Designing a complex intervention for dementia case management in primary care

PubMed Central

2013-01-01

Background Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers. Methods Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process. Results The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source. Conclusions Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in ‘real life’ settings. PMID:23865537

Attitudes towards disability management: A survey of employees returning to work and their supervisors.

PubMed

Busse, Jason W; Dolinschi, Roman; Clarke, Andrew; Scott, Liz; Hogg-Johnson, Sheilah; Amick, Benjamin C; Rivilis, Irina; Cole, Donald

2011-01-01

Return to work after a leave on disability is a common phenomenon, but little is known about the attitudes of employees or their supervisors towards the disability management process. We report on employee and supervisor feedback from one disability management experience. 389 consecutive employees from the Ontario offices of a single private Canadian insurance company returning to work from short-term disability, and their supervisors. We surveyed employees and their supervisors about their experience with, and attitudes towards, the disability management process. Of those surveyed, 88 employees and 75 supervisors provided data (response rates of 22.6% and 19.3% respectively). The majority of respondents (79.1% of employees and supervisors) endorsed positive attitudes towards their disability management experience. More than 25% of employees disagreed with the following three items: case managers contributed to recovery, case managers removed barriers to recovery, and sufficient support was provided in the return to work process. More than 25% of employees and managers reported that a commitment to modify an unhelpful work situation was not followed through. The majority of participating employees returning to work from short-term disability, and their supervisors, reported a high level of satisfaction with the disability management process. Areas that may benefit from attention include some aspects of case manager-employee interaction and ensuring that support during the return to work process is provided, including modification to work situations when appropriate.

Evaluation of participatory planning: Lessons from Hungarian Natura 2000 management planning processes.

PubMed

Kovács, Eszter; Kelemen, Eszter; Kiss, Gabriella; Kalóczkai, Ágnes; Fabók, Veronika; Mihók, Barbara; Megyesi, Boldizsár; Pataki, György; Bodorkós, Barbara; Balázs, Bálint; Bela, Györgyi; Margóczi, Katalin; Roboz, Ágnes; Molnár, Dániel

2017-12-15

Stakeholder participation in nature conservation policies and especially in the management of protected areas has gained importance in the last decades. These changes are underlined by democratic principles and the perceived contribution of stakeholder involvement to the effectiveness of conservation management. Evaluating participatory processes is essential to learn about the past and thus increase the quality of future processes. The evaluation can be useful for the organisations responsible for planning and management, stakeholders and policy makers as well. The present paper shows the results of a systematic evaluation of 25 participatory processes related to the development of management plans for Natura 2000 sites in Hungary between 2007 and 2015. A conceptual framework was developed to evaluate the process and outcome of participatory management planning processes. Criteria were based on the scientific literature on public participation and tailored to conservation-related management planning and stakeholder involvement. Evaluated processes were grouped in three cases based on their time range and financial sources. Overall, the analysed processes scored at a medium level, showing better performance in the process criteria than in the outcome criteria. The best case scored significantly higher in four criteria compared to the other cases: representativeness, resource availability for facilitation, new, creative ideas and impact on the plan. The main factors behind the success were (1) embeddedness of the planning process in a larger project, where the plan was a tool for conservation, (2) carrying out only one process at a time, (3) previous experience of facilitators and planners with participatory planning and (4) the opportunity and capacity to propose a payment scheme as an incentive. But even this case received low scores in some criteria: conflict resolution, early involvement and well defined goals. Based on the results we suggest that more data is needed to evaluate the implementation of the plans and, in many cases, the impact of the process on the plan. Performance can be improved with the assistance of policy makers by further developing guidelines, harmonising payment schemes with the conservation measures of the plans and providing training on conflict resolution. The evaluation framework proved to be suitable for the assessment of a large set of conservation related management planning processes, but it also had some limitations, e.g. concerning the incorporation of stakeholders' views in the evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Discharge planning: a collaboration between provider and payer case managers using Medicare's Conditions of Participation.

PubMed

Birmingham, Jackie

2004-01-01

Discharge planning is a legally mandated function for hospitals and is one of the "basic" hospital roles as outlined in Medicare's Conditions of Participation. This article will define discharge planning; describe the steps in the discharge planning process; list rules and regulations that influence discharge planning in hospitals; and compare hospital-based actions with payer-based actions when planning discharges. Case managers who work for payers interact with hospital-based case managers to facilitate the discharge planning process for patients. Those who form this patient-provider-payer triangle will benefit by reviewing the dynamics of the discharge planning process.

Adapting to climate change at Olympic National Forest and Olympic National Park

USGS Publications Warehouse

Halofsky, Jessica E.; Peterson, David L.; O'Halloran, Kathy A.; Hoffman, Catherine H.

2011-01-01

Climate change presents a major challenge to natural resource managers both because of the magnitude of potential effects of climate change on ecosystem structure, processes, and function, and because of the uncertainty associated with those potential ecological effects. Concrete ways to adapt to climate change are needed to help natural resource managers take the first steps to incorporate climate change into management and take advantage of opportunities to counteract the negative effects of climate change. We began a climate change adaptation case study at Olympic National Forest (ONF) in partnership with Olympic National Park (ONP) to determine how to adapt management of federal lands on the Olympic Peninsula, Washington, to climate change. The case study began in the summer of 2008 and continued for 1½ years. The case study process involved science-based sensitivity assessments, review of management activities and constraints, and adaptation workshops in each of four focus areas (hydrology and roads, fish, vegetation, and wildlife). The process produced adaptation options for ONF and ONP, and illustrated the utility of place-based vulnerability assessment and science-management workshops in adapting to climate change. The case study process provides an example for other national forests, national parks, and natural resource agencies of how federal land management units can collaborate in the initial stages of climate change adaptation. Many of the ideas generated through this process can potentially be applied in other locations and in other agencies

Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France.

PubMed

de Stampa, Matthieu; Vedel, Isabelle; Trouvé, Hélène; Ankri, Joël; Saint Jean, Olivier; Somme, Dominique

2014-04-07

The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.

The "wins" of change: evaluating the impact of predicted changes on case management practice.

PubMed

Stanton, Marietta P; Barnett Lammon, Carol Ann

2008-01-01

A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

COLLABORATE©, Part IV: Ramping Up Competency-Based Performance Management.

PubMed

Treiger, Teresa M; Fink-Samnick, Ellen

The purpose of this fourth part of the COLLABORATE© article series provides an expansion and application of previously presented concepts pertaining to the COLLABORATE paradigm of professional case management practice. The model is built upon a value-driven foundation that: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sectors where case management is practiced. As an industry, health care continues to evolve. Terrain shifts and new influences continually surface to challenge professional case management practice. The need for top-performing and nimble professionals who are knowledgeable and proficient in the workplace continues to challenge human resource departments. In addition to care setting knowledge, professional case managers must continually invest in their practice competence toolbox to grow skills and abilities that transcend policies and processes. These individuals demonstrate agility in framing (and reframing) their professional practice to facilitate the best possible outcomes for their clients. Therefore, the continued emphasis on practice competence conveyed through the performance management cycle is an essential ingredient to performance management focused on customer service excellence and organizational improvement. Professional case management transcends professional disciplines, educational levels, and practice settings. Business objectives continue to drive work process and priorities in many practice settings. However, competencies that align with regulatory and accreditation requirements should be the critical driver for consistent, high-quality case management practice. Although there is inherent value in what various disciplines bring to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities.

The process of decision-making in home-care case management: implications for the introduction of universal assessment and information technology.

PubMed

Egan, Mary; Wells, Jennie; Byrne, Kerry; Jaglal, Susan; Stolee, Paul; Chesworth, Bert M; Hillier, Loretta M

2009-07-01

Increasingly, jurisdictions are adopting universal assessment procedures and information technology to aid in healthcare data collection and care planning. Before their potential can be realised, a better understanding is needed of how these systems can best be used to support clinical practice. We investigated the decision-making process and information needs of home-care case managers in Ontario, Canada, prior to the widespread use of universal assessment, with a view of determining how universal assessment and information technology could best support this work. Three focus groups and two individual interviews were conducted; questioning focused on decision-making in the post-acute care of individuals recovering from a hip fracture. We found that case managers' decisional process was one of a clinician-broker, combining clinical expertise and information about local services to support patient goals within the context of limited resources. This process represented expert decision-making, and the case managers valued their ability to carry out non-standardised interviews and override system directives when they noted that data may be misleading. Clear information needs were found in four areas: services available outside of their regions, patient medical information, patient pre-morbid functional status and partner/spouse health and functional status. Implications for the use of universal assessment are discussed. Recommendations are made for further research to determine the impact of universal assessment and information technology on the process and outcome of home-care case manager decision-making.

Improving healthcare services using web based platform for management of medical case studies.

PubMed

Ogescu, Cristina; Plaisanu, Claudiu; Udrescu, Florian; Dumitru, Silviu

2008-01-01

The paper presents a web based platform for management of medical cases, support for healthcare specialists in taking the best clinical decision. Research has been oriented mostly on multimedia data management, classification algorithms for querying, retrieving and processing different medical data types (text and images). The medical case studies can be accessed by healthcare specialists and by students as anonymous case studies providing trust and confidentiality in Internet virtual environment. The MIDAS platform develops an intelligent framework to manage sets of medical data (text, static or dynamic images), in order to optimize the diagnosis and the decision process, which will reduce the medical errors and will increase the quality of medical act. MIDAS is an integrated project working on medical information retrieval from heterogeneous, distributed medical multimedia database.

Clinical Management of Two Root Resorption Cases in Endodontic Practice

PubMed Central

2016-01-01

Root resorption is a pathological process involving loss of hard dental tissues. It may occur as a consequence of dental trauma, orthodontic treatment, and bleaching, and occasionally it accompanies periodontal disease. Although the mechanism of resorption process is examined in detail, its etiology is not fully understood. Wide open apical foramen is more difficult to manage and the root canal may often overfill. In this report we present two cases of root resorption and describe means for its clinical management. We conclude that useful measure of a success or failure in managing root resorption is the persistence of the resorption process. It is a clear sign of an active ongoing inflammatory process and shows the clinical need for retreatment. PMID:27648314

How to Take HRMS Process Management to the Next Level with Workflow Business Event System

NASA Technical Reports Server (NTRS)

Rajeshuni, Sarala; Yagubian, Aram; Kunamaneni, Krishna

2006-01-01

Oracle Workflow with the Business Event System offers a complete process management solution for enterprises to manage business processes cost-effectively. Using Workflow event messaging, event subscriptions, AQ Servlet and advanced queuing technologies, this presentation will demonstrate the step-by-step design and implementation of system solutions in order to integrate two dissimilar systems and establish communication remotely. As a case study, the presentation walks you through the process of propagating organization name changes in other applications that originated from the HRMS module without changing applications code. The solution can be applied to your particular business cases for streamlining or modifying business processes across Oracle and non-Oracle applications.

Case management after long-term absence from work in China: a case report.

PubMed

Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

2011-03-01

Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

Case management redesign in an urban facility.

PubMed

Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

2011-01-01

To explore strategies for improving patient throughput and to redesign case management processes to facilitate level of care transitions and safe discharges. Large Urban Medical Center in South Los Angeles County, with 384 licensed beds that services poor, underserved communities. Both qualitative and quantitative methods were applied. Combined theoretical frameworks were used for needs assessment, intervention strategies, and change management. Observations, interviews, surveys, and database extraction methods were used. The sample consisted of case management staff members and several other staff from nursing, social work, and emergency department staff. Postintervention measures indicated improvement in reimbursements for services, reduction in length of stay, increased productivity, improved patients' access to care, and avoiding unnecessary readmission or emergency department visits. Effective change management strategies must consider multiple factors that influence daily operations and service delivery. Creating accountability by using performance measures associated with patient transitions is highlighted by the case study results. The authors developed a process model to assist in identifying and tracking outcome measures related to patient throughput, front-end assessments, and effective patient care transitions. This model can be used in future research to further investigate best case management practices.

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

PubMed

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

Comparing Dutch case management care models for people with dementia and their caregivers: The design of the COMPAS study.

PubMed

MacNeil Vroomen, Janet; Van Mierlo, Lisa D; van de Ven, Peter M; Bosmans, Judith E; van den Dungen, Pim; Meiland, Franka J M; Dröes, Rose-Marie; Moll van Charante, Eric P; van der Horst, Henriëtte E; de Rooij, Sophia E; van Hout, Hein P J

2012-05-28

Dementia care in the Netherlands is shifting from fragmented, ad hoc care to more coordinated and personalised care. Case management contributes to this shift. The linkage model and a combination of intensive case management and joint agency care models were selected based on their emerging prominence in the Netherlands. It is unclear if these different forms of case management are more effective than usual care in improving or preserving the functioning and well-being at the patient and caregiver level and at the societal cost. The objective of this article is to describe the design of a study comparing these two case management care models against usual care. Clinical and cost outcomes are investigated while care processes and the facilitators and barriers for implementation of these models are considered. Mixed methods include a prospective, observational, controlled, cohort study among persons with dementia and their primary informal caregiver in regions of the Netherlands with and without case management including a qualitative process evaluation. Inclusion criteria for the cohort study are: community-dwelling individuals with a dementia diagnosis who are not terminally-ill or anticipate admission to a nursing home within 6 months and with an informal caregiver who speaks fluent Dutch. Person with dementia-informal caregiver dyads are followed for two years. The primary outcome measure is the Neuropsychiatric Inventory for the people with dementia and the General Health Questionnaire for their caregivers. Secondary outcomes include: quality of life and needs assessment in both persons with dementia and caregivers, activity of daily living, competence of care, and number of crises. Costs are measured from a societal perspective using cost diaries. Process indicators measure the quality of care from the participant's perspective. The qualitative study uses purposive sampling methods to ensure a wide variation of respondents. Semi-structured interviews with stakeholders based on the theoretical model of adaptive implementation are planned. This study provides relevant insights into care processes, description of two case management models along with clinical and economic data from persons with dementia and caregivers to clarify important differences in two case management care models compared to usual care.

Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study

PubMed Central

2012-01-01

Background Dementia care in the Netherlands is shifting from fragmented, ad hoc care to more coordinated and personalised care. Case management contributes to this shift. The linkage model and a combination of intensive case management and joint agency care models were selected based on their emerging prominence in the Netherlands. It is unclear if these different forms of case management are more effective than usual care in improving or preserving the functioning and well-being at the patient and caregiver level and at the societal cost. The objective of this article is to describe the design of a study comparing these two case management care models against usual care. Clinical and cost outcomes are investigated while care processes and the facilitators and barriers for implementation of these models are considered. Design Mixed methods include a prospective, observational, controlled, cohort study among persons with dementia and their primary informal caregiver in regions of the Netherlands with and without case management including a qualitative process evaluation. Inclusion criteria for the cohort study are: community-dwelling individuals with a dementia diagnosis who are not terminally-ill or anticipate admission to a nursing home within 6 months and with an informal caregiver who speaks fluent Dutch. Person with dementia-informal caregiver dyads are followed for two years. The primary outcome measure is the Neuropsychiatric Inventory for the people with dementia and the General Health Questionnaire for their caregivers. Secondary outcomes include: quality of life and needs assessment in both persons with dementia and caregivers, activity of daily living, competence of care, and number of crises. Costs are measured from a societal perspective using cost diaries. Process indicators measure the quality of care from the participant’s perspective. The qualitative study uses purposive sampling methods to ensure a wide variation of respondents. Semi-structured interviews with stakeholders based on the theoretical model of adaptive implementation are planned. Discussion This study provides relevant insights into care processes, description of two case management models along with clinical and economic data from persons with dementia and caregivers to clarify important differences in two case management care models compared to usual care. PMID:22640695

Process and Outcomes of School Nurse Case Management for Students with Asthma

ERIC Educational Resources Information Center

Engelke, Martha Keehner; Swanson, Melvin; Guttu, Martha

2014-01-01

There have been many studies that have examined the impact of school-based asthma programs on students with asthma. However, most studies do not provide adequate elaboration on the components of the program. Therefore, replication of these programs is difficult. This study examines the process of school nurse case management, which includes the…

The development of an acute care case manager orientation.

PubMed

Strzelecki, S; Brobst, R

1997-01-01

The authors describe the development of an inpatient acute care case manager orientation in a community hospital. Benner's application of the Dreyfus model of skill acquisition provides the basis for the orientation program. The candidates for the case manager position were expert clinicians. Because of the role change it was projected that they would function as advanced beginners. It was also predicted that, as the case managers progressed within the role, the educational process would need to be adapted to facilitate progression of skills to the proficient level. Feedback from participants reinforced that the model supported the case manager in the role transition. In addition, the model provided a predictive framework for ongoing educational activities.

Towards adaptive and integrated management paradigms to meet the challenges of water governance.

PubMed

Halbe, J; Pahl-Wostl, C; Sendzimir, J; Adamowski, J

2013-01-01

Integrated Water Resource Management (IWRM) aims at finding practical and sustainable solutions to water resource issues. Research and practice have shown that innovative methods and tools are not sufficient to implement IWRM - the concept needs to also be integrated in prevailing management paradigms and institutions. Water governance science addresses this human dimension by focusing on the analysis of regulatory processes that influence the behavior of actors in water management systems. This paper proposes a new methodology for the integrated analysis of water resources management and governance systems in order to elicit and analyze case-specific management paradigms. It builds on the Management and Transition Framework (MTF) that allows for the examination of structures and processes underlying water management and governance. The new methodology presented in this paper combines participatory modeling and analysis of the governance system by using the MTF to investigate case-specific management paradigms. The linking of participatory modeling and research on complex management and governance systems allows for the transfer of knowledge between scientific, policy, engineering and local communities. In this way, the proposed methodology facilitates assessment and implementation of transformation processes towards IWRM that require also the adoption of adaptive management principles. A case study on flood management in the Tisza River Basin in Hungary is provided to illustrate the application of the proposed methodology.

Evaluating the Facilities Planning, Design, and Construction Department: The Capital Programs Management Audit.

ERIC Educational Resources Information Center

Kaiser, Harvey H.; Kirkwood, Dennis M.

2000-01-01

Presents a diagnostic model for assessing the state of an institution's capital programs management (CPM) by delineating "work processes" which comprise that function. What capital programs management is, its resources, and its phases and work processes are described, followed by case studies of the CPM Process Model as an assessment tool. (GR)

The Case for Case-Mix: A New Construct for Hospital Management

PubMed Central

Plomann, Marilyn Peacock; Garzino, Fred R.

1981-01-01

Case-mix is a useful methodology for health care management, planning and control. It provides managers with a powerful tool by providing a framework for relating resource consumption profiles with specific treatment patterns. In the long run, it will assist hospital planners in analyzing the demands which different classes of patients bring to the hospital. Decisions concerning capital financing, facilities planning, new services, and the medical and financial implications of physician activities are more efficiently analyzed within a case-mix framework. In the near term, inventory management, staffing policies and the on-going need for the astute management of cash flow will be postively and decisively affected by the use of case-mix measures. The benefits derived from a case-mix system are not limited to hospitals possessing sophisticated management information systems. The case-mix methodology also provides a useful tool for hospitals with less advanced data processing systems and management practices in applying a variety of management science techniques to their planning and control activities.

Leadership development and succession planning in case management.

PubMed

Miodonski, Kathleen; Hines, Patricia

2013-01-01

The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

A case-based reasoning tool for breast cancer knowledge management with data mining concepts and techniques

NASA Astrophysics Data System (ADS)

Demigha, Souâd.

2016-03-01

The paper presents a Case-Based Reasoning Tool for Breast Cancer Knowledge Management to improve breast cancer screening. To develop this tool, we combine both concepts and techniques of Case-Based Reasoning (CBR) and Data Mining (DM). Physicians and radiologists ground their diagnosis on their expertise (past experience) based on clinical cases. Case-Based Reasoning is the process of solving new problems based on the solutions of similar past problems and structured as cases. CBR is suitable for medical use. On the other hand, existing traditional hospital information systems (HIS), Radiological Information Systems (RIS) and Picture Archiving Information Systems (PACS) don't allow managing efficiently medical information because of its complexity and heterogeneity. Data Mining is the process of mining information from a data set and transform it into an understandable structure for further use. Combining CBR to Data Mining techniques will facilitate diagnosis and decision-making of medical experts.

Negotiating the COAPRT Learning Outcomes Transition Using Quality Management Tools: A Case Study of the COAPRT Beta Test Site

ERIC Educational Resources Information Center

Ellis, Gary D.

2014-01-01

This paper is a case study. It tells the story of the process that the Council on Accreditation for Parks, Recreation, Tourism and Related Professions beta test site created its learning outcomes assessment program. A planning process was used that has evolved from quality management philosophy and practice: DMADV. Use of DMADV required precise…

A Case Study of Classroom Management Practices and the Influence on Classroom Disruptions

ERIC Educational Resources Information Center

Rusk, Robert Brian

2016-01-01

This qualitative case study explored how the classroom management practices of sampled teachers in a private school in central Oregon influenced classroom disruptions. Through the study, the researcher was able to provide insight on the differences in specific classroom management processes between teachers who had a high number of Positive…

Case management information systems: how to put the pieces together now and beyond year 2000.

PubMed

Matthews, P

1999-01-01

Healthcare organizations must establish the goals and objectives of their case management processes before functional and system requirements can be defined. A gap analysis will identify existing systems that can be used to support case management as well as areas in need of systems support. The gap analysis will also identify short-term tactical projects and long-term strategic initiatives supporting the automation of case management. The projects resulting from the gap analysis must be incorporated into the organization's business and information systems plan and budget to ensure appropriate funding and prioritization.

Identifying Training Needs to Improve Indigenous Community Representatives Input into Environmental Resource Management Consultative Processes: A Case Study of the Bundjalung Nation

ERIC Educational Resources Information Center

Lloyd, David; Norrie, Fiona

2004-01-01

Despite increased engagement of Indigenous representatives as participants on consultative panels charged with processes of natural resource management, concerns have been raised by both Indigenous representatives and management agencies regarding the ability of Indigenous people to have quality input into the decisions these processes produce. In…

A New Process for Organizing Assessments of Social, Economic, and Environmental Outcomes: Case Study of Wildland Fire Management in the USA

EPA Science Inventory

Ecological risk assessments typically are organized using the processes of planning (a discussion among managers, stakeholders, and analysts to clarify ecosystem management goals and assessment scope) and problem formulation (evaluation of existing information to generate hypothe...

Managing Dualities in Planned Change Initiatives

ERIC Educational Resources Information Center

Barge, J. Kevin; Lee, Michael; Maddux, Kristy; Nabring, Richard; Townsend, Bryan

2008-01-01

Dualities play an important role in creating the conditions for change and managing planned change initiatives. Building on Seo, Putnam, and Bartunek's (2003) work, this study focuses on the dualities associated with managing change processes. A case study of a planned change process called the Circle of Prosperity Initiative, a multi-stakeholder…

A new process for organizing assessments of social, economic and environmental outcomes: case study of wildland fire management in the U.S.A.

EPA Science Inventory

Ecological risk assessments typically are organized using the processes of planning (a discussion among managers, stakeholders and analysis to clarify ecosystem management goals and assessment scope) and problem formulation (evaluation of existing information to generate hypothes...

Teaching Case: MiHotel--Applicant Processing System Design Case

ERIC Educational Resources Information Center

Miller, Robert E.; Dunn, Paul

2018-01-01

This teaching case describes the functionality of an applicant processing system designed for a fictitious hotel chain. The system detailed in the case includes a webform where applicants complete and submit job applications. The system also includes a desktop application used by hotel managers and Human Resources to track applications and process…

Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

PubMed

Swanson, Jeffrey; Weissert, William G

2017-08-01

Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

PubMed

Morales-Asencio, Jose M; Kaknani-Uttumchandani, Shakira; Cuevas-Fernández-Gallego, Magdalena; Palacios-Gómez, Leopoldo; Gutiérrez-Sequera, José L; Silvano-Arranz, Agustina; Batres-Sicilia, Juan Pedro; Delgado-Romero, Ascensión; Cejudo-Lopez, Ángela; Trabado-Herrera, Manuel; García-Lara, Esteban L; Martin-Santos, Francisco J; Morilla-Herrera, Juan C

2015-10-01

Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events. © 2015 John Wiley & Sons, Ltd.

Case management in an acute-care hospital: collaborating for quality, cost-effective patient care.

PubMed

Grootveld, Kim; Wen, Victoria; Bather, Michelle; Park, Joan

2014-01-01

Case management has recently been advanced as a valuable component in achieving quality patient care that is also cost-effective. At St. Michael's Hospital, in Toronto, Ontario, case managers from a variety of professional backgrounds are central to a new care initiative--Rapid Assessment and Planning to Inform Disposition (RAPID)--in the General Internal Medicine (GIM) Unit that is designed to improve patient care and reconcile high emergency department volumes through "smart bed spacing." Involved in both planning and RAPID, GIM's case managers are the link between patient care and utilization management. These stewards of finite resources strive to make the best use of dollars spent while maintaining a commitment to quality care. Collaborating closely with physicians and others across the hospital, GIM's case managers have been instrumental in bringing about significant improvements in care coordination, utilization management and process redesign. Copyright © 2014 Longwoods Publishing.

Paper and Process: How Youth Programs Manage Program Intake, Individual Service Strategy Development, and Case Files.

ERIC Educational Resources Information Center

Callahan, Jim; McLaughlin, Brenda

This guide presents information and materials to help youth programs manage program intake, design an individual service strategy (ISS) as mandated in the Workforce Investment Act, and manage case files. The materials are based on information obtained from staff working in seven successful youth workforce investment programs in Maryland,…

Energy management study: A proposed case of government building

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount ofmore » energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.« less

Energy management study: A proposed case of government building

NASA Astrophysics Data System (ADS)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

2015-05-01

Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

PubMed

King, Robert

2009-05-01

In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.

Improving adolescent pregnancy outcomes and maternal health:a case study of comprehensive case managed services.

PubMed

Bowman, Elizabeth K; Palley, Howard A

2003-01-01

Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

Aims and harvest of moral case deliberation.

PubMed

Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

2013-09-01

Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

48 CFR 750.7110 - Processing cases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Processing cases. 750.7110 Section 750.7110 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS Extraordinary Contractual Actions To Protect Foreign Policy...

30 CFR 285.111 - When and how does MMS charge me processing fees on a case-by-case basis?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When and how does MMS charge me processing fees on a case-by-case basis? 285.111 Section 285.111 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER...

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals. PMID:20807408

Multimedia case management system implemented in Java

NASA Astrophysics Data System (ADS)

Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

1999-01-01

Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

Bertolotti's syndrome: a case report.

PubMed

Mitra, Raj; Carlisle, Mark

2009-01-01

A case report and literature review is presented. To review relevant data for the management of Bertolotti's syndrome and to determine whether the transverse process-ilium articulation may be a pain generator. Bertolotti's syndrome is associated with axial low back pain secondary to arthritic changes; the pain generator in the disorder is unclear. We present a case report of symptomatic Bertolotti's syndrome managed with intra-articular steroid injections. A patient with Bertolotti's syndrome had significant relief of axial pain after steroid injection of the ilium-transverse process articulation. Steroid therapy may be a non-surgical alternative for the treatment of symptomatic Bertolotti's syndrome.

Impact of HMO ownership on management processes and utilization outcomes.

PubMed

Ahern, M; Molinari, C

2001-05-01

To examine the effects of health maintenance organization (HMO) ownership characteristics on selected utilization outcomes and management processes affecting utilization. We used 1995 HMO data from the American Association of Health Plans. Using regression analysis, we examined the relation between HMO utilization (hospital discharges, days, and average length of stay; cardiac catheterization procedures; and average cost of outpatient prescriptions) and the structural characteristics of HMOs: ownership type (insurance company, hospital, physician, independent, and national managed care company), HMO size, for-profit status, model type, geographic region, and payer mix. HMO ownership type is significantly associated with medical management processes, including risk sharing by providers, risk sharing by consumers, and other management strategies. Relative to hospital-owned HMOs, insurance company-owned HMOs have fewer hospital discharges, fewer hospital days, and longer lengths of stay. National managed care organization-owned HMOs have fewer cardiac catheterizations and lower average outpatient prescription costs. Independently owned HMOs have more cardiac catheterizations. For-profit HMOs have lower prescription costs. Relative to hospital-owned HMOs, insurance company-owned HMOs are more likely to use hospital risk sharing and provider capitation and less likely to use out-of-pocket payments for hospital use and a closed formulary. National managed care organization-owned HMOs are less likely to use provider capitation, out-of-pocket payments for hospital use, catastrophic case management, and hospital risk sharing. Physician-hospital-owned HMOs are less likely to use catastrophic case management. For-profit HMOs are more likely to use hospital risk sharing and catastrophic case management. HMO ownership type affects utilization outcomes and management strategies.

A Process Management System for Networked Manufacturing

NASA Astrophysics Data System (ADS)

Liu, Tingting; Wang, Huifen; Liu, Linyan

With the development of computer, communication and network, networked manufacturing has become one of the main manufacturing paradigms in the 21st century. Under the networked manufacturing environment, there exist a large number of cooperative tasks susceptible to alterations, conflicts caused by resources and problems of cost and quality. This increases the complexity of administration. Process management is a technology used to design, enact, control, and analyze networked manufacturing processes. It supports efficient execution, effective management, conflict resolution, cost containment and quality control. In this paper we propose an integrated process management system for networked manufacturing. Requirements of process management are analyzed and architecture of the system is presented. And a process model considering process cost and quality is developed. Finally a case study is provided to explain how the system runs efficiently.

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

PubMed

Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy

2016-09-30

Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.

Evaluating the effects of ecosystem management: a case study in a Missouri Ozark forest

Treesearch

Wendy K. Gram; Victoria L. Sork; Robert J. Marquis; Rochelle B. Renken; Richard L. Clawson; et. al.

2002-01-01

Many federal and state management agencies have shifted from commodity-based management systems to multiple resource-based management systems that emphasize sustainable ecosystem management. Long-term sustainability of ecosystem functions and processes is at the core of ecosystem management, but a blueprint for assessing sustainability under different management...

A real-time dashboard for managing pathology processes.

PubMed

Halwani, Fawaz; Li, Wei Chen; Banerjee, Diponkar; Lessard, Lysanne; Amyot, Daniel; Michalowski, Wojtek; Giffen, Randy

2016-01-01

The Eastern Ontario Regional Laboratory Association (EORLA) is a newly established association of all the laboratory and pathology departments of Eastern Ontario that currently includes facilities from eight hospitals. All surgical specimens for EORLA are processed in one central location, the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital (TOH), where the rapid growth and influx of surgical and cytology specimens has created many challenges in ensuring the timely processing of cases and reports. Although the entire process is maintained and tracked in a clinical information system, this system lacks pre-emptive warnings that can help management address issues as they arise. Dashboard technology provides automated, real-time visual clues that could be used to alert management when a case or specimen is not being processed within predefined time frames. We describe the development of a dashboard helping pathology clinical management to make informed decisions on specimen allocation and tracking. The dashboard was designed and developed in two phases, following a prototyping approach. The first prototype of the dashboard helped monitor and manage pathology processes at the DPLM. The use of this dashboard helped to uncover operational inefficiencies and contributed to an improvement of turn-around time within The Ottawa Hospital's DPML. It also allowed the discovery of additional requirements, leading to a second prototype that provides finer-grained, real-time information about individual cases and specimens. We successfully developed a dashboard that enables managers to address delays and bottlenecks in specimen allocation and tracking. This support ensures that pathology reports are provided within time frame standards required for high-quality patient care. Given the importance of rapid diagnostics for a number of diseases, the use of real-time dashboards within pathology departments could contribute to improving the quality of patient care beyond EORLA's.

75 FR 9638 - Surface Transportation Project Delivery Pilot Program; Caltrans Audit Report

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

... practice on a case- by-case basis. The FHWA recommends that Caltrans develop a departmentwide, holistic corrective action management approach and system that will develop and implement an internal process review... the Pilot Program. During the on-site audit, Caltrans staff and management continued to express...

Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

PubMed

van der Plas, Annicka G M; Onwuteaka-Philipsen, Bregje D; Vissers, Kris C; Deliens, Luc; Jansen, Wim J J; Francke, Anneke L

2016-01-01

To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

Integrating Organizational Learning and Business Praxis: A Case for Intelligent Project Management.

ERIC Educational Resources Information Center

Cavaleri, Steven A.; Fearon, David S.

2000-01-01

Project management provides a natural home for organizational learning, freeing it from mechanical processes. Organizational learning plays a critical role in intelligent project management, which combines manageability, performance outcomes of knowledge management, and innovation. Learning should be integrated into an organization's core…

Managing the Public Sector Research and Development Portfolio Selection Process: A Case Study of Quantitative Selection and Optimization

DTIC Science & Technology

2016-09-01

PUBLIC SECTOR RESEARCH & DEVELOPMENT PORTFOLIO SELECTION PROCESS: A CASE STUDY OF QUANTITATIVE SELECTION AND OPTIMIZATION by Jason A. Schwartz...PUBLIC SECTOR RESEARCH & DEVELOPMENT PORTFOLIO SELECTION PROCESS: A CASE STUDY OF QUANTITATIVE SELECTION AND OPTIMIZATION 5. FUNDING NUMBERS 6...describing how public sector organizations can implement a research and development (R&D) portfolio optimization strategy to maximize the cost

Enabling Business Processes through Information Management and IT Systems: The FastFit and Winter Gear Distributors Case Studies

ERIC Educational Resources Information Center

Kesner, Richard M.; Russell, Bruce

2009-01-01

The "FastFit Case Study" and its companion, the "Winter Gear Distributors Case Study" provide undergraduate business students with a suitable and even familiar business context within which to initially consider the role of information management (IM) and to a lesser extent the role of information technology (IT) systems in enabling a business.…

A case of malignant hyperthermia captured by an anesthesia information management system.

PubMed

Maile, Michael D; Patel, Rajesh A; Blum, James M; Tremper, Kevin K

2011-04-01

Many cases of malignant hyperthermia triggered by volatile anesthetic agents have been described. However, to our knowledge, there has not been a report describing the precise changes in physiologic data of a human suffering from this process. Here we describe a case of malignant hyperthermia in which monitoring information was frequently and accurately captured by an anesthesia information management system.

Role transition from caregiver to case manager--Part II.

PubMed

Schmitt, Nancy

2006-01-01

This two-part article explores the process of role transition as it pertains to nurses moving from roles of caregivers to roles of case managers. Part 1 of the article presented a theoretical model that demonstrated the interplay of significant factors in the process of role transition and discussed how this model could be used to examine nurses' experience of this transition. Part 2 presents findings from a qualitative study involving interview and focus group data contributed by nurses who have made the transition from caregiver to case manager. Data point to specific tensions experienced by these nurses, which are associated with time-task orientation, interactions and relationships, business culture and objectives, and self-image and professional identity. Recommendations for preparing and supporting nurses through this role are also offered.

Innovation Process Design: A Change Management and Innovation Dimension Perspective

NASA Astrophysics Data System (ADS)

Peisl, Thomas; Reger, Veronika; Schmied, Juergen

The authors propose an innovative approach to the management of innovation integrating business, process, and maturity dimensions. Core element of the concept is the adaptation of ISO/IEC 15504 to the innovation process including 14 innovation drivers. Two managerial models are applied to conceptualize and visualize the respective innovation strategies, the Balanced Scorecard and a Barriers in Change Processes Model. An illustrative case study shows a practical implementation process.

Moving to alternative refrigerants. Ten case histories. Comfort coolers, industrial process, and commercial refrigeration. Stratospheric ozone protection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-11-01

Table of Contents: Case Histories: Comfort Coolers; Coventry Management Systems - Texaco Heritage Plaza; New York Life Insurance Company; and Westinghouse Electric Corporation. Case Histories: Industrial Process: Eastman Chemical Company; and DuPont. Case Histories: Commercial Refrigeration: Market Basket Supermarkets; Jitney Jungle Stores of America; Furr's Supermarkets; Emil Villa's Hick'ry Pit Restaurants; and Wawa Convenience Stores.

Managing integrated oncology treatment in virtual networks.

PubMed

Stanicki, Verena; Becker, Matthias; Böckmann, Britta

2015-01-01

Interdisciplinary and intersectoral coordinated healthcare management based on Clinical Practice Guidelines is essential to achieve high quality in oncological networks. The objective of our research project is to create a cookbook, which can be used by oncological networks as a template. The cookbook is based on guideline-compliant care processes. To develop these care processes, the three S3-guidelines breast, colon and prostate carcinoma have been formalized. The thus-obtained platform-independent process fragments were transformed into an underlying metamodel, which is based on HL7 and can be used for modeling clinical pathways. Additional, qualitative guided interviews were chosen to capitalize on the experts' (e.g. chief residents, resident specialists) wide knowledge and experience in oncological health care management. One of these use cases (tumor board scheduling) is developed for a healthcare management platform which is linked to a national electronic case record. The projected result of our approach is a cookbook which shows, how the treatment can be controlled by interdisciplinary and intersectoral care processes in an oncological network.

Diffusion of Policy Discourse into Rural Spheres Through Co-Management of State Forestlands: Two Cases from West Java, Indonesia

NASA Astrophysics Data System (ADS)

Kubo, Hideyuki

2008-07-01

In the context of state forestland management in tropical regions, the implementation of a co-management approach has been widely advocated in order to include the voices of local people and accommodate their interests in management decision-making. Most co-management literatures, however, underestimate the significance of statutory authority held by state to control forestlands and resources. By clarifying the implications of state ownership of forestland, this article aims to critically examine co-management processes with reference to Foucault’s notion of power and subject. Case studies were conducted at two co-management pilot sites in Gunung Halimun-Salak National Park, West Java, Indonesia. Findings demonstrate that co-management processes actually materialize shared decision-making arrangements between state forest bureaucracy and rural people through the application of equity approaches, such as deliberation, negotiation, and experimentation. At the same time, these processes can also function to diffuse state policy discourse in rural spheres, which makes rural subjects who accept and practice the policy discourse. The research also reveals that the diffusion process is complex and does not necessarily make a durable subject unless they are pertinently organized. The results of this research indicate that co-management of state forestlands is a double-edged process for local people who risk becoming a proxy of state bureaucracy in the implementation of state policy. Proponents of co-management should, therefore, critically examine whether new institutional arrangements, which are developed through co-management, truly reflect values and needs of local people and assist them to develop a pertinent subject to deal with it.

Stakeholder involvement for management of the coastal zone.

PubMed

Oen, Amy Mp; Bouma, Geiske M; Botelho, Maria; Pereira, Patrícia; Haeger-Eugensson, Marie; Conides, Alexis; Przedrzymirska, Joanna; Isaksson, Ingela; Wolf, Christina; Breedveld, Gijs D; Slob, Adriaan

2016-10-01

The European Union (EU) has taken the lead to promote the management of coastal systems. Management strategies are implemented by the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD), as well as the recent Maritime Spatial Planning (MSP) Directive. Most EU directives have a strong focus on public participation; however, a recent review found that the actual involvement of stakeholders was variable. The "Architecture and roadmap to manage multiple pressures on lagoons" (ARCH) research project has developed and implemented participative methodologies at different case study sites throughout Europe. These cases represent a broad range of coastal systems, and they highlight different legislative frameworks that are relevant for coastal zone management. Stakeholder participation processes were subsequently evaluated at 3 case study sites in order to assess the actual implementation of participation in the context of their respective legislative frameworks: 1) Byfjorden in Bergen, Norway, in the context of the WFD; 2) Amvrakikos Gulf, Greece, in the context of the MSFD; and 3) Nordre Älv Estuary, Sweden, in the context of the MSP Directive. An overall assessment of the evaluation criteria indicates that the ARCH workshop series methodology of focusing first on the current status of the lagoon or estuary, then on future challenges, and finally on identifying management solutions provided a platform that was conducive for stakeholder participation. Results suggest that key criteria for a good participatory process were present and above average at the 3 case study sites. The results also indicate that the active engagement that was initiated at the 3 case study sites has led to capacity building among the participants, which is an important intermediary outcome of public participation. A strong connection between participatory processes and policy can ensure the legacy of the intermediary outcomes, which is an important and necessary start toward more permanent resource management outcomes such as ecological and economic improvement. Integr Environ Assess Manag 2016;12:701-710. © 2016 SETAC. © 2016 SETAC.

A new process for organizing assessments of social, economic, and environmental outcomes: case study of wildland fire management in the USA

Treesearch

Randall JF Bruins; Wayne R Jr. Munns; Stephen J Botti; Steve Brink; David Cleland; Larry Kapustka; Danny Lee; al. et

2010-01-01

Ecological risk assessments typically are organized using the processes of planning (a discussion among managers, stakeholders, and analysts to clarify ecosystem management goals and assessment scope) and problem formulation (evaluation of existing information to generate hypotheses about adverse ecological effects, select assessment endpoints, and develop an analysis...

Doing Knowledge Transfer: Engaging Management and Labor with Research on Employee Health and Safety

ERIC Educational Resources Information Center

Kramer, Desre M.; Cole, Donald C.; Leithwood, Kenneth

2004-01-01

In workplace health interventions, engaging management and union decision makers is considered important for the success of the project, yet little research has described the process of making this happen. A case study of a knowledge-transfer process is presented to describe the practices and processes adopted by a knowledge broker who engaged…

SFA Ombudsman Serving Students. Interim Report, September 1999 to March 2000.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Student Financial Assistance.

This 6-page pamphlet shares what the Student Financial Assistance (SFA) Office of the Ombudsman has learned from cases it has handled. An initial section offers information on the case management process, noting that the ombudsman process depends on the case's complexity and that many are revolved quickly. Next, it examines customer-reported case…

Therapist concerns and process issues in grappling with functional autobiographical amnesia.

PubMed

Tripathi, Ravikesh; Bharath, Srikala; Desai, Geetha; Mehrotra, Seema

2013-07-01

Dissociative amnesia is relatively rare form of the dissociative disorder. This paper aims at describing the salient features of a case of functional autobiographical amnesia in a young adult and the approach adopted in the psychological management of this case. The case highlights concerns of the therapist at various stages of the therapy process.

Reflective practice: a framework for case manager development.

PubMed

Brubakken, Karen; Grant, Sara; Johnson, Mary K; Kollauf, Cynthia

2011-01-01

The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article. The practice setting is a community based case management department in a large midwestern metropolitan health care system with Magnet recognition. Advanced practice nurses provide care for clients with chronic health conditions. Twenty-four narratives were used to identify behaviors of community based case managers and to distinguish stages of practice. The behaviors of advanced practice found within the narratives were labeled and analyzed for similarities. Related behaviors were grouped and descriptor statements were written. These statements grouped into 3 domains of practice: relationship/partnership, coordination/collaboration, and clinical knowledge/decision making. The statements in each domain showed practice variations from competent to expert, and 3 stages were determined. Reliability and validity of the framework involved analysis of additional narratives. The reflective practice process, used for monthly case review presentations, provides opportunity for professional development and group learning focused on improving case manager practice. The framework is also being used in orientation as new case managers acclimate to the role. Reflective writing has unveiled the richness and depth of nurse case manager practice. The depth of knowledge and skills involved in community-based case management is captured within this reflective practice framework. This framework provides a format for describing community based case manager practice development over the course of time and has been used as a tool for orientation and peer review.

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

Driving for successful change processes in healthcare by putting staff at the wheel.

PubMed

Erlingsdottir, Gudbjörg; Ersson, Anders; Borell, Jonas; Rydenfält, Christofer

2018-03-19

Purpose The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources. After being managerially initiated, both processes were driven by local agency, decisions, planning and engagement. Design/methodology/approach The data in the paper derive from two qualitative case studies. Data were collected through in-depth interviews, observations and document studies. The cases are presented as process descriptions covering the different phases of the change processes. The focus in the studies is on the roles and interactions of the actors involved, the type of leadership and the distribution of agency. Findings Five factors emerged as paramount to the successful change processes in the two cases: local ownership of problems; a coached process where management initiates the change process and the problem recognition, and then lets the staff define the problems, formulate solutions and drive necessary changes; distributed leadership directed at enabling and supporting the staff's intentions and long-term self-leadership; mutually formulated norms and values that serve as a unifying force for the staff; and generous time allocation and planning, which allows the process to take time, and creates room for reevaluation. The authors also noted that in both cases, reorganization into multi-professional teams lent stability and endurance to the completed changes. Originality/value The research shows how management can initiate and support successful change processes that are staff driven and characterized by local agency, decisions, planning and engagement. Empirical descriptions of successful change processes are rare, which is why the description of such processes in this research increases the value of the paper.

Medical Management: Process Analysis Study Report

DTIC Science & Technology

2011-10-28

in Medical Management (care coordinator, case manager, PCM, clinic nurses , referral management shop, utilization management?, etc). The goal is to...Enterprise Nursing Procedure Manual, revealed that fact from the Navy’s perspective. An OASD(HA) TRICARE Management Activity (TMA) Senior...Requirements Analyst, Clinical Information Management (IM) and retired Army Colonel Nurse , Patricia Kinder, essentially told us no single application suite

Green Residential Demolitions: Case Study of Vacant Land Reuse in Storm Water Management in Cleveland

EPA Science Inventory

The demolition process impacts how vacant land might be reused for storm water management. For five residential demolition sites (Cleveland, Ohio), an enhanced green demolition process was observed in 2012, and soil physical and hydrologic characteristics were measured predemolit...

How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol.

PubMed

Goicolea, Isabel; Vives-Cases, Carmen; San Sebastian, Miguel; Marchal, Bruno; Kegels, Guy; Hurtig, Anna-Karin

2013-03-23

Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues-such as IPV management-get integrated into health systems, and that focuses on healthcare teams' learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.

Making Total Quality Management + Just-in-Time Manufacturing Work.

ERIC Educational Resources Information Center

Waldrop, Phillip S.; Scott, Thomas E.

2000-01-01

In one case study, teamwork was implemented in mainstream production; in a second, teamwork was applied to an ad hoc project. The cases show that process technologies and management strategies such as just-in-time are not enough; selection of the appropriate mix of individuals with complementary traits is crucial. (SK)

48 CFR 50.103-5 - Processing cases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Processing cases. 50.103-5 Section 50.103-5 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT... knowledge of individuals when documentary evidence is lacking, and audits if considered necessary to...

Reengineering outcomes management: an integrated approach to managing data, systems, and processes.

PubMed

Neuman, K; Malloch, K; Ruetten, V

1999-01-01

The integration of outcomes management into organizational reengineering projects is often overlooked or marginalized in proportion to the entire project. Incorporation of an integrated outcomes management program strengthens the overall quality of reengineering projects and enhances their sustainability. This article presents a case study in which data, systems, and processes were reengineered to form an effective Outcomes Management program as a component of the organization's overall project. The authors describe eight steps to develop and monitor an integrated outcomes management program. An example of an integrated report format is included.

How Preferences for Public Participation are Linked to Perceptions of the Context, Preferences for Outcomes, and Individual Characteristics

NASA Astrophysics Data System (ADS)

Tuler, Seth; Webler, Thomas

2010-08-01

Practitioners and stakeholders involved in environmental and risk assessment and decision-making efforts have access to a growing list of policies and guidance for implementing good process. The advice is often general. There is little understanding of how situation specific features are relevant in new circumstances. In a series of ten case studies we investigated how people’s (a) perceptions of the context, (b) preferences for outcomes, and (c) affiliations, experiences and motivations are related to their preferences for process features in a particular situation. The cases are in three policy areas: watershed management, forestry management, and clean-up and public health management of radioactively contaminated sites. We conclude this paper with a discussion of how the results can inform process design. Process design should be based on a diagnostic approach that specifically assesses relevant situational characteristics.

Mineral scale management Part III, Nonprocess elements in the paper industry

Treesearch

Alan W. Rudie; Peter W. Hart

2006-01-01

Efforts to comply with effluent standards have led to a situation where mills have little leeway in managing trace metals without developing mineral scale deposits. In most cases, the trace metals can be managed with minor process changes and siitable levels of process control. The principal tools available to the mill are pH and good washing in the first chorine...

A Qualitative Research on the University Administrators' Capacity to Use Management Knowledge Tools (The Case of TRNC Universities)

ERIC Educational Resources Information Center

Dagli, Gokmen; Silman, Fatos; Birol, Cem

2009-01-01

In order to reach goals and continue the ongoing learning process, like other organizations, universities also need the effective use of knowledge management. Knowledge management is an ongoing process and it has to be organized in a manner that is always open to new ideas. In universities where research and development studies play an important…

Draugen HSE-case - occupational health risk management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glas, J.J.P.; Kjaer, E.

1996-12-31

The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to workmore » environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.« less

Using Knowledge Management to Revise Software-Testing Processes

ERIC Educational Resources Information Center

Nogeste, Kersti; Walker, Derek H. T.

2006-01-01

Purpose: This paper aims to use a knowledge management (KM) approach to effectively revise a utility retailer's software testing process. This paper presents a case study of how the utility organisation's customer services IT production support group improved their test planning skills through applying the American Productivity and Quality Center…

Case Study: IRS Business System Modernization Process Improvement

DTIC Science & Technology

2004-03-01

31 CMU/SEI-2004-TR-002 iii List of Figures Figure 1: Managing Organizational Change ............................................................ 9...and constant emphasis on training in project management and acquisition, as well as in the SA-CMM. Figure 1: Managing Organizational Change Other

[Case management process identified from experience of nurse case managers].

PubMed

Park, Eun-Jun; Kim, Chunmi

2008-12-01

The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

Knowledge Management in Preserving Ecosystems: The Case of Seoul

ERIC Educational Resources Information Center

Lee, Jeongseok

2009-01-01

This study explores the utility of employing knowledge management as a framework for understanding how public managers perform ecosystem management. It applies the grounded theory method to build a model. The model is generated by applying the concept of knowledge process to an investigation of how the urban ecosystem is publicly managed by civil…

Health-care management of an unexpected case of Ebola virus disease at the Alcorcón Foundation University Teaching Hospital.

PubMed

Rodríguez-Caravaca, Gil; Timermans, Rafael; Parra-Ramírez, Juan Manuel; Domínguez-Hernández, Francisco Javier; Algora-Weber, Alejandro; Delgado-Iribarren, Alberto; Hermida-Gutiérrez, Guillermo

2015-04-01

The first Ebola virus infected patient outside Africa was diagnosed and treated at Alcorcón Foundation University Teaching Hospital (AFUTH). We describe the integrated management strategy (medical, occupational health, preventive and public health) applied to the case. Descriptive study of health-care management of an unexpected case of Ebola virus disease (EVD) at AFUTH treated on 6 October 2014. We describe the clinical evolution of the patient while he was attended at the Emergency Department, the drawing-up process of the action protocol, the process of training of hospital staff, the administrative management for transferring the patient to the referral centre, and the measures implemented for cleaning, disinfection and management of waste. Qualitative variables are expressed as percentages. Our centre designed and updated, from May to October, five versions of the acting and care protocol for patients with EVD. The protocol was in force at the AFUTH when a nursing assistant was attended on 6 October 2014. All preventive, diagnostic and therapeutic measures outlined in the protocol were applied and 206 professionals had received training and information about care procedures with a suspect case. Health-care management of an unexpected case of EVD was adequate and there was no secondary cases in our staff as a result. All resources available should be used to fight EVD. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

CIMOSA process classification for business process mapping in non-manufacturing firms: A case study

NASA Astrophysics Data System (ADS)

Latiffianti, Effi; Siswanto, Nurhadi; Wiratno, Stefanus Eko; Saputra, Yudha Andrian

2017-11-01

A business process mapping is one important means to enable an enterprise to effectively manage the value chain. One of widely used approaches to classify business process for mapping purpose is Computer Integrated Manufacturing System Open Architecture (CIMOSA). CIMOSA was initially designed for Computer Integrated Manufacturing (CIM) system based enterprises. This paper aims to analyze the use of CIMOSA process classification for business process mapping in the firms that do not fall within the area of CIM. Three firms of different business area that have used CIMOSA process classification were observed: an airline firm, a marketing and trading firm for oil and gas products, and an industrial estate management firm. The result of the research has shown that CIMOSA can be used in non-manufacturing firms with some adjustment. The adjustment includes addition, reduction, or modification of some processes suggested by CIMOSA process classification as evidenced by the case studies.

Essential activities and knowledge domains of case management: new insights from the CCMC role and functions study.

PubMed

Tahan, Hussein

2006-01-01

The Commission for Case Manager Certification (CCMC) defines case management (CM) as "a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs. [Case management] uses communication and available resources to promote quality, cost-effective outcomes." The practice of CM spans the entire health-care spectrum, including pre-acute, acute, and post-acute settings, and the involvement of varied care providers, such as nurses, social workers, rehabilitation counselors, physicians, and other allied health professionals. So what does it mean to practice as a case manager? What roles and job functions are performed and what knowledge is required of a professional in the field for effective practice? These highly relevant questions reflect the thinking of the CCMC commissioners when the latest Case Manager Role and Functions study was undertaken. The primary purpose of this research, which is conducted every 5 years by the CCMC, is to capture the current state of CM practice. This type of in-depth research is required to support an evidence-based certification examination such as the one offered by CCMC-the certified case manager (CCM) credential. Moreover, as the first and largest nationally accredited organization to certify US case managers, the CCMC recognizes its responsibility to undertake and promote scientifically conducted research in the field of CM.

INTEGRATED WATERSHED MANAGEMENT: PRINCIPLES AND PRACTICE. Book Review

EPA Science Inventory

Through a wide range of information and topics, Integrated Watershed Management Principles and Practice shows how involved the watershed management planning process can be. The book is informative, and the author obviously has researched the subject thoroughly. The book's case...

77 FR 67348 - Privacy Act of 1974; System of Records-Alternative Dispute Resolution (ADR) Center Case Tracking...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

... J2EE application that is platform independent and captures all information relating to Alternative Dispute Resolution case processing. It tracks, manages, and reports on all data, events, and procedures... records to indicate that it will be used: (1) To track, manage, and report on all data, events, and...

Risk management in medical product development process using traditional FMEA and fuzzy linguistic approach: a case study

NASA Astrophysics Data System (ADS)

Kirkire, Milind Shrikant; Rane, Santosh B.; Jadhav, Jagdish Rajaram

2015-12-01

Medical product development (MPD) process is highly multidisciplinary in nature, which increases the complexity and the associated risks. Managing the risks during MPD process is very crucial. The objective of this research is to explore risks during MPD in a dental product manufacturing company and propose a model for risk mitigation during MPD process to minimize failure events. A case study approach is employed. The existing MPD process is mapped with five phases of the customized phase gate process. The activities during each phase of development and risks associated with each activity are identified and categorized based on the source of occurrence. The risks are analyzed using traditional Failure mode and effect analysis (FMEA) and fuzzy FMEA. The results of two methods when compared show that fuzzy approach avoids the duplication of RPNs and helps more to convert cognition of experts into information to get values of risk factors. The critical, moderate, low level and negligible risks are identified based on criticality; risk treatments and mitigation model are proposed. During initial phases of MPD, the risks are less severe, but as the process progresses the severity of risks goes on increasing. The MPD process should be critically designed and simulated to minimize the number of risk events and their severity. To successfully develop the products/devices within the manufacturing companies, the process risk management is very essential. A systematic approach to manage risks during MPD process will lead to the development of medical products with expected quality and reliability. This is the first research of its kind having focus on MPD process risks and its management. The methodology adopted in this paper will help the developers, managers and researchers to have a competitive edge over the other companies by managing the risks during the development process.

Pharmacological pain management in chronic pancreatitis

PubMed Central

Olesen, Søren S; Juel, Jacob; Graversen, Carina; Kolesnikov, Yuri; Wilder-Smith, Oliver HG; Drewes, Asbjørn M

2013-01-01

Intense abdominal pain is a prominent feature of chronic pancreatitis and its treatment remains a major clinical challenge. Basic studies of pancreatic nerves and experimental human pain research have provided evidence that pain processing is abnormal in these patients and in many cases resembles that seen in neuropathic and chronic pain disorders. An important ultimate outcome of such aberrant pain processing is that once the disease has advanced and the pathophysiological processes are firmly established, the generation of pain can become self-perpetuating and independent of the initial peripheral nociceptive drive. Consequently, the management of pain by traditional methods based on nociceptive deafferentation (e.g., surgery and visceral nerve blockade) becomes difficult and often ineffective. This novel and improved understanding of pain aetiology requires a paradigm shift in pain management of chronic pancreatitis. Modern mechanism based pain treatments taking into account altered pain processing are likely to increasingly replace invasive therapies targeting the nociceptive source, which should be reserved for special and carefully selected cases. In this review, we offer an overview of the current available pharmacological options for pain management in chronic pancreatitis. In addition, future options for pain management are discussed with special emphasis on personalized pain medicine and multidisciplinarity. PMID:24259960

Data Quality- and Master Data Management - A Hospital Case.

PubMed

Arthofer, Klaus; Girardi, Dominic

2017-01-01

Poor data quality prevents the analysis of data for decisions which are critical for business. It also has a negative impact on business processes. Nevertheless the maturity level of data quality- and master data management is still insufficient in many organizations nowadays. This article discusses the corresponding maturity of companies and a management cycle integrating data quality- and master data management in a case dealing with benchmarking in hospitals. In conclusion if data quality and master data are not properly managed, structured data should not be acquired in the first place due to the added expense and complexity.

Analysis of Closed Claims in the Clinical Management of Rheumatoid Arthritis in Japan

PubMed Central

Otaki, Yasuhiro; Ishida, Makiko DaSilva; Saito, Yuichi; Oyama, Yasuaki; Oiso, Giichiro; Moriyama, Mitsuru

2017-01-01

Background: Despite an increasing awareness of the risk of medical errors, few data sources are available to highlight the characteristics and patterns of medical errors in the clinical management of rheumatoid arthritis (RA). The present study aimed to evaluate medical malpractice claims associated with the management of RA and other autoimmune connective tissue diseases (ACTDs). Methods: We analyzed 38 ACTD-associated closed claims extracted from a total of 8530 claims processed between July 2004 and June 2014 by the Tokyo headquarters office of Sompo Japan Nipponkoa Incorporated, a leading malpractice insurer in Japan. Results: RA was the most common ACTD assessed in this study, accounting for 20 cases. Although the male-to-female ratio among these cases was 5:15, in accordance with the general demographic distribution of RA, the proportion of patients older than 60 years (77.8%) was relatively high as the general range of RA susceptibility is 30–50 years. The analysis of allegation types among RA cases revealed statistically significant differences from non-RA cases (Fisher's exact test) as well as the following key findings: diagnosis-related allegations were absent (P < 0.01), whereas medication-related allegations were distinctively common (P = 0.02). Clinical processes related to the assessment process were most vulnerable to breakdown and leading to negligence identified with subsequent medication-related allegations, particularly among RA cases. Conclusions: The characteristics of malpractice claims associated with RA management, including the high frequency of medication-related allegations, breakdowns in the assessment process, and high claim numbers among patients older than 60 years, suggest the importance of caution exercised by physicians when administering immunosuppressants for the clinical treatment of RA. PMID:28584209

[Evaluations by hospital-ward physicians of patient care management quality for patients hospitalized after an emergency department admission].

PubMed

Bartiaux, M; Mols, P

2017-01-01

patient management in the acute and sub-acute setting of an Emergency Department is challenging. An assessment of the quality of provided care enables an evaluation of failings. It contributes to the identification of areas for improvement. to obtain an analysis, by hospital-ward physicians, of adult patient care management quality, as well as of the correctness of diagnosis made during emergency admissions. To evaluate the consequences of inadequate patient care management on morbidity, mortality and cost and duration of hospitalization. prospective data analysis obtained between the 1/12/2009 and the 21/12/2009 from physicians using a questionnaire on adult-patient emergency admissions and subsequent hospitalization. questionnaires were completed for 332 patients. Inadequate management of patient care were reported for 73/332 (22 %) cases. Incorrect diagnoses were reported for 20/332 (6 %) cases. 35 cases of inadequate care management (10.5 % overall) were associated with morbidity (34 cases) or mortality (1 case), including 4 cases (1.2 % ) that required emergency intensive-care or surgical interventions. this quality study analyzed the percentage of patient management cases and incorrect diagnoses in the emergency department. The data for serious outcome and wrong diagnosis are comparable with current literature. To improve performance, we consider the process for establishing a diagnosis and therapeutic care.

Planning and Implementing Total Quality Management in the Royal Australian Air Force: A Multiple Case Study Analysis

DTIC Science & Technology

1990-09-01

change barriers, and necessary checks and balances built into processes. Furthermore, this assessment should address management system variables which...organisation’s 69 immediate product and their worklife . Focus must be maintained on improving RAAF processes. In addition to a quality committee structure as

RFID in the Apparel Retail Industry: A Case Study from Galeria Kaufhof

NASA Astrophysics Data System (ADS)

Al-Kassab, Jasser; Blome, Philipp; Wolfram, Gerd; Thiesse, Frédéric; Fleisch, Elgar

This contribution deals with the business valueof radio frequency identification (RFID) technology in the apparel retail industry. We present a case study of an RFID project at Galeria Kaufhof, a subsidiary of Metro Group and one of the largest department store chains in Europe. The trial shows that operational efficiency gains through the automation of logistical in-store processes, such as inventory counting or goods receipt, are possible. Moreover, RFID enables new customer applications on the sales floor, which allow for a redesign of the customer interface, and thus an improvement of the service processes and the service quality. In addition, the analyses of the gathered data on the sales floor help to close the "data void" between the goods receipt and the point of sales of the department store, thus offering the opportunity to directly observe and analyze physical in-store processes. The RFID data analyses allow for deriving valuable information for the department store management in the areas of inventory management, category management, store layout management, and department store processes.

Process-related factors associated with disciplinary board decisions

PubMed Central

2013-01-01

Background In most health care systems disciplinary boards have been organised in order to process patients’ complaints about health professionals. Although, the safe-guarding of the legal rights of the involved parties is a crucial concern, there is limited knowledge about what role the complaint process plays with regard to board decision outcomes. Using complaint cases towards general practitioners, the aim of this study was to identify what process factors are statistically associated with disciplinary actions as seen from the party of the complainant and the defendant general practitioner, respectively. Methods Danish Patient Complaints Board decisions concerning general practitioners completed in 2007 were examined. Information on process factors was extracted from the case files and included complaint delay, complainant’s lawyer involvement, the number of general practitioners involved, event duration, expert witness involvement, case management duration and decision outcome (discipline or no discipline). Multiple logistic regression analyses were performed on compound case decisions eventually involving more general practitioners (as seen from the complainant’s side) and on separated decisions (as seen from the defendant general practitioner’s side). Results From the general practitioner’s side, when the number of general practitioners involved in a complaint case increased, odds of being disciplined significantly decreased (OR=0.661 per additional general practitioner involved, p<0.001). Contrarily, from the complainant’s side, no association could be detected between complaining against a plurality of general practitioners and the odds of at least one general practitioner being disciplined. From both sides, longer case management duration was associated with higher odds of discipline (OR=1.038 per additional month, p=0.010). No association could be demonstrated with regard to complaint delay, lawyer involvement, event duration, or expert witness involvement. There was lawyer involvement in 5% of cases and expert witness involvement in 92% of cases. The mean complaint delay was 3 months and 18 days and the mean case management duration was 14 months and 7 days. Conclusions Certain complaint process factors might be statistically associated with decision outcomes. However, the impact diverges as seen from the different parties. Future studies are merited in order to uncover the judicial mechanisms lying behind. PMID:23294599

Process-related factors associated with disciplinary board decisions.

PubMed

Birkeland, Søren; Christensen, Rene dePont; Damsbo, Niels; Kragstrup, Jakob

2013-01-07

In most health care systems disciplinary boards have been organised in order to process patients' complaints about health professionals. Although, the safe-guarding of the legal rights of the involved parties is a crucial concern, there is limited knowledge about what role the complaint process plays with regard to board decision outcomes. Using complaint cases towards general practitioners, the aim of this study was to identify what process factors are statistically associated with disciplinary actions as seen from the party of the complainant and the defendant general practitioner, respectively. Danish Patient Complaints Board decisions concerning general practitioners completed in 2007 were examined. Information on process factors was extracted from the case files and included complaint delay, complainant's lawyer involvement, the number of general practitioners involved, event duration, expert witness involvement, case management duration and decision outcome (discipline or no discipline). Multiple logistic regression analyses were performed on compound case decisions eventually involving more general practitioners (as seen from the complainant's side) and on separated decisions (as seen from the defendant general practitioner's side). From the general practitioner's side, when the number of general practitioners involved in a complaint case increased, odds of being disciplined significantly decreased (OR=0.661 per additional general practitioner involved, p<0.001). Contrarily, from the complainant's side, no association could be detected between complaining against a plurality of general practitioners and the odds of at least one general practitioner being disciplined. From both sides, longer case management duration was associated with higher odds of discipline (OR=1.038 per additional month, p=0.010). No association could be demonstrated with regard to complaint delay, lawyer involvement, event duration, or expert witness involvement. There was lawyer involvement in 5% of cases and expert witness involvement in 92% of cases. The mean complaint delay was 3 months and 18 days and the mean case management duration was 14 months and 7 days. Certain complaint process factors might be statistically associated with decision outcomes. However, the impact diverges as seen from the different parties. Future studies are merited in order to uncover the judicial mechanisms lying behind.

40 CFR 35.2020 - Reserves.

Code of Federal Regulations, 2010 CFR

2010-07-01

... projects using innovative processes and techniques. (d) Reserve for water quality management. Each State... water quality management planning under § 35.2023, except that in the case of Guam, the Virgin Islands... State management assistance grants. Each State may request that the Regional Administrator reserve, from...

Workflow Automation: A Collective Case Study

ERIC Educational Resources Information Center

Harlan, Jennifer

2013-01-01

Knowledge management has proven to be a sustainable competitive advantage for many organizations. Knowledge management systems are abundant, with multiple functionalities. The literature reinforces the use of workflow automation with knowledge management systems to benefit organizations; however, it was not known if process automation yielded…

Chore to Champions: The Making of Better People Managers. IES Report.

ERIC Educational Resources Information Center

Tamkin, P.; Hirsh, W.; Tyers, C.

The process of making better people managers was examined. Data were collected through interviews with managers and staff at five case study organizations in the United Kingdom and through interviews with a sample of business schools and management developers. The study established that managers must be able to do the following things: (1) empower…

Internet Telehealth for Pediatric Asthma Case Management: Integrating Computerized and Case Manager Features for Tailoring a Web-Based Asthma Education Program

PubMed Central

Wise, Meg; Gustafson, David H.; Sorkness, Christine A.; Molfenter, Todd; Staresinic, Anthony; Meis, Tracy; Hawkins, Robert P.; Shanovich, Kathleen Kelly; Walker, Nola P.

2008-01-01

This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthmanurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the yearlong integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised. PMID:16928987

A real-time dashboard for managing pathology processes

PubMed Central

Halwani, Fawaz; Li, Wei Chen; Banerjee, Diponkar; Lessard, Lysanne; Amyot, Daniel; Michalowski, Wojtek; Giffen, Randy

2016-01-01

Context: The Eastern Ontario Regional Laboratory Association (EORLA) is a newly established association of all the laboratory and pathology departments of Eastern Ontario that currently includes facilities from eight hospitals. All surgical specimens for EORLA are processed in one central location, the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital (TOH), where the rapid growth and influx of surgical and cytology specimens has created many challenges in ensuring the timely processing of cases and reports. Although the entire process is maintained and tracked in a clinical information system, this system lacks pre-emptive warnings that can help management address issues as they arise. Aims: Dashboard technology provides automated, real-time visual clues that could be used to alert management when a case or specimen is not being processed within predefined time frames. We describe the development of a dashboard helping pathology clinical management to make informed decisions on specimen allocation and tracking. Methods: The dashboard was designed and developed in two phases, following a prototyping approach. The first prototype of the dashboard helped monitor and manage pathology processes at the DPLM. Results: The use of this dashboard helped to uncover operational inefficiencies and contributed to an improvement of turn-around time within The Ottawa Hospital's DPML. It also allowed the discovery of additional requirements, leading to a second prototype that provides finer-grained, real-time information about individual cases and specimens. Conclusion: We successfully developed a dashboard that enables managers to address delays and bottlenecks in specimen allocation and tracking. This support ensures that pathology reports are provided within time frame standards required for high-quality patient care. Given the importance of rapid diagnostics for a number of diseases, the use of real-time dashboards within pathology departments could contribute to improving the quality of patient care beyond EORLA's. PMID:27217974

[Comparing case management care models for people with dementia and their caregivers: the design of the COMPAS study].

PubMed

van Hout, H P J; Macneil Vroomen, J L; Van Mierlo, L D; Meiland, F J M; Moll van Charante, E P; Joling, K J; van den Dungen, P; Dröes, R M; van der Horst, H E; de Rooij, S E J A

2014-04-01

Dementia care in The Netherlands is shifting from fragmented, ad hoc care to more coordinated and personalized care. Case management contributes to this shift. The linkage model and a combination of intensive case management and joint agency care models were selected based on their emerging prominence in The Netherlands. It is unclear if these different forms of case management are more effective than usual care in improving or preserving the functioning and well-being at the patient and caregiver level and at the societal cost. The objective of this article is to describe the design of a study comparing these two case management care models against usual care. Clinical and cost outcomes are investigated while care processes and the facilitators and barriers for implementation of these models are considered. Mixed methods include a prospective, observational, controlled, cohort study among persons with dementia and their primary informal caregiver in regions of The Netherlands with and without case management including a qualitative process evaluation. Community-dwelling individuals with a dementia diagnosis with an informal caregiver are included. The primary outcome measure is the Neuropsychiatric Inventory for the people with dementia and the General Health Questionnaire for their caregivers. Costs are measured from a societal perspective. Semi-structured interviews with stakeholders based on the theoretical model of adaptive implementation are planned. 521 pairs of persons with dementia and their primary informal caregiver were included and are followed over two years. In the linked model substantially more impeding factors for implementation were identified compared with the model. This article describes the design of an evaluation study of two case management models along with clinical and economic data from persons with dementia and caregivers. The impeding and facilitating factors differed substantially between the two models. Further results on cost-effectiveness are expected by the beginning of 2015. This is a Dutch adaptation of MacNeil Vroomen et al., Comparing Dutch case management care models for people with dementia and their caregivers: The design of the COMPAS study.

Managing frame diversity in environmental participatory processes - Example from the Fogera woreda in Ethiopia.

PubMed

Hassenforder, Emeline; Brugnach, Marcela; Cullen, Beth; Ferrand, Nils; Barreteau, Olivier; Daniell, Katherine Anne; Pittock, Jamie

2016-07-15

Many participatory processes fail to generate social change and collaborative outcomes. This failure can partly be explained by how divergent stakeholders' frames are handled. This paper builds on the framing and participation literature to explain how facilitators can manage frame diversity and foster collaborative outcomes. It suggests two pragmatic steps: identifying frames and managing frames. The two steps are applied to a participatory process for natural resource management in Fogera, Ethiopia. Effectiveness of facilitators' strategies to manage frame diversity in the Fogera case is discussed. Two main elements challenging effectiveness are identified: counter-strategies used by facilitators and most-powerful stakeholders, and the constraining factors knowledge, champions and frame sponsorship. We argue that these elements need to be taken into account by participatory process facilitators when managing frame diversity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Identifying barriers to recovery from work related upper extremity disorders: use of a collaborative problem solving technique.

PubMed

Shaw, William S; Feuerstein, Michael; Miller, Virginia I; Wood, Patricia M

2003-08-01

Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers' compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers' reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p < .05), but not to medical care. Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.

A Process-Based Knowledge Management System for Schools: A Case Study in Taiwan

ERIC Educational Resources Information Center

Lee, Chi-Lung; Lu, Hsi-Peng; Yang, Chyan; Hou, Huei-Tse

2010-01-01

Knowledge management systems, or KMSs, have been widely adopted in business organizations, yet little research exists on the actual integration of the knowledge management model and the application of KMSs in secondary schools. In the present study, the common difficulties and limitations regarding the implementation of knowledge management into…

Accountability, Fiscal Management, and Student Achievement in East St. Louis, Illinois 1994-2006: Implications for Urban Educational Reform Policy

ERIC Educational Resources Information Center

O'Malley, Michael P.; Roseboro, Donyell L.; Hunt, John

2012-01-01

This instrumental case study reviews the 1994-2004 period of state financial oversight in East St. Louis, Illinois School District 189, with a secondary review of the initial years of NCLB implementation. Although the oversight panel's fiscal management did generate financial stability, case findings indicate that its accountability processes did…

Model Transformation for a System of Systems Dependability Safety Case

NASA Technical Reports Server (NTRS)

Murphy, Judy; Driskell, Stephen B.

2010-01-01

Software plays an increasingly larger role in all aspects of NASA's science missions. This has been extended to the identification, management and control of faults which affect safety-critical functions and by default, the overall success of the mission. Traditionally, the analysis of fault identification, management and control are hardware based. Due to the increasing complexity of system, there has been a corresponding increase in the complexity in fault management software. The NASA Independent Validation & Verification (IV&V) program is creating processes and procedures to identify, and incorporate safety-critical software requirements along with corresponding software faults so that potential hazards may be mitigated. This Specific to Generic ... A Case for Reuse paper describes the phases of a dependability and safety study which identifies a new, process to create a foundation for reusable assets. These assets support the identification and management of specific software faults and, their transformation from specific to generic software faults. This approach also has applications to other systems outside of the NASA environment. This paper addresses how a mission specific dependability and safety case is being transformed to a generic dependability and safety case which can be reused for any type of space mission with an emphasis on software fault conditions.

A PBOM configuration and management method based on templates

NASA Astrophysics Data System (ADS)

Guo, Kai; Qiao, Lihong; Qie, Yifan

2018-03-01

The design of Process Bill of Materials (PBOM) holds a hinge position in the process of product development. The requirements of PBOM configuration design and management for complex products are analysed in this paper, which include the reuse technique of configuration procedure and urgent management need of huge quantity of product family PBOM data. Based on the analysis, the function framework of PBOM configuration and management has been established. Configuration templates and modules are defined in the framework to support the customization and the reuse of configuration process. The configuration process of a detection sensor PBOM is shown as an illustration case in the end. The rapid and agile PBOM configuration and management can be achieved utilizing template-based method, which has a vital significance to improve the development efficiency for complex products.

[New professional field in France: Analysis of the training needs of case managers].

PubMed

Somme, Dominique; Corvol, Aline; Couturier, Yves; Pimouguet, Clément; Moreau, Olivier; Perivier, Samuel; Balard, Frédéric; de Stampa, Matthieu

2015-01-01

Case management is a relatively new career field in France. It was first introduced on an experimental basis in 2007-2008, and was then developedfollowing the National Alzheimer Plan and finally enshrined in legislation in 2012. This careerfield is based on a set of tasks widely described internationally: identifying the right level of intervention, standardized multidimensional assessment, planning all aid (care and social services), implementation of the plan, monitoring and reassessment and periodic reassessment of all needs in a continuous and long-term process. The specific, systematic and dedicated nature of these tasks to these tasks makes training essential. Regulations also stipulate that the professional must acquire additional training by a dedicated inter-university degree. This requirement is a French specificity The authors present the history of case management and training in France and analyze the various international training frameworks identified by an Internet search. Moreover, based on the opinions expressed by case managers at different times of the scientific assessment and a review ofseveral studies conducted by inter-university case management program students, this article highlights the specific training needs of case managers and how the proposed training can meet these needs.

Modeling Soil Sodicity Problems under Dryland and Irrigated Conditions: Case Studies in Argentina and Colombia

NASA Astrophysics Data System (ADS)

Pla-Sentís, Ildefonso

2014-05-01

Salt-affected soils, both saline and sodic, my develop both under dryland and irrigated conditions, affecting negatively the physical and chemical soil properties, the crop production and the animal and human health.Among the development processes of salt-affected soils, the processes of sodification have been generally received less attention and is less understood than the development of saline soils. Although in both of them, hydrological processes are involved in their development, in the case of sodic soils we have to consider some additional chemical and physicochemical reactions, making more difficult their modeling and prediction. In this contribution we present two case studies: one related to the development of sodic soils in the lowlands of the Argentina Pampas, under dryland conditions and sub-humid temperate climate, with pastures for cattle production; the other deals with the development of sodic soils in the Colombia Cauca Valley, under irrigated conditions and tropical sub-humid climate, in lands used for sugarcane cropping dedicated to sugar and ethanol production. In both cases the development of sodicity in the surface soil is mainly related to the effects of the composition and level of groundwater, affected in the case of Argentina Pampas by the off-site changes in dryland use and management in the upper zones and by the drainage conditions in the lowlands, and in the case of the Cauca Valley, by the on-site irrigation and drainage management in lands with sugarcane. There is shown how the model SALSODIMAR, developed by the main author, based on the balance of water and soluble componentes of both the irrigation water and groundwater under different water and land management conditions, may be adapted for the diagnosis and prediction of both problems, and for the selection of alternatives for their management and amelioration.

ED breast cases and other breast emergencies.

PubMed

Khadem, Nasim; Reddy, Sravanthi; Lee, Sandy; Larsen, Linda; Walker, Daphne

2016-02-01

Patients with pathologic processes of the breast commonly present in the Emergency Department (ED). Familiarity with the imaging and management of the most common entities is essential for the radiologist. Additionally, it is important to understand the limitations of ED imaging and management in the acute setting and to recognize when referrals to a specialty breast center are necessary. The goal of this article is to review the clinical presentations, pathophysiology, imaging, and management of emergency breast cases and common breast pathology seen in the ED.

Taking Control of Enrollment Management at Small Private Universities: Creating an Interactive Interface

ERIC Educational Resources Information Center

Maltz, Elliot

2007-01-01

Enrollment management is a process critical to most small private universities that rely on tuition for a significant portion of their operating budgets. Often these universities rely on outside consultants to help them in performing this important process. This case study describes how university assets were used to create an interactive…

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

PubMed

Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

2015-06-18

Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

Enrollment Management in the Comprehensive Community College: A Case Study of Bronx Community College

ERIC Educational Resources Information Center

Ritze, Nancy

2006-01-01

Faced with growing pressure to demonstrate student success and achieve financial stability, community colleges have increasingly turned to enrollment management. Using Bronx Community College as an example, this chapter examines the role institutional research can play in the enrollment management process.

Evaluating participatory decision processes: which methods inform reflective practice?

PubMed

Kaufman, Sanda; Ozawa, Connie P; Shmueli, Deborah F

2014-02-01

Evaluating participatory decision processes serves two key purposes: validating the usefulness of specific interventions for stakeholders, interveners and funders of conflict management processes, and improving practice. However, evaluation design remains challenging, partly because when attempting to serve both purposes we may end up serving neither well. In fact, the better we respond to one, the less we may satisfy the other. Evaluations tend to focus on endogenous factors (e.g., stakeholder selection, BATNAs, mutually beneficial tradeoffs, quality of the intervention, etc.), because we believe that the success of participatory decision processes hinges on them, and they also seem to lend themselves to caeteris paribus statistical comparisons across cases. We argue that context matters too and that contextual differences among specific cases are meaningful enough to undermine conclusions derived solely from comparisons of process-endogenous factors implicitly rooted in the caeteris paribus assumption. We illustrate this argument with an environmental mediation case. We compare data collected about it through surveys geared toward comparability across cases to information elicited through in-depth interviews geared toward case specifics. The surveys, designed by the U.S. Institute of Environmental Conflict Resolution, feed a database of environmental conflicts that can help make the (statistical) case for intervention in environmental conflict management. Our interviews elicit case details - including context - that enable interveners to link context specifics and intervention actions to outcomes. We argue that neither approach can "serve both masters." Copyright © 2013 Elsevier Ltd. All rights reserved.

Exploring the life cycle management of industrial solid waste in the case of copper slag.

PubMed

Song, Xiaolong; Yang, Jianxin; Lu, Bin; Li, Bo

2013-06-01

Industrial solid waste has potential impacts on soil, water and air quality, as well as human health, during its whole life stages. A framework for the life cycle management of industrial solid waste, which integrates the source reduction process, is presented and applied to copper slag management. Three management scenarios of copper slag are developed: (i) production of cement after electric furnace treatment, (ii) production of cement after flotation, and (iii) source reduction before the recycling process. A life cycle assessment is carried out to estimate the environmental burdens of these three scenarios. Life cycle assessment results showed that the environmental burdens of the three scenarios are 2710.09, 2061.19 and 2145.02 Pt respectively. In consideration of the closed-loop recycling process, the environmental performance of the flotation approach excelled that of the electric furnace approach. Additionally, although flash smelting promotes the source reduction of copper slag compared with bath smelting, it did not reduce the overall environmental burdens resulting from the complete copper slag management process. Moreover, it led to the shifting of environmental burdens from ecosystem quality damage and resources depletion to human health damage. The case study shows that it is necessary to integrate the generation process into the whole life cycle of industrial solid waste, and to make an integrated assessment for quantifying the contribution of source reduction, rather than to simply follow the priority of source reduction and the hierarchy of waste management.

Management Design Theories

NASA Astrophysics Data System (ADS)

Pries-Heje, Jan; Baskerville, Richard L.

This paper elaborates a design science approach for management planning anchored to the concept of a management design theory. Unlike the notions of design theories arising from information systems, management design theories can appear as a system of technological rules, much as a system of hypotheses or propositions can embody scientific theories. The paper illus trates this form of management design theories with three grounded cases. These grounded cases include a software process improvement study, a user involvement study, and an organizational change study. Collectively these studies demonstrate how design theories founded on technological rules can not only improve the design of information systems, but that these concepts have great practical value for improving the framing of strategic organi zational design decisions about such systems. Each case is either grounded in an empirical sense, that is to say, actual practice, or it is grounded to practices described extensively in the practical literature. Such design theories will help managers more easily approach complex, strategic decisions.

A Case Study Approach to Marine and Aquatic Issues.

ERIC Educational Resources Information Center

Snively, Gloria

1993-01-01

Suggests using case studies of resource management conflict involving marine and aquatic resource issues to increase student involvement in decision-making processes. Provides information for a potential case involving oyster farms and six steps to help students explore problems and make decisions. (MDH)

Environmental Sustainability Change Management in SMEs: Learning from Sustainability Champions

ERIC Educational Resources Information Center

Chadee, Doren; Wiesner, Retha; Roxas, Banjo

2011-01-01

This study identifies the change management processes involved in undertaking environmental sustainability (ES) initiatives within Small and Medium Size Enterprises (SMEs) and relate these to the main attributes of learning organisations. Using case study techniques, the study draws from the change management experiences of a sample of 12 ES…

10 CFR 710.22 - Initial decision process.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) The Manager shall make an initial decision as to the individual's access authorization eligibility... Officer refers the individual's case to the Manager in accordance with § 710.25(e) or § 710.26(b). (b..., the Manager's initial decision as to the individual's access authorization eligibility shall be made...

Integration of Leadership Styles of School Director

ERIC Educational Resources Information Center

Pavlovic, Nebojsa; Oljaca, Milka; Kostovic, Svetlana

2012-01-01

Management style can be defined as a special behavior of directors in the work process that affects the performance in an organization, in this case-school. Management style has two related meanings: first is behavior of directors to employees, second is directors' approach in school regarding management, participation of employees in decision…

Assessing the whole person: case managers take a holistic approach to physical and mental health.

PubMed

Carter, Jolynne Jo; Zawalski, Sandra; Sminkey, Patrice V; Christopherson, Bruce

2015-01-01

Given the prevalence of mental health issues, particularly depressive disorders, in the U.S. population, professional case managers should increase their sensitivity to and awareness of mental illnesses, as well as their impact on physical health. Throughout the case management process, case managers frequently observe behaviors and symptoms such as those associated with depressive disorders. Case managers need to have, at a minimum, a working knowledge of mental and behavioral health issues and be familiar with basic screening tools. This will enable them to become more attuned to symptoms and behaviors that indicate that the individual should be further assessed and diagnosed by a physician. Across the case management spectrum, including acute care, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with individuals (clients who receive case management services) and their families/support systems. With more than one quarter of the U.S. population affected by a depressive disorder, professional case managers who practice holistically bring together the mental and physical aspects of health. This is particularly important in a health care system and among payer sources that continue to divide the two. Case managers elevate their practice by demonstrating a greater understanding of the interconnectedness of mental and physical health and can positively influence the transdisciplinary care team to take a person-centered approach to address all health issues, in pursuit of the individual's health goals. Professional case managers must increase their understanding of mental health, becoming more aware of "red flags" that may necessitate a further evaluation and assessment by a mental health professional. They should also hone their communication skills, particularly the use of motivational interviewing techniques, to encourage individuals to discuss their feelings, worries, fears, and anxiety, as well as any potential symptoms of depression, which may range from mild to severe. Without judgment or bias, the case manager, as the advocate, can provide the information, support, or other services needed to address mental health issues, to support and further the individual's health goals.

Does case-mix based reimbursement stimulate the development of process-oriented care delivery?

PubMed

Vos, Leti; Dückers, Michel L A; Wagner, Cordula; van Merode, Godefridus G

2010-11-01

Reimbursement based on the total care of a patient during an acute episode of illness is believed to stimulate management and clinicians to reduce quality problems like waiting times and poor coordination of care delivery. Although many studies already show that this kind of case-mix based reimbursement leads to more efficiency, it remains unclear whether care coordination improved as well. This study aims to explore whether case-mix based reimbursement stimulates development of care coordination by the use of care programmes, and a process-oriented way of working. Data for this study were gathered during the winter of 2007/2008 in a survey involving all Dutch hospitals. Descriptive and structural equation modelling (SEM) analyses were conducted. SEM reveals that adoption of the case-mix reimbursement within hospitals' budgeting processes stimulates hospitals to establish care programmes by the use of process-oriented performance measures. However, the implementation of care programmes is not (yet) accompanied by a change in focus from function (the delivery of independent care activities) to process (the delivery of care activities as being connected to a chain of interdependent care activities). This study demonstrates that hospital management can stimulate the development of care programmes by the adoption of case-mix reimbursement within hospitals' budgeting processes. Future research is recommended to confirm this finding and to determine whether the establishment of care programmes will in time indeed lead to a more process-oriented view of professionals. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Review of ecological-based risk management approaches used at five Army Superfund sites.

PubMed

Poucher, Sherri L; Tracey, Gregory A; Johnson, Mark S; Haines, Laurie B

2012-04-01

Factors used in environmental remedial decision making concerning ecological risk are not well understood or necessarily consistent. Recent Records of Decision (RODs) for Army CERCLA sites were reviewed to select case studies where remedial management occurred in response to ecological risks. Thirty-four Army RODs were evaluated representing decisions promulgated between 1996 and 2004. Five were selected based on assessments that remedial actions were clearly linked to concern for ecological receptors. The Ecological Risk Assessment (ERA) approach and the subsequent risk management process were reviewed for each site. The case studies demonstrated that the ERA findings, as well as critical management decisions regarding interpretation of identified ecological risks, were determinants of remedial action objectives. Decisions regarding the selection of remedial alternatives were based on a set of criteria prescribed by Superfund requirements and guidance. Remedial alternative evaluations require protection of human health and the environment, but protective conditions were determined using different methods at each site. Examining the remedial management process for the 5 case study sites revealed that uncertainty in the risk assessment and decisions regarding appropriate spatial scales for both risk assessment and remediation were important factors influencing remedial action decisions. The case reviews also revealed that levels of documentation were variable from site to site. In the future, more detailed documentation of decision criteria and the development of criteria that consider the resilience of the site will result in more technically defensible ecological risk management. Copyright © 2011 SETAC.

ACHP | News | Mrs. Laura Bush Presents "Preserve America History Teacher

Science.gov Websites

cases. However, regulatory and statutory changes since then have significantly altered case management practices. The Section 106 review process has evolved to focus ACHP participation on high-profile cases . Involvement in these cases can also lead the ACHP to pursue broad changes to Federal agency programs or

[A reflective case report applied to pain management in a complex care situation].

PubMed

Kinsperger, Laura; Mayrhofer, Stefanie Maria; Pichler, Birgit; Qin, Hong; Rheinfrank, Iris; Schrems, Berta

2015-10-01

This case report deals with the unsatisfying pain management of a 44 year old patient with cardiac arrest and subsequent cardiopulmonary resuscitation. The patient has (1) a reduced consciousness, (2) is isolated due to an infection with multi-resistant germs, (3) has a tracheotomy and (4) contractures of the muscles in fingers and hands. During nursing care he shows facial expressions and body postures that indicate pain which is insufficiently addressed. The case was processed according to the model of reflexive case report by Johns (1995) and interpreted by theoretical expertise and the change of the perspective. Therefore the following questions were answered: Which factors made the nurse who brought the case to the case deliberation feeling dissatisfied with the pain management? Insufficient pain management due to a lack of knowledge, no assessment of the state of consciousness, pain and isolation probably led to unnecessary burden of the patient, next of kin and nurses. Training, systematic pain management and multi-disciplinary case conferences might facilitate dealing with comparable complex situations of caring in the future. The present case report shows that pain can only be treated successfully if pain-triggering factors are recognized, systematically assessed and treated. An adequate external assessment of the pain situation is especially important when dealing with patients who suffer from disorders of consciousness. In complex cases, in which multiple factors influence the pain situation, interdisciplinary case conferences may help to improve the quality of pain management.

Case analysis online: a strategic management case model for the health industry.

PubMed

Walsh, Anne; Bearden, Eithne

2004-01-01

Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

The Process of Integrating "Knowledge Management" into Teacher's "Teaching Resources"--A Case Study on the Hospitality College

ERIC Educational Resources Information Center

Cheng, Kai-Wen; Chen, Yu-Fen

2008-01-01

Many people may think knowledge management is only applicable to enterprises. In fact, the inventor of knowledge management, Peter F. Drucker (2000), once stated that knowledge management can also be applied to schools and the major difference lies in the nature of how things are managed rather than what principles or norms are applied.…

Mining level of control in medical organizations.

PubMed

Çalimli, Olgu; Türkeli, Serkan; Eken, Emir Gökberk; Gönen, Halil Emre

2014-01-01

In literature of strategic management, there are three layers of control defined in organizational structures. These layers are strategic, tactical and operational, in which resides senior, medium level and low level managers respectively. In strategic level, institutional strategies are determined according to senior managers' perceived state of organization. In tactical level, this strategy is processed into methods and activities of a business management plan. Operational level embodies actions and functions to sustain specified business management plan. An acknowledged lead organization in Turkish medical area is examined using case study and data mining method in the scope of this paper. The level of decisions regarded in managerial purposes evaluated through chosen organization's business intelligence event logs report. Hence specification of management level importance of medical organizations is made. Case study, data mining and descriptive statistical method of taken case's reports present that positions of "Chief Executive Officer", "Outpatient Center Manager", "General Manager", monitored and analyzed functions of operational level management more frequently than strategic and tactical level. Absence of strategic management decision level research in medical area distinguishes this paper and consequently substantiates its significant contribution.

An epidemiologic perspective on a case management program.

PubMed

Kahler, Deborah; Salber, Patricia; Wilson, Thomas

2010-01-01

to improve a case management (CM) program using the principles and tools of epidemiology. Specifically, to use epidemiology to describe the population being managed, to analyze factors influencing outcomes, to assess the degree to which the CM process (or intervention) is related to those outcomes, to utilize the findings in order to make recommendations (to take action) for both better evaluation and improved and more efficient CM process, to provide an estimate of the impact of the CM program based on the comparison of pre-CM and post-CM interventions, and finally to discuss the caveat that pre-CM period probably does not provide a prediction of patterns to be expected in the post-CM period had CM not been present (an ideal, but difficult-to-find referent population for this kind of effectiveness analysis). a Medicare Advantage health plan. there were a total of 12,185 individuals who met the continuous enrollment requirement of 6 months (28 days) prior to initial contact with the CM department and 6 months after the contact date: 53% were female; the average age was 73.9 (standard deviation = ± 9.5). There was a linear relationship between the average "dose" of CM-as measured by the number of times a case manager had contact with a case-and the risk profile of the case-as measured by a standard risk assessment tool provided by the Centers for Medicare & Medicaid Services. The month-to-month costs for the study population prior to CM showed a sharp rise in the month prior to the initial contact with CM and a sharp decline beginning before the contact. This pattern was consistent across different risk profiles and our operational definition of CM "dose."The average costs 6 months prior to CM were higher than the average costs 6 months after the CM. The difference in cost varied by "dose" category. When coupled with the number of cases per dosage category, the greatest value for the CM program was in the management of moderate risk cases called two to four times.However, some of the overall decline that begins prior to the initial CM contact is likely attributed to "regression to the mean" (i.e., costs may have shown a decline in spite of CM) but not all. Subsequent studies will be designed to assess the degree to which this is the case by including an equivalent referent; ideally, one that has not experienced CM or, in the absence of that, one that experienced a different kind of CM so that a valid "comparative effectiveness" study can be conducted. the "dose" of CM to its cases was in synch with an independent assessment of risk of the cases. This implies that case managers were directing their resources to those in need. However, case managers and CM processes are a limited resource and it is of interest for management to allocate those CM resources in the most efficient way possible. Methods of assessment based on individual experiences of case managers can be improved with structured, population-based assessment. These population-based tools, according to the principles of epidemiology, will be used to better allocate CM resources for optimized impact on patient populations in the future.

Improving cost-effectiveness of and outcomes from drug therapy in patients with atrial fibrillation in managed care: role of the pharmacist.

PubMed

Johnson, Samuel G

2009-08-01

The medical care costs for procedures, medications, and testing associated with atrial fibrillation (AF) in the United States are high and projected to increase markedly in the future as the number of Americans affected grows. The burden on patient quality of life, the health care system, and society are pharmacoeconomic considerations in managing AF. To identify key pharmacoeconomic considerations in managing AF and describe ways in which managed care pharmacists can improve the cost-effectiveness of and outcomes from drug therapy for AF. The high medical care costs of AF are largely the result of the high cost of hospitalization and inpatient procedures. Recurrence of AF dramatically increases costs, especially for hospital care. Managed care pharmacists have many opportunities to provide cost-effective care to and improve outcomes in patients with AF. Policy and process review, population management, and case management are key strategies for improving outcomes in patients with AF. Pharmacist input into policy and process review, including pharmacy benefits design, formulary management, and the use of information technology, can help ensure that the use of drug therapy for AF is cost-effective. Population management strategies, such as development of clinical pathways and patient registries, seek to improve the quality, consistency, and cost-effectiveness of care and the likelihood that desired therapeutic outcomes are achieved through targeted interventions. Case management strategies focus on longitudinal care for individuals in order to improve quality. Pharmacist-managed anticoagulation services and antiarrhythmic drug monitoring are the 2 most widely known case management strategies for patients with AF. Managed care pharmacists can screen patients with AF for the use of anticoagulation, which is needed to prevent embolic stroke but is under-used, even though recommended by evidence-based guidelines. The clinical efficacy and cost-effectiveness of pharmacist-managed anticoagulation services for patients with AF are well documented. Pharmacist-managed antiarrhythmic drug monitoring is a less well-known case management strategy that facilitates early detection and intervention to minimize toxicity. Managed care pharmacists can play an instrumental role in implementing strategies to improve the cost-effectiveness of and outcomes from drug therapy for AF.

Deployment of lean six sigma in care coordination: an improved discharge process.

PubMed

Breslin, Susan Ellen; Hamilton, Karen Marie; Paynter, Jacquelyn

2014-01-01

This article presents a quality improvement project to reduce readmissions in the Medicare population related to heart failure, acute myocardial infarction, and pneumonia. The article describes a systematic approach to the discharge process aimed at improving transitions of care from hospital to post-acute care, utilizing Lean Six Sigma methodology. Inpatient acute care hospital. A coordinated discharge process, which includes postdischarge follow-up, can reduce avoidable readmissions. Implications for The quality improvement project demonstrated the significant role case management plays in preventing costly readmissions and improving outcomes for patients through better transitions of care from the hospital to the community. By utilizing Lean Six Sigma methodology, hospitals can focus on eliminating waste in their current processes and build more sustainable improvements to deliver a safe, quality, discharge process for their patients. Case managers are leading this effort to improve care transitions and assure a smoother transition into the community postdischarge..

Promoting and Disseminating Good Practice in the Planning and Management of Educational Facilities: Capital Investment Strategic Planning - A Case Study, Gold Coast Institute of TAFE, Queensland, Australia.

ERIC Educational Resources Information Center

Crump, Kelvin

This paper presents a case study of the process of capital investment strategic planning at the Gold Coast Institute of Technical and Further Education (TAFE), Queensland, Australia. Capital investment strategic planning is a means of contributing to success by providing strategies to ensure that assets are managed efficiently, effectively, and…

Thesis - keeping the management system {open_quotes}live{close_quotes} and reaching the workforce

DOE Office of Scientific and Technical Information (OSTI.GOV)

Primrose, M.J.; Bentley, P.D.; Graaf, G.C. van der

1996-12-31

Previous papers given to SPE conferences have described the Shell Group approach to Safety Management Systems and to Safety Cases. Their extension to HSE MS and to HSE Cases has also been addressed. Since 1984 the Enhanced Safety Management (ESM) programme within Shell companies has led to a significant improvement in the management of safety but it was only when structured management systems (based upon an understanding of the business processes) were introduced that true integration of HSE as a line responsibility became a reality. This paper describes the THESIS software package and the way that management systems have beenmore » made {open_quote}live{close_quote} and how workforce involvement can be demonstrated.« less

Strategic Financial Management for Conferences, Workshops, and Meetings. Jossey-Bass Higher and Adult Education Series and Jossey-Bass Management Series.

ERIC Educational Resources Information Center

Simerly, Robert G.

This book shows how to design and implement a strategic financial management system for any organization that plans conferences, workshops, and meetings. It guides the reader through steps in the budgeting and strategic financial management process. Case studies, hints, and guidelines for avoiding the most common mistakes are given, and…

Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan.

PubMed

Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu

2014-08-11

The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.

Integrating team resource management program into staff training improves staff’s perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan

PubMed Central

2014-01-01

Background The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. Methods We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. Results During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Conclusion Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation. PMID:25115403

RESEARCH: Theory in Practice: Applying Participatory Democracy Theory to Public Land Planning

PubMed

Moote; Mcclaran; Chickering

1997-11-01

/ Application of participatory democracy theory to public participation in public land planning, while widely advocated, has not been closely examined. A case study is used here to explicate the application of participatory democracy concepts to public participation in public land planning and decision making. In this case, a Bureau of Land Management resource area manager decided to make a significant shift from the traditional public involvement process to a more participatory method-coordinated resource management (CRM). This case was assessed using document analysis, direct observation of CRM meetings, questionnaires, and interviews of key participants. These sources were used to examine the CRM case using participatory democracy concepts of efficacy, access and representation, continuous participation throughout planning, information exchange and learning, and decision-making authority. The case study suggests that social deliberation in itself does not ensure successful collaboration and that establishing rules of operation and decision making within the group is critical. Furthermore, conflicts between the concept of shared decision-making authority and the public land management agencies' accountability to Congress, the President, and the courts need further consideration.KEY WORDS: Case study; Coordinated resource management; Public participation; Administrative discretion; Representation; Consensus; Collaboration

Use of monitoring data to support conservation management and policy decisions in Micronesia.

PubMed

Montambault, Jensen Reitz; Wongbusarakum, Supin; Leberer, Trina; Joseph, Eugene; Andrew, Wayne; Castro, Fran; Nevitt, Brooke; Golbuu, Yimnang; Oldiais, Noelle W; Groves, Craig R; Kostka, Willy; Houk, Peter

2015-10-01

Adaptive management implies a continuous knowledge-based decision-making process in conservation. Yet, the coupling of scientific monitoring and management frameworks remains rare in practice because formal and informal communication pathways are lacking. We examined 4 cases in Micronesia where conservation practitioners are using new knowledge in the form of monitoring data to advance marine conservation. These cases were drawn from projects in Micronesia Challenge jurisdictions that received funding for coupled monitoring-to-management frameworks and encompassed all segments of adaptive management. Monitoring in Helen Reef, Republic of Palau, was catalyzed by coral bleaching and revealed evidence of overfishing that led to increased enforcement and outreach. In Nimpal Channel, Yap, Federated States of Micronesia (FSM), monitoring the recovery of marine food resources after customary restrictions were put in place led to new, more effective enforcement approaches. Monitoring in Laolao Bay, Saipan, Commonwealth of the Northern Mariana Islands, was catalyzed by observable sediment loads from poor land-use practices and resulted in actions that reduced land-based threats, particularly littering and illegal burning, and revealed additional threats from overfishing. Pohnpei (FSM) began monitoring after observed declines in grouper spawning aggregations. This data led to adjusting marine conservation area boundaries and implementing market-based size class restrictions. Two themes emerged from these cases. First, in each case monitoring was conducted in a manner relevant to the social and ecological systems and integrated into the decision-making process. Second, conservation practitioners and scientists in these cases integrated culturally appropriate stakeholder engagement throughout all phases of the adaptive management cycle. More broadly, our study suggests, when describing adaptive management, providing more details on how monitoring and management activities are linked at similar spatial scales and across similar time frames can enhance the application of knowledge. © 2015 The Authors Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Management of Post-Traumatic Phlegmasia Cerulea Dolens via Right-to-Left Femoral Vein to Femoral Vein Bypass (Palma Procedure).

PubMed

Dua, Anahita; Heller, Jennifer; Lee, Cheong

2017-11-01

Phlegmasia cerulea dolens (PCD) is a rare condition resulting from venous occlusion that impairs arterial flow. We report a rare case of post-traumatic PCD after ligation of the iliac vein with successful treatment by right-to-left femoral vein to femoral vein bypass using left great saphenous vein (Palma procedure). The clinical presentation, diagnostic process, and approach to management along with a literature review on the operative management of PCD are presented in this case report.

Governance Challenges in Joint Inter-Jurisdictional Management: The Grand Teton National Park, Wyoming, Elk Case

NASA Astrophysics Data System (ADS)

Clark, Susan G.; Vernon, Marian E.

2015-08-01

The controversial elk reduction program (elk hunt) in Grand Teton National Park, WY, has been a source of conflict since it was legislated in 1950. The hunt is jointly managed by the National Park Service and the Wyoming Game and Fish Department. This forced organizational partnership and the conflicting mandates of these two agencies have led to persistent conflict that seems irresolvable under the current decision-making process. To better understand the decision-making process and participant perspectives, we reviewed management documents, technical literature, and newspaper articles, and interviewed 35 key participants in this case. We used these data to analyze and appraise the adequacy of the decision-making process for the park elk hunt and to ask whether it reflects the common interest. We found deficiencies in all functions of the decision-making process. Neither the decisions made nor the process itself include diverse perspectives, nor do they attend to valid and appropriate participant concerns. Agency officials focus their attention on technical rather than procedural concerns, which largely obfuscates the underlying tension in the joint inter-jurisdictional management arrangement and ultimately contributes to the hunt's annual implementation to the detriment of the common interest. We offer specific yet widely applicable recommendations to better approximate an inclusive and democratic decision-making process that serves the community's common interests.

Corporate Energy Conservation Program for Alcoa North American Extrusions: Office of Industrial Technologies (OIT) Aluminum BestPractices Management Case Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy

2001-08-06

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

Assessing Higher Level Learning: Developing Rubrics for Case Analysis

ERIC Educational Resources Information Center

Rochford, Linda; Borchert, Patricia S.

2011-01-01

Case study analyses allow students to demonstrate proficiency in executing authentic tasks in marketing and management, facilitating faculty evaluation of higher order learning outcomes. Effective and consistent assessment of case analyses depends in large part on the development of sound rubrics. The authors explored the process of rubric…

The Mammoth-June Ecosystem Management Project, Inyo National Forest

Treesearch

Connie Millar

1996-01-01

The Sierra Nevada Ecosystem Project (SNEP) case-study assessmentof the Mammoth-June Ecosystem Management Project(MJEMP) was undertaken to review and analyze the efficacy of alocal landscape analysis in achieving ecosystem-management objectivesin the Sierra Nevada. Of primary interest to SNEP was applicationof the new U.S. Forest Service (USFS) regional process...

Watershed Management Optimization Support Tool (WMOST) v1: User Manual and Case Study Examples

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is intended to be used as a screening tool as part of an integrated watershed management process such as that described in EPA’s watershed planning handbook (EPA 2008).1 The objective of WMOST is to serve as a public-doma...

Developmental Visual Dysfunction: Models for Assessment and Management.

ERIC Educational Resources Information Center

Erhardt, Rhoda Priest

This book describes transdisciplinary management of multiply disabled children with vision problems and presents four theoretical models of visual assessment and three illustrative case studies in a sequence appropriate to the learning process. The first three models are intended to lead to assessment and management of the child and the last to…

The Vocational Skills Gap for Management Accountants: The Stakeholders' Perspectives.

ERIC Educational Resources Information Center

Hassall, Trevor; Joyce, John; Montano, Jose Luis Arquero; Anes, Jose Antonio Donoso

2003-01-01

Develops a case study that examines the process of the professional education and training of management accountants. Identifies the relative importance of a specified range of vocational skills needed for a chartered management accountant, and prioritizes areas for development and training based on opinions of employers and students. (Author/LRW)

A Multiple Case Study of a Baldrige-Based Peer Review Process in an Urban School District

ERIC Educational Resources Information Center

Ray, Janet L.

2012-01-01

Distinct purposes were identified for this phenomenological multiple-case study. The first purpose of the study was to determine in what ways the BbPRP influenced (a) leadership, (b) strategic planning, and (c) process management among the five selected schools within AISD. The second purpose of this study was to examine administrators'…

The Link between the Process of Change and Coaching in an Organization--A Case Study

ERIC Educational Resources Information Center

Jim, Josephine

2016-01-01

The aim of this case study was to highlight coaching in the process of change using a real life information technology and operational change project in an institution. It demonstrates the critical importance of coaching in change management, for successful change to occur. Any sustaining change requires ongoing coaching as an integral part of the…

The influence of flexible management practices on the sharing of experiential knowledge in the workplace: a case study of food service helpers.

PubMed

Ledoux, Elise; Cloutier, Esther; Fournier, Pierre-Sébastien

2012-01-01

Previous studies have shown that the job knowledge and prudent knowledge of experienced workers constitute a wealth that needs to be shared in workplaces to promote worker integration, job retention and occupational health and safety. It appears, however, that certain management practices undermine this knowledge sharing process. This case study of food service helpers in institutional food service departments is part of a research project aimed at comparing the impact of different work organization methods on knowledge sharing in the workplace on the basis of case studies carried out in several organizations. The results of this case study reveal that by destabilizing and weakening the work teams, flexible management practices create an environment that is not conducive to experiential knowledge sharing.

Improving data collection processes for routine evaluation of treatment cost-effectiveness.

PubMed

Monto, Sari; Penttilä, Riku; Kärri, Timo; Puolakka, Kari; Valpas, Antti; Talonpoika, Anna-Maria

2016-04-01

The healthcare system in Finland has begun routine collection of health-related quality of life (HRQoL) information for patients in hospitals to support more systematic cost-effectiveness analysis (CEA). This article describes the systematic collection of HRQoL survey data, and addresses challenges in the implementation of patient surveys and acquisition of cost data in the case hospital. Challenges include problems with incomplete data and undefined management processes. In order to support CEA of hospital treatments, improvements are sought from the process management literature and in the observation of healthcare professionals. The article has been written from an information system and process management perspective, concluding that process ownership, automation of data collection and better staff training are keys to generating more reliable data.

Improving perioperative performance: the use of operations management and the electronic health record.

PubMed

Foglia, Robert P; Alder, Adam C; Ruiz, Gardito

2013-01-01

Perioperative services require the orchestration of multiple staff, space and equipment. Our aim was to identify whether the implementation of operations management and an electronic health record (EHR) improved perioperative performance. We compared 2006, pre operations management and EHR implementation, to 2010, post implementation. Operations management consisted of: communication to staff of perioperative vision and metrics, obtaining credible data and analysis, and the implementation of performance improvement processes. The EHR allows: identification of delays and the accountable service or person, collection and collation of data for analysis in multiple venues, including operational, financial, and quality. Metrics assessed included: operative cases, first case on time starts; reason for delay, and operating revenue. In 2006, 19,148 operations were performed (13,545 in the Main Operating Room (OR) area, and 5603, at satellite locations); first case on time starts were 12%; reasons for first case delay were not identifiable; and operating revenue was $115.8M overall, with $78.1M in the Main OR area. In 2010, cases increased to 25,856 (+35%); Main OR area increased to 13,986 (+3%); first case on time starts improved to 46%; operations outside the Main OR area increased to 11,870 (112%); case delays were ascribed to nurses 7%, anesthesiologists 22%, surgeons 33%, and other (patient, hospital) 38%. Five surgeons (7%) accounted for 29% of surgical delays and 4 anesthesiologists (8%) for 45% of anesthesiology delays; operating revenue increased to $177.3M (+53%) overall, and in the Main OR area rose to $101.5M (+30%). The use of operations management and EHR resulted in improved processes, credible data, promptly sharing the metrics, and pinpointing individual provider performance. Implementation of these strategies allowed us to shift cases between facilities, reallocate OR blocks, increase first case on time starts four fold and operative cases by 35%, and these changes were associated with a 53% increase in operating revenue. The fact that revenue increase was greater than case volume (53% vs. 35%) speaks for improved performance. Copyright © 2013 Elsevier Inc. All rights reserved.

The management pattern carried out in a cataract surgery day ward.

PubMed

Lin, Jing; Fang, Xiaoqun; Wu, Suhong

2013-06-01

To evaluate the management practice and process of a cataract surgery day ward. From January to December in 2012, a portion of the cataract patients were evaluated for the pattern of day ward management. Methods were as follows: 1) Establish the cataract day ward. 2) Enroll the patients who met the following criteria: voluntary, local residents or outsiders who stayed in a hotel near the hospital, accompanied by family, and who had simple senile cataract without any systemic major diseases. 3) Establish the hospitalization process. 4) Analyze the nursing process. After cataract day surgery, the patients were followed for 2 hours and completed a questionnaire about their needs and sentiments. A total of 3971 cases were observed in this study; 49 cases were switched to a normal pattern of hospitalization because of operative complications, 1 case had a strong desire to switch to a normal pattern of hospitalization because of ocular discomfort, 8 cases went back to the hospital for treatment because of ocular pain, and 52 cases called on the phone to seek help. Overall, 3820 cases(96.2%) returned on time the next day to visit the doctor. No patients showed severe postoperative complications and 98% expressed great satisfaction with the day ward process. Only 200 cases expressed great concern about not knowing how to deal with postoperative pain, the changes in condition outside the hospital, the therapeutic effects, and the problem of expense reimburse-ment. Day ward cataract surgery is an efficient and safe mode, and has the potential to relieve the demand for inpatient beds and to ensure timely treatment of the patients. In addition, it helps the patients enjoy health care at public expense, reserving reimbursement for those who need to be hospitalized. Nurses should pay more attention to systemic evaluation of the patients, health education, and psychological guidance, and keep in close communication with doctors, which is the key to ensure the safety of day ward practice.

Determining climate change management priorities: A case study from Wisconsin

USGS Publications Warehouse

LeDee, Olivia E.; Ribic, Christine

2015-01-01

A burgeoning dialogue exists regarding how to allocate resources to maximize the likelihood of long-term biodiversity conservation within the context of climate change. To make effective decisions in natural resource management, an iterative, collaborative, and learning-based decision process may be more successful than a strictly consultative approach. One important, early step in a decision process is to identify priority species or systems. Although this promotes the conservation of select species or systems, it may inadvertently alter the future of non-target species and systems. We describe a process to screen terrestrial wildlife for potential sensitivity to climate change and then use the results to engage natural resource professionals in a process of identifying priorities for monitoring, research, and adaptation strategy implementation. We demonstrate this approach using a case study from Wisconsin. In Wisconsin, experts identified 23 out of 353 species with sufficient empirical research and management understanding to inform targeted action. Habitat management and management of hydrological conditions were the common strategies for targeted action. Although there may be an interest in adaptation strategy implementation for many species and systems, experts considered existing information inadequate to inform targeted action. According to experts, 40% of the vertebrate species in Wisconsin will require near-term intervention for climate adaptation. These results will inform state-wide conservation planning as well as regional efforts.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, P E

Tips and case histories on computer use for idea and outline processing: Productivity software to solve problems of idea hierarchy, transitions, and developments is matched to solutions for communicators. One case is text that ranges from methods and procedures to histories and legal definitions of classification for the US Department of Energy. Applications of value to writers, editors, and managers are for research; calendars; creativity; prioritization; idea discovery and manipulation; file and time management; and contents, indexes, and glossaries. 6 refs., 7 figs.

SEPG Europe 2012 Conference Proceedings

DTIC Science & Technology

2012-09-01

Process Management http://www.sei.cmu.edu SEI markings v3.2/ DM-0000022 / 30 August 2011 Copyright 2012 Carnegie Mellon University This material...Change Management Decisions in Large Enterprise Transformation Programs 18 3.1 Abstract 18 3.2 Introduction 18 3.3 Barriers for Transformation 18...Case Study #3: Enterprise Transformation Through Enterprise Data Management (Investment and Asset Management ) 25 3.7 Conclusions and Recommendations 27

Developing a Three Processes Framework to Analyze Hydrologic Performance of Urban Stormwater Management in a Watershed Scale

NASA Astrophysics Data System (ADS)

Lyu, H.; Ni, G.; Sun, T.

2016-12-01

Urban stormwater management contributes to recover water cycle to a nearly natural situation. It is a challenge for analyzing the hydrologic performance in a watershed scale, since the measures are various of sorts and scales and work in different processes. A three processes framework is developed to simplify the urban hydrologic process on the surface and evaluate the urban stormwater management. The three processes include source utilization, transfer regulation and terminal detention, by which the stormwater is controlled in order or discharged. Methods for analyzing performance are based on the water controlled proportions by each process, which are calculated using USEPA Stormwater Management Model. A case study form Beijing is used to illustrate how the performance varies under a set of designed events of different return periods. This framework provides a method to assess urban stormwater management as a whole system considering the interaction between measures, and to examine if there is any weak process of an urban watershed to be improved. The results help to make better solutions of urban water crisis.

Description and process evaluation of pharmacists' interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial).

PubMed

Howard, Rachel; Rodgers, Sarah; Avery, Anthony J; Sheikh, Aziz

2014-02-01

To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices. PINCER pharmacists manually recorded patients' demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded, double-entered into SPSS version 15 and then summarised using percentages for categorical data (with 95% confidence interval (CI)) and, as appropriate, means (± standard deviation) or medians (interquartile range) for continuous data. Pharmacists spent a median of 20 min (interquartile range 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95% CI 70, 74; 1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95% CI 73, 76; 1516/2038) of cases and 1685 actions were taken in 61% (95% CI 59, 63; 1246/2038) of cases; 66% (95% CI 64, 68; 1383/2105) of interventions recommended by pharmacists were completed and 5% (95% CI 4, 6; 104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists' placement; the remaining recommendations were rejected or considered not relevant by GPs. The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training. © 2013 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

Are we prepared for Affordable Care Act provisions of care coordination? Case managers' self-assessments and views on physicians' roles.

PubMed

Moreo, Kathleen; Moreo, Natalie; Urbano, Frank L; Weeks, Matthew; Greene, Laurence

2014-01-01

Care coordination, traditionally the purview of the case management field, is recognized as a national priority for improving health care delivery and patient outcomes. With reforms of the Affordable Care Act (ACA) of 2010, case managers face new challenges and opportunities in providing care coordination services. The evolving roles of case managers as members of interprofessional care teams will be influenced by new policies that enable physicians to be reimbursed for care coordination. This qualitative study aimed to evaluate case managers' self-assessed readiness for ACA reforms of care coordination and their perceptions of physicians' understanding of case management and ability to lead care coordination efforts in evolving models. Provisions of care coordination in the ACA affect case managers in all practice settings. The majority of this study's participants represented hospital and managed care settings. An invitation to complete an 11-item online survey was sent by e-mail to 8,110 case managers in an opt-in database maintained by a health care continuing education company. Survey questions were designed to assess respondents' (1) self-reported levels of knowledge and preparation for ACA care coordination provisions and (2) beliefs about the readiness and abilities of physicians to administer care coordination services. In addition, demographic data and open-ended comments regarding physicians' roles in conducting care coordination were collected. Over a restricted 9-day period, 834 case managers representing various health care settings responded to the survey. The majority of respondents (63%) indicated that more than 50% of their day is dedicated to performing care coordination activities. However, 80% of all respondents reported being "not at all knowledgeable" or only "somewhat knowledgeable" about the new care coordination provisions in the ACA. Only 8% admitted to being "very prepared" to implement ACA changes. The majority of respondents (68%) perceive their case management departments to be at least "somewhat prepared" to implement necessary changes. Whereas 67% of respondents expect physicians to have at least a "moderate role" in implementing care coordination services, only 12% believe that physicians have more than "some" understanding of the processes of care coordination and case managers' roles. These qualitative study findings suggest that case managers from multiple practice settings perceive a lack of preparedness, knowledge, and understanding among themselves and physicians regarding ACA reforms that may significantly affect the delivery of care coordination services. The findings call for new initiatives in interprofessional education to address the knowledge gaps and enhance understanding of the collaborative roles among case managers and physicians.

Automating Finance

ERIC Educational Resources Information Center

Moore, John

2007-01-01

In past years, higher education's financial management side has been riddled with manual processes and aging mainframe applications. This article discusses schools which had taken advantage of an array of technologies that automate billing, payment processing, and refund processing in the case of overpayment. The investments are well worth it:…

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, High-Level Use Cases for DMS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jianhui; Lu, Xiaonan; Martino, Sal

Many distribution management systems (DMS) projects have achieved limited success because the electric utility did not sufficiently plan for actual use of the DMS functions in the control room environment. As a result, end users were not clear on how to use the new application software in actual production environments with existing, well-established business processes. An important first step in the DMS implementation process is development and refinement of the “to be” business processes. Development of use cases for the required DMS application functions is a key activity that leads to the formulation of the “to be” requirements. It ismore » also an important activity that is needed to develop specifications that are used to procure a new DMS.« less

A multi-setting audit of the management of genital Chlamydia trachomatis infection.

PubMed

Morgan, Jane; Donnell, Andre; Bell, Anita

2010-05-28

To audit current management of genital chlamydia infection in the Waikato District Health Board (DHB), using 2008 Ministry of Health (MOH) management guidelines as the standard. Any setting within Waikato DHB that diagnosed 25 or more cases of chlamydia during February-October 2008 was eligible to participate. Each site was asked to complete an audit using a proforma for 20 consecutive cases. Nineteen of 20 eligible sites provided data on 415 cases; 18.4% of all Waikato DHB cases during the 9 months. Treatment was documented for 380 (91.6%); of these, 369 (97.1%), or 88.9% of all 415 cases, had treatment within 28 days. Documentation of discussions with cases and outcomes was limited, restricting assessment of actual practice. Nonetheless, effective partner notification was lacking. Participants noted they had reviewed their own processes and made suggestions for improvements. The audit has identified potential gaps between recommendations within the MOH guidelines and current practice. This has helped the development of ongoing education and training resources for local providers. Further, it is hoped participation in the audit may contribute to improved case management in high-caseload settings in our district. There is commitment to re-audit to evaluate this.

Batch Model for Batched Timestamps Data Analysis with Application to the SSA Disability Program

PubMed Central

Yue, Qingqi; Yuan, Ao; Che, Xuan; Huynh, Minh; Zhou, Chunxiao

2016-01-01

The Office of Disability Adjudication and Review (ODAR) is responsible for holding hearings, issuing decisions, and reviewing appeals as part of the Social Security Administration’s disability determining process. In order to control and process cases, the ODAR has established a Case Processing and Management System (CPMS) to record management information since December 2003. The CPMS provides a detailed case status history for each case. Due to the large number of appeal requests and limited resources, the number of pending claims at ODAR was over one million cases by March 31, 2015. Our National Institutes of Health (NIH) team collaborated with SSA and developed a Case Status Change Model (CSCM) project to meet the ODAR’s urgent need of reducing backlogs and improve hearings and appeals process. One of the key issues in our CSCM project is to estimate the expected service time and its variation for each case status code. The challenge is that the systems recorded job departure times may not be the true job finished times. As the CPMS timestamps data of case status codes showed apparent batch patterns, we proposed a batch model and applied the constrained least squares method to estimate the mean service times and the variances. We also proposed a batch search algorithm to determine the optimal batch partition, as no batch partition was given in the real data. Simulation studies were conducted to evaluate the performance of the proposed methods. Finally, we applied the method to analyze a real CPMS data from ODAR/SSA. PMID:27747132

An Analysis of the Process of Management by Objectives Adapted to an Army Battalion

DTIC Science & Technology

1975-06-06

Development The concept of MBO was first introduced to the business management environment by Peter F. Drucker in 195^ in his book The Practice of...hands should drop everything and pitch in, they treat it as just another case of management created hysteria. 15 In contrast, Drucker offers... manage - ment by self control, 16 In his most recent book, Management ; Tasks, Responsibilities, Practices, Drucker further refines his MBO

The Implementation of Enrollment Management at Two Public Universities Experiencing Demographic and Funding Challenges

ERIC Educational Resources Information Center

Lee, Stephen

2010-01-01

The purpose of this study was to evaluate the implementation of enrollment management at two public universities. The theoretical framework was conceptual and centered on the effectiveness of the implementation process as a pivotal factor in the development of a comprehensive enrollment management operation. This multi-site case study included 14…

Risk and cooperation: managing hazardous fuel in mixed ownership landscapes

Treesearch

A. Paige Fischer; Susan Charnley

2012-01-01

Managing natural processes at the landscape scale to promote forest health is important, especially in the case of wildfire, where the ability of a landowner to protect his or her individual parcel is constrained by conditions on neighboring ownerships. However, management at a landscape scale is also challenging because it requires cooperation on plans and actions...

The Budget Process in Parks and Recreation. A Case Study Manual.

ERIC Educational Resources Information Center

Kelsey, Craig; Gray, Howard

This case study manual, designed for undergraduate or graduate students studying the area of parks and recreation fiscal management, considers the practical, critical skills of budgeting techniques. The manual deals with the most common budgeting styles in a step-by-step approach with case study exercises. Each chapter includes an introduction to…

Something's Fishy in Paxton Lake: A Case on Speciation in Sticklebacks.

ERIC Educational Resources Information Center

Sharp, Joan

2002-01-01

Introduces a case study on speciation and evolutionary mechanisms. Teaches science process skills as well as natural selection, biological species concepts, basic genetic terminology, and classification. Includes teaching notes and classroom management strategies. (Contains 14 references.) (YDS)

Waste management barriers in developing country hospitals: Case study and AHP analysis.

PubMed

Delmonico, Diego V de Godoy; Santos, Hugo H Dos; Pinheiro, Marco Ap; de Castro, Rosani; de Souza, Regiane M

2018-01-01

Healthcare waste management is an essential field for both researchers and practitioners. Although there have been few studies using statistical methods for its evaluation, it has been the subject of several studies in different contexts. Furthermore, the known precarious practices for waste management in developing countries raise questions about its potential barriers. This study aims to investigate the barriers in healthcare waste management and their relevance. For this purpose, this paper analyses waste management practices in two Brazilian hospitals by using case study and the Analytic Hierarchy Process method. The barriers were organized into three categories - human factors, management, and infrastructure, and the main findings suggest that cost and employee awareness were the most significant barriers. These results highlight the main barriers to more sustainable waste management, and provide an empirical basis for multi-criteria evaluation of the literature.

Exploring the Use of Enterprise Content Management Systems in Unification Types of Organizations

NASA Astrophysics Data System (ADS)

Izza Arshad, Noreen; Mehat, Mazlina; Ariff, Mohamed Imran Mohamed

2014-03-01

The aim of this paper is to better understand how highly standardized and integrated businesses known as unification types of organizations use Enterprise Content Management Systems (ECMS) to support their business processes. Multiple case study approach was used to study the ways two unification organizations use their ECMS in their daily work practices. Arising from these case studies are insights into the differing ways in which ECMS is used to support businesses. Based on the comparisons of the two cases, this study proposed that unification organizations may use ECMS in four ways, for: (1) collaboration, (2) information sharing that supports a standardized process structure, (3) building custom workflows that support integrated and standardized processes, and (4) providing links and access to information systems. These findings may guide organizations that are highly standardized and integrated in fashion, to achieve their intended ECMS-use, to understand reasons for ECMS failures and underutilization and to exploit technologies investments.

The potential of disease management for neuromuscular hereditary disorders.

PubMed

Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

2009-01-01

Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

Managers' views on and experiences with moral case deliberation in nursing teams.

PubMed

Weidema, Froukje C; Molewijk, A C Bert; Kamsteeg, Frans; Widdershoven, Guy A M

2015-11-01

Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences regarding facilitating MCD's implementation have not yet been studied. As part of an empirical qualitative study on implementing MCD in mental health care, a responsive evaluation design was used. Using former research findings (iterative procedures), a managers' focus group was organised. Managers appreciated MCD, fostering nurses' empowerment and critical reflection - according to managers, professional core competences. Managers found MCD a challenging intervention, resulting in dilemmas due to MCD's confidential and egalitarian nature. Managers value MCD's process-related outcomes, yet these are difficult to control/regulate. MCD urges managers to reflect on their role and (hierarchical) position both within MCD and in the nursing team. MCD is in line with transformative and participatory management, fostering dialogical interaction between management and nursing team. © 2015 John Wiley & Sons Ltd.

Florida's Medicaid AIDS Waiver: An Assessment of Dimensions of Quality

PubMed Central

Cowart, Marie E.; Mitchell, Jean M.

1995-01-01

Some State Medicaid agencies have implemented home and community-based waiver programs targeting acquired immunodeficiency syndrome (AIDS) patients. Under these initiatives, State Medicaid agencies can provide home and community-based services to persons with AIDS (PWA) as an alternative to more costly Medicaid-covered institutional care. This article evaluates quality of care under the Florida Medicaid waiver for PWA along two dimensions: program effectiveness and client satisfaction. Clients are generally satisfied with their case managers and the range and availability of services. Case managers appear to be well trained. Moreover, the probability of turnover is quite low, despite heavy caseloads and high mortality. The major difficulty faced by clients and case managers relates to the process of becoming Medicaid eligible. PMID:10151885

Implementation of nursing process in clinical settings: the case of three governmental hospitals in Ethiopia, 2017.

PubMed

Semachew, Ayele

2018-03-13

The purpose of this survey was to evaluate the implementation of the nursing process at three randomly selected governmental hospitals found in Amhara Region North West Ethiopia. From the total 338 reviewed documents, 264 (78.1%) have a nursing process format attached with the patient's profile/file, 107 (31.7%) had no nursing diagnosis, 185 (54.7%) of nurses stated their plan of care based on priority, 173 (51.2%) of nurses did not document their interventions based on plan and 179 (53.0%) of nurses did not evaluate their interventions. The overall implementation of nursing process among Felege Hiwot Referal hospital, Debretabor general hospital and Finoteselam general hospitals were 49.12, 68.18, and 69.42% respectively. Nursing professionals shall improve documentation required in implementing the nursing process. Nursing managers (matron, ward heads) shall supervise the overall implementation of nursing process. Hospital nursing services managers (matrons) shall arrange and facilitate case presentations by the nursing staffs which focus on documentation and updates on nursing process. Hospitals need to establish and support nursing process coordinating staff in their institution.

The Evolution of End-of-Life Care: Ethical Implications for Case Management.

PubMed

Fink-Samnick, Ellen

2016-01-01

This article: : Applicable to all health care sectors where case management is practiced. Few topics are more intimate and multifaceted for case managers than engaging with today's culturally diverse patient populations around end-of-life processes. The already prominent focus of this issue has been further elevated by a series of events to receive public attention. These include the Institute of Medicine's 2014 report-Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, rising numbers of patients around the globe requesting to end life on their own terms, and corresponding death with dignity initiatives and legislation.Another vital factor in the end-of-life equation involves how the latest generation of shared decision making influences the management of treatment dialogues among practitioners, patients, as well as insurance companies. Case managers are at the intersection of these complex interactions, working to achieve ethical, as well as legal accountability to the patient, employer, and profession while balancing personal perspectives. Professionals strive to effectively intervene with patients and their support systems facing end-of-life care decisions. It is essential case managers actively consider the intricacies of ethical practice and current contexts including death with dignity legislation, shared decision making, and shifts in regulations and reimbursement for end-of-life care.Case management's ethical envelope will continue to be pushed. To that end amid shifting societal constructs, professionals must have mastery of applicable codes, standards, principles, and rules essential for adherence to ethical practice.

Comparative lifecycle assessment of alternatives for waste management in Rio de Janeiro - Investigating the influence of an attributional or consequential approach.

PubMed

Bernstad Saraiva, A; Souza, R G; Valle, R A B

2017-10-01

The environmental impacts from three management alternatives for organic fraction of municipal solid waste were compared using lifecycle assessment methodology. The alternatives (sanitary landfill, selective collection of organic waste for anaerobic digestion and anaerobic digestion after post-separation of organic waste) were modelled applying an attributional as well as consequential approach, in parallel with the aim of identifying if and how these approaches can affect results and conclusions. The marginal processes identified in the consequential modelling were in general associated with higher environmental impacts than average processes modelled with an attributional approach. As all investigated waste management alternatives result in net-substitution of energy and in some cases also materials, the consequential modelling resulted in lower absolute environmental impacts in five of the seven environmental impact categories assessed in the study. In three of these, the chosen modelling approach can alter the hierarchy between compared waste management alternatives. This indicates a risk of underestimating potential benefits from efficient energy recovery from waste when applying attributional modelling in contexts in which electricity provision historically has been dominated by technologies presenting rather low environmental impacts, but where projections point at increasing impacts from electricity provision in coming years. Thus, in the present case study, the chosen approach affects both absolute and relative results from the comparison. However, results were largely related to the processes identified as affected by investigated changes, and not merely the chosen modelling approach. The processes actually affected by future choices between different waste management alternatives are intrinsically uncertain. The study demonstrates the benefits of applying different assumptions regarding the processes affected by investigated choices - both for provision of energy and materials substituted by waste management processes in consequential LCA modelling, in order to present outcomes that are relevant as decision support within the waste management sector. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Art of Strategic Management: A Case-Based Exercise

ERIC Educational Resources Information Center

Maranville, Steven

2011-01-01

This article contends that the strategic thinking process is composed of two joint, but paradigmatically distinct, activities--analysis and synthesis. Analysis represents the scientific paradigm, whereas synthesis represents the artistic paradigm. Nevertheless, the Strategic Management course is dominated by the scientific paradigm, even though…

Food Culture, Preferences and Ethics in Dysphagia Management.

PubMed

Kenny, Belinda

2015-11-01

Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia management. The case examines a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. © 2015 John Wiley & Sons Ltd.

Towards a resilience management framework for complex enterprise systems upgrade implementation

NASA Astrophysics Data System (ADS)

Teoh, Say Yen; Yeoh, William; Zadeh, Hossein Seif

2017-05-01

The lack of knowledge of how resilience management supports enterprise system (ES) projects accounts for the failure of firms to leverage their investments in costly ES implementations. Using a structured-pragmatic-situational (SPS) case study research approach, this paper reports on an investigation into the resilience management of a large utility company as it implemented an ES upgrade. Drawing on the literature and on the case study findings, we developed a process-based resilience management framework that involves three strategies (developing situation awareness, demystifying threats, and executing restoration plans) and four organisational capabilities that transform resilience management concepts into practices. We identified the crucial phases of ES upgrade implementation and developed indicators for how different strategies and capabilities of resilience management can assist managers at different stages of an ES upgrade. This research advances the state of existing knowledge by providing specific and verifiable propositions for attaining a state of resilience, the knowledge being grounded in the empirical reality of a case study. Moreover, the framework offers ES practitioners a roadmap to better identify appropriate responses and levels of preparedness.

Case Report: Activity Diagrams for Integrating Electronic Prescribing Tools into Clinical Workflow

PubMed Central

Johnson, Kevin B.; FitzHenry, Fern

2006-01-01

To facilitate the future implementation of an electronic prescribing system, this case study modeled prescription management processes in various primary care settings. The Vanderbilt e-prescribing design team conducted initial interviews with clinic managers, physicians and nurses, and then represented the sequences of steps carried out to complete prescriptions in activity diagrams. The diagrams covered outpatient prescribing for patients during a clinic visit and between clinic visits. Practice size, practice setting, and practice specialty type influenced the prescribing processes used. The model developed may be useful to others engaged in building or tailoring an e-prescribing system to meet the specific workflows of various clinic settings. PMID:16622168

[Acute pain therapy in German hospitals as competitive factor. Do competition, ownership and case severity influence the practice of acute pain therapy?].

PubMed

Erlenwein, J; Hinz, J; Meißner, W; Stamer, U; Bauer, M; Petzke, F

2015-07-01

Due to the implementation of the diagnosis-related groups (DRG) system, the competitive pressure on German hospitals increased. In this context it has been shown that acute pain management offers economic benefits for hospitals. The aim of this study was to analyze the impact of the competitive situation, the ownership and the economic resources required on structures and processes for acute pain management. A standardized questionnaire on structures and processes of acute pain management was mailed to the 885 directors of German departments of anesthesiology listed as members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin). For most hospitals a strong regional competition existed; however, this parameter affected neither the implementation of structures nor the recommended treatment processes for pain therapy. In contrast, a clear preference for hospitals in private ownership to use the benchmarking tool QUIPS (quality improvement in postoperative pain therapy) was found. These hospitals also presented information on coping with the management of pain in the corporate clinic mission statement more often and published information about the quality of acute pain management in the quality reports more frequently. No differences were found between hospitals with different forms of ownership in the implementation of acute pain services, quality circles, expert standard pain management and the implementation of recommended processes. Hospitals with a higher case mix index (CMI) had a certified acute pain management more often. The corporate mission statement of these hospitals also contained information on how to cope with pain, presentation of the quality of pain management in the quality report, implementation of quality circles and the implementation of the expert standard pain management more frequently. There were no differences in the frequency of using the benchmarking tool QUIPS or the implementation of recommended treatment processes with respect to the CMI. In this survey no effect of the competitive situation of hospitals on acute pain management could be demonstrated. Private ownership and a higher CMI were more often associated with structures of acute pain management which were publicly accessible in terms of hospital marketing.

A management approach that drives actions strategically: balanced scorecard in a mental health trust case study.

PubMed

Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter

2006-01-01

Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.

The Science Manager's Guide to Case Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.

2001-09-24

This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

Patient population management: taking the leap from variance analysis to outcomes measurement.

PubMed

Allen, K M

1998-01-01

Case managers today at BCHS have a somewhat different role than at the onset of the Collaborative Practice Model. They are seen throughout the organization as: Leaders/participants on cross-functional teams. Systems change agents. Integrating/merging with quality services and utilization management. Outcomes managers. One of the major cross-functional teams is in the process of designing a Care Coordinator role. These individuals will, as one of their functions, assume responsibility for daily patient care management activities. A variance tracking program has come into the Utilization Management (UM) department as part of a software package purchased to automate UM work activities. This variance program could potentially be used by the new care coordinators as the role develops. The case managers are beginning to use a Decision Support software, (Transition Systems Inc.) in the collection of data that is based on a cost accounting system and linked to clinical events. Other clinical outcomes data bases are now being used by the case manager to help with the collection and measurement of outcomes information. Hoshin planning will continue to be a framework for defining and setting the targets for clinical and financial improvements throughout the organization. Case managers will continue to be involved in many of these system-wide initiatives. In the words of Galileo, 1579, "You need to count what's countable, measure what's measurable, and what's not measurable, make measurable."

Case Studies in the Field of Marketing Education: Learner Impact, Case Performance, and Cost Efficiency

ERIC Educational Resources Information Center

Spais, George S.

2005-01-01

The major objective of this study is to identify a methodology that will help educators in marketing to efficiently manage the design, impact, and cost of case studies. It is my intention is to examine the impact of case study characteristics in relation to the degree of learner involvement in the learning process. The author proposes that…

Collaboration of hospital case managers and home care liaisons when transitioning patients.

PubMed

Kelly, Margaret M; Penney, Erika D

2011-01-01

Hospital case managers frequently collaborate with home care liaisons when coordinating special discharge plans. This article focuses on the collaborative relationship between the hospital case manager and on-site liaison whose primary role centers around care coordination and patient teaching. Ineffective collaboration between hospital case managers and these clinical on-site liaisons can lead to serious lapses in care and services for patients, families, and the health care team when transitioning from hospital to home care. In a review of literature, little detail was found about the collaborative practice between hospital case managers and home care liaisons. This article discusses how collegiality, collaboration, and role clarification between hospital case managers and on-site home care liaisons can improve coordination of care and services for patients and their families in the transition from hospital to home care. Included is a set of guidelines developed by case managers at a major metropolitan acute care hospital to inform and improve their practice with home care liaisons. The authors are nursing case managers who practice in a major metropolitan teaching hospital. They met by telephone and in person with case managers from 3 metropolitan medical centers as well as on-site liaisons from 2 skilled nursing facilities and 5 home care agencies to develop practice recommendations for their department regarding work with home care liaisons. Conversations between hospital case managers and on-site home care liaisons revealed that all had experiences in which suboptimal collaboration negatively impacted home care coordination for patients and their families. Furthermore, outcomes in similar patient scenarios varied widely based on the individual practices of the case managers and liaisons involved in discharge coordination. Multiple issues were discussed, including blurred role and responsibility delineations, variations in communication styles and practices, and different levels of experience and training. Consensus regarding the implementation of the hospital's guidelines was achieved through a series of discussions within the workgroup in developing practice guidelines. Multiple revisions and secondary reviews by colleagues and directors took place before the guidelines were accepted and implemented. Recommendations for improving collaboration with liaisons included (1) taking time to become familiar with one another's practices and backgrounds; (2) ensuring clear discussions of roles, responsibilities, and expectations with liaisons related to individual cases and organizational requirements and limitations; (3) providing time and forums for ongoing communication and follow-up; and (4) recognizing that responsibility for certain aspects of the discharge planning process may be shared but that the case manager, in partnership with the multidisciplinary team, is ultimately accountable for the effectiveness and outcomes of the discharge plan.

Integrated catchment modelling within a strategic planning and decision making process: Werra case study

NASA Astrophysics Data System (ADS)

Dietrich, Jörg; Funke, Markus

Integrated water resources management (IWRM) redefines conventional water management approaches through a closer cross-linkage between environment and society. The role of public participation and socio-economic considerations becomes more important within the planning and decision making process. In this paper we address aspects of the integration of catchment models into such a process taking the implementation of the European Water Framework Directive (WFD) as an example. Within a case study situated in the Werra river basin (Central Germany), a systems analytic decision process model was developed. This model uses the semantics of the Unified Modeling Language (UML) activity model. As an example application, the catchment model SWAT and the water quality model RWQM1 were applied to simulate the effect of phosphorus emissions from non-point and point sources on water quality. The decision process model was able to guide the participants of the case study through the interdisciplinary planning and negotiation of actions. Further improvements of the integration framework include tools for quantitative uncertainty analyses, which are crucial for real life application of models within an IWRM decision making toolbox. For the case study, the multi-criteria assessment of actions indicates that the polluter pays principle can be met at larger scales (sub-catchment or river basin) without significantly compromising cost efficiency for the local situation.

The Organization of Teaching Process for the Development of Key Competencies (Case Study: Future Managers)

ERIC Educational Resources Information Center

Khusainova, Guzel R.; Galeeva, Farida T.; Giniyatullina, Diana R.; Tarasova, Natalya M.; Tsareva, Ekaterina E.

2016-01-01

This article is focused on the development of the organizational forms of future managers training for the development of their key competencies, namely, creativity and the ability to work in a team. The analysis of works of the researchers in the field of management and pedagogics shows that small groups as an organizational form has great…

The Management of Student Affairs Programs in Community Colleges: Revamping Processes and Structures. Horizons Issues Monograph Series.

ERIC Educational Resources Information Center

Deegan, William L.

Based on a review of the management literature in the fields of business and education and on case studies, interviews, and discussions, this monograph identifies the prerequisites for the successful management of student affairs programs. Chapter 1 presents perspectives on the student affairs profession, summarizes the problems facing the field,…

The Impact of Managerialism on the Strategy Work of University Middle Managers

ERIC Educational Resources Information Center

Davis, Annemarie; Jansen van Rensburg, Mari; Venter, Peet

2016-01-01

In an attempt to understand the effects of managerialism on university managers in a developing country, we set out to gather rich data on the strategy work of middle managers through a single case study at a South African university. Managerialism has the potential to solve inefficiencies in university systems and processes, as it could help to…

Development of tools for evaluating integrated municipal waste management using life-cycle management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thorneloe, S.; Weitz, K.; Nishtala, S.

1998-08-01

Municipal solid waste (MSW) management increasingly is based on integrated systems. The US initiated research in 1994 through funding by the US Environmental Protection Agency and the US Department of Energy to develop (1) a decision support tool; (2) a database; and (3) case studies. This paper provides an overview of the research that is in process.

Designing and examining e-waste recycling process: methodology and case studies.

PubMed

Li, Jinhui; He, Xin; Zeng, Xianlai

2017-03-01

Increasing concerns on resource depletion and environmental pollution have largely obliged electrical and electronic waste (e-waste) should be tackled in an environmentally sound manner. Recycling process development is regarded as the most effective and fundamental to solve the e-waste problem. Based on global achievements related to e-waste recycling in the past 15 years, we first propose a theory to design an e-waste recycling process, including measuring e-waste recyclability and selection of recycling process. And we summarize the indicators and tools in terms of resource dimension, environmental dimension, and economic dimension, to examine the e-waste recycling process. Using the sophisticated experience and adequate information of e-waste management, spent lithium-ion batteries and waste printed circuit boards are chosen as case studies to implement and verify the proposed method. All the potential theory and obtained results in this work can contribute to future e-waste management toward best available techniques and best environmental practices.

Applying Cases to Solve Ethical Problems: The Significance of Positive and Process-Oriented Reflection

PubMed Central

Antes, Alison L.; Thiel, Chase E.; Martin, Laura E.; Stenmark, Cheryl K.; Connelly, Shane; Devenport, Lynn D.; Mumford, Michael D.

2015-01-01

This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case was viewed as positive or negative, and whether the outcomes, process, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision-making are discussed. PMID:26257506

A complex case of congenital cystic renal disease

PubMed Central

Cordiner, David S; Evans, Clair A; Brundler, Marie-Anne; McPhillips, Maeve; Murio, Enric; Darling, Mark; Taheri, Sepideh

2012-01-01

This case outlines the potential complexity of autosomal recessive polycystic kidney disease (ARPKD). It highlights the challenges involved in managing this condition, some of the complications faced and areas of uncertainty in the decision making process. With a paucity of published paediatric cases on this subject, this should add to the pool of information currently available. PMID:22605879

Process antecedents of challenging, under-cover and readily-adopted innovations.

PubMed

Adams, Richard; Tranfield, David; Denyer, David

2013-01-01

The purpose of the study is to test the utility of a taxonomy of innovation based on perceived characteristics in the context of healthcare by exploring the extent to which discrete innovation types could be distinguished from each other in terms of process antecedents. A qualitative approach was adopted to explore the process antecedents of nine exemplar cases of "challenging", "under-cover" and "readily-adopted" healthcare innovations. Data were collected by semi-structured interview and from secondary sources, and content analysed according to a theoretically informed framework of innovation process. Cluster analysis was applied to determine whether innovation types could be distinguished on the basis of process characteristics. The findings provide moderate support for the proposition that innovations differentiated on the basis of the way they are perceived by potential users exhibit different process characteristics. Innovations exhibiting characteristics previously believed negatively to impact adoption may be successfully adopted but by a different configuration of processes than by innovations exhibiting a different set of characteristics. The findings must be treated with caution because the sample consists of self-selected cases of successful innovation and is limited by sample size. Nevertheless, the study sheds new light on important process differences in healthcare innovation. The paper offers a heuristic device to aid clinicians and managers to better understand the relatively novel task of promoting and managing innovation in healthcare. The paper advances the argument that there is under-exploited opportunity for cross-disciplinary organisational learning for innovation management in the NHS. If efficiency and quality improvement targets are to be met through a strategy of encouraging innovation, it may be advantageous for clinicians and managers to reflect on what this study found mostly to be absent from the processes of the innovations studied, notably management commitment in the form of norms, resource allocation and top management support. This paper is based on original empirical work. It extends previous adoption related studies by applying a configurational approach to innovation attributes to offer new insights on healthcare innovation and highlight the importance of attention to process.

Evaluation of a case-based urology learning program.

PubMed

Mishra, Kirtishri; Snow-Lisy, Devon C; Ross, Jonathan; Goldfarb, David A; Goldman, Howard; Campbell, Steven C

2013-12-01

To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter. A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys. The target group was 2 pilot urology training programs (the Cleveland Clinic and University Hospitals-Case Medical Center). The responses were entirely anonymous. A total of 32 trainees participated (8 fellows and 24 residents), representing a 53% response rate. Most trainees (79%) were able to process cases within an average of ≤ 10 minutes. Of the trainees, 91% reported referring back to particular cases for patient care, to review for examinations, or for studying. Most trainees believed a case-based urology learning program would be a potentially important resource for clinical practice (69%) and for preparing for the in-service (63%) or board (69%) examinations. Most trainees believed the program met its goals of illustrating the basics principles of the disease process (88%), outlining the fundamentals of evaluation and management (94%), and improving the trainees' knowledge base (91%). An electronic case-based urology learning program is feasible and useful and stimulates learning at all trainee levels. Copyright © 2013 Elsevier Inc. All rights reserved.

Ensuring IT service continuity in the face of increasing threats.

PubMed

Nair, Vishwanath

2014-01-01

How is IT service continuity related to business continuity management? Is it just a glorified disaster recovery procedure? Will IT service continuity help increase the assurance of IT services from the business owner to the customer? This paper is an attempt at answering these and many such questions. It is presented as a case study of IT service continuity management implementation at Emirates Group IT, Dubai. It takes the reader through the need for the process as felt by the business, through the learning acquired during implementation, to the practices deployed for managing the process on an ongoing basis. It provides a detailed view of the kind of pitfalls that could be encountered during implementation of the IT service continuity management process in a large-scale enterprise.

Using the "Seven A's" assessment tool for developing competency in case management.

PubMed

Gallagher, Louise P; Truglio-Londrigan, Marie

2004-01-01

In the latter part of the 20th century, healthcare reform sparked a transition in the nursing curriculum from acute care to primary and secondary care. Faculty responded to this challenge by redesigning curricula in creative ways. The transitional curriculum introduced community clinical experiences designed to challenge students to practice in diverse, nontraditional sites and in more independent ways. Such practice requires the nurse to function as designer, coordinator, and manager of patient care in addition to the traditional provider role. Additionally, the transitional curricula emphasized the roles of communicator, educator, facilitator, listener, and advocate to a greater degree. For students to achieve competence in the above roles, the curriculum must include learning activities that allow them to practice as case managers in the community. This paper presents the "Seven A's" as a framework for students to gain an understanding of and engage in the role and process of case management in the community.

Bristol Ridge: A 28-nm $$\\times$$ 86 Performance-Enhanced Microprocessor Through System Power Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sundaram, Sriram; Grenat, Aaron; Naffziger, Samuel

Power management techniques can be effective at extracting more performance and energy efficiency out of mature systems on chip (SoCs). For instance, the peak performance of microprocessors is often limited by worst case technology (Vmax), infrastructure (thermal/electrical), and microprocessor usage assumptions. Performance/watt of microprocessors also typically suffers from guard bands associated with the test and binning processes as well as worst case aging/lifetime degradation. Similarly, on multicore processors, shared voltage rails tend to limit the peak performance achievable in low thread count workloads. In this paper, we describe five power management techniques that maximize the per-part performance under the before-mentionedmore » constraints. Using these techniques, we demonstrate a net performance increase of up to 15% depending on the application and TDP of the SoC, implemented on 'Bristol Ridge,' a 28-nm CMOS, dual-core x 86 accelerated processing unit.« less

Integrating care for high-risk patients in England using the virtual ward model: lessons in the process of care integration from three case sites

PubMed Central

Lewis, Geraint; Vaithianathan, Rhema; Wright, Lorraine; Brice, Mary R; Lovell, Paul; Rankin, Seth; Bardsley, Martin

2013-01-01

Background Patients at high risk of emergency hospitalisation are particularly likely to experience fragmentation in care. The virtual ward model attempts to integrate health and social care by offering multidisciplinary case management to people at high predicted risk of unplanned hospitalisation. Objective To describe the care practice in three virtual ward sites in England and to explore how well each site had achieved meaningful integration. Method Case studies conducted in Croydon, Devon and Wandsworth during 2011–2012, consisting of semi-structured interviews, workshops, and site visits. Results Different versions of the virtual wards intervention had been implemented in each site. In Croydon, multidisciplinary care had reverted back to one-to-one case management. Conclusions To integrate successfully, virtual ward projects should safeguard the multidisciplinary nature of the intervention, ensure the active involvement of General Practitioners, and establish feedback processes to monitor performance such as the number of professions represented at each team meeting. PMID:24250284

[Performance development of a university operating room after implementation of a central operating room management].

PubMed

Waeschle, R M; Sliwa, B; Jipp, M; Pütz, H; Hinz, J; Bauer, M

2016-08-01

The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7.45 a.m. to 3.30 p.m. from 2009 to 2014. The achievement of process target times for the morning surgery start time and the turnover times of anesthesia and OR-nurses were calculated as indicators of process quality. The number of operations and cumulative incision-suture time were also analyzed as aggregated performance indicators. In order to assess the development of revenues in the operating theatre, the revenues from diagnosis-related groups (DRG) in all inpatient and occupational accident cases, adjusted for the regional basic case value from 2009, were calculated for each year. The development of revenues was also analyzed after deduction of revenues resulting from altered economic case weighting. It could be shown that the achievement of process target values for the morning surgery start time could be improved by 40 %, the turnover times for anesthesia reduced by 50 % and for the OR-nurses by 36 %. Together with the introduction of central planning for reallocation, an increase in operation numbers of 21 % and cumulative incision-suture times of 12% could be realized. Due to these additional operations the DRG revenues in 2014 could be increased to 132 % compared to 2009 or 127 % if the revenues caused by economic case weighting were excluded. The personnel complement in anesthesia (-1.7 %) and OR-nurses (+2.6 %) as well as anesthetists (+6.7 %) increased less compared to the revenues or were slightly reduced. This improvement in process quality and cumulative incision-suture times as well as the increase in revenues, reflect the positive impact of an efficiency-oriented central OR management. The OR management releases due to measures of process optimization the necessary personnel and time resources and therefore achieves the basic prerequisites for increased revenues of surgical disciplines. The method presented can be used by other hospitals as a guideline to analyze performance development.

Green stormwater infrastructure eco-planning and development on the regional scale: a case study of Shanghai Lingang New City, East China

NASA Astrophysics Data System (ADS)

Xu, Haishun; Chen, Liang; Zhao, Bing; Zhang, Qiuzhuo; Cai, Yongli

2016-06-01

Urban underlying surface has been greatly changed with rapid urbanization, considered to be one of the major causes for the destruction of urban natural hydrological processes. This has imposed a huge challenge for stormwater management in cities. There has been a shift from gray water management to green stormwater management thinking. The green stormwater infrastructure (GSI) is regarded as an effective and cost-efficient stormwater management eco-landscape approach. China's GSI practice and the development of its theoretical framework are still in the initial stage. This paper presents an innovative framework for stormwater management, integrating green stormwater infrastructure and landscape security patterns on a regional scale based on an urban master plan. The core concept of green stormwater infrastructure eco-planning is to form an interconnected GSI network (i.e., stormwater management landscape security pattern) which consists of the location, portion, size, layout, and structure of GSI so as to efficiently safeguard natural hydrological processes. Shanghai Lingang New City, a satellite new town of Shanghai, China was selected as a case study for GSI studies. Simulation analyses of hydrological processes were carried out to identify the critical significant landscape nodes in the highpriority watersheds for stormwater management. GSI should be planned and implemented in these identified landscape nodes. The comprehensive stormwater management landscape security pattern of Shanghai Lingang New City is designed with consideration of flood control, stormwater control, runoff reduction, water quality protection, and rainwater utilization objectives which could provide guidelines for smart growth and sustainable development of this city.

Participatory research towards co-management: lessons from artisanal fisheries in coastal Uruguay.

PubMed

Trimble, Micaela; Berkes, Fikret

2013-10-15

Participatory research has become increasingly common in natural resources management. Even though participatory research is considered a strategy to facilitate co-management, there is little empirical evidence supporting this. The objective of the present paper is to analyze the contributions of participatory research to help encourage the emergence of co-management, based on a case study in Piriápolis artisanal fishery in coastal Uruguay (where management has been top-down). We argue that participatory research involving artisanal fishers, government, and other stakeholders (university scientists and NGOs) can be a key stimulus towards co-management. We build this argument by considering "seven faces" by which co-management can be analyzed: (1) as power sharing; (2) as institution building; (3) as trust building; (4) as process; (5) as learning and knowledge co-production; (6) as problem solving; and (7) as governance. Our findings show that participatory research had an impact on these various faces: (1) power was shared when making research decisions; (2) a multi-stakeholder group (POPA), with a common vision and goals, was created; (3) trust among participants increased; (4) the process of group formation was valued by participants; (5) stakeholders learned skills for participation; (6) two problem-solving exercises were conducted; and (7) a diversity of stakeholders of the initial problem identified by fishers (sea lions' impact on long-line fishery) participated in the process. The case shows that participatory research functions as a platform which enhances learning and knowledge co-production among stakeholders, paving the way towards future co-management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Risk-Based Approach for Microbiological Food Safety Management in the Dairy Industry: The Case of Listeria monocytogenes in Soft Cheese Made from Pasteurized Milk.

PubMed

Tenenhaus-Aziza, Fanny; Daudin, Jean-Jacques; Maffre, Alexandre; Sanaa, Moez

2014-01-01

According to Codex Alimentarius Commission recommendations, management options applied at the process production level should be based on good hygiene practices, HACCP system, and new risk management metrics such as the food safety objective. To follow this last recommendation, the use of quantitative microbiological risk assessment is an appealing approach to link new risk-based metrics to management options that may be applied by food operators. Through a specific case study, Listeria monocytogenes in soft cheese made from pasteurized milk, the objective of the present article is to practically show how quantitative risk assessment could be used to direct potential intervention strategies at different food processing steps. Based on many assumptions, the model developed estimates the risk of listeriosis at the moment of consumption taking into account the entire manufacturing process and potential sources of contamination. From pasteurization to consumption, the amplification of a primo-contamination event of the milk, the fresh cheese or the process environment is simulated, over time, space, and between products, accounting for the impact of management options, such as hygienic operations and sampling plans. A sensitivity analysis of the model will help orientating data to be collected prioritarily for the improvement and the validation of the model. What-if scenarios were simulated and allowed for the identification of major parameters contributing to the risk of listeriosis and the optimization of preventive and corrective measures. © 2013 Society for Risk Analysis.

Guidelines for Implementing Change: A Case Study

NASA Astrophysics Data System (ADS)

Masekela, Belinda; Nienaber, Rita

To attain and sustain a competitive advantage organizations are continually faced with the need to change their structures, processes and technologies. Converting to new technology and implementing a new information management system in an organization results in inevitable changes in organizational procedures impacting on the people involved. A major problem encountered during this process is resistance to change, which may contribute to total failure of this system. Change management is the process that can be used to negate this impact and assist employees in transitioning to a new way of doing things.

Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers.

PubMed

Sellars, Marcus; Detering, Karen M; Silvester, William

2015-04-23

Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person's values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers. An invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample. 120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client's wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service. This survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to.

Intensive case management for high-risk patients with first-episode psychosis: service model and outcomes.

PubMed

Brewer, Warrick J; Lambert, Timothy J; Witt, Katrina; Dileo, John; Duff, Cameron; Crlenjak, Carol; McGorry, Patrick D; Murphy, Brendan P

2015-01-01

The first episode of psychosis is a crucial period when early intervention can alter the trajectory of the young person's ongoing mental health and general functioning. After an investigation into completed suicides in the Early Psychosis Prevention and Intervention Centre (EPPIC) programme, the intensive case management subprogramme was developed in 2003 to provide assertive outreach to young people having a first episode of psychosis who are at high risk owing to risk to self or others, disengagement, or suboptimal recovery. We report intensive case management model development, characterise the target cohort, and report on outcomes compared with EPPIC treatment as usual. Inclusion criteria, staff support, referral pathways, clinical review processes, models of engagement and care, and risk management protocols are described. We compared 120 consecutive referrals with 50 EPPIC treatment as usual patients (age 15-24 years) in a naturalistic stratified quasi-experimental real-world design. Key performance indicators of service use plus engagement and suicide attempts were compared between EPPIC treatment as usual and intensive case management, and psychosocial and clinical measures were compared between intensive case management referral and discharge. Referrals were predominately unemployed males with low levels of functioning and educational attainment. They were characterised by a family history of mental illness, migration and early separation, with substantial trauma, history of violence, and forensic attention. Intensive case management improved psychopathology and psychosocial outcomes in high-risk patients and reduced risk ratings, admissions, bed days, and crisis contacts. Characterisation of intensive case management patients validated the clinical research focus and identified a first episode of psychosis high-risk subgroup. In a real-world study, implementation of an intensive case management stream within a well-established first episode of psychosis service showed significant improvement in key service outcomes. Further analysis is needed to determine cost savings and effects on psychosocial outcomes. Targeting intensive case management services to high-risk patients with unmet needs should reduce the distress associated with pathways to care for patients, their families, and the community. National Health & Medical Research Council and the Colonial Foundation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health impact assessment in multinationals: A case study of the Royal Dutch/Shell Group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Birley, Martin

2005-10-15

Health impact assessment is part of the risk management process of multinational corporations/companies. Sexually transmitted infections, including HIV/AIDS, and the 'paradox of plenty' are used as examples of the challenges they face. The 'business case' for impact assessment is explained. The policies, procedures, standards, and activities used by Shell to manage such risks are described. An approach to capacity building and competency development is presented that applies to both company staff and external contractors.

A case study of polypharmacy management in nine European countries: Implications for change management and implementation.

PubMed

McIntosh, Jennifer; Alonso, Albert; MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.

[Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study].

PubMed

Mejía, Vilma; Gonzalez, Carlos; Delfino, Alejandro E; Altermatt, Fernando R; Corvetto, Marcia A

The primary purpose of this study was to compare the effect of high fidelity simulation versus a computer-based case solving self-study, in skills acquisition about malignant hyperthermia on first year anesthesiology residents. After institutional ethical committee approval, 31 first year anesthesiology residents were enrolled in this prospective randomized single-blinded study. Participants were randomized to either a High Fidelity Simulation Scenario or a computer-based Case Study about malignant hyperthermia. After the intervention, all subjects' performance in was assessed through a high fidelity simulation scenario using a previously validated assessment rubric. Additionally, knowledge tests and a satisfaction survey were applied. Finally, a semi-structured interview was done to assess self-perception of reasoning process and decision-making. 28 first year residents finished successfully the study. Resident's management skill scores were globally higher in High Fidelity Simulation versus Case Study, however they were significant in 4 of the 8 performance rubric elements: recognize signs and symptoms (p = 0.025), prioritization of initial actions of management (p = 0.003), recognize complications (p = 0.025) and communication (p = 0.025). Average scores from pre- and post-test knowledge questionnaires improved from 74% to 85% in the High Fidelity Simulation group, and decreased from 78% to 75% in the Case Study group (p = 0.032). Regarding the qualitative analysis, there was no difference in factors influencing the student's process of reasoning and decision-making with both teaching strategies. Simulation-based training with a malignant hyperthermia high-fidelity scenario was superior to computer-based case study, improving knowledge and skills in malignant hyperthermia crisis management, with a very good satisfaction level in anesthesia residents. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

The Relationship between Board of Management's Involvement in the Recruitment Process and Their Levels of Education: A Case of Public Secondary Schools in Wareng Sub County in Uasin Gishu County, Kenya

ERIC Educational Resources Information Center

Wainaina, Isabellah Wanjiku

2015-01-01

Boards of Managements (B.O.M) carry with them the success or failure of the schools' management. The success of B.O.M is portrayed through good academic performance and high discipline standards in schools. Poor management on the other hand, may lead to the dissolution of the Board and nomination of another to manage the school. Performance of the…

Resettlement: A Cultural and Psychological Crisis.

ERIC Educational Resources Information Center

Hulewat, Phyllis

1996-01-01

The stages of resettlement and need to integrate past cultural experience into their new life are similar for all immigrants. Describes stages of resettlement and basic elements needed to manage the resettlement process. Three specific groups of clients are identified, and case management methods are presented for dealing with issues raised by…

Recruiting and integrating stakeholders and sustaining participation in environmental management: A conceptual framework and case study from the Great Lakes Area of Concern

EPA Science Inventory

Stakeholder participation is now widely viewed as an essential component of environmental management projects. Although scholarship has identified and conceptualized numerous elements and components of high-quality participation, we argue that the processes of recruiting stakehol...

10 CFR 710.22 - Initial decision process.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) The Manager shall make an initial decision as to the individual's access authorization eligibility... Officer refers the individual's case to the Manager in accordance with § 710.25(e) or § 710.26(b). (b) Unless an extension of time is granted by the Director, Office of Personnel Security, DOE Headquarters...

10 CFR 710.22 - Initial decision process.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) The Manager shall make an initial decision as to the individual's access authorization eligibility... Administrative Judge refers the individual's case to the Manager in accordance with § 710.25(e) or § 710.26(b). (b) Unless an extension of time is granted by the Director, Office of Personnel Security, DOE...

10 CFR 710.22 - Initial decision process.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) The Manager shall make an initial decision as to the individual's access authorization eligibility... Officer refers the individual's case to the Manager in accordance with § 710.25(e) or § 710.26(b). (b) Unless an extension of time is granted by the Director, Office of Personnel Security, DOE Headquarters...

10 CFR 710.22 - Initial decision process.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) The Manager shall make an initial decision as to the individual's access authorization eligibility... Officer refers the individual's case to the Manager in accordance with § 710.25(e) or § 710.26(b). (b) Unless an extension of time is granted by the Director, Office of Personnel Security, DOE Headquarters...

Issues and challenges of involving users in medical device development.

PubMed

Bridgelal Ram, Mala; Grocott, Patricia R; Weir, Heather C M

2008-03-01

User engagement has become a central tenet of health-care policy. This paper reports on a case study in progress that highlights user engagement in the research process in relation to medical device development. To work with a specific group of medical device users to uncover unmet needs, translating these into design concepts, novel technologies and products. To validate a knowledge transfer model that may be replicated for a range of medical device applications and user groups. In depth qualitative case study to elicit and analyse user needs. The focus is on identifying design concepts for medical device applications from unmet needs, and validating these in an iterative feedback loop to the users. The case study has highlighted three interrelated challenges: ensuring unmet needs drive new design concepts and technology development; managing user expectations and managing the research process. Despite the challenges, active participation of users is crucial to developing usable and clinically effective devices.

A review of consumer involvement in evaluations of case management: consistency with a recovery paradigm.

PubMed

Marshall, Sarah L; Crowe, Trevor P; Oades, Lindsay G; Deane, Frank F; Kavanagh, David J

2007-03-01

This Open Forum examines research on case management that draws on consumer perspectives. It clarifies the extent of consumer involvement and whether evaluations were informed by recovery perspectives. Searches of three databases revealed 13 studies that sought to investigate consumer perspectives. Only one study asked consumers about experiences of recovery. Most evaluations did not adequately assess consumers' views, and active consumer participation in research was rare. Supporting an individual's recovery requires commitment to a recovery paradigm that incorporates traditional symptom reduction and improved functioning, with broader recovery principles, and a shift in focus from illness to well-being. It also requires greater involvement of consumers in the implementation of case management and ownership of their own recovery process, not just in research that evaluates the practice.

Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

PubMed

Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

2014-01-01

The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).

The utilization of six sigma and statistical process control techniques in surgical quality improvement.

PubMed

Sedlack, Jeffrey D

2010-01-01

Surgeons have been slow to incorporate industrial reliability techniques. Process control methods were applied to surgeon waiting time between cases, and to length of stay (LOS) after colon surgery. Waiting times between surgeries were evaluated by auditing the operating room records of a single hospital over a 1-month period. The medical records of 628 patients undergoing colon surgery over a 5-year period were reviewed. The average surgeon wait time between cases was 53 min, and the busiest surgeon spent 291/2 hr in 1 month waiting between surgeries. Process control charting demonstrated poor overall control of the room turnover process. Average LOS after colon resection also demonstrated very poor control. Mean LOS was 10 days. Weibull's conditional analysis revealed a conditional LOS of 9.83 days. Serious process management problems were identified in both analyses. These process issues are both expensive and adversely affect the quality of service offered by the institution. Process control mechanisms were suggested or implemented to improve these surgical processes. Industrial reliability and quality management tools can easily and effectively identify process control problems that occur on surgical services. © 2010 National Association for Healthcare Quality.

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Multidisciplinary analysis of invasive meningococcal disease as a framework for continuous quality and safety improvement in regional Australia

PubMed Central

Taylor, Kathryn A; Durrheim, David N; Merritt, Tony; Massey, Peter; Ferguson, John; Ryan, Nick; Hullick, Carolyn

2018-01-01

Background System factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues. Context Baseline assessment of IMD cases (2005–2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge. Methods Clinical governance, in partnership with clinical and public health services, established a multidisciplinary Meningococcal Reference Group (MRG) to routinely review management of all IMD cases. The MRG comprised representatives from primary care, acute care, public health, laboratory medicine and clinical governance. Baseline data were compared with two subsequent evaluation points (2011–2012 and 2013–2015). Interventions Phase I involved multidisciplinary process mapping and development of a standardised audit tool from national IMD management guidelines. Phase II involved formalisation of group processes and advocacy for operational change. Phase III focused on dissemination of findings to clinicians and managers. Results Greatest care improvements were observed in the final evaluation. Median antibiotic delay decreased from 72 to 42 min and proportion of cases triaged appropriately improved from 38% to 75% between 2013 and 2015. Increasing fatal outcomes were attributed to the emergence of more virulent meningococcal serotypes. Conclusions The MRG was a key mechanism for identifying system gaps, advocating for change and enhancing communication and coordination across services. Employing IMD case review as a focus for district-level process reflection presents an innovative patient safety approach, combining the strengths of prospective hazard analysis with more traditional RCA methodologies. PMID:29527576

A Case of Error Disclosure: A Communication Privacy Management Analysis

PubMed Central

Petronio, Sandra; Helft, Paul R.; Child, Jeffrey T.

2013-01-01

To better understand the process of disclosing medical errors to patients, this research offers a case analysis using Petronios’s theoretical frame of Communication Privacy Management (CPM). Given the resistance clinicians often feel about error disclosure, insights into the way choices are made by the clinicians in telling patients about the mistake has the potential to address reasons for resistance. Applying the evidenced-based CPM theory, developed over the last 35 years and dedicated to studying disclosure phenomenon, to disclosing medical mistakes potentially has the ability to reshape thinking about the error disclosure process. Using a composite case representing a surgical mistake, analysis based on CPM theory is offered to gain insights into conversational routines and disclosure management choices of revealing a medical error. The results of this analysis show that an underlying assumption of health information ownership by the patient and family can be at odds with the way the clinician tends to control disclosure about the error. In addition, the case analysis illustrates that there are embedded patterns of disclosure that emerge out of conversations the clinician has with the patient and the patient’s family members. These patterns unfold privacy management decisions on the part of the clinician that impact how the patient is told about the error and the way that patients interpret the meaning of the disclosure. These findings suggest the need for a better understanding of how patients manage their private health information in relationship to their expectations for the way they see the clinician caring for or controlling their health information about errors. Significance for public health Much of the mission central to public health sits squarely on the ability to communicate effectively. This case analysis offers an in-depth assessment of how error disclosure is complicated by misunderstandings, assuming ownership and control over information, unwittingly following conversational scripts that convey misleading messages, and the difficulty in regulating privacy boundaries in the stressful circumstances that occur with error disclosures. As a consequence, the potential contribution to public health is the ability to more clearly see the significance of the disclosure process that has implications for many public health issues. PMID:25170501

Introduction to Command, Control and Communications (C3) Through Comparative Case Analysis

DTIC Science & Technology

1990-03-01

enhancing the process of learning from experience. Case study allows the student to apply concepts , theories, and techniques to an actual incident within...part of the thesis describes selected principles and concepts of 33 related to cormruication management, interoperability, command structure and...The solutions to the cases require applying the principles and concepts presented in the first rart. The four cases are: (1) the Iran hostage rescue

Is there a role for a test controller in the development of new ATC equipment?

NASA Technical Reports Server (NTRS)

Westrum, Ron

1994-01-01

Earl Wiener points out that human factors problems fixed during the R & D stage are paid for once. When they are not fixed during R & D, they are then paid for every day. How users are involved in the R & D process to assist in developing equipment is a critical issue. Effective involvement can produce real improvements. Ineffective involvement can produce inefficient kludges or systems that are actually dangerous. The underlying problem is the management of information and ideas. To develop a really generative system a great deal would have to change in the way that the FAA innovates. Use of test controllers would solve only some of the problems. For instance, we have cockpit resource management now for pilots; we may have it soon for controllers. But the management of ideas in the innovation process also needs intellectual resource management. Simply involving users is not enough. Brought in at the wrong point in the development process, users can block or compromise innovation. User involvement must be carefully considered. A test controller may be one solution to this problem. It might be necessary to have several kinds of test controllers (en route versus TRACON, for instance). No doubt further problems would surface in getting test controllers into operation. I would recommend that the FAA engage in a series of case studies of controller involvement in the innovation process. A systematic comparison of effective and ineffective cases would do much to clarify what we ought to do in the future. Unfortunately, I have been unable to find any cases where test controllers have been used. Perhaps we need to create some, to see how they work.

The business process management software for successful quality management and organization: A case study from the University of Split School of Medicine.

PubMed

Sapunar, Damir; Grković, Ivica; Lukšić, Davor; Marušić, Matko

2016-05-01

Our aim was to describe a comprehensive model of internal quality management (QM) at a medical school founded on the business process analysis (BPA) software tool. BPA software tool was used as the core element for description of all working processes in our medical school, and subsequently the system served as the comprehensive model of internal QM. The quality management system at the University of Split School of Medicine included the documentation and analysis of all business processes within the School. The analysis revealed 80 weak points related to one or several business processes. A precise analysis of medical school business processes allows identification of unfinished, unclear and inadequate points in these processes, and subsequently the respective improvements and increase of the QM level and ultimately a rationalization of the institution's work. Our approach offers a potential reference model for development of common QM framework allowing a continuous quality control, i.e. the adjustments and adaptation to contemporary educational needs of medical students. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Knowledge-based expert systems and a proof-of-concept case study for multiple sequence alignment construction and analysis.

PubMed

Aniba, Mohamed Radhouene; Siguenza, Sophie; Friedrich, Anne; Plewniak, Frédéric; Poch, Olivier; Marchler-Bauer, Aron; Thompson, Julie Dawn

2009-01-01

The traditional approach to bioinformatics analyses relies on independent task-specific services and applications, using different input and output formats, often idiosyncratic, and frequently not designed to inter-operate. In general, such analyses were performed by experts who manually verified the results obtained at each step in the process. Today, the amount of bioinformatics information continuously being produced means that handling the various applications used to study this information presents a major data management and analysis challenge to researchers. It is now impossible to manually analyse all this information and new approaches are needed that are capable of processing the large-scale heterogeneous data in order to extract the pertinent information. We review the recent use of integrated expert systems aimed at providing more efficient knowledge extraction for bioinformatics research. A general methodology for building knowledge-based expert systems is described, focusing on the unstructured information management architecture, UIMA, which provides facilities for both data and process management. A case study involving a multiple alignment expert system prototype called AlexSys is also presented.

Knowledge-based expert systems and a proof-of-concept case study for multiple sequence alignment construction and analysis

PubMed Central

Aniba, Mohamed Radhouene; Siguenza, Sophie; Friedrich, Anne; Plewniak, Frédéric; Poch, Olivier; Marchler-Bauer, Aron

2009-01-01

The traditional approach to bioinformatics analyses relies on independent task-specific services and applications, using different input and output formats, often idiosyncratic, and frequently not designed to inter-operate. In general, such analyses were performed by experts who manually verified the results obtained at each step in the process. Today, the amount of bioinformatics information continuously being produced means that handling the various applications used to study this information presents a major data management and analysis challenge to researchers. It is now impossible to manually analyse all this information and new approaches are needed that are capable of processing the large-scale heterogeneous data in order to extract the pertinent information. We review the recent use of integrated expert systems aimed at providing more efficient knowledge extraction for bioinformatics research. A general methodology for building knowledge-based expert systems is described, focusing on the unstructured information management architecture, UIMA, which provides facilities for both data and process management. A case study involving a multiple alignment expert system prototype called AlexSys is also presented. PMID:18971242

Process evaluation of an interorganizational cooperation initiative in vocational rehabilitation: the Dirigo project.

PubMed

Ståhl, Christian; Andersén, Åsa; Anderzén, Ingrid; Larsson, Kjerstin

2017-05-11

This study analyzes the process of establishing and developing a cooperative vocational rehabilitation project with special focus on organizational and professional aspects. In the project, officials from the Swedish Social Insurance Agency and the Swedish Public Employment Service worked cooperatively with participants on long-term sick leave, youths with disability benefits, and people receiving social allowances. The officials used Motivational Interviewing (MI) as a method when meeting participants, and were able to offer flexible and tailored case management. The goal was to improve work ability and promote self-sufficiency. The process evaluation was carried out through continuous data collection throughout the project (2012-2014), resulting in a total of 28 individual interviews and 17 focus groups with officials and managers. The material was categorized through an inductive content analysis, and analyzed using social capital as a theoretical frame. The evaluation points to how issues related to design, organization and management contributed to the project not reaching its goals, e.g. problems with recruitment of participants, the funding structure, and staffing problems on the managerial level. Still, officials reported positive effects of close cooperation, which was perceived as facilitating the case management by fostering a mutual understanding and access to resources and rehabilitation measures from more than one authority. Cooperative work combined with the use of MI and flexible case management seem to promote an increased trust between officials from different authorities and participants, which in the study is conceptualized as bonding and bridging social capital (between officials) and linking social capital (between officials and participants). The organizational problems combined with the relatively large differences in approaches between the project and regular practice obstructed implementation, where the authorities involved did not appear to be ready for implementing methodologies that require organizational restructuring.

Case management by nurses in primary care: analysis of 73 'success stories'.

PubMed

Elwyn, Glyn; Williams, Meryl; Roberts, Catherine; Newcombe, Robert G; Vincent, Judith

2008-01-01

There is interest as to whether case management reduces unplanned patient admission to hospital. However, very little is known about how the intervention is delivered and what the most salient outcome measures are. Qualitative study embedded in a wider evaluation. Primary health care. Analysis of case manager case reports in a service innovation evaluation study. Case management provides home-based care to frail elderly patients using a process of assessment and medication review. This often leads to new diagnoses, to the co-ordination of further care and the tailoring of services to suit the needs of individuals. The benefits reported are complex and relate to improving a patient's quality of life more than the prevention or otherwise of admission to hospital. The type of attention provided by these roles seems to be absent from current NHS arrangements. The role enables time to be spent assessing the individual needs of patients who live at the margins of independent living. The case managers describe having the time and the skills to assess a mix of clinical and social problems, and then accessing the correct networks to help elderly people with multiple illnesses navigate a complex system of providers. More weight should be given to the ability of this intervention to result in improved quality of life for patients, and to the investigation of costs and benefits.

Creating patient value in glaucoma care: applying quality costing and care delivery value chain approaches--a five-year case study in the Rotterdam Eye Hospital.

PubMed

de Korne, Dirk F; Sol, Kees; Custers, Thomas; van Sprundel, Esther; van Ineveld, B Martin; Lemij, Hans G; Klazinga, Niek S

2009-01-01

The purpose of this paper is to explore in a specific hospital care process the applicability in practice of the theories of quality costing and value chains. In a retrospective case study an in-depth evaluation of the use of a quality cost model (QCM) and the applicability of Porter's care delivery value chain (CDVC) was performed in a specific care process: glaucoma care over the period 2001 to 2006 in the Rotterdam Eye Hospital in The Netherlands. The case study shows a reduction of costs per product by increasing the number of outpatient visits and surgery combined with a higher patient satisfaction. Reduction of costs of non-compliance by using the QCM is small, due to the absence of (external) financial incentives for both the hospital and individual physicians. For CDVC to be supportive to an integrated quality and cost management the notion "patient value" needs far more specification as mutually agreed on by the stakeholders involved and related reimbursement needs to depend on realised outcomes. The case study just focused on one specific care process in one hospital. To determine effects in other areas of health care, it is important to study the use and applicability of the QCM and the CDVC in other care processes and settings. QCM and a CDVC can be useful tools for hospital management to manage the outcomes on both quality and costs, but impact is dependent on the incentives in the context of the existing organisational and reimbursement system and asks for an agreed on operationalisation among the various stakeholders of the notion of patient value.

Integrating automated support for a software management cycle into the TAME system

NASA Technical Reports Server (NTRS)

Sunazuka, Toshihiko; Basili, Victor R.

1989-01-01

Software managers are interested in the quantitative management of software quality, cost and progress. An integrated software management methodology, which can be applied throughout the software life cycle for any number purposes, is required. The TAME (Tailoring A Measurement Environment) methodology is based on the improvement paradigm and the goal/question/metric (GQM) paradigm. This methodology helps generate a software engineering process and measurement environment based on the project characteristics. The SQMAR (software quality measurement and assurance technology) is a software quality metric system and methodology applied to the development processes. It is based on the feed forward control principle. Quality target setting is carried out before the plan-do-check-action activities are performed. These methodologies are integrated to realize goal oriented measurement, process control and visual management. A metric setting procedure based on the GQM paradigm, a management system called the software management cycle (SMC), and its application to a case study based on NASA/SEL data are discussed. The expected effects of SMC are quality improvement, managerial cost reduction, accumulation and reuse of experience, and a highly visual management reporting system.

Research on Chinese Intelligent Guanglianda in High-rise Construction

NASA Astrophysics Data System (ADS)

Romanovich, Marina; Shi, Peiyu; Wang, Ziyue; Zhao, Liang; Gerasimova, Vera

2018-03-01

Since the reform and opening up in China, the rapid development of China's construction industry, especially after 2011, BIM technology in China has a rapid development and depth of application. This article mainly discusses the process of development of China's construction industry management and the process of development of BIM technology in China and, the use of software in China, the main use of revit in 3D modeling (design stage), the use of Guanglianda in the whole process of construction management. This article researches on Guanglianda and the applications were described, for example, in the integrated project of management information, labor management information, construction video surveillance, material management, material site acceptance. This paper also elaborates on the cooperation of Revit and Guanglianda in different stages. This paper also elaborates on a construction case in China, and makes a description of the problems of crane, facts and time, and then explores the reasons behind the rapid construction of China. And the feasibility of China's construction management approach to the introduction of Russia.

Telemedicine utilization to support the management of the burns treatment involving patient pathways in both developed and developing countries: a case study.

PubMed

Syed-Abdul, Shabbir; Scholl, Jeremiah; Chen, Chiehfeng Cliff; Santos, Martinho D P S; Jian, Wen-Shan; Liou, Der-Ming; Li, Yu-Chuan

2012-01-01

This case study reports on the utilization of telemedicine to support the management of the burns treatment in the islands of Sao Tome and Principe by Taipei Medical University-affiliated hospital in Taiwan. The authors share experiences about usage of telemedicine to support treatment of the burn victims in a low-income country that receive reconstructive surgery in a developed country. Throughout the entire care process, telemedicine has been used not only to provide an expert advice from distance but also to help establish and maintain the doctor-patient relationship, to keep patients in contact with their families, and to help educate and consult the medical personal physically present in Sao Tome and Principe. This case study presents the details of how this process has been conducted to date, on what were learned from this process, and on issues that should be considered to improve this process in the future. The authors plan to create instructional videos and post them on YouTube to aid clinical workers providing similar treatment during the acute care and rehabilitation process and also to support eLearning in many situations where it otherwise is not possible to use videoconferencing to establish real-time contact between doctors at the local site and remote specialists.

Case Study Method in Business Education in the USA

ERIC Educational Resources Information Center

Velushchak, Maryna

2014-01-01

Business Education is dynamic in nature and needs diverse information to deal with different business problems. To understand the peculiar situations and to manage them effectively, case studies are widely used. Researchers in education have already demonstrated that students' active participation in the educational process increases their…

Rooms with a View

ERIC Educational Resources Information Center

Kearney, Kerri S.; Mathers, Judith K.

2007-01-01

This case, based on actual events, was developed for a course in educational leadership or media management. Students will test their own processes for ethical leadership through this complex crisis in which a superintendent must decide whether to take public responsibility for questionable decisions made by his staff. This case highlights the…

Modeling and Advanced Control for Sustainable Process ...

EPA Pesticide Factsheets

This book chapter introduces a novel process systems engineering framework that integrates process control with sustainability assessment tools for the simultaneous evaluation and optimization of process operations. The implemented control strategy consists of a biologically-inspired, multi-agent-based method. The sustainability and performance assessment of process operating points is carried out using the U.S. E.P.A.’s GREENSCOPE assessment tool that provides scores for the selected economic, material management, environmental and energy indicators. The indicator results supply information on whether the implementation of the controller is moving the process towards a more sustainable operation. The effectiveness of the proposed framework is illustrated through a case study of a continuous bioethanol fermentation process whose dynamics are characterized by steady-state multiplicity and oscillatory behavior. This book chapter contribution demonstrates the application of novel process control strategies for sustainability by increasing material management, energy efficiency, and pollution prevention, as needed for SHC Sustainable Uses of Wastes and Materials Management.

A methodological framework to support the initiation, design and institutionalization of participatory modeling processes in water resources management

NASA Astrophysics Data System (ADS)

Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan

2018-01-01

Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.

Good practices in managing work-related indoor air problems: a psychosocial perspective.

PubMed

Lahtinen, Marjaana; Huuhtanen, Pekka; Vähämäki, Kari; Kähkönen, Erkki; Mussalo-Rauhamaa, Helena; Reijula, Kari

2004-07-01

Indoor air problems at workplaces are often exceedingly complex. Technical questions are interrelated with the dynamics of the work community, and the cooperation and interaction skills of the parties involved in the problem solving process are also put to the test. The objective of our study was to analyze the process of managing and solving indoor air problems from a psychosocial perspective. This collective case study was based on data from questionnaires, interviews and various documentary materials. Technical inspections of the buildings and indoor air measurements were also carried out. The following four factors best differentiated successful cases from impeded cases: extensive multiprofessional collaboration and participative action, systematic action and perseverance, investment in information and communication, and process thinking and learning. The study also proposed a theoretical model for the role of the psychosocial work environment in indoor air problems. The expertise related to social and human aspects of problem solving plays a significant role in solving indoor air problems. Failures to properly handle these aspects may lead to resources being wasted and result in a problematic situation becoming stagnant or worse. Copyright 2004 Wiley-Liss, Inc.

Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity.

PubMed

Shivaji, Tara; Cortes Martins, Helena

2015-01-01

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25-6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46-8:52).

Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerity

PubMed Central

Shivaji, Tara; Cortes Martins, Helena

2015-01-01

In a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53–10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25–6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46–8:52). PMID:26734448

How do strategic decisions and operative practices affect operating room productivity?

PubMed

Peltokorpi, Antti

2011-12-01

Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

Review of crisis resource management (CRM) principles in the setting of intraoperative malignant hyperthermia.

PubMed

Isaak, Robert Scott; Stiegler, Marjorie Podraza

2016-04-01

The practice of medicine is characterized by routine and typical cases whose management usually goes according to plan. However, the occasional case does arise which involves rare catastrophic emergencies, such as intraoperative malignant hyperthermia (MH), which require a comprehensive, coordinated, and resource-intensive treatment plan. Physicians are expected to provide expert quality care for routine, typical cases, but is it reasonable to expect the same standard of expertise and comprehensive management when the emergency involves a rare entity? Although physicians would like to say yes to this question, the reality is that no physician will ever amass the amount of experience in patient care needed to truly qualify as an expert in the management of a rare emergency entity, such as MH. However, physicians can become expert in the global process of managing emergencies by using the principles of crisis resource management (CRM). In this article, we review the key concepts of CRM, using a real life example of a team who utilized CRM principles to successfully manage an intraoperative MH crisis, despite there being no one on the team who had ever previously encountered a true MH crisis.

Global Lakes Sentinel Services: Monitoring Water Quality Trends in Deep, Clear Lakes to Detect Causes and Effects of Changes in Trophic Status

NASA Astrophysics Data System (ADS)

Poser, Kathrin; Peters, Steef; Hommersom, Annelies; Giardino, Claudia; Bresciani, Mariano; Cazzaniga, Ilaria; Schenk, Karin; Heege, Thomas; Philipson, Petra; Ruescas, Ana; Bottcher, Martin; Stelzer, Kerstin

2015-12-01

The GLaSS project develops a prototype infrastructure to ingest and process large amounts of Sentinel-2 and Sentinel-3 data for lakes and reservoirs. To demonstrate the value of satellite observations for the management of aquatic ecosystems, global case studies are performed addressing different types of lakes with their respective problems and management questions. One of these case studies is concentrating on deep clear lakes worldwide. The aim of this case study is to evaluate trends of chlorophyll-a concentrations (Chl-a) as a proxy of the trophic status based on the MERIS full resolution data archive. Some preliminary results of this case study are presented here.

Participative management in health care services.

PubMed

Muller, M

1995-03-01

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

Instituting organizational learning for quality improvement through strategic planning nominal group processes.

PubMed

White, D B

2000-01-01

Healthcare managers are faced with unprecedented challenges as characterized by managed care constraints, downsizing, increased client needs, and a society demanding more responsive services. Managers must initiate change for quality, efficiency, and survival. This article provides information and strategies for (a) assessing the change readiness of an organization, (b) conducting an organizational diagnosis, (c) instituting a team culture, (d) developing a change strategy, (e) integrating the strategy with a quality improvement process, and (f) identifying the leadership skills to implement organization renewal. Nominal group processes, namely, SWOT and the Search Conference, are described, and case examples are provided. The implementation strategies have been used successfully in a variety of milieus; practical advice for success is described in detail.

Space and Power in the Ivory Tower: Decision Making in Public Higher Education

ERIC Educational Resources Information Center

Blanchette, Sandra McCoskrie

2011-01-01

The challenges of managing physical space in higher education are often left unspoken and under researched. In this multiple case study of three urban universities, decision-making processes are examined with particular attention to who has institutional decision-making authority. Effective and efficient space management is important because the…

Space and Power in the Ivory Tower: Decision Making in Public Higher Education

ERIC Educational Resources Information Center

Blanchette, Sandra McCoskrie

2010-01-01

The challenges of managing physical space in public higher education are often left unspoken and under researched. In this multiple case study of three urban universities, decision-making processes are examined with particular attention to who has institutional decision-making authority. Effective and efficient space management is important…

Self-Management Skills: An Important Link to Successful Special Education Postsecondary Transition Planning

ERIC Educational Resources Information Center

Carter, Sharon D.

2013-01-01

This qualitative case study investigated the process of teaching the self-management strategies, self-determination, and self-monitoring to chronically misbehaved students from the perspective of a secondary special education teacher. The investigation used a purposeful sample to select an urban high school setting and a tenured special education…

U.S. Army Medical Department Journal (May-June 1998)

DTIC Science & Technology

1998-06-01

patients. Dental Management of a Patient with Osteogenesis Imperfecta is a case report on the dental management of molar extraction in a patient with the...bone-forming disease osteogenesis imperfecta . Through a continual process of evaluation and improvement in training, the AMEDD’s combat medics will continue to conserve the fighting strength.

Experiential Workshop with Educational Leadership Doctoral Students: Managing Affective Reactions to Organizational Change

ERIC Educational Resources Information Center

Falls, Leigh; Jara, Teresa; Sever, Tim

2009-01-01

Managing change processes, resistance to change, and organizational members' emotional reactions to change are crucial skills for future educational leaders to learn. Our case study is based on a workshop conducted using two experiential exercises to facilitate current educational leadership doctoral students' reflections on their own reactions to…

Software for improving the quality of project management, a case study: international manufacture of electrical equipment

NASA Astrophysics Data System (ADS)

Preradović, D. M.; Mićić, Lj S.; Barz, C.

2017-05-01

Production conditions in today’s world require software support at every stage of production and development of new products, for quality assurance and compliance with ISO standards. In addition to ISO standards such as usual metrics of quality, companies today are focused on other optional standards, such as CMMI (Capability Maturity Model Integrated) or prescribing they own standards. However, while there is intensive progress being made in the PM (project management), there is still a significant number of projects, at the global level, that are failures. These have failed to achieve their goals, within budget or timeframe. This paper focuses on checking the role of software tools through the rate of success in projects implemented in the case of internationally manufactured electrical equipment. The results of this research show the level of contribution of the project management software used to manage and develop new products to improve PM processes and PM functions, and how selection of the software tools affects the quality of PM processes and successfully completed projects.

Health Services for Management of Chronic Non-Cancer Pain in Kuwait: A Case Study Review

PubMed Central

Lakha, S. Fatima; Pennefather, Peter; Badr, Hanan E.; Mailis-Gagnon, Angela

2016-01-01

The experience of chronic pain is universal, yet pain management services delivered by health professionals vary substantially, depending on the context and patient. This review is a part of a series that has examined the issue of chronic non-cancer pain services and management in different global cities. The review is structured as a case study of the availability of management services for people living with chronic non-cancer pain within the context of the Kuwaiti health systems, and the cases are built from evidence in the published literature identified through a comprehensive review process. The evolution of the organizational structure of the public and private health systems in Kuwait is described. These are discussed in terms of their impact on the delivery of comprehensive chronic pain management service by health professionals in Kuwait. This review also includes a description of chronic pain patient personas to highlight expected barriers as well as compliance issues with services likely to be encountered in Kuwait. The case study analysis and persona descriptions illustrate a need to move beyond pain symptom management towards considering the entire person and his/her individual experience of pain such that health care success is judged by enhancement of patient well-being rather than access to services. A road map for improving integrative chronic pain management in Kuwait is discussed. PMID:26595816

Health Services for Management of Chronic Non-Cancer Pain in Kuwait: A Case Study Review.

PubMed

Lakha, S Fatima; Pennefather, Peter; Badr, Hanan E; Mailis-Gagnon, Angela

2016-01-01

The experience of chronic pain is universal, yet pain management services delivered by health professionals vary substantially, depending on the context and patient. This review is a part of a series that has examined the issue of chronic non-cancer pain services and management in different global cities. The review is structured as a case study of the availability of management services for people living with chronic non-cancer pain within the context of the Kuwaiti health systems, and the cases are built from evidence in the published literature identified through a comprehensive review process. The evolution of the organizational structure of the public and private health systems in Kuwait is described. These are discussed in terms of their impact on the delivery of comprehensive chronic pain management service by health professionals in Kuwait. This review also includes a description of chronic pain patient personas to highlight expected barriers as well as compliance issues with services likely to be encountered in Kuwait. The case study analysis and persona descriptions illustrate a need to move beyond pain symptom management towards considering the entire person and his/her individual experience of pain such that health care success is judged by enhancement of patient well-being rather than access to services. A road map for improving integrative chronic pain management in Kuwait is discussed. © 2015 S. Karger AG, Basel.

A case study comparison of landfire fuel loading and emissions generation on a mixed conifer forest in northern Idaho, USA

Treesearch

Josh Hyde; Eva K. Strand; Andrew T. Hudak; Dale Hamilton

2015-01-01

The use of fire as a land management tool is well recognized for its ecological benefits in many natural systems. To continue to use fire while complying with air quality regulations, land managers are often tasked with modeling emissions from fire during the planning process. To populate such models, the Landscape Fire and Resource Management Planning Tools (...

Mitigating risks related to facilities management.

PubMed

O'Neill, Daniel P; Scarborough, Sydney

2013-07-01

By looking at metrics focusing on the functionality, age, capital investment, transparency, and sustainability (FACTS) of their organizations' facilities, facilities management teams can build potential business cases to justify upgrading the facilities. A FACTS analysis can ensure that capital spent on facilities will produce a higher or more certain ROI than alternatives. A consistent process for managing spending helps to avoid unexpected spikes that cost the enterprise more in the long run.

A Mixed Methods Case Study: Exploring the Association between Teachers' Perceived Self-Efficacy and Classroom Management Skills at a Middle School in Central Pennsylvania

ERIC Educational Resources Information Center

Stuart, Charles Edward

2017-01-01

Teacher efficacy has been researched for over 30 years, teacher efficacy refers to the beliefs of teachers in their abilities to have an impact on classroom management. Classroom management skills have been proven to be a plaguing aspect of the teaching and learning process over the past century. This study answers question about classroom…

Inbound freight: an untapped resource for saving money.

PubMed

Kuehn, Kurt

2007-12-01

With all the responsibilities placed on materials managers, it is not surprising that some processes such as shipping are overlooked when it comes to cutting costs. But by taking a closer look at inbound freight costs, materials managers might discover an untapped resource for saving thousands, and in some cases millions, of dollars. Finding out how costs vary among vendors for shipping the same type of item can eliminate unnecessary freight charges. Initially, the process takes time, but the bottom line will be better for it.

Managing resources in NHS dentistry: using health economics to inform commissioning decisions.

PubMed

Holmes, Richard D; Steele, Jimmy; Exley, Catherine E; Donaldson, Cam

2011-05-31

The aim of this study is to develop, apply and evaluate an economics-based framework to assist commissioners in their management of finite resources for local dental services. In April 2006, Primary Care Trusts in England were charged with managing finite dental budgets for the first time, yet several independent reports have since criticised the variability in commissioning skills within these organisations. The study will explore the views of stakeholders (dentists, patients and commissioners) regarding priority setting and the criteria used for decision-making and resource allocation. Two inter-related case studies will explore the dental commissioning and resource allocation processes through the application of a pragmatic economics-based framework known as Programme Budgeting and Marginal Analysis. The study will adopt an action research approach. Qualitative methods including semi-structured interviews, focus groups, field notes and document analysis will record the views of participants and their involvement in the research process. The first case study will be based within a Primary Care Trust where mixed methods will record the views of dentists, patients and dental commissioners on issues, priorities and processes associated with managing local dental services. A Programme Budgeting and Marginal Analysis framework will be applied to determine the potential value of economic principles to the decision-making process. A further case study will be conducted in a secondary care dental teaching hospital using the same approach. Qualitative data will be analysed using thematic analysis and managed using a framework approach. The recent announcement by government regarding the proposed abolition of Primary Care Trusts may pose challenges for the research team regarding their engagement with the research study. However, whichever commissioning organisations are responsible for resource allocation for dental services in the future; resource scarcity is highly likely to remain an issue. Wider understanding of the complexities of priority setting and resource allocation at local levels are important considerations in the development of dental commissioning processes, national oral health policy and the future new dental contract which is expected to be implemented in April 2014.

The importance of work or productive activity in life care planning and case management.

PubMed

Reid, Christine; Riddick-Grisham, Susan

2015-01-01

The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities.

Not Missing the Future: The Case for Technology and Business Process Change

ERIC Educational Resources Information Center

VanDenBerg, Doug

2010-01-01

As technology has evolved, the opportunity to transform and enhance the business processes of academic records managers has become more attractive. Many institutions embrace business-process change as a part of their ongoing strategy, but others defer--or simply avoid--any such change. But now more than ever, according to this author, it is…

Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

ERIC Educational Resources Information Center

Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

2015-01-01

This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

From shared care to disease management: key-influencing factors.

PubMed

Eijkelberg, I M; Spreeuwenberg, C; Mur-Veeman, I M; Wolffenbuttel, B H

2001-01-01

In order to improve the quality of care of chronically ill patients the traditional boundaries between primary and secondary care are questioned. To demolish these boundaries so-called 'shared care' projects have been initiated in which different ways of substitution of care are applied. When these projects end, disease management may offer a solution to expand the achieved co-operation between primary and secondary care. Answering the question: What key factors influence the development and implementation of shared care projects from a management perspective and how are they linked? The theoretical framework is based on the concept of the learning organisation. Reference point is a multiple case study that finally becomes a single case study. Data are collected by means of triangulation. The studied cases concern two interrelated Dutch shared care projects for type 2 diabetic patients, that in the end proceed as one disease management project. In these cases the predominant key-influencing factors appear to be the project management, commitment and local context, respectively. The factor project management directly links the latter two, albeit managing both appear prerequisites to its success. In practice this implies managing the factors' interdependency by the application of change strategies and tactics in a committed and skillful way. Project management, as the most important and active key factor, is advised to cope with the interrelationships of the influencing factors in a gradually more fundamental way by using strategies and tactics that enable learning processes. Then small-scale shared care projects may change into a disease management network at a large scale, which may yield the future blueprint to proceed.

Three Case Studies on Business Collaboration and Process Management

ERIC Educational Resources Information Center

Fan, Shaokun

2012-01-01

The importance of collaboration has been recognized for more than 2000 years. While recent improvement in technology creates vast opportunities for collaboration, effective collaboration remains challenging as ad hoc teams work across time, geographical, language, and technical boundaries, and suffer from process inefficiency. My dissertation…

Using Green Chemistry and Engineering Principles to Design, Assess, and Retrofit Chemical Processes for Sustainability

EPA Science Inventory

The concepts of green chemistry and engineering (GC&E) have been promoted as an effective qualitative framework for developing more sustainable chemical syntheses, processes, and material management techniques. This has been demonstrated by many theoretical and practical cases. I...

Managing bundled payments.

PubMed

Draper, Andrew

2011-04-01

Results of Medicare's ACE demonstration project and Geisinger Health System's ProvenCare initiative provide insight into the challenges hospitals will face as bundled payment proliferates. An early analysis of these results suggests that hospitals would benefit from bringing full automation using clinical IT tools to bear in their efforts to meet these challenges. Other important factors contributing to success include board and physician leadership, organizational structure, pricing methodology for bidding, evidence-based medical practice guidelines, supply cost management, process efficiency management, proactive and aggressive case management, business development and marketing strategy, and the financial management system.

Overall comparative analysis of management and outcomes of cardiac cases reported on board merchant ships.

PubMed

Apostolatos, Charalampos; Andria, Vivian; Licari, Julie

Telemedical assistance has always been the cornerstone of medical care on board. Significant technological progress has provided improved scientific tools and equipment for high-quality communication and prompt management of either minor incidents or major emergencies on board. Med Solutions International is a medical management company, offering services exclusively to the maritime industry. Registered vessels contact the medical team and healthcare professionals provide immediate guidelines for onboard management as well as necessary action thereafter, i.e. examination ashore or urgent medical evacuation. Since cardiac conditions or diseases are potentially the most dangerous when traveling at sea, it is of major importance to analyse and evaluate the overall management and outcomes of cases reporting symptoms of possible heart disease so as to improve telemedical assistance services in future. The study included cases reporting cardiac symptoms from 5 major shipping companies during the year 2016. Data was collected from telecommunication, emails and seafarers' final medical reports. A descriptive analysis of overall management and outcomes was performed. The study showed that the number of confirmed cardiovascular cases on board was very low. Among 551 total cases and 44 cases with reported cardiac symptoms there was only one heart attack, one pulmonary oedema and one suspected myocarditis. In the majority of cases, chest pain was musculoskeletal or due to respiratory infection. Symptoms resulting from issues such as stress or anxiety often present as potential cardiac conditions. Stress may also amplify the severity of symptoms. Language barriers between the seafarer, the master and the doctor often make communication very difficult. According to our findings there are grounds to intensify the prevention process through more efficient pre-employment medical examinations and improve management on board through more intensive training. Communication problems often complicate medical management on board. Effective communication and knowledge of patient's medical history and risk profile is very important to reviewing physician. Effective diagnosis depends on accurate and objective description of symptoms and clinical condition.

Ecological Knowledge Among Communities, Managers and Scientists: Bridging Divergent Perspectives to Improve Forest Management Outcomes

NASA Astrophysics Data System (ADS)

Rist, Lucy; Shackleton, Charlie; Gadamus, Lily; Chapin, F. Stuart; Gowda, C. Made; Setty, Siddappa; Kannan, Ramesh; Shaanker, R. Uma

2016-04-01

Multiple actors are typically involved in forest management, namely communities, managers and researchers. In such cases, suboptimal management outcomes may, in addition to other factors, be symptomatic of a divergence in perspectives among these actors driven by fundamental differences in ecological knowledge. We examine the degree of congruence between the understandings of actors surrounding key issues of management concern in three case studies from tropical, subtropical and boreal forests. We identify commonly encountered points of divergence in ecological knowledge relating to key management processes and issues. We use these to formulate seven hypotheses about differences in the bodies of knowledge that frequently underlie communication and learning failures in forest management contexts where multiple actors are involved and outcomes are judged to be suboptimal. Finally, we present a set of propositions to acknowledge and narrow these differences. A more complete recognition of the full triangulation between all actors involved, and of the influence that fundamental differences in ecological knowledge can exert, may help lead to a more fruitful integration between local knowledge and practice, manager knowledge and practice, and contemporary science in forest management.

A case study of the influences of audience and purpose on the composing processes of an engineer

NASA Technical Reports Server (NTRS)

Stalnaker, B. J.

1981-01-01

The design and preliminary findings of a study of composing processes (on the job) of engineers, managers, and scientists is presented. The influences of audience and purpose on the composing process of engineers was of concern; specifically, the cognitive processes, physical behaviors, and factors that influence the evoluton of a piece of writing. An overview of the study, related literature, outlines of research design, and preliminary findings from a case study of engineers are given. It is suggested that teaching be adapted to help students learn to represent rhetorical problems to guide composing for effective writing.

Case and Administrative Support Tools

EPA Pesticide Factsheets

Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).

Patient-, health worker-, and health facility-level determinants of correct malaria case management at publicly funded health facilities in Malawi: results from a nationally representative health facility survey.

PubMed

Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-02-20

Prompt and effective case management is needed to reduce malaria morbidity and mortality. However, malaria diagnosis and treatment is a multistep process that remains problematic in many settings, resulting in missed opportunities for effective treatment as well as overtreatment of patients without malaria. Prior to the widespread roll-out of malaria rapid diagnostic tests (RDTs) in late 2011, a national, cross-sectional, complex-sample, health facility survey was conducted in Malawi to assess patient-, health worker-, and health facility-level factors associated with malaria case management quality using multivariate Poisson regression models. Among the 2,019 patients surveyed, 34% had confirmed malaria defined as presence of fever and parasitaemia on a reference blood smear. Sixty-seven per cent of patients with confirmed malaria were correctly prescribed the first-line anti-malarial, with most cases of incorrect treatment due to missed diagnosis; 31% of patients without confirmed malaria were overtreated with an anti-malarial. More than one-quarter of patients were not assessed for fever or history of fever by health workers. The most important determinants of correct malaria case management were patient-level clinical symptoms, such as spontaneous complaint of fever to health workers, which increased both correct treatment and overtreatment by 72 and 210%, respectively (p<0.0001). Complaint of cough was associated with a 27% decreased likelihood of correct malaria treatment (p=0.001). Lower-level cadres of health workers were more likely to prescribe anti-malarials for patients, increasing the likelihood of both correct treatment and overtreatment, but no other health worker or health facility-level factors were significantly associated with case management quality. Introduction of RDTs holds potential to improve malaria case management in Malawi, but health workers must systematically assess all patients for fever, and then test and treat accordingly, otherwise, malaria control programmes might miss an opportunity to dramatically improve malaria case management, despite better diagnostic tools.

International impact research and management

USGS Publications Warehouse

Marion, J.L.; Leung, Y.; Hammitt, William E.; Cole, David N.

1998-01-01

To be sustainable, ecotourism requires the protection of natural environments and processes both from development and operation of the tourism infrastructure, and from the activities of ecotourists within protected areas. This book chapter reviews the international literature on the study of visitor or recreation-related resource impacts with special reference to ecotourism. Four case examples are presented to characterize the geographic scope, focus, and principal findings of this recreation ecology literature and its relevance to ecotourism management. Case examples include the Cairngorms National Nature Reserve, Scotland; the Great Barrier Reef, Australia; the Central American tropics; and wildlife viewing in Kenya?s protected areas. Implications for the management of international protected areas and ecotourism resources are discussed.

Judicial case management and the custody and access assessment: melding the approaches.

PubMed

Leverette, J; Crowe, T; Wenglensky, R; Dunbar, M

1997-08-01

The presence of the Unified Family Court, with procedures emphasizing judicial case management and settlement in custody disputes, provided an opportunity to combine these practices with those of a university hospital-based family court clinic experienced in the provision of custody assessments. Specifically, a process integrating the clinical custody assessment with the work of counsel and court procedures was developed. This format, incorporating the preparation of a clinical settlement conference brief, was then evaluated with emphasis on time management, outcome in relation to settlement or trial, and the effect of clinical assessment at critical points in the combined endeavour. Seventy-two judicial referrals conducted using this format were reviewed. To assess efficiency, we determined time intervals to various points in the process and compared them to previous local practice. Settlement rates, recorded incrementally to mark each component's contribution, were compared with rates noted in the literature. Assessment functions were identified according to the point of resolution of the dispute and in a manner to facilitate comparison with previously published work. The format resulted in 50% of cases settling without trial in under 5 months, a minimum settlement rate of 50%, and confirmed the ability of clinical assessment to contribute flexibly to dispute resolution in several conciliation venues and at trial. Combining legal and mental health efforts can results in more efficient use of resources and a substantial diversion of cases from continuing litigation. While altering the process of clinical assessments enhances such findings, further work is required to assure appropriate selection criteria for various intervention formats.

Process and impact of mergers of NHS trusts: multicentre case study and management cost analysis

PubMed Central

Fulop, Naomi; Protopsaltis, Gerasimos; Hutchings, Andrew; King, Annette; Allen, Pauline; Normand, Charles; Walters, Rhiannon

2002-01-01

Objective To study the processes involved in and impact of mergers between NHS trusts, including the effect on management costs. Design Cross sectional study involving in depth interviews and documentary analysis; case study to compare savings in management costs between case trusts and control trusts. Setting Nine trusts (cross sectional study) and four trusts (case study) in London. Participants 96 interviews with trust board members, other senior managers, clinicians, service managers, and representatives of health authorities, regional office, community health councils, local authorities, other trusts in the area, and primary care groups and trusts. Main outcome measures Stated and unstated drivers, and impact of merger on delivery and development of services, management structures, and staff recruitment, retention, and morale. Effects of difference in trust size before and after the merger. Savings in management costs two years after merger. Results Some important drivers for merger are not publicly stated. Mergers had a negative effect on delivery of services because of a loss of managerial focus on services. Planned developments in services were delayed by at least 18 months. Trusts' larger sizes after mergers had unintended negative consequences, as well as predicted advantages. The tendency for one trust's management team to dominate over the other resulted in tension. No improvement in recruitment or retention of clinical and managerial staff was reported. Perceived differences in organisational culture were an important barrier to bringing together two or more organisations. Two years after merger, merged trusts had not achieved the objective of saving £500 000 a year in management costs. Conclusions Important unintended consequences need to be accounted for when mergers are planned. Mergers can cause considerable disruptions to services, and require greater management support than previously acknowledged. Other organisations undergoing restructuring, such as primary care groups developing into primary care trusts and health authorities merging into strategic health authorities, should take these findings into account. What is already known on this topicResearch suggests that effectiveness increases as the amount of activity by specialised units in certain clinical specialities increasesLittle empirical research has looked at the impact of mergers; most studies focus on financial variablesMergers result in short term disruption caused by difficulties in integrating services and personnelWhat this study addsImportant drivers for NHS mergers that are not stated publicly have implications for the process and impact of mergersMergers have positive effects, as well as unintended negative consequences that disrupt services and set back developments in servicesPerceived differences in organisational culture impede bringing organisations togetherMergers do not achieve target savings in management costs in first two years after merger PMID:12153920

Assessing the impact of fisheries co-management interventions in developing countries: a meta-analysis.

PubMed

Evans, Louisa; Cherrett, Nia; Pemsl, Diemuth

2011-08-01

Co-management is now established as a mainstream approach to small-scale fisheries management across the developing world. A comprehensive review of 204 potential cases reveals a lack of impact assessments of fisheries co-management. This study reports on a meta-analysis of the impact of fisheries co-management in developing countries in 90 sites across 29 case-studies. The top five most frequently measured process indicators are participation, influence, rule compliance, control over resources, and conflict. The top five most frequently measured outcome indicators are access to resources, resource well-being, fishery yield, household well-being, and household income. To deal with the diversity of the 52 indicators measured and the different ways these data are collected and analysed, we apply a coding system to capture change over time. The results of the meta-analysis suggest that, overall fisheries co-management delivers benefits to end-users through improvements in key process and outcome indicators. However, the dataset as a whole is constituted primarily of data from the Philippines. When we exclude this body of work, few generalisations can be made about the impact of fisheries co-management. The lack of comparative data suitable for impact assessment and the difficulties in comparing data and generalising across countries and regions reiterates calls in other fields for more systematic approaches to understanding and evaluating governance frameworks. Copyright © 2011 Elsevier Ltd. All rights reserved.

Detailed prospective peer review in a community radiation oncology clinic.

PubMed

Mitchell, James D; Chesnut, Thomas J; Eastham, David V; Demandante, Carlo N; Hoopes, David J

In 2012, we instituted detailed prospective peer review of new cases. We present the outcomes of peer review on patient management and time required for peer review. Peer review rounds were held 3 to 4 days weekly and required 2 physicians to review pertinent information from the electronic medical record and treatment planning system. Eight aspects were reviewed for each case: 1) workup and staging; 2) treatment intent and prescription; 3) position, immobilization, and simulation; 4) motion assessment and management; 5) target contours; 6) normal tissue contours; 7) target dosimetry; and 8) normal tissue dosimetry. Cases were marked as, "Meets standard of care," "Variation," or "Major deviation." Changes in treatment plan were noted. As our process evolved, we recorded the time spent reviewing each case. From 2012 to 2014, we collected peer review data on 442 of 465 (95%) radiation therapy patients treated in our hospital-based clinic. Overall, 91 (20.6%) of the cases were marked as having a variation, and 3 (0.7%) as major deviation. Forty-two (9.5%) of the cases were altered after peer review. An overall peer review score of "Variation" or "Major deviation" was highly associated with a change in treatment plan (P < .01). Changes in target contours were recommended in 10% of cases. Gastrointestinal cases were significantly associated with a change in treatment plan after peer review. Indicators on position, immobilization, simulation, target contours, target dosimetry, motion management, normal tissue contours, and normal tissue dosimetry were significantly associated with a change in treatment plan. The mean time spent on each case was 7 minutes. Prospective peer review is feasible in a community radiation oncology practice. Our process led to changes in 9.5% of cases. Peer review should focus on technical factors such as target contours and dosimetry. Peer review required 7 minutes per case. Published by Elsevier Inc.

The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow

PubMed Central

2010-01-01

Background Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell. Methods We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell. Results Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement). Conclusions Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT. PMID:20181123

Estuary ecosystem restoration: implementing and institutionalizing adaptive management: Institutionalizing adaptive management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ebberts, Blaine D.; Zelinsky, Ben D.; Karnezis, Jason P.

We successfully implemented and institutionalized an adaptive management (AM) process for the Columbia Estuary Ecosystem Restoration Program, which is a large-scale restoration program focused on improving ecosystem conditions in the 234-km lower Columbia River and estuary. For our purpose, “institutionalized” means the AM process and restoration program are embedded in the work flow of the implementing agencies and affected parties. While plans outlining frameworks, processes, or approaches to AM of ecosystem restoration programs are commonplace, establishment for the long term is not. This paper presents the basic AM framework and explains how AM was implemented and institutionalized. Starting with amore » common goal, we pursued included a well-understood governance and decision-making structure, routine coordination and communication activities, data and information sharing, commitment from partners and upper agency management to the AM process, and meaningful cooperation among program managers and partners. The overall approach and steps to implement and institutionalize AM for ecosystem restoration explained here are applicable to situations where it has been less than successful or, as in our case, the restoration program is just getting started.« less

Rationalization and sensemaking in care management: an experience of change in a hospital of the SUS (Unified Health System).

PubMed

Azevedo, Creuza da Silva; Sá, Marilene de Castilho; Cunha, Marcela; Matta, Gustavo Correa; Miranda, Lilian; Grabois, Victor

2017-06-01

This study aimed to analyze organizational processes of change in the hospital care management by using qualitative evaluation developed in the case study. The study was developed at the Hospital Fornecedores de Cana de Piracicaba, in São Paulo State, Brazil, in September and October of 2012. There were 25 interviews with members of the senior board of directors of the hospital, managers and health professionals linked to healthcare of adults, in addition to the analysis of managerial documents and observations of some activities. In this article it is analyzed part of the results, dividing the organizational change in three axes: the planning process developed in the healthcare sectors; The protocol/creation of assisted routines in order to obtain better efficiency and safety for the patient; and the work of hospitalist physicians. The study highlights the complexity of the processes of change in the care management sphere in hospitals and the dynamism between a given management concept and its rational tools and the subjects and groups that seek, in the micropolitic and intersubjective processes, meanings to their practices.

Recommendations for Using the Case Study Method in International Business Research

ERIC Educational Resources Information Center

Vissak, Tiia

2010-01-01

The case study method has not been as frequently used in international business (IB) research as quantitative methods. Moreover, it has been sometimes misused and quite often criticized. Still, it can be very useful for understanding such complex phenomena as the internationalization process or the management of multinational enterprises. Based on…

Transforming the Corporate Training Function through Developing a Training Strategy and Advisory Board: A Longitudinal Case Study

ERIC Educational Resources Information Center

Kalman, Howard K.

2008-01-01

This study examined use of a strategic planning process to reinvent a corporate training department. The naturalistic case describes how the corporate training function gained credibility and influence with senior management, developed alignment with organizational goals, and began transforming the function into a performance improvement…

Using Decision Structures for Policy Analysis in Software Product-line Evolution - A Case Study

NASA Astrophysics Data System (ADS)

Sarang, Nita; Sanglikar, Mukund A.

Project management decisions are the primary basis for project success (or failure). Mostly, such decisions are based on an intuitive understanding of the underlying software engineering and management process and have a likelihood of being misjudged. Our problem domain is product-line evolution. We model the dynamics of the process by incorporating feedback loops appropriate to two decision structures: staffing policy, and the forces of growth associated with long-term software evolution. The model is executable and supports project managers to assess the long-term effects of possible actions. Our work also corroborates results from earlier studies of E-type systems, in particular the FEAST project and the rules for software evolution, planning and management.

On knowledge transfer management as a learning process for ad hoc teams

NASA Astrophysics Data System (ADS)

Iliescu, D.

2017-08-01

Knowledge management represents an emerging domain becoming more and more important. Concepts like knowledge codification and personalisation, knowledge life-cycle, social and technological dimensions, knowledge transfer and learning management are integral parts. Focus goes here in the process of knowledge transfer for the case of ad hoc teams. The social dimension of knowledge transfer plays an important role. No single individual actors involved in the process, but a collective one, representing the organisation. It is critically important for knowledge to be managed from the life-cycle point of view. A complex communication network needs to be in place to supports the process of knowledge transfer. Two particular concepts, the bridge tie and transactive memory, would eventually enhance the communication. The paper focuses on an informational communication platform supporting the collaborative work on knowledge transfer. The platform facilitates the creation of a topic language to be used in knowledge modelling, storage and reuse, by the ad hoc teams.

Design of a Recommendation System for Adding Support in the Treatment of Chronic Patients.

PubMed

Torkar, Simon; Benedik, Peter; Rajkovič, Uroš; Šušteršič, Olga; Rajkovič, Vladislav

2016-01-01

Rapid growth of chronic disease cases around the world is adding pressure on healthcare providers to ensure a structured patent follow-up during chronic disease management process. In response to the increasing demand for better chronic disease management and improved health care efficiency, nursing roles have been specialized or enhanced in the primary health care setting. Nurses become key players in chronic disease management process. Study describes a system to help nurses manage the care process of patient with chronic disease. It supports focusing nurse's attention on those resources/solutions that are likely to be most relevant to their particular situation/problem in nursing domain. System is based on multi-relational property graph representing a flexible modeling construct. Graph allows modeling a nursing ontology and the indices that partition domain into an efficient, searchable space where the solution to a problem is seen as abstractly defined traversals through its vertices and edges.

Trial of an electronic decision support system to facilitate shared decision making in community mental health.

PubMed

Woltmann, Emily M; Wilkniss, Sandra M; Teachout, Alexandra; McHugo, Gregory J; Drake, Robert E

2011-01-01

Involvement of community mental health consumers in mental health decision making has been consistently associated with improvements in health outcomes. Electronic decision support systems (EDSSs) that support both consumer and provider decision making may be a sustainable way to improve dyadic communication in a field with approximately 50% workforce turnover per year. This study examined the feasibility of such a system and investigated proximal outcomes of the system's performance. A cluster randomized design was used to evaluate an EDSS at three urban community mental health sites. Case managers (N=20) were randomly assigned to the EDSS-supported planning group or to the usual care planning group. Consumers (N=80) were assigned to the same group as their case managers. User satisfaction with the care planning process was assessed for consumers and case managers (possible scores range from 1 to 5, with higher summary scores indicating more satisfaction). Recall of the care plan was assessed for consumers. Linear regression with adjustment for grouping by worker was used to assess satisfaction scores. A Wilcoxon rank-sum test was used to examine knowledge of the care plan. Compared with case managers in the control group, those in the intervention group were significantly more satisfied with the care planning process (mean ± SD score=4.0 ± .5 versus 3.3 ± .5; adjusted p=.01). Compared with consumers in the control group, those in the intervention group had significantly greater recall of their care plans three days after the planning session (mean proportion of plan goals recalled=75% ± 28% versus 57% ± 32%; p=.02). There were no differences between the clients in the intervention and control groups regarding satisfaction. This study demonstrated that clients can build their own care plans and negotiate and revise them with their case managers using an EDSS.

Inspection of the Department`s export licensing process for dual-use and munitions commodities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-08-10

The purpose of our inspection was to review the Department of Energy`s (Energy) export licensing process for dual-use and military (munitions) commodities subject to nuclear nonproliferation controls. Specifically, we reviewed Energy`s authorities, procedures, and policies pertaining to the export licensing process and examined procedures for safeguarding data transmitted between Energy and other agencies involved in the export licensing process. We also reviewed Energy`s role as a member of the Subgroup on Nuclear Export Coordination. Our review of the sample of 60 export cases did not find evidence to lead us to believe that Energy`s recommendations for these cases were inappropriatemore » or incorrect. We identified, however, problems regarding management systems associated with the export license review process. We found that without documentation supporting export licensing decisions by the Export Control Operations Division (ECOD), we could not determine whether ECOD analysts considered all required criteria in their review of export cases referred to Energy. For example, we found that the ECOD did not retain records documenting the bases for its advice, recommendations, or decisions regarding its reviews of export license cases or revisions to lists of controlled commodities and, therefore, was not in compliance with certain provisions of the Export Administration Act, as amended, and Energy records management directives. Additionally, we found that the degree of compliance by Energy with the export licensing review criteria contained in the Export Administration Regulations and the Nuclear Non-Proliferation Act of 1978 could not be determined because ECOD did not retain records documenting the bases for its advice and recommendations on export cases.« less

PCMO L01-Setting Specifications for Biological Investigational Medicinal Products.

PubMed

Krause, Stephan O

2015-01-01

This paper provides overall guidance and best practices for the setting of specifications for clinical biological drug substances and drug products within the framework of ICH guidelines on pharmaceutical development [Q8(R2) and Q11], quality risk management (Q9), and quality systems (Q10). A review is provided of the current regulatory expectations for the specification setting process as part of a control strategy during product development, pointing to existing challenges for the investigational new drug/investigational medicinal product dossier (IND/IMPD) sponsor. A case study illustrates how the investigational medicinal product specification revision process can be managed within a flexible quality system, and how specifications can be set and justified for early and late development stages. This paper provides an overview for the setting of product specifications for investigational medicinal products used in clinical trials. A case study illustrates how product specifications of investigational medicinal products can be justified and managed within a modern product quality system. © PDA, Inc. 2015.

Structured decision making as a framework for large-scale wildlife harvest management decisions

USGS Publications Warehouse

Robinson, Kelly F.; Fuller, Angela K.; Hurst, Jeremy E.; Swift, Bryan L.; Kirsch, Arthur; Farquhar, James F.; Decker, Daniel J.; Siemer, William F.

2016-01-01

Fish and wildlife harvest management at large spatial scales often involves making complex decisions with multiple objectives and difficult tradeoffs, population demographics that vary spatially, competing stakeholder values, and uncertainties that might affect management decisions. Structured decision making (SDM) provides a formal decision analytic framework for evaluating difficult decisions by breaking decisions into component parts and separating the values of stakeholders from the scientific evaluation of management actions and uncertainty. The result is a rigorous, transparent, and values-driven process. This decision-aiding process provides the decision maker with a more complete understanding of the problem and the effects of potential management actions on stakeholder values, as well as how key uncertainties can affect the decision. We use a case study to illustrate how SDM can be used as a decision-aiding tool for management decision making at large scales. We evaluated alternative white-tailed deer (Odocoileus virginianus) buck-harvest regulations in New York designed to reduce harvest of yearling bucks, taking into consideration the values of the state wildlife agency responsible for managing deer, as well as deer hunters. We incorporated tradeoffs about social, ecological, and economic management concerns throughout the state. Based on the outcomes of predictive models, expert elicitation, and hunter surveys, the SDM process identified management alternatives that optimized competing objectives. The SDM process provided biologists and managers insight about aspects of the buck-harvest decision that helped them adopt a management strategy most compatible with diverse hunter values and management concerns.

Developing 21st Century Process Skills through Project Design

ERIC Educational Resources Information Center

Yoo, Jeong-Ju; MacDonald, Nora M.

2014-01-01

The goal of this paper is to illustrate how the promotion of 21st Century process skills can be used to enhance student learning and workplace skill development: thinking, problem solving, collaboration, communication, leadership, and management. As an illustrative case, fashion merchandising and design students conducted research for a…

Case Study of 'Engineering Peer Meetings' in JPL's ST-6 Project

NASA Technical Reports Server (NTRS)

Chao, Lawrence P.; Tumer, Irem

2004-01-01

This design process error-proofing case study describes a design review practice implemented by a project manager at NASA Jet Propulsion Laboratory. There are many types of reviews at NASA: required and not, formalized and informal, programmatic and technical. Standing project formal reviews such as the Preliminary Design Review (PDR) and Critical Design Review (CDR) are a required part of every project and mission development. However, the engineering peer reviews that support teams technical work on such projects are often informal, ad hoc, and inconsistent across the organization. This case study discusses issues and innovations identified by a project manager at JPL and implemented in 'engineering peer meetings' for his group.

Case Study of "Engineering Peer Meetings" in JPL's ST-6 Project

NASA Technical Reports Server (NTRS)

Tumer, Irem Y.; Chao, Lawrence P.

2003-01-01

This design process error-proofing case study describes a design review practice implemented by a project manager at NASA Jet Propulsion Laboratory. There are many types of reviews at NASA: required and not, formalized and informal, programmatic and technical. Standing project formal reviews such as the Preliminary Design Review (PDR) and Critical Design Review (CDR) are a required part of every project and mission development. However, the engineering peer reviews that support teams technical work on such projects are often informal, ad hoc, and inconsistent across the organization. This case study discusses issues and innovations identified by a project manager at JPL and implemented in "engineering peer meetings" for his group.

[Standard of integration management at company level and its auditing].

PubMed

Flach, T; Hetzel, C; Mozdzanowski, M; Schian, H-M

2006-10-01

Responsibility at company level for the employment of workers with health-related problems or disabilities has increased, inter alia because of integration management at company level according to section 84 (2) of the German Social Code Book IX. Although several recommendations exist, no standard is available for auditing and certification. Such a standard could be a basis for granting premiums according to section 84 (3) of Book IX of the German Social Code. AUDIT AND CERTIFICATION: One product of the international "disability management" movement is the "Consensus Based Disability Management Audit" (CBDMA). The Audit is a systematic and independent measurement of the effectiveness of integration management at company level. CBDMA goals are to give evidence of the quality of the integration management implemented, to identify opportunities for improvement and recommend appropriate corrective and preventive action. In May 2006, the integration management of Ford-Werke GmbH Germany with about 23 900 employees was audited and certified as the first company in Europe. STANDARD OF INTEGRATION MANAGEMENT AT COMPANY LEVEL: In dialogue with corporate practitioners, the international standard of CBDMA has been adapted, completed and verified concerning its practicability. Process orientation is the key approach, and the structure is similar to DIN EN ISO 9001:2000. Its structure is as follows: (1) management-labour responsibility (goals and objectives, program planning, management-labour review), (2) management of resources (disability manager and DM team, employees' participation, cooperation with external partners, infrastructure), (3) communication (internal and external public relations), (4) case management (identifying cases, contact, situation analysis, planning actions, implementing actions and monitoring, process and outcome evaluation), (5) analysis and improvement (analysis and program evaluation), (6) documentation (manual, records).

[Allocation decisions of health insurance rehabilitation managers--An explorative case study concerning stroke rehabilitation].

PubMed

Hasenbein, U; Wallesch, C-W

2003-12-01

We investigated processes of and subjective reasons for resource allocation in three out of four rehabilitation specialists of a regional office of a major health insurance. Decisions of health insurance personnel include approval of and duration of rehabilitation treatment and choice of clinical provider. Insurance specialists are mainly involved in documentation and coordination, whereas decisions mainly follow expert recommendations, mainly of the medical service. Allocation is based primarily on somatic impairment and disability, psychosocial function, motivation and rehabilitation potential are regarded as secondary. Goals and expected results of rehabilitation are neither individually defined nor their achievement evaluated. Decision processes are dominated by routines and agreements. Only exceptionally, defined rules and procedures are applied. Active case management is hampered by a highly specialized internal structure of the investigated insurance fund. The optimal fulfillment of individual requirements for a limited-time rehabilitation treatment is the central criterion for decision making. However, the specialists lack detailed information concerning appropriateness, quality and efficacy of rehabilitation providers, especially when taking patient-related variables into account. Instead, they trust that only high-quality institutions are contracted. Systematic control and feedback of rehabilitation results is not available. The surveyed rehabilitation managers do not include cost aspects in their decision-making. They would regard this as alien to a member- and patient-oriented policy. Improvement potentials with respect to rehabilitation case management are being reviewed.

Hemothorax: Etiology, diagnosis, and management.

PubMed

Broderick, Stephen R

2013-02-01

Most cases of hemothorax are related to blunt or penetrating chest trauma. Criteria for surgical intervention for initial hemothorax are well defined. Appropriate management of retained hemothorax following initial trauma management is critical, and the best approach remains controversial. Spontaneous hemothorax is much less common and results from a variety of pathologic processes. This article reviews the etiology, diagnosis, and treatment of traumatic and spontaneous hemothorax in modern practice. Copyright © 2013 Elsevier Inc. All rights reserved.

Analysis of Selection Process for Management Education: Korean Military Case.

DTIC Science & Technology

1984-06-01

applicable to selecting Korean military officers for postgraduate education in management, is proposed. 1! 6! 6i N 0102. L r * 014- 6601 2 Unclassified...officers uhc can manage the ailitary Fersctrel Ard modern uea~ons efficiently. As a result, the military has begun to educate some of its cfficers in the...referal, advisinj 4 aiplicant- about alternatives in employment, and furthering public relations. Oijectives cf group interview might te to assess

The Business Case for Systems Engineering Study: Results of the Systems Engineering Effectiveness Survey

DTIC Science & Technology

2012-11-01

reflecting the fact that project managers can often optimize the value of one of these parameters, but only at the expense of the other two. For example...which system developers can compare their SE capabilities to manage SE process improvements. As a reward for their participation, the companion...higher requirements development and management capability is strongly associat- ed with better program performance, particularly on challenging projects

A radiological chronicle of the presentation and management of a long gap oesophageal atresia.

PubMed

Charlesworth, Paul; Mahomed, Anies

2009-01-01

Long gap oesophageal atresia is a clinically and technically challenging condition to manage. Documentation of the gap between the upper and lower pouches is critical to deciding the timing and feasibility of a primary anastamosis. Integral to this process is the role of radiology. We present a case of long gap oesophageal atresia accompanied by chronological radiography demonstrating its' staged management and highlighting some common complications.

A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

ERIC Educational Resources Information Center

Codjoe, Henry M.; Helms, Marilyn M.

2005-01-01

Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

75 FR 34754 - Privacy Act; Notification of a New Privacy Act System of Records, Title Eight Automated Paperless...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... automated case management system, to process complaints, compliance reviews, and to track the activities... comment on the new system of records. The new system report was submitted to the Office of Management and... a New Privacy Act System of Records, Title Eight Automated Paperless Office Tracking System (TEAPOTS...

Mapping marine habitat suitability and uncertainty of Bayesian networks: a case study using Pacific benthic macrofauna

Treesearch

Andrea Havron; Chris Goldfinger; Sarah Henkel; Bruce G. Marcot; Chris Romsos; Lisa Gilbane

2017-01-01

Resource managers increasingly use habitat suitability map products to inform risk management and policy decisions. Modeling habitat suitability of data-poor species over large areas requires careful attention to assumptions and limitations. Resulting habitat suitability maps can harbor uncertainties from data collection and modeling processes; yet these limitations...

An Analysis of Technological Issues Emanating from Faculty Transition to a New Learning Management System

ERIC Educational Resources Information Center

Sanga, Mapopa William

2016-01-01

This case study investigated the process 119 faculty members underwent as they transitioned from using Desire to Learn (D2L) learning management system (LMS), to using Canvas LMS. Other than analyzing technological issues faculty members encountered while navigating various aspects of the Canvas interface, the study also analyzed technological…

Project Management Series Case Study: The Office of Registration and Records

ERIC Educational Resources Information Center

Burgher, Karl E.; Snyder, Michael

2012-01-01

This is the third in a series of eight articles on project management (PM) in the academy. In this article, the authors describe the step-by-step implementation of a structural change to Indiana State University's (ISU's) Office of Registration and Records (ORR). The process described may vary as it is implemented elsewhere, but the authors…

Reconciling an invasive plant’s role in aquatic food webs: a case study of an adaptive management process for water hyacinth

USDA-ARS?s Scientific Manuscript database

1. Globally, invasive species have a multitude of ecological and socio-economic impacts. However, invasive species can provide novel structure and habitat for native species. The growing rate of biological invasions world-wide presents an urgent dilemma: how can natural resource managers minimize ne...

Implementation of an Integrated Information Management System at the National Library of Wales: A Case Study

ERIC Educational Resources Information Center

Evans, Manon Foster; Thomas, Sian

2007-01-01

Purpose: This paper aims to describe the experiences of the National Library of Wales in implementing an integrated information management system. Design/methodology/approach: Discusses the stages involved in the procurement process, data migration and general system implementation. Findings: Emphasises the need for a well-prepared yet flexible…

Students with Learning Disabilities within the Context of Inclusive Education: Issues of Identification and School Management

ERIC Educational Resources Information Center

Sakiz, Halis

2018-01-01

This paper reports findings of a case study carried out in two elementary mainstream schools in Turkey. The main aim of the study was to investigate the role of identification and school management within the process of educating students with learning disabilities in mainstream schools. Interviews with stakeholders, observations and documentary…

Structuring Assignments to Improve Understanding and Presentation Skills: Experiential Learning in the Capstone Strategic Management Team Presentation

ERIC Educational Resources Information Center

Helms, Marilyn M.; Whitesell, Melissa

2017-01-01

In the strategic management course, students select, analyze, and present viable future alternatives based on information provided in cases or computer simulations. Rather than understanding the entire process, the student's focus is on the final presentation. Chickering's (1977) research on active learning suggests students learn more effectively…

A Strategic Plan of Academic Management System as Preparation for EAC Accreditation Visit--From UKM Perspective

ERIC Educational Resources Information Center

Ab-Rahman, Mohammad Syuhaimi; Yusoff, Abdul Rahman Mohd; Abdul, Nasrul Amir; Hipni, Afiq

2015-01-01

Development of a robust platform is important to ensure that the engineering accreditation process can run smoothly, completely and the most important is to fulfill the criteria requirements. In case of Malaysia, the preparation for EAC (Engineering Accreditation Committee) assessment required a good strategic plan of academic management system…

The role of the landscape architect in applied forest landscape management: a case study on process

Treesearch

Wayne Tlusty

1979-01-01

Land planning allocations are often multi-resource concepts, with visual quality objectives addressing the appropriate level of visual resource management. Current legislation and/or regulations often require interdisciplinary teams to implement planning decisions. A considerable amount of information is currently avail-able on visual assessment techniques both for...

Management of anaphylaxis in an austere or operational environment.

PubMed

Ellis, B Craig; Brown, Simon G A

2014-01-01

We present a case report of a Special Operations Soldier who developed anaphylaxis as a consequence of a bee sting, resulting in compromise of the operation. We review the current literature as it relates to the pathophysiology of the disease process, its diagnosis, and its management. An evidence-based field treatment algorithm is suggested. 2014.

Using the reference framework for good measles management in practice--a case study from North Rhine-Westphalia.

PubMed

Schröter, Matthias; Schröder-Bäck, Peter; Brand, Helmut

2009-12-01

In 2005, WHO Europe reconfirmed the objective of eradicating measles and fixed a strategy plan for the years 2005 up to 2010. While a downward trend of measles infections in Germany between 2001 and 2004 could be observed, as many as 780 cases of measles were reported in 2005 and in 2006 even 2.281 cases. These high figures in 2006 were almost exclusively caused by an outbreak in the German region of North Rhine-Westphalia. This case study describes how a reference framework for good health management of measles prevention was applied for this region. As a result, various recommendations for action could be given, among them the recommendation to implement individual vaccination reminder systems for parents and bonus systems for parents. Based on these results, a comprehensive policy concept has been drawn up and has become the subject of a political agreement process in this region. Thus this case study shows a paradigm how reference frameworks for good health management can be utilised in practice.

Infectious Disease Surveillance in the 21st Century: An Integrated Web-Based Surveillance and Case Management System

PubMed Central

Haney, Gillian; Cocoros, Noelle; Cranston, Kevin; DeMaria, Alfred

2014-01-01

The Massachusetts Virtual Epidemiologic Network (MAVEN) was deployed in 2006 by the Massachusetts Department of Public Health, Bureau of Infectious Disease to serve as an integrated, Web-based disease surveillance and case management system. MAVEN replaced program-specific, siloed databases, which were inaccessible to local public health and unable to integrate electronic reporting. Disease events are automatically created without human intervention when a case or laboratory report is received and triaged in real time to state and local public health personnel. Events move through workflows for initial notification, case investigation, and case management. Initial development was completed within 12 months and recent state regulations mandate the use of MAVEN by all 351 jurisdictions. More than 300 local boards of health are using MAVEN, there are approximately one million events, and 70 laboratories report electronically. MAVEN has demonstrated responsiveness and flexibility to emerging diseases while also streamlining routine surveillance processes and improving timeliness of notifications and data completeness, although the long-term resource requirements are significant. PMID:24587547

A case study of polypharmacy management in nine European countries: Implications for change management and implementation

PubMed Central

MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. PMID:29668763

Management for the anterior combined with posterior urethral stricture: a 9-year single centre experience

PubMed Central

Deng, Tuo; Liao, Banghua; Luo, Deyi; Liu, Bing; Wang, Kunjie; Liu, Jiaming; Jin, Tao

2015-01-01

Objective: Therapy for anterior combined with posterior urethral stricture is difficult and controversial. This study aims to introduce a standard process for managing anterior combined with posterior urethral stricture. Patients and methods: 19 patients with anterior combined with posterior urethral stricture were treated following our standard process. Average (range) age was 52 (21-72) years old. In this standard process, anterior urethral stricture should be treated first. Endoscopic surgery is applied for anterior urethra stricture as a priority as long as obliteration does not occur, and operation for posterior urethral stricture can be conducted in the same stage. Otherwise, an open reconstructive urethroplasty for anterior urethral is needed; while in this condition, the unobliterated posterior urethra can also be treated with endoscopic surgery in the same stage; however, if posterior urethra obliteration exists, then open reconstructive urethroplasty for posterior urethral stricture should be applied 2-3 months later. Results: The median (range) follow-up time was 25.8 (3-56) months. All 19 patients were normal in urethrography after 1 month of the surgery. 4 patients (21.1%) recurred urethral stricture during follow-up, and the locations of recurred stricture were bulbomembranous urethra (2 cases), bulbar urethra (1 case) and bladder neck (1 case). 3 of them restored to health through urethral dilation, yet 1 underwent a second operation. 2 patients (10.5%) complaint of dripping urination. No one had painful erection, stress urinary incontinence or other complications. Conclusions: The management for anterior combined with posterior urethral stricture following our standard process is effective and safe. PMID:26064293

Management of unmanned moving sensors through human decision layers: a bi-level optimization process with calls to costly sub-processes

NASA Astrophysics Data System (ADS)

Dambreville, Frédéric

2013-10-01

While there is a variety of approaches and algorithms for optimizing the mission of an unmanned moving sensor, there are much less works which deal with the implementation of several sensors within a human organization. In this case, the management of the sensors is done through at least one human decision layer, and the sensors management as a whole arises as a bi-level optimization process. In this work, the following hypotheses are considered as realistic: Sensor handlers of first level plans their sensors by means of elaborated algorithmic tools based on accurate modelling of the environment; Higher level plans the handled sensors according to a global observation mission and on the basis of an approximated model of the environment and of the first level sub-processes. This problem is formalized very generally as the maximization of an unknown function, defined a priori by sampling a known random function (law of model error). In such case, each actual evaluation of the function increases the knowledge about the function, and subsequently the efficiency of the maximization. The issue is to optimize the sequence of value to be evaluated, in regards to the evaluation costs. There is here a fundamental link with the domain of experiment design. Jones, Schonlau and Welch proposed a general method, the Efficient Global Optimization (EGO), for solving this problem in the case of additive functional Gaussian law. In our work, a generalization of the EGO is proposed, based on a rare event simulation approach. It is applied to the aforementioned bi-level sensor planning.

Modelling a critical infrastructure-driven spatial database for proactive disaster management: A developing country context

PubMed Central

Baloye, David O.

2016-01-01

The understanding and institutionalisation of the seamless link between urban critical infrastructure and disaster management has greatly helped the developed world to establish effective disaster management processes. However, this link is conspicuously missing in developing countries, where disaster management has been more reactive than proactive. The consequence of this is typified in poor response time and uncoordinated ways in which disasters and emergency situations are handled. As is the case with many Nigerian cities, the challenges of urban development in the city of Abeokuta have limited the effectiveness of disaster and emergency first responders and managers. Using geospatial techniques, the study attempted to design and deploy a spatial database running a web-based information system to track the characteristics and distribution of critical infrastructure for effective use during disaster and emergencies, with the purpose of proactively improving disaster and emergency management processes in Abeokuta.

Improving pneumonia case-management in Benin: a randomized trial of a multi-faceted intervention to support health worker adherence to Integrated Management of Childhood Illness guidelines

PubMed Central

Osterholt, Dawn M; Onikpo, Faustin; Lama, Marcel; Deming, Michael S; Rowe, Alexander K

2009-01-01

Background Pneumonia is a leading cause of death among children under five years of age. The Integrated Management of Childhood Illness strategy can improve the quality of care for pneumonia and other common illnesses in developing countries, but adherence to these guidelines could be improved. We evaluated an intervention in Benin to support health worker adherence to the guidelines after training, focusing on pneumonia case management. Methods We conducted a randomized trial. After a health facility survey in 1999 to assess health care quality before Integrated Management of Childhood Illness training, health workers received training plus either study supports (job aids, non-financial incentives and supervision of workers and supervisors) or "usual" supports. Follow-up surveys were conducted in 2001, 2002 and 2004. Outcomes were indicators of health care quality for Integrated Management-defined pneumonia. Further analyses included a graphical pathway analysis and multivariable logistic regression modelling to identify factors influencing case-management quality. Results We observed 301 consultations of children with non-severe pneumonia that were performed by 128 health workers in 88 public and private health facilities. Although outcomes improved in both intervention and control groups, we found no statistically significant difference between groups. However, training proceeded slowly, and low-quality care from untrained health workers diluted intervention effects. Per-protocol analyses suggested that health workers with training plus study supports performed better than those with training plus usual supports (20.4 and 19.2 percentage-point improvements for recommended treatment [p = 0.08] and "recommended or adequate" treatment [p = 0.01], respectively). Both groups tended to perform better than untrained health workers. Analyses of treatment errors revealed that incomplete assessment and difficulties processing clinical findings led to missed pneumonia diagnoses, and missed diagnoses led to inadequate treatment. Increased supervision frequency was associated with better care (odds ratio for recommended treatment = 2.1 [95% confidence interval: 1.1-3.9] per additional supervisory visit). Conclusion Integrated Management of Childhood Illness training was useful, but insufficient, to achieve high-quality pneumonia case management. Our study supports led to additional improvements, although large gaps in performance still remained. A simple graphical pathway analysis can identify specific, common errors that health workers make in the case-management process; this information could be used to target quality improvement activities, such as supervision (ClinicalTrials.gov number NCT00510679). PMID:19712484

Processing older persons as clients in elderly care: A study of the micro-processes of care management practice.

PubMed

Olaison, Anna

2017-02-01

Elder care has undergone a marketization in recent years in which various models for care management have been introduced with the aim of making assessments efficient. This article investigates the effects the care management model has on resource allocation for home care when handling the requests of older persons in the needs assessment process. Sixteen tape-recorded assessment conversations with associated case-file texts were analyzed through discourse analysis. The results show that a managerialist thinking has had a partial impact on the assessment process where the documentation requirements have entailed bureaucratization in terms of the transfer that occurs from talk to text. The findings from the study nevertheless indicate that the assessment conversations have clear elements of an individual-centred perspective in which there is room for a care rational dialogue. This constitutes a welfare policy dilemma today. Providing for older people's requests should be on the basis of quality and an individual-centred perspective and care management has had a contrary effect in which focus is directed instead towards needs assessment and bureaucratic processes.

Understanding micro-processes of institutionalization: stewardship contracting and national forest management

Treesearch

Cassandra Moseley; Susan Charnley

2014-01-01

This paper examines micro-processes of institutionalization, using the case of stewardship contracting within the US Forest Service. Our basic premise is that, until a new policy becomes an everyday practice among local actors, it will not become institutionalized at the macro-scale. We find that micro-processes of institutionalization are driven by a mixture of large-...

Risk tradeoffs in adaptive ecosystem management: the case of the U.S. Forest Service

Treesearch

Marc J. Stern; Caysie A. Martin; S. Andrew Predmore; Wayde C. Morse

2014-01-01

Natural resource planning processes on public lands in the United States are driven in large part by the requirements of the National Environmental Policy Act (NEPA), which dictates general processes for analyzing and disclosing the likely impacts of proposed actions. The outcomes of these processes are the result of multiple factors, many related to the manifold...

Toward a process-level view of distributed healthcare tasks: Medication management as a case study.

PubMed

Werner, Nicole E; Malkana, Seema; Gurses, Ayse P; Leff, Bruce; Arbaje, Alicia I

2017-11-01

We aim to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). MM during older adults' hospital-to-skilled-home-healthcare (SHHC) transitions is a healthcare process with tasks distributed across people, organizations, and time. MM has typically been studied at the task level, but a process-level is needed to fully understand and improve MM during transitions. A process-level view allows for a broader investigation of how tasks are distributed throughout the work system through an investigation of interactions and the resultant emergent properties. We studied MM during older adults' hospital-to-SHHC transitions through interviews and observations with 60 older adults, their 33 caregivers, and 79 SHHC providers at 5 sites associated with 3 SHHC agencies. Study findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries. Findings highlight the importance of a process-level view of healthcare delivery occurring across system boundaries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pneumoperitoneum after virtual colonoscopy: causes, risk factors, and management.

PubMed

Baccaro, Leopoldo M; Markelov, Alexey; Wilhelm, Jakub; Bloch, Robert

2014-06-01

Computed tomographic virtual colonoscopy (CTVC) is a safe and minimally invasive modality when compared with fiberoptic colonoscopy for evaluating the colon and rectum. We have reviewed the risks for colonic perforation by investigating the relevant literature. The objectives of this study were to assess the risk of colonic perforation during CTVC, describe risk factors, evaluate ways to reduce the incidence complications, and to review management and treatment options. A formal search of indexed publications was performed through PubMed. Search queries using keywords "CT colonography," "CT virtual colonoscopy," "virtual colonoscopy," and "perforation" yielded a total of 133 articles. A total of eight case reports and four review articles were selected. Combining case reports and review articles, a total of 25 cases of colonic perforation after CTVC have been reported. Causes include, but are not limited to, diverticular disease, irritable bowel diseases, obstructive processes, malignancies, and iatrogenic injury. Both operative and nonoperative management has been described. Nonoperative management has been proven safe and successful in minimally symptomatic and stable patients. Colonic perforation after CTVC is a rare complication and very few cases have been reported. Several risk factors are recurrent in the literature and must be acknowledged at the time of the study. Management options vary and should be tailored to each individual patient.

The importance of work or productive activity in life care planning and case management

PubMed Central

Reid, Christine; Riddick-Grisham, Susan

2015-01-01

Abstract INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities. PMID:26409330

Optimization Case Study: ISR Allocation in the Global Force Management Process

DTIC Science & Technology

2016-09-01

Communications Intelligence (COMINT), and other intelligence collection capabilities. The complexity of FMV force allocation makes FMV the ideal...Joint Staff (2014). 5 This chapter will step through the GFM allocation process and develop an understanding of the GFM process depicted in Figure 1...contentious. The contentious issue will go through a resolution process consisting of action officer and General Officer/Flag Officer (GOFO) level forums

Closed Loop Requirements and Analysis Management

NASA Technical Reports Server (NTRS)

Lamoreaux, Michael; Verhoef, Brett

2015-01-01

Effective systems engineering involves the use of analysis in the derivation of requirements and verification of designs against those requirements. The initial development of requirements often depends on analysis for the technical definition of specific aspects of a product. Following the allocation of system-level requirements to a product's components, the closure of those requirements often involves analytical approaches to verify that the requirement criteria have been satisfied. Meanwhile, changes that occur in between these two processes need to be managed in order to achieve a closed-loop requirement derivation/verification process. Herein are presented concepts for employing emerging Team center capabilities to jointly manage requirements and analysis data such that analytical techniques are utilized to effectively derive and allocate requirements, analyses are consulted and updated during the change evaluation processes, and analyses are leveraged during the design verification process. Recommendations on concept validation case studies are also discussed.

Business continuity and risk management at a strategic level: Case study of the Flemish government.

PubMed

Bouve, Joris; Steens, Herman-Peter; Ruebens, Martin

2018-01-01

The Flemish government comprises a number of different departments and agencies with the autonomy to optimise their service level in a proactive and resilient manner. Recently, the Flemish government defined four organisational values: openness, decisiveness, trust and agility. In addition, the Internal Audit Agency developed guidelines concerning internal control and organisational management, in which risk management was emphasised. In combination with goal setting and process management, this paper considers risk management as a starting point for the overall management of Flemish government entities. The paper then develops tools to support the establishment of business continuity and risk management processes. These tools fit into the organisation's strategic framework and are easy to understand, pragmatically designed and flexible in their use. The paper goes on to illustrate how the Department of the Chancellery and Public Governance is implementing BCM and risk management, and how it is integrating BCM, risk management and crisis management. It will then focus on the Flemish government's long-term strategy across the boundaries between the different entities and the question of how risk management can become a useful tool for policy makers.

Implications of case managers' perceptions and attitude on safety of home-delivered care.

PubMed

Jones, Sarahjane

2015-12-01

Perceptions on safety in community care have been relatively unexplored. A project that sought to understand the multiple perspectives on safety in the NHS case-management programme was carried out in relation to the structure, process, and outcome of care. This article presents a component of the nursing perspective that highlights an important element in the structure of nursing care that could potentially impede the nurses' ability to be fully effective and safe. A single case study of the case-management programme was undertaken. Three primary care organisations from three strategic health authorities participated, and three focus groups were conducted (one within each organisation). In total, 17 case management nurses participated. Data were audiotaped and transcribed verbatim and subjected to framework analysis. Nursing staff attitudes were identified as a structure of care that influence safety outcomes, particularly their perceptions of the care setting and the implications it has on their role and patient behaviour. Greater understanding of the expected role of the community nurse is necessary, and relevant training is required for nurses to be successful in empowering patients to perform more safely. In addition, efforts need to be made to improve patients' trust in the health-care system to prevent harm and promote more effective utilisation of resources.

From shared care to disease management: key-influencing factors

PubMed Central

Eijkelberg, Irmgard M.J.G.; Spreeuwenberg, Cor; Mur-Veeman, Ingrid M.; Wolffenbuttel, Bruce H.R.

2001-01-01

Abstract Background In order to improve the quality of care of chronically ill patients the traditional boundaries between primary and secondary care are questioned. To demolish these boundaries so-called ‘shared care’ projects have been initiated in which different ways of substitution of care are applied. When these projects end, disease management may offer a solution to expand the achieved co-operation between primary and secondary care. Objective Answering the question: What key factors influence the development and implementation of shared care projects from a management perspective and how are they linked? Theory The theoretical framework is based on the concept of the learning organisation. Design Reference point is a multiple case study that finally becomes a single case study. Data are collected by means of triangulation. The studied cases concern two interrelated Dutch shared care projects for type 2 diabetic patients, that in the end proceed as one disease management project. Results In these cases the predominant key-influencing factors appear to be the project management, commitment and local context, respectively. The factor project management directly links the latter two, albeit managing both appear prerequisites to its success. In practice this implies managing the factors' interdependency by the application of change strategies and tactics in a committed and skilful way. Conclusion Project management, as the most important and active key factor, is advised to cope with the interrelationships of the influencing factors in a gradually more fundamental way by using strategies and tactics that enable learning processes. Then small-scale shared care projects may change into a disease management network at a large scale, which may yield the future blueprint to proceed. PMID:16896415

Assessing the Utility of Seasonal SST Forecasts to the Fisheries Management Process: a Pacific Sardine Case Study

NASA Astrophysics Data System (ADS)

Tommasi, D.; Stock, C. A.

2016-02-01

It is well established that environmental fluctuations affect the productivity of numerous fish stocks. Recent advances in prediction capability of dynamical global forecast systems, such as the state of the art NOAA Geophysical Fluid dynamics Laboratory (GFDL) 2.5-FLOR model, allow for climate predictions of fisheries-relevant variables at temporal scales relevant to the fishery management decision making process. We demonstrate that the GFDL FLOR model produces skillful seasonal SST anomaly predictions over the continental shelf , where most of the global fish yield is generated. The availability of skillful SST projections at this "fishery relevant" scale raises the potential for better constrained estimates of future fish biomass and improved harvest decisions. We assessed the utility of seasonal SST coastal shelf predictions for fisheries management using the case study of Pacific sardine. This fishery was selected because it is one of the few to already incorporate SST into its harvest guideline, and show a robust recruitment-SST relationship. We quantified the effectiveness of management under the status quo harvest guideline (HG) and under alternative HGs including future information at different levels of uncertainty. Usefulness of forecast SST to management was dependent on forecast uncertainty. If the standard deviation of the SST anomaly forecast residuals was less than 0.65, the alternative HG produced higher long-term yield and stock biomass, and reduced the probability of either catch or stock biomass falling below management-set threshold values as compared to the status quo. By contrast, probability of biomass falling to extremely low values increased as compared to the status quo for all alternative HGs except for a perfectly known future SST case. To safeguard against occurrence of such low probability but costly events, a harvest cutoff biomass also has to be implemented into the HG.

Using Analytics to Transform a Problem-Based Case Library: An Educational Design Research Approach

ERIC Educational Resources Information Center

Schmidt, Matthew; Tawfik, Andrew A.

2018-01-01

This article describes the iterative design, development, and evaluation of a case-based learning environment focusing on an ill-structured sales management problem. We discuss our processes and situate them within the broader framework of educational design research. The learning environment evolved over the course of three design phases. A…

Students' Research Experiences during Consulting Projects: Three Themes Emerging from Case Studies

ERIC Educational Resources Information Center

Phillips, Carissa M. Holler

2010-01-01

Student consulting projects, an advanced form of problem-based learning, allow students to apply the skills developed in their classes on behalf of client organizations. A review of selected case studies in business education and other management education literature shows that research is an integral part of this consulting process. More than…

Global Education and the Cooperation of NGOs and Schools: A German Case Study

ERIC Educational Resources Information Center

Bergmüller, Claudia

2016-01-01

In recent years, there has been growing pressure but also an increase of possibilities for non-governmental organizations (NGOs) to cooperate with schools in the field of global education. However, especially in cases of more continuous forms of cooperation, difficulties in process management are noted and the intended cooperation impacts often…

Life in the Cloud: A WorldShare Management Services Case Study

ERIC Educational Resources Information Center

Hartman, Robin R.

2012-01-01

A small, private academic library took the risk of moving from a traditional integrated library system to adopting a system "in the cloud." This case study presents the setting, history, and local needs of the library, including staffing challenges, and explains the decision-making rationale and process. A description of the library's transition…

Management of Re-Occurring Cases of Examination Malpractice in Plateau State Collage of Health Technology Pankshin, Nigeria

ERIC Educational Resources Information Center

Dusu, Paul Bot; Gotan, Anthony; Deshi, Jummai M.; Gambo, Barashe

2016-01-01

Nigeria's educational system is gradually degenerating, as the sanctity of education process has been affected by malpractice. The purpose of this paper was to assess re-occurring incidence of examination malpractice in Plateau State College of Health Technology Pankshin, Nigeria. It looked at cases of examination malpractice and students'…

Children with Disabilities in the Child Protective Services System: An Analog Study of Investigation and Case Management

ERIC Educational Resources Information Center

Manders, Jeanette E.; Stoneman, Zolinda

2009-01-01

Objective: The study used a series of vignettes to investigate how the presence of three disabilities (cerebral palsy, intellectual disabilities, emotional/behavioral disabilities) affects the processes and outcomes of child abuse investigations at two levels of child injury severity (moderate, severe). Method: Seventy-five CPS case workers…

Multidisciplinary Case Study on Higher Education: An Innovative Experience in the Business Management Degree

ERIC Educational Resources Information Center

Martínez-Cañas, Ricardo; del Pozo-Rubio, Raúl; Mondéjar-Jiménez, José; Ruiz-Palomino, Pablo

2012-01-01

Higher education is constantly changing and looking for innovative educational solutions in order to increase the level of the student's knowledge and skills. As an important part of this set of educational policies, a new process is emerging for the ideation, planning and implementation of multidisciplinary case studies for students with the aim…

The Role of Integrated Modelling and Assessment for Decision-Making: Lessons from Water Allocation Issues in Australia

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Guillaume, J. H. A.; El Sawah, S.; Hamilton, S.

2014-12-01

Integrated modelling and assessment (IMA) is best regarded as a process that can support environmental decision-making when issues are strongly contested and uncertainties pervasive. To be most useful, the process must be multi-dimensional and phased. Principally, it must be tailored to the problem context to encompass diverse issues of concern, management settings and stakeholders. This in turn requires the integration of multiple processes and components of natural and human systems and their corresponding spatial and temporal scales. Modellers therefore need to be able to integrate multiple disciplines, methods, models, tools and data, and many sources and types of uncertainty. These dimensions are incorporated into iteration between the various phases of the IMA process, including scoping, problem framing and formulation, assessing options and communicating findings. Two case studies in Australia are employed to share the lessons of how integration can be achieved in these IMA phases using a mix of stakeholder participation processes and modelling tools. One case study aims to improve the relevance of modelling by incorporating stakeholder's views of irrigated viticulture and water management decision making. It used a novel methodology with the acronym ICTAM, consisting of Interviews to elicit mental models, Cognitive maps to represent and analyse individual and group mental models, Time-sequence diagrams to chronologically structure the decision making process, an All-encompassing conceptual model, and computational Models of stakeholder decision making. The second case uses a hydro-economic river network model to examine basin-wide impacts of water allocation cuts and adoption of farm innovations. The knowledge exchange approach used in each case was designed to integrate data and knowledge bearing in mind the contextual dimensions of the problem at hand, and the specific contributions that environmental modelling was thought to be able to make.

How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study.

PubMed

Holter, Marianne T S; Johansen, Ayna; Brendryen, Håvar

2016-06-28

eHealth programs may be better understood by breaking down the components of one particular program and discussing its potential for interactivity and tailoring in regard to concepts from face-to-face counseling. In the search for the efficacious elements within eHealth programs, it is important to understand how a program using lapse management may simultaneously support working alliance, internalization of motivation, and behavior maintenance. These processes have been applied to fully automated eHealth programs individually. However, given their significance in face-to-face counseling, it may be important to simulate the processes simultaneously in interactive, tailored programs. We propose a theoretical model for how fully automated behavior change eHealth programs may be more effective by simulating a therapist's support of a working alliance, internalization of motivation, and managing lapses. We show how the model is derived from theory and its application to Endre, a fully automated smoking cessation program that engages the user in several "counseling sessions" about quitting. A descriptive case study based on tools from the intervention mapping protocol shows how each therapeutic process is simulated. The program supports the user's working alliance through alliance factors, the nonembodied relational agent Endre and computerized motivational interviewing. Computerized motivational interviewing also supports internalized motivation to quit, whereas a lapse management component responds to lapses. The description operationalizes working alliance, internalization of motivation, and managing lapses, in terms of eHealth support of smoking cessation. A program may simulate working alliance, internalization of motivation, and lapse management through interactivity and individual tailoring, potentially making fully automated eHealth behavior change programs more effective.

How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study

PubMed Central

Johansen, Ayna; Brendryen, Håvar

2016-01-01

Background eHealth programs may be better understood by breaking down the components of one particular program and discussing its potential for interactivity and tailoring in regard to concepts from face-to-face counseling. In the search for the efficacious elements within eHealth programs, it is important to understand how a program using lapse management may simultaneously support working alliance, internalization of motivation, and behavior maintenance. These processes have been applied to fully automated eHealth programs individually. However, given their significance in face-to-face counseling, it may be important to simulate the processes simultaneously in interactive, tailored programs. Objective We propose a theoretical model for how fully automated behavior change eHealth programs may be more effective by simulating a therapist’s support of a working alliance, internalization of motivation, and managing lapses. Methods We show how the model is derived from theory and its application to Endre, a fully automated smoking cessation program that engages the user in several “counseling sessions” about quitting. A descriptive case study based on tools from the intervention mapping protocol shows how each therapeutic process is simulated. Results The program supports the user’s working alliance through alliance factors, the nonembodied relational agent Endre and computerized motivational interviewing. Computerized motivational interviewing also supports internalized motivation to quit, whereas a lapse management component responds to lapses. The description operationalizes working alliance, internalization of motivation, and managing lapses, in terms of eHealth support of smoking cessation. Conclusions A program may simulate working alliance, internalization of motivation, and lapse management through interactivity and individual tailoring, potentially making fully automated eHealth behavior change programs more effective. PMID:27354373

Revision Stapedectomy with Necrosis of the Long Process of the Incus: Does the Degree of Necrosis Matter? A Retrospective Clinical Study.

PubMed

Ghonim, Mohamed; Shabana, Yousef; Ashraf, Bassem; Salem, Mohamed

2017-04-01

To discuss the different modalities for managing necrosis of the long process of the incus in revision stapedectomy on the basis of the degree of necrosis and compare the results with those reported in the literature. Thirty-six patients underwent revision stapedectomy with the necrosis of the long process of the incus from 2009 to 2016. The patients were divided into three groups on the basis of the degree of necrosis. For group A (minimal necrosis), augmentation technique with bone cement was performed. For group B (partial necrosis), the cement plug technique was performed. For group C (sever necrosis), malleus relocation with malleovestibulopexy was performed using reshaped necrosed incus. Air and bone conduction thresholds at frequencies of 500-3000 Hz were reviewed pre- and postoperatively using conventional audiometry. The air-bone gap (ABG) and bone conduction thresholds were measured. Postoperative ABG was reduced to <10 dB in 28 cases (77.8%) and <20 dB in all cases (100%). There was no significant change in postoperative bone conduction thresholds. The mean patient follow-up duration was 23 (range, 18-36) months. The cement plug technique was used in 75% of cases. Managing necrosis of the long process of the incus in revision stapedectomy should be considered according to the degree of necrosis. The cement plug technique is considered to be a reasonable option in most cases. Malleus relocation with malleovestibulopexy is an effective alternative to prosthesis.

Radiology information system: a workflow-based approach.

PubMed

Zhang, Jinyan; Lu, Xudong; Nie, Hongchao; Huang, Zhengxing; van der Aalst, W M P

2009-09-01

Introducing workflow management technology in healthcare seems to be prospective in dealing with the problem that the current healthcare Information Systems cannot provide sufficient support for the process management, although several challenges still exist. The purpose of this paper is to study the method of developing workflow-based information system in radiology department as a use case. First, a workflow model of typical radiology process was established. Second, based on the model, the system could be designed and implemented as a group of loosely coupled components. Each component corresponded to one task in the process and could be assembled by the workflow management system. The legacy systems could be taken as special components, which also corresponded to the tasks and were integrated through transferring non-work- flow-aware interfaces to the standard ones. Finally, a workflow dashboard was designed and implemented to provide an integral view of radiology processes. The workflow-based Radiology Information System was deployed in the radiology department of Zhejiang Chinese Medicine Hospital in China. The results showed that it could be adjusted flexibly in response to the needs of changing process, and enhance the process management in the department. It can also provide a more workflow-aware integration method, comparing with other methods such as IHE-based ones. The workflow-based approach is a new method of developing radiology information system with more flexibility, more functionalities of process management and more workflow-aware integration. The work of this paper is an initial endeavor for introducing workflow management technology in healthcare.

Drivers of Environmental Institutional Dynamics in Decentralized African Countries.

PubMed

Hassenforder, Emeline; Barreteau, Olivier; Daniell, Katherine Anne; Pittock, Jamie; Ferrand, Nils

2015-12-01

This paper builds on the assumption that an effective approach to support the sustainability of natural resource management initiatives is institutional "bricolage." We argue that participatory planning processes can foster institutional bricolage by encouraging stakeholders to make their own arrangements based on the hybridization of old and new institutions. This papers aims at identifying how participatory process facilitators can encourage institutional bricolage. Specifically the paper investigates the specific contextual and procedural drivers of institutional dynamics in two case studies: the Rwenzori region in Uganda and the Fogera woreda in Ethiopia. In both cases, participatory planning processes were implemented. This research has three innovative aspects. First, it establishes a clear distinction between six terms which are useful for identifying, describing, and analyzing institutional dynamics: formal and informal; institutions and organizations; and emergence and change. Secondly, it compares the contrasting institutional dynamics in the two case studies. Thirdly, process-tracing is used to identify contextual and procedural drivers to institutional dynamics. We assume that procedural drivers can be used as "levers" by facilitators to trigger institutional bricolage. We found that facilitators need to pay particular attention to the institutional context in which the participatory planning process takes place, and especially at existing institutional gaps or failures. We identified three clusters of procedural levers: the selection and engagement of participants; the legitimacy, knowledge, and ideas of facilitators; and the design of the process, including the scale at which it is developed, the participatory tools used and the management of the diversity of frames.

Drivers of Environmental Institutional Dynamics in Decentralized African Countries

NASA Astrophysics Data System (ADS)

Hassenforder, Emeline; Barreteau, Olivier; Daniell, Katherine Anne; Pittock, Jamie; Ferrand, Nils

2015-12-01

This paper builds on the assumption that an effective approach to support the sustainability of natural resource management initiatives is institutional "bricolage." We argue that participatory planning processes can foster institutional bricolage by encouraging stakeholders to make their own arrangements based on the hybridization of old and new institutions. This papers aims at identifying how participatory process facilitators can encourage institutional bricolage. Specifically the paper investigates the specific contextual and procedural drivers of institutional dynamics in two case studies: the Rwenzori region in Uganda and the Fogera woreda in Ethiopia. In both cases, participatory planning processes were implemented. This research has three innovative aspects. First, it establishes a clear distinction between six terms which are useful for identifying, describing, and analyzing institutional dynamics: formal and informal; institutions and organizations; and emergence and change. Secondly, it compares the contrasting institutional dynamics in the two case studies. Thirdly, process-tracing is used to identify contextual and procedural drivers to institutional dynamics. We assume that procedural drivers can be used as "levers" by facilitators to trigger institutional bricolage. We found that facilitators need to pay particular attention to the institutional context in which the participatory planning process takes place, and especially at existing institutional gaps or failures. We identified three clusters of procedural levers: the selection and engagement of participants; the legitimacy, knowledge, and ideas of facilitators; and the design of the process, including the scale at which it is developed, the participatory tools used and the management of the diversity of frames.

Prioritized List of Research Needs to support MRWFD Case Study Flowsheet Advancement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Law, Jack Douglas; Soelberg, Nicholas Ray

In FY-13, a case study evaluation was performed of full recycle technologies for both the processing of light-water reactor (LWR) used nuclear fuels as well as fast reactor (FR) fuel in the full recycle option. This effort focused on the identification of the case study processes and the initial preparation of material balance flowsheets for the identified technologies. In identifying the case study flowsheets, it was decided that two cases would be developed: one which identifies the flowsheet as currently developed and another near-term target flowsheet which identifies the flowsheet as envisioned within two years, pending the results of ongoingmore » research. The case study focus is on homogeneous aqueous recycle of the U/TRU resulting from the processing of LWR fuel as feed for metal fuel fabrication. The metal fuel is utilized in a sodium-cooled fast reactor, and the used fast reactor fuel is processed using electrochemical separations. The recovered U/TRU from electrochemical separations is recycled to fuel fabrication and the fast reactor. Waste streams from the aqueous and electrochemical processing are treated and prepared for disposition. Off-gas from the separations and waste processing are also treated. As part of the FY-13 effort, preliminary process unknowns and research needs to advance the near-term target flowsheets were identified. In FY-14, these research needs were updated, expanded and prioritized. This report again updates the prioritized list of research needs based upon results to date in FY-15. The research needs are listed for each of the main portions of the flowsheet: 1) Aqueous headend, 2) Headend tritium pretreatment off-gas, 3) Aqueous U/Pu/Np recovery, 4) Aqueous TRU product solidification, 5) Aqueous actinide/lanthanide separation, 6) Aqueous off-gas treatment, 7) Aqueous HLW management, 8) Treatment of aqueous process wastes, 9) E-chem actinide separations, 10) E-chem off-gas, 11) E-chem HLW management. The identified research needs were prioritized within each of these areas. No effort was made to perform an overall prioritization. This information will be used by the MRWFD Campaign leadership in research planning for FY-16. Additionally, this information will be incorporated into the next version of the Case Study Report scheduled to be issued September 2015.« less

Toxic metals in WEEE: characterization and substance flow analysis in waste treatment processes.

PubMed

Oguchi, Masahiro; Sakanakura, Hirofumi; Terazono, Atsushi

2013-10-01

Waste electrical and electronic equipment (WEEE) has received extensive attention as a secondary source of metals. Because WEEE also contains toxic substances such as heavy metals, appropriate management of these substances is important in the recycling and treatment of WEEE. As a basis for discussion toward better management of WEEE, this study characterizes various types of WEEE in terms of toxic metal contents. The fate of various metals contained in WEEE, including toxic metals, was also investigated in actual waste treatment processes. Cathode-ray tube televisions showed the highest concentration and the largest total amount of toxic metals such as Ba, Pb, and Sb, so appropriate recycling and disposal of these televisions would greatly contribute to better management of toxic metals in WEEE. A future challenge is the management of toxic metals in mid-sized items such as audio/visual and ICT equipment because even though the concentrations were not high in these items, the total amount of toxic metals contained in them is not negligible. In the case of Japan, such mid-sized WEEE items as well as small electronic items are subject to municipal solid waste treatment. A case study showed that a landfill was the main destination of toxic metals contained in those items in the current treatment systems. The case study also showed that changes in the flows of toxic metals will occur when treatment processes are modified to emphasize resource recovery. Because the flow changes might lead to an increase in the amount of toxic metals released to the environment, the flows of toxic metals and the materials targeted for resource recovery should be considered simultaneously. Copyright © 2012 Elsevier B.V. All rights reserved.

Applying industrial engineering practices to radiology.

PubMed

Rosen, Len

2004-01-01

Seven hospitals in Oregon and Washington have successfully adopted the Toyota Production System (TPS). Developed by Taiichi Ohno, TPS focuses on finding efficiencies and cost savings in manufacturing processes. A similar effort has occurred in Canada, where Toronto's Hospital for Sick Children has developed a database for its diagnostic imaging department built on the principles of TPS applied to patient encounters. Developed over the last 5 years, the database currently manages all interventional patient procedures for quality assurance, inventory, equipment, and labor. By applying industrial engineering methodology to manufacturing processes, it is possible to manage these constraints, eliminate the obstacles to achieving streamlined processes, and keep the cost of delivering products and services under control. Industrial engineering methodology has encouraged all stakeholders in manufacturing plants to become participants in dealing with constraints. It has empowered those on the shop floor as well as management to become partners in the change process. Using a manufacturing process model to organize patient procedures enables imaging department and imaging centers to generate reports that can help them understand utilization of labor, materials, equipment, and rooms. Administrators can determine the cost of individual procedures as well as the total and average cost of specific procedure types. When Toronto's Hospital for Sick Children first implemented industrial engineering methodology to medical imaging interventional radiology patient encounters, it focused on materials management. Early in the process, the return on investment became apparent as the department improved its management of more than 500,000 dollars of inventory. The calculated accumulated savings over 4 years for 10,000 interventional procedures alone amounted to more than 140,000 dollars. The medical imaging department in this hospital is only now beginning to apply what it has learned to other factors contributing to case cost. It has started to analyze its service contracts with equipment vendors. The department also is accumulating data to measure room, equipment, and labor utilization. The hospital now has a true picture of the real cost associated with each patient encounter in medical imaging. It can now begin to manage case costs, perform better capacity planning, create more effective relationships with its material suppliers, and optimize scheduling of patients and staff.

Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya

PubMed Central

2010-01-01

Abstract Background The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. Methods The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. Results The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a “resource team”, supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. Conclusions For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes. PMID:20594373

Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya.

PubMed

Abuya, Timothy; Amin, Abdinasir; Molyneux, Sassy; Akhwale, Willis; Marsh, Vicki; Gilson, Lucy

2010-07-02

The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes.

AOIPS water resources data management system

NASA Technical Reports Server (NTRS)

Merritt, E. S.; Shotwell, R. L.; Place, M. C.; Belknap, N. J.

1976-01-01

A geocoded data management system applicable for hydrological applications was designed to demonstrate the utility of the Atmospheric and Oceanographic Information Processing System (AOIPS) for hydrological applications. Within that context, the geocoded hydrology data management system was designed to take advantage of the interactive capability of the AOIPS hardware. Portions of the Water Resource Data Management System which best demonstrate the interactive nature of the hydrology data management system were implemented on the AOIPS. A hydrological case study was prepared using all data supplied for the Bear River watershed located in northwest Utah, southeast Idaho, and western Wyoming.

A Database-Based and Web-Based Meta-CASE System

NASA Astrophysics Data System (ADS)

Eessaar, Erki; Sgirka, Rünno

Each Computer Aided Software Engineering (CASE) system provides support to a software process or specific tasks or activities that are part of a software process. Each meta-CASE system allows us to create new CASE systems. The creators of a new CASE system have to specify abstract syntax of the language that is used in the system and functionality as well as non-functional properties of the new system. Many meta-CASE systems record their data directly in files. In this paper, we introduce a meta-CASE system, the enabling technology of which is an object-relational database system (ORDBMS). The system allows users to manage specifications of languages and create models by using these languages. The system has web-based and form-based user interface. We have created a proof-of-concept prototype of the system by using PostgreSQL ORDBMS and PHP scripting language.

Integrating Local Environmental Management and Federal/State Interests Through Governance: The Case of the Garden Island Environmental Advisory Committee

NASA Astrophysics Data System (ADS)

Hercock, Marion

2002-09-01

The apparently unresolvable differences between managing national defense and local conservation, public recreation, and scientific research can be overcome through an advisory committee, with a strong and dedicated entity to drive the processes of governance and change. The case of the Garden Island Environmental Advisory Committee shows how the organizational and political difficulties of integrating state interests and federal concerns were met. Garden Island, off the coast of Perth, the capital of the State of Western Australia, is a base for the Royal Australian Navy which is administered by the federal Department of Defence. Examples are given of the committee's approach to integrated environmental management and the implementation of the Navy's environmental policy.

Management and control of microbiologically influenced corrosion (MIC) in the oil and gas industry-Overview and a North Sea case study.

PubMed

Skovhus, Torben Lund; Eckert, Richard B; Rodrigues, Edgar

2017-08-20

Microbiologically influenced corrosion (MIC) is the terminology applied where the actions of microorganisms influence the corrosion process. In literature, terms such as microbial corrosion, biocorrosion, microbially influenced/induced corrosion, and biodegradation are often applied. MIC research in the oil and gas industry has seen a revolution over the past decade, with the introduction of molecular microbiological methods: (MMM) as well as new industry standards and procedures of sampling biofilm and corrosion products from the process system. This review aims to capture the most important trends the oil and gas industry has seen regarding MIC research over the past decade. The paper starts out with an overview of where in the process stream MIC occurs - from the oil reservoir to the consumer. Both biotic and abiotic corrosion mechanisms are explained in the context of managing MIC using a structured corrosion management (CM) approach. The corrosion management approach employs the elements of a management system to ensure that essential corrosion control activities are carried out in an effective, sustainable, well-planned and properly executed manner. The 3-phase corrosion management approach covering of both biotic and abiotic internal corrosion mechanisms consists of 1) corrosion assessment, 2) corrosion mitigation and 3) corrosion monitoring. Each of the three phases are described in detail with links to recent field cases, methods, industry standards and sampling protocols. In order to manage the corrosion threat, operators commonly use models to support decision making. The models use qualitative, semi-quantitative or quantitative measures to help assess the rate of degradation caused by MIC. The paper reviews four existing models for MIC Threat Assessment and describe a new model that links the threat of MIC in the oil processing system located on an offshore platform with a Risk Based Inspection (RBI) approach. A recent field case highlights and explains the conflicting historic results obtained through serial dilution of culture media using the most probable number (MPN) method as compared to data obtained from corrosion monitoring and the quantitative polymerase chain reaction (qPCR) method. Results from qPCR application in the field case have changed the way MIC is monitored on the oil production facility in the North Sea. A number of high quality resources have been published as technical conference papers, books, educational videos and peer-reviewed scientific papers, and thus we end the review with an updated list of state-of-the-art resources for anyone desiring to become more familiar with the topic of MIC in the upstream oil and gas sector. Copyright © 2017 Elsevier B.V. All rights reserved.

Systemic Case Formulation, Individualized Process Monitoring, and State Dynamics in a Case of Dissociative Identity Disorder.

PubMed

Schiepek, Günter K; Stöger-Schmidinger, Barbara; Aichhorn, Wolfgang; Schöller, Helmut; Aas, Benjamin

2016-01-01

Objective: The aim of this case report is to demonstrate the feasibility of a systemic procedure (synergetic process management) including modeling of the idiographic psychological system and continuous high-frequency monitoring of change dynamics in a case of dissociative identity disorder. The psychotherapy was realized in a day treatment center with a female client diagnosed with borderline personality disorder (BPD) and dissociative identity disorder. Methods: A three hour long co-creative session at the beginning of the treatment period allowed for modeling the systemic network of the client's dynamics of cognitions, emotions, and behavior. The components (variables) of this idiographic system model (ISM) were used to create items for an individualized process questionnaire for the client. The questionnaire was administered daily through an internet-based monitoring tool (Synergetic Navigation System, SNS), to capture the client's individual change process continuously throughout the therapy and after-care period. The resulting time series were reflected by therapist and client in therapeutic feedback sessions. Results: For the client it was important to see how the personality states dominating her daily life were represented by her idiographic system model and how the transitions between each state could be explained and understood by the activating and inhibiting relations between the cognitive-emotional components of that system. Continuous monitoring of her cognitions, emotions, and behavior via SNS allowed for identification of important triggers, dynamic patterns, and psychological mechanisms behind seemingly erratic state fluctuations. These insights enabled a change in management of the dynamics and an intensified trauma-focused therapy. Conclusion: By making use of the systemic case formulation technique and subsequent daily online monitoring, client and therapist continuously refer to detailed visualizations of the mental and behavioral network and its dynamics (e.g., order transitions). Effects on self-related information processing, on identity development, and toward a more pronounced autonomy in life (instead of feeling helpless against the chaoticity of state dynamics) were evident in the presented case and documented by the monitoring system.

A retrospective explanatory case study of the implementation of a bleeding management quality initiative, in an Australian cardiac surgery unit.

PubMed

Pearse, Bronwyn Louise; Rickard, Claire M; Keogh, Samantha; Lin Fung, Yoke

2018-03-09

Bleeding management in cardiac surgery is challenging. Many guidelines exist to support bleeding management; however, literature demonstrates wide variation in practice. In 2012, a quality initiative was undertaken at The Prince Charles Hospital, Australia to improve bleeding management for cardiac surgery patients. The implementation of the quality initiative resulted in significant reductions in the incidence of blood transfusion, re-exploration for bleeding; superficial leg and chest wound infections; length of hospital stay, and cost. Given the success of the initiative, we sought to answer the question; "How and why was the process of implementing a bleeding management quality initiative in the cardiac surgery unit successful, and sustainable?" A retrospective explanatory case study design was chosen to explore the quality initiative. Analysis of the evidence was reviewed through phases of the 'Knowledgeto Action' planned change model. Data was derived from: (1) document analysis, (2) direct observation of the local environment, (3) clinical narratives from interviews, and analysed with a triangulation approach. The study period extended from 10/2011 to 6/2013. Results demonstrated the complexity of changing practice, as well as the significant amount of dedicated time and effort required to support individual, department and system wide change. Results suggest that while many clinicians were aware of the potential to apply improved practice, numerous barriers and challenges needed to be overcome to implement change across multiple disciplines and departments. The key successful components of the QI were revealed through the case study analysis as: (1) an appropriately skilled project manager to facilitate the implementation process; (2) tools to support changes in workflow and decision making including a bleeding management treatment algorithm with POCCTs; (3) strong clinical leadership from the multidisciplinary team and; (4) the evolution of the project manager position into a perpetual clinical position to support sustainability. Copyright © 2018 Australian College of Critical Care Nurses Ltd. All rights reserved.

Research and Practice of Uav Remote Sensing in the Monitoring and Management of Construction Projects in Riparian Areas

NASA Astrophysics Data System (ADS)

Yu, J.; Gan, Z.; Zhong, L.; Deng, L.

2018-04-01

The objective of this paper is to investigate the use of UAV remote sensing in the monitoring and management of construction projects in riparian areas through the case study of embankment construction projects' monitoring in the Three Gorges Reservoir area. A three-step approach is proposed to address the problem: data acquisition with UAV, data processing, and monitoring information extraction. The results of the case study demonstrate that UAV remote sensing is capable of providing fast and accurate measurements and calculations for the needs of monitoring of riparian constructions.

The anatomy of a shark attack: a case report and review of the literature.

PubMed

Caldicott, D G; Mahajani, R; Kuhn, M

2001-07-01

Shark attacks are rare but are associated with a high morbidity and significant mortality. We report the case of a patient's survival from a shark attack and their subsequent emergency medical and surgical management. Using data from the International Shark Attack File, we review the worldwide distribution and incidence of shark attack. A review of the world literature examines the features which make shark attacks unique pathological processes. We offer suggestions for strategies of management of shark attack, and techniques for avoiding adverse outcomes in human encounters with these endangered creatures.

Evaluating hospital design from an operations management perspective.

PubMed

Vos, Leti; Groothuis, Siebren; van Merode, Godefridus G

2007-12-01

This paper describes an evaluation method for the assessment of hospital building design from the viewpoint of operations management to assure that the building design supports the efficient and effective operating of care processes now and in the future. The different steps of the method are illustrated by a case study. In the case study an experimental design is applied to assess the effect of used logistical concepts, patient mix and technologies. The study shows that the evaluation method provides a valuable tool for the assessment of both functionality and the ability to meet future developments in operational control of a building design.

Comparing the Costs and Benefits of Re-Accreditation Processes. AIR 2002 Forum Paper.

ERIC Educational Resources Information Center

Shibley, Lisa R.; Volkwein, J. Fredericks

This study examined the costs and benefits of reaccredidation processes at a public research university. A case study approach was used to examining the costs and benefits of reaccredidation activities by Middle States Association (MSA), American Assembly of Collegiate Schools of Business-International Association for Management Education (AACSB),…

Model Transformation for a System of Systems Dependability Safety Case

NASA Technical Reports Server (NTRS)

Murphy, Judy; Driskell, Steve

2011-01-01

The presentation reviews the dependability and safety effort of NASA's Independent Verification and Validation Facility. Topics include: safety engineering process, applications to non-space environment, Phase I overview, process creation, sample SRM artifact, Phase I end result, Phase II model transformation, fault management, and applying Phase II to individual projects.

Environmental and sustainability ethics in supply chain management.

PubMed

Beamon, Benita M

2005-04-01

Environmentally Conscious Supply Chain Management (ECSCM refers to the control exerted over all immediate and eventual environmental effects of products and processes associated with converting raw materials into final products. While much work has been done in this area, the focus has traditionally been on either: product recovery (recycling, remanufacturing, or re-use) or the product design function only (e.g., design for environment). Environmental considerations in manufacturing are often viewed as separate from traditional, value-added considerations. However, the case can be made that professional engineers have an ethical responsibility to consider the immediate and eventual environmental impacts of products and processes that they design and/or manage. This paper describes ECSCM as a component of engineering ethics, and highlights the major issues associated with ethical decision-making in supply chain management.

Everglades Landscape Model: Integrated Assessment of Hydrology, Biogeochemistry, and Biology

NASA Astrophysics Data System (ADS)

Fitz, H. C.; Wang, N.; Sklar, F. H.

2002-05-01

Water management infrastructure and operations have fragmented the greater Everglades into separate, impounded basins, altering flows and hydropatterns. A significant area of this managed system has experienced anthropogenic eutrophication. This combination of altered hydrology and water quality has interacted to degrade vegetative habitats and other ecological characteristics of the Everglades. One of the modeling tools to be used in developing restoration alternatives is the Everglades Landscape Model (ELM), a process-based, spatially explicit simulation of ecosystem dynamics across a heterogeneous, 10,000 km2 region. The model has been calibrated to capture hydrologic and surface water quality dynamics across most of the Everglades landscape over decadal time scales. We evaluated phosphorus loading throughout the Everglades system under two base scenarios. The 1995 base case assumed current management operations, with phosphorus inflow concentrations fixed at their long term, historical average. The 2050 base case assumed future modifications in water and nutrient management, with all managed inflows to the Everglades having reduced phosphorus concentrations. In an example indicator subregion that currently is highly eutrophic, the 31-yr simulations predicted that desirable periphyton and macrophyte communities were maintained under the 2050 base case, whereas in the 1995 base case, periphyton biomass and production decreased to negligible levels and macrophytes became extremely dense. The negative periphyton response in the 1995 base case was due to high phosphorus loads and rapid macrophyte growth that shaded this algal community. Along an existing 11 km eutrophication gradient, the model indicated that the 2050 base case had ecologically significant reductions in phosphorus accumulation compared to the 1995 base case. Indicator regions (in Everglades National Park) distant from phosphorus inflow points also exhibited reductions in phosphorus accumulation under the 2050 base case, albeit to a lesser extent due to its distance from phosphorus inflows. The ELM fills a critical information need in Everglades management, and has become an accepted tool in evaluating scenarios of potential restoration of the natural system.

Globalization and Leadership and Management: A Comparative Analysis of Primary Schools in England and Finland

ERIC Educational Resources Information Center

Webb, Rosemary; Vulliamy, Graham; Sarja, Anneli; Hamalainen, Seppo

2006-01-01

This article analyses the impact of processes of globalization on both policy and practice in relation to primary school leadership and management in England and Finland. Data are drawn from case study research carried out from 1994-1996 in six schools in Finland and six schools in England and a follow-up study on teacher professionalism…

Location-Based Critical Infrastructure Interdependency (LBCII)

DTIC Science & Technology

2010-04-01

Effective disaster management reduces devastation and cost . This section describes the processes of disaster management, including the elements of CEM...it has reasonable probability, based on the tectonic geology and the history of the region. The case highlights the usability of network- centric...of earthquake risk assessment in Cartago, Costa Rica . International Institute for Geo-Information Science and Earth Observation (ITC): Enschede

Projection matrices as a forest management tool: an invasive tree case study

Treesearch

Ian J. Renne; Benjamin F. Tracy; Timothy P. Spira

2003-01-01

Life history parameters of many forest-dwelling species are affected by native and non-native pests. In turn, these pests alter forest processes and cost the United States billions of dollars annually. Population projection matrices can aid ecologists and managers in evaluating the impact of pests on forest species as well as devising effective strategies for pest...

Mechanical mid-story reduction treatments for forest fuel management

Treesearch

B. Rummer; K. Outcalt; D. Brockway

2002-01-01

There are many forest stands where exclusion of fire or lack of management has led to dense understorys and fuel accumulation. Generally, the least expensive treatment is to introduce a regime of prescribed fire as a surrogate for natural forest fire processes in these stands. However, in some cases prescribed fire is not an option. For example, heavy fuel loadings may...

Higher Educational Policy, Interest Politics and Crisis Management: Facets and Aspects of the Greek Case within the EHEA

ERIC Educational Resources Information Center

Papadakis, Nikos E.; Tsakanika, Theofano; Kyridis, Argyris

2012-01-01

With this paper we approach the new policy making paradigm for Europe's higher education policy, set with the Bologna Process, given emphasis to the legitimacy deficit of this political venture and the necessity of a crisis management over the implementation phase within national frames. The implementation of the Bologna's policies, using Greece…

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

A Case Study for Executive Leadership

ERIC Educational Resources Information Center

Hill, Phyllis J.

1975-01-01

A newly appointed woman dean discusses the value of a management development program involving a process of self-analysis and self-determination of leadership style and effectiveness (the University of Illinois "Executive Leadership Seminar"). (JT)

The role of paediatric nurses in medication safety prior to the implementation of electronic prescribing: a qualitative case study.

PubMed

Farre, Albert; Heath, Gemma; Shaw, Karen; Jordan, Teresa; Cummins, Carole

2017-04-01

Objectives To explore paediatric nurses' experiences and perspectives of their role in the medication process and how this role is enacted in everyday practice. Methods A qualitative case study on a general surgical ward of a paediatric hospital in England, one year prior to the planned implementation of ePrescribing. Three focus groups and six individual semi-structured interviews were conducted, involving 24 nurses. Focus groups and interviews were audio-recorded, transcribed, anonymized and subjected to thematic analysis. Results Two overarching analytical themes were identified: the centrality of risk management in nurses' role in the medication process and the distributed nature of nurses' medication risk management practices. Nurses' contribution to medication safety was seen as an intrinsic feature of a role that extended beyond just preparing and administering medications as prescribed and placed nurses at the heart of a dynamic set of interactions, practices and situations through which medication risks were managed. These findings also illustrate the collective nature of patient safety. Conclusions Both the recognized and the unrecognized contributions of nurses to the management of medications needs to be considered in the design and implementation of ePrescribing systems.

Integrated management of depression: improving system quality and creating effective interfaces.

PubMed

Myette, Thomas L

2008-04-01

Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.

Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study.

PubMed

Learmonth, Yvonne C; Motl, Robert W

2018-01-01

Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis (MS). There is disagreement regarding the strength of this research, perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing. We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS. A systematic scoping review was conducted based on a literature search of five databases to identify feasibility processes described in preliminary studies of physical activity in MS. We read and extracted methodology from each study based on the following feasibility metrics: process (e.g. recruitment), resource (e.g. monetary costs), management (e.g. personnel time requirements) and scientific outcomes (e.g. clinical/participant reported outcome measures). We illustrate the use of the four feasibility metrics within a randomised controlled trial of a home-based exercise intervention in persons with MS. Twenty-five studies were identified. Resource feasibility (e.g. time and resources) and scientific outcomes feasibility (e.g. clinical outcomes) methodologies were applied and described in many studies; however, these metrics have not been systematically addressed. Metrics related to process feasibility (e.g. recruitment) and management feasibility (e.g. human and data management) are not well described within the literature. Our case study successfully enabled us to address the four feasibility metrics, and we provide new information on management feasibility (i.e. estimate data completeness and estimate data entry) and scientific outcomes feasibility (i.e. determining data collection materials appropriateness). Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility. This review serves as a clarion call for feasibility trials that will substantially strengthen the foundation of research on exercise in MS.

Integrated Risk Management Within NASA Programs/Projects

NASA Technical Reports Server (NTRS)

Connley, Warren; Rad, Adrian; Botzum, Stephen

2004-01-01

As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the chances for mission success.

A characterization of workflow management systems for extreme-scale applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferreira da Silva, Rafael; Filgueira, Rosa; Pietri, Ilia

We present that the automation of the execution of computational tasks is at the heart of improving scientific productivity. Over the last years, scientific workflows have been established as an important abstraction that captures data processing and computation of large and complex scientific applications. By allowing scientists to model and express entire data processing steps and their dependencies, workflow management systems relieve scientists from the details of an application and manage its execution on a computational infrastructure. As the resource requirements of today’s computational and data science applications that process vast amounts of data keep increasing, there is a compellingmore » case for a new generation of advances in high-performance computing, commonly termed as extreme-scale computing, which will bring forth multiple challenges for the design of workflow applications and management systems. This paper presents a novel characterization of workflow management systems using features commonly associated with extreme-scale computing applications. We classify 15 popular workflow management systems in terms of workflow execution models, heterogeneous computing environments, and data access methods. Finally, the paper also surveys workflow applications and identifies gaps for future research on the road to extreme-scale workflows and management systems.« less

A characterization of workflow management systems for extreme-scale applications

DOE PAGES

Ferreira da Silva, Rafael; Filgueira, Rosa; Pietri, Ilia; ...

2017-02-16

We present that the automation of the execution of computational tasks is at the heart of improving scientific productivity. Over the last years, scientific workflows have been established as an important abstraction that captures data processing and computation of large and complex scientific applications. By allowing scientists to model and express entire data processing steps and their dependencies, workflow management systems relieve scientists from the details of an application and manage its execution on a computational infrastructure. As the resource requirements of today’s computational and data science applications that process vast amounts of data keep increasing, there is a compellingmore » case for a new generation of advances in high-performance computing, commonly termed as extreme-scale computing, which will bring forth multiple challenges for the design of workflow applications and management systems. This paper presents a novel characterization of workflow management systems using features commonly associated with extreme-scale computing applications. We classify 15 popular workflow management systems in terms of workflow execution models, heterogeneous computing environments, and data access methods. Finally, the paper also surveys workflow applications and identifies gaps for future research on the road to extreme-scale workflows and management systems.« less

An application of business process method to the clinical efficiency of hospital.

PubMed

Leu, Jun-Der; Huang, Yu-Tsung

2011-06-01

The concept of Total Quality Management (TQM) has come to be applied in healthcare over the last few years. The process management category in the Baldrige Health Care Criteria for Performance Excellence model is designed to evaluate the quality of medical services. However, a systematic approach for implementation support is necessary to achieve excellence in the healthcare business process. The Architecture of Integrated Information Systems (ARIS) is a business process architecture developed by IDS Scheer AG and has been applied in a variety of industrial application. It starts with a business strategy to identify the core and support processes, and encompasses the whole life-cycle range, from business process design to information system deployment, which is compatible with the concept of healthcare performance excellence criteria. In this research, we apply the basic ARIS framework to optimize the clinical processes of an emergency department in a mid-size hospital with 300 clinical beds while considering the characteristics of the healthcare organization. Implementation of the case is described, and 16 months of clinical data are then collected, which are used to study the performance and feasibility of the method. The experience gleaned in this case study can be used a reference for mid-size hospitals with similar business models.

Sustainable wetland management and support of ecosystem services

USGS Publications Warehouse

Smith, Loren M.; Euliss, Ned H.; Wilcox, Douglas A.; Brinson, Mark M.

2009-01-01

This article is a follow-up on a previous piece in the National Wetlands Newsletter in which we outlined problems associated with a static, local approach to wetland management versus an alternative that proposes a temporal and geomorphic approach (Euliss et al. 2009). We extend that concept by drawing on companion papers recently published in the journal Wetlands (Euliss et al. 2008, Smith et al. 2008). Here we highlight reasons for the failure of many managed wetlands to provide a suite of ecosystem services (e.g., carbon storage, diodiversity, ground-water recharge, contaminant filtering, floodwater storage). Our principal theme is that wetland management is best approached by giving consideration to the hydrogeomorphic processes that maintain productive ecosystems and by removing physical and social impediments to those processes. Traditional management actions are often oriented toward maintaining static conditions in wetlands without considering the temporal cycles that wetlands need to undergo or achieve productivity for specific groups of wildlife, such as waterfowl. Possibly more often, a manager's ability to influence hydrogeomorphic processes is restricted by activities in surrounding watersheds. These could be dams, for example, which do not allow management of flood-pulse processes essential to productivity of riparian systems. In most cases, sediments and nutrients associated with land use in contributing watersheds complicate management of wetlands for a suite of services, including wildlife. Economic or policy forces far-removed from a wetland often interact to prevent occurrence of basic ecosystem processes. Our message is consistent with recommendation of supply-side sustainability of Allen et al. (2002) in which ecosystems are managed "for the system that produces outputs rather than the outputs themselves."

Understanding the work done by NHS commissioning managers: an exploration of the microprocesses underlying day-to-day sensemaking in UK primary care organisations.

PubMed

Checkland, Kath; Harrison, Stephen; Snow, Stephanie; Coleman, Anna; McDermott, Imelda

2013-01-01

The purpose of this paper is to explore the practical daily work undertaken by middle-level managers in Primary Care Trusts (PCTs), focusing upon the micro-processes by which these managers enact sensemaking in their organisations. The research took a case study approach, undertaking detailed case studies in four PCTs in England. Data collection included shadowing managers, meeting observations and interviews. The research elucidated two categories of enactment behaviour exhibited by PCT managers: presence/absence; and the production of artefacts. Being "present" in or "absent" from meetings enacted sensemaking over and above any concrete contribution to the meeting made by the actors involved. This paper explores the factors affecting these processes, and describes the situations in which enactment of sense is most likely to occur. Producing artefacts such as meeting minutes or PowerPoint slides also enacted sense in the study sites in addition to the content of the artefact. The factors affecting this are explored. The study has practical implications for all managers seeking to maximise their influence in their organisations. It also provides specific evidence relevant to managers working in the new Clinical Commissioning Groups currently being formed in England. The study expands the understanding of sensemaking in organisations in two important ways. Firstly, it moves beyond discourse to explore the ways in which behaviours can enact sense. Secondly, it explores the distinction between active and unconscious sensemaking.

An ontological case base engineering methodology for diabetes management.

PubMed

El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

2014-08-01

Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

Analysis of the development and diffusion of technological innovations in oil spill forecasting: The MEDESS-4MS case

NASA Astrophysics Data System (ADS)

Marcati, Alberto; Prete, M. Irene; Mileti, Antonio; Cortese, Mario; Zodiatis, George; Karaolia, Andria; Gauci, Adam; Drago, Aldo

2016-11-01

This paper presents a case study on the management of users' engagement in the development of a new technology. Based on the experience of MEDESS-4MS, an integrated operational model for oil spill Decision Support System covering the whole Mediterranean Sea, the case study is aimed at the development of a framework for user engagement and for the management of its dual logic. Indeed, users may play a dual role in the innovation process, contributing to both the design of the innovation and its promotion. Users contribute to shaping the innovation, by aggregating and integrating knowledge, and they facilitate its diffusion, by adopting the innovation and fostering its adoption within the socio-economic system.

Software Safety Risk in Legacy Safety-Critical Computer Systems

NASA Technical Reports Server (NTRS)

Hill, Janice L.; Baggs, Rhoda

2007-01-01

Safety Standards contain technical and process-oriented safety requirements. Technical requirements are those such as "must work" and "must not work" functions in the system. Process-Oriented requirements are software engineering and safety management process requirements. Address the system perspective and some cover just software in the system > NASA-STD-8719.13B Software Safety Standard is the current standard of interest. NASA programs/projects will have their own set of safety requirements derived from the standard. Safety Cases: a) Documented demonstration that a system complies with the specified safety requirements. b) Evidence is gathered on the integrity of the system and put forward as an argued case. [Gardener (ed.)] c) Problems occur when trying to meet safety standards, and thus make retrospective safety cases, in legacy safety-critical computer systems.

The writing process: A powerful approach for the language-disabled student.

PubMed

Moulton, J R; Bader, M S

1985-01-01

Our understanding of the writing process can be a powerful tool for teaching language-disabled students the "how" of writing. Direct, explicit instruction in writing process helps these students learn to explore their ideas and to manage the multiple demands of writing. A case study of one student, Jeff, demonstrates how we structure the stages of writing: prewriting, planning, drafting, revising, and proofreading. When these stages are clearly defined and involve specific skills, language-disabled students can reach beyond their limitations and strengthen their expression. The case study of Jeff reveals the development of his sense of control and his regard for himself as a writer.

Expert knowledge elicitation using computer simulation: the organization of frail elderly case management as an illustration.

PubMed

Chiêm, Jean-Christophe; Van Durme, Thérèse; Vandendorpe, Florence; Schmitz, Olivier; Speybroeck, Niko; Cès, Sophie; Macq, Jean

2014-08-01

Various elderly case management projects have been implemented in Belgium. This type of long-term health care intervention involves contextual factors and human interactions. These underlying complex mechanisms can be usefully informed with field experts' knowledge, which are hard to make explicit. However, computer simulation has been suggested as one possible method of overcoming the difficulty of articulating such elicited qualitative views. A simulation model of case management was designed using an agent-based methodology, based on the initial qualitative research material. Variables and rules of interaction were formulated into a simple conceptual framework. This model has been implemented and was used as a support for a structured discussion with experts in case management. The rigorous formulation provided by the agent-based methodology clarified the descriptions of the interventions and the problems encountered regarding: the diverse network topologies of health care actors in the project; the adaptation time required by the intervention; the communication between the health care actors; the institutional context; the organization of the care; and the role of the case manager and his or hers personal ability to interpret the informal demands of the frail older person. The simulation model should be seen primarily as a tool for thinking and learning. A number of insights were gained as part of a valuable cognitive process. Computer simulation supporting field experts' elicitation can lead to better-informed decisions in the organization of complex health care interventions. © 2013 John Wiley & Sons, Ltd.

Decision support systems and the healthcare strategic planning process: a case study.

PubMed

Lundquist, D L; Norris, R M

1991-01-01

The repertoire of applications that comprises health-care decision support systems (DSS) includes analyses of clinical, financial, and operational activities. As a whole, these applications facilitate developing comprehensive and interrelated business and medical models that support the complex decisions required to successfully manage today's health-care organizations. Kennestone Regional Health Care System's use of DSS to facilitate strategic planning has precipitated marked changes in the organization's method of determining capital allocations. This case study discusses Kennestone's use of DSS in the strategic planning process, including profiles of key DSS modeling components.

Implementing interorganizational cooperation in labour market reintegration: a case study.

PubMed

Ståhl, Christian

2012-06-01

To bring people with complex medical, social and vocational needs back to the labour market, interorganizational cooperation is often needed. Yet, studies of processes and strategies for achieving sustainable interorganizational cooperation are sparse. The aim of this study was to analyse the implementation processes of Swedish legislation on financial coordination, with specific focus on different strategies for and perspectives on implementing interorganizational cooperation. A multiple-case study was used, where two local associations for financial coordination were studied in order to elucidate and compare the development of cooperative work in two settings. The material, collected during a 3-year period, consisted of documents, individual interviews with managers, and focus groups with officials. Two different implementation strategies were identified. In case 1, a linear strategy was used to implement cooperative projects, which led to difficulties in maintaining cooperative work forms due to a fragmented and time-limited implementation process. In case 2, an interactive strategy was used, where managers and politicians were continuously involved in developing a central cooperation team that became a central part of a developing structure for interorganizational cooperation. An interactive cooperation strategy with long-term joint financing was here shown to be successful in overcoming organizational barriers to cooperation. It is suggested that a strategy based on adaptation to local conditions, flexibility and constant evaluation is preferred for developing sustainable interorganizational cooperation when implementing policies or legislation affecting interorganizational relationships.

Process' standardization and change management in higher education. The case of TEI of Athens

NASA Astrophysics Data System (ADS)

Chalaris, Ioannis; Chalaris, Manolis; Gritzalis, Stefanos; Belsis, Petros

2015-02-01

The establishment of mature operational procedures and the effort of standardizing and certifying these procedures is a particularly arduous and demanding task which requires strong commitment from management to the existing objectives, administrative stability and continuity, availability of resources, an adequate implementation team with support from all stakeholders and of course great tolerance until tangible results of the investment are shown. Ensuring these conditions, particularly in times of economic crisis, is an extremely difficult task for large organizations such as TEI of Athens where there is heterogeneity in personnel and changes in the administrative hierarchy arise plethora of additional difficulties and require an effective change management. In this work we depict the path of standardization and certification of administrative functions of TEI of Athens, with emphasis on difficulties encountered and how to address them and in particular issues of change management and the culture related to this effort. The requirement for infrastructure needed to be maintained in processes and tools process & strategic management is embodied, in order to evolve mechanisms for continuous improvement processes and storage / recovery of the resulting knowledge. The work concludes with a general design of a road map of internal audit and continuous improvement processes for a large institution of higher education.

ED-WAVE tool design approach: Case of a textile wastewater treatment plant in Blantyre, Malawi

NASA Astrophysics Data System (ADS)

Chipofya, V.; Kraslawski, A.; Avramenko, Y.

The ED-WAVE tool is a PC based package for imparting training on wastewater treatment technologies. The system consists of four modules viz. Reference Library, Process Builder, Case Study Manager, and Treatment Adviser. The principles of case-based design and case-based reasoning as applied in the ED-WAVE tool are utilised in this paper to evaluate the design approach of the wastewater treatment plant at Mapeto David Whitehead & Sons (MDW&S) textile and garments factory, Blantyre, Malawi. The case being compared with MDW&S in the ED-WAVE tool is Textile Case 4 in Sri Lanka (2003). Equalisation, coagulation and rotating biological contactors is the sequencing of treatment units at Textile Case 4 in Sri Lanka. Screening, oxidation ditches and sedimentation is the sequencing of treatment units at MDW&S textile and garments factory. The study suggests that aerobic biological treatment is necessary in the treatment of wastewater from a textile and garments factory. MDW&S incorporates a sedimentation process which is necessary for the removal of settleable matter before the effluent is discharged to the municipal wastewater treatment plant. The study confirmed the practical use of the ED-WAVE tool in the design of wastewater treatment systems, where after encountering a new situation; already collected decision scenarios (cases) are invoked and modified in order to arrive at a particular design alternative. What is necessary, however, is to appropriately modify the case arrived at through the Case Study Manager in order to come up with a design appropriate to the local situation taking into account technical, socio-economic and environmental aspects.

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

PubMed Central

2011-01-01

Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Conclusions Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making. PMID:21214905

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data.

PubMed

Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

2011-01-07

No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making.

Coastal forests and groundwater: Using case studies to understand the effects of drivers and stressors for resource management

Treesearch

Timothy Callahan; Devendra Amatya; Peter Stone

2017-01-01

Forests are receiving more attention for the ecosystem goods and services they provide and the potential change agents that may affect forest health and productivity. Highlighting case examples from coastal forests in South Carolina, USA, we describe groundwater processes with respect to stressors and potential responses of a wetland-rich forested landscape,...

[Management of requests for euthanasia. Discussion of cases].

PubMed

Englert, M

2008-09-01

Since September 2002, more than 2.000 legal euthanasia's were performed in Belgium. The present paper reviews the necessary steps to be followed by the physician for a correct achievement of the process initiated by the patient's demand to die. Interpretation of the legal conditions to be respected by the physician is discussed from reports of ten cases of requests for euthanasia.

Whose urban forest? The political ecology of foraging urban nontimber forest products

Treesearch

Patrick T. Hurley; Marla R. Emery; Rebecca McLain; Melissa Poe; Brian Grabbatin; Cari L. Goetcheus

2015-01-01

Drawing on case studies of foraging in Philadelphia, Pennsylvania and Mt. Pleasant, South Carolina, we point to foraging landscapes and practices within diverse urban forest spaces. We examine these spaces in relation to U.S. conservation and development processes and the effects of management and governance on species valued by foragers. These case studies reveal the...

A Case Study with Green Dot Public Schools on Managing the Tension between Fidelity and Adaptation When Scaling-Up

ERIC Educational Resources Information Center

Cevallos, Pedro F., Jr.

2009-01-01

This dissertation was a single case study with Green Dot Public Schools (GDPS) describing their rapid scale-up process. Specifically, it investigates the phenomenon of the inherent tension between maintaining the fidelity of the original model school's design, culture and values with local adaptation of the brand by stakeholders at the expansion…

A Case Study with Green Dot Public Schools on Managing the Tension between Fidelity and Adaptation when Scaling-Up

ERIC Educational Resources Information Center

Cevallos, Pedro Felipe, Jr.

2009-01-01

This dissertation was a single case study with Green Dot Public Schools (GDPS) describing their rapid scale-up process. Specifically, it investigates the phenomenon of the inherent tension between maintaining the fidelity of the original model school's design, culture and values with local adaptation of the brand by stakeholders at the expansion…

Research for Policy (R4P): development of a reflection tool for researchers to improve knowledge utilization.

PubMed

Hegger, Ingrid; Marks, Lisanne K; Janssen, Susan W J; Schuit, Albertine J; Keijsers, Jolanda F M; van Oers, Hans A M

2016-09-30

To improve knowledge utilization in policymaking, alignment between researchers and policymakers during knowledge production is essential, but difficult to maintain. In three previously reported case studies, we extensively evaluated complex research projects commissioned by policymakers to investigate how alignment is achieved in a research process and to discover ways to enhance knowledge contributions to health policy. In the present study, we investigated how the findings of these three research projects could be integrated into a practical tool for researchers to enhance their contribution to evidence-based policy. A cross-case analysis was conducted to integrate the findings of the evaluation of the three research projects and to identify important alignment areas in these projects. By means of an iterative process, we prepared a tool that includes reflection questions for researchers. The "Research for Policy" tool was tested with input from the project managers of three new research projects. Based on the findings, the final version of the Research for Policy tool was prepared. By cross-case analysis of the three case studies, the following important alignment areas were identified: the goal, quality, relevance, timing, and presentation of research, the tasks and authorities of actors, the consultative structure and vertical alignment within organizations, and the organizational environment. The project managers regarded the Research for Policy tool as a useful checklist for addressing the important alignment areas in a research project. Based on their feedback, the illustrative examples from the case studies were added to the reflection questions. The project managers suggested making the tool accessible not only to researchers but also to policymakers. The format of the Research for Policy tool was further adjusted to users' needs by adding clickable links. Alignment between research and policymaking requires continuous efforts and a clear understanding of process issues in the research project. The Research for Policy tool offers practical alignment guidance and facilitates reflection on process issues, which supports researchers in aligning with policymakers and in acting in a context-sensitive way.

The role of certification in the buyer/planner position: a case study at Harley-Davidson Motor Company.

PubMed

Orange, V J; Robinson, D E

1999-02-01

The use of buyer/planners may becoming more popular. If they are, the reason is probably that many companies are integrating materiel management skill sets as a way of increasing the effectiveness of their supply chains. Harley-Davidson recently created a supply management function composed of buyer/planners. This article describes the method it used to achieve the transition, the training plan it implemented to support the process, and the role management played in achieving success.

Knowledge management system for risk mitigation in supply chain uncertainty: case from automotive battery supply chain

NASA Astrophysics Data System (ADS)

Marie, I. A.; Sugiarto, D.; Surjasa, D.; Witonohadi, A.

2018-01-01

Automotive battery supply chain include battery manufacturer, sulphuric acid suppliers, polypropylene suppliers, lead suppliers, transportation service providers, warehouses, retailers and even customers. Due to the increasingly dynamic condition of the environment, supply chain actors were required to improve their ability to overcome various uncertainty issues in the environment. This paper aims to describe the process of designing a knowledge management system for risk mitigation in supply chain uncertainty. The design methodology began with the identification of the knowledge needed to solve the problems associated with uncertainty and analysis of system requirements. The design of the knowledge management system was described in the form of a data flow diagram. The results of the study indicated that key knowledge area that needs to be managed were the knowledge to maintain the stability of process in sulphuric acid process and knowledge to overcome the wastes in battery manufacturing process. The system was expected to be a media acquisition, dissemination and storage of knowledge associated with the uncertainty in the battery supply chain and increase the supply chain performance.

Optimization and resilience in natural resources management

USGS Publications Warehouse

Williams, Byron K.; Johnson, Fred A.

2015-01-01

We consider the putative tradeoff between optimization and resilience in the management of natural resources, using a framework that incorporates different sources of uncertainty that are common in natural resources management. We address one-time decisions, and then expand the decision context to the more complex problem of iterative decision making. For both cases we focus on two key sources of uncertainty: partial observability of system state and uncertainty as to system dynamics. Optimal management strategies will vary considerably depending on the timeframe being considered and the amount and quality of information that is available to characterize system features and project the consequences of potential decisions. But in all cases an optimal decision making framework, if properly identified and focused, can be useful in recognizing sound decisions. We argue that under the conditions of deep uncertainty that characterize many resource systems, an optimal decision process that focuses on robustness does not automatically induce a loss of resilience.

A Case Study of Obsolescence Management Constraints During Development of Sustainment-Dominated Systems

NASA Astrophysics Data System (ADS)

Welch, Jonathan

This case study focused on obsolescence management constraints that occur during development of sustainment-dominated systems. Obsolescence management constraints were explored in systems expected to last 20 years or more and that tend to use commercial off-the-shelf products. The field of obsolescence has received little study, but obsolescence has a large cost for military systems. Because developing complex systems takes an average of 3 to 8 years, and commercial off-the-shelf components are typically obsolete within 3 to 5 years, military systems are often deployed with obsolescence issues that are transferred to the sustainment community to determine solutions. The main problem addressed in the study was to identify the constraints that have caused 70% of military systems under development to be obsolete when they are delivered. The purpose of the study was to use a qualitative case study to identify constraints that interfered with obsolescence management occurring during the development stages of a program. The participants of this case study were managers, subordinates, and end-users who were logistics and obsolescence experts. Researchers largely agree that proactive obsolescence management is a lower cost solution for sustainment-dominated systems. Program managers must understand the constraints and understand the impact of not implementing proactive solutions early in the development program lifecycle. The conclusion of the study found several constraints that prevented the development program from early adoption of obsolescence management theories, specifically pro-active theories. There were three major themes identified: (a) management commitment, (b) lack of details in the statement of work, and (c) vendor management. Each major theme includes several subthemes. The recommendation is future researchers should explore two areas: (a) comparing the cost of managing obsolescence early in the development process versus the costs of managing later, (b) exploring the costs and value to start a centralized obsolescence group at each major defense contractor location.

[Management policy-making for work and education in health: the case of the Bahia State Health Department, Brazil, 2007-2008].

PubMed

Pinto, Isabela Cardoso de Matos; Teixeira, Carmen Fontes

2011-09-01

The construction of Brazil's Unified National Health System (SUS) has raised a set of challenges for the health sector's administrators and personnel, including issues of work management and continuing education for health workers, in view of the financial, political, and organizational constraints in the process of changing the healthcare model. The current study aimed to analyze the process of formulating the Health Work and Education Management Policy by the Bahia State Health Department. Public policy cycle was used as the theoretical framework. The study analyzed data from institutional documents and records of participant observation by one of the authors. The results include mapping the governmental and nongovernmental stakeholders that participated in the process. The analysis highlights a series of problems in the SUS in Bahia related to work management and health workers' profile, taken as the point of departure for priority-setting in the State Strategic Agenda and Health Plan for 2008-2011.

Georgia resource assessment project: Institutionalizing LANDSAT and geographic data base techniques

NASA Technical Reports Server (NTRS)

Pierce, R. R.; Rado, B. Q.; Faust, N.

1981-01-01

Digital data from LANDSAT for each 1.1-acre cell in Georgia were processed and the land cover conditions were categorized. Several test cases were completed and an operational hardware and software processing capability was established at the Georgia Institute of Technology. The operational capability was developed to process the entire state (60,000 sq. miles and 14 LANDSAT scenes) in a cooperative project between eleven divisions and agencies at the regional, state, and federal levels. Products were developed for State agencies such as in both mapped and statistical formats. A computerized geographical data base was developed for management programs. To a large extent the applications of the data base evolved as users of LANDSAT information requested that other data (i.e., soils, slope, land use, etc.) be made compatible with LANDSAT for management programs. To date, geographic data bases incorporating LANDSAT and other spatial data deal with elements of the municipal solid waste management program, and reservoir management for the Corps of Engineers. LANDSAT data are also being used for applications in wetland, wildlife, and forestry management.

The MIKS (Member Integrated Knowledge System) Model: A Visualization of the Individual Organizational Member's Role When a Knowledge Management System Is Utilized in the Learning Organization

ERIC Educational Resources Information Center

Grobmeier, Cynthia

2007-01-01

Relating knowledge management (KM) case studies in various organizational contexts to existing theoretical constructs of learning organizations, a new model, the MIKS (Member Integrated Knowledge System) Model is proposed to include the role of the individual in the process. Their degree of motivation as well as communication and learning…

Combining Project Management Methods: A Case Study of Dlstributed Work Practices

NASA Astrophysics Data System (ADS)

Backlund, Per; Lundell, Björn

The increasing complexity of information systems development (ISD) projects call for improved project management practices. This, together with an endeavour to improve the success rate of ISD projects (Lyytinen and Robey 1999; Cooke-Davies 2002; White and Fortune 2002), has served as drivers for various efforts in process improvement such as the introduction of new development methods (Fitzgerald 1997; Iivari and Maansaari 1998).

Automated lattice data generation

NASA Astrophysics Data System (ADS)

Ayyar, Venkitesh; Hackett, Daniel C.; Jay, William I.; Neil, Ethan T.

2018-03-01

The process of generating ensembles of gauge configurations (and measuring various observables over them) can be tedious and error-prone when done "by hand". In practice, most of this procedure can be automated with the use of a workflow manager. We discuss how this automation can be accomplished using Taxi, a minimal Python-based workflow manager built for generating lattice data. We present a case study demonstrating this technology.

Using School Performance Data to Drive School and Education District Office Accountability and Improvement: The Case of Ghana

ERIC Educational Resources Information Center

Prew, Martin; Quaigrain, Kenneth

2010-01-01

This article looks at a school management tool that allows school managers and education district offices to review the performance of their schools and use the broad-based data to undertake orchestrated planning with districts planning delivery based on the needs of schools and in support of school improvement plans. The review process also…

Replacing the Lab Manual with a Learning Management System in Physics Investigations for K-4 Pre-Service Teachers

ERIC Educational Resources Information Center

Sobolewski, Stanley; Numan, Muhammad Z.

2018-01-01

The traditional laboratory investigation uses a procedure written on paper; students then record their responses on a supplied data page or laboratory notebook. In an attempt to make this process more efficient, the use of a Learning Management System (in this case D2L) was used to present the material and collect student feedback. Each student…

How stakeholder roles, power, and negotiation impact natural resource policy: A political economy view

USGS Publications Warehouse

Caughlan, L.

2002-01-01

Natural resource management decisions are complicated by multiple property rights, management objectives, and stakeholders with varying degrees of influence over the decision making process. In order to make efficient decisions, managers must incorporate the opinions and values of the involved stakeholders as well as understand the complex institutional constraints and opportunities that influence the decision-making process. Often this type of information is not understood until after a decision has been made, which can result in wasted time and effort.The purpose of my dissertation was to show how institutional frameworks and stakeholder involvement influence the various phases of the resource management decision-making process in a public choice framework. The intent was to assist decision makers and stakeholders by developing a methodology for formally incorporating stakeholders'' objectives and influence into the resource management planning process and to predict the potential success of rent-seeking activity based on stakeholder preferences and level of influence. Concepts from decision analysis, institutional analysis, and public choice economics were used in designing this interdisciplinary framework. The framework was then applied to an actual case study concerning elk and bison management on the National Elk Refuge and Grand Teton National Park near Jackson, Wyoming. The framework allowed for the prediction of the level of support and conflict for all relevant policy decisions, and the identification of each stakeholder''s level of support or opposition for each management decision.

A multicriteria-based methodology for site prioritisation in sediment management.

PubMed

Alvarez-Guerra, Manuel; Viguri, Javier R; Voulvoulis, Nikolaos

2009-08-01

Decision-making for sediment management is a complex task that incorporates the selections of areas for remediation and the assessment of options for any mitigation required. The application of Multicriteria Analysis (MCA) to rank different areas, according to their need for sediment management, provides a great opportunity for prioritisation, a first step in an integrated methodology that finally aims to assess and select suitable alternatives for managing the identified priority sites. This paper develops a methodology that starts with the delimitation of management units within areas of study, followed by the application of MCA methods that allows ranking of these management units, according to their need for remediation. This proposed process considers not only scientific evidence on sediment quality, but also other relevant aspects such as social and economic criteria associated with such decisions. This methodology is illustrated with its application to the case study area of the Bay of Santander, in northern Spain, highlighting some of the implications of utilising different MCA methods in the process. It also uses site-specific data to assess the subjectivity in the decision-making process, mainly reflected through the assignment of the criteria weights and uncertainties in the criteria scores. Analysis of the sensitivity of the results to these factors is used as a way to assess the stability and robustness of the ranking as a first step of the sediment management decision-making process.

Case Study: University of Anyplace: Strategic Legal Risk Review.

ERIC Educational Resources Information Center

Hall, John T.; Ferguson, Rowan

2000-01-01

Considers legal issues and risks faced by a fictional American university as it seeks to establish an operation based in London. Addresses the first step in the process of risk management, the risk review exercise, and provides an explanation of the legal issues involved to allow progression to the second stage in the process (evaluation of the…

Managed care and total quality management: a necessary integration.

PubMed

Phoon, J; Corder, K; Barter, M

1996-01-01

The process of quality improvement/total quality management (QI/TQM) plays a key role in the delivery of health care in a managed care system. The concepts and ideas surrounding QI/TQM and managed care are interrelated, and the success of health care delivery depends on the integration and coexistence of these two philosophies. In looking more closely at these concepts, it becomes clear that the principles of QI/TQM must underlie strategic decisions involved in the implementation of a managed care system. Nurses play a key role in the success of this integration as nurse case managers, nurse practitioners, and nurse administrators. They have a direct impact on the many variables and goals of both QI/TQM and managed care.

Manuka Honey: A Case Study of Severe Atopic Eczematous Dermatitis Reaction to Henna Tattoo.

PubMed

Harrison, Jeanine

Many mainstream medications were derived from plants and originally utilized in patient management well prior to the extensive research and testing processes of current pharmaceutical standards. The evolution of therapeutic management within the pharmaceutical and skin care industry often uses synthetic processing of products with less of a focus on the natural ingredients from which they were originally derived. However, more recently there has been a shift in pharmacological management to include the therapeutic use of more holistic medicines and practices and thus a broadening of the uses of nontraditional medical treatment options. This has been seen in the use of treatments, such as Manuka honey, for skin conditions and dermal injuries. It is often with off-label uses, or conditions resistant to other treatments, that then prompt the use of holistic products and the true value of the product is validated. As with the following case study, the example of the use of Manuka honey on a severe atopic contact dermatitis eczematous reaction provides further documentation and supportive evidence of the potential efficacy of the properties of this particular natural product.

Improving medical stores management through automation and effective communication.

PubMed

Kumar, Ashok; Cariappa, M P; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

2016-01-01

Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan-Do-Study-Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.

A Recipe for Streamlining Mission Management

NASA Technical Reports Server (NTRS)

Mitchell, Andrew E.; Semancik, Susan K.

2004-01-01

This paper describes a project's design and implementation for streamlining mission management with knowledge capture processes across multiple organizations of a NASA directorate. Thc project's focus is on standardizing processes and reports; enabling secure information access and case of maintenance; automating and tracking appropriate workflow rules through process mapping; and infusing new technologies. This paper will describe a small team's experiences using XML technologies through an enhanced vendor suite of applications integrated on Windows-based platforms called the Wallops Integrated Scheduling and Document Management System (WISDMS). This paper describes our results using this system in a variety of endeavors, including providing range project scheduling and resource management for a Range and Mission Management Office; implementing an automated Customer Feedback system for a directorate; streamlining mission status reporting across a directorate; and initiating a document management, configuration management and portal access system for a Range Safety Office's programs. The end result is a reduction of the knowledge gap through better integration and distribution of information, improved process performance, automated metric gathering, and quicker identification of problem areas and issues. However, the real proof of the pudding comes through overcoming the user's reluctance to replace familiar, seasoned processes with new technology ingredients blended with automated procedures in an untested recipe. This paper shares some of the team's observations that led to better implementation techniques, as well as an IS0 9001 Best Practices citation. This project has provided a unique opportunity to advance NASA's competency in new technologies, as well as to strategically implement them within an organizational structure, while wetting the appetite for continued improvements in mission management.

Integrating a Genetic Algorithm Into a Knowledge-Based System for Ordering Complex Design Processes

NASA Technical Reports Server (NTRS)

Rogers, James L.; McCulley, Collin M.; Bloebaum, Christina L.

1996-01-01

The design cycle associated with large engineering systems requires an initial decomposition of the complex system into design processes which are coupled through the transference of output data. Some of these design processes may be grouped into iterative subcycles. In analyzing or optimizing such a coupled system, it is essential to be able to determine the best ordering of the processes within these subcycles to reduce design cycle time and cost. Many decomposition approaches assume the capability is available to determine what design processes and couplings exist and what order of execution will be imposed during the design cycle. Unfortunately, this is often a complex problem and beyond the capabilities of a human design manager. A new feature, a genetic algorithm, has been added to DeMAID (Design Manager's Aid for Intelligent Decomposition) to allow the design manager to rapidly examine many different combinations of ordering processes in an iterative subcycle and to optimize the ordering based on cost, time, and iteration requirements. Two sample test cases are presented to show the effects of optimizing the ordering with a genetic algorithm.

Assessment and Management of Professionalism Issues in Pathology Residency Training: Results From Surveys and a Workshop by the Graduate Medical Education Committee of the College of American Pathologists.

PubMed

Domen, Ronald E; Talbert, Michael L; Johnson, Kristen; Post, Miriam D; Brissette, Mark D; Conran, Richard Michael; Hoffman, Robert D; McCloskey, Cindy B; Raciti, Patricia M; Roberts, Cory Anthony; Rojiani, Amyn M; Tucker, J Allan; Powell, Suzanne Zein-Eldin

2015-01-01

Professionalism issues are common in residency training and can be very difficult to recognize and manage. Almost one-third of the milestones for pathology recently instituted by the Accreditation Council for Graduate Medical Education encompass aspects of professionalism. Program directors are often unsure of how and when to remediate residents for unprofessional behavior. We used a case-based educational approach in a workshop setting to assist program directors in the management of unprofessional behavior in residents. Eight case scenarios highlighting various aspects of unprofessional behavior by pathology residents were developed and presented in an open workshop forum at the annual pathology program director's meeting. Prior to the workshop, 2 surveys were conducted: (1) to collect data on program directors' experience with identifying, assessing, and managing unprofessional behavior in their residents and (2) to get feedback from workshop registrants on how they would manage each of the 8 case scenarios. A wide range of unprofessional behaviors have been observed by pathology program directors. Although there is occasionally general agreement on how to manage specific behaviors, there remains wide variation in how to manage many of the presented unprofessional behaviors. Remediation for unprofessional behavior in pathology residents remains a difficult and challenging process. Additional education and research in this area are warranted.

Annual Statement of Assurance. Fiscal Year 1991

DTIC Science & Technology

1991-01-01

risk) assessment rating process. In orientation sessions, we made a pointed effort to emphasize the statutory root of the IMC Program. We undertook... rating process. Training in the development of the management control plan was also provided using examples and a sample format. To illustrate the...application of IMC principles to the risk rating process, a case study approach was presented in a workshop mode with questions and answers following

Mutagen Sensitivity, Apoptosis, and Polymorphism in DNA Repair as Measures of Prostate Cancer Risk

DTIC Science & Technology

2005-02-01

blood tubes are immediately refrigerated and delivered on ice within 6 hours to the GCRC core facility at Georgetown University for processing . Case...is CLIA certified. There is a centrally monitored storage facility with -80’C freezers. The established recruitment and optimized sample processing in...controls. We have established the recruitment procedures, sample collection, processing , repository, and data management. This is a substantial effort

The influence of scale preferences on the design of a water innovation: a case in Dutch river management.

PubMed

Vreugdenhil, Heleen; Vreudenhil, Heleen; Slinger, Jill; Kater, Emiel; Thissen, Wil

2010-07-01

The debate on scale use in river management focuses primarily on the (lack of) fit between the bio-geophysical and institutional systems. However, in this article we focus on the 'subjective' aspect of scale preferences in water governance. We apply an adapted version of the Integrated Scale Hierarchy for Rivers to determine the degree of fit between the scale preferences of the actors involved in a Dutch case study and the scale requirements of the innovative river management concept. This allows us to understand which riverine processes and characteristics are regarded as important by the different actors and to identify mismatches in scale perspectives as they manifest themselves in water management practice. We discover that inflexibility in scale use on the part of the involved actors places bounds on the design and quality of interventions and demonstrate that a more flexible use of scales in the design phase of a river management intervention has the potential to lead to more effective solutions.

[Lean logistics management in healthcare: a case study].

PubMed

Aguilar-Escobar, V G; Garrido-Vega, P

2013-01-01

To study the applicability of the principles of Lean Production to manage the supply chain of a hospital. In particular, to determine which Lean practices and principles are applicable, the benefits obtained and the main barriers for its implementation. Managing the hospital supply chain is an important issue, both for its effect on the quality of care and its impact on costs. This study is based on a case study. 2005-10. Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technological investments. The implementation of the comprehensive plan has reduced inventory, decreased lead times and improved service quality. Also, there have been other important improvements: enhanced employee satisfaction and increased staff productivity, both dedicated to health and the logistics. The experience analysed has shown the applicability and appropriateness of Lean principles and some of its techniques in managing the logistics of hospitals. It also identifies some of the main difficulties that may arise. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Implementation of the first adaptive management plan for a European migratory waterbird population: The case of the Svalbard pink-footed goose Anser brachyrhynchus

USGS Publications Warehouse

Madsen, Jesper; Williams, James Henty; Johnson, Fred A.; Tombre, Ingunn M.; Dereliev, Sergey; Kuijken, Eckhart

2017-01-01

An International Species Management Plan for the Svalbard population of the pink-footed goose was adopted under the Agreement on the Conservation of African-Eurasian Migratory Waterbirds in 2012, the first case of adaptive management of a migratory waterbird population in Europe. An international working group (including statutory agencies, NGO representatives and experts) agreed on objectives and actions to maintain the population in favourable conservation status, while accounting for biodiversity, economic and recreational interests. Agreements include setting a population target to reduce agricultural conflicts and avoid tundra degradation, and using hunting in some range states to maintain stable population size. As part of the adaptive management procedures, adjustment to harvest is made annually subject to population status. This has required streamlining of monitoring and assessment activities. Three years after implementation, indicators suggest the attainment of management results. Dialogue, consensus-building and engagement among stakeholders represent the major process achievements.

The Influence of Scale Preferences on the Design of a Water Innovation: A Case in Dutch River Management

PubMed Central

Slinger, Jill; Kater, Emiel; Thissen, Wil

2010-01-01

The debate on scale use in river management focuses primarily on the (lack of) fit between the bio-geophysical and institutional systems. However, in this article we focus on the ‘subjective’ aspect of scale preferences in water governance. We apply an adapted version of the Integrated Scale Hierarchy for Rivers to determine the degree of fit between the scale preferences of the actors involved in a Dutch case study and the scale requirements of the innovative river management concept. This allows us to understand which riverine processes and characteristics are regarded as important by the different actors and to identify mismatches in scale perspectives as they manifest themselves in water management practice. We discover that inflexibility in scale use on the part of the involved actors places bounds on the design and quality of interventions and demonstrate that a more flexible use of scales in the design phase of a river management intervention has the potential to lead to more effective solutions. PMID:20640852

Time-based management of patient processes.

PubMed

Kujala, Jaakko; Lillrank, Paul; Kronström, Virpi; Peltokorpi, Antti

2006-01-01

The purpose of this paper is to present a conceptual framework that would enable the effective application of time based competition (TBC) and work in process (WIP) concepts in the design and management of effective and efficient patient processes. This paper discusses the applicability of time-based competition and work-in-progress concepts to the design and management of healthcare service production processes. A conceptual framework is derived from the analysis of both existing research and empirical case studies. The paper finds that a patient episode is analogous to a customer order-to-delivery chain in industry. The effective application of TBC and WIP can be achieved by focusing on through put time of a patient episode by reducing the non-value adding time components and by minimizing time categories that are main cost drivers for all stakeholders involved in the patient episode. The paper shows that an application of TBC in managing patient processes can be limited if there is no consensus about optimal care episode in the medical community. In the paper it is shown that managing patient processes based on time and cost analysis enables one to allocate the optimal amount of resources, which would allow a healthcare system to minimize the total cost of specific episodes of illness. Analysing the total cost of patient episodes can provide useful information in the allocation of limited resources among multiple patient processes. This paper introduces a framework for health care managers and researchers to analyze the effect of reducing through put time to the total cost of patient episodes.

Using CASE to Exploit Process Modeling in Technology Transfer

NASA Technical Reports Server (NTRS)

Renz-Olar, Cheryl

2003-01-01

A successful business will be one that has processes in place to run that business. Creating processes, reengineering processes, and continually improving processes can be accomplished through extensive modeling. Casewise(R) Corporate Modeler(TM) CASE is a computer aided software engineering tool that will enable the Technology Transfer Department (TT) at NASA Marshall Space Flight Center (MSFC) to capture these abilities. After successful implementation of CASE, it could then go on to be applied in other departments at MSFC and other centers at NASA. The success of a business process is dependent upon the players working as a team and continuously improving the process. A good process fosters customer satisfaction as well as internal satisfaction in the organizational infrastructure. CASE provides a method for business process success through functions consisting of systems and processes business models; specialized diagrams; matrix management; simulation; report generation and publishing; and, linking, importing, and exporting documents and files. The software has an underlying repository or database to support these functions. The Casewise. manual informs us that dynamics modeling is a technique used in business design and analysis. Feedback is used as a tool for the end users and generates different ways of dealing with the process. Feedback on this project resulted from collection of issues through a systems analyst interface approach of interviews with process coordinators and Technical Points of Contact (TPOCs).

Web-GIS oriented systems viability for municipal solid waste selective collection optimization in developed and transient economies.

PubMed

Rada, E C; Ragazzi, M; Fedrizzi, P

2013-04-01

Municipal solid waste management is a multidisciplinary activity that includes generation, source separation, storage, collection, transfer and transport, processing and recovery, and, last but not least, disposal. The optimization of waste collection, through source separation, is compulsory where a landfill based management must be overcome. In this paper, a few aspects related to the implementation of a Web-GIS based system are analyzed. This approach is critically analyzed referring to the experience of two Italian case studies and two additional extra-European case studies. The first case is one of the best examples of selective collection optimization in Italy. The obtained efficiency is very high: 80% of waste is source separated for recycling purposes. In the second reference case, the local administration is going to be faced with the optimization of waste collection through Web-GIS oriented technologies for the first time. The starting scenario is far from an optimized management of municipal solid waste. The last two case studies concern pilot experiences in China and Malaysia. Each step of the Web-GIS oriented strategy is comparatively discussed referring to typical scenarios of developed and transient economies. The main result is that transient economies are ready to move toward Web oriented tools for MSW management, but this opportunity is not yet well exploited in the sector. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

Failure mode effect analysis and fault tree analysis as a combined methodology in risk management

NASA Astrophysics Data System (ADS)

Wessiani, N. A.; Yoshio, F.

2018-04-01

There have been many studies reported the implementation of Failure Mode Effect Analysis (FMEA) and Fault Tree Analysis (FTA) as a method in risk management. However, most of the studies usually only choose one of these two methods in their risk management methodology. On the other side, combining these two methods will reduce the drawbacks of each methods when implemented separately. This paper aims to combine the methodology of FMEA and FTA in assessing risk. A case study in the metal company will illustrate how this methodology can be implemented. In the case study, this combined methodology will assess the internal risks that occur in the production process. Further, those internal risks should be mitigated based on their level of risks.

Mapping knowledge translation and innovation processes in Cancer Drug Development: the case of liposomal doxorubicin.

PubMed

Fajardo-Ortiz, David; Duran, Luis; Moreno, Laura; Ochoa, Hector; Castaño, Victor M

2014-09-03

We explored how the knowledge translation and innovation processes are structured when theyresult in innovations, as in the case of liposomal doxorubicin research. In order to map the processes, a literature network analysis was made through Cytoscape and semantic analysis was performed by GOPubmed which is based in the controlled vocabularies MeSH (Medical Subject Headings) and GO (Gene Ontology). We found clusters related to different stages of the technological development (invention, innovation and imitation) and the knowledge translation process (preclinical, translational and clinical research), and we were able to map the historic emergence of Doxil as a paradigmatic nanodrug. This research could be a powerful methodological tool for decision-making and innovation management in drug delivery research.

"Fiefdoms" and co-management: the paradox of autonomy in an experience of democratization of hospital management.

PubMed

da Silva, Atila Mendes; Sá, Marilene de Castilho; Miranda, Lilian

2015-10-01

This study aimed to analyze the implementation of Management Committees and Production Units in a hospital in Rio de Janeiro based on the views of the actors responsible for this process, focusing on the issue of autonomy of the subjects involved in care delivery. This case study adopted a qualitative clinical psychosociological research approach using mainly semi-structured interviews. The management arrangements were valued by the interviewees principally as a way of increasing worker commitment, since the inclusion of workers in the Management Committees is likely to widen decision-making capacity and, at the same time, make staff more committed to care delivery. On the other hand, workers mentioned resistance arising from a struggle to maintain the concentration of power within the professional categories, and the challenge of dealing with differing conflicts of interests. The study suggests that the Management Committees and Production Units should include possibilities of addressing conflicts and intersubjective processes to avoid becoming excessively idealized and ineffective spaces.

Understanding the Data Complexity continuum to reduce data management costs and increase data usability through partnerships with the National Centers for Environmental Information

NASA Astrophysics Data System (ADS)

Mesick, S.; Weathers, K. W.

2017-12-01

Data complexity can be seen as a continuum from complex to simple. The term data complexity refers to data collections that are disorganized, poorly documented, and generally do not follow best data management practices. Complex data collections are challenging and expensive to manage. Simplified collections readily support automated archival processes, enhanced discovery and data access, as well as production of services that make data easier to reuse. In this session, NOAA NCEI scientific data stewards will discuss the data complexity continuum. This talk will explore data simplification concepts, methods, and tools that data managers can employ which may offer more control over data management costs and processes, while achieving policy goals for open data access and ready reuse. Topics will include guidance for data managers on best allocation of limited data management resources; models for partnering with NCEI to accomplish shared data management goals; and will demonstrate through case studies the benefits of investing in documentation, accessibility, and services to increase data value and return on investment.

Thresholds for conservation and management: structured decision making as a conceptual framework

USGS Publications Warehouse

Nichols, James D.; Eaton, Mitchell J.; Martin, Julien; Edited by Guntenspergen, Glenn R.

2014-01-01

changes in system dynamics. They are frequently incorporated into ecological models used to project system responses to management actions. Utility thresholds are components of management objectives and are values of state or performance variables at which small changes yield substantial changes in the value of the management outcome. Decision thresholds are values of system state variables at which small changes prompt changes in management actions in order to reach specified management objectives. Decision thresholds are derived from the other components of the decision process.We advocate a structured decision making (SDM) approach within which the following components are identified: objectives (possibly including utility thresholds), potential actions, models (possibly including ecological thresholds), monitoring program, and a solution algorithm (which produces decision thresholds). Adaptive resource management (ARM) is described as a special case of SDM developed for recurrent decision problems that are characterized by uncertainty. We believe that SDM, in general, and ARM, in particular, provide good approaches to conservation and management. Use of SDM and ARM also clarifies the distinct roles of ecological thresholds, utility thresholds, and decision thresholds in informed decision processes.

Study on Adaptive Parameter Determination of Cluster Analysis in Urban Management Cases

NASA Astrophysics Data System (ADS)

Fu, J. Y.; Jing, C. F.; Du, M. Y.; Fu, Y. L.; Dai, P. P.

2017-09-01

The fine management for cities is the important way to realize the smart city. The data mining which uses spatial clustering analysis for urban management cases can be used in the evaluation of urban public facilities deployment, and support the policy decisions, and also provides technical support for the fine management of the city. Aiming at the problem that DBSCAN algorithm which is based on the density-clustering can not realize parameter adaptive determination, this paper proposed the optimizing method of parameter adaptive determination based on the spatial analysis. Firstly, making analysis of the function Ripley's K for the data set to realize adaptive determination of global parameter MinPts, which means setting the maximum aggregation scale as the range of data clustering. Calculating every point object's highest frequency K value in the range of Eps which uses K-D tree and setting it as the value of clustering density to realize the adaptive determination of global parameter MinPts. Then, the R language was used to optimize the above process to accomplish the precise clustering of typical urban management cases. The experimental results based on the typical case of urban management in XiCheng district of Beijing shows that: The new DBSCAN clustering algorithm this paper presents takes full account of the data's spatial and statistical characteristic which has obvious clustering feature, and has a better applicability and high quality. The results of the study are not only helpful for the formulation of urban management policies and the allocation of urban management supervisors in XiCheng District of Beijing, but also to other cities and related fields.

Power monitoring and control for large scale projects: SKA, a case study

NASA Astrophysics Data System (ADS)

Barbosa, Domingos; Barraca, João. Paulo; Maia, Dalmiro; Carvalho, Bruno; Vieira, Jorge; Swart, Paul; Le Roux, Gerhard; Natarajan, Swaminathan; van Ardenne, Arnold; Seca, Luis

2016-07-01

Large sensor-based science infrastructures for radio astronomy like the SKA will be among the most intensive datadriven projects in the world, facing very high demanding computation, storage, management, and above all power demands. The geographically wide distribution of the SKA and its associated processing requirements in the form of tailored High Performance Computing (HPC) facilities, require a Greener approach towards the Information and Communications Technologies (ICT) adopted for the data processing to enable operational compliance to potentially strict power budgets. Addressing the reduction of electricity costs, improve system power monitoring and the generation and management of electricity at system level is paramount to avoid future inefficiencies and higher costs and enable fulfillments of Key Science Cases. Here we outline major characteristics and innovation approaches to address power efficiency and long-term power sustainability for radio astronomy projects, focusing on Green ICT for science and Smart power monitoring and control.

Intelligent elevator management system using image processing

NASA Astrophysics Data System (ADS)

Narayanan, H. Sai; Karunamurthy, Vignesh; Kumar, R. Barath

2015-03-01

In the modern era, the increase in the number of shopping malls and industrial building has led to an exponential increase in the usage of elevator systems. Thus there is an increased need for an effective control system to manage the elevator system. This paper is aimed at introducing an effective method to control the movement of the elevators by considering various cases where in the location of the person is found and the elevators are controlled based on various conditions like Load, proximity etc... This method continuously monitors the weight limit of each elevator while also making use of image processing to determine the number of persons waiting for an elevator in respective floors. Canny edge detection technique is used to find out the number of persons waiting for an elevator. Hence the algorithm takes a lot of cases into account and locates the correct elevator to service the respective persons waiting in different floors.

Health promotion in supplementary health care: outsourcing, microregulation and implications for care.

PubMed

Silva, Kênia Lara; Sena, Roseni Rosângela; Rodrigues, Andreza Trevenzoli; Araújo, Fernanda Lopes; Belga, Stephanie Marques Moura Franco; Duarte, Elysângela Dittz

2015-01-01

to analyze health promotion programs in the supplementary health care. This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis. Home care has been described as the main action in the field of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the beneficiaries. Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.

Risk management and measuring productivity with POAS--Point of Act System--a medical information system as ERP (Enterprise Resource Planning) for hospital management.

PubMed

Akiyama, M

2007-01-01

The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM (evidence-based medicine) through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man (Business Process), Material (Medical Materials and Medicine), Money (Expenditure for purchase and Receipt), and Information (Medical Records) completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.

Current causes and management of violence against women in Nigeria.

PubMed

Aimakhu, C O; Olayemi, O; Iwe, C A B; Oluyemi, F A; Ojoko, I E; Shoretire, K A; Adeniji, R A; Aimakhu, V E

2004-01-01

Violence against women is an important health and human rights issue. It carries with it both short- and long-term sequelae for women that can affect both their physical and psychological wellbeing. Every day obstetric providers treat patients who have been assaulted. Timely identification can interrupt the cycle of violence, prevent further injury and initiate the help-seeking process. The objectives of this study were to survey how often Nigerian obstetrician-gynaecologists see these patients in their practice and to describe the demographics and management of their most recent case so as to give an idea of the extent of the problem. This is especially important as abuse is grossly under-reported because the victims are afraid to report it because of male dominance in society and the fear of losing their homes. We used a self-administered questionnaire survey of 138 practising obstetricians and gynaecologists in Nigeria. Questions were asked about the yearly estimation of cases seen and how recently a case was seen. The type of abuse, risk factors and management of their most recent case was also documented. Most (98.6%) obstetricians surveyed had previously managed a case of violence. The mean estimate of abused women seen was 7.0 per year. Details of the last case managed were recollected by 91.3% of respondents. The majority (51.6%) of patients were pregnant. The assailant was the husband in 69.8% of cases and the most common factor for abuse was as a result of women requesting money for the family needs from their husbands. The most common type of abuse was physical (79.4%), with 34.9% of patients sustaining cuts. Treatment and counselling were the forms of management in most cases. The police were informed in 9.5% of cases and one obstetrician had to give evidence in court. Of the pregnant abused women, 73.8% had live births. Better job opportunities and female empowerment can reduce the risk of violence. Obstetricians should screen routinely for battery, provide education about violence, assess the danger, review safety plans and refer women appropriately. We cannot solve the problem alone, but sensitivity and commitment can begin to make a difference.

Improving health care, Part 1: The clinical value compass.

PubMed

Nelson, E C; Mohr, J J; Batalden, P B; Plume, S K

1996-04-01

CLINICAL VALUE COMPASS APPROACH: The clinical Value Compass, named to reflect its similarity in layout to a directional compass, has at its four cardinal points (1) functional status, risk status, and well-being; (2) costs; (3) satisfaction with health care and perceived benefit; and (4) clinical outcomes. To manage and improve the value of health care services, providers will need to measure the value of care for similar patient populations, analyze the internal delivery processes, run tests of changed delivery processes, and determine if these changes lead to better outcomes and lower costs. GETTING STARTED--OUTCOMES AND AIM: In the case example, the team's aim is "to find ways to continually improve the quality and value of care for AMI (acute myocardial infection) patients." VALUE MEASURES--SELECT A SET OF OUTCOME AND COST MEASURES: Four to 12 outcome and cost measures are sufficient to get started. In the case example, the team chose 1 or more measures for each quadrant of the value compass. An operational definition is a clearly specified method explaining how to measure a variable. Measures in the case example were based on information from the medical record, administrative and financial records, and patient reports and ratings at eight weeks postdischarge. Measurement systems that quantify the quality of processes and results of care are often add-ons to routine care delivery. However, the process of measurement should be intertwined with the process of care delivery so that front-line providers are involved in both managing the patient and measuring the process and related outcomes and costs.

[Establishment of malaria early warning system in Jiangsu Province II application of digital earth system in malaria epidemic management and surveillance].

PubMed

Wang, Wei-Ming; Zhou, Hua-Yun; Liu, Yao-Bao; Li, Ju-Lin; Cao, Yuan-Yuan; Cao, Jun

2013-04-01

To explore a new mode of malaria elimination through the application of digital earth system in malaria epidemic management and surveillance. While we investigated the malaria cases and deal with the epidemic areas in Jiangsu Province in 2011, we used JISIBAO UniStrong G330 GIS data acquisition unit (GPS) to collect the latitude and longitude of the cases located, and then established a landmark library about early-warning areas and an image management system by using Google Earth Free 6.2 and its image processing software. A total of 374 malaria cases were reported in Jiangsu Province in 2011. Among them, there were 13 local vivax malaria cases, 11 imported vivax malaria cases from other provinces, 20 abroad imported vivax malaria cases, 309 abroad imported falciparum malaria cases, 7 abroad imported quartan malaria cases (Plasmodium malaria infection), and 14 abroad imported ovale malaria cases (P. ovale infection). Through the analysis of Google Earth Mapping system, these malaria cases showed a certain degree of aggregation except the abroad imported quartan malaria cases which were highly sporadic. The local vivax malaria cases mainly concentrated in Sihong County, the imported vivax malaria cases from other provinces mainly concentrated in Suzhou City and Wuxi City, the abroad imported vivax malaria cases concentrated in Nanjing City, the abroad imported falciparum malaria cases clustered in the middle parts of Jiangsu Province, and the abroad imported ovale malaria cases clustered in Liyang City. The operation of Google Earth Free 6.2 is simple, convenient and quick, which could help the public health authority to make the decision of malaria prevention and control, including the use of funds and other health resources.

Addressing hospital-acquired pressure ulcers: patient care managers enhancing outcomes at the point of service.

PubMed

Frumenti, Jeanine M; Kurtz, Abby

2014-01-01

An innovative leadership training program for patient care managers (PCMs) aimed at improving the management of operational failures was conducted at a large metropolitan hospital center. The program focused on developing and enhancing the transformational leadership skills of PCMs by improving their ability to manage operational failures in general and, in this case, hospital-acquired pressure ulcers. The PCMs received 8 weeks of intense training using the Toyota Production System process improvement approach, along with executive coaching. Compared with the control group, the gains made by the intervention group were statistically significant.

A case study in R and D productivity: Helping the program manager cope with job stress and improve communication effectiveness

NASA Technical Reports Server (NTRS)

Bodensteiner, W. D.; Gerloff, E. A.

1985-01-01

Certain structural changes in the Naval Material Command which resulted from a comparison of its operations to those of selected large-scale private sector companies are described. Central to the change was a reduction in the number of formal reports from systems commands to headquarters, and the provision of Program Management Assistance Teams (at the request of the program manager) to help resolve project problems. It is believed that these changes improved communication and information-processing, reduced program manager stress, and resulted in improved productivity.

An application of the AHP in water resources management: a case study on urban drainage rehabilitation in Medan City

NASA Astrophysics Data System (ADS)

Tarigan, A. P. M.; Rahmad, D.; Sembiring, R. A.; Iskandar, R.

2018-02-01

This paper illustrates an application of Analytical Hierarchy Process (AHP) as a potential decision-making method in water resource management related to drainage rehabilitation. The prioritization problem of urban drainage rehabilitation in Medan City due to limited budget is used as a study case. A hierarchical structure is formed for the prioritization criteria and the alternative drainages to be rehabilitated. Based on the AHP, the prioritization criteria are ranked and a descending-order list of drainage is made in order to select the most favorable drainages to have rehabilitation. A sensitivity analysis is then conducted to check the consistency of the final decisions in case of minor changes in judgements. The results of AHP computed manually are compared with that using the software Expert Choice. It is observed that the top three ranked drainages are consistent, and both results of the AHP methods, calculated manually and performed using Expert Choice, are in agreement. It is hoped that the application of the AHP will help the decision-making process by the city government in the problem of urban drainage rehabilitation.

Application of a geomorphic and temporal perspective to wetland management in North America

USGS Publications Warehouse

Smith, L.M.; Euliss, N.H.; Wilcox, D.A.; Brinson, M.M.

2008-01-01

The failure of managed wetlands to provide a broad suite of ecosystem services (e.g., carbon storage, wildlife habitat, ground-water recharge, storm-water retention) valuable to society is primarily the result of a lack of consideration of ecosystem processes that maintain productive wetland ecosystems or physical and social forces that restrict a manager's ability to apply actions that allow those processes to occur. Therefore, we outline a course of action that considers restoration of ecosystem processes in those systems where off-site land use or physical alterations restrict local management. Upon considering a wetland system, or examining a particular management regime, there are several factors that will allow successful restoration of wetland services. An initial step is examination of the political/social factors that have structured the current ecological condition and whether those realities can be addressed. Most successful restorations of wetland ecosystem services involve cooperation among multiple agencies, acquisition of funds from non-traditional sources, seeking of scientific advice on ecosystem processes, and cultivation of good working relationships among biologists, managers, and maintenance staff. Beyond that, in on-site wetland situations, management should examine the existing hydrogeomorphic situation and processes (e.g., climatic variation, tides, riverine flood-pulse events) responsible for maintenance of ecosystem services within a given temporal framework appropriate for that wetland's hydrologic pattern. We discuss these processes for five major wetland types (depressional, lacustrine, estuarine, riverine, and man-made impoundments) and then provide two case histories in which this approach was applied: Seney National Wildlife Refuge with a restored fen system and Bosque del Apache National Wildlife Refuge where riverine processes have been simulated to restore native habitat. With adequate partnerships and administrative and political support, managers faced with degraded and/or disconnected wetland processes will be able to restore ecosystem services for society in our highly altered landscape by considering wetlands in their given hydrogeomorphic setting and temporal stage. ?? 2008 The Society of Wetland Scientists.

Disability management: the application of preventive measures, health promotion and case management in Italy.

PubMed

La Torre, G; De Giusti, M; Mannocci, A; De Waure, C; Agostinelli, A; Schena, S; Capelli, G; Ricciardi, W; Boccia, A; Damiani, G; von Pinoci, M; Fanton, C; Federico, B

2009-03-01

Disability Management can be defined as a practice to improve workers' health and to reduce the impact and costs of disability. The aim of the study was to estimate the diffusion of DM in Italian companies. A survey was conducted using a questionnaire, the Worksite Disability Management Audit. The questionnaire was structured into five parts addressing the following domains: 1) characteristics of the company; 2) health promotion activities; 3) preventive measures; 4) case management; 5) disability management. We selected public and private companies and collected information by direct interview. Twenty companies entered the survey. Twelve Companies (60%) indicated that health promotion programs and sensibilisation campaigns are usually carried out. The presence of an individual who provided workplace safety indications and materials was stated by 19 companies (95%). Periodical medical examinations are carried out by 19 companies (95%); 16 (80%) have an evaluation process for ergonomics concerns. Risk assessment and analysis are performed by all companies and the security procedures and policies are updated at least once in a year in 40% of cases. Health status monitoring of injured workers is performed in eight (40%) of the companies, while Disability Management is present as a whole in only three companies. This survey highlights that Disability Management is not undertaken in most companies and that, where applied, there is still confusion and disorganization about ways to promote health and manage workers' illness and disability. Hence, there is still the need to promote an all-inclusive evaluation and management of workers' safety, illness and disabilities.

Web-GIS oriented systems viability for municipal solid waste selective collection optimization in developed and transient economies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rada, E.C., E-mail: Elena.Rada@ing.unitn.it; Ragazzi, M.; Fedrizzi, P.

Highlights: ► As an appropriate solution for MSW management in developed and transient countries. ► As an option to increase the efficiency of MSW selective collection. ► As an opportunity to integrate MSW management needs and services inventories. ► As a tool to develop Urban Mining actions. - Abstract: Municipal solid waste management is a multidisciplinary activity that includes generation, source separation, storage, collection, transfer and transport, processing and recovery, and, last but not least, disposal. The optimization of waste collection, through source separation, is compulsory where a landfill based management must be overcome. In this paper, a few aspectsmore » related to the implementation of a Web-GIS based system are analyzed. This approach is critically analyzed referring to the experience of two Italian case studies and two additional extra-European case studies. The first case is one of the best examples of selective collection optimization in Italy. The obtained efficiency is very high: 80% of waste is source separated for recycling purposes. In the second reference case, the local administration is going to be faced with the optimization of waste collection through Web-GIS oriented technologies for the first time. The starting scenario is far from an optimized management of municipal solid waste. The last two case studies concern pilot experiences in China and Malaysia. Each step of the Web-GIS oriented strategy is comparatively discussed referring to typical scenarios of developed and transient economies. The main result is that transient economies are ready to move toward Web oriented tools for MSW management, but this opportunity is not yet well exploited in the sector.« less

ARE MACRO AND MICRO ENVIRONMENT AFFECTING MANAGEMENT OF FRESH WATER RESOURCES? A CASE FROM IRAN WITH PESTLE ANALYSIS.

PubMed

Atighechian, Golrokh; Maleki, Mohammadreza; Aryankhesal, Aidin; Jahangiri, Katayoun

2016-07-24

Oil spill in fresh water can affect ecological processes and accordingly it can influence human health. Iran, due to having 58.8 % of the world oil reserves, is highly vulnerable to water contamination by oil products. The aim of this study was to determine environmental factors affecting the management of the oil spill into one of the river in Iran using the PESTLE analysis. This was a qualitative case study conducted in 2015 on an oil spill incident in Iran and its roots from a disaster management approach. Semi-structured interviews were conducted for data collection. Seventy managers and staffs with those responsible or involved in oil spill incident management were recruited to the study. Qualitative content analysis approach was employed for the data analysis. Document analysis was used to collect additional information. Findings of the present study indicated that different factors affected the management of the event of oil spill onto one of the central river and consequently the management of drink water resources. Using this analysis, managers can plan for such events and develop scenarios for them to have better performance for the future events.

ARE MACRO AND MICRO ENVIRONMENT AFFECTING MANAGEMENT OF FRESH WATER RESOURCES? A CASE FROM IRAN WITH PESTLE ANALYSIS

PubMed Central

Atighechian, Golrokh; Maleki, Mohammadreza; Aryankhesal, Aidin; Jahangiri, Katayoun

2016-01-01

Introduction: Oil spill in fresh water can affect ecological processes and accordingly it can influence human health. Iran, due to having 58.8 % of the world oil reserves, is highly vulnerable to water contamination by oil products. Aim: The aim of this study was to determine environmental factors affecting the management of the oil spill into one of the river in Iran using the PESTLE analysis. Material and methods: This was a qualitative case study conducted in 2015 on an oil spill incident in Iran and its roots from a disaster management approach. Semi-structured interviews were conducted for data collection. Seventy managers and staffs with those responsible or involved in oil spill incident management were recruited to the study. Qualitative content analysis approach was employed for the data analysis. Document analysis was used to collect additional information. Results: Findings of the present study indicated that different factors affected the management of the event of oil spill onto one of the central river and consequently the management of drink water resources. Using this analysis, managers can plan for such events and develop scenarios for them to have better performance for the future events. PMID:27698608

Waste management facility accident analysis (WASTE ACC) system: software for analysis of waste management alternatives

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kohout, E.F.; Folga, S.; Mueller, C.

1996-03-01

This paper describes the Waste Management Facility Accident Analysis (WASTE{underscore}ACC) software, which was developed at Argonne National Laboratory (ANL) to support the US Department of Energy`s (DOE`s) Waste Management (WM) Programmatic Environmental Impact Statement (PEIS). WASTE{underscore}ACC is a decision support and database system that is compatible with Microsoft{reg_sign} Windows{trademark}. It assesses potential atmospheric releases from accidents at waste management facilities. The software provides the user with an easy-to-use tool to determine the risk-dominant accident sequences for the many possible combinations of process technologies, waste and facility types, and alternative cases described in the WM PEIS. In addition, its structure willmore » allow additional alternative cases and assumptions to be tested as part of the future DOE programmatic decision-making process. The WASTE{underscore}ACC system demonstrates one approach to performing a generic, systemwide evaluation of accident risks at waste management facilities. The advantages of WASTE{underscore}ACC are threefold. First, the software gets waste volume and radiological profile data that were used to perform other WM PEIS-related analyses directly from the WASTE{underscore}MGMT system. Second, the system allows for a consistent analysis across all sites and waste streams, which enables decision makers to understand more fully the trade-offs among various policy options and scenarios. Third, the system is easy to operate; even complex scenario runs are completed within minutes.« less

Application of threshold concepts to ecological management problems: occupancy of Golden Eagles in Denali National Park, Alaska: Chapter 5

USGS Publications Warehouse

Eaton, Mitchell J.; Martin, Julien; Nichols, James D.; McIntyre, Carol; McCluskie, Maggie C.; Schmutz, Joel A.; Lubow, Bruce L.; Runge, Michael C.; Edited by Guntenspergen, Glenn R.

2014-01-01

In this chapter, we demonstrate the application of the various classes of thresholds, detailed in earlier chapters and elsewhere, via an actual but simplified natural resource management case study. We intend our example to provide the reader with the ability to recognize and apply the theoretical concepts of utility, ecological and decision thresholds to management problems through a formalized decision-analytic process. Our case study concerns the management of human recreational activities in Alaska’s Denali National Park, USA, and the possible impacts of such activities on nesting Golden Eagles, Aquila chrysaetos. Managers desire to allow visitors the greatest amount of access to park lands, provided that eagle nesting-site occupancy is maintained at a level determined to be acceptable by the managers themselves. As these two management objectives are potentially at odds, we treat minimum desired occupancy level as a utility threshold which, then, serves to guide the selection of annual management alternatives in the decision process. As human disturbance is not the only factor influencing eagle occupancy, we model nesting-site dynamics as a function of both disturbance and prey availability. We incorporate uncertainty in these dynamics by considering several hypotheses, including a hypothesis that site occupancy is affected only at a threshold level of prey abundance (i.e., an ecological threshold effect). By considering competing management objectives and accounting for two forms of thresholds in the decision process, we are able to determine the optimal number of annual nesting-site restrictions that will produce the greatest long-term benefits for both eagles and humans. Setting a utility threshold of 75 occupied sites, out of a total of 90 potential nesting sites, the optimization specified a decision threshold at approximately 80 occupied sites. At the point that current occupancy falls below 80 sites, the recommended decision is to begin restricting access to humans; above this level, it is recommended that all eagle territories be opened to human recreation. We evaluated the sensitivity of the decision threshold to uncertainty in system dynamics and to management objectives (i.e., to the utility threshold).

Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England.

PubMed

Hewitt, K A; Nalabanda, A; Cassell, J A

2015-05-01

Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks.

[Peripheral nerves phenolisation in spasticity management - forgotten art or interesting perspective?

PubMed

Kiwerski, Jerzy; Turżańska, Karolina; Pluta, Ryszard; Drelich, Małgorzata; Zarębska, Aneta; Jabłoński, Mirosław

Spasticity is one of the most common obstacles in the process of rehabilitation after permanent central nervous system injury. Statistics show that the problem affects more than 12 billion people all over the world. Treatment of spasticity is necessary for proper rehabilitation, prevention of secondary disability, pain management and also strongly influences quality of life. Nowadays the most common formula used for the treatment of local spasticity is injection of botulinum toxin. Years ago and also nowadays physicians all over the world successfully used phenol as the chemodenervating factor. This technique today almost forgot in Poland but still used in other countries. Peripheral nerves phenolisation had been used in STOCER (Konstancin) since 1965. The procedure was performed once in 59 patients, twice in 13 patients and three times in 7 patients. Evaluation was based on clinical presentation completed with patient self evaluation form. Good - 36 cases (45%), moderate - 34 cases (43%), bad - 9 cases (12%). Peripheral nerve phenolisation seems to be an interesting alternative to botulinum toxin in the management of spasticity.

Epidemiological Data Management during an Outbreak of Ebola Virus Disease: Key Issues and Observations from Sierra Leone.

PubMed

Owada, Kei; Eckmanns, Tim; Kamara, Kande-Bure O'Bai; Olu, Olushayo Oluseun

2016-01-01

Sierra Leone experienced intense transmission of Ebola virus disease (EVD) from May 2014 to November 2015 during which a total of 8,704 confirmed cases and over 3,589 confirmed deaths were reported. Our field observation showed many issues in the EVD data management system, which may have contributed to the magnitude and long duration of the outbreak. In this perspective article, we explain the key issues with EVD data management in the field, and the resulting obstacles in analyzing key epidemiological indicators during the outbreak response work. Our observation showed that, during the latter part of the EVD outbreak, surveillance and data management improved at all levels in the country as compared to the earlier stage. We identified incomplete filling and late arrival of the case investigation forms at data management centers, difficulties in detecting double entries and merging identified double entries in the database, and lack of clear process of how death of confirmed cases in holding, treatment, and community care centers are reported to the data centers as some of challenges to effective data management. Furthermore, there was no consolidated database that captured and linked all data sources in a structured way. We propose development of a new application tool easily adaptable to new occurrences, regular data harmonization meetings between national and district data management teams, and establishment of a data quality audit system to assure good quality data as ways to improve EVD data management during future outbreaks.

Characterizing Process-Based River and Floodplain Restoration Projects on Federal Lands in Oregon, and Assessing Catalysts and Barriers to Implementation

NASA Astrophysics Data System (ADS)

Bianco, S.; Jones, J. A.; Gosnell, H.

2017-12-01

Process-based restoration, a new approach to river and floodplain management, is being implemented on federal lands across Oregon. These management efforts are aimed at promoting key physical processes in order to improve river ecological function, create diverse habitat, and increase biological productivity for ESA-listed bull trout and spring Chinook salmon. Although the practice is being disseminated across the Pacific Northwest, it remains unclear what is driving aquatic and riparian ecosystem restoration towards this process-based approach and away from form-based methods such as Rosgen's Natural Channel Design. The technical aspects of process-based restoration have been described in the literature (ex. Beechie et al. 2010), but little is known about the practice from a social science perspective, and few case studies exist to assess the impact of these efforts. We combine semi-structured qualitative interviews with management experts and photogrammetric analysis to better understand how complex social processes and changing ideas about aquatic ecosystems are manifesting on the ground in federal land management. This study characterizes process-based river and floodplain restoration projects on federal lands in Oregon, and identifies catalysts and barriers to its implementation. The Deer Creek Floodplain Enhancement project serves as a case study for photogrammetric analysis. To characterize long-term changes at Deer Creek, geomorphic features were mapped and classified using orthoimage mosaics developed from a time series of historic aerial photographs dating back to 1954. 3D Digital Elevation Models (3D-DEMs) were created of portions of the modified sections of Deer Creek and its floodplain immediately before and after restoration using drone-captured aerial photography and a photogrammetric technique called Structure from Motion. These 3D-DEMs have enabled extraction of first-order geomorphic variables to compare pre- and post-project conditions. This study improves understanding of the historic range of conditions at Deer Creek, and assesses how process-based restoration activities drive short-term changes in geomorphic features, which can in turn influence complex riverine processes such as energy dissipation and sediment deposition.

Social-ecological resilience and social conflict: institutions and strategic adaptation in Swedish water management.

PubMed

Galaz, Victor

2005-11-01

Dealing with uncertainty and complexity in social-ecological systems is profoundly dependent on the ability of natural resource users to learn and adapt from ecological surprises and crises. This paper analyzes why and how learning processes are affected by strategic behavior among natural resource users and how social conflict is affected by social and ecological uncertainty. The claim is that social conflict among natural resource users seriously inhibits the possibilities of learning and adaptation in social-ecological systems. This is done combining insights from political science, experimental economics, and social-psychology and an analytical case study elaborating social conflict and institutional change in Swedish water management institutions. This paper also discusses the crucial role the institutional context plays in defining the outcome of learning processes in Swedish water management institutions and hence highlights previously poorly elaborated political aspects of learning processes and institutional change in social-ecological systems.

Green supply chain management strategy selection using analytic network process: case study at PT XYZ

NASA Astrophysics Data System (ADS)

Adelina, W.; Kusumastuti, R. D.

2017-01-01

This study is about business strategy selection for green supply chain management (GSCM) for PT XYZ by using Analytic Network Process (ANP). GSCM is initiated as a response to reduce environmental impacts from industrial activities. The purposes of this study are identifying criteria and sub criteria in selecting GSCM Strategy, and analysing a suitable GSCM strategy for PT XYZ. This study proposes ANP network with 6 criteria and 29 sub criteria, which are obtained from the literature and experts’ judgements. One of the six criteria contains GSCM strategy options, namely risk-based strategy, efficiency-based strategy, innovation-based strategy, and closed loop strategy. ANP solves complex GSCM strategy-selection by using a more structured process and considering green perspectives from experts. The result indicates that innovation-based strategy is the most suitable green supply chain management strategy for PT XYZ.

Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review

PubMed Central

Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie

2017-01-01

Objective The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Design Thematic analysis review of CM studies. Methods We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004–December 2015 period, then updated to July 2017, with the keywords ‘CM’ and ‘frequent use’. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir’s implementation of health innovations framework was used to organise results into four broad levels of factors: (1) environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Results Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. Conclusions CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. PMID:29061623

Improving the Effectiveness of Higher Education Institutions through Inter-University Co-Operation: The Case of Peking University. Improving the Managerial Effectiveness of Higher Education Institutions.

ERIC Educational Resources Information Center

Weifang, Min

This case study on the experience of the University of Peking, China, in inter-university cooperation describes the process of identifying appropriate partner institutions and implementing collaborative programs with them. It also highlights a number of lessons for those managing inter-university cooperation and shows how such initiatives can be…

Ranger's Legacy

NASA Technical Reports Server (NTRS)

1987-01-01

With its Landsat satellites, development of sensors, and advancement of processing techniques, NASA provided the initial technology base for another Earth-benefit application of image processing, Earth resources survey by means of remote sensing. Since each object has its own unique "signature," it is possible to distinguish among surface features and to generate computer-processed imagery identifying specific features of importance to resource managers. This capability, commercialized by Perceptive Scientific Instruments, Inc., offers practical application in such areas as agricultural crop forecasting, rangeland and forest management, land use planning, mineral and petroleum exploration, map making, water quality evaluation and disaster assessment. Major users of the technology have been federal, state, and local governments, but it is making its way into commercial operations, for example, resource exploration companies looking for oil, gas and mineral sources, and timber production firms seeking more efficient treeland management. Supporting both government and private users is a small industry composed of companies producing the processing hardware software. As is the case in the medical application, many of these companies are direct offspring of NASA's work.

Ecosystem services as a common language for coastal ecosystem-based management.

PubMed

Granek, Elise F; Polasky, Stephen; Kappel, Carrie V; Reed, Denise J; Stoms, David M; Koch, Evamaria W; Kennedy, Chris J; Cramer, Lori A; Hacker, Sally D; Barbier, Edward B; Aswani, Shankar; Ruckelshaus, Mary; Perillo, Gerardo M E; Silliman, Brian R; Muthiga, Nyawira; Bael, David; Wolanski, Eric

2010-02-01

Ecosystem-based management is logistically and politically challenging because ecosystems are inherently complex and management decisions affect a multitude of groups. Coastal ecosystems, which lie at the interface between marine and terrestrial ecosystems and provide an array of ecosystem services to different groups, aptly illustrate these challenges. Successful ecosystem-based management of coastal ecosystems requires incorporating scientific information and the knowledge and views of interested parties into the decision-making process. Estimating the provision of ecosystem services under alternative management schemes offers a systematic way to incorporate biogeophysical and socioeconomic information and the views of individuals and groups in the policy and management process. Employing ecosystem services as a common language to improve the process of ecosystem-based management presents both benefits and difficulties. Benefits include a transparent method for assessing trade-offs associated with management alternatives, a common set of facts and common currency on which to base negotiations, and improved communication among groups with competing interests or differing worldviews. Yet challenges to this approach remain, including predicting how human interventions will affect ecosystems, how such changes will affect the provision of ecosystem services, and how changes in service provision will affect the welfare of different groups in society. In a case study from Puget Sound, Washington, we illustrate the potential of applying ecosystem services as a common language for ecosystem-based management.

Beyond the lab: observations on the process by which science successfully informs management and policy decisions

NASA Astrophysics Data System (ADS)

Flores, S.

2012-12-01

Scientific findings inform management decisions and policy products through various ways, these include: synthesis reports, white papers, in-person and web-based seminars (webinars), communication from specialized staff, and seminal peer-reviewed journal articles. Scientists are often told that if they want their science to inform management decisions and policy products that they must: clearly and simply articulate discreet pieces of scientific information and avoid attaching advocacy messages to the science; however, solely relying on these tenants does not ensure that scientific products will infuse the realms of management and policy. The process by which science successfully informs management decisions and policy products rarely begins at the time the results come out of the lab, but rather, before the research is carried out. Having an understanding of the political climate, management needs, agency research agendas, and funding limitations, as well as developing a working relationship with the intended managers and policy makers are key elements to developing the kind of science results and products that often make an impact in the management and policy world. In my presentation I will provide case-studies from California (USA) to highlight the type of coastal, ocean and climate science that has been successful in informing management decisions and policy documents, as well as provide a state-level agency perspective on the process by which this occurs.

[Case study: school meals' management in Santiago de Cali and Bogota].

PubMed

Díaz, Mónica del Pilar; Montoya, Iván A; Montoya, Luz A

2011-10-01

This research was aimed at ascertaining the state's role regarding hunger and how it manages to combat this matter; a food security program in two Colombian cities was thus assessed (i.e. school meals' provision in Cali and Bogota). A qualitative approach was adopted; documentary analysis, participant observation and in-depth interviews with various actors for both selected cases were used as data collection techniques. It was found that several measures taken in this area were not covered by regulatory principles aimed at covering all the dimensions of food security. Serious weaknesses in school meals' management in Cali were associated with a weak environment regarding the fight against hunger. School meals' management in Bogotá was aimed at recognizing the right to food as being supported by an institutional process where the issue of reducing hunger has become a firm purpose. School meals' program management was associated with the characteristics of its product, thereby affecting the program and the population's food and nutritional status; state management thus becomes another dimension of food security.

Vicious circles in inflammatory bowel disease.

PubMed

Sonnenberg, Amnon; Collins, Judith F

2006-10-01

Inflammatory bowel disease can present with a bewildering array of disease manifestations whose overall impact on patient health is difficult to disentangle. The multitude of disease complications and therapeutic side effects result in conflicting ideas on how to best manage a patient. The aim of the study is to test the usefulness of influence diagrams in resolving conflicts centered on managing complex disease processes. The influences of a disease process and the ensuing medical interventions on the health of a patient with inflammatory bowel disease are modeled by an influence diagram. Patient health is the focal point of multiple influences affecting its overall strength. Any downstream influence represents the focal point of other preceding upstream influences. The mathematics underlying the influence diagram is similar to that of a decision tree. Its formalism allows one to consider additive and inhibitory influences and include in the same analysis qualitatively different types of parameters, such as diagnoses, complications, side effects, and therapeutic outcomes. Three exemplary cases are presented to illustrate the potential use of influence diagrams. In all three case scenarios, Crohn's disease resulted in disease manifestations that seemingly interfered with its own therapy. The presence of negative feedback loops rendered the management of each case particularly challenging. The analyses by influence diagrams revealed subtle interactions among the multiple influences and their joint contributions to the patient's overall health that would have been difficult to appreciate by verbal reasoning alone. Influence diagrams represent a decision tool that is particularly suited to improve decision-making in inflammatory bowel disease. They highlight key factors of a complex disease process and help to assess their quantitative interactions.

The Legacy Ecosystem Management Framework: From Theory to Application in the Detention Pond Case Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coty, J; Stevenson, M; Vogt, K A

The Detention Pond is a constructed and lined storm water treatment basin at Lawrence Livermore National Laboratory that serves multiple stakeholder objectives and programmatic goals. This paper examines the process and outcome involved in the development of a new management plan for the Detention Pond. The plan was created using a new ecosystem management tool, the Legacy Framework. This stakeholder-driven conceptual framework provides an interdisciplinary methodology for determining ecosystem health, appropriate management strategies, and sensitive indicators. The conceptual framework, the Detention Ponds project, and the use of the framework in the context of the project, are described and evaluated, andmore » evaluative criteria for this and other ecosystem management frameworks are offered. The project benefited in several ways from use of the Legacy Framework, although refinements to the framework are suggested. The stakeholder process created a context and environment in which team members became receptive to using an ecosystem management approach to evaluate and support management alternatives previously not considered. This allowed for the unanimous agreement to pursue support from upper management and organizational funding to implement a progressive management strategy. The greatly improved stakeholder relations resulted in upper management support for the project.« less

Process-Based Governance in Public Administrations Using Activity-Based Costing

NASA Astrophysics Data System (ADS)

Becker, Jörg; Bergener, Philipp; Räckers, Michael

Decision- and policy-makers in public administrations currently lack on missing relevant information for sufficient governance. In Germany the introduction of New Public Management and double-entry accounting enable public administrations to get the opportunity to use cost-centered accounting mechanisms to establish new governance mechanisms. Process modelling in this case can be a useful instrument to help the public administrations decision- and policy-makers to structure their activities and capture relevant information. In combination with approaches like Activity-Based Costing, higher management level can be supported with a reasonable data base for fruitful and reasonable governance approaches. Therefore, the aim of this article is combining the public sector domain specific process modelling method PICTURE and concept of activity-based costing for supporting Public Administrations in process-based Governance.

Risk Tradeoffs in Adaptive Ecosystem Management: The Case of the U.S. Forest Service

NASA Astrophysics Data System (ADS)

Stern, Marc J.; Martin, Caysie A.; Predmore, S. Andrew; Morse, Wayde C.

2014-06-01

Natural resource planning processes on public lands in the United States are driven in large part by the requirements of the National Environmental Policy Act (NEPA), which dictates general processes for analyzing and disclosing the likely impacts of proposed actions. The outcomes of these processes are the result of multiple factors, many related to the manifold smaller incremental decisions made by agency personnel directing the processes. Through interviews with decision makers, team leaders, and team members on five NEPA processes within the U.S. Forest Service, this study examines those incremental decisions. Risk, in particular external relationship risk, emerged as a dominant lens through which agency personnel weigh and make process-related decisions. We discuss the tradeoffs associated with agency actors' emphasis on this form of risk and their potential implications for adaptive ecosystem management and organizational performance.

Managing Distributed Innovation Processes in Virtual Organizations by Applying the Collaborative Network Relationship Analysis

NASA Astrophysics Data System (ADS)

Eschenbächer, Jens; Seifert, Marcus; Thoben, Klaus-Dieter

Distributed innovation processes are considered as a new option to handle both the complexity and the speed in which new products and services need to be prepared. Indeed most research on innovation processes was focused on multinational companies with an intra-organisational perspective. The phenomena of innovation processes in networks - with an inter-organisational perspective - have been almost neglected. Collaborative networks present a perfect playground for such distributed innovation processes whereas the authors highlight in specific Virtual Organisation because of their dynamic behaviour. Research activities supporting distributed innovation processes in VO are rather new so that little knowledge about the management of such research is available. With the presentation of the collaborative network relationship analysis this gap will be addressed. It will be shown that a qualitative planning of collaboration intensities can support real business cases by proving knowledge and planning data.

ISO 9001 in a neonatal intensive care unit (NICU).

PubMed

Vitner, Gad; Nadir, Erez; Feldman, Michael; Yurman, Shmuel

2011-01-01

The aim of this paper is to present the process for approving and certifying a neonatal intensive care unit to ISO 9001 standards. The process started with the department head's decision to improve services quality before deciding to achieve ISO 9001 certification. Department processes were mapped and quality management mechanisms were developed. Process control and performance measurements were defined and implemented to monitor the daily work. A service satisfaction review was conducted to get feedback from families. In total, 28 processes and related work instructions were defined. Process yields showed service improvements. Family satisfaction improved. The paper is based on preparing only one neonatal intensive care unit to the ISO 9001 standard. The case study should act as an incentive for hospital managers aiming to improve service quality based on the ISO 9001 standard. ISO 9001 is becoming a recommended tool to improve clinical service quality.

Case conferences between general practitioners and specialist teams to plan end of life care of people with end stage heart failure and lung disease: an exploratory pilot study

PubMed Central

2014-01-01

Background Most people die of non-malignant disease, but most patients of specialist palliative care services have cancer. Adequate end of life care for people with non-malignant disease requires acknowledgement of their limited prognosis and appropriate care planning. Case conferences between specialist palliative care services and GPs improve outcomes in cancer-based populations. We report a pilot study of case conferences between the patient’s GP and specialist staff to facilitate care planning for people with end stage heart failure or non-malignant lung disease in a regional health service in Queensland Australia. Methods Single face to face case conferences about patients with a primary diagnosis of advanced heart failure or respiratory failure from non-malignant disease were conducted between a palliative care consultant, a case management nurse and the patient’s GP. Annualised rates of service utilisation (emergency department [ED] presentations, ED discharges back to home, hospital admissions, and admission length of stay) before and after case conference were calculated. Content and counts of case conference recommendations, and the rate of adherence to recommendations were also assessed. A process evaluation of case conferences was undertaken. Results Twenty-three case conferences involving 21 GPs were conducted between November 2011 and November 2012. One GP refused to participate. Ten patients died, three at home. Of 82 management recommendations made, 55 (67%) were enacted. ED admissions fell from 13.9 per annum (pa) to 2.1 (difference 11.8, 95% CI 2.2-21.3, p = 0.001); ED admissions leading to discharge home from 3.9 to 0.4 pa (difference 3.5, 95% CI -0.4-7.5, p = 0.05); hospital admissions from 11.4 to 3.5 pa (difference 7.9, 95% CI 2.2-13.7, p = 0.002); and length of stay from 7.0 to 3.7 days (difference 3.4, 95% CI 0.9-5.8, p = 0.007). Participating health professionals were enthusiastic about the process. Conclusions This pilot is the initial step in the development and testing of a complex intervention based on a model of integrated care. A single case conference involving the patient’s heart or lung failure team is associated with significant reductions in service utilization, apparently by improving case coordination, enhancing symptom management and assessing and managing carer needs. A randomized controlled trial is being developed. Trial registration Australian and New Zealand Controlled Trials Register ACTRN12613001377729: Registered 16/12/2013. PMID:24829539

Avoidable Technical and Clinical Denial Write-Off Management in Hospitals, Physician Offices, and Clinics.

PubMed

Terra, Sandra Marlene; Byrne, Amanda

2016-01-01

This article reviews the various types of technical and clinical denials that are usually "written off" and proposes strategies to prevent this loss. For purposes of this writing, avoidable technical and clinical denial write-offs are defined as revenue lost from "first-pass" denials rejections. For example, a procedure that requires an authorization is performed without having had an authorization obtained. After appeals and attempts to recoup the revenue, often unsuccessful, the organization ultimately "writes off" the revenue as not collectable. The question to ask is: Are these claims really not collectable or can actionable steps be taken to conserve these dollars and improve the bottom line? Acute care hospitals, physician offices, and clinics. In today's environment, the need to manage costs is ubiquitous. Cost management is on the priority list of all savvy health care executives, even if margins are healthy, revenue is under pressure, and the magnitude of cost reduction needed is greater than what past efforts have achieved. As hospitals and physician clinics prioritize areas for improvement, reduction in lost revenue-especially avoidable lost revenue-should be at the top of the list. Attentively managing claim denial write-offs will significantly reduce lost revenue. There is significant interface between case management and the revenue cycle. Developing core competencies for reducing clinical and technical denials should be a critical imperative in overall cost management strategy. Case managers are well placed to prevent these unnecessary losses through accurate status determination and clinical documentation review. These clinical professionals can also provide insight into work flow and other processes inherent in the preauthorization process.

An interval-based possibilistic programming method for waste management with cost minimization and environmental-impact abatement under uncertainty.

PubMed

Li, Y P; Huang, G H

2010-09-15

Considerable public concerns have been raised in the past decades since a large amount of pollutant emissions from municipal solid waste (MSW) disposal of processes pose risks on surrounding environment and human health. Moreover, in MSW management, various uncertainties exist in the related costs, impact factors and objectives, which can affect the optimization processes and the decision schemes generated. In this study, an interval-based possibilistic programming (IBPP) method is developed for planning the MSW management with minimized system cost and environmental impact under uncertainty. The developed method can deal with uncertainties expressed as interval values and fuzzy sets in the left- and right-hand sides of constraints and objective function. An interactive algorithm is provided for solving the IBPP problem, which does not lead to more complicated intermediate submodels and has a relatively low computational requirement. The developed model is applied to a case study of planning a MSW management system, where mixed integer linear programming (MILP) technique is introduced into the IBPP framework to facilitate dynamic analysis for decisions of timing, sizing and siting in terms of capacity expansion for waste-management facilities. Three cases based on different waste-management policies are examined. The results obtained indicate that inclusion of environmental impacts in the optimization model can change the traditional waste-allocation pattern merely based on the economic-oriented planning approach. The results obtained can help identify desired alternatives for managing MSW, which has advantages in providing compromised schemes under an integrated consideration of economic efficiency and environmental impact under uncertainty. Copyright 2010 Elsevier B.V. All rights reserved.

Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part I: Innovation Management at Lego Group

NASA Astrophysics Data System (ADS)

Rusu, G.; Avasilcăi, S.

2015-11-01

Customers' proactive engagement in the innovation process represents a business priority for companies which adopt the open innovation business model. In such a context, it is of outmost importance for companies to use the online environment and social media, in order to create an interactive and open dialogue with customers and other important external stakeholders, achieving to gather creative solutions and innovative ideas by involving them in the process of co-creating value. Thus, the current paper is based on a case study approach, which aims to highlight the open innovation business model of the LEGO Group, one of the most successful and active company in engaging customers in submitting ideas and creative solutions for developing new products and new technologies, through online platforms. The study then proceeds to analyze the innovation management at LEGO Group, emphasizing the most important elements regarding the management team, the success and failures, the evolution of the LEGO products focusing on the innovation efforts of the company, its mission, vision, and values, emphasizing the innovation terms which guide the actions and objectives of the LEGO Group. Also, the research based on the case study approach, outlines the most important policies and strategies of the company, the organizational structure consisting of flat structures which facilitate the orientation of the team management on the innovation process and the proactive involvement of consumers and other external stakeholders in product development, highlighting also the most important activities developed by the management team in exploring the new opportunities which may occur on the market, involving customers in sharing their ideas at festivals, participating to discussions of adult fans on web-based platforms and establishing partnerships with the external stakeholders in order to create value. Moreover, the paper is focused on identifying the company's concerns regarding the competitive strategies, new technologies developed for sustainable development and innovation, emphasizing also the concerns of the LEGO Group for a long-term orientation strategy which implies developing innovative products, made by ecological materials, reducing the negative impact on the environment. In addition, the company aims to foster innovation maintaining a clear vision, multiple contacts with the internal and external environment, and the flat structures which enable the communication between innovative management teams and top management team. Consequently, the study provides the insights regarding the innovation management of the LEGO Group, emphasizing the role of engaging customers and other external stakeholders in the co-creation of value.

Use of structured decision-making to explicitly incorporate environmental process understanding in management of coastal restoration projects: Case study on barrier islands of the northern Gulf of Mexico.

PubMed

Dalyander, P Soupy; Meyers, Michelle; Mattsson, Brady; Steyer, Gregory; Godsey, Elizabeth; McDonald, Justin; Byrnes, Mark; Ford, Mark

2016-12-01

Coastal ecosystem management typically relies on subjective interpretation of scientific understanding, with limited methods for explicitly incorporating process knowledge into decisions that must meet multiple, potentially competing stakeholder objectives. Conversely, the scientific community lacks methods for identifying which advancements in system understanding would have the highest value to decision-makers. A case in point is barrier island restoration, where decision-makers lack tools to objectively use system understanding to determine how to optimally use limited contingency funds when project construction in this dynamic environment does not proceed as expected. In this study, collaborative structured decision-making (SDM) was evaluated as an approach to incorporate process understanding into mid-construction decisions and to identify priority gaps in knowledge from a management perspective. The focus was a barrier island restoration project at Ship Island, Mississippi, where sand will be used to close an extensive breach that currently divides the island. SDM was used to estimate damage that may occur during construction, and guide repair decisions within the confines of limited availability of sand and funding to minimize adverse impacts to project objectives. Sand was identified as more limiting than funds, and unrepaired major breaching would negatively impact objectives. Repairing minor damage immediately was determined to be generally more cost effective (depending on the longshore extent) than risking more damage to a weakened project. Key gaps in process-understanding relative to project management were identified as the relationship of island width to breach formation; the amounts of sand lost during breaching, lowering, or narrowing of the berm; the potential for minor breaches to self-heal versus developing into a major breach; and the relationship between upstream nourishment and resiliency of the berm to storms. This application is a prototype for using structured decision-making in support of engineering projects in dynamic environments where mid-construction decisions may arise; highlights uncertainty about barrier island physical processes that limit the ability to make robust decisions; and demonstrates the potential for direct incorporation of process-based models in a formal adaptive management decision framework. Published by Elsevier Ltd.

Use of structured decision-making to explicitly incorporate environmental process understanding in management of coastal restoration projects: Case study on barrier islands of the northern Gulf of Mexico

USGS Publications Warehouse

Dalyander, P. Soupy; Meyers, Michelle B.; Mattsson, Brady; Steyer, Gregory; Godsey, Elizabeth; McDonald, Justin; Byrnes, Mark R.; Ford, Mark

2016-01-01

Coastal ecosystem management typically relies on subjective interpretation of scientific understanding, with limited methods for explicitly incorporating process knowledge into decisions that must meet multiple, potentially competing stakeholder objectives. Conversely, the scientific community lacks methods for identifying which advancements in system understanding would have the highest value to decision-makers. A case in point is barrier island restoration, where decision-makers lack tools to objectively use system understanding to determine how to optimally use limited contingency funds when project construction in this dynamic environment does not proceed as expected. In this study, collaborative structured decision-making (SDM) was evaluated as an approach to incorporate process understanding into mid-construction decisions and to identify priority gaps in knowledge from a management perspective. The focus was a barrier island restoration project at Ship Island, Mississippi, where sand will be used to close an extensive breach that currently divides the island. SDM was used to estimate damage that may occur during construction, and guide repair decisions within the confines of limited availability of sand and funding to minimize adverse impacts to project objectives. Sand was identified as more limiting than funds, and unrepaired major breaching would negatively impact objectives. Repairing minor damage immediately was determined to be generally more cost effective (depending on the longshore extent) than risking more damage to a weakened project. Key gaps in process-understanding relative to project management were identified as the relationship of island width to breach formation; the amounts of sand lost during breaching, lowering, or narrowing of the berm; the potential for minor breaches to self-heal versus developing into a major breach; and the relationship between upstream nourishment and resiliency of the berm to storms. This application is a prototype for using structured decision-making in support of engineering projects in dynamic environments where mid-construction decisions may arise; highlights uncertainty about barrier island physical processes that limit the ability to make robust decisions; and demonstrates the potential for direct incorporation of process-based models in a formal adaptive management decision framework.

32 CFR 1801.33 - Allocation of resources; agreed extensions of time.

Code of Federal Regulations, 2010 CFR

2010-07-01

...” basis and utilizing two or more processing queues to ensure that smaller as well as larger (i.e... management of the NACIC-wide program defined by this part and for establishing priorities for cases...

Good governance and sustainability: a case study from Pakistan.

PubMed

Israr, Syed Muhammad; Islam, Anwar

2006-01-01

On the basis of a case study in Pakistan, the paper argues that good governance, characterized by transparency, accountability and meaningful community participation, plays a critical role in the sustainability of donor-funded health systems projects in the public health sector. The Family Health Project (FHP) (1992-1999), funded by the World Bank, has been used as a case study. Critical analysis of secondary data mainly obtained from the Department of Health (DoH) in the province of Sindh in Pakistan is the major tool used for the study. Data from other sources including the World Bank have also been used. The analysis reveals that the existing health care system could not fully absorb and sustain major "sociopolitical" thrusts of the project, meaningful community participation and "democratic" decision-making processes being the most important ones. The hierarchical structure and management process made it difficult to produce a sense of ownership of the project among all managers and the rank and file staff. The Provincial Health Development Center (PHDC) and District Health Development Centers (DHDCs) established by the FHP did not receive adequate financial and political support from DoH and the Ministry of Health to have much control of the project at the local level. Consequently, these Centers largely failed to institutionalize a continuing training program for district level health officials/professionals. Due to lack of political support, the District Health Management Teams (DHMTs) could not be institutionalized. Community participation in the DHMTs was symbolic rather than forceful. Improved coordination among all stakeholders, more stable and competent leadership, more meaningful community participation, greater devolution of project management to the district level, and better management of resources would have resulted in more effective and efficient implementation of the project. Based on these findings, the paper introduces a Sustainable Management Approach (SMA) as a tool that can be used to ensure the sustainability of health systems projects, particularly those funded by international organizations in developing countries. Good governance and a conducive organizational culture are important prerequisites for incorporating any new project within an existing system. This includes prior consensus building among all stakeholders, a meaningful and inclusive participatory planning, implementation and evaluation process involving communities, political commitment, and the identification and use of appropriate leadership for project management.

A Qualitative Study on Change Management in Primary Schools Award Winning and Non-Award Winning Schools Case in Study of TQM

ERIC Educational Resources Information Center

Altunay, Esen; Arli, Didem; Yalcinkaya, Munevver

2012-01-01

The aim of this study was to determine the need of change in primary schools and to reveal out the principals' experiences during the change process by taking the total quality management practices into consideration and finally give suggestions according to the results of the study. In this study by employing qualitative research method, semi…

Tmproving the Consult Management Process at David Grant Medical Center

DTIC Science & Technology

1998-08-01

and the regional referral facility for the DoD Health Services Region 10 in Northern California. It offers most major medical, surgical , and dental...services (Payne, 1987). The primary components of UM include pre -certification, concurrent and retrospective review, case management, and discharge...6-13. O’Brien, K., McComb, J., Fox, N., Beam, D., & Wright, J. (1996). Do dentists refer orthodontic patients inappropriately. British Dental

Isohaline position as a habitat indicator for estuarine populations

USGS Publications Warehouse

Jassby, Alan D.; Kimmerer, W.J.; Monismith, Stephen G.; Armor, C.; Cloern, James E.; Powell, T.M.; Vedlinski, Timothy J.

1995-01-01

The striped bass survival data were also used to illustrate a related important point: incorporating additionalexplanatory variables may decrease the prediction error for a population or process, but it can increase theuncertainty in parameter estimates and management strategies based on these estimates. Even in cases wherethe uncertainty is currently too large to guide management decisions, an uncertainty analysis can identify themost practical direction for future data acquisition.

Can entomophagous nematodes slow the spread of invasive pest populations? The case study of Beddingia siricidicola released for the management of Sirex noctilio

Treesearch

Juan C. Corley; José M. Villacide; Andrew M. Liebhold

2014-01-01

Though rarely used in this way, biological control could potentially be exploited for managing spread of invasive species. Because spread of invasive species emerges from the combined action of population growth and dispersal, natural enemies that affect either of these processes should also affect spread. Dispersal of parasitoid species plays a key role in determining...