would enhance their competencies and self- confidence; and decrease the rate of reality shock and turnover within the first year of employment. Policy makers, nurse educators, and nurse administrators and clinical nurses need to collaborate to develop a formal system with binding policies and regulations concerning the implementation of Nursing Residency Program. There is also a need to address and modify current orientation programmes offered by hospitals for novice nurses to enhance their transition into clinical practice. © 2018 International Council of Nurses.

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

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

Science.gov (United States)

Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne

2008-01-18

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. 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. 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). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as

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

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.

Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

Science.gov (United States)

Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise

2015-01-01

In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

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.

Pollution prevention program implementation plan

International Nuclear Information System (INIS)

Engel, J.A.

1996-09-01

The Pollution Prevention Program Implementation Plan (the Plan) describes the Pacific Northwest National Laboratory's (PNNL) Pollution Prevention (P2) Program. The Plan also shows how the P2 Program at PNNL will be in support of and in compliance with the Hanford Site Waste Minimization and Pollution Prevention (WMin/P2) Awareness Program Plan and the Hanford Site Guide for Preparing and Maintaining Generator Group Pollution Prevention Program Documentation. In addition, this plan describes how PNNL will demonstrate compliance with various legal and policy requirements for P2. This plan documents the strategy for implementing the PNNL P2 Program. The scope of the P2 Program includes implementing and helping to implement P2 activities at PNNL. These activities will be implemented according to the Environmental Protection Agency's (EPA) hierarchy of source reduction, recycling, treatment, and disposal. The PNNL P2 Program covers all wastes generated at the Laboratory. These include hazardous waste, low-level radioactive waste, radioactive mixed waste, radioactive liquid waste system waste, polychlorinated biphenyl waste, transuranic waste, and sanitary waste generated by activities at PNNL. Materials, resource, and energy conservation are also within the scope of the PNNL P2 Program

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

Science.gov (United States)

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill

2013-01-01

Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859

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.

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

Science.gov (United States)

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

2018-01-01

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

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

Directory of Open Access Journals (Sweden)

Nhan Tran

2017-06-01

Full Text Available ABSTRACT 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.

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

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

Science.gov (United States)

Nemeth, Lynne S; Feifer, Chris; Stuart, Gail W; Ornstein, Steven M

2008-01-16

by leaders. 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.

Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

Science.gov (United States)

Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

2018-05-10

Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by

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; 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

Implementation of a tobacco-free workplace program at a local mental health authority.

Science.gov (United States)

Correa-Fernández, Virmarie; Wilson, William T; Shedrick, Deborah A; Kyburz, Bryce; L Samaha, Hannah; Stacey, Timothy; Williams, Teresa; Lam, Cho Y; Reitzel, Lorraine R

2017-06-01

Tobacco-free workplace policies that incorporate evidence-based practices can increase the reach and effectiveness of tobacco dependence treatment among underserved populations but may be underutilized due to limited knowledge about implementation processes. This paper describes the implementation of a comprehensive tobacco-free workplace program at a behavioral healthcare community center in Texas. The center participated in a tobacco-free workplace program implementation project that provided guidance and resources and allowed center autonomy in implementation. Six employee-based subcommittees guided implementation of program components including consumer and staff surveys, policy development, signage, tobacco use assessments, communication, and nicotine replacement distribution. Timeline development, successes, challenges, lessons learned, and sustainability initiatives are delineated. Concerns about the tobacco-free workplace policy from the center's staff and consumers were gradually replaced by strong support for the initiative. Program success was enabled by consistent support from the center's leadership, publicity of program efforts, and educational campaigns. The center surpassed the program expectations when it adopted a tobacco-free hiring policy, which was not an initial program goal. This center's path to a tobacco-free workplace provides an implementation and sustainability model for other behavioral health community centers and other organizations to become tobacco free.

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

Science.gov (United States)

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

2015-01-01

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

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

From Theory to Practice: One Agency's Experience with Implementing an Evidence-Based Model.

Science.gov (United States)

Murray, Maureen; Culver, Tom; Farmer, Betsy; Jackson, Leslie Ann; Rixon, Brian

2014-07-01

As evidence-based practice is becoming integrated into children's mental health services as a means of improving outcomes for children and youth with severe behavioral and emotional problems, therapeutic foster care (TFC) which is a specialized treatment program for such youth, is one of few community-based programs considered to be evidence-based. "Together Facing the Challenge" (TFTC) which was developed as a component of a randomized trial of TFC has been identified as an evidence-based model. We describe the experiences reported by one of the agencies that participated in our study and how they have incorporated TFTC into their on-going practice. They highlight key implementation strategies, challenges faced, and lessons learned as they moved forward towards full implementation of TFTC throughout their agency.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

Science.gov (United States)

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-01-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (Pabsenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

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

Science.gov (United States)

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

2017-01-01

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

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

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

The Lions Quest Program in Turkey: Teachers' Views and Classroom Practices

Science.gov (United States)

Gol-Guven, Mine

2016-01-01

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…

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.

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

International Nuclear Information System (INIS)

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

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

14 CFR 1214.505 - Program implementation.

Science.gov (United States)

2010-01-01

... Administrators) before implementation. 5 See footnote 1 to § 1214.502(e). (2) A management review process to... Critical Space System Personnel Reliability Program § 1214.505 Program implementation. (a) The Director of... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Program implementation. 1214.505 Section...

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

Science.gov (United States)

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-10-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

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

Development and Implementation of a Mental Health Work Rehabilitation Program: Results of a Developmental Evaluation.

Science.gov (United States)

Sylvain, Chantal; Durand, Marie-José; Velasquez Sanchez, Astrid; Lessard, Nathalie; Maillette, Pascale

2018-05-23

Purpose Long-term work disability due to common mental disorders (CMDs) is a growing problem. Yet optimal interventions remain unclear and little is known about implementation challenges in everyday practice. This study aimed to support and evaluate, in real time, the development and implementation of a work rehabilitation program (WRP) designed to promote post-CMD return-to-work (RTW). Methods A 2-year developmental evaluation was performed using a participatory approach. At program outset, the researchers held five work meetings to revise the program's logic model and discuss its underlying change theory with clinicians. Data collection tools used throughout the study period were structured charts of activities conducted with workers (n = 41); in-depth interviews with program clinicians and managers (n = 9); and participant observation during work meetings. Quantitative data were analyzed using descriptive statistics. Qualitative data underwent thematic analysis using a processual approach. Results Three types of activity were developed and implemented: individual and group interventions targeting workers, and joint activities targeting partners (physicians, employers, others). While worker-targeted activities were generally implemented as planned, joint activities were sporadic. Analysis of the implementation process revealed five challenges faced by clinicians. Determinants included clinicians, host organization, sociopolitical context and resources provided by the evaluation. Conclusion The program studied is original in that it is based on the best available scientific knowledge, yet adapted to contextual particularities. The identified implementation challenges highlight the need for greater importance to be placed on the external, non-program context to ensure sustainable implementation in everyday practice.

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.

Program Implementation Plan

International Nuclear Information System (INIS)

1987-06-01

The Program Implementation Plan (PIP) describes the US Department of Energy's (DOE's) current approaches for managing the permanent disposal of defense high-level waste (HLW), transuranic (TRU) waste, and low-level waste (LLW) from atomic energy defense activities. It documents the implementation of the HLW and TRU waste policies as stated in the Defense Waste Management Plan (DWMP) (DOE/DP-0015), dated June 1983, and also addresses the management of LLW. The narrative reflects both accomplishments and changes in the scope of activities. All cost tables and milestone schedules are current as of January 1987. The goals of the program, to provide safe processing and utilization, storage, and disposal of DOE radioactive waste and byproducts to support defense nuclear materials production activities, and to implement cost-effective improvements in all of its ongoing and planned activities, have not changed

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.

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…

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…

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.

Implementation of inpatient models of pharmacogenetics programs.

Science.gov (United States)

Cavallari, Larisa H; Lee, Craig R; Duarte, Julio D; Nutescu, Edith A; Weitzel, Kristin W; Stouffer, George A; Johnson, Julie A

2016-12-01

The operational elements essential for establishing an inpatient pharmacogenetic service are reviewed, and the role of the pharmacist in the provision of genotype-guided drug therapy in pharmacogenetics programs at three institutions is highlighted. Pharmacists are well positioned to assume important roles in facilitating the clinical use of genetic information to optimize drug therapy given their expertise in clinical pharmacology and therapeutics. Pharmacists have assumed important roles in implementing inpatient pharmacogenetics programs. This includes programs designed to incorporate genetic test results to optimize antiplatelet drug selection after percutaneous coronary intervention and personalize warfarin dosing. Pharmacist involvement occurs on many levels, including championing and leading pharmacogenetics implementation efforts, establishing clinical processes to support genotype-guided therapy, assisting the clinical staff with interpreting genetic test results and applying them to prescribing decisions, and educating other healthcare providers and patients on genomic medicine. The three inpatient pharmacogenetics programs described use reactive versus preemptive genotyping, the most feasible approach under the current third-party payment structure. All three sites also follow Clinical Pharmacogenetics Implementation Consortium guidelines for drug therapy recommendations based on genetic test results. With the clinical emergence of pharmacogenetics into the inpatient setting, it is important that pharmacists caring for hospitalized patients are well prepared to serve as experts in interpreting and applying genetic test results to guide drug therapy decisions. Since genetic test results may not be available until after patient discharge, pharmacists practicing in the ambulatory care setting should also be prepared to assist with genotype-guided drug therapy as part of transitions in care. Copyright © 2016 by the American Society of Health

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

International Nuclear Information System (INIS)

Holdsworth, Rodger

2003-01-01

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

Implementation of tobacco cessation brief intervention in complementary and alternative medicine practice: qualitative evaluation.

Science.gov (United States)

Eaves, Emery R; Howerter, Amy; Nichter, Mark; Floden, Lysbeth; Gordon, Judith S; Ritenbaugh, Cheryl; Muramoto, Myra L

2017-06-23

This article presents findings from qualitative interviews conducted as part of a research study that trained Acupuncture, Massage, and Chiropractic practitioners' in Arizona, US, to implement evidence-based tobacco cessation brief interventions (BI) in their routine practice. The qualitative phase of the overall study aimed to assess: the impact of tailored training in evidence-based tobacco cessation BI on complementary and alternative medicine (CAM) practitioners' knowledge and willingness to implement BIs in their routine practice; and their patients' responses to cessation intervention in CAM context. To evaluate the implementation of skills learned from a tailored training program, we conducted semi-structured qualitative interviews with 54 CAM practitioners in Southern Arizona and 38 of their patients. Interview questions focused on reactions to the implementation of tobacco cessation BIs in CAM practice. After participating in a tailored BI training, CAM practitioners reported increased confidence, knowledge, and motivation to address tobacco in their routine practice. Patients were open to being approached by CAM practitioners about tobacco use and viewed BIs as an expected part of wellness care. Tailored training motivated CAM practitioners in this study to implement evidence-based tobacco cessation BIs in their routine practice. Results suggest that CAM practitioners can be a valuable point of contact and should be included in tobacco cessation efforts.

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.

Corporate Wellness Programs: Implementation Challenges in the Modern American Workplace

Directory of Open Access Journals (Sweden)

Bahaudin G. Mujtaba

2013-01-01

Full Text Available Being healthy is important for living well and achieving longevity. In the business realm, furthermore, employers want healthy employees, as these workers tend to be more productive, have fewer rates of absenteeism, and use less of their health insurance resources. This article provides an overview of corporate “wellness” efforts in the American workplace and the concomitant challenges which employers will confront in implementing these programs. Consequently, employers and managers must reflect upon wellness policies and objectives, consult with professionals, and discuss the ramifications thereof prior to implementation. The authors herein explore how employers are implementing policies that provide incentives to employees who lead “healthy” lifestyles as well as ones that impose costs on employees who lead “unhealthy” lifestyles.The distinctive contribution of this article is that it proactively explores wellness program implementation challenges and also supplies “best practices” in the modern workplace, so employers can be better prepared when they promulgate wellness policies, and then take practical steps to help their employees become healthier and thereby help to reduce insurance costs. The article, moreover, addresses how wellness policy incentives—in the form of “carrots” as well as penalties—in the form of “sticks” could affect employees, especially “non-healthy” employees, as well as employers, particularly legally. Based on the aforementioned challenges, the authors make practical recommendations for employers and managers, so that they can fashion and implement wellness policies that are deemed to be legal, ethical, and efficacious.

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

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.

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.

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 $1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Putting program evaluation into practice: enhancing the Girls Just Wanna Have Fun program.

Science.gov (United States)

Bean, Corliss N; Kendellen, Kelsey; Halsall, Tanya; Forneris, Tanya

2015-04-01

In recent years there has been a call for increased community physical activity and sport programs for female youth that are deliberately structured to foster positive developmental outcomes. In addition, researchers have recognized the need to empirically evaluate such programs to ensure that youth are provided with optimal opportunities to thrive. This study represents a utilization-focused evaluation of Girls Just Wanna Have Fun, a female-only physical activity-based life skills community program. A utilization-focused evaluation is particularly important when the evaluation is to help stakeholders utilize the findings in practice. The purpose of this study was twofold: (a) to gain an understanding of the ongoing successes and challenges after year two of program implementation and (b) to examine how the adaptations made based on feedback from the first year evaluation were perceived as impacting the program. From interviews with youth participants and program leaders, three main themes with eight sub-themes emerged. The main themes were: (a) applying lessons learned can make a significant difference, (b) continually implementing successful strategies, and (c) ongoing challenges. Overall, this evaluation represents an important step in understanding how to improve program delivery to better meet the needs of the participants in community-based programming. Copyright © 2014 Elsevier Ltd. All rights reserved.

Drug use prevention: factors associated with program implementation in Brazilian urban schools.

Science.gov (United States)

Pereira, Ana Paula Dias; Sanchez, Zila M

2018-03-07

A school is a learning environment that contributes to the construction of personal values, beliefs, habits and lifestyles, provide convenient settings for the implementation of drug use prevention programs targeting adolescents, who are the population group at highest risk of initiating drug use. The objective of the present study was to investigate the prevalence of factors associated with implementing drug use prevention programs in Brazilian public and private middle and high urban schools. The present population-based cross-sectional survey was conducted with a probability sample of 1151 school administrators stratified by the 5 Brazilian administrative divisions, in 2014. A close-ended, self-reported online questionnaire was used. Logistic regression analysis was used to identify factors associated with implementing drug use prevention programs in schools. A total of 51.1% of the schools had adopted drug use prevention programs. The factors associated with program implementation were as follows: belonging to the public school network; having a library; development of activities targeting sexuality; development of "Health at School Program" activities; offering extracurricular activities; and having an administrator that participated in training courses on drugs. The adoption of drug use prevention practices in Brazilian schools may be expanded with greater orchestration of schools through specialized training of administrators and teachers, expansion of the School Health Program and concomitant development of the schools' structural and curricular attributes.

Implementing corporate wellness programs: a business approach to program planning.

Science.gov (United States)

Helmer, D C; Dunn, L M; Eaton, K; Macedonio, C; Lubritz, L

1995-11-01

1. Support of key decision makers is critical to the successful implementation of a corporate wellness program. Therefore, the program implementation plan must be communicated in a format and language readily understood by business people. 2. A business approach to corporate wellness program planning provides a standardized way to communicate the implementation plan. 3. A business approach incorporates the program planning components in a format that ranges from general to specific. This approach allows for flexibility and responsiveness to changes in program planning. 4. Components of the business approach are the executive summary, purpose, background, ground rules, approach, requirements, scope of work, schedule, and financials.

Implementing shared decision making in federally qualified health centers, a quasi-experimental design study: the Office-Guidelines Applied to Practice (Office-GAP) program

OpenAIRE

Olomu, Adesuwa; Hart-Davidson, William; Luo, Zhehui; Kelly-Blake, Karen; Holmes-Rovner, Margaret

2016-01-01

Background Use of Shared Decision-Making (SDM) and Decision Aids (DAs) has been encouraged but is not regularly implemented in primary care. The Office-Guidelines Applied to Practice (Office-GAP) intervention is an application of a previous model revised to address guidelines based care for low-income populations with diabetes and coronary heart disease (CHD). Objective: To evaluate Office-GAP Program feasibility and preliminary efficacy on medication use, patient satisfaction with physician ...

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 ...

Practical C programming

CERN Document Server

Oualline, Steve

1997-01-01

There are lots of introductory C books, but this is the first one that has the no-nonsense, practical approach that has made Nutshell Handbooks® famous. C programming is more than just getting the syntax right. Style and debugging also play a tremendous part in creating programs that run well and are easy to maintain. This book teaches you not only the mechanics of programming, but also describes how to create programs that are easy to read, debug, and update. Practical rules are stressed. For example, there are fifteen precedence rules in C (&& comes before || comes before ?:). The practi

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…

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

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...

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.

A Practical Approach to Implementing the Core Competencies in a Child and Adolescent Psychiatry Residency Program

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Dingle, Arden D.; Sexson, Sandra B.

2007-01-01

Objective: The authors describe the development and implementation of the Accreditation Council for Graduate Medical Education's core competencies in a child and adolescent psychiatry residency program. Method: The authors identify the program's organizational approach and participants and detail various strategies and methods of defining,…

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…

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

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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.

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

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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.

Getting to uptake: do communities of practice support the implementation of evidence-based practice?

Science.gov (United States)

Barwick, Melanie A; Peters, Julia; Boydell, Katherine

2009-02-01

Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

Implementing an Employee Assistance Program.

Science.gov (United States)

Gam, John; And Others

1983-01-01

Describes in detail the implementation of an employee assistance program in a textile plant. Reviews the historical development, referral process, and termination guidelines of the program and contains descriptive statistics for six periods of the program's operation. (Author/JAC)

Closing the Research-Practice Gap: Factors Affecting Adoption and Implementation of a Children's Mental Health Program

Science.gov (United States)

Henderson, Joanna L.; MacKay, Sherri; Peterson-Badali, Michele

2006-01-01

Despite the availability of effective interventions, they are not widely used in community mental health centers. This study examined the adoption and implementation of The Arson Prevention Program for Children (TAPP-C), a program for juvenile firesetters developed at a teaching hospital and disseminated to community settings. Questionnaire data…

How GPs implement clinical guidelines in everyday clinical practice

DEFF Research Database (Denmark)

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

2015-01-01

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....... 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...

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

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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.

The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.

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Coulam, Robert; Kralewski, John; Dowd, Bryan; Gans, David

2016-01-01

Although there are numerous studies of the factors influencing the adoption of quality assurance (QA) programs by medical group practices, few have focused on the role of group practice administrators. To gain insights into the role these administrators play in QA programs, we analyzed how medical practices adopted and implemented the Medicare Physician Quality Reporting System (PQRS), the largest physician quality reporting system in the United States. We conducted focus group interviews in 2011 with a national convenience sample of 76 medical group practice administrators. Responses were organized and analyzed using the innovation decision framework of Van de Ven and colleagues. Administrators conducted due diligence on PQRS, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations. Virtually, all who attempted it agreed that PQRS was straightforward to implement. However, the complexities of Medicare's PQRS reports impeded use of the data by administrators to support quality management. Group practice administrators are playing a prominent role in activities related to the quality of patient care--they are not limited to the business side of the practice. Especially, as PQRS becomes more nearly universal after 2014, Medicare should take account of the role that administrators play, by more actively engaging administrators in shaping these programs and making it easier for administrators to use the results. More research is needed on the rapidly evolving role of nonphysician administration in medical group practices. Practice administrators have a larger role than commonly understood in how quality reporting initiatives are adopted and used and are in an exceptional position to influence the more appropriate use of these resources if

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

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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.

Implementation and Outcomes of a Comprehensive Type 2 Diabetes Program in Rural Guatemala.

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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.

Implementing Evidence-Based Practices for People With Schizophrenia

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Drake, Robert E.; Bond, Gary R.; Essock, Susan M.

2009-01-01

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions. PMID:19491315

The Cascading Effects of Multiple Dimensions of Implementation on Program Outcomes: a Test of a Theoretical Model.

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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.

Identification of major factors in Australian primary care pharmacists' practice environment that have a bearing on the implementation of professional models of practice.

Science.gov (United States)

Jackson, John K; Hussainy, Safeera Y; Kirkpatrick, Carl M J

2017-08-01

practice, correlate well with the enabling factors identified in the profession's vision statement, with the addition of three factors in the Environmental domain of stakeholder attitudes, health system reform and external competition. What is known about the topic? The extensive range of patient-focused professional programs developed for application by pharmacists in primary care in Australia has yet to be widely implemented. What does this paper add? Factors both within and beyond the pharmacists' immediate practice environment that have a bearing on the uptake of professional programs have been identified and prioritised using a structured thematic approach. What are the implications for practitioners? The results demonstrate the need for a multifactorial approach to the implementation of professional models of practice in this setting.

Project of program law relative to the implementation of the 'Grenelle de l'environnement' program

International Nuclear Information System (INIS)

2008-01-01

The 'Grenelle de l'environnement' is a sustainable development program launched by the French government and which involves together the government and representatives of the civil society in order to elaborate an action plan with concrete measures in favor of the environment. The program is based on four steps. The first step is the creation of six working groups aiming at taking up the following challenges: fighting against climate change and controlling energy demand; preserving biodiversity and natural resources; establishing a healthy environment; adopting sustainable production and consumption practices (agriculture, fishing, food industry, forestry etc); building up an ecological democracy: institutions and governance; and promoting ecological development practices favorable to competitiveness and employment. The three other steps are: the consultation of public authorities, the negotiations between the government and representatives of the local authorities, of the non-governmental organisations, of the employers and of the employees, and finally, the implementation of commitments. This project of program law faithfully summarizes the commitments of the Grenelle, and precises and completes some of the choices according to the proposals of the operational committees. (J.S.)

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.

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.

Implementation of customized health information technology in diabetes self management programs.

Science.gov (United States)

Alexander, Susan; Frith, Karen H; O'Keefe, Louise; Hennigan, Michael A

2011-01-01

The project was a nurse-led implementation of a software application, designed to combine clinical and demographic records for a diabetes education program, which would result in secure, long-term record storage. Clinical information systems may be prohibitively expensive for small practices and require extensive training for implementation. A review of the literature suggests that the use of simple, practice-based registries offer an economical method of monitoring the outcomes of diabetic patients. The database was designed using a common software application, Microsoft Access. The theory used to guide implementation and staff training was Rogers' Diffusion of Innovations theory (1995). Outcomes after a 3-month period included incorporation of 100% of new clinical and demographic patient records into the database and positive changes in staff attitudes regarding software applications used in diabetes self-management training. These objectives were met while keeping project costs under budgeted amounts. As a function of the clinical nurse specialist (CNS) researcher role, there is a need for CNSs to identify innovative and economical methods of data collection. The success of this nurse-led project reinforces suggestions in the literature for less costly methods of data maintenance in small practice settings. Ongoing utilization and enhancement have resulted in the creation of a robust database that could aid in the research of multiple clinical issues. Clinical nurse specialists can use existing evidence to guide and improve both their own practice and outcomes for patients and organizations. Further research regarding specific factors that predict efficient transition of informatics applications, how these factors vary according to practice settings, and the role of the CNS in implementation of such applications is needed.

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.

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

Science.gov (United States)

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

2017-11-29

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

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

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.

Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis.

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Aarons, Gregory A; Wells, Rebecca S; Zagursky, Karen; Fettes, Danielle L; Palinkas, Lawrence A

2009-11-01

We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.

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.

Teaching implementation science in a new Master of Science Program in Germany: a survey of stakeholder expectations.

Science.gov (United States)

Ullrich, Charlotte; Mahler, Cornelia; Forstner, Johanna; Szecsenyi, Joachim; Wensing, Michel

2017-04-27

Implementation science in healthcare is an evolving discipline in German-speaking countries. In 2015, the Medical Faculty of the University of Heidelberg, Germany, implemented a two-year full-time Master of Science program Health Services Research and Implementation Science. The curriculum introduces implementation science in the context of a broader program that also covers health services research, healthcare systems, research methods, and generic academic skills. Our aim was to assess the expectations of different stakeholder groups regarding the master's program. An online survey listing desired competencies of prospective graduates was developed and administered to four groups: national experts in the field (including potential employers of graduates), teaching staff, enrolled students, and prospective students (N = 169). Competencies were extracted from the curriculum's module handbook. A five-point Likert scale was used for the assessment of 42 specific items. Data were analyzed descriptively. A total of 83 people participated in the survey (response rate 49%). The online survey showed a strong agreement across the groups concerning the desired competencies of graduates. About two-thirds of the listed competencies (27 items) were felt to be crucial or very important by 80% or more of participants, with little difference between stakeholder groups. Of the eight items specifically related to implementation in practice, six were in this category. Knowledge of implementation strategies (90% very important), knowledge of barriers and enablers of implementation (89%), and knowledge of evidence-based practice (89%) were the top priorities. The master's program is largely orientated towards the desired competencies of graduates according to students, teaching staff, and national experts.

PRACTICE OF DRAFTING AND IMPLEMENTING OF FINANCING PROJECTS IN NON-FORMAL EDUCATION

Directory of Open Access Journals (Sweden)

BUZOIANU Daniela Angela

2015-06-01

Full Text Available In Petroleum and Gas University, besides teaching and research activities, a priority is non-formal education area. In the academic center of Ploiesti, the activities of non-formal education take place through Center for Porjects, Programs and Cultural - Artistic events (CPPECA and Student’s Culture House, located in the University campus (CCS. The mission of the Center for Projects, Programs and Cultural - Artistic events and Student’s Culture House is: - To offer a big diversity of activities in non-formal education area for students and teachers; - To become an essential and defining pillar in continous formation of young people. The purpose is to promote excellence also in non-formal education fied , starting from the value and tradition of university education in Romanian oil area The Center for Project, Programs and Cultural - Artistic events (CPPECA and Student’s House of Culture have: • An educational function; • A real multidirectional cultural vocation through: - initiating,implementing and developing cultural projects and programs; - organizing and developing specific events like shows, festivals, national and international contests. The paper presents practical aspects in development and implementation of financing projects in non-formal education field.

Factors influencing the quality of implementation of a positive youth development program in Hong Kong.

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Shek, Daniel T L; Law, Moon Y M

2013-01-01

This study examines how social workers collaborate with school teachers in implementing a school-based positive youth development program in Hong Kong. Individual and focus group interviews are conducted with social workers cooperating with school teachers in implementing the Project P.A.T.H.S. in a school context. Through the interviews, strategies for establishing inter-disciplinary collaboration and factors that hinder or facilitate program implementation are identified. This case study highlights factors that facilitate the collaboration between social workers and school teachers, including the following: 1) sufficient training for instructors, 2) sharing of the practice wisdom and teaching experiences, 3) building up mutual support among different parties, 4) use of proactive communication, and 5) demonstration of self-disclosure.

Implementing human factors in clinical practice

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

2015-01-01

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 received aviation-derived human factors training. Results The human factors training was evaluated positively, and thought to be both acceptable and relevant to practice. However, the staff found it harder to implement what they had learned in their own clinical areas, and this was principally attributed to features of the informal organisational cultures. Conclusions In order to successfully apply human factors approaches in hospital, careful consideration needs to be given to the local context and informal culture of clinical practice. PMID:24631959

Implementation of evidence-based knowledge in general practice.

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Le, Jette Videbæk

2017-12-01

Background Keeping up with the evidence and implementing it into the daily care for patients are fundamental prerequisites for delivering a high quality of care in general practice. However, despite many years of research into dissemination and implementation of evidence-based recommendations, significant challenges remain. In recent years, organisational factors have become widely acknowledged as vitally important for ensuring successful implementation. Further knowledge is needed to understand more about which factors affect the seeking and implementation of evidence-based knowledge in general practice. Aim The overall aim was to investigate how evidence-based knowledge is sought and implemented in general practice and to analyse associations with GP characteristics and quality of care. Three separate studies, each covering a specific part of the overall aim, were undertaken: I. To examine how GPs implement clinical practice guidelines in everyday clinical practice, and how implementation approaches differ between practices. II. To assess GPs’ information seeking behaviour with regard to the use and perceived importance of scientific medical information sources and to investigate associations with GP characteristics. III. To investigate if there are associations between specific formalised implementation activities within general practice and quality of care – exemplified by the use of spirometry testing among first-time users of medication against obstructive lung diseases. Methods The study was designed as a mixed methods study combining qualitative interviews, questionnaire and register data. Study I was a qualitative interview study that involved purposefully selected GPs representing seven different practices. The interviews were analysed using systematic text condensation, and results were used to qualify the development of a national survey of general practitioners regarding their seeking and implementation of evidence-based knowledge. This survey was

IAEA's Safeguards Implementation Practices Guides

International Nuclear Information System (INIS)

Mathews, C.; Sahar, S.; Cisar, V.

2015-01-01

Implementation of IAEA safeguards benefits greatly from effective cooperation among the IAEA, State or regional authorities (SRAs), and operators of facilities and other locations. To improve such cooperation, the IAEA has produced numerous safeguards guidance documents in its Services Series publications. The IAEA also provides assistance, training and advisory services that are based on the published guidance. The foundation of the IAEA's safeguards guidance is the Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols (IAEA Services Series 21) published in March of 2012. The large majority of States have concluded CSAs and therefore will benefit from this guidance. Many States with CSAs also have concluded small quantities protocols (SQPs) to their CSAs. In April of 2013, the IAEA published the Safeguards Implementation Guide for States with SQPs (IAEA Services Series 22). Other guidance focuses on specific topics such as preparing additional protocol declarations and nuclear material accounting. This paper will describe a recent effort to produce a ''Safeguards Implementation Practices'' (SIP) series of guides that will provide additional explanatory information about safeguards implementation, and share the practical experiences and lessons learned of States and the IAEA over the many decades of implementing safeguards. The topics to be addressed in four SIP guides include: 1) Facilitating IAEA Verification Activities; 2) Establishing and Maintaining State Safeguards Infrastructure; 3) Provision of Information to the IAEA; and 4) Collaborative Approaches to Safeguards Implementation. The SIP Guides build upon the content of IAEA Services Series 21. Because the SIP Guides are intended to share implementation practices and lessons learned of States, a number of experienced State experts have participated in the development of the documents, through a joint Member State Support Programme task

The Educational Programs Audit Dress Rehearsal; Paradigm One: Practice Makes Perfect or How a New Approach to the Audit Helps Programs Succeed.

Science.gov (United States)

Pfeffer, Eileen; Kester, Donald L.

Described is a procedure (Audit Dress Rehearsal) used in a special education program audit consultation service which included a practice audit designed to lower anxiety and raise awareness of concern for program success. The introduction includes sections dealing with evaluation and audit personnel, planning and implementing an audit, and stages…

Development, implementation and evaluation of an evidence-based program for introduction of new health technologies and clinical practices in a local healthcare setting.

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Harris, Claire; Garrubba, Marie; Allen, Kelly; King, Richard; Kelly, Cate; Thiagarajan, Malar; Castleman, Beverley; Ramsey, Wayne; Farjou, Dina

2015-12-28

This paper reports the process of establishing a transparent, accountable, evidence-based program for introduction of new technologies and clinical practices (TCPs) in a large Australian healthcare network. Many countries have robust evidence-based processes for assessment of new TCPs at national level. However many decisions are made by local health services where the resources and expertise to undertake health technology assessment (HTA) are limited and a lack of structure, process and transparency has been reported. An evidence-based model for process change was used to establish the program. Evidence from research and local data, experience of health service staff and consumer perspectives were incorporated at each of four steps: identifying the need for change, developing a proposal, implementation and evaluation. Checklists assessing characteristics of success, factors for sustainability and barriers and enablers were applied and implementation strategies were based on these findings. Quantitative and qualitative methods were used for process and outcome evaluation. An action research approach underpinned ongoing refinement to systems, processes and resources. A Best Practice Guide developed from the literature and stakeholder consultation identified seven program components: Governance, Decision-Making, Application Process, Monitoring and Reporting, Resources, Administration, and Evaluation and Quality Improvement. The aims of transparency and accountability were achieved. The processes are explicit, decisions published, outcomes recorded and activities reported. The aim of ascertaining rigorous evidence-based information for decision-making was not achieved in all cases. Applicants proposing new TCPs provided the evidence from research literature and local data however the information was often incorrect or inadequate, overestimating benefits and underestimating costs. Due to these limitations the initial application process was replaced by an Expression of

Implementing Comprehensive Reform: Implications for Practice

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Stout, Karen A.

2016-01-01

This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.

The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model

OpenAIRE

Moore, Julia E.; Grouchy, Michelle; Graham, Ian D.; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E.

2016-01-01

Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. F...

Implementing a collaborative return-to-work program: Lessons from a qualitative study in a large Canadian healthcare organization.

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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.

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.

Bridging the Gap between Research and Practice: Implementation Science

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Olswang, Lesley B.; Prelock, Patricia A.

2015-01-01

Purpose: This article introduces implementation science, which focuses on research methods that promote the systematic application of research findings to practice. Method: The narrative defines implementation science and highlights the importance of moving research along the pipeline from basic science to practice as one way to facilitate…

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

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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.

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.

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.

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.

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.

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

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 and a lineari......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...... on pilot plant equipment on the department of Chemical Engineering DTU Lyngby....

Westinghouse Hanford Company Pollution Prevention Program Implementation Plan

International Nuclear Information System (INIS)

Floyd, B.C.

1994-10-01

This plan documents Westinghouse Hanford Company's (WHC) Pollution Prevention (P2) (formerly Waste Minimization) program. The program includes WHC; BCS Richland, Inc. (BCSR); and ICF Kaiser Hanford Company (ICF KH). The plan specifies P2 program activities and schedules for implementing the Hanford Site Waste Minimization and Pollution Prevention Awareness (WMin/P2) Program Plan requirements (DOE 1994a). It is intended to satisfy the U.S. Department of Energy (DOE) and other legal requirements that are discussed in both the Hanford Site WMin/P2 plan and paragraph C of this plan. As such, the Pollution Prevention Awareness Program required by DOE Order 5400.1 (DOE 1988) is included in the WHC P2 program. WHC, BCSR, and ICF KH are committed to implementing an effective P2 program as identified in the Hanford Site WMin/P2 Plan. This plan provides specific information on how the WHC P2 program will develop and implement the goals, activities, and budget needed to accomplish this. The emphasis has been to provide detailed planning of the WHC P2 program activities over the next 3 years. The plan will guide the development and implementation of the program. The plan also provides background information on past program activities. Because the plan contains greater detail than in the past, activity scope and implementation schedules may change as new priorities are identified and new approaches are developed and realized. Some activities will be accelerated, others may be delayed; however, all of the general program elements identified in this plan and contractor requirements identified in the Site WMin/P2 plan will be developed and implemented during the next 3 years. This plan applies to all WHC, BCSR, and ICF KH organizations and subcontractors. It will be distributed to those with defined responsibilities in this plan; and the policy, goals, objectives, and strategy of the program will be communicated to all WHC, BCSR, and ICF KH employees

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

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.

Cost basis for implementing ALARA programs

International Nuclear Information System (INIS)

Kent, C.E.

1985-01-01

A method of implementing effective ALARA programs is discussed. A basic element of the cost benefit methodology is the valuation of a man-rem. In the program, this is derived from an assessment of radiation exposure risk and societal valuation of harmful effects. The man-rem value is used as an element in the cost benefit analysis. The analysis includes an assessment of the differential man-rem resulting from the action, implementation cost, and operational savings

Intersectorality in the 'Health in Schools' Program: an evaluation of the political-management process and working practices.

Science.gov (United States)

Sousa, Marta Caires de; Esperidião, Monique Azevedo; Medina, Maria Guadalupe

2017-06-01

This study analyzed inter-sectoral activities between the health and education sectors in implementing the Health in Schools program in a city within a metropolitan region in northeast Brazil. Analysis of the political-management process looked at the following dimensions: professional practices and subject understanding of intersectorality. The results show that subjects define intersectorality as partnership and joint efforts. Regarding decision making and resource mobilization, during program implementation we noticed that healthcare leads, and education tends to play a more peripheral role. Health activities in the schools use a biomedical approach and primarily consist of lectures. We believe that the program strengthened the relationship between these two sectors. However, intersectoral coordination in the political-management process and practices show weaknesses and limitations.

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.

A System for Individualizing Instruction. Practical Answers to U-SAIL Implementation Questions. Monograph No. 4.

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Utah System Approach to Individualized Learning Project.

The U-SAIL system is a practical approach to individualization of instruction in which a problem-solving process is employed to install a program in logical sequential phases. U-SAIL is a nationally validated, successfully replicated, cost-feasible system for individualization of instruction which can be implemented in a variety of settings with…

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

OpenAIRE

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 here is: what combinations of background factors and implementation strategies lead to successful implementations in health care? Methods: Sources for this study are evaluations of 72 completed imple...

Johnson and Johnson strives to implement best practices by year 2000

International Nuclear Information System (INIS)

Kauffman, H.A.

1999-01-01

Johnson and Johnson is the world's most comprehensive broadly-based manufacturer of health care products. Utilizing a decentralized management philosophy, the 188 operating companies around the world operate independently. Although Johnson and Johnson is not an energy intensive company, it has had a coordinated energy program since 1972. In the 1990s, however, a renewed focus, prompted by the link between energy usage and pollution, led to some very aggressive energy reduction goals to be completed by the end of the year 2000. To assist the operating companies in meeting these goals. a comprehensive set of Best Practices was developed. They cover all facility energy-using equipment and maintenance practices. Inputs included projects completed at Johnson and Johnson facilities worldwide, best practices from several US government voluntary programs, and recommendations from consultants and engineering firms. The end product is now being used worldwide to benchmark the progress. To ensure that these Best Practices are incorporated into new construction as well as the existing facilities, the authors developed their New Facility Design Criteria which is in the format that architectural/engineering firms can easily utilize. They originally validated the Best Practices in two retrofit pilots and two new buildings. They all achieved significant energy savings. As of April 1999, they have completed 62% of the Best Practices at the 96 facilities in the US and Puerto Rico. Twenty-four of these facilities had achieved an 80% completion level in 1998 and were recognized with the internal recognition plaque. Through full implementation of these Best Practices, Johnson and Johnson feel confident that they will be able to meet the Year 2000 energy reduction goals

Implementing shared decision making in federally qualified health centers, a quasi-experimental design study: the Office-Guidelines Applied to Practice (Office-GAP) program.

Science.gov (United States)

Olomu, Adesuwa; Hart-Davidson, William; Luo, Zhehui; Kelly-Blake, Karen; Holmes-Rovner, Margaret

2016-08-02

Use of Shared Decision-Making (SDM) and Decision Aids (DAs) has been encouraged but is not regularly implemented in primary care. The Office-Guidelines Applied to Practice (Office-GAP) intervention is an application of a previous model revised to address guidelines based care for low-income populations with diabetes and coronary heart disease (CHD). To evaluate Office-GAP Program feasibility and preliminary efficacy on medication use, patient satisfaction with physician communication and confidence in decision in low-income population with diabetes and coronary heart disease (CHD) in a Federally Qualified Healthcare Center (FQHC). Ninety-five patients participated in an Office-GAP program. A quasi-experimental design study, over 6 months with 12-month follow-up. Office-GAP program integrates health literacy, communication skills education for patients and physicians, patient/physician decision support tools and SDM into routine care. 1) Implementation rates of planned program elements 2) Patient satisfaction with communication and confidence in decision, and 3) Medication prescription rates. We used the GEE method for hierarchical logistic models, controlling for confounding. Feasibility of the Office-GAP program in the FQHC setting was established. We found significant increase in use of Aspirin/Plavix, statin and beta-blocker during follow-up compared to baseline: Aspirin OR 1.5 (95 % CI: 1.1, 2.2) at 3-months, 1.9 (1.3, 2.9) at 6-months, and 1.8 (1.2, 2.8) at 12-months. Statin OR 1.1 (1.0, 1.3) at 3-months and 1.5 (1.1, 2.2) at 12-months; beta-blocker 1.8 (1.1, 2.9) at 6-months and 12-months. Program elements were consistently used (≥ 98 % clinic attendance at training and tool used). Patient satisfaction with communication and confidence in decision increased. The use of Office-GAP program to teach SDM and use of DAs in real time was demonstrated to be feasible in FQHCs. It has the potential to improve satisfaction with physician communication and

Implementation of a Radiological Safety Coach program

Energy Technology Data Exchange (ETDEWEB)

Konzen, K.K. [Safe Sites of Colorado, Golden, CO (United States). Rocky Flats Environmental Technology Site; Langsted, J.M. [M.H. Chew and Associates, Golden, CO (United States)

1998-02-01

The Safe Sites of Colorado Radiological Safety program has implemented a Safety Coach position, responsible for mentoring workers and line management by providing effective on-the-job radiological skills training and explanation of the rational for radiological safety requirements. This position is significantly different from a traditional classroom instructor or a facility health physicist, and provides workers with a level of radiological safety guidance not routinely provided by typical training programs. Implementation of this position presents a challenge in providing effective instruction, requiring rapport with the radiological worker not typically developed in the routine radiological training environment. The value of this unique training is discussed in perspective with cost-savings through better radiological control. Measures of success were developed to quantify program performance and providing a realistic picture of the benefits of providing one-on-one or small group training. This paper provides a description of the unique features of the program, measures of success for the program, a formula for implementing this program at other facilities, and a strong argument for the success (or failure) of the program in a time of increased radiological safety emphasis and reduced radiological safety budgets.

