The evaluation of the National Long Term Care Demonstration. 4. Case management under channeling.

PubMed Central

Phillips, B R; Kemper, P; Applebaum, R A

1988-01-01

The channeling demonstration involved provision of comprehensive case management and direct service expansion. This article considers the former. Under both models, comprehensive case management was implemented largely as intended; moreover, channeling substantially increased the receipt of comprehensive care management. However, channeling was not a pure test of the effect of comprehensive case management: roughly 10-20 percent of control group members received comparable case management services. This was particularly the case for the financial control model. Thus, the demonstration was not a test of case management compared to no case management; rather, it compared channeling case management to the existing community care system, which already was providing comprehensive case management to some of the population eligible for channeling. PMID:3130331

Implementing a pilot work injury management program in Hong Kong.

PubMed

Lai, Hon-Sun; Chan, Chetwyn C H

2007-12-01

This paper reports the results of implementing a pilot case management system for work injuries in Hong Kong. The case management approach was characterized by use of a case manager who worked closely with each of the reported injury cases. The case manager undertook the roles of assessor, referral agent, counselor, work-site liaison, and return-to-work (RTW) expert. A quasi-experimental study design was used. The study compared the RTW and workers' compensation outcomes in injured workers in a cleaning company in a case management group (n = 296) and a conventional rehabilitation group (n = 137). Outcomes of the intervention were followed up at 6 months. The results indicated that the RTW rate was 97.0% and 94.2% for the case management and conventional rehabilitation groups respectively, with no significant differences between them. Participants in the case management group had significantly fewer days of sick leave (mean = 27.5 and 41.6 days, respectively) and lower compensation costs (mean = HK$7,212.2 and $20,617.3, respectively) than those in the comparison group. Age of the participants was found to influence the outcomes with those who were between 41 and 50 years old and received case management intervention had shorter sick leave and lower cost of compensation than their conventional rehabilitation counterpart. The majority of the participants who had returned to work in both the case management (95.8%) and the conventional rehabilitation (96.2%) groups were found to maintain their work status 6 months after the intervention. The findings suggested that applying the case management approach to the Hong Kong workers' compensation system was more effective overall. Nevertheless, the inherent problems associated with implementing such an approach within the existing system, which focuses on compensation and medical interventions, remained unresolved.

Case management and adherence to an online disease management system.

PubMed

Robertson, Lucy; Smith, Michael; Tannenbaum, Dennis

2005-01-01

Non-adherence to treatment presents a significant obstacle to achieving favourable health outcomes. We have studied consumers' adherence to an online disease management system for depression, called Recovery Road. Recovery Road was implemented on a pilot basis for mental health care in Western Australia. Recovery Road was available for use by consumers and clinicians to augment usual treatment. One hundred and thirty consumers who had been diagnosed with major depression were enrolled. Consumers who used Recovery Road (n = 98) were provided with education, progress monitoring, e-consultation, e-diary and online evidenced-based therapy. Consumers received either standard, automated adherence reminders by email (n = 69), or case management, which included personalized email and telephone follow-up in response to non-adherence (n = 29). After the first eight sessions, the adherence was 84% in the case management group and 55% in the automatic reminders group. The results suggest that case management increases adherence to online disease management systems.

Metropolitan transportation management center : a case study : Michigan intelligent transportation system : improving safety and air quality while reducing stress for motorists

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Michigan's Intelligent Transportation Systems transportation management center (MITSC). It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts ...

Case Management: Let Us Count the Ways.

ERIC Educational Resources Information Center

Austin, Carol D.

Case management as implemented in programs for the elderly, has focused on interactions between the client and case manager in the areas of assessment, care planning, service plan implementation, and follow-up. Variation in these case management tasks suggests that no single model can be implemented in all local delivery systems. This emphasis on…

Case management helps prevent criminal justice recidivism for people with serious mental illness.

PubMed

Leutwyler, Heather; Hubbard, Erin; Zahnd, Elaine

2017-09-11

Purpose The purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism. Design/methodology/approach Examples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented. Findings Currently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management. Originality/value Providing effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

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 Database Design and Development Case: NanoTEK Networks

ERIC Educational Resources Information Center

Ballenger, Robert M.

2010-01-01

This case provides a real-world project-oriented case study for students enrolled in a management information systems, database management, or systems analysis and design course in which database design and development are taught. The case consists of a business scenario to provide background information and details of the unique operating…

Case management for the subacute patient in a skilled nursing facility.

PubMed

Carr, D D

2000-01-01

The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

Meeting the challenges of case management with remote patient monitoring technology.

PubMed

Cherry, J C; Colliflower, S J; Tsiperfal, A

2000-01-01

The article presents an overview of some of the current trends in health care and the challenges faced by nurse case managers who are providing disease management services. It discusses some of the emerging technologies available today for innovative case management. In particular, this article describes a program run by a healthcare system in Sacramento, California that uses an Internet-based technology to enhance their nurse case management model. The article demonstrates how the Health Hero platform enables interactive communication between nurse case managers and their patients, thereby meeting some of the challenges the nurse case managers are faced with in the modern disease-management world.

Standards for Data Exchange and Case Management Information Systems in Support of Comprehensive Integrated School-Linked Services. Version 2.0.

ERIC Educational Resources Information Center

Far West Lab. for Educational Research and Development, San Francisco, CA.

This report is intended as a guide for local comprehensive integrated school-linked services sites and software vendors in developing and implementing case management information systems for the exchange and management of client data. The report is also intended to influence new development and future revisions of data systems, databases, and…

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

PubMed Central

Rusnak, James E.

1987-01-01

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

Pathways Triple P and the Child Welfare System: A Promising Fit.

PubMed

Petra, Megan; Kohl, Patricia

2010-04-01

Parents referred to the child welfare system following maltreatment allegations are often ill-prepared to constructively address child disruptive behaviors, despite the high prevalence of these behaviors among this population. Evidence-based parent-mediated interventions are effective in improving parenting skills; however, they are rarely offered within the child welfare system. The purpose of this pilot project was to evaluate the fit and acceptability of one parent-mediated training program (Pathways Triple P) to case managers and parents within this system of care. We implemented Pathways Triple P and subsequently interviewed referring case managers and parents who had participated in the program. Case managers felt the program would work well within the existing child welfare system and would help them to better serve parents. They felt the program had potential to improve parenting skills and prevent future maltreatment. Parents appreciated the program's use of diverse methods, and the variety of parenting techniques taught. In keeping with case manager expectations, participants reported that their enhanced parenting skills and new ability to use non-physical discipline resulted in a better home life. We conclude that Pathways Triple P fits well within the child welfare system and is acceptable to both case managers and parents within this system.

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part I.

PubMed

O'Donnell, Lolita T

2007-01-01

To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

[Construction and operation status of management system of laboratories of schistosomiasis control institutions in Hubei Province].

PubMed

Zhao-Hui, Zheng; Jun, Qin; Li, Chen; Hong, Zhu; Li, Tang; Zu-Wu, Tu; Ming-Xing, Zeng; Qian, Sun; Shun-Xiang, Cai

2016-10-09

To analyze the construction and operation status of management system of laboratories of schistosomiasis control institutions in Hubei Province, so as to provide the reference for the standardized detection and management of schistosomiasis laboratories. According to the laboratory standard of schistosomiasis at provincial, municipal and county levels, the management system construction and operation status of 60 schistosomiasis control institutions was assessed by the acceptance examination method from 2013 to 2015. The management system was already occupied over all the laboratories of schistosomiasis control institutions and was officially running. There were 588 non-conformities and the inconsistency rate was 19.60%. The non-conformity rate of the management system of laboratory quality control was 38.10% (224 cases) and the non-conformity rate of requirements of instrument and equipment was 23.81% (140 cases). The management system has played an important role in the standardized management of schistosomiasis laboratories.

Case Management: Service or Symptom?

ERIC Educational Resources Information Center

Netting, F. Ellen

1992-01-01

Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

FoodCASE: A system to manage food composition, consumption and TDS data.

PubMed

Presser, Karl; Weber, David; Norrie, Moira

2018-01-01

Food and nutrition scientists, nowadays, need to manage an increasing amount of data regarding food composition, food consumption and Total Diet Studies (TDS). The corresponding datasets can contain information about several thousand different foods, in different versions from different studies. FoodCASE is a system that has been developed to manage these different datasets. It also support flexible means of linking between datasets and generally provide support for the different processes involved in the acquisition, management and processing of data. In this paper, the most important concepts to implement existing guidelines and standards for proper food data management are presented, as well as different use cases of data import and proofs of concepts demonstrating the ability to manage data in FoodCASE. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient ratings of case managers in a medical home: associations with patient satisfaction and health care utilization.

PubMed

Jubelt, Lindsay E; Graham, Jove; Maeng, Daniel D; Li, Huilin; Epstein, Andrew J; Metlay, Joshua P

2014-11-18

Case managers are employed in medical homes to coordinate care for clinically complex patients. To measure the association of patient perceptions of case manager performance with overall satisfaction and subsequent health care utilization. Retrospective cohort study. Integrated health system in Pennsylvania. Members of the health system-owned health plan who 1) received primary care in the health system's clinics, 2) were exposed to clinic-embedded case managers, and 3) completed a survey of satisfaction with care. Survey assessment of case manager performance and overall satisfaction with care and claims-based assessment of case manager performance and subsequent hospitalizations or emergency department visits. Survey measures were dichotomized into very good versus less than very good. A total of 1755 patients (44%) completed the survey and 1415 met study criteria. Survey respondents who reported very good ratings of case manager performance across all items had a higher probability of reporting very good overall satisfaction with care (92.2% vs. 62.5%; P < 0.001) and had a lower incidence of subsequent emergency department visits (incidence rate ratio, 0.79 [95% CI, 0.64 to 0.98]; P = 0.029) but not hospitalizations (incidence rate ratio, 0.92 [CI, 0.75 to 1.11]; P = 0.37) up to 2 years after the survey compared with survey respondents who reported less-than-very good case manager performance on 1 or more questions on the survey. Satisfaction data demonstrated substantial ceiling effects. Survey nonresponse may have introduced bias in the results. Patients' favorable perceptions of case managers are associated with higher overall satisfaction with care and may lower risk for future acute care use. Robert Wood Johnson Foundation and the U.S. Department of Veterans Affairs.