Implementation of a Radiological Safety Coach program

International Nuclear Information System (INIS)

Konzen, K.K.

1998-01-01

The Safe Sites of Colorado Radiological Safety program has implemented a Safety Coach position, responsible for mentoring workers and line management by providing effective on-the-job radiological skills training and explanation of the rational for radiological safety requirements. This position is significantly different from a traditional classroom instructor or a facility health physicist, and provides workers with a level of radiological safety guidance not routinely provided by typical training programs. Implementation of this position presents a challenge in providing effective instruction, requiring rapport with the radiological worker not typically developed in the routine radiological training environment. The value of this unique training is discussed in perspective with cost-savings through better radiological control. Measures of success were developed to quantify program performance and providing a realistic picture of the benefits of providing one-on-one or small group training. This paper provides a description of the unique features of the program, measures of success for the program, a formula for implementing this program at other facilities, and a strong argument for the success (or failure) of the program in a time of increased radiological safety emphasis and reduced radiological safety budgets

IMPLEMENTATION OF A SAFETY PROGRAM FOR THE WORK ACCIDENTS’ CONTROL. A CASE STUDY IN THE CHEMICAL INDUSTRY

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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.

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.

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.

Implementing human factors in clinical practice.

Science.gov (United States)

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

2015-05-01

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. 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 received aviation-derived human factors training. The human factors training was evaluated positively, and thought to be both acceptable and relevant to practice. However, the staff found it harder to implement what they had learned in their own clinical areas, and this was principally attributed to features of the informal organisational cultures. In order to successfully apply human factors approaches in hospital, careful consideration needs to be given to the local context and informal culture of clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Using systematized tacit knowledge to prioritize implementation challenges in existing maternal health programs: implications for the post MDG era.

Science.gov (United States)

Becerril-Montekio, Victor; Alcalde-Rabanal, Jacqueline; Darney, Blair G; Orozco-Nuñez, Emanuel

2016-10-01

Strategic priority setting and implementation of strategies to reduce maternal mortality are key to the post Millennium Development Goal (MDG) 2015 agenda. This article highlights the feasibility and the advantages of using a systematized tacit knowledge approach, using data from maternal health program personnel, to identify local challenges to implementing policies and programs to inform the post MDG era. Communities of practice, conceived as groups of people sharing professional interests, experiences and knowledge, were formed with diverse health personnel implementing maternal health programs in Mexico and Nicaragua. Participants attended several workshops and developed different online activities aiming to strengthen their capacities to acquire, analyze, adapt and apply research results and to systematize their experience and knowledge of the actual implementation of these programs. Concept mapping, a general method designed to organize and depict the ideas of a group on a particular topic, was used to manage, discuss and systematize their tacit knowledge about implementation problems of the programs they work in. Using a special online concept mapping platform, participants prioritized implementation problems by sorting them in conceptual clusters and rating their importance and feasibility of solution. Two hundred and thirty-one participants from three communities of practice in each country registered on the online concept mapping platform and 200 people satisfactorily completed the sorting and rating activities. Participants further discussed these results to prioritize the implementation problems of maternal health programs. Our main finding was a great similarity between the Mexican and the Nicaraguan general results highlighting the importance and the feasibility of solution of implementation problems related to the quality of healthcare. The use of rigorously organized tacit knowledge of health personnel proved to be a feasible and useful tool for

Safe Patient Handling and Mobility: Development and Implementation of a Large-Scale Education Program.

Science.gov (United States)

Lee, Corinne; Knight, Suzanne W; Smith, Sharon L; Nagle, Dorothy J; DeVries, Lori

This article addresses the development, implementation, and evaluation of an education program for safe patient handling and mobility at a large academic medical center. The ultimate goal of the program was to increase safety during patient mobility/transfer and reduce nursing staff injury from lifting/pulling. This comprehensive program was designed on the basis of the principles of prework, application, and support at the point of care. A combination of online learning, demonstration, skill evaluation, and coaching at the point of care was used to achieve the goal. Specific roles and responsibilities were developed to facilitate implementation. It took 17 master trainers, 88 certified trainers, 176 unit-based trainers, and 98 coaches to put 3706 nurses and nursing assistants through the program. Evaluations indicated both an increase in knowledge about safe patient handling and an increased ability to safely mobilize patients. The challenge now is sustainability of safe patient-handling practices and the growth and development of trainers and coaches.

A practical guide for implementing and maintaining value-added clinical systems learning roles for medical students using a diffusion of innovations framework.

Science.gov (United States)

Gonzalo, Jed D; Graaf, Deanna; Ahluwalia, Amarpreet; Wolpaw, Dan R; Thompson, Britta M

2018-03-21

After emphasizing biomedical and clinical sciences for over a century, US medical schools are expanding experiential roles that allow students to learn about health care delivery while also adding value to patient care. After developing a program where all 1st-year medical students are integrated into interprofessional care teams to contribute to patient care, authors use a diffusion of innovations framework to explore and identify barriers, facilitators, and best practices for implementing value-added clinical systems learning roles. In 2016, authors conducted 32 clinical-site observations, 29 1:1 interviews with mentors, and four student focus-group interviews. Data were transcribed verbatim, and a thematic analysis was used to identify themes. Authors discussed drafts of the categorization scheme, and agreed upon results and quotations. Of 36 sites implementing the program, 17 (47%) remained, 8 (22%) significantly modified, and 11 (31%) withdrew from the program. Identified strategies for implementing value-added roles included: student education, patient characteristics, patient selection methods, activities performed, and resources. Six themes influencing program implementation and maintenance included: (1) educational benefit, (2) value added to patient care from student work, (3) mentor time and site capacity, (4) student engagement, (5) working relationship between school, site, and students, and, (6) students' continuity at the site. Health systems science is an emerging focus for medical schools, and educators are challenged to design practice-based roles that enhance education and add value to patient care. Health professions' schools implementing value-added roles will need to invest resources and strategize about best-practice strategies to guide efforts.

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.

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

The use of collaboration to implement evidence-based safe practices.

Science.gov (United States)

Clarke, John R

2013-12-01

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year. Significance for public healthSince the Institute of Medicine's To Err is Human identified medical errors as a major cause of death, the public has been interested in the recommendations for reporting of medical errors and implementing safe systems for the delivery of healthcare. The Commonwealth of Pennsylvania has followed those recommendations and found that an essential intermediate step between analysing reports and implementing safe systems is collaborative learning among healthcare institutions. The experience in Pennsylvania should be useful to other public organizations wishing to improve safety.

Health workers' views of a program to facilitate physical health care in mental health settings: implications for implementation and training.

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Baker, Wendy; Harris, Melanie; Battersby, Malcolm

2014-12-01

Physical comorbidities shorten the lifespan of people with severe mental illness therefore mental health clinicians need to support service users in risk factor-related behaviour change. We investigated mental health care workers' views of a physical health self-management support program in order to identify implementation requirements. Qualitative interviews were conducted with workers who had differing levels of experience with a self-management support program. Themes were identified using interpretive descriptive analysis and then matched against domains used in implementation models to draw implications for successful practice change. Three main themes emerged related to: (1) understandings of disease management within job roles; (2) requirements for putting self-management support into practice; and (3) challenges of coordination in disease management. Priority domains from implementation models were inner and outer health service settings. While staff training is required, practice change for care which takes account of both mental and physical health also requires changes in organisational frameworks. © The Royal Australian and New Zealand College of Psychiatrists 2014.

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

Implementation of the safety assessment in the practice of industrial radiography

International Nuclear Information System (INIS)

Alfonso Pallarés, C.; Pérez Reyes, Y.

2015-01-01

The CNSN as regulatory authority has regulatory control processes based on regulations, permits, inspections and limitation to ensure the supervision and control of the practice of industrial radiography. On the other hand in the light of the new regulations approved and being implemented such as: Resolution 334/2011 CITMA 'Regulation on Notification and authorization of practices and activities associated with the use of ionizing radiation sources' and Resolution 17 / 2012, Security Guide: Security Assessment Practices and Activities associated with the use of ionizing radiation (recommendatory), it is necessary for compliance with regulatory requirements concerning the safety assessment. Since 2009 it has been applied this experience in different medical practices and industry, providing a systematic and consistent basis, to the safety assessment of all facilities and activities, which has helped increase the confidence that has been achieved an adequate level of security. The work was able to identify that there is a group of barriers operating in the risk reduction in various accident sequences and therefore have a relative importance in risk reduction, recommendations in this regard to improve the program management of safety in the practice of industrial radiography. [es

Implementation of pharmacogenetics: the University of Maryland Personalized Anti-platelet Pharmacogenetics Program.

Science.gov (United States)

Shuldiner, Alan R; Palmer, Kathleen; Pakyz, Ruth E; Alestock, Tameka D; Maloney, Kristin A; O'Neill, Courtney; Bhatty, Shaun; Schub, Jamie; Overby, Casey Lynnette; Horenstein, Richard B; Pollin, Toni I; Kelemen, Mark D; Beitelshees, Amber L; Robinson, Shawn W; Blitzer, Miriam G; McArdle, Patrick F; Brown, Lawrence; Jeng, Linda Jo Bone; Zhao, Richard Y; Ambulos, Nicholas; Vesely, Mark R

2014-03-01

Despite a substantial evidence base, implementation of pharmacogenetics into routine patient care has been slow due to a number of non-trivial practical barriers. We implemented a Personalized Anti-platelet Pharmacogenetics Program (PAP3) for cardiac catheterization patients at the University of Maryland Medical Center and the Baltimore Veterans Administration Medical Center Patients' are offered CYP2C19 genetic testing, which is performed in our Clinical Laboratory Improvement Amendment (CLIA)-certified Translational Genomics Laboratory. Results are returned within 5 hr along with clinical decision support that includes interpretation of results and prescribing recommendations for anti-platelet therapy based on the Clinical Pharmacogenetics Implementation Consortium guidelines. Now with a working template for PAP3, implementation of other drug-gene pairs is in process. Lessons learned as described in this article may prove useful to other medical centers as they implement pharmacogenetics into patient care, a critical step in the pathway to personalized and genomic medicine. © 2014 Wiley Periodicals, Inc.

75 FR 48934 - Coral Reef Conservation Program Implementation Guidelines

Science.gov (United States)

2010-08-12

...-01] RIN 0648-ZC19 Coral Reef Conservation Program Implementation Guidelines AGENCY: National Oceanic... Guidelines (Guidelines) for the Coral Reef Conservation Program (CRCP or Program) under the Coral Reef... assistance for coral reef conservation projects under the Act. NOAA revised the Implementation Guidelines for...

Ten practical lessons for an effective radon risk communication program

International Nuclear Information System (INIS)

Fisher, A.; Johnson, F.R.

1990-01-01

Those responsible for state and local radon programs often express frustration about the small share of homes that have been tested for radon, and the small share of those with high readings that have been mitigated. Several recent studies have examined how well alternative ways of communicating about radon's risk have accomplished the goals of motivating appropriate testing and mitigation. Unfortunately, the results of these studies have not reached practitioners. This paper is for them. It summarizes the practical implications that are most crucial for planning and implementing an effective radon risk communication program--a program that will motivate people to test for radon and mitigate when radon levels are high, without unduly alarming those whose radon levels are low

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion

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Lawrence A. Palinkas

2018-05-01

Full Text Available Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP.Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents.Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission.Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion.

Science.gov (United States)

Palinkas, Lawrence A; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

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

Practical implementation of good practice in health, environment and safety management in enterprise in the Lodz region.

Science.gov (United States)

Michalak, Jacek

2002-10-01

Good practice in health, environment and safety management in enterprise (GP HESME) is the process that aims at continuous improvement in health, environment and safety performance, involving all stakeholders within and outside the enterprise. The GP HESME system is intended to function at different levels: international, national, local community, and enterprise. The most important issues at the first stage of GP HESME implementation in the Lodz region are described. Also, the proposals of future activities in Lodz are presented. Practical implementation of GP HESME requires close co-operation among all stakeholders: local authorities, employers, employees, research institutions, and the state inspectorate. The WHO and the Nofer Institute of Occupational Medicine (NIOM) are initiating implementation, delivering professional consultation, education and training of stakeholders in the NIOM School of Public Health. The implementation of GP HESME in the Lodz region started in 1999 from a WHO meeting on criteria and indicators, followed by close collaboration of NIOM with the city's Department of Public Health. 'Directions of Actions for Health of Lodz Citizens' is now the city's official document that includes GP HESME as an important part of public health policy in Lodz. Several conferences were organized by NIOM together with the Professional Managers' Club, Labor Inspection, and the city's Department of Public Health to assess the most important needs of enterprises. The employers and managerial staff, who predominated among the participants, stated the need for tailored sets of indicators and economic appraisal of GP HESME activities. Special attention is paid to GP HESME in supermarkets and community-owned enterprises, e.g., a local transportation company. A special program for small- and medium-size enterprises will be the next step of GP HESME in the Lodz region. The implementation of GP HESME is possible if the efforts of local authorities; research

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...... challenges and provide a structured classification of ecodesign practices, a systematic literature review was performed for the identification and classification of the existing practices, supporting the selection of the most suitable ones according to companies’ specific needs and characteristics....

Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

Science.gov (United States)

Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

2015-08-01

There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. © The Author(s) 2015.

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

Science.gov (United States)

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

2018-01-01

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

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).

Health promotion practice and its implementation in Swedish health care.

Science.gov (United States)

Brobeck, E; Odencrants, S; Bergh, H; Hildingh, C

2013-09-01

Health promotion practice is an important work assignment within the entire health and medical care sector. Nurses are important for the development and implementation of health promotion in clinical practice. The aim was to describe how district nurses view health promotion practice and how it was implemented in clinical practice following a training initiative. The study has a descriptive design and a qualitative method. The sample consisted of three focus groups with 16 participants. The interviews were conducted as a conversation with focus on the district nurses view of health promotion and its implementation in clinical practice. The data have been processed using manifest qualitative content analysis. Three categories, titled Training as motivation, Lack of grounding and Lack of scope were identified. The result demonstrated that training provides motivation, but also the importance of grounding in the organization and the need for scope in performing health promotion practice. Our results show that the training initiative has contributed positively to the district nurses' view of health promotion practice, but that they also feel that there are obstacles. The district nurses in our study suggest that health promotion practice should be more visible, and not something that is done when time permits. The district nurses feel motivated and have an enthusiasm for health promotion practice but more time and resources are required to design successful health-promoting initiatives. Before implementing a major training initiative for healthcare personnel in health promotion, it is essential to examine whether the conditions for this exist in the organization. © 2013 International Council of Nurses.

Educating change agents: a qualitative descriptive study of graduates of a Master's program in evidence-based practice.

Science.gov (United States)

Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen

2016-02-25

Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.

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

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.

Development, implementation and evaluation of a clinical research engagement and leadership capacity building program in a large Australian health care service.

Science.gov (United States)

Misso, Marie L; Ilic, Dragan; Haines, Terry P; Hutchinson, Alison M; East, Christine E; Teede, Helena J

2016-01-14

Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education. The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up. It is anticipated that this clinical research engagement and leadership capacity building

Enhancing leadership and relationships by implementing a peer mentoring program.

Science.gov (United States)

Gafni Lachter, Liat R; Ruland, Judith P

2018-03-30

Peer-mentoring is often described as effective means to promote professional and leadership skills, yet evidence on practical models of such programs for occupational therapy students are sparse. The purpose of this study was to evaluate the outcomes of a peer-mentoring program designed for graduate occupational therapy students. Forty-seven second-year student volunteers were randomly assigned to individually mentor first-year students in a year-long program. Students met biweekly virtually or in person to provide mentorship on everyday student issues, according to mentees' needs. Faculty-led group activities prior and during the peer-mentoring program took place to facilitate the mentorship relationships. Program effectiveness was measured using the Multi-factor Leadership Questionnaire (Avolio & Bass, MLQ: Multifactor Leadership Questionnaire, 2004) and an open-ended feedback survey. Results of multi-variate MANOVA for repeated measures indicating significant enhancement in several leadership skills (F(12,46) = 4.0, P = 0.001, η 2  = 0.579). Qualitative data from feedback surveys indicated that an opportunity to help; forming relationships; and structure as enabler were perceived as important participation outcomes. Students expressed high satisfaction and perceived value from their peer-mentoring experience. As we seek ways to promote our profession and the leadership of its members, it is recommended to consider student peer-mentoring to empower them to practice and advance essential career skills from the initial stages of professional development. Evidence found in this study demonstrates that peer-mentoring programs can promote leadership development and establishment of networks in an occupational therapy emerging professional community, at a low cost. The peer-mentoring blueprint and lessons learned are presented with hopes to inspire others to implement peer-mentoring programs in their settings. © 2018 Occupational Therapy Australia.

Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial.

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Anna L Barker

Full Text Available There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; 'falls alert' signs; supervision of patients in the bathroom; ensuring patients' walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six 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 program acceptability (suitability, practicality and benefits was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%. Views were mixed regarding positioning patients' walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised

The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model.

Science.gov (United States)

Moore, Julia E; Grouchy, Michelle; Graham, Ian D; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E

2016-05-01

Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility. Copyright © 2016 Longwoods Publishing.

Overview of implementation of DARPA GPU program in SAIC

Science.gov (United States)

Braunreiter, Dennis; Furtek, Jeremy; Chen, Hai-Wen; Healy, Dennis

2008-04-01

This paper reviews the implementation of DARPA MTO STAP-BOY program for both Phase I and II conducted at Science Applications International Corporation (SAIC). The STAP-BOY program conducts fast covariance factorization and tuning techniques for space-time adaptive process (STAP) Algorithm Implementation on Graphics Processor unit (GPU) Architectures for Embedded Systems. The first part of our presentation on the DARPA STAP-BOY program will focus on GPU implementation and algorithm innovations for a prototype radar STAP algorithm. The STAP algorithm will be implemented on the GPU, using stream programming (from companies such as PeakStream, ATI Technologies' CTM, and NVIDIA) and traditional graphics APIs. This algorithm will include fast range adaptive STAP weight updates and beamforming applications, each of which has been modified to exploit the parallel nature of graphics architectures.

The operation of a Research and Development (R&D) program and its significance for practice change in community pharmacy.

Science.gov (United States)

Hermansyah, Andi; Sainsbury, Erica; Krass, Ines

2017-01-01

Community pharmacy practice in Australia is changing and Research and Development (R&D) in community pharmacy plays an important role in contributing to the changes. A range of Cognitive Pharmacy Services (CPS) were developed from R&D programs, yet their implementation has been minimal indicating slow practice change within community pharmacy. Given the vital role of R&D, little is known about the operation and the extent to which it has been effective in supporting practice change in community pharmacy. In depth, semi-structured interviews were conducted with 27 key stakeholders in the pharmacy and healthcare system in Australia. All interviews were audio-recorded, transcribed ad verbatim and analysed using an inductive approach. Participants perceived that the R&D program has played an important role in the advent of CPS. Furthermore, they considered that evidence generated by the R&D projects is a critical influence on policy formulation, funding and implementation of CPS into practice. However, policy decisions and subsequent implementation are also influenced by other factors associated with context and facilitation which in turn foster or inhibit effective Knowledge Translation (KT) in the community pharmacy sector. While R&D programs have been viewed as essential for supporting changes in community pharmacy practice through development and funding of CPS, the overall impact has been small, as contemporary practice continues to be predominantly a dispensing model. Given the complexity and dynamic nature of the community pharmacy system, stakeholders must take into account the inter-relationship between context, evidence and facilitation for successful KT in community pharmacy practice.

Implementation of Motivational Interviewing in Practice

DEFF Research Database (Denmark)

Nielsen, Charlotte; Louise Rasmussen, Line

Implementation of Motivational Interviewing in practice Background In 2012 at Department of Nephrology an investigation among patients showed, that the patient’s did not experience acknowledgement during admission, though the nurses was educated in 'Motivational Interviewing'. Objectives To improve...... patient satisfaction during admission To maintain and improve the nurses competencies in patient-centred communication. Methods Literature study Breakthrough series method and Plan Do Study Act circles. Training by Mooney and Brinkerhoff (development of nurses competences) Pre - focus group interviews...... with the nurses. Implementation process in 3 phases - Preparation - Implementation (4 selected keypersons) - Follow-up Result The four selected keypersons aroused curiosity and motivation for a patient-centred admission interview. The nurses experienced the interaction with the patient became more dynamic. Data...

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

Practical goal programming

CERN Document Server

Jones, Dylan

2010-01-01

This book and its treatment of goal programming will help organizations meet targets and objectives. The book includes many worked-out examples and tutorial exercises, and is designed to demostrate and teach its readers good modeling practice.

Implementation contexts of a Tuberculosis Control Program in Brazilian prisons

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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.

IMPLEMENTATION OF WORK LIFE QUALITY PROGRAMS WITH THE PROJECT MANAGEMENT MODEL

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Maria Lúcia Granja Coutinho

2010-06-01

Full Text Available The research studies the implementation of Quality of Working Life (QWL programs using project management techniques. Quality of Work Life projects have undergone a constant increase in scope to the point where they currently involve such diverse themes as change in dietary habits, exercise, stress management, socio environmental responsibility, and adult education. The major focus of this research is to analyze the processes and knowledge areas of project management being used to deal with this increased scope. The managerial processes identified were divided into categories of preparation, structuring, execution, and conclusion. The knowledge areas studied were: communication, risks, human resources, and acquisitions. The firms studied included mid to large sized firms located in the north, southeast and south of Brazil. We interviewed managers, directors, CEOs, plant managers, and line managers as part of this effort. The results suggest that the project management practices used were ad hoc and based on day to day needs. They also suggest that sound project management practices are applicable to QWL programs in the firms we studied.

Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

Science.gov (United States)

Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

2011-11-01

This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

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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.

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

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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.

Implementing Home Health Standards in Clinical Practice.

Science.gov (United States)

Gorski, Lisa A

2016-02-01

In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

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.

Roadmap for a participatory research-practice partnership to implement evidence.

Science.gov (United States)

Harrison, Margaret B; Graham, Ian D

2012-12-01

Our research team has undertaken implementation of evidence in the form of practice guideline recommendations for populations in hospital, community, and long-term care settings with diverse provider and patient populations (people with chronic wounds, e.g., pressure and leg ulcers, heart failure, stroke, diabetes, palliative care, cancer, and maternity care). Translating evidence into clinical practice at the point of care is a complex and often overwhelming challenge for the health system as well as for individual practitioners. To ensure that best available evidence is integrated into practice, "local evidence" needs to be generated and this process accomplishes a number of things: it focuses all involved on the "same page," identifies important facilitating factors as well as barriers, provides empirical support for planning, and in itself is a key aspect of implementation. In doing this work, we developed a roadmap, the Queen's University Research Roadmap for Knowledge Implementation (QuRKI) that outlines three major phases of linked research and implementation activity: (1) issue identification/clarification; (2) solution building; and (3) implementation, evaluation, and nurturing the change. In this paper, we describe our practical experience as researchers working at point-of-care and how research can be used to facilitate the implementation of evidence. An exemplar is used to illustrate the fluid interplay of research and implementation activities and present the range of supporting research. QuRKI serves as a guide for researchers in the formation of a strategic alliance with the practice community for undertaking evidence-informed reorganization of care. Using this collaborative approach, researchers play an integral role in focusing on, and using evidence during all discussions. We welcome further evaluation of its usefulness in the field. © 2012 Sigma Theta Tau International.

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.

Using information management to implement a clinical resource management program.

Science.gov (United States)

Rosenstein, A H

1997-12-01

This article provides a consultant's account of a 250-bed community hospital's experience in implementing the Clinical Resource Management (CRM) program, a four-stage process of using information to identify opportunities for improvement, developing an effective resource management team, implementing process improvement activities, and measuring the impact on outcomes of care. CASE STUDY EXAMPLE--CONGESTIVE HEART FAILURE: The chair of the departments of internal medicine and family practice selected congestive heart failure for in-depth study. A task force focused on treatment and patient disposition in the emergency room (ER), where most of the nonelective admissions originated. A set of standardized ER orders was developed that emphasized rapid and effective diuresis through the initiation of a progressive diuretic dosing schedule directly linked to patient response. Factors critical to the success of the CRM program included allocating adequate time to promote and sell the value and importance of the program, as well as securing the support of both information systems and physicians. The main barriers to success involved limitations in the information system infrastructure and delays attributable to committee review. Short-term results from the CRM program were encouraging, with average lengths of stay reduced by 0.5 days and average costs of care reduced by 12% for the ten diagnoses studied with no adverse results. Nonstudy diagnoses showed no notable improvement. Recognizing the growing importance of information management not only for clinical decision support but for accommodating all the necessary internal and external reporting requirements will require a significant commitment and investment in technology and personnel resources.

Turtle Graphics implementation using a graphical dataflow programming approach

OpenAIRE

Lovejoy, Robert Steven

1992-01-01

Approved for public release; distribution is unlimited This thesis expands the concepts of object-oriented programming to implement a visual dataflow programming language. The main thrust of this research is to develop a functional prototype language, based upon the Turtle Graphics tool provided by LOGO programming language, for children to develop both their problem solving skills as well as their general programming skills. The language developed for this thesis was implemented in the...

INTEGRATED PRACTICE LEARNING MODEL TO IMPROVE WAITER/S’ COMPETENCY ON HOSPITALITY STUDY PROGRAM, POLITEKNIK NEGERI BALI

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I Made Darma Oka

2017-12-01

Full Text Available Hospitality Study Program, Politeknik Negeri Bali (PNB, hadn’t implemented integrated learning practice optimally. The aim of this research was improving the learning process method as an integrated practice learning model involving three courses (Food Production, FB Service, English for Restaurant in the same topic. This study was conducted on the forth semester of Hotel Study Program as the sample used in this research. After the random sampling was selected two classes as research samples, those were IVA class as an experiment group and IVB class as a control. Thus the samples could be determined according to the number of students in each class as many as 26 people. The application of integrated practice learning had an effect on the achievement of student competency in waiter/s occupation at Hotel Studies Program. The result of statistical test showed that there was a significant difference of competency achievement between integrated learning practices with partial practice learning students groups. It’s suggested to the management Hospitality Study Program to encourage and to facilitate the lecturers especially of core subjects to apply integrated learning practices in order to achieve the competency.

Implementation of a Novel Structured Social and Wellness Committee in a Surgical Residency Program: A Case Study.

Science.gov (United States)

Van Orden, Kathryn E; Talutis, Stephanie D; Ng-Glazier, Joanna H; Richman, Aaron P; Pennington, Elliot C; Janeway, Megan G; Kauffman, Douglas F; Dechert, Tracey A

2017-01-01

This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness.

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.

Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.

Science.gov (United States)

Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J

2017-08-01

In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017

Stakeholder perspectives on implementing a universal Lynch syndrome screening program: a qualitative study of early barriers and facilitators.

Science.gov (United States)

Schneider, Jennifer L; Davis, James; Kauffman, Tia L; Reiss, Jacob A; McGinley, Cheryl; Arnold, Kathleen; Zepp, Jamilyn; Gilmore, Marian; Muessig, Kristin R; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia L; Peterson, Susan K; Goddard, Katrina A B

2016-02-01

Evidence-based guidelines recommend that all newly diagnosed colon cancer be screened for Lynch syndrome (LS), but best practices for implementing universal tumor screening have not been extensively studied. We interviewed a range of stakeholders in an integrated health-care system to identify initial factors that might promote or hinder the successful implementation of a universal LS screening program. We conducted interviews with health-plan leaders, managers, and staff. Interviews were audio-recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). We completed 14 interviews with leaders/managers and staff representing involved clinical and health-plan departments. Although stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote or hinder implementation. Facilitating factors included perceived benefits of screening for patients and organization, collaboration between departments, and availability of organizational resources. Barriers were also identified, including: lack of awareness of guidelines, lack of guideline clarity, staffing and program "ownership" concerns, and cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication, patient and provider/staff education, and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.

Implementing a Swedish regionalized medical program supported by digital technologies: possibilities and challenges from a management perspective.

Science.gov (United States)

Pettersson, Fanny L M

2013-01-01

In 2011, Umeå University in Sweden was facing its first attempt to transform the existing medical program into a regionalized medical program (RMP), supported by the use of digital technologies. The Swedish RMP means that students are distributed in geographically separated groups while doing their five clinical clerkship semesters. To provide medical students with ways of undertaking their theoretical studies when geographically distributed, digital technologies are used for educational and administrative purposes. In this article, the Swedish RMP will be described and related to previous international research on educating medical students in rural settings. The aim of this article was, from a management perspective, to understand if and how contradictions arise during the implementation process of the Swedish RMP, supported by digital technologies. Based on this analysis, a further aim was to discuss, from a management perspective, the possibilities and challenges for improvement of this medical educational practice, as well as to provide implications for other similar changes in medical programs internationally. To identify possible contradictions during the implementation process, ethnographically inspired observations were made during management work meetings, before and during the first regionalized semester. In addition, in-depth follow-up interviews were held in May and June 2011 with six management executives of the Swedish RMP, concerning their expectations and experiences of the implementation process. The qualitative and activity theory (AT)-inspired analysis resulted in the emergence of two main themes and seven sub-themes. The analysis suggests that a number of contradictions arose during the implementation process of the Swedish RMP. For instance, a contradiction constituted as a conflict between the university management and some teachers concerning how digital technologies and technology enhanced learning (TEL) could and should be used when

Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice.

Science.gov (United States)

Breckenridge-Sproat, Sara T; Throop, Meryia D; Raju, Dheeraj; Murphy, Deborah A; Loan, Lori A; Patrician, Patricia A

2015-01-01

This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an evidence-based practice (EBP) culture among nurses in a military healthcare setting. The need to identify gaps in practice, apply principles of EBP, and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: the Organizational Readiness for System-wide Integration of Evidence-Based Practice, EBP Beliefs, and EBP Implementation scales. The study took place in 3 military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Three hundred sixty nurses (38%) completed baseline, and 325 (31%) completed follow-up surveys. Scores improved on all 3 measures following implementation of the program; however, the differences were statistically significant only for the Organizational Readiness for System-wide Integration of Evidence-Based Practice scale (70.96 vs 77.63, t = -3.95, P culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a unit-level mentored EBP program is sustainable despite changes in organizational structure and workforce composition.

Logo! 8 a practical introduction, with circuit solutions and example programs

CERN Document Server

Kruse, Stefan

2015-01-01

Addressing students and engineers, but also hobby engineers, this practical guide will help to easily and cost-effectively implement technical solutions in home and installation technology, as well as small-scale automation solutions in machine and plant engineering. The book descriptively illustrates how to plan LOGO! 8 projects, develop programs and how to select the hardware. Standard control technology scenarios are demonstrated by building on the fundamentals of modern information technology and with the help of several real-life sample switches. In addition, readers are provided with practice-oriented descriptions of various basic and special LOGO! 8 modules with which specific tasks can be very flexibly implemented. Compared to former generations and competing products, LOGO! 8 comprises an integrated Ethernet interface, easy Internet control, a space-saving design and also more digital and analog outputs. The basic and special functions of the logic module can be used to replace several switching devi...

42 CFR 414.406 - Implementation of programs.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Implementation of programs. 414.406 Section 414.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) § 414.406 Implementation...

Lean and leadership practices: development of an initial realist program theory.

Science.gov (United States)

Goodridge, Donna; Westhorp, Gill; Rotter, Thomas; Dobson, Roy; Bath, Brenna

2015-09-07

Lean as a management system has been increasingly adopted in health care settings in an effort to enhance quality, capacity and safety, while simultaneously containing or reducing costs. The Ministry of Health in the province of Saskatchewan, Canada has made a multi-million dollar investment in Lean initiatives to create "better health, better value, better care, and better teams", affording a unique opportunity to advance our understanding of the way in which Lean philosophy, principles and tools work in health care. In order to address the questions, "What changes in leadership practices are associated with the implementation of Lean?" and "When leadership practices change, how do the changed practices contribute to subsequent outcomes?", we used a qualitative, multi-stage approach to work towards developing an initial realist program theory. We describe the implications of realist assumptions for evaluation of this Lean initiative. Formal theories including Normalization Process Theory, Theories of Double Loop and Organization Leaning and the Theory of Cognitive Dissonance help understand this initial rough program theory. Data collection included: key informant consultation; a stakeholder workshop; documentary review; 26 audiotaped and transcribed interviews with health region personnel; and team discussions. A set of seven initial hypotheses regarding the manner in which Lean changes leadership practices were developed from our data. We hypothesized that Lean, as implemented in this particular setting, changes leadership practices in the following ways. Lean: a) aligns the aims and objectives of health regions; b) authorizes attention and resources to quality improvement and change management c) provides an integrated set of tools for particular tasks; d) changes leaders' attitudes or beliefs about appropriate leadership and management styles and behaviors; e) demands increased levels of expertise, accountability and commitment from leaders; f) measures and

Overcoming barriers to implementation of evidence-based practice concepts in athletic training education: perceptions of select educators.

Science.gov (United States)

Manspeaker, Sarah; Van Lunen, Bonnie

2011-01-01

The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making. To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers. Qualitative interviews of emergent design with grounded theory. Undergraduate CAATE-accredited athletic training education programs. Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± 7.06. Interviews were conducted to evaluate perceived barriers and strategies for overcoming these barriers to implementation of evidence-based concepts in the curriculum. Interviews were explored qualitatively through open and axial coding. Established themes and categories were triangulated and member checked to determine trustworthiness. Educators identified 3 categories of need for EBP instruction: respect for the athletic training profession, use of EBP as part of the decision-making toolbox, and third-party reimbursement. Barriers to incorporating EBP concepts included time, role strain, knowledge, and the gap between clinical and educational practices. Suggested strategies for surmounting barriers included identifying a starting point for inclusion and approaching inclusion from a faculty perspective. Educators must transition toward instruction of EBP, regardless of barriers present in their academic programs, in order to maintain progress with other health professions' clinical practices and educational standards. Because today's students are tomorrow's clinicians, we need to include EBP concepts in entry-level education to promote critical thinking, inspire potential research interest, and further develop the available body of knowledge in our

CSSP implementation plan for space plasma physics programs

International Nuclear Information System (INIS)

Baker, D.N.; Williams, D.J.; Johns Hopkins Univ., Laurel, MD)

1985-01-01

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

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...

[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.

A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study.

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Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

2016-01-01

Best practice guidelines are a tool for narrowing research-to-practice gaps and improving care outcomes. There is some empirical understanding of guideline implementation in nursing settings, yet there has been almost no consideration of the longer-term sustainability of guideline-based practice improvements. Many healthcare innovations are not sustained, underscoring the need for knowledge about how to promote their survival. To understand how a nursing best practice guidelines program was sustained on acute healthcare center nursing units. We undertook a qualitative descriptive case study of an organization-wide nursing best practice guidelines program with four embedded nursing unit subcases. The setting was a large, tertiary/quaternary urban health center in Canada. The nursing department initiated a program to enhance patient safety through the implementation of three guidelines: falls prevention, pressure ulcer prevention, and pain management. We selected four inpatient unit subcases that had differing levels of program sustainability at an average of almost seven years post initial program implementation. Data sources included 39 key informant interviews with nursing leaders/administrators and frontline nurses; site visits; and program-related documents. Data collection and content analysis were guided by a framework for the sustainability of healthcare innovations. Program sustainability was characterized by three elements: benefits, routinization, and development. Seven key factors most accounted for the differences in the level of program sustainability between subcases. These factors were: perceptions of advantages, collaboration, accountability, staffing, linked levels of leadership, attributes of formal unit leadership, and leaders' use of sustainability activities. Some prominent relationships between characteristics and factors explained long-term program sustainability. Of primary importance was the extent to which unit leaders used sustainability

Practical examples of how knowledge management is addressed in Point Lepreau heat transport ageing management programs

International Nuclear Information System (INIS)

Slade, J.; Gendron, T.; Greenlaw, G.

2009-01-01

In the mid-1990s, New Brunswick Power Nuclear implemented a Management System Process Model at the Point Lepreau Generating Station that provides the basic elements of a knowledge management program. As noted by the IAEA, the challenge facing the nuclear industry now is to make improvements in knowledge management in areas that are more difficult to implement. Two of these areas are: increasing the value of existing knowledge, and converting tacit knowledge to explicit knowledge (knowledge acquisition). This paper describes some practical examples of knowledge management improvements in the Point Lepreau heat transport system ageing management program. (author)

Voices of chief nursing executives informing a doctor of nursing practice program.

Science.gov (United States)

Embree, Jennifer L; Meek, Julie; Ebright, Patricia

The purpose of this article is to describe the business case framework used to guide doctor of nursing practice (DNP) program enhancements and to discuss methods used to gain chief nurse executives' (CNEs) perspectives for desired curricular and experiential content for doctor of nursing practice nurses in health care system executive roles. Principal results of CNE interview responses were closely aligned to the knowledge, skills and/or attitudes identified by the national leadership organizations. Major conclusions of this article are that curriculum change should include increased emphasis on leadership, implementation science, and translation of evidence into practice methods. Business, information and technology management, policy, and health care law content would also need to be re-balanced to facilitate DNP graduates' health care system level practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Monitoring of good practices programs and independence for electricity and natural gas system operators. Report 2012

International Nuclear Information System (INIS)

2013-09-01

Electricity and natural gas transmission system operators (TSO) and distribution system operators (DSO) are regulated operators that provide public service functions for the benefit of the network users and the consumers they serve. Accordingly, European and French law requires that they be under independent and nondiscriminatory obligations. In particular, they must develop a good practices program which includes a range of measures to prevent the risk of discriminatory practices in network access. Pursuant to Article L.134-15 of the Energy Code, the Energy Regulatory Commission (CRE) is publishing this year its 8. annual report on the monitoring of good practices programs and independence for electricity and natural gas system operators for the year 2012. This report is based on analysis of the 'reports on the implementation of good practices programs' submitted to the CRE by the operators in late 2012 and audits carried out by the CRE services in these companies in 2012

Monitoring of good practices programs and independence for electricity and natural gas system operators. 2010 report

International Nuclear Information System (INIS)

2011-01-01

Electricity and natural gas transmission system operators (TSO) and distribution system operators (DSO) are regulated operators that provide public service functions for the benefit of the network users and the consumers they serve. Accordingly, European and French law requires that they be under independent and nondiscriminatory obligations. In particular, they must develop a good practices program which includes a range of measures to prevent the risk of discriminatory practices in network access. Pursuant to Article L.134-15 of the Energy Code, the Energy Regulatory Commission (CRE) is publishing this year its 6. annual report on the monitoring of good practices programs and independence for electricity and natural gas system operators for the year 2010. This report is based on analysis of the 'reports on the implementation of good practices programs' submitted to the CRE by the operators in late 2010 and audits carried out by the CRE services in these companies in 2010

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.

Implementation of a Psychoeducational Program for Cancer Survivors and Family Caregivers at a Cancer Support Community Affiliate: A Pilot Effectiveness Study.

Science.gov (United States)

Dockham, Bonnie; Schafenacker, Ann; Yoon, Hyojin; Ronis, David L; Kershaw, Trace; Titler, Marita; Northouse, Laurel

2016-01-01

Psychoeducational interventions, tested for efficacy in randomized clinical trials, are seldom implemented in clinical practice where cancer survivors and their family caregivers can benefit from them. This study examined the effectiveness of the FOCUS Program on cancer survivors' and their family caregivers' outcomes when implemented at a Cancer Support Community (CSC) affiliate by agency social workers. Study aims were to (1) test effects of the program on survivor and caregiver outcomes as a unit and (2) determine program feasibility in terms of enrollment, retention, intervention fidelity, and satisfaction. A preintervention and postintervention pilot effectiveness study was conducted with 34 cancer survivor-caregiver dyads (ie, pairs). The FOCUS Program, originally delivered by nurses in dyads' homes, was modified to a small-group format and delivered by CSC social workers. The primary outcome was quality of life (QOL). Intermediary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included repeated-measures analysis of variance. Dyads had significant improvements in total QOL; physical, emotional, and functional QOL; benefits of illness; and self-efficacy. Effect sizes were similar to prior randomized clinical trial findings. Although dyads were difficult to recruit (enrollment, 60%), both retention (92%) and intervention fidelity (94%) were high. It was possible to implement the FOCUS Program at a CSC affiliate by agency staff, obtain positive intervention effects, and maintain intervention fidelity. Researchers and clinicians need to collaborate to implement more evidence-based interventions in practice settings for cancer survivors and their family caregivers.

IMPLEMENTATION OF PROGRAM THE VILLAGE EMPOWERMENT IN RIAU PROVINCE

Directory of Open Access Journals (Sweden)

trio saputra

2017-03-01

Full Text Available Village empowerment program Implementation (PPD is a program of the Riau provincial government and the community empowerment directed to rural villages to accelerate poverty reduction through economic development and rural communities. The method used in this research is qualitative discriftif, collecting data through interviews, observation and documentation. The theory used is Edward III of policy implementation. Four variables in the analysis of public policies is Communications, Resources, attitudes and bureaucratic structures. PPD Communications implemented in two ways, namely as a reference guide book uniformity of language policy and technical meetings Tiered as form of direct communication between stakeholders in dealing with problems that arise. Resources consist of human resources and budget. The attitude and commitment of the determination visible implementing decree on the implementation team, commitment to cooperation and commitment duplication of programs by the district / city. While PPD graded organizational structure that is provincial, district / city and district. Each level has a structure and job descriptions of each.

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

Child Protection Program Implementations in Sport Management

Directory of Open Access Journals (Sweden)

Özgün PARASIZ

2015-07-01

Full Text Available The protection and provision of the welfare of children who are in a vulnerable condition to all kinds of risk in the modern world in every field they actively take part in is acknowledged as one 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 in. The aim of this study is to examine in which dimensions child protection system, defined as the provision of the child’s safety in all aspects including physical, social, emotional, economic, cultural, ethnic, moral, religious and political on a legal basis and in practice, is implemented within the sport systems of England and to identify the policies of sports organizations. In the study, scanning method based o n the literature was used. Research data was obtained by examining the related sources on the subject in various international libraries, journals, books and sports organizations. According to the information obtained in the study, child protection progra ms were identified to be a legal obligation for independent sports organizations responsible for the management of the sport (such as Federations, Olympic committees, sport clubs. The fundamental purpose of child protection programs is to diminish the ris k of all kinds of (sexual, physical and emotional child abuse. Sports organization establish child protection systems within their governing structure and work in coordination with the related units of clubs, federations and central administrations. Moreo ver, by providing special trainings to administrators and coaches, the stipulation of obtaining a special document for coaches who shall work with sportsmen under the age of 18 has been laid down. Special regulations and educational programs for sport fede rations have been prepared intended for the functioning of child protection system in

Empowering families by engaging and relating Murri way: a grounded theory study of the implementation of the Cape York Baby Basket program.

Science.gov (United States)

McCalman, Janya; Searles, Andrew; Bainbridge, Roxanne; Ham, Rachael; Mein, Jacki; Neville, Johanna; Campbell, Sandra; Tsey, Komla

2015-05-21

Evaluating program outcomes without considering how the program was implemented can cause misunderstandings and inefficiencies when initiating program improvements. In conjunction with a program evaluation, reported elsewhere, this paper theorises the process of implementing an Indigenous Australian maternal and child health program. The Baby Basket program was developed in 2009 for the remote Cape York region and aimed to improve the attendance and engagement of Indigenous women at antenatal and postnatal clinics through providing three baskets of maternal and baby goods and associated health education. Constructivist grounded theory methods were used to generate and analyse data from qualitative interviews and focus groups with Indigenous women who received the baskets, their extended family members, and healthcare workers who delivered them. Data was coded in NVivo with concepts iteratively compared until higher order constructs and their relationships could be modelled to explain the common purpose for participants, the process involved in achieving that purpose, key strategies, conditions and outcomes. Theoretical terms are italicised. Program implementation entailed empowering families through a process of engaging and relating Murri (Queensland Indigenous) way. Key influencing conditions of the social environment were the remoteness of communities, keeping up with demand, families' knowledge, skills and roles and organisational service approaches and capacities. Engaging and relating Murri way occurred through four strategies: connecting through practical support, creating a culturally safe practice, becoming informed and informing others, and linking at the clinic. These strategies resulted in women and families taking responsibility for health through making healthy choices, becoming empowered health consumers and advocating for community changes. The theoretical model was applied to improve and revise Baby Basket program implementation, including

Understanding implementation in complex public organizations – implication for practice

Directory of Open Access Journals (Sweden)

Gry Cecilie Høiland

2016-10-01

Full Text Available The effective implementation of politically initiated public service innovations to the front-lines of the public service organization, where the innovation is to be applied, is a challenge that both practitioners and researchers struggle to solve. We highlight the importance of analysing contextual factors at several levels of the implementation system, as well as the importance of considering how the practical everyday work situations of the front-line workers influence their application of the innovation in question. We illustrate this by exploring the implementation process of a specific work inclusion measure, looking at its wider context and some of its implementation outcomes at a specific public agency. The intention is to illustrate the significance of considering the contextual complexity influencing implementation work as a reminder for practitioners to take this into account in their planning and practices.

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.

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.

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

Science.gov (United States)

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

2014-09-30

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

Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

Science.gov (United States)

Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

2015-05-01

The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

The Effect of a Collaborative Mentoring Program on Beginning Science Teachers' Inquiry-based Teaching Practice

Science.gov (United States)

Nam, Jeonghee; Seung, Eulsun; Go, MunSuk

2013-03-01

This study investigated how a collaborative mentoring program influenced beginning science teachers' inquiry-based teaching and their reflection on practice. The one-year program consisted of five one-on-one mentoring meetings, weekly science education seminars, weekly mentoring group discussions, and self-evaluation activities. The participants were three beginning science teachers and three mentors at the middle school level (7-9th grades) in an urban area of South Korea. For each beginning teacher, five lessons were evaluated in terms of lesson design/implementation, procedural knowledge, and classroom culture by using the Reformed Teaching Observation Protocol. Five aspects of the beginning teachers' reflections were identified. This study showed that a collaborative mentoring program focusing on inquiry-based science teaching encouraged the beginning teachers to reflect on their own perceptions and teaching practice in terms of inquiry-based science teaching, which led to changes in their teaching practice. This study also highlighted the importance of collaborative interactions between the mentors and the beginning teachers during the mentoring process.

Challenges Inherent in the Design and Implementation of After-School Intervention Programs for Middle Grade Underachieving Readers

Science.gov (United States)

Velten, Justin; Mokhtari, Kouider

2016-01-01

In this brief report, we share three challenges we encountered when designing and implementing an after school intervention program for an ethnically diverse group of middle grade underachieving readers. We also offer practical solutions to help guide middle school teams in anticipating and addressing potential problems when putting in place…

Implementation Practices of Finland in Facilitating IAEA Verification Activities

International Nuclear Information System (INIS)

Martikka, E.; Ansaranta, T.; Honkamaa, T.; Hamalainen, M.

2015-01-01

The Member States provide the information to the IAEA according to the Safeguards Agreements and Additional Protocols. For example, the requirements to provide the reports and declarations are very general and there are no explanation what the IAEA is looking for from that information. It is important for the States to understand how their efforts to collect and provide information, and to facilitate IAEA verification activities, contribute to the achievement of objectives and finally to draw conclusions on the exclusively peaceful use of nuclear materials in a State. The IAEA is producing a new series of guidance called Safeguards Implementation Practices, SIP, guides, which are shedding light on the requirements and sharing the good practices of States. It is hoped that the SIP Guides will create a better understanding of the needs of the IAEA and the important role of States and facility operators in achieving safeguards objectives. The guides are also important for the States to share their lessons learned and good practices for the benefit of other States that might be developing their capabilities or enhancing their processes and procedures. The way is very wide and long, when a State decides to start up a new nuclear programme. At first there is a need for legislation, regulatory body, contact point, international agreements and then finally practical implementation of the safeguards in the nuclear facilities. There are a lot of issues to be prepared in advance to facilitate the IAEA's implementation of verification activities successfully, effectively and with the good quality. Using the structure of the IAEA's draft SIP Guide on Facilitating Verification Activities as a framework, this paper will describe the most relevant implementation practices and experiences in Finland. (author)

Measuring Costs to Community-Based Agencies for Implementation of an Evidence-Based Practice.

Science.gov (United States)

Lang, Jason M; Connell, Christian M

2017-01-01

Healthcare reform has led to an increase in dissemination of evidence-based practices. Cost is frequently cited as a significant yet rarely studied barrier to dissemination of evidence-based practices and the associated improvements in quality of care. This study describes an approach to measuring the incremental, unreimbursed costs in staff time and direct costs to community-based clinics implementing an evidence-based practice through participating in a learning collaborative. Initial implementation costs exceeding those for providing "treatment as usual" were collected for ten clinics implementing trauma-focused cognitive behavioral therapy through participation in 10-month learning collaboratives. Incremental implementation costs of these ten community-based clinic teams averaged the equivalent of US$89,575 (US$ 2012). The most costly activities were training, supervision, preparation time, and implementation team meetings. Recommendations are made for further research on implementation costs, dissemination of evidence-based practices, and implications for researchers and policy makers.

Implementing an interdisciplinary intergenerational program using the Cyber Seniors® reverse mentoring model within higher education.

Science.gov (United States)

Leedahl, Skye N; Brasher, Melanie Sereny; Estus, Erica; Breck, Bethany M; Dennis, Cory B; Clark, Samantha C

2018-01-24

Intergenerational service-learning in higher education positively affects older adults and students, but little is known about the effectiveness of interdisciplinary, reverse mentoring programs that use technology as the medium of bringing generations together. This study describes an intergenerational service-learning program that utilizes reverse mentoring within higher education, the "Engaging Generations Program," at a midsized public university in New England where students help older adults learn about technology, and students gain communication and teaching skills. In this article, we outline how the program was implemented, present quantitative data on participation outcomes for students and older adults and qualitative data from older adults, and discuss best practices. Analysis of pre/post surveys found that students' attitudes toward aging improved (p < 0.01) and older adults interest in technology improved (p < 0.05) after program participation. Best practices identified included: multiple meetings with the same pair to deepen friendships, in-person training for student leaders, student responsibility for scheduling, tailoring sessions to each participant, student documentation of meetings, and active involvement by community partners.

Promoting physical therapists’ of research evidence to inform clinical practice: part 1 - theoretical foundation, evidence, and description of the PEAK program

Science.gov (United States)

2014-01-01

Background There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura’s social cognitive theory and Malcolm Knowles’s adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. Discussion The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a “Best Practices List” - a list of locally generated, evidence-based, actionable behaviors relevant to the groups’ clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. Summary This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program �

Promoting physical therapists' of research evidence to inform clinical practice: part 1--theoretical foundation, evidence, and description of the PEAK program.

Science.gov (United States)

Tilson, Julie K; Mickan, Sharon

2014-06-25

There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura's social cognitive theory and Malcolm Knowles's adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a "Best Practices List" - a list of locally generated, evidence-based, actionable behaviors relevant to the groups' clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program - an educational program designed to

Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

Science.gov (United States)

Willems, Mia; Schröder, Carin; Post, Marcel; van der Weijden, Trudy; Visser-Meily, Anne

2013-10-23

The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB).This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherlands. This study includes a quantitative evaluation with a non controlled pre-post intervention design and a mixed methods process evaluation. From each stroke unit, enterprising nurses and therapists will be recruited and trained as KB. The KB will work for one year on the implementation of the guideline recommendations in their team. To evaluate the effectiveness of the KB, a questionnaire will be administered to patients, health professionals and KBs at baseline (T0) and after one year (T1). Furthermore, semi structured interviews with 5 KBs will be performed at T1.The primary outcome of this implementation project will be the support health professionals give patients to exercise and be physically active, as reported by patients and health professionals themselves. The support immediately after the intervention is compared with the support at the start of the intervention.Additionally we will explore the influence of socio-demographic characteristics of health professionals and determinants identified in the Theory of Planned Behavior (intention, attitude, subjective norm and perceived behavioral control) on the change of supportive behavior of health professionals. Finally, KBs will complete a questionnaire on their own psychological and social demographic characteristics and on organizational conditions needed for health-care improvement such as time, workforce, sponsoring and support from management. With this study we will gain insight in when and why knowledge brokers seem to be

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.

The INEL approach: Environmental Restoration Program management and implementation methodology

International Nuclear Information System (INIS)

1996-01-01

The overall objectives of the INEL Environmental Restoration (ER) Program management approach are to facilitate meeting mission needs through the successful implementation of a sound, and effective project management philosophy. This paper outlines the steps taken to develop the ER program, and explains further the implementing tools and processes used to achieve what can be viewed as fundamental to a successful program. The various examples provided will demonstrate how the strategies for implementing these operating philosophies are actually present and at work throughout the program, in spite of budget drills and organizational changes within DOE and the implementing contractor. A few of the challenges and successes of the INEL Environmental Restoration Program have included: a) completion of all enforceable milestones to date, b) acceleration of enforceable milestones, c) managing funds to reduce uncosted obligations at year end by utilizing greater than 99% of FY-95 budget, d) an exemplary safety record, e) developing a strategy for partial Delisting of the INEL by the year 2000, f) actively dealing with Natural Resource Damages Assessment issues, g) the achievement of significant project cost reductions, h) and implementation of a partnering charter and application of front end quality principles

Implementing ABPM into Clinical Practice.

Science.gov (United States)

Hinderliter, Alan L; Voora, Raven A; Viera, Anthony J

2018-02-05

To review the data supporting the use of ambulatory blood pressure monitoring (ABPM), and to provide practical guidance for practitioners who are establishing an ambulatory monitoring service. ABPM results more accurately reflect the risk of cardiovascular events than do office measurements of blood pressure. Moreover, many patients with high blood pressure in the office have normal blood pressure on ABPM-a pattern known as white coat hypertension-and have a prognosis similar to individuals who are normotensive in both settings. For these reasons, ABPM is recommended by the US Preventive Services Task Force to confirm the diagnosis of hypertension in patients with high office blood pressure before medical therapy is initiated. Similarly, the 2017 ACC/AHA High Blood Pressure Clinical Practice Guideline advocates the use of out-of-office blood pressure measurements to confirm hypertension and evaluate the efficacy of blood pressure-lowering medications. In addition to white coat hypertension, blood pressure phenotypes that are associated with increased cardiovascular risk and that can be recognized by ABPM include masked hypertension-characterized by normal office blood pressure but high values on ABPM-and high nocturnal blood pressure. In this review, best practices for starting a clinical ABPM service, performing an ABPM monitoring session, and interpreting and reporting ABPM data are described. ABPM is a valuable adjunct to careful office blood pressure measurement in diagnosing hypertension and in guiding antihypertensive therapy. Following recommended best practices can facilitate implementation of ABPM into clinical practice.

A SCILAB Program for Computing General-Relativistic Models of Rotating Neutron Stars by Implementing Hartle's Perturbation Method

Science.gov (United States)

Papasotiriou, P. J.; Geroyannis, V. S.

We implement Hartle's perturbation method to the computation of relativistic rigidly rotating neutron star models. The program has been written in SCILAB (© INRIA ENPC), a matrix-oriented high-level programming language. The numerical method is described in very detail and is applied to many models in slow or fast rotation. We show that, although the method is perturbative, it gives accurate results for all practical purposes and it should prove an efficient tool for computing rapidly rotating pulsars.

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

OpenAIRE

Watt, Susan; Sword, Wendy; Krueger, Paul

2005-01-01

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 moth...

Interdisciplinary Practice Approach to Proteins Study and Analysis in Undergraduate Program in Biotechnology

Directory of Open Access Journals (Sweden)

L.P. Xavier

2013-05-01

Full Text Available The undergraduate program in Biotechnology at Federal University of Pará has been consolidated as excellence course in Pará, however there are still difficulties in some practice classes. In this way, the aim of this research was to develop low cost and easy implementation methodologies of teaching and learning that help the students to understand the integration of contents, and promote interdisciplinary and greater integration among professors. The main theme of the study was “Proteins: obtaining to analysis”. Professors charged of subjects in Biochemistry, Protein Biochemistry, Protein Engineering, Microbiology and Separation Methods of Biotech Products, has developed this work, which has been promoted by the program PROINT of UFPA. The main purpose of PROINT has been the consolidation of undergraduate teaching projects. Thirty students enrolled in the third semester were involved in this study. To perform the practice classes: a were made models with alternative materials (Styrofoam, cardboard; b were used the tutorials and exercises online as a complement to the teaching and learning process and; c were analyzed chromatograms, simulation purification steps, assembled and interpreted tables purification (falcon tubes, colored beads. Were used also conventional materials and reagents purchased in practices related to microbiology with the support of PROINT. Until now had been a greater interest and participation of students in the implementation of practices and a greater understanding of the theoretical content covered.

Evaluating the effectiveness of implementing quality management practices in the medical industry.

Science.gov (United States)

Yeh, T-M; Lai, H-P

2015-01-01

To discuss the effectiveness of 30 quality management practices (QMP) including Strategic Management, Balanced ScoreCard, Knowledge Management, and Total Quality Management in the medical industry. A V-shaped performance evaluation matrix is applied to identify the top ten practices that are important but not easy to use or implement. Quality Function Deployment (QFD) is then utilized to find key factors to improve the implementation of the top ten tools. The questionnaires were sent to the nursing staff and administrators in a hospital through e-mail and posts. A total of 250 copies were distributed and 217 copies were valid. The importance, easiness, and achievement (i.e., implementation level) of 30 quality management practices were used. Key factors for QMP implementation were sequenced in order of importance as top management involvement, inter-department communication and coordination, teamwork, hospital-wide participation, education and training, consultant professionalism, continuous internal auditing, computerized process, and incentive compensation. Top management can implement the V-shaped performance matrix to determine whether quality management practices need improvement and if so, utilize QFD to find the key factors for improvement.

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.

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.

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.

Environmental Practices. Motivations and Their Influence on the Level of Implementation

Directory of Open Access Journals (Sweden)

María de la Cruz del Río-Rama

2018-03-01

Full Text Available The objective of this research is to identify and analyze good environmental practices followed by the Thermal sector in Spain. It is also to analyze if the motivations that lead thermal establishments to implement environmental practices influence their level of implementation. The methodology used is the performance of a descriptive and regression analysis of the data obtained through a structured questionnaire. The target population consists of 112 health resorts, obtaining a sample size of 62 valid surveys, which implies a response rate of 55.36%. The results obtained have enabled the performance of an environmental diagnosis of the Thermal sector in Spain, identifying the strengths and weaknesses of Environmental Management, as well as corroborating that motivations affect the level of implementation of environmental practices.

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.

NAP SACC: Implementation of an Obesity Prevention Intervention in an American Indian Head Start Program.

Science.gov (United States)

Mattingly, Julie A; Andresen, Pamela A

2016-01-01

Low-income American Indian preschoolers are at greatest risk for overweight and obesity among children aged 2-5 years. The Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) program is an evidence-based intervention that promotes healthy weight development for children enrolled in child care centers. The goal of this continuous quality improvement program is for the child care staff to establish environmental policies and practices that positively influence nutrition and physical activity-related behaviors. A community needs assessment of a Head Start program on an American Indian reservation identified obesity as a priority issue. This project implemented NAP SACC at 15 Head Start sites on the reservation.

Implemented or not implemented? Process evaluation of the school-based obesity prevention program DOiT and associations with program effectiveness

NARCIS (Netherlands)

van Nassau, F.; Singh, A.S.; Hoekstra, T.; van Mechelen, W.; Brug, J.; Chinapaw, M.J.M.

This study investigates if and to what extent the Dutch Obesity Intervention in Teenagers (DOiT) program was implemented as intended and how this affected program effectiveness. We collected data at 20 prevocational education schools in the Netherlands. We assessed seven process indicators:

Implemented or not implemented? : Process evaluation of the school-based obesity prevention program DOiT and associations with program effectiveness

NARCIS (Netherlands)

van Nassau, Femke; Singh, Amika S; Hoekstra, T.; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai J M

This study investigates if and to what extent the Dutch Obesity Intervention in Teenagers (DOiT) program was implemented as intended and how this affected program effectiveness. We collected data at 20 prevocational education schools in the Netherlands. We assessed seven process indicators:

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

Implementing and evaluating shared decision making in oncology practice.

Science.gov (United States)

Kane, Heather L; Halpern, Michael T; Squiers, Linda B; Treiman, Katherine A; McCormack, Lauren A

2014-01-01

Engaging individuals with cancer in decision making about their treatments has received increased attention; shared decision making (SDM) has become a hallmark of patient-centered care. Although physicians indicate substantial interest in SDM, implementing SDM in cancer care is often complex; high levels of uncertainty may exist, and health care providers must help patients understand the potential risks versus benefits of different treatment options. However, patients who are more engaged in their health care decision making are more likely to experience confidence in and satisfaction with treatment decisions and increased trust in their providers. To implement SDM in oncology practice, physicians and other health care providers need to understand the components of SDM and the approaches to supporting and facilitating this process as part of cancer care. This review summarizes recent information regarding patient and physician factors that influence SDM for cancer care, outcomes resulting from successful SDM, and strategies for implementing SDM in oncology practice. We present a conceptual model illustrating the components of SDM in cancer care and provide recommendations for facilitating SDM in oncology practice. © 2014 American Cancer Society, Inc.

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

Challenges and Ideas from a Research Program on High Quality, Evidence-Based Practice in School Mental Health

Science.gov (United States)

Weist, Mark D.; Youngstrom, Eric A.; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2013-01-01

Objective Reviews the progression of a research program designed to develop, implement and study the implementation of “achievable” evidence-based practices (EBPs) in schools. Reviews challenges encountered and ideas to overcome them to enhance this avenue of research. Method Presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on Personal Wellness. In both studies primary aims focused on changes in clinician attitudes and behavior, including the delivery of high quality, evidence-based practices and secondary aims focused on student level impacts. Results A number of challenges, many not reported in the literature are reviewed, and ideas for overcoming them are presented. Conclusions Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health (SMH) services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians. PMID:24063310

"Finding the Joy in the Unknown": Implementation of STEAM Teaching Practices in Middle School Science and Math Classrooms

Science.gov (United States)

Quigley, Cassie F.; Herro, Dani

2016-06-01

In response to a desire to strengthen the economy, educational settings are emphasizing science, technology, engineering, and mathematics (STEM) curriculum and programs. Yet, because of the narrow approach to STEM, educational leaders continue to call for a more balanced approach to teaching and learning, which includes the arts, design, and humanities. This desire created space for science, technology, engineering, arts, and mathematics (STEAM) education, a transdisciplinary approach that focuses on problem-solving. STEAM-based curricula and STEAM-themed schools are appearing all over the globe. This growing national and global attention to STEAM provides an opportunity for teacher education to explore the ways in which teachers implement STEAM practices, examining the successes and challenges, and how teachers are beginning to make sense of this innovative teaching practice. The purpose of this paper is to examine the implementation of STEAM teaching practices in science and math middle school classrooms, in hopes to provide research-based evidence on this emerging topic to guide teacher educators.

Directions in implementation research methods for behavioral and social science.

Science.gov (United States)

Irwin, Molly; Supplee, Lauren H

2012-10-01

There is a growing interest, by researchers, policymakers, and practitioners, in evidence-based policy and practice. As a result, more dollars are being invested in program evaluation in order to establish "what works," and in some cases, funding is specifically tied to those programs found to be effective. However, reproducing positive effects found in research requires more than simply adopting an evidence-based program. Implementation research can provide guidance on which components of an intervention matter most for program impacts and how implementation components can best be implemented. However, while the body of rigorous research on effective practices continues to grow, research on implementation lags behind. To address these issues, the Administration for Children and Families and federal partners convened a roundtable meeting entitled, Improving Implementation Research Methods for Behavioral and Social Science, in the fall of 2010. This special section of the Journal of Behavioral Health Services & Research includes papers from the roundtable and highlights the role implementation science can play in shedding light on the difficult task of taking evidence-based practices to scale.

Implementing 'Continuous Improvement' in the U.S. Nuclear Regulatory Commission's Decommissioning Program

International Nuclear Information System (INIS)

Orlando, D. A.; Buckley, J. T.; Johnson, R. L.; Gillen, D. M.

2006-01-01

The United States Nuclear Regulatory Commission's (US NRC's) comprehensive decommissioning program encompasses the decommissioning of all US NRC licensed facilities, ranging from the termination of routine licenses for sealed sources, to the closure of complex materials sites and nuclear power reactor facilities. Of the approximately 200 materials licenses that are terminated each year, most are routine and require little, if any, remediation to meet the US NRC unrestricted release criteria. However, some present technical and policy challenges that require large expenditures of resources, including a few complex materials sites that have requested license termination under the restricted-use provisions of 10 CFR 20.1403. Fiscal constraints to reduce budgeted resources in the decommissioning program, as well as concerns over the time to complete the decommissioning process have led to actions to improve the program and use resources more efficiently. In addition, the US NRC's Strategic Plan requires efforts to identify and implement improvements to US NRC programs in order to improve efficiency, effectiveness, timeliness, and openness, of the US NRC's activities, while maintaining the necessary focus on safety. Decommissioning regulations, and more recently the analysis of several issues associated with implementing those regulations, also have been significant catalysts for improvements in the decommissioning program. Actions in response to these catalysts have resulted in a program focused on the management of complex sites in a comprehensive, consistent, and risk-informed manner, as opposed to the past practice of focusing on sites deemed to be problematic. This paper describes the current status of the decommissioning of US NRC-licensed nuclear facilities, including an overview of recent decommissioning project completion efforts. It provides a detailed summary of past, current, and future improvements in the US NRC decommissioning program including the

Evaluation of the pharmacy practice program in the 6-year pharmaceutical education curriculum in Japan: community pharmacy practice program.

Science.gov (United States)

Utsumi, Miho; Hirano, Sachi; Fujii, Yuki; Yamamoto, Hiroshi

2015-01-01

The purpose of this study was to highlight concerns with the current pharmacy practice program and suggest aspects for improvement. A further aim of the study was to enhance the educational effects of the program, from the students' point of view. We surveyed 1,607 pharmacy students in Japan who had completed the pharmacy practice program in either 2010 or 2011. The students completed a self-descriptive questionnaire comprising 48 questions examining their experience of the pharmacy practice program. For community pharmacy practice, four factors were extracted through exploratory analysis: "satisfactory learning (pharmacy)," "support system of the university," "creation and clarification of the training plan," and "dialogue with patients." When comparing the mean values for each of the four factors between 2011 and 2012, the 2012 group scored significantly higher (p programs. From the results of McNemar's test, from 2011 to 2012, there was a significant decrease in the number of students who were unable to experience "charge system of patients" at neither hospitals nor pharmacies (p program introduced some initiatives. Furthermore, conducting training at multiple facilities deepens student learning and assists with the correction of problems, such as the disparities within the teaching system and learning content at each of the training facilities.

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 ...

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-…

Safeguards Implementation Practices Guide on Facilitating IAEA Verification Activities

Energy Technology Data Exchange (ETDEWEB)

NONE

2014-12-15

The IAEA implements safeguards pursuant to agreements concluded with States. It is in the interests of both States and the IAEA to cooperate to facilitate the practical implementation of safeguards. Such cooperation is explicitly required under all types of safeguards agreement. Effective cooperation depends upon States and the IAEA sharing a common understanding of their respective rights and obligations. To address this, in 2012 the IAEA published Services Series 21, Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols, which aimed at enhancing understanding of the safeguards obligations of both States and the IAEA and at improving their cooperation in safeguards implementation. States may establish different processes and procedures at the national level, and set up different systems as required to meet their safeguards obligations. Indeed, a variety of approaches are to be expected, owing to such differences as the size and complexity of States’ nuclear programmes and their regulatory framework. The purpose of this Safeguards Implementation Practices (SIP) Guide is to share the experiences and good practices as well as the lessons learned by both States and the IAEA, acquired over the many decades of safeguards implementation. The information contained in the SIP Guides is provided for explanatory purposes and use of the Guides is not mandatory. The descriptions in the SIP Guides have no legal status and are not intended to add to, subtract from, amend or derogate from, in any way, the rights and obligations of the IAEA and the States set forth in The Structure and Content of Agreements between the Agency and States Required in Connection with the Treaty on the Non-Proliferation of Nuclear Weapons (issued as INFCIRC/153 (Corrected)) and Model Protocol Additional to the Agreement(s) between State(s) and the International Atomic Energy Agency for the Application of Safeguards (issued as INFCIRC/540 (Corrected)). This SIP

Safeguards Implementation Practices Guide on Facilitating IAEA Verification Activities

International Nuclear Information System (INIS)

2014-01-01

The IAEA implements safeguards pursuant to agreements concluded with States. It is in the interests of both States and the IAEA to cooperate to facilitate the practical implementation of safeguards. Such cooperation is explicitly required under all types of safeguards agreement. Effective cooperation depends upon States and the IAEA sharing a common understanding of their respective rights and obligations. To address this, in 2012 the IAEA published Services Series 21, Guidance for States Implementing Comprehensive Safeguards Agreements and Additional Protocols, which aimed at enhancing understanding of the safeguards obligations of both States and the IAEA and at improving their cooperation in safeguards implementation. States may establish different processes and procedures at the national level, and set up different systems as required to meet their safeguards obligations. Indeed, a variety of approaches are to be expected, owing to such differences as the size and complexity of States’ nuclear programmes and their regulatory framework. The purpose of this Safeguards Implementation Practices (SIP) Guide is to share the experiences and good practices as well as the lessons learned by both States and the IAEA, acquired over the many decades of safeguards implementation. The information contained in the SIP Guides is provided for explanatory purposes and use of the Guides is not mandatory. The descriptions in the SIP Guides have no legal status and are not intended to add to, subtract from, amend or derogate from, in any way, the rights and obligations of the IAEA and the States set forth in The Structure and Content of Agreements between the Agency and States Required in Connection with the Treaty on the Non-Proliferation of Nuclear Weapons (issued as INFCIRC/153 (Corrected)) and Model Protocol Additional to the Agreement(s) between State(s) and the International Atomic Energy Agency for the Application of Safeguards (issued as INFCIRC/540 (Corrected)). This SIP

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.

Hanford Environmental Management Program implementation plan

International Nuclear Information System (INIS)

1988-08-01

The Hanford Environmental Management Program (HEMP) was established to facilitate compliance with the applicable environmental statues, regulations, and standards on the Hanford Site. The HEMP provides a structured approach to achieve environmental management objectives. The Hanford Environmental Management Program Plan (HEMP Plan) was prepared as a strategic level planning document to describe the program management, technical implementation, verification, and communications activities that guide the HEMP. Four basic program objectives are identified in the HEMP Plan as follows: establish ongoing monitoring to ensure that Hanford Site operations comply with environmental requirements; attain regulatory compliance through the modification of activities; mitigate any environmental consequences; and minimize the environmental impacts of future operations at the Hanford Site. 2 refs., 24 figs., 27 tabs

Best practices in nursing homes. Clinical supervision, management, and human resource practices.

Science.gov (United States)

Dellefield, Mary Ellen

2008-07-01

Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described. Copyright 2009, SLACK Incorporated.

Prohibiting physicians' dual practice in Iran: Policy options for implementation.

Science.gov (United States)

Bazyar, Mohammad; Rashidian, Arash; Jahanmehr, Nader; Behzadi, Faranak; Moghri, Javad; Doshmangir, Leila

2018-04-23

In Iran, based on the recent national policy documents, physician dual practice (PDP) has been prohibited. This study aimed to develop policy options (POs) to implement physicians' dual practice prohibition law in Iran. International evidence published in English and local documents published in Persian about PDP analyzed and results (advantages, disadvantages, challenges and requirements to ban PDP, and applied policies to limit the dual practice) were extracted. Results discussed among the research team in 5 rounds of meetings. In each meeting, any possible PO to limit PDP in Iran was proposed based on brainstorming technique and 12 POs were developed. These 12 POs and their advantages and disadvantages were discussed in a focus group discussion attended by 14 informed policy makers, and 3 additional POs were added. Fifteen POs were developed. Each PO has its own advantages and disadvantages. It is worth to highlight that not only are the proposed POs not mutually exclusive but they are also mutually reinforcing; that is, each of these POs can be applied alone or they can be implemented alongside each other simultaneously. No single optimal PO exists for dealing with the dual practice in Iranian health system. Implementing a mix of POs could reduce possible complications of each PO and increase the chance of successful implementation of the law. It is advisable to follow a conservative and incremental approach and start with POs that will cause less resistance and political challenges. Copyright © 2018 John Wiley & Sons, Ltd.

The FITS model office ergonomics program: a model for best practice.

Science.gov (United States)

Chim, Justine M Y

2014-01-01

An effective office ergonomics program can predict positive results in reducing musculoskeletal injury rates, enhancing productivity, and improving staff well-being and job satisfaction. Its objective is to provide a systematic solution to manage the potential risk of musculoskeletal disorders among computer users in an office setting. A FITS Model office ergonomics program is developed. The FITS Model Office Ergonomics Program has been developed which draws on the legislative requirements for promoting the health and safety of workers using computers for extended periods as well as previous research findings. The Model is developed according to the practical industrial knowledge in ergonomics, occupational health and safety management, and human resources management in Hong Kong and overseas. This paper proposes a comprehensive office ergonomics program, the FITS Model, which considers (1) Furniture Evaluation and Selection; (2) Individual Workstation Assessment; (3) Training and Education; (4) Stretching Exercises and Rest Break as elements of an effective program. An experienced ergonomics practitioner should be included in the program design and implementation. Through the FITS Model Office Ergonomics Program, the risk of musculoskeletal disorders among computer users can be eliminated or minimized, and workplace health and safety and employees' wellness enhanced.

Conception of a product-related TopRunner pulse program. Supplementary scientific consultancy services: Working out of program modules for the practical implementation; Konzeption eines produktbezogenen TopRunner-Impulsprogramms. Ergaenzende wissenschaftliche Beratungsleistung: Erarbeitung von Programm-Modulen zur praktischen Umsetzung

Energy Technology Data Exchange (ETDEWEB)

Grether, Stefanie; Graulich, Kathrin; Griesshammer, Rainer

2009-11-20

Top runners - that is, devices with the most efficient advanced technology - are offered by the manufacturers too rare, and are required too little from the consumers. Under this aspect, the project under consideration accompanies scientifically the practical implementation in the preparatory phase of a presumably TopRunner pulse program. In addition, three other objectives are pursued: (1) Development of a product database for top runner products; (2) Construction of a comprehensive power saving brochure for the consumer advice (content and layout); (3) Design of a e-learning concept for power saving advice.

SRS ES and H Standards Compliance Program Implementation Plan

International Nuclear Information System (INIS)

Hearn, W.H.

1993-01-01

On March 8, 1990, the Defense Nuclear Facilities Safety Board (DNFSB) issued Recommendation 90-2 to the Secretary of Energy. This recommendation, based upon the DNFSB's initial review and evaluation of the content and implementation of standards relating to the design, construction, operations, and decommissioning of defense nuclear facilities of the U.S. Department of Energy (DOE), called for three actions: identification of specific standards that apply to design, construction, operation and decommissioning of DOE facilities; assessment of the adequacy of those standards for protecting public health and safety; and determination of the extent to which they have and are being implemented. The purpose of this Implementation Plan is to define the single program for all sitewide and facility 90-2 ES and H Standards Compliance efforts, which will satisfy the HQ Implementation Plan, avoid duplicate efforts, be as simple and achievable as possible, include cost-saving innovations, use a graded approach based on facility hazards and future needs of facilities, and support configuration control for facility requirements. The Defense Waste Processing Facility (DWPF) has been designated a pilot facility for the 90-2 program and has progressed with their facility program ahead of the site-level program. The DWPF, and other Government-Owned Contractor-Operated (GOCO) facilities that progress on an enhanced schedule, will serve as pilot facilities for the site-level program. The lessons learned with their requirement identifications, and their assessments of the adequacy of and their compliance with these requirements will be used to improve the efficiency of the site-level and subsequent programs

Identifying Strategies Programs Adopt to Meet Healthy Eating and Physical Activity Standards in Afterschool Programs.

Science.gov (United States)

Weaver, Robert G; Moore, Justin B; Turner-McGrievy, Brie; Saunders, Ruth; Beighle, Aaron; Khan, M Mahmud; Chandler, Jessica; Brazendale, Keith; Randell, Allison; Webster, Collin; Beets, Michael W

2017-08-01

The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.

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

Implementing falls prevention research into policy and practice in Australia: past, present and future.

Science.gov (United States)

Lord, Stephen R; Sherrington, Catherine; Cameron, Ian D; Close, Jacqueline C T

2011-12-01

Falls in older Australians are a significant public health issue with one in three older people falling one or more times each year. Many fall prevention randomized controlled trials have been conducted in Australia as well as across the world. The findings of these studies now constitute a substantial evidence base that can provide direction for health and lifestyle interventions for preventing falls in older people. This research evidence has contributed to health policy in Australia to some extent, but is yet to be widely implemented into practice. This opinion piece overviews previous policy initiatives and describes a new Partnership research program funded by the Australian National Health and Medical Research Council (NHMRC), which seeks to further influence health policy and address the ongoing research-practice gap. Copyright © 2011. Published by Elsevier Ltd.

Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

Science.gov (United States)

Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

2014-03-01

In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Practical implementation of liquid biofuels: The transferability of the Brazilian experiences

International Nuclear Information System (INIS)

Alonso-Pippo, Walfrido; Luengo, Carlos A.; Alonsoamador Morales Alberteris, Lidice; García del Pino, Gilberto; Duvoisin, Sergio

2013-01-01

The main purpose of this paper was to carry out a systematic analysis of the particularities and trends pertaining to the development of biofuels in Brazil—a country which has demonstrated its leadership in this field during the last 40 years. The Brazilian experiences with biofuels are often used as references for decision making by other developed and developing countries. The transferability of Brazil's biofuels practices would be appreciated by many researchers and energy policy markers across the world. This work uses an adapted 5W2H (what, when, where, why, who, how, and how much) analysis technique to answer a variety of questions about the subject. The data, facts, and figures herein are offered as resources for other researchers and policy makers seeking benchmarking. Also, this work discusses the main certainties and uncertainties of the sugarcane agro-industry, and also goes into detail about the ethanol supply chain structure, its management, and particularities. Finally, this research analyzes the central aspects of biofuels implementation in Brazil, lists the most important aspects to consider during a selection of possible standard biofuels, and presents the main aspects of the National Program of Biodiesel Production and its sustainability. - Highlights: • A systemic cause–effect analysis was carried out on biofuel program success. • Main questions concerning implementation of liquid biofuels in Brazil were studied. • Main weakness aspects of biofuel logistic were treated. • During selection of benchmarking strategy. What needs to take into account?

DEMOGRAPHIC-ANAMNESTIC PARAMETERS WHICH AFFECT IMPLEMENTATION OF BABY FRIENDLY PROGRAM

Directory of Open Access Journals (Sweden)

Bozidar Jovanovic

2005-12-01

Full Text Available Various studies and extensive researches, particularly during recent years, on the advantages of breastfeeding and the use of breast milk in infant`s nourishment, have stressed its immeasurable benefit to mothers, infants, family and society. The objective of the research was to ascertain demographic and anamnestic factors affecting the implementation of the baby friendly program. The study was undertaken at OGC CC Kragujevac and based on data from 432 women. The mean age of the examinees was 25,9 years and they were 6 months younger than the corresponding examinees from similar world researches. In most cases, the examinees were from urban areas and lived in bigger families, which did not affect the implementation of the program. With equal probability, it was the first or second pregnancy and in most cases, there were no hospitalizations during the pregnancy in both tested groups. Medications are more often used during the implementation of the baby friendly program. The reason for positive influence of the use of medications during the pregnancy on implementation of the baby friendly program probably lies in better supervision of the pregnancy. The gestation age did not influence the selection into the program. By means of higher level of supervision and by the use of medications during pregnancy, we can positively influence mother`s and infant`s starting with the baby friendly programme implementation.

Molecular implementation of simple logic programs.

Science.gov (United States)

Ran, Tom; Kaplan, Shai; Shapiro, Ehud

2009-10-01

Autonomous programmable computing devices made of biomolecules could interact with a biological environment and be used in future biological and medical applications. Biomolecular implementations of finite automata and logic gates have already been developed. Here, we report an autonomous programmable molecular system based on the manipulation of DNA strands that is capable of performing simple logical deductions. Using molecular representations of facts such as Man(Socrates) and rules such as Mortal(X) logical deductions and delivers the result. This prototype is the first simple programming language with a molecular-scale implementation.

Ontario's emergency department process improvement program: the experience of implementation.

Science.gov (United States)

Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

2015-06-01

In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the

The Action Research Program: Experiential Learning in Systems-Based Practice for First-Year Medical Students.

Science.gov (United States)

Ackerman, Sara L; Boscardin, Christy; Karliner, Leah; Handley, Margaret A; Cheng, Sarah; Gaither, Thomas W; Hagey, Jill; Hennein, Lauren; Malik, Faizan; Shaw, Brian; Trinidad, Norver; Zahner, Greg; Gonzales, Ralph

2016-01-01

Systems-based practice focuses on the organization, financing, and delivery of medical services. The American Association of Medical Colleges has recommended that systems-based practice be incorporated into medical schools' curricula. However, experiential learning in systems-based practice, including practical strategies to improve the quality and efficiency of clinical care, is often absent from or inconsistently included in medical education. A multidisciplinary clinician and nonclinician faculty team partnered with a cardiology outpatient clinic to design a 9-month clerkship for 1st-year medical students focused on systems-based practice, delivery of clinical care, and strategies to improve the quality and efficiency of clinical operations. The clerkship was called the Action Research Program. In 2013-2014, 8 trainees participated in educational seminars, research activities, and 9-week clinic rotations. A qualitative process and outcome evaluation drew on interviews with students, clinic staff, and supervising physicians, as well as students' detailed field notes. The Action Research Program was developed and implemented at the University of California, San Francisco, an academic medical center in the United States. All educational activities took place at the university's medical school and at the medical center's cardiology outpatient clinic. Students reported and demonstrated increased understanding of how care delivery systems work, improved clinical skills, growing confidence in interactions with patients, and appreciation for patients' experiences. Clinicians reported increased efficiency at the clinic level and improved performance and job satisfaction among medical assistants as a result of their unprecedented mentoring role with students. Some clinicians felt burdened when students shadowed them and asked questions during interactions with patients. Most student-led improvement projects were not fully implemented. The Action Research Program is a

2008 report on the Monitoring of good practices programs and independence for electricity and natural gas system operators

International Nuclear Information System (INIS)

2009-01-01

Electricity and natural gas transmission system operators (TSO) and distribution system operators (DSO) are regulated operators that provide public service functions for the benefit of the network users and the consumers they serve. Accordingly, European and French law requires that they be under independent and nondiscriminatory obligations. In particular, they must develop a good practices program which includes a range of measures to prevent the risk of discriminatory practices in network access. Pursuant to Article L.134-15 of the Energy Code, the Energy Regulatory Commission (CRE) is publishing this year its 4. annual report on the monitoring of good practices programs and independence for electricity and natural gas system operators for the year 2008. This report is based on analysis of the 'reports on the implementation of good practices programs' submitted to the CRE by the operators in late 2008 and audits carried out by the CRE services in these companies in 2008

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

Science.gov (United States)

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

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.

Exploring the barriers to and facilitators of implementing research into practice.

Science.gov (United States)

Johnston, Bridget; Coole, Carol; Narayanasamy, Melanie; Feakes, Ruth; Whitworth, Gillian; Tyrell, Tracy; Hardy, Beth

2016-08-02

District and community nursing roles have changed rapidly in recent years. Community nurses are increasingly being tasked with carrying out multiple roles, which require them to put research into practice and use evidence-based tools and interventions. The implementation of interventions and tools needs to be developed from empirical research, requiring evidence, to be translated into practice. However, this process may be compromised or enhanced by a number of factors. This exploratory, descriptive qualitative study sought to identify barriers and facilitators to community nurses implementing research into practice. Four focus groups were conducted with registered community nurses and district nurses (n=22). Analysis identified four main themes: keeping up to date with evidence; using a clinical tool; education/training and implementation. Findings suggest that there are barriers at a personal, professional and organisational level. Strategies are suggested to overcome these obstacles.

Policy Implementation: Implications for Evaluation

Science.gov (United States)

DeGroff, Amy; Cargo, Margaret

2009-01-01

Policy implementation reflects a complex change process where government decisions are transformed into programs, procedures, regulations, or practices aimed at social betterment. Three factors affecting contemporary implementation processes are explored: networked governance, sociopolitical context and the democratic turn, and new public…

Implementation and outcomes of an evidence-based precepting program for burn nurses.

Science.gov (United States)

Robbins, Johnnie R; Valdez-Delgado, Krystal K; Caldwell, Nicole W; Yoder, Linda H; Hayes, Elizabeth J; Barba, Michaèl G; Greeley, Hope L; Mitchell, Colleen; Mann-Salinas, Elizabeth A

2017-11-01

There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty. The Iowa Model of Evidence-based Practice served as the model for this project. A working group was formed consisting of nurse scientists, clinical nurse leaders, clinical nurse specialists, lead preceptors, staff nurse preceptors and wound care coordinators. A systematic review of the literature was conducted focusing on nurse transition; preceptor development and transitioning nurse training programs with competency assessment, ongoing multifaceted evaluation and retention strategies were created. The evidence-based Vermont Nurses in Partnership (VNIP) Clinical Transition Framework was selected and subsequent education was provided to all Burn Center leaders and staff. Benchmarks for basic knowledge assessment (BKAT) and burn wound care were established among current staff by work site and education level to help evaluate transitioning nurses. Policies were modified to count each preceptor/transitioning nurse dyad as half an employee on the schedule. Multiple high-fidelity simulation scenarios were created to expand hands-on opportunities. From September 2012-December 2013, 110 (57% acute care nursing) Burn Center staff attended the VNIP Clinical Coaching Course, to include 34 interdisciplinary staff (rehabilitation, education, respiratory therapy, and outpatient clinic staff) and 100% of identified preceptors (n=33). A total of 30 new nurses participated in the transition program: 26 (87%) completed, 3 (10%) did not complete

Designing, testing, and implementing a sustainable nurse home visiting program: right@home.

Science.gov (United States)

Goldfeld, Sharon; Price, Anna; Kemp, Lynn

2018-05-01

Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

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

Implementation and Sustainability of an Evidence-Based Program: Lessons Learned from the Prism Applied to "First Step to Success"

Science.gov (United States)

Woodbridge, Michelle W.; Sumi, W. Carl; Yu, Jennifer; Rouspil, Kristen; Javitz, Harold S.; Seeley, John R.; Walker, Hill M.

2014-01-01

Although numerous studies address the efficacy of school-based interventions, fewer focus on how to support sustainability of interventions from the perspective of participants. To address this research gap, we use the Practical, Robust Implementation and Sustainability Model to examine how the characteristics of an evidence-based program interact…

Management practices in substance abuse treatment programs.

Science.gov (United States)

McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

2009-07-01

Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

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

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

Electronic health records and patient safety: co-occurrence of early EHR implementation with patient safety practices in primary care settings.

Science.gov (United States)

Tanner, C; Gans, D; White, J; Nath, R; Pohl, J

2015-01-01

The role of electronic health records (EHR) in enhancing patient safety, while substantiated in many studies, is still debated. This paper examines early EHR adopters in primary care to understand the extent to which EHR implementation is associated with the workflows, policies and practices that promote patient safety, as compared to practices with paper records. Early adoption is defined as those who were using EHR prior to implementation of the Meaningful Use program. We utilized the Physician Practice Patient Safety Assessment (PPPSA) to compare primary care practices with fully implemented EHR to those utilizing paper records. The PPPSA measures the extent of adoption of patient safety practices in the domains: medication management, handoffs and transition, personnel qualifications and competencies, practice management and culture, and patient communication. Data from 209 primary care practices responding between 2006-2010 were included in the analysis: 117 practices used paper medical records and 92 used an EHR. Results showed that, within all domains, EHR settings showed significantly higher rates of having workflows, policies and practices that promote patient safety than paper record settings. While these results were expected in the area of medication management, EHR use was also associated with adoption of patient safety practices in areas in which the researchers had no a priori expectations of association. Sociotechnical models of EHR use point to complex interactions between technology and other aspects of the environment related to human resources, workflow, policy, culture, among others. This study identifies that among primary care practices in the national PPPSA database, having an EHR was strongly empirically associated with the workflow, policy, communication and cultural practices recommended for safe patient care in ambulatory settings.

Management assessments of Quality Assurance Program implementation effectiveness

International Nuclear Information System (INIS)

Snyder, D.A.

1984-01-01

This paper describes a method currently being used by UNC Nuclear Industries, Richland, Washington, to help assure the effectiveness of Quality Assurance (QA) Program implementation. Assessments are conducted annually by management in each department, and the results summarized to the president and his staff. The purpose of these assessments is to review the adequacy of the department's implementing procedures, training/instruction on implementing procedures, and procedure implementation effectiveness. The primary purpose is to assess effectiveness and take improvement action where the need is indicated. The QA organization provides only general guidance in conducting the assessments

The implementation of full ATLAS detector simulation program

International Nuclear Information System (INIS)

Rimoldi, A.; Dell'Acqua, A.; Stavrianakou, M.; Amako, K.; Kanzaki, J.; Morita, Y.; Murakami, K.; Sasaki, T.; Saeki, T.; Ueda, I.; Tanaka, S.; Yoshida, H.

2001-01-01

The ATLAS detector is one of the most sophisticated and huge detectors ever designed up to now. A detailed, flexible and complete simulation program is needed in order to study the characteristics and possible problems of such a challenging apparatus and to answer to all raising questions in terms of physics, design optimization, etc. To cope with these needs the authors are implementing an application based on the simulation framework FADS/Goofy (Framework for ATLAS Detector Simulation /Geant4-based Object-Oriented Folly) in the Geant4 environment. The user's specific code implementation is presented in details for the different applications implemented until now, from the various components of the ATLAS spectrometer to some particular testbeam facilities. Particular emphasis is put in describing the simulation of the Muon Spectrometer and its subsystems as a test case for the implementation of the whole detector simulation program: the intrinsic complexity in the geometry description of the Muon System is one of the more demanding problems that are faced. The magnetic field handling, the physics impact in the event processing in presence of backgrounds from different sources and the implementation of different possible generators (including Pythia) are also discussed

APhA 2011 REMS white paper: Summary of the REMS stakeholder meeting on improving program design and implementation.

Science.gov (United States)

American Pharmacists Association; Bough, Marcie

2011-01-01

, stakeholders should continue to work collaboratively with FDA and manufacturers to improve REMS program design and implementation issues. A workable REMS system will require effective patient interventions, standardized elements that limit barriers to implementation for both patients and providers, standardized yet flexible implementation strategies, use of existing technologies in practice settings, increased opportunities for provider input early in REMS design processes, improved communication strategies and awareness of program requirements, and viable provider compensation models needed to offset costs to implement and comply with REMS program requirements.

Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia.

Science.gov (United States)

Hassali, Mohamed Azmi Ahmad; Al-Haddad, Mahmoud; Shafie, Asrul Akmal; Tangiisuran, Balamurugan; Saleem, Fahad; Atif, Muhammad; Al-Qazaz, Harith

2012-06-01

This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia. A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry. A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers. General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.

Examining Barriers to Sustained Implementation of School-Wide Prevention Practices

Science.gov (United States)

Turri, Mary G.; Mercer, Sterett H.; McIntosh, Kent; Nese, Rhonda N. T.; Strickland-Cohen, M. Kathleen; Hoselton, Robert

2016-01-01

The purpose of this study was to determine if an experimental 5-item measure of barriers to implementing and sustaining school-wide prevention practices, the "Assessment of Barriers to Implementation and Sustainability in Schools" (ABISS), would relate to objective measures of school-wide positive behavioral interventions and supports…

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.

The programming language 'PEARL' and its implementation

International Nuclear Information System (INIS)

Pelz, K.

1978-01-01

This paper describes the real time programming language PEARL, its history and design principles and the portability techniques involved in the implementation of a subset of the language on four computer systems. (Auth.)

The design and implementation of vehicle scrapping programs

International Nuclear Information System (INIS)

Sahu, R.; Baxter, R.A.

1993-01-01

A number of metropolitan air basins in the US are currently faced with increased difficulty in attaining national and regional clean air standards. Significant controls on stationary sources over the years have allowed mobile sources to become the primary source of air emission in many areas. Programs allowing the use of mobile source offsets for stationary source emission by removal of older, higher emitting vehicles through scrappage programs are, therefore, conceptually attractive and are starting to be implemented. However, achieving success in such scrappage programs is a challenge given the associated technical, economic and social issues. This paper presents a discussion of the important issues that must be considered if vehicle scrappage programs are to be successful, including recent guidance and views of the EPA and state governments on the credits associated with the programs. Although the main focus of such programs is the reduction of criteria pollutants (CO, ROG, NO x , and PM 10 ), the impact on air toxics also has to be considered. The paper will then focus on the technical design of vehicle scrappage programs such that the resulting credits are real, verifiable, enforceable, and cost-effective. Information available under existing vehicle I/M programs along with economic, vehicle maintenance, and geographic data will be used with statistical techniques in order to meet predetermined program goals regarding emissions reduction and cost-effectiveness. A later case-study paper will discuss the actual implementation of such as program in an ozone non-attainment area

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

Science.gov (United States)

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

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

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.

Implementation Plan for the Office of Nuclear Energy Knowledge Management Program

Energy Technology Data Exchange (ETDEWEB)

Kimberlyn C. Mousseau

2011-12-01

The primary purpose of the Department of Energy (DOE), Office of Nuclear Energy (NE) Knowledge Management (KM) Program is to capture, share, disseminate, and ensure the ability to apply the knowledge created by the major nuclear energy Research and Development (R&D) programs. In support of the KM program, the Implementation Plan for the Office of NE KM Program outlines the knowledge management and distributed data environment that is required for its success. In addition to enumerating some strategic goals and objectives, this document characterizes the initial program and identifies computer-based areas of investment required for increased knowledge sharing and collaboration. It identifies and addresses investments already in existence and describes how these investments can be further enhanced and implemented to support a distributed KM program. The Idaho National Laboratory (INL) is leading the effort to identify and address these investments through the implementation of a distributed KM program that includes participants from ten of the major DOE national laboratories.

Professional development programs in health promotion: tools and processes to favor new practices.

Science.gov (United States)

Torres, Sara; Richard, Lucie; Guichard, Anne; Chiocchio, François; Litvak, Eric; Beaudet, Nicole

2017-06-01

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children's vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde's (Une grille d'analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297-312, 2010) analytical grid to assess deductively the program participants' use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants. © The Author 2015. Published by

Dynamics behind the scale up of evidence-based obesity prevention: protocol for a multi-site case study of an electronic implementation monitoring system in health promotion practice.

Science.gov (United States)

Conte, Kathleen P; Groen, Sisse; Loblay, Victoria; Green, Amanda; Milat, Andrew; Persson, Lina; Innes-Hughes, Christine; Mitchell, Jo; Thackway, Sarah; Williams, Mandy; Hawe, Penelope

2017-12-06

The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been designed to assist and track the delivery of preventive policies and programs. However, there is little evidence on whether e-monitoring systems improve the dissemination, adoption, and ongoing delivery of evidence-based preventive programs. Also, given considerable difficulties with e-monitoring systems in the clinical sector, scholars have called for a more sophisticated re-examination of e-monitoring's role in enhancing implementation. In the state of New South Wales (NSW), Australia, the Population Health Information Management System (PHIMS) was created to support the dissemination of obesity prevention programs to 6000 childcare centres and elementary schools across all 15 local health districts. We have established a three-way university-policymaker-practice research partnership to investigate the impact of PHIMS on practice, how PHIMS is used, and how achievement of key performance indicators of program adoption may be associated with local contextual factors. Our methods encompass ethnographic observation, key informant interviews and participatory workshops for data interpretation at a state and local level. We use an on-line social network analysis of the collaborative relationships across local health district health promotion teams to explore the relationship between PHIMS use and the organisational structure of practice. Insights will be sensitised by institutional theory, practice theory and complex adaptive system thinking, among other theories which make sense of socio-technical action. Our working hypothesis is that the science of getting evidence-based programs into practice rests on an in-depth understanding of the role they play in the on

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.

The Process of Implementing HRM Practices : A Case Study in the Dutch Federal Government

NARCIS (Netherlands)

van Mierlo, Jorrit; Bondarouk, Tatiana

2018-01-01

Yearly, organisations create and implemented new HRM practices. To make those HRM practices work in an effective way, their implementation is of great importance. The goal of this paper is to uncover the mechanisms in which new HRM practices develop in federal governmental organisations. We do so by

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…

Development and implementation of a hospital-based patient safety program

International Nuclear Information System (INIS)

Frush, Karen S.; Alton, Michael; Frush, Donald P.

2006-01-01

Evidence from numerous studies indicates that large numbers of patients are harmed by medical errors while receiving health-care services in the United States today. The 1999 Institute of Medicine report on medical errors recommended that hospitals and health-care agencies ''establish safety programs to act as a catalyst for the development of a culture of safety'' [1]. In this article, we describe one approach to successful implementation of a hospital-based patient safety program. Although our experience at Duke University Health System will be used as an example, the needs, principles, and solutions can apply to a variety of other health-care practices. Key components include the development of safety teams, provision of tools that teams can use to support an environment of safety, and ongoing program modification to meet patient and staff needs and respond to changing priorities. By moving patient safety to the forefront of all that we do as health-care providers, we can continue to improve our delivery of health care to children and adults alike. This improvement is fostered when we enhance the culture of safety, develop a constant awareness of the possibility of human and system errors in the delivery of care, and establish additional safeguards to intercept medical errors in order to prevent harm to patients. (orig.)

Implementation of departmental quality strategies is positively associated with clinical practice: results of a multicenter study in 73 hospitals in 7 European countries.

NARCIS (Netherlands)

Suñol, R.; Wagner, C.; Arah, O.A.; Kristensen, S.; Pfaff, H.; Klazinga, N.; Thompson, C.A.; Wang, A.; DerSarkissian, M.; Bartels, P.; Michel, P.; Groene, O.

2015-01-01

Background: Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. Objective: To assess variations in clinical practice and explore

33 CFR 385.13 - Projects implemented under additional program authority.

Science.gov (United States)

2010-07-01

... Implementation Report is prepared and approved in accordance with § 385.26; and (3) Not exceed a total cost of... RESTORATION PLAN CERP Implementation Processes § 385.13 Projects implemented under additional program authority. (a) To expedite implementation of the Plan, the Corps of Engineers and non-Federal sponsors may...

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

Using a Moodle-Based Professional Development Program to Train Science Teachers to Teach for Creativity and its Effectiveness on their Teaching Practices

Science.gov (United States)

Al-Balushi, Sulaiman M.; Al-Abdali, Nasser S.

2015-08-01

This study describes a distance learning professional development program that we designed for the purpose of training science teachers to teach for creativity. The Moodle platform was used to host the training. To ensure that trainees would benefit from this distance learning program, we designed the instructional activities according to the Community of Inquiry framework, which consists of three main elements: cognitive presence, teaching presence and social presence. Nineteen science teachers in Oman engaged in the training, which lasted for 36 working days. To measure the effectiveness of the training program on science teachers' instructional practices related to teaching for creativity, we used a pre-post one-group quasi-experimental design. An observation form was used to assess and document participants' practices. Paired t test results showed that there was a statistically significant improvement in science teachers' practices related to teaching for creativity. During the implementation of the training program, we observed that cognitive presence and teaching presence were the two most successful elements of the program. The training program involved participants in different instructional activities which were designed to help them understand the role of creativity in science; a wide range of instructional techniques designed to nurture students' creativity was discussed. The program also provided participants with opportunities to relate their practices to teaching for creativity and to design and implement lesson plans geared toward teaching for creativity. However, the social presence element was not satisfying. Participants' virtual interactions with each other and their engagement in online discussion forums were limited. This paper provides some recommendations to overcome such pitfalls.

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

Science.gov (United States)

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

2015-10-16

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

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

Science.gov (United States)

2011-06-24

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

Strategies and policies for improving energy efficiency programs: Closing the loop between evaluation and implementation

International Nuclear Information System (INIS)

Vine, Edward

2008-01-01

Program implementers often use evaluation results to improve the performance of their programs, but, as described in this paper, this is not always the case. Based on a review of the literature, participation in workshops, and interviews with over 50 program implementers, evaluators, and regulators in the United States and Canada, the utilization of evaluation results is investigated by asking the following questions: (1) How are program evaluation results used by program implementers and other stakeholders? (2) How are program evaluation results communicated to program implementers and other stakeholders? (3) Are the needs of program implementers being met by program evaluation? (4) What is the role of the utility regulator in facilitating the use of program evaluation results? (5) What other mechanisms can facilitate the use of program evaluation results? While there is some consensus on the answers to these questions, the type of interest in and use of evaluation varies by functional role (e.g., evaluator versus implementer), maturity of the energy efficiency market, institutional context (e.g., evaluation and implementation conducted inside the same organization, or evaluation and implementation conducted by separate entities), and by regulatory demands and evaluation interests

Beliefs and implementation of evidence-based practice among community health nurses: A cross-sectional descriptive study.

Science.gov (United States)

Pereira, Filipa; Pellaux, Victoria; Verloo, Henk

2018-03-08

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n = 100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by

Annual report on the Monitoring of good practices programs and independence for electricity and natural gas system operators - 2006

International Nuclear Information System (INIS)

2007-01-01

Electricity and natural gas transmission system operators (TSO) and distribution system operators (DSO) are regulated operators that provide public service functions for the benefit of the network users and the consumers they serve. Accordingly, European and French law requires that they be under independent and nondiscriminatory obligations. In particular, they must develop a good practices program which includes a range of measures to prevent the risk of discriminatory practices in network access. Pursuant to Article L.134-15 of the Energy Code, the Energy Regulatory Commission (CRE) is publishing this year its 2. annual report on the monitoring of good practices programs and independence for electricity and natural gas system operators for the year 2006. This report is based on analysis of the 'reports on the implementation of good practices programs' submitted to the CRE by the operators in late 2006 and audits carried out by the CRE services in these companies in 2006

Annual report on the Monitoring of good practices programs and independence for electricity and natural gas system operators - 2007

International Nuclear Information System (INIS)

2008-01-01

Electricity and natural gas transmission system operators (TSO) and distribution system operators (DSO) are regulated operators that provide public service functions for the benefit of the network users and the consumers they serve. Accordingly, European and French law requires that they be under independent and nondiscriminatory obligations. In particular, they must develop a good practices program which includes a range of measures to prevent the risk of discriminatory practices in network access. Pursuant to Article L.134-15 of the Energy Code, the Energy Regulatory Commission (CRE) is publishing this year its 3. annual report on the monitoring of good practices programs and independence for electricity and natural gas system operators for the year 2007. This report is based on analysis of the 'reports on the implementation of good practices programs' submitted to the CRE by the operators in late 2007 and audits carried out by the CRE services in these companies in 2007

Teachers' Readiness to Implement Nutrition Education Programs: Beliefs, Attitudes, and Barriers

Science.gov (United States)

Perikkou, Anastasia; Kokkinou, Eleni; Panagiotakos, Demosthenes B.; Yannakoulia, Mary

2015-01-01

Teachers' attitudes about school food environments and their readiness to implement school-based nutrition programs were investigated. A total of 1,436 primary-school teachers filled out a questionnaire on their demographic and professional characteristics and their attitudes, beliefs, and barriers for implementing health educational programs. The…

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...

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).

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.

Seminar program for postgraduate specialty training in general practice: proposal for a 5-year thematic catalogue

Directory of Open Access Journals (Sweden)

Sommer, Susanne

2017-11-01

Full Text Available Introduction: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide. We have investigated, if the development of a common 5-year program of learning topics is conceivable between the different university departments of General practice in Germany.Method: The seminar program working group of the DEGAM (German College of General Practitioners and Family Physicians has conducted an online survey based on information gathered via preliminary telephone conference (n=7; physicians with postgraduate teaching experience among all German university departments of General Practice and two non-university teaching institutions, identified via the internet. 884 topics were extracted from 14 Seminar programs. The topics were entered in a database, discussed and categorized: Practice management/practice work flow/standardized documentation forms/quality management (n=33 topics, common acute and chronic diseases, including disease management programs (n=29 topics, communication, neurological, psychological and psychiatric consultations (n=24 topics, common medical problems, including eye, ear, nose, throat, skin and pediatric problems (n=99 Topics family physicians general approach, including epidemiology, shared decision making, test of time (n=42 Topics. These topics have been rated for priority and desirable number of teaching-units.Results: A catalogue of 111 topics was designed, encompassing 160 teaching units. There is a suggestion of wide topics collections plus an add-on catalogue.Conclusion: A proposal for a 5-year-thematic catalogue for postgraduate training of general practice residents in Germany has been developed. This newly developed curriculum has the potential to improve knowledge and skills that have not been covered during in

Systems engineering implementation plan for the liquid effluents services program

International Nuclear Information System (INIS)

Lowe, S.S.

1995-01-01

A graded approach is being taken by the Liquid Effluents Services Program in implementing systems engineering because of the advanced state of the program. The approach is cost-effective and takes credit for related work already completed, yet retains the benefits of systems engineering. This plan describes how the Liquid Effluents Services Program will implement systems engineering so there is a common understanding. Systems engineering work to be performed and the products of that work are identified. The relation to the current planning process and integration with the sitewide systems engineering effort is described

Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries

NARCIS (Netherlands)

Sunol, Rosa; Wagner, Cordula; Arah, Onyebuchi A.; Kristensen, Solvejg; Pfaff, Holger; Klazinga, Niek; Thompson, Caroline A.; Wang, Aolin; Dersarkissian, Maral; Bartels, Paul; Michel, Philippe; Groene, Oliver; Kringos, D. S.; Lombarts, M. J. M. H.; Plochg, T.; Lopez, M. A.; Secanell, M.; Sunol, R.; Vallejo, P.; Bartels, P. D.; Kristensen, S.; Michel, P.; Saillour-Glenisson, F.; Car, M.; Jones, S.; Klaus, E.; Bottaro, S.; Garel, P.; Saluvan, M.; Bruneau, C.; Depaigne-Loth, A.; Shaw, C. D.; Hammer, A.; Ommen, O.; Pfaff, H.; Groene, O.; Botje, D.; Wagner, C.; Kutaj-Wasikowska, H.; Kutriba, B.; Escoval, A.; Lívio, A.; Eiras, M.; Franca, M.; Leite, I.; Almeman, F.; Kus, H.; Ozturk, K.; Mannion, R.; Dersarkissian, M.

2015-01-01

Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. To assess variations in clinical practice and explore associations with hospital-

RAY TRACING IMPLEMENTATION IN JAVA PROGRAMMING LANGUAGE

OpenAIRE

Aybars UĞUR; Mustafa TÜRKSEVER

2002-01-01

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 ...

200 Areas Remedial Investigation/Feasibility Study Implementation Plan - Environmental Restoration Program

International Nuclear Information System (INIS)

Knepp, A. J.

1999-01-01

The 200 Areas Remedial Investigation/Feasibility Study Implementation Plan - Environmental Restoration Program (Implementation Plan) addresses approximately 700 soil waste sites (and associated structures such as pipelines) resulting from the discharge of liquids and solids from processing facilities to the ground (e.g., ponds, ditches, cribs,burial grounds) in the 200 Areas and assigned to the Environmental Restoration Program. The Implementation Plan outlines the framework for implementing assessment activities in the 200 Areas to ensure consistency in documentation, level of characterization, and decision making. The Implementation Plan also consolidates background information and other typical work plan materials, to serve as a single referenceable source for this type of information

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.

The SOS Club: A Practical Peer Helper Program.

Science.gov (United States)

Scarborough, Janna L.

1997-01-01

Describes a peer helper program developed for students in grades K-5. The program applies the concept that each student has something positive to offer the school and is responsible for providing that service. Discusses program goals and objectives, ways to gain support for the program, training, implementation, and evaluation. (RJM)

Implementation of radiation safety program in a medical institution

International Nuclear Information System (INIS)

Palanca, Elena D.

1999-01-01

A medical institution that utilizes radiation for the diagnosis and treatment of diseases of malignancies develops and implements a radiation safety program to keep occupational exposures of radiation workers and exposures of non-radiation workers and the public to the achievable and a more achievable minimum, to optimize the use of radiation, and to prevent misadministration. The hospital radiation safety program is established by a core medical radiation committee composed of trained radiation safety officers and head of authorized users of radioactive materials and radiation machines from the different departments. The radiation safety program sets up procedural guidelines of the safe use of radioactive material and of radiation equipment. It offers regular training to radiation workers and radiation safety awareness courses to hospital staff. The program has a comprehensive radiation safety information system or radsis that circularizes the radiation safety program in the hospital. The radsis keeps the drafted and updated records of safety guides and policies, radioactive material and equipment inventory, personnel dosimetry reports, administrative, regulatory and licensing activity document, laboratory procedures, emergency procedures, quality assurance and quality control program process, physics and dosimetry procedures and reports, personnel and hospital staff training program. The medical radiation protection committee is tasked to oversee the actual implementation of the radiation safety guidelines in the different radiation facilities in the hospital, to review personnel exposures, incident reports and ALARA actions, operating procedures, facility inspections and audit reports, to evaluate the existing radiation safety procedures, to make necessary changes to these procedures, and make modifications of course content of the training program. The effective implementation of the radiation safety program provides increased confidence that the physician and

Practical strategies for nursing education program evaluation.

Science.gov (United States)

Lewallen, Lynne Porter

2015-01-01

Self-evaluation is required for institutions of higher learning and the nursing programs within them. The literature provides information on evaluation models and instruments, and descriptions of how specific nursing education programs are evaluated. However, there are few discussions in the nursing education literature of the practical aspects of nursing education program evaluation: how to get started, how to keep track of data, who to involve in data collection, and how to manage challenging criteria. This article discusses the importance of program evaluation in the academic setting and provides information on practical ways to organize the evaluation process and aggregate data, and strategies for gathering data from students, graduates, alumni, and employers of graduates. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessment Practices in Undergraduate Accounting Programs

Science.gov (United States)

Lusher, Anna L.

2010-01-01

This study examined accounting program assessment plans at 102 colleges and universities in the United States. The research focused on identifying assessment practices in undergraduate accounting programs by examining the skills and competencies assessed and determining the methods of assessment used. The study also investigated what course and/or…

Moving research into practice: lessons from the US Agency for Healthcare Research and Quality's IDSRN program

Directory of Open Access Journals (Sweden)

Taylor Erin

2007-03-01

Full Text Available Abstract Background The U.S. Agency for Healthcare Research and Quality's (AHRQ Integrated Delivery Systems Research Network (IDSRN program was established to foster public-private collaboration between health services researchers and health care delivery systems. Its broad goal was to link researchers and delivery systems to encourage implementation of research into practice. We evaluated the program to address two primary questions: 1 How successful was IDSRN in generating research findings that could be applied in practice? and 2 What factors facilitate or impede such success? Methods We conducted in-person and telephone interviews with AHRQ staff and nine IDSRN partner organizations and their collaborators, reviewed program documents, analyzed projects funded through the program, and developed case studies of four IDSRN projects judged promising in supporting research implementation. Results Participants reported that the IDSRN structure was valuable in creating closer ties between researchers and participating health systems. Of the 50 completed projects studied, 30 had an operational effect or use. Some kinds of projects were more successful than others in influencing operations. If certain conditions were met, a variety of partnership models successfully supported implementation. An internal champion was necessary for partnerships involving researchers based outside the delivery system. Case studies identified several factors important to success: responsiveness of project work to delivery system needs, ongoing funding to support multiple project phases, and development of applied products or tools that helped users see their operational relevance. Factors limiting success included limited project funding, competing demands on potential research users, and failure to reach the appropriate audience. Conclusion Forging stronger partnerships between researchers and delivery systems has the potential to make research more relevant to users

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.

Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice.

Science.gov (United States)

Canada, Amanda N

2016-04-01

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence

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

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…

International Good Practice on Practical Implementation of Characterisation in Decommissioning. Radiological Characterization in Decommissioning of Nuclear Facilities: International Good Practice on Practical Implementation

International Nuclear Information System (INIS)

Larsson, A.; Empdage, M.; Weber, I.; )

2017-01-01

Within the Nuclear Energy Agency (NEA), the Working Party on Decommissioning and Dismantling (WPDD) operates under the umbrella of the Radioactive Waste Management Committee (RWMC). The WPDD provides a focus for the analysis of decommissioning policy, strategy and regulation, including the related issues of waste management, release of buildings and sites from regulatory control and associated cost estimation and funding. WPDD also convenes task groups comprised of experts from the NEA member countries to review related topics such as characterisation techniques which support decommissioning and associated waste management. The Task Group on Radiological Characterisation and Decommissioning was established in 2011 to identify and present characterisation good practice at different stages of decommissioning and to identify areas that could, or should, be developed further through international cooperation and coordination. By the end of 2016 two phases of work will be complete. The first phase developed strategic guidance for decision makers on the selection and tailoring of strategies for radiological characterisation, which gives an overview of good practice for radiological characterisation at different phases of the life cycle of a nuclear installation. The second phase has focused on strategies for practical implementation of radiological characterisation from a waste and materials end-state perspective. This paper provides a summary of the phase 2 findings, covering: -) a major international survey (questionnaire) to elicit the views of characterisation experts regarding good practice; -) Learning drawn from recent international case studies; -) The collation and analysis of regulations, standards and guidance documents; -) Learning distilled from an international conference on characterisation co-organised by the task group; and -) Overall conclusions regarding characterisation good practice, recommendations and identified areas for further international

American Historical Association Faculty Development Program: Planning and Implementation.

Science.gov (United States)

Hoffmann, Charles

The planning and implementation processes of the Long Island Faculty Development Program are described. Originally sponsored by the American Historical Association's Faculty Development Program to improve history instruction, this project includes faculty representatives from four Long Island universities, colleges, and junior colleges. The…

Implementing evidence-based practice during an economic downturn.

Science.gov (United States)

Beck, Mary S; Staffileno, Beth A

2012-01-01

Building a sustainable evidence-based practice (EBP) infrastructure during times of financial constraints poses challenges for nurse leaders. To be successful, plans need to be creative and adaptive, while mindful of limited resources. This commentary describes change management strategies used to implement an EBP infrastructure at a hospital after organizational restructuring occurred.

Improving the implementation of responsible alcohol management practices by community sporting clubs: A randomised controlled trial.

Science.gov (United States)

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco; Sidey, Maree; McElduff, Patrick; Wiggers, John H

2015-07-01

Despite an increased prevalence of risky alcohol consumption and alcohol-related harm among members of sporting groups and at sporting venues, sporting clubs frequently fail to implement alcohol management practices consistent with liquor legislation and best practice guidelines. The aim of this study was to assess the impact of a multi-strategy intervention in improving the implementation of responsible alcohol management practices by sports clubs. A randomised controlled trial was conducted with 87 football clubs, with half randomised to receive a multi-strategy intervention to support clubs to implement responsible alcohol management practices. The 2-year intervention, which was based on implementation and capacity building theory and frameworks, included project officer support, funding, accreditation rewards, printed resources, observational audit feedback, newsletters, training and support from state sporting organisations. Interviews were undertaken with club presidents at baseline and post-intervention to assess alcohol management practice implementation. Post-intervention, 88% of intervention clubs reported implementing '13 or more' of 16 responsible alcohol management practices, which was significantly greater than the proportion of control groups reporting this level of implementation (65%) [odds ratio: 3.7 (95% confidence interval: 1.1-13.2); P = 0.04]. All intervention components were considered highly useful and three-quarters or more of clubs rated the amount of implementation support to be sufficient. The multi-strategy intervention was successful in improving alcohol management practices in community sports clubs. Further research is required to better understand implementation barriers and to assess the long-term sustainability of the change in club alcohol management practices. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Kyiv institutional buildings sector energy efficiency program: Lending and implementation assessment

Energy Technology Data Exchange (ETDEWEB)

Secrest, T.J.; Freeman, S.L. [Pacific Northwest National Lab., Richland, WA (United States); Popelka, A. [Tysak Engineering, Acton, MA (United States); Shestopal, P.A.; Gagurin, E.V. [Agency for Rational Energy Use and Ecology, Kyiv (Ukraine)

1997-08-01

The government of Ukraine, through the State Committee of Energy Conservation (State Committee), is considering the implementation of energy efficiency measures in state and municipal institutional buildings in the city of Kyiv. The State Committee entered into a Memorandum of Cooperation with the US Department of Energy (DOE) to conduct an assessment of the institutional buildings sector efficiency potential. This assessment will be used to support a potential loan by the World Bank for implementing a buildings efficiency improvement program in Kyiv. This report provides an assessment of the options for structuring the lending scenarios and the implementation of the program. Components to the lending structure are options for the disbursement of funds, options for the loan service, and other financial options and considerations. Program implementation includes management structures, reporting, installation activities, and post-installation activities such as training and verification.

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

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...

An Implementation of the Object-Oriented Concurrent Programming Language SINA

NARCIS (Netherlands)

Triphathi, Anand; Berge, Eric; Aksit, Mehmet

SINA is an object-oriented language for distributed and concurrent programming. The primary focus of this paper is on the object-oriented concurrent programming mechanisms of SINA and their implementation. This paper presents the SINA constructs for concurrent programming and inter-object

Development and implementation of the waste diversion program at MDS Nordion's Cobalt Operations Facility

International Nuclear Information System (INIS)

Wasiak, T.

2004-01-01

Historically, the MDS Nordion (MDSN) Cobalt Operations Facility sent solid waste for disposal to Atomic Energy of Canada Ltd.'s Chalk River Laboratories (AECL-CRL). A large portion of this waste was not contaminated. Because this non-contaminated waste originated in the 'active area' of the MDSN facility, it was routinely disposed of as low-level active waste. In 2002, MDSN undertook an initiative to develop and implement a more sophisticated and more economical waste management program. The Waste Diversion Program (WDP) ensures continued environmental and public protection, and reduces the demand on Canada's limited capacity for storage of radioactive material and the associated operating costs. The goal of the WDP is to reduce the volume of waste currently being shipped to AECL-CRL's Waste Management Operation as low-level active waste. The presentation discusses key elements of both the development and the implementation of WDP. It focuses on the following areas: the regulatory environment surrounding the waste disposal issues in Canada and abroad. Methods used by MDSN for determination of radionuclides, which could be present in the facility. Choice of equipment and calculation of individual alarm levels for each identified radionuclide. Key elements of the practical implementation of the program. CNSC Regulatory approval process. The bottom line - dollars and cents. The primary objective of the WDP is to ensure that only waste, which meets regulatory requirements, is diverted from the solid active waste stream. This has been successfully accomplished in MDSN's Cobalt Operations Facility. The objective of the presentation is to share the knowledge and experience obtained in the development process, and thus provide a guideline for other nuclear facilities interested in establishing similar proactive and cost effective programs. (author)

A Three-Year Reflective Writing Program as Part of Introductory Pharmacy Practice Experiences

Science.gov (United States)

Vaughn, Jessica; Kerr, Kevin; Zielenski, Christopher; Toppel, Brianna; Johnson, Lauren; McCauley, Patrina; Turner, Christopher J.

2013-01-01

Objectives. To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program. Design. Reflective writing was integrated into 6 IPPE courses to develop students’ lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors. Assessment. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor’s opinions regarding the student’s achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created. Conclusions. A 3-year reflective writing program improved pharmacy students’ reflection and reflective writing skills. PMID:23788811

Challenges and Practices in Building and Implementing Biosafety and Biosecurity Programs to Enable Basic and Translational Research with Select Agents.

Science.gov (United States)

Jonsson, Colleen B; Cole, Kelly Stefano; Roy, Chad J; Perlin, David S; Byrne, Gerald

2013-04-29

Select agent research in the United States must meet federally-mandated biological surety guidelines and rules which are comprised of two main components: biosecurity and biosafety. Biosecurity is the process employed for ensuring biological agents are properly safeguarded against theft, loss, diversion, unauthorized access or use/release. Biosafety is those processes that ensure that operations with such agents are conducted in a safe, secure and reliable manner. As such, a biological surety program is generally concerned with biological agents that present high risk for adverse medical and/or agricultural consequences upon release outside of proper containment. The U.S. Regional and National Biocontainment Laboratories (RBL, NBL) represent expertise in this type of research, and are actively engaged in the development of programs to address these critical needs and federal requirements. While this comprises an ongoing activity for the RBLs, NBLs and other facilities that handle select agents as new guidelines and regulations are implemented, the present article is written with the goal of presenting a simplified yet comprehensive review of these requirements. Herein, we discuss the requirements and the various activities that the RBL/NBL programs have implemented to achieve these metrics set forth by various agencies within the U.S. Federal government.

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

Science.gov (United States)

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

2014-01-01

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