The Implementation of an Office Systems Management Curriculum for the 1980s.

ERIC Educational Resources Information Center

Stallard, John J.

1982-01-01

Describes the implementation of an office systems management curriculum (at the University of Tennessee, Knoxville) that trains students to develop their conceptual skills and to train for management-level positions. Courses involve the automated office, records systems, office systems analysis, case studies, and management information systems.…

Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

PubMed

Granata, Randy L; Hamilton, Karen

2015-01-01

Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

Evaluating Management Strategies for Automated Test Systems/Equipment (ATS/E): An F-15 Case Study

DTIC Science & Technology

2005-03-01

ethnography , grounded theory , case study , phenomenological research , and narrative research (also known as bibliography from...Creswell, 2003:183). Example inquiry strategies identified by Creswell are: narrative , phenomenology , ethnography , case study , and grounded theory ...other managed systems. Methodology The researcher chose a qualitative research methodology and

[Poliomyelitis case surveillance data management in Burkina Faso].

PubMed

Drabo, Koiné Maxime; Nana, Félicité; Kouassi, Kouassi Lazare; Konfé, Salifou; Hien, Hervé; Saizonou, Jacques; Ouedraogo, Tinoaga Laurent

2015-01-01

The global initiative for poliomyelitis eradication can only remain relevant if survey systems are regularly assessed. In order to identify shortcomings and to propose improvement, the data collection and transmission during case investigation were assessed in the Banfora health district in Burkina Faso. The survey targeted six (6) primary health centres, the district laboratory and the national laboratory, all involved in the poliomyelitis surveillance system. Data from registers, forms documenting suspected cases, stool sample forms and weekly reports were collected by means of a data grid. Data from actors involved in the poliomyelitis case investigation system were collected by means of an individual questionnaire. The reactivity of investigating suspected cases was satisfactory with a median alert questionnaire notification time of 18 hours. The completeness of the reporting system was satisfactory. Nevertheless, the promptness of data management by primary heath centres and the national laboratory remained unsatisfactory. Evaluation of data management revealed logistic and organization shortcomings. The overall efficacy of the poliomyelitis surveillance could be improved by using management tools for laboratory supplies, collecting data related to the homes of suspected cases and implementing a cold chain maintenance plan.

How would case managers' practice change in a consumer-directed care environment in Australia?

PubMed

You, Emily Chuanmei; Dunt, David; Doyle, Colleen

2017-01-01

The aim of this study was to explore case managers' perceived changes in their practice in the future when consumer-directed care (CDC) is widely implemented in Australia's community aged care system. Purposeful sampling was used and semi-structured individual and group interviews were conducted between September 2012 and March 2013. Participants were drawn from a list of all case managers who administered publicly funded community aged care packages in Victoria, Australia. Empowerment theory was used to guide the analysis and interpretation of the data. The thematic analysis revealed that case managers had mixed views about CDC. They also perceived changes in case managers' practice in the future when CDC is widely implemented. These might specifically include: first, case managers would not directly manage clients' budgets. While some case managers were concerned about losing power for this change, others believed that they would still have important financial roles to perform, such as setting rules, providing financial support and monitoring clients' use of budgets. Second, case managers would focus on performing roles in providing information, and empowering, facilitating and educating clients. These would help to strengthen clients' capacities and assist them to self-manage their care. Third, case managers would work in partnership with clients through frequent or skilful communication, mutual goal setting and goal facilitation. Fourth, case managers would manage more clients. In addition, they would provide less support to each individual client and perform less care co-ordination role. The findings suggest case managers paying attention to power balance regarding budget management in a CDC environment. Furthermore, they might frequently or skilfully communicate with, empower, facilitate and educate clients; work together with them to set up goals; and facilitate them to achieve goals. New research using empowerment theory to examine the actual practice of case managers in a well-established CDC system is warranted. © 2015 John Wiley & Sons Ltd.

A New Approach to Integrate Internet-of-Things and Software-as-a-Service Model for Logistic Systems: A Case Study

PubMed Central

Chen, Shang-Liang; Chen, Yun-Yao; Hsu, Chiang

2014-01-01

Cloud computing is changing the ways software is developed and managed in enterprises, which is changing the way of doing business in that dynamically scalable and virtualized resources are regarded as services over the Internet. Traditional manufacturing systems such as supply chain management (SCM), customer relationship management (CRM), and enterprise resource planning (ERP) are often developed case by case. However, effective collaboration between different systems, platforms, programming languages, and interfaces has been suggested by researchers. In cloud-computing-based systems, distributed resources are encapsulated into cloud services and centrally managed, which allows high automation, flexibility, fast provision, and ease of integration at low cost. The integration between physical resources and cloud services can be improved by combining Internet of things (IoT) technology and Software-as-a-Service (SaaS) technology. This study proposes a new approach for developing cloud-based manufacturing systems based on a four-layer SaaS model. There are three main contributions of this paper: (1) enterprises can develop their own cloud-based logistic management information systems based on the approach proposed in this paper; (2) a case study based on literature reviews with experimental results is proposed to verify that the system performance is remarkable; (3) challenges encountered and feedback collected from T Company in the case study are discussed in this paper for the purpose of enterprise deployment. PMID:24686728

A new approach to integrate Internet-of-things and software-as-a-service model for logistic systems: a case study.

PubMed

Chen, Shang-Liang; Chen, Yun-Yao; Hsu, Chiang

2014-03-28

Cloud computing is changing the ways software is developed and managed in enterprises, which is changing the way of doing business in that dynamically scalable and virtualized resources are regarded as services over the Internet. Traditional manufacturing systems such as supply chain management (SCM), customer relationship management (CRM), and enterprise resource planning (ERP) are often developed case by case. However, effective collaboration between different systems, platforms, programming languages, and interfaces has been suggested by researchers. In cloud-computing-based systems, distributed resources are encapsulated into cloud services and centrally managed, which allows high automation, flexibility, fast provision, and ease of integration at low cost. The integration between physical resources and cloud services can be improved by combining Internet of things (IoT) technology and Software-as-a-Service (SaaS) technology. This study proposes a new approach for developing cloud-based manufacturing systems based on a four-layer SaaS model. There are three main contributions of this paper: (1) enterprises can develop their own cloud-based logistic management information systems based on the approach proposed in this paper; (2) a case study based on literature reviews with experimental results is proposed to verify that the system performance is remarkable; (3) challenges encountered and feedback collected from T Company in the case study are discussed in this paper for the purpose of enterprise deployment.

Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

PubMed

Swank, Morgan L; Harken, Tabetha R; Porto, Manuel

2013-08-01

Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

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.

Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

PubMed

Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian

The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

Classroom Management for Kids Who Won't Sit Still and Other "Bad Apples"

ERIC Educational Resources Information Center

Cahill, Susan M.

2006-01-01

This article presents a case description of collaboration between an occupational therapist and a general education teacher to develop an effective classroom management system. The classroom management system described here was based on the Alert Program for Self-regulation: How Does Your Engine Run? In addition, the case description provides a…

Avoidable costs of comprehensive case management.

PubMed

Issel, L M; Anderson, R A

1999-01-01

Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.

Case Management Ethics: High Professional Standards for Health Care's Interconnected Worlds.

PubMed

Sminkey, Patrice V; LeDoux, Jeannie

2016-01-01

The purpose of this discussion is to draw attention to the considerable pressure on professional case managers today to coordinate with multiple stakeholders, with responsibilities that put them at the forefront of contact with payers and providers. This discussion raises awareness of how case managers, and board-certified case managers in particular, must demonstrate that they adhere to the highest ethical standards, as codified by the Commission for Case Manager Certification's Code of Professional Conduct for Case Managers. This discussion applies to case management practices and work settings across the full continuum of health care. As advocates for clients (individuals receiving case management services) and their families/support systems, case managers must adhere to the highest of ethical and professional standards. The Code of Professional Conduct for Case Managers is an indispensable resource for case managers to ensure that they place the public interest above their own, respect the rights and inherent dignity of clients, maintain objectivity in their relationships with clients, and act with integrity and fidelity with clients and others, as stipulated by the code.

Space Transportation System Western Launch Site Construction Management Information System - A Case Study.

DTIC Science & Technology

1979-09-01

The Corps of Engineers Management Information System (COEMIS) is used by the Corps of Engineers in their role as Construction Agents on Air Force...California. The research concluded that the Corps of Engineers Management Information System can be an effective, efficient management tool which has the

Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

PubMed

Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

1988-01-01

This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part II.

PubMed

O'Donnell, Lolita T

2007-01-01

The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

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

Shifting the burden or expanding access to care? Assessing malaria trends following scale-up of community health worker malaria case management and reactive case detection.

PubMed

Larsen, David A; Winters, Anna; Cheelo, Sanford; Hamainza, Busiku; Kamuliwo, Mulakwa; Miller, John M; Bridges, Daniel J

2017-11-02

Malaria is a significant burden to health systems and is responsible for a large proportion of outpatient cases at health facilities in endemic regions. The scale-up of community management of malaria and reactive case detection likely affect both malaria cases and outpatient attendance at health facilities. Using health management information data from 2012 to 2013 this article examines health trends before and after the training of volunteer community health workers to test and treat malaria cases in Southern Province, Zambia. An estimated 50% increase in monthly reported malaria infections was found when community health workers were involved with malaria testing and treating in the community (incidence rate ratio 1.52, p < 0.001). Furthermore, an estimated 6% decrease in outpatient attendance at the health facility was found when community health workers were involved with malaria testing and treating in the community. These results suggest a large public health benefit to both community case management of malaria and reactive case detection. First, the capacity of the malaria surveillance system to identify malaria infections was increased by nearly one-third. Second, the outpatient attendance at health facilities was modestly decreased. Expanding the capacity of the malaria surveillance programme through systems such as community case management and reactive case detection is an important step toward malaria elimination.

[Application of information management system about medical equipment].

PubMed

Hang, Jianjin; Zhang, Chaoqun; Wu, Xiang-Yang

2011-05-01

Based on the practice of workflow, information management system about medical equipment was developed and its functions such as gathering, browsing, inquiring and counting were introduced. With dynamic and complete case management of medical equipment, the system improved the management of medical equipment.

Case study and lessons learned for the Great Lakes ITS Program, Airport ITS Integration and the Road Infrastructure Management System projects, final report, Wayne County, Michigan

DOT National Transportation Integrated Search

2007-03-02

This report presents the case study and lessons learned for the national evaluation of the Great Lakes Intelligent Transportation Systems (GLITS) Airport ITS Integration and Road Infrastructure Management System (RIMS) projects. The Airport ITS Integ...

Medical Training Skills Curriculum for Case Management Assistants.

ERIC Educational Resources Information Center

Family Planning Council of Southeastern Pennsylvania, Philadelphia.

This manual helps service care providers working with HIV-infected people learn how HIV affects the body's major systems, emphasizing the structure and functions of each system and direct and indirect effects of HIV on each system. The curriculum was developed for case management assistants (CMAs) who work in homes of HIV-infected people. Lessons…

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."

Establishing treatment protocols for clinical mastitis.

PubMed

Roberson, Jerry R

2003-03-01

Each farm has a unique mix of mastitis pathogens and management procedures that have evolved over time. The herd veterinarian should work with the manager/owner to systematically develop treatment protocols that meet the needs and management of the farm. To establish a mastitis treatment protocol, it is necessary to develop a system to routinely identify clinical mastitis cases, develop a herd-specific severity level assessment system, manage the clinical mastitis cases based on severity level and culture result (when available), avoid antibiotic residues, and monitor the success of the system and alter the protocol as necessary.

Evolution from safety management system (SMS) to HSE MS: Incorporating health aspects into the HSE management system

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

Jong, G. de

1996-12-31

There is increasing recognition within the E&P industry that protection and promotion of the health of people at work is more than taking care of individual health. It is an organizational issue which can be managed using the same principles as for safety and environment. The synergy`s with safety and environmental management provide the link with the management system. However line managers need to under the critical Health issues: what are they are they relevant? How do we manage them? what are the standards? What are the management tools to be used? How do we monitor performance? What is themore » role of the line? What is the role of the health advisers? What training and competencies are needed for health management? What are the benefits? These questions have to be clarified before acceptance can be achieved for full integration of Health aspects into the HSE Management System. Health Risk Assessment was developed as a tool for systematic identification and assessment of health hazards and risks. It specifies the need for and type of controls and recovery measures, which can subsequently be incorporated in HSE Management System and HSE Cases. Our experience to date indicates that Health can successfully be integrated in HSE Management Systems and HSE Cases by using the same principles as developed for Safety Management Systems and Safety Cases. There are still many problems which need to be addressed but the methodology used appears to be sound and will eventually enhance line management understanding of the health management aspects relevant to the E&P Industry.« less

Productivity--a key to managing cost-per-case. Part 1.

PubMed

Orefice, J J; Jennings, M C

1983-08-01

Productivity and productivity management are critical to effective case-mix management. Case-mix management expands on traditional productivity management to include the relationship between such intermediate products as patient days, tests and meals, and the ultimate end product, the case. As hospitals search to increase the profitability of specific case types, they must focus on two critical productivity control points. First, they must examine length of stay and ancillary utilization as one level of productivity. Then they must turn to more traditional analyses and review departmental productivity in the production of the intermediate products. No case-mix management system is complete unless it focuses on both of these critical relationships. Part two of this article will explore performance reporting and its role in managing both productivity and case mix.

The Trade-Offs of Developing a Case Management Model for Chronically Mentally Ill People.

ERIC Educational Resources Information Center

Belcher, John R.

1993-01-01

Addresses role of case management in care of chronically mentally ill persons. Notes that case management can be effective if designed so that services match client needs and service costs are measured accurately. Contends that profit-maximizing nature of U.S. health care system makes some form of capitation likely in design of case management…

A Case Study of the United States Navy’s Enterprise Resource Planning System

DTIC Science & Technology

2006-06-01

incarnations, MRP-II added the capabilities of shop-floor management and distribution management activities. Later versions included the ability to manage ... finances , human resources, engineering, and project management. Enterprise Resource Planning systems were then developed as an integrated system

A Health Systems Approach to Integrated Community Case Management of Childhood Illness: Methods and Tools

PubMed Central

McGorman, Laura; Marsh, David R.; Guenther, Tanya; Gilroy, Kate; Barat, Lawrence M.; Hammamy, Diaa; Wansi, Emmanuel; Peterson, Stefan; Hamer, Davidson H.; George, Asha

2012-01-01

Integrated community case management (iCCM) of childhood illness is an increasingly popular strategy to expand life-saving health services to underserved communities. However, community health approaches vary widely across countries and do not always distribute resources evenly across local health systems. We present a harmonized framework, developed through interagency consultation and review, which supports the design of CCM by using a systems approach. To verify that the framework produces results, we also suggest a list of complementary indicators, including nine global metrics, and a menu of 39 country-specific measures. When used by program managers and evaluators, we propose that the framework and indicators can facilitate the design, implementation, and evaluation of community case management. PMID:23136280

Learning from Action Evaluation of the Use of Multimedia Case Studies in Management Information Systems Courses

ERIC Educational Resources Information Center

Kawulich, Barbara B.

2011-01-01

This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…

Case mix management in context.

PubMed

King, H

1988-02-01

The advent of DRGs has demanded that hospitals account for all costs and resources. A case mix management system must take into consideration every component of a total managerial accounting strategy. This article discusses the factors healthcare institutions need to address to achieve a completely interfaced accounting system.

Crisis Management Systems: A Case Study for Aspect-Oriented Modeling

NASA Astrophysics Data System (ADS)

Kienzle, Jörg; Guelfi, Nicolas; Mustafiz, Sadaf

The intent of this document is to define a common case study for the aspect-oriented modeling research community. The domain of the case study is crisis management systems, i.e., systems that help in identifying, assessing, and handling a crisis situation by orchestrating the communication between all parties involved in handling the crisis, by allocating and managing resources, and by providing access to relevant crisis-related information to authorized users. This document contains informal requirements of crisis management systems (CMSs) in general, a feature model for a CMS product line, use case models for a car crash CMS (CCCMS), a domain model for the CCCMS, an informal physical architecture description of the CCCMS, as well as some design models of a possible object-oriented implementation of parts of the CCCMS backend. AOM researchers who want to demonstrate the power of their AOM approach or technique can hence apply the approach at the most appropriate level of abstraction.

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.

Data Mining in Course Management Systems: Moodle Case Study and Tutorial

ERIC Educational Resources Information Center

Romero, Cristobal; Ventura, Sebastian; Garcia, Enrique

2008-01-01

Educational data mining is an emerging discipline, concerned with developing methods for exploring the unique types of data that come from the educational context. This work is a survey of the specific application of data mining in learning management systems and a case study tutorial with the Moodle system. Our objective is to introduce it both…

The Stryker Mobile Gun System: A Case Study on Managing Complexity

DTIC Science & Technology

2009-06-01

In his article Managing Innovation in Complex Product Systems, Howard Rush (1997) identified three “hotspot” categories: 1) requirements... Managing innovation in complex product systems. The Institution for Electrical Engineers. Retrieved February 2, 2009, from http

The Application of an Engineering Design and Information Systems Case Study in a Senior Level Product Data Management Course

ERIC Educational Resources Information Center

Connolly, Patrick

2011-01-01

This study examines the use of an engineering design and information systems case study over a three week period in a senior level class covering the topics of product data management (PDM) and product lifecycle management (PLM). Students that have taken the course in the past have struggled with the sometimes nebulous and difficult to…

Metropolitan transportation management center : a case study : Boston Central Artery/Tunnel Integrated Project control system : responding to incidents rapidly and effectively

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of the Boston Central Artery/Tunnel Integration Project Control System (IPCS) operations control center. It follows the outline provided in the companion document, Metropolitan Transportation Management Ce...

Comprehensive nursing case management. An advanced practice model.

PubMed

Taylor, P

1999-01-01

Under managed care and capitated reimbursement systems, case management is a core strategy for providing high-quality, cost-effective care by decreasing fragmentation, enhancing quality, ensuring efficient use of resources, and containing costs. Although case management is used in various areas of the healthcare arena, it suffers from a lack of consensus regarding its definition, essential components, and appropriate application. The purpose of this paper is to examine the components and limitations of existing case management models, outline the competencies of an effective case manager, and present a model of advanced practice nursing case management that focuses on a continuum of care that integrates medical and psychosocial resources to promote optimal clinical fiscal outcomes and enables patients to work as partners with the healthcare team in facilitating and maintaining their physical and emotional well-being.

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.

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...

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.

Signal systems asset management state-of-the-practice review

DOT National Transportation Integrated Search

2004-04-01

The purpose of this project is to obtain a better understanding of operations-level asset management by examining the specific case of signal systems. Key products will include: a synthesis of existing signal systems asset management practices; a gen...

Case Management Agency Systems of Administering Long-Term Care: Evidence from the Channeling Demonstration.

ERIC Educational Resources Information Center

Kemper, Peter

1990-01-01

Examines what was learned from channeling demonstration about potential of case management agency systems for administering home care benefits. Considers both advantages (substitution of lower cost for higher cost services, negotiation of lower prices for services, quality assurance) and disadvantages (difficulty controlling participation rates,…

Using landscape limnology to classify freshwater ecosystems for multi-ecosystem management and conservation

USGS Publications Warehouse

Soranno, Patricia A.; Cheruvelil, Kendra Spence; Webster, Katherine E.; Bremigan, Mary T.; Wagner, Tyler; Stow, Craig A.

2010-01-01

Governmental entities are responsible for managing and conserving large numbers of lake, river, and wetland ecosystems that can be addressed only rarely on a case-by-case basis. We present a system for predictive classification modeling, grounded in the theoretical foundation of landscape limnology, that creates a tractable number of ecosystem classes to which management actions may be tailored. We demonstrate our system by applying two types of predictive classification modeling approaches to develop nutrient criteria for eutrophication management in 1998 north temperate lakes. Our predictive classification system promotes the effective management of multiple ecosystems across broad geographic scales by explicitly connecting management and conservation goals to the classification modeling approach, considering multiple spatial scales as drivers of ecosystem dynamics, and acknowledging the hierarchical structure of freshwater ecosystems. Such a system is critical for adaptive management of complex mosaics of freshwater ecosystems and for balancing competing needs for ecosystem services in a changing world.

A Randomized Controlled Trial of Consensus-Based Child Abuse Case Management

ERIC Educational Resources Information Center

Goldbeck, L.; Laib-Koehnemund, A.; Fegert, J. M.

2007-01-01

Objective: This study evaluates the effects of expert-assisted child abuse and neglect case management in the German child welfare and healthcare system as perceived by the case workers themselves. Methods: Case workers with different professions (social workers, counselors, clinic-based and office-based psychotherapists, and physicians)…

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…

A Symbiosis between Instructional Systems Design and Project Management

ERIC Educational Resources Information Center

Pan, Cheng-Chang

2012-01-01

This study is intended to explore a complementary relationship between instructional systems design (ISD) and project management in an attempt to build a plausible case for integrating project management as a distinct course in the core of the graduate instructional systems design programs. It is argued that ISD and project management should form…

76 FR 48812 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-09

... closed case listings used to manage investigations, to produce statistical reports, and to control..., Department of Defense. CIG-26 System Name: Case Control System--Investigative System Location: Department of... Number (SSN), address, case control number, records of investigations to include Reports of Investigation...

FDDI information management system for centralizing interactive, computerized multimedia clinical experiences in pediatric rheumatology/Immunology.

PubMed

Rouhani, R; Cronenberger, H; Stein, L; Hannum, W; Reed, A M; Wilhelm, C; Hsiao, H

1995-01-01

This paper describes the design, authoring, and development of interactive, computerized, multimedia clinical simulations in pediatric rheumatology/immunology and related musculoskeletal diseases, the development and implementation of a high speed information management system for their centralized storage and distribution, and analytical methods for evaluating the total system's educational impact on medical students and pediatric residents. An FDDI fiber optic network with client/server/host architecture is the core. The server houses digitized audio, still-image video clips and text files. A host station houses the DB2/2 database containing case-associated labels and information. Cases can be accessed from any workstation via a customized interface in AVA/2 written specifically for this application. OS/2 Presentation Manager controls, written in C, are incorporated into the interface. This interface allows SQL searches and retrievals of cases and case materials. In addition to providing user-directed clinical experiences, this centralized information management system provides designated faculty with the ability to add audio notes and visual pointers to image files. Users may browse through case materials, mark selected ones and download them for utilization in lectures or for editing and converting into 35mm slides.

Septic Systems Case Studies

EPA Pesticide Factsheets

A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

[Characteristics of case management programs and their potential for patient empowerment].

PubMed

Grün, Oskar; Maier, Manfred

2008-01-01

Different types of case management programs have been increasingly developed for health care systems. This study, therefore, aimed to identify similarities and differences of case management programs, to estimate their shaping with special emphasis on patient empowerment, and to develop an instrument for their differentiation. During an interdisciplinary seminar for students, eight different case management programs were selected and analyzed. Five characteristics of case management programs were identified: type of case, extent of functions, players involved, limits of availability and need for resources. The programs were categorized into information-, provider-, disease- or patient centred. With these characteristics the selected programs could be exactly described and their potential for patient empowerment could be assessed. This newly developed tool for describing case management programs allows for their sufficient differentiation. The potential for patient empowerment apparently is most prominent in patient centred programs.

A cloud-based home management system for patients with a left ventricular assist device: a case report.

PubMed

Nomoto, Shinichi; Utsumi, Momoe; Minakata, Kenji

2016-07-04

Since implantable left ventricular assist devices (LVAD) with smaller configurations became available for bridge-to-transplant or even destination therapy in patients with end-stage heart failure, an increasing number of patients with these devices are receiving home medical management. However, these patients may be anxious about potential complications such as pump failure, thromboembolism, and infections that may occur during home management. To provide a sense of security during home management of patients with LVAD and to establish an ideal shared-care system, we developed a patient-centered cloud-based home management system for patients with LVAD. In this case report, we describe this system and report a trial of it in a 64-year-old patient with an LVAD.

Intraoperative non-record-keeping usage of anesthesia information management system workstations and associated hemodynamic variability and aberrancies.

PubMed

Wax, David B; Lin, Hung-Mo; Reich, David L

2012-12-01

Anesthesia information management system workstations in the anesthesia workspace that allow usage of non-record-keeping applications could lead to distraction from patient care. We evaluated whether non-record-keeping usage of the computer workstation was associated with hemodynamic variability and aberrancies. Auditing data were collected on eight anesthesia information management system workstations and linked to their corresponding electronic anesthesia records to identify which application was active at any given time during the case. For each case, the periods spent using the anesthesia information management system record-keeping module were separated from those spent using non-record-keeping applications. The variability of heart rate and blood pressure were also calculated, as were the incidence of hypotension, hypertension, and tachycardia. Analysis was performed to identify whether non-record-keeping activity was a significant predictor of these hemodynamic outcomes. Data were analyzed for 1,061 cases performed by 171 clinicians. Median (interquartile range) non-record-keeping activity time was 14 (1, 38) min, representing 16 (3, 33)% of a median 80 (39, 143) min of procedure time. Variables associated with greater non-record-keeping activity included attending anesthesiologists working unassisted, longer case duration, lower American Society of Anesthesiologists status, and general anesthesia. Overall, there was no independent association between non-record-keeping workstation use and hemodynamic variability or aberrancies during anesthesia either between cases or within cases. Anesthesia providers spent sizable portions of case time performing non-record-keeping applications on anesthesia information management system workstations. This use, however, was not independently associated with greater hemodynamic variability or aberrancies in patients during maintenance of general anesthesia for predominantly general surgical and gynecologic procedures.

The mapping competences of the nurse Case/Care Manager in the context of Intensive Care.

PubMed

Alfieri, Emanuela; Ferrini, Anna Chiara; Gianfrancesco, Francesca; Lise, Gianluca; Messana, Giovanni; Tirelli, Lorenzo; Lorenzo, Ana; Sarli, Leopoldo

2017-03-15

Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager. In particular, it has been compared the experience of an Intensive Care Units where the Case/Care Manager's profile is operational to a different Unit where a Case/Care Manager is not yet in force. a Levati's model was used to map the Case/Care Manager's skills, involving each unit whole working staff, executives and caregivers through semi-structured interviews. It has been taken into consideration the Anaesthesia Unit and Emergency Unit of Cesena's healthcare organisation (AUSL of Romagna) and a Cardiology Intensive Care Unit of Piacenza's healthcare organisation, where the Case/Care Manager's profile has not been experimented yet. Firstly, it a data collection in each healthcare organization has been organised. Subsequently, semi-structured interviews to doctors, unit nurses, caregivers, nurses' coordinators and medical staff have been used to compare each healthcare system. The interviewees' described their expectations in relation to the Case/Care Manager working in a critical area. Then, every data collected during interviews has been organised to map a Case/Care Manager's essential professional profile to work in a critical area together with medical staff. Piacenza's O.U. critical area experience reported a major demand for patients' and patient's families' assistance. On the other hand, the very same aspects seem to have been better achieved in Cesena's O.U., where a Case/Care Manager's recent introduction has actually helped to overcome the void in organising systems. a Case/Care Manager's profile has been drafted on the basis of the comparative analysis conducted. It has been noted how the Case/Care Manager's professional profile can really improve relationships and communications between medical staff and patients, promoting a major unity among the working team. According to the present research, the Case/Care Manager's profile has been proved helpful in positively influencing the team activity and to elicit major satisfaction both in patients and their family.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

PubMed

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

Collaborations in leadership: the nurse case management and nursing administration connection.

PubMed

Carr, Dana Deravin

2009-01-01

With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. All settings, particularly acute care hospitals and integrated delivery systems. The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty.

Management of A Rare Case of Communicating Internal-External Inflammatory Resorption.

PubMed

Arora, Suraj; Gill, Gurdeep Singh; Saluja, Priyanka; Setia, Vikas

2015-05-01

The present case describes the successful management of a rare case of communicating internal-external resorption in which both internal and external resorption seem to develop independent of each other. The case report highlights the importance of correct diagnosis and need of revision of classification system of resorptive defects.

Management of A Rare Case of Communicating Internal-External Inflammatory Resorption

PubMed Central

Arora, Suraj; Saluja, Priyanka; Setia, Vikas

2015-01-01

The present case describes the successful management of a rare case of communicating internal-external resorption in which both internal and external resorption seem to develop independent of each other. The case report highlights the importance of correct diagnosis and need of revision of classification system of resorptive defects. PMID:26155588

Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.

PubMed

Nair, Bala G; Grunzweig, Katherine; Peterson, Gene N; Horibe, Mayumi; Neradilek, Moni B; Newman, Shu-Fang; Van Norman, Gail; Schwid, Howard A; Hao, Wei; Hirsch, Irl B; Patchen Dellinger, E

2016-06-01

Poor perioperative glycemic management can lead to negative surgical outcome. Improved compliance to glucose control protocol could lead to better glucose management. An Anesthesia Information Management System based decision support system-Smart Anesthesia Manager™ (SAM) was used to generate real-time reminders to the anesthesia providers to closely adhere to our institutional glucose management protocol. Compliance to hourly glucose measurements and correct insulin dose adjustments was compared for the baseline period (12 months) without SAM and the intervention period (12 months) with SAM decision support. Additionally, glucose management parameters were compared for the baseline and intervention periods. A total of 1587 cases during baseline and 1997 cases during intervention met the criteria for glucose management (diabetic patients or non-diabetic patients with glucose level >140 mg/dL). Among the intervention cases anesthesia providers chose to use SAM reminders 48.7 % of the time primarily for patients who had diabetes, higher HbA1C or body mass index, while disabling the system for the remaining cases. Compliance to hourly glucose measurement and correct insulin doses increased significantly during the intervention period when compared with the baseline (from 52.6 to 71.2 % and from 13.5 to 24.4 %, respectively). In spite of improved compliance to institutional protocol, the mean glucose levels and other glycemic management parameters did not show significant improvement with SAM reminders. Real-time electronic reminders improved intraoperative compliance to institutional glucose management protocol though glycemic parameters did not improve even when there was greater compliance to the protocol.

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.

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

PubMed Central

Monsen, Karen A.; Elsbernd, Scott A.; Barnhart, Linda; Stock, Jacquie; Prock, Carla E.; Looman, Wendy S.; Nardella, Maria

2013-01-01

Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems. PMID:23533804

A prototype case-based reasoning human assistant for space crew assessment and mission management

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Holland, Albert W.; Wood, Joanna

1993-01-01

We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

Data Overload Impact on Project Management: How Knowledge Management Systems Can Improve Federal Agencies Effectiveness

ERIC Educational Resources Information Center

Rodriguez, Jacinto

2013-01-01

This mixed method exploratory case study was used to explore the effect data overload has on project management, how data overload affects project management effectiveness, how prepared program office staff is to manage multiple projects effectively, and how the program office's organizational structure and data management systems affect project…

Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

ERIC Educational Resources Information Center

Naradko, Anthony M.

2017-01-01

The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

A case study : Georgia's intelligent transportation system : NAVIGATOR systems integrator contract -- use of a systems integrator to manage ITS implementation

DOT National Transportation Integrated Search

2000-03-01

This case study is one of a series of case studies that examine procurement approaches used to deliver Intelligent Transportation System (ITS) projects. ITS projects are often complex and leverage the latest technology in telecommunications, computer...

Modified stretched exponential model of computer system resources management limitations-The case of cache memory

NASA Astrophysics Data System (ADS)

Strzałka, Dominik; Dymora, Paweł; Mazurek, Mirosław

2018-02-01

In this paper we present some preliminary results in the field of computer systems management with relation to Tsallis thermostatistics and the ubiquitous problem of hardware limited resources. In the case of systems with non-deterministic behaviour, management of their resources is a key point that guarantees theirs acceptable performance and proper working. This is very wide problem that stands for many challenges in financial, transport, water and food, health, etc. areas. We focus on computer systems with attention paid to cache memory and propose to use an analytical model that is able to connect non-extensive entropy formalism, long-range dependencies, management of system resources and queuing theory. Obtained analytical results are related to the practical experiment showing interesting and valuable results.

41 CFR 102-80.150 - What is meant by “reasonable worst case fire scenario”?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What is meant by âreasonable worst case fire scenarioâ? 102-80.150 Section 102-80.150 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80...

41 CFR 102-80.150 - What is meant by “reasonable worst case fire scenario”?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is meant by âreasonable worst case fire scenarioâ? 102-80.150 Section 102-80.150 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80...

Risk-based requirements management framework with applications to assurance cases

NASA Astrophysics Data System (ADS)

Feng, D.; Eyster, C.

The current regulatory approach for assuring device safety primarily focuses on compliance with prescriptive safety regulations and relevant safety standards. This approach, however, does not always lead to a safe system design even though safety regulations and standards have been met. In the medical device industry, several high profile recalls involving infusion pumps have prompted the regulatory agency to reconsider how device safety should be managed, reviewed and approved. An assurance case has been cited as a promising tool to address this growing concern. Assurance cases have been used in safety-critical systems for some time. Most assurance cases, if not all, in literature today are developed in an ad hoc fashion, independent from risk management and requirement development. An assurance case is a resource-intensive endeavor that requires additional effort and documentation from equipment manufacturers. Without a well-organized requirements infrastructure in place, such “ additional effort” can be substantial, to the point where the cost of adoption outweighs the benefit of adoption. In this paper, the authors present a Risk-Based Requirements and Assurance Management (RBRAM) methodology. The RBRAM is an elaborate framework that combines Risk-Based Requirements Management (RBRM) with assurance case methods. Such an integrated framework can help manufacturers leverage an existing risk management to present a comprehensive assurance case with minimal additional effort while providing a supplementary means to reexamine the integrity of the system design in terms of the mission objective. Although the example used is from the medical industry, the authors believe that the RBRAM methodology underlines the fundamental principle of risk management, and offers a simple, yet effective framework applicable to aerospace industry, perhaps, to any industry.

The success of a management information system in health care - a case study from Finland.

PubMed

Kivinen, Tuula; Lammintakanen, Johanna

2013-02-01

The purpose of this article is to describe perspectives on information availability and information use among users of a management information system in one specialized health care organization. The management information system (MIS) is defined as the information system that provides management with information about financial and operational aspects of hospital management. The material for this qualitative case study was gathered by semi-structured interviews. The interviewees were purposefully selected from one specialized health care organization. The organization has developed its management information system in recent years. Altogether 13 front-line, middle and top-level managers were interviewed. The two themes discussed were information availability and information use. The data were analyzed using inductive content analysis using ATLAS.ti computer program. The main category "usage of management information system" consisted of four sub-categories: (1) system quality, (2) information quality, (3) use and user satisfaction and (4) development of information culture. There were many organizational and cultural aspects which influence the use of MIS in addition to factors concerning system usability and users. The connection between information culture and information use was recognized and the managers proposed numerous ways to increase the use of information in management work. The implementation and use of management information system did not seem to be planned as an essential tool in strategic information management in the health care organization studied. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Complex Adaptive Systems as Metaphors for Organizational Management

ERIC Educational Resources Information Center

Palmberg, Klara

2009-01-01

Purpose: The purpose of this paper is to explore the concept of complex adaptive systems (CAS) from the perspective of managing organizations, to describe and explore the management principles in a case study of an organization with unconventional ways of management and to present a tentative model for managing organizations as CAS--system…

VHBuild.com: A Web-Based System for Managing Knowledge in Projects.

ERIC Educational Resources Information Center

Li, Heng; Tang, Sandy; Man, K. F.; Love, Peter E. D.

2002-01-01

Describes an intelligent Web-based construction project management system called VHBuild.com which integrates project management, knowledge management, and artificial intelligence technologies. Highlights include an information flow model; time-cost optimization based on genetic algorithms; rule-based drawing interpretation; and a case-based…

Harnessing Technology for School Accountability: A Case Study of Implementing a Management Information System

ERIC Educational Resources Information Center

Enomoto, Ernestine K.; Conley, Sharon

2007-01-01

Schools employ educational technology to comply with pressures for greater accountability and efficiency in conducting operations. Specifically, schools use "management information systems" designed to automate data collection of student attendance, grades, test scores, and so on. These management information systems (MIS) employed…

Improving publicly funded substance abuse treatment: the value of case management.

PubMed Central

Shwartz, M; Baker, G; Mulvey, K P; Plough, A

1997-01-01

OBJECTIVES: This study evaluated the impact of case management on client retention in treatment and short-term relapse for clients in the publicly funded substance abuse treatment system. METHODS: A retrospective cohort design was used to study clients discharged from the following four modalities in 1993 and 1994: short-term residential (3112 clients), long-term residential (2888 clients), outpatient (7431 clients), and residential detox (7776 clients). Logistic regression models were used to analyze the impact of case management after controlling for baseline characteristics. RESULTS: The odds that case-managed clients reached a length of stay previously identified as associated with more successful treatment were 1.6 (outpatient programs) to 3.6 (short-term residential programs) times higher than the odds for non-case-managed clients. With the exception of outpatient clients, the odds of case-managed clients' being admitted to detox within 90 days after discharge (suggesting relapse) were about two thirds those of non-case-managed clients. The odds of case-managed detox clients' transitioning to post-detox treatment (a good outcome) were 1.7 times higher than the odds for non-case-managed clients. CONCLUSIONS: Case management is a low-cost enhancement that improves short-term outcomes of substance abuse treatment programs. PMID:9357349

Applying Service-Oriented Architecture on The Development of Groundwater Modeling Support System

NASA Astrophysics Data System (ADS)

Li, C. Y.; WANG, Y.; Chang, L. C.; Tsai, J. P.; Hsiao, C. T.

2016-12-01

Groundwater simulation has become an essential step on the groundwater resources management and assessment. There are many stand-alone pre- and post-processing software packages to alleviate the model simulation loading, but the stand-alone software do not consider centralized management of data and simulation results neither do they provide network sharing functions. Hence, it is difficult to share and reuse the data and knowledge (simulation cases) systematically within or across companies. Therefore, this study develops a centralized and network based groundwater modeling support system to assist model construction. The system is based on service-oriented architecture and allows remote user to develop their modeling cases on internet. The data and cases (knowledge) are thus easy to manage centralized. MODFLOW is the modeling engine of the system, which is the most popular groundwater model in the world. The system provides a data warehouse to restore groundwater observations, MODFLOW Support Service, MODFLOW Input File & Shapefile Convert Service, MODFLOW Service, and Expert System Service to assist researchers to build models. Since the system architecture is service-oriented, it is scalable and flexible. The system can be easily extended to include the scenarios analysis and knowledge management to facilitate the reuse of groundwater modeling knowledge.

[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.

77 FR 5865 - Privacy Act; System of Records: State-59, Refugee Case Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

..., pursuant to the provisions of the Privacy Act of 1974, as amended (5 U.S.C. 552a) and Office of Management... with the Office of Management and Budget. The amended system description, ``Refugee Case Records, State... Presidential Documents, Pg. 2880 (Refugee Resettlement Grants Program); Refugee Crisis in Iraq Act of 2007...

Spatial Case Information Management System (SCIMS)

Science.gov Websites

SCIMS facilitates the update of the Land Administration System (LAS) Case File location. Please select Cleanup Notes Utilities LAS Request Import Utility Privacy Copyright System Status Support User Guide

Cost accounting, management control, and planning in health care.

PubMed

Siegrist, R B; Blish, C S

1988-02-01

Advantages and pharmacy applications of computerized hospital management-control and planning systems are described. Hospitals must define their product lines; patient cases, not tests or procedures, are the end product. Management involves operational control, management control, and strategic planning. Operational control deals with day-to-day management on the task level. Management control involves ensuring that managers use resources effectively and efficiently to accomplish the organization's objectives. Management control includes both control of unit costs of intermediate products, which are procedures and services used to treat patients and are managed by hospital department heads, and control of intermediate product use per case (managed by the clinician). Information from the operation and management levels feeds into the strategic plan; conversely, the management level controls the plan and the operational level carries it out. In the system developed at New England Medical Center, Boston, Massachusetts, the intermediate product-management system enables managers to identify intermediate products, develop standard costs, simulate changes in departmental costs, and perform variance analysis. The end-product management system creates a patient-level data-base, identifies end products (patient-care groupings), develops standard resource protocols, models alternative assumptions, performs variance analysis, and provides concurrent reporting. Examples are given of pharmacy managers' use of such systems to answer questions in the areas of product costing, product pricing, variance analysis, productivity monitoring, flexible budgeting, modeling and planning, and comparative analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

29 CFR 102.119 - Privacy Act Regulations: notification as to whether a system of records contains records...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Regional Office Files (NLRB-25), Regional Advice and Injunction Litigation System (RAILS) and Associated Headquarters Files (NLRB-28), and Appeals Case Tracking System (ACTS) and Associated Headquarters Files (NLRB... Judicial Case Management Systems-Pending Case List (JCMS-PCL) and Associated Headquarters Files (NLRB-21...

29 CFR 102.119 - Privacy Act Regulations: notification as to whether a system of records contains records...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regional Office Files (NLRB-25), Regional Advice and Injunction Litigation System (RAILS) and Associated Headquarters Files (NLRB-28), and Appeals Case Tracking System (ACTS) and Associated Headquarters Files (NLRB... Judicial Case Management Systems-Pending Case List (JCMS-PCL) and Associated Headquarters Files (NLRB-21...

29 CFR 102.119 - Privacy Act Regulations: notification as to whether a system of records contains records...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Regional Office Files (NLRB-25), Regional Advice and Injunction Litigation System (RAILS) and Associated Headquarters Files (NLRB-28), and Appeals Case Tracking System (ACTS) and Associated Headquarters Files (NLRB... Judicial Case Management Systems-Pending Case List (JCMS-PCL) and Associated Headquarters Files (NLRB-21...

29 CFR 102.119 - Privacy Act Regulations: notification as to whether a system of records contains records...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Regional Office Files (NLRB-25), Regional Advice and Injunction Litigation System (RAILS) and Associated Headquarters Files (NLRB-28), and Appeals Case Tracking System (ACTS) and Associated Headquarters Files (NLRB... Judicial Case Management Systems-Pending Case List (JCMS-PCL) and Associated Headquarters Files (NLRB-21...

Linking case management and community development.

PubMed

Austin, Carol D; McClelland, Robert W; Gursansky, Di

2006-01-01

Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

Undiagnosed light chain systemic amyloidosis: does it matter to anesthesiologists? -a case report-

PubMed Central

Kim, Gwan Ho; Lee, Woo Kyung; Na, Se Hee

2013-01-01

Light chain systemic amyloidosis is rare but may accompany laryngeal or pulmonary involvement, which may increase the risk in airway management. We present a case of a patient planned for resection of cervical epidural mass. The patient had face and neck ecchymoses and purpuras with an unknown cause. Mask ventilation and intubation were successful, but the operation was cancelled to evaluate bleeding from facial skin lesions. A diagnosis of light chain systemic amyloidosis prompted evaluation of involvement of other organs and treatment. This case shows the importance of preoperative evaluation and careful airway management in patients with systemic amyloidosis. PMID:24363850

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre

PubMed Central

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

Objectives This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. Methods We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Results Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Conclusion Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users. PMID:28002491

Global Hawk Systems Engineering. Case Study

DTIC Science & Technology

2010-01-01

Management Core System ( TBMCS ) (complex software development) • F-111 Fighter (joint program with significant involvement by the Office of the...Software Requirements Specification TACC Tailored Airworthiness Certification Criteria TBMCS Theater Battle Management Core System TEMP Test and

Different approaches for centralized and decentralized water system management in multiple decision makers' problems

NASA Astrophysics Data System (ADS)

Anghileri, D.; Giuliani, M.; Castelletti, A.

2012-04-01

There is a general agreement that one of the most challenging issues related to water system management is the presence of many and often conflicting interests as well as the presence of several and independent decision makers. The traditional approach to multi-objective water systems management is a centralized management, in which an ideal central regulator coordinates the operation of the whole system, exploiting all the available information and balancing all the operating objectives. Although this approach allows to obtain Pareto-optimal solutions representing the maximum achievable benefit, it is based on assumptions which strongly limits its application in real world contexts: 1) top-down management, 2) existence of a central regulation institution, 3) complete information exchange within the system, 4) perfect economic efficiency. A bottom-up decentralized approach seems therefore to be more suitable for real case applications since different reservoir operators may maintain their independence. In this work we tested the consequences of a change in the water management approach moving from a centralized toward a decentralized one. In particular we compared three different cases: the centralized management approach, the independent management approach where each reservoir operator takes the daily release decision maximizing (or minimizing) his operating objective independently from each other, and an intermediate approach, leading to the Nash equilibrium of the associated game, where different reservoir operators try to model the behaviours of the other operators. The three approaches are demonstrated using a test case-study composed of two reservoirs regulated for the minimization of flooding in different locations. The operating policies are computed by solving one single multi-objective optimal control problem, in the centralized management approach; multiple single-objective optimization problems, i.e. one for each operator, in the independent case; using techniques related to game theory for the description of the interaction between the two operators, in the last approach. Computational results shows that the Pareto-optimal control policies obtained in the centralized approach dominate the control policies of both the two cases of decentralized management and that the so called price of anarchy increases moving toward the independent management approach. However, the Nash equilibrium solution seems to be the most promising alternative because it represents a good compromise in maximizing management efficiency without limiting the behaviours of the reservoir operators.

Site-Based Management versus Systems-Based Thinking: The Impact of Data-Driven Accountability and Reform

ERIC Educational Resources Information Center

Mette, Ian M.; Bengtson, Ed

2015-01-01

This case was written to help prepare building-level and central office administrators who are expected to effectively lead schools and systems in an often tumultuous world of educational accountability and reform. The intent of this case study is to allow educators to examine the impact data management has on the types of thinking required when…

Implementation of Network Leader Sponsored Supply Chain Management Systems: A Case Study of Supplier IT Business Value

ERIC Educational Resources Information Center

Miller, Mark S.

2010-01-01

This qualitative multiple-case study was conducted to explore and understand how the implementation of required relationship-specific supply chain management system (SCMS) dictated by the network leader within a supplier network affects a supplier organization. The study, on a very broad sense, attempted to research the current validity of how the…

Another Link in the Chain: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

ERIC Educational Resources Information Center

Guthrie, Anne M.; McLaine, Pat

Policy and practice for screening children for lead poisoning have dominated the dialogue about the health care system's role in lead poisoning prevention, with little attention directed to how the health care system responds to a lead-poisoned child once identified. This report details a study of the case management and environmental…

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.

An architecture model for multiple disease management information systems.

PubMed

Chen, Lichin; Yu, Hui-Chu; Li, Hao-Chun; Wang, Yi-Van; Chen, Huang-Jen; Wang, I-Ching; Wang, Chiou-Shiang; Peng, Hui-Yu; Hsu, Yu-Ling; Chen, Chi-Huang; Chuang, Lee-Ming; Lee, Hung-Chang; Chung, Yufang; Lai, Feipei

2013-04-01

Disease management is a program which attempts to overcome the fragmentation of healthcare system and improve the quality of care. Many studies have proven the effectiveness of disease management. However, the case managers were spending the majority of time in documentation, coordinating the members of the care team. They need a tool to support them with daily practice and optimizing the inefficient workflow. Several discussions have indicated that information technology plays an important role in the era of disease management. Whereas applications have been developed, it is inefficient to develop information system for each disease management program individually. The aim of this research is to support the work of disease management, reform the inefficient workflow, and propose an architecture model that enhance on the reusability and time saving of information system development. The proposed architecture model had been successfully implemented into two disease management information system, and the result was evaluated through reusability analysis, time consumed analysis, pre- and post-implement workflow analysis, and user questionnaire survey. The reusability of the proposed model was high, less than half of the time was consumed, and the workflow had been improved. The overall user aspect is positive. The supportiveness during daily workflow is high. The system empowers the case managers with better information and leads to better decision making.

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…

77 FR 54935 - Government-Owned Inventions, Available for Licensing.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

...: Systems and Methods for Peak-Seeking Control Polarization-Induced Fading in Fiber-Optic System; NASA Case... FURTHER INFORMATION CONTACT: Mark W. Homer, Patent Counsel, NASA Management Office--JPL, 4800 Oak Grove...; NASA Case No. NPO-47580-1: Energy Harvesting Systems and Methods of Assembling Same; NASA Case No. NPO...

Radio frequency identification: the big role player in health care management.

PubMed

Mehrjerdi, Yahia Zare

2011-01-01

This paper seeks to review the fundamental concepts of radio frequency identification (RFID) and to discuss the fact that the road to success for healthcare systems is the thorough management of patients, employees, equipment, medications, and records throughout the industry. Thereafter, it aims to prepare a deep review of the technology, study seven new cases on the topic of healthcare management and deliver a broad applications area thereof. The paper identifies key elements of RFID through the review of healthcare management literature and case studies. For this purpose, seven cases from the healthcare industry are reviewed to demonstrate the extent of the applications of RFID in this area. To make healthcare management systems functional and successfully operational, RFID solutions can be used to reduce operating costs through management of patients, employees, equipment, medications, and records to improve tracking and tracing, and preventing the lost of resources under any circumstances. This paper delivers a review of RFID on the healthcare industry. For this reason, the basic and key point on RFID technology is discussed and seven cases from the literature are reviewed.

Application fields for the new Object Management Group (OMG) Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN) in the perioperative field.

PubMed

Wiemuth, M; Junger, D; Leitritz, M A; Neumann, J; Neumuth, T; Burgert, O

2017-08-01

Medical processes can be modeled using different methods and notations. Currently used modeling systems like Business Process Model and Notation (BPMN) are not capable of describing the highly flexible and variable medical processes in sufficient detail. We combined two modeling systems, Business Process Management (BPM) and Adaptive Case Management (ACM), to be able to model non-deterministic medical processes. We used the new Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN). First, we explain how CMMN, DMN and BPMN could be used to model non-deterministic medical processes. We applied this methodology to model 79 cataract operations provided by University Hospital Leipzig, Germany, and four cataract operations provided by University Eye Hospital Tuebingen, Germany. Our model consists of 85 tasks and about 20 decisions in BPMN. We were able to expand the system with more complex situations that might appear during an intervention. An effective modeling of the cataract intervention is possible using the combination of BPM and ACM. The combination gives the possibility to depict complex processes with complex decisions. This combination allows a significant advantage for modeling perioperative processes.

Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

PubMed

Kneale, Laura; Choi, Yong; Demiris, George

2016-01-01

Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

Visualising Pareto-optimal trade-offs helps move beyond monetary-only criteria for water management decisions

NASA Astrophysics Data System (ADS)

Hurford, Anthony; Harou, Julien

2014-05-01

Water related eco-system services are important to the livelihoods of the poorest sectors of society in developing countries. Degradation or loss of these services can increase the vulnerability of people decreasing their capacity to support themselves. New approaches to help guide water resources management decisions are needed which account for the non-market value of ecosystem goods and services. In case studies from Brazil and Kenya we demonstrate the capability of many objective Pareto-optimal trade-off analysis to help decision makers balance economic and non-market benefits from the management of existing multi-reservoir systems. A multi-criteria search algorithm is coupled to a water resources management simulator of each basin to generate a set of Pareto-approximate trade-offs representing the best case management decisions. In both cases, volume dependent reservoir release rules are the management decisions being optimised. In the Kenyan case we further assess the impacts of proposed irrigation investments, and how the possibility of new investments impacts the system's trade-offs. During the multi-criteria search (optimisation), performance of different sets of management decisions (policies) is assessed against case-specific objective functions representing provision of water supply and irrigation, hydropower generation and maintenance of ecosystem services. Results are visualised as trade-off surfaces to help decision makers understand the impacts of different policies on a broad range of stakeholders and to assist in decision-making. These case studies show how the approach can reveal unexpected opportunities for win-win solutions, and quantify the trade-offs between investing to increase agricultural revenue and negative impacts on protected ecosystems which support rural livelihoods.

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…

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.

Overview of Medicaid capitation and case-management initiatives

PubMed Central

Freund, Deborah A.; Neuschler, Edward

1986-01-01

Case-management programs have grown in number and in acceptance in the Medicaid program since 1981. In this article, we review their structure and incentives as well as what is known about their impact on cost and use. These programs also have been difficult to implement, posing myriad management challenges for prepaid program managers and State administrators. We highlight the problems in the following areas: eligibility, enrollment, rate setting, and management information systems. PMID:10311923

Post-Soviet transition: improving health services delivery and management.

PubMed

Antoun, Joseph; Phillips, Frank; Johnson, Tricia

2011-01-01

During the post-Soviet transition of the last 2 decades, ex-Communist countries of the Eastern Bloc, including eastern and central Europe, the Soviet Union, and its satellite and aligned states, have undergone major health system reforms. Many health systems of those countries--previously adopting a Soviet-type Semashko model--are currently called "in transition," as reform agendas, such as shifting to a Bismarck, Beveridge, or mixed financing scheme or adopting new health delivery management policies, are still in development. In this article, we first review common characteristics of Semashko health systems (the predominant health system of Communist countries during the Soviet era) and then discuss the "new public management" principles that ex-Communist countries have recently started to adopt with various degrees of success. We then illustrate experiences with these principles using 2 case studies, from Russia and Albania, and propose health policy options for both cases. Based on a review of the literature and on the our work experience in Russia and Albania, we found that the 2 ex-Semashko systems have not fully capitalized on expected positive outcomes of new public management principles due to low local healthcare financing levels, depreciated healthcare infrastructure and operational capacities, overlapping and contradicting ideology and policies of the former and newer health systems, and finally, lack of leadership that has successful experience with these principles. In the case of pharmaceutical pricing, reimbursement, and access in Russia, we show how a well-intentioned but suboptimally designed and managed pharmaceutical coverage scheme has suffered moral hazard and adverse selection and has adversely impacted the new public management promise of efficient medicine coverage. In the case of Albania, the delayed investment in human resource reform within a depreciated and underfinanced delivery system has adversely affected the implementation of new public management principles. © 2011 Mount Sinai School of Medicine.

Talent management best practices: how exemplary health care organizations create value in a down economy.

PubMed

Groves, Kevin S

2011-01-01

: Difficult economic conditions and powerful workforce trends pose significant challenges to managing talent in health care organizations. Although robust research evidence supports the many benefits of maintaining a strong commitment to talent management practices despite these challenges, many organizations compound the problem by resorting to workforce reductions and limiting or eliminating investments in talent management. : This study examines how nationwide health care systems address these challenges through best practice talent management systems. Addressing important gaps in talent management theory and practice, this study develops a best practice model of talent management that is grounded in the contextual challenges facing health care practitioners. : Utilizing a qualitative case study that examined 15 nationwide health care systems, data were collected through semistructured interviews with 30 executives and document analysis of talent management program materials submitted by each organization. : Exemplary health care organizations employ a multiphased talent management system composed of six sequential phases and associated success factors that drive effective implementation. Based on these findings, a model of talent management best practices in health care organizations is presented. : Health care practitioners may utilize the best practice model to assess and enhance their respective talent management systems by establishing the business case for talent management, defining, identifying, and developing high-potential leaders, carefully communicating high-potential designations, and evaluating talent management outcomes.

Developing a health information network within an integrated delivery system: a case study.

PubMed

Wager, K A; Heda, S; Austin, C J

1997-05-01

Changes in the health care environment, such as the growth of integrated delivery systems and the proliferation of managed care, are having a profound impact on the way in which health care organizations manage both clinical and financial information. Health information networks (HINs) are emerging to support the goals and internal needs of integrated delivery systems. In this environment, health care managers must assume a leadership role in planning for the development of HINs. The article provides an overview of the principal issues that should be addressed in an organization's information systems plan when a HIN is being developed and includes a case study that illustrates the key points discussed.

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.

Commercial vehicle fleet management and information systems. Technical memorandum 2 : summary of case study interviews

DOT National Transportation Integrated Search

1997-10-01

The FHWA has commissioned the Commercial Vehicle Fleet Management and Information Systems study to determine if there are fleet management needs that the public sector can address through the development of ITS for commercial vehicle operations. As p...

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.

Effectiveness of Implementation of Electronic Malaria Information System as the National Malaria Surveillance System in Thailand

PubMed Central

2016-01-01

Background In moving toward malaria elimination, one strategy is to implement an active surveillance system for effective case management. Thailand has developed and implemented the electronic Malaria Information System (eMIS) capturing individualized electronic records of suspected or confirmed malaria cases. Objective The main purpose of this study was to determine how well the eMIS improves the quality of Thailand’s malaria surveillance system. In particular, the focus of the study was to evaluate the effectiveness of the eMIS in terms of the system users’ perception and the system outcomes (ie, quality of data) regarding the management of malaria patients. Methods A mixed-methods technique was used with the framework based on system effectiveness attributes: data quality, timeliness, simplicity, acceptability, flexibility, stability, and usefulness. Three methods were utilized: data records review, survey of system users, and in-depth interviews with key stakeholders. From the two highest endemic provinces, paper forms matching electronic records of 4455 noninfected and 784 malaria-infected cases were reviewed. Web-based anonymous questionnaires were distributed to all 129 eMIS data entry staff throughout Thailand, and semistructured interviews were conducted with 12 management-level officers. Results The eMIS is well accepted by system users at both management and operational levels. The data quality has enabled malaria personnel to perform more effective prevention and control activities. There is evidence of practices resulting in inconsistencies and logical errors in data reporting. Critical data elements were mostly completed, except for a few related to certain dates and area classifications. Timeliness in reporting a case to the system was acceptable with a delay of 3-4 days. The evaluation of quantitative and qualitative data confirmed that the eMIS has high levels of simplicity, acceptability, stability, and flexibility. Conclusions Overall, the system implemented has achieved its objective. The results of the study suggested that the eMIS helps improve the quality of Thailand’s malaria surveillance system. As the national malaria surveillance system, the eMIS’s functionalities have provided the malaria staff working at the point of care with close-to-real-time case management data quality, covering case detection, case investigation, drug compliance, and follow-up visits. Such features has led to an improvement in the quality of the malaria control program; the government officials now have quicker access to both individual and aggregated data to promptly react to possible outbreak. The eMIS thus plays one of the key roles in moving toward the national goal of malaria elimination by the next decade. PMID:27227156

Magnitude of anthropogenic phosphorus storage in the agricultural production and the waste management systems at the regional and country scales.

PubMed

Chowdhury, Rubel Biswas; Chakraborty, Priyanka

2016-08-01

Based on a systematic review of 17 recent substance flow analyses of phosphorus (P) at the regional and country scales, this study presents an assessment of the magnitude of anthropogenic P storage in the agricultural production and the waste management systems to identify the potential for minimizing unnecessary P storage to reduce the input of P as mineral fertilizer and the loss of P. The assessment indicates that in case of all (6) P flow analyses at the regional scale, the combined mass of annual P storage in the agricultural production and the waste management systems is greater than 50 % of the mass of annual P inflow as mineral fertilizer in the agricultural production system, while this is close to or more than 100 % in case of half of these analyses. At the country scale, in case of the majority (7 out of 11) of analyses, the combined mass of annual P storage in the agricultural production and the waste management systems has been found to be roughly equivalent or greater than 100 % of the mass of annual P inflow as mineral fertilizer in the agricultural production system, while it ranged from 30 to 60 % in the remaining analyses. A simple scenario analysis has revealed that the annual storage of P in this manner over 100 years could result in the accumulation of a massive amount of P in the agricultural production and the waste management systems at both the regional and country scales. This study suggests that sustainable P management initiatives at the regional and country scales should put more emphasis on minimizing unwanted P storage in the agricultural production and the waste management systems.

System integration case study : FAST-TRAC : preliminary IV deliverable : #2-systems integration case study

DOT National Transportation Integrated Search

1999-02-12

This report focuses on the system integration aspect of the Transportation Information Management System (TIMS), a component of the FAST-TRAC project. The TIMS functions as the center of a communications network which integrates advanced traffic cont...

Total Quality Management and the System Safety Secretary

NASA Technical Reports Server (NTRS)

Elliott, Suzan E.

1993-01-01

The system safety secretary is a valuable member of the system safety team. As downsizing occurs to meet economic constraints, the Total Quality Management (TQM) approach is frequently adopted as a formula for success and, in some cases, for survival.

Artificial-intelligence-based optimization of the management of snow removal assets and resources.

DOT National Transportation Integrated Search

2002-10-01

Geographic information systems (GIS) and artificial intelligence (AI) techniques were used to develop an intelligent : snow removal asset management system (SRAMS). The system has been evaluated through a case study examining : snow removal from the ...

Information Systems and Management Training.

ERIC Educational Resources Information Center

Curry, B.; Smith, D. G.

1991-01-01

A case study of a South Wales manufacturer illustrates the need for companies to adopt an integrated strategy for computerization and information systems. Lack of management training blending computing and business skills can have a crippling effect on system development and organizational health. (SK)

Strategies Nurse Managers Used to Offset Challenges during Electronic Medical Records Implementation: A Case Study

ERIC Educational Resources Information Center

Easterling, Latasha

2015-01-01

The purpose of this qualitative, descriptive case study was to discover successful approaches used, by nurse managers, to reduce barriers during the implementation of electronic medical record system in one hospital. Fourteen nurse managers were interviewed from an academic health science center in Mississippi. A pilot study was conducted to…

Teaching Case: Analysis of an Electronic Voting System

ERIC Educational Resources Information Center

Thompson, Nik; Toohey, Danny

2014-01-01

This teaching case discusses the analysis of an electronic voting system. The development of the case was motivated by research into information security and management, but as it includes procedural aspects, organizational structure and personnel, it is a suitable basis for all aspects of systems analysis, planning and design tasks. The material…

Information and knowledge management for sustainable forestry

Treesearch

Alan J. Thomson; Michael Rauscher; Daniel L. Schmoldt; Harald Vacik

2007-01-01

Institutional information and knowledge management often involves a range of systems and technologies to aid decisions and produce reports. Construction of a knowledge system organizing hierarchy facilitates exploration of the interrelationships among knowledge management, inventory and monitoring, statistics and modeling, and policy. Two case studies illustrate these...

Complexity Science Applications to Dynamic Trajectory Management: Research Strategies

NASA Technical Reports Server (NTRS)

Sawhill, Bruce; Herriot, James; Holmes, Bruce J.; Alexandrov, Natalia

2009-01-01

The promise of the Next Generation Air Transportation System (NextGen) is strongly tied to the concept of trajectory-based operations in the national airspace system. Existing efforts to develop trajectory management concepts are largely focused on individual trajectories, optimized independently, then de-conflicted among each other, and individually re-optimized, as possible. The benefits in capacity, fuel, and time are valuable, though perhaps could be greater through alternative strategies. The concept of agent-based trajectories offers a strategy for automation of simultaneous multiple trajectory management. The anticipated result of the strategy would be dynamic management of multiple trajectories with interacting and interdependent outcomes that satisfy multiple, conflicting constraints. These constraints would include the business case for operators, the capacity case for the Air Navigation Service Provider (ANSP), and the environmental case for noise and emissions. The benefits in capacity, fuel, and time might be improved over those possible under individual trajectory management approaches. The proposed approach relies on computational agent-based modeling (ABM), combinatorial mathematics, as well as application of "traffic physics" concepts to the challenge, and modeling and simulation capabilities. The proposed strategy could support transforming air traffic control from managing individual aircraft behaviors to managing systemic behavior of air traffic in the NAS. A system built on the approach could provide the ability to know when regions of airspace approach being "full," that is, having non-viable local solution space for optimizing trajectories in advance.

Preparing health care organizations for successful case management programs.

PubMed

Bonvissuto, C A; Kastens, J M; Atwell, S R

1997-01-01

This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

Software Development With Application Generators: The Naval Aviation Logistics Command Management Information System Case

DTIC Science & Technology

1992-09-01

Aviation Logistics Command Management Information System (NALCOMIS) prototyping development effort, the critical success factors required to implement prototyping with application generators in other areas of DoD.

Obesity weight management and bariatric surgery case management programs: a review of literature.

PubMed

Echols, Jennie

2010-01-01

The proportion of Americans with clinically severe obesity has vast implications for the nation's healthcare system since this population have twice as many chronic medical conditions as people with normal weight. Through the use of review of literature, this article (a) describes the types of weight loss programs; (b) reviews the results from studies on effectiveness of bariatric surgery; and (c) identifies recommendations for obesity and bariatric surgery case management programs. Disease management companies appear to be concentrating on general weight loss strategies associated with wellness and other condition-specific disease management products, whereas larger national healthcare companies with at-risk and insurance products offer specific bariatric surgery management products. Case management programs within healthcare systems, health management organizations, and insurance companies are frequently faced with the management of individuals with morbid obesity and, increasingly, those who are requesting or have undergone bariatric surgery. Research shows that morbid obesity is a disease that remains generally unresponsive to diet and drug therapy but appears to respond well to bariatric surgery. Research findings suggest that surgical treatment is more effective than pharmacological treatment of weight loss and the control of some comorbidities associated with obesity. The number of Americans having weight loss surgery increased by 804% between 1998 and 2004, which appears to be a driver for the recent development of obesity disease management and bariatric surgery case management programs. Although the immaturity and lack of studies citing outcomes of obesity disease and case management programs limit the identification of best practices based on outcomes, emerging practices can be identified and recommendations for case management can be formulated. In addition to primary prevention and treatment programs for obesity, this article describes program activities in detail for the following key areas: (1) identification and engagement; (2) coaching, education, and support; (3) collaboration among treating providers; (4) preparation, management, and follow-up when bariatric surgery is indicated; (5) aggressive follow-up until personal goals are achieved; and (6) outcome measurement.

The integrated scheduling system: A case study in project management

NASA Technical Reports Server (NTRS)

Bishop, Peter C.; Learned, David B.; Yoes, Cissy A.

1989-01-01

A prototype project management system was developed for the Level III Project Office for the Space Station Freedom. The main goal was to establish a framework for the Space Station Project Office whereby Project and Office Managers can jointly establish and review scheduled milestones and activities. The objective was to assist office managers in communicating their objectives, milestones, schedules, and other project information more effectively and efficiently. Consideration of sophisticated project management systems was included, but each of the systems had limitations in meeting the stated objectives.

Revolutionizing Child Welfare with Outcomes Management

PubMed Central

Toche-Manley, Linda L.; Dietzen, Laura; Nankin, Jesse; Beigel, Astrid

2013-01-01

Outcomes management technology holds great promise for improving the quality of services provided to youth in the child welfare system. Advantages include better detection of behavioral health and trauma-related issues, early indicators of case progress or risk of failure and program- and system-level learning. Yet organizational barriers to implementation persist. Attention is spent in this paper on addressing these barriers so the use of outcomes management technology becomes a common practice. A model for predicting resiliency is presented, along with case examples demonstrating its potential use for treatment planning and monitoring progress. PMID:23460130

Recognition and management of idiopathic systemic capillary leak syndrome: an evidence-based review.

PubMed

Baloch, Noor Ul-Ain; Bikak, Marvi; Rehman, Abdul; Rahman, Omar

2018-05-01

Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases. Areas covered: The purpose of the present review is to provide an up-to-date, evidence-based review of our understanding of SCLS and its management in the light of currently available evidence. Idiopathic SCLS was first described in 1960 and, since then, more than 250 cases have been reported. A large number of cases have been reported over the past one decade, most likely due to improved recognition. In the acute care setting, most patients with SCLS are managed as per the Surviving Sepsis guidelines and receive aggressive volume resuscitation - which is not the optimal management strategy for such patients. There is a need to raise awareness amongst physicians and clinicians in order to improve recognition of this disorder and ensure its appropriate management.

The Challenge of Implementing an ERP System in a Small and Medium Enterprise--A Teaching Case of ERP Project Management

ERIC Educational Resources Information Center

Xu, Hongjiang; Rondeau, Patrick J.; Mahenthiran, Sakthi

2011-01-01

Enterprise Resource Planning (ERP) system implementation projects are notoriously risky. While large-scale ERP cases continue to be developed, relatively few new ERP cases have been published that further ERP implementation education in small to medium size firms. This case details the implementation of a new ERP system in a medium sized…

Management Information Systems for Higher Education. Studies in Institutional Management in Higher Education.

ERIC Educational Resources Information Center

Hussain, K. M., Ed.

Contents include an introduction to information systems (basic concepts and life-cycle); development of an information system (design, implementation, testing, and conversion); operation (evaluation and maintenance, quality control, and economics); and case studies of such systems at the New University of Lisbon, Bath University, Laval University…

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

LMS Transitioning to "Moodle": A Surprising Case of Successful, Emergent Change Management

ERIC Educational Resources Information Center

Lawler, Alan

2011-01-01

During 2009-10 the University of Ballarat implemented the open-source learning management system (LMS) "Moodle" alongside its existing legacy LMS, "Blackboard". While previous IT implementations have been troublesome at the university, notably the student information and finance management systems in 2008-09, the…

Technical Communications in OSS Content Management Systems: An Academic Institutional Case Study

ERIC Educational Resources Information Center

Cripps, Michael J.

2011-01-01

Single sourcing through a content management system (CMS) is altering technical communication practices in many organizations, including institutions of higher education. Open source software (OSS) solutions are currently among the most popular content management platforms adopted by colleges and universities in the United States and abroad. The…

A strategy to decide whether to move the last case of the day in an operating room to another empty operating room to decrease overtime labor costs.

PubMed

Dexter, F

2000-10-01

We examined how to program an operating room (OR) information system to assist the OR manager in deciding whether to move the last case of the day in one OR to another OR that is empty to decrease overtime labor costs. We first developed a statistical strategy to predict whether moving the case would decrease overtime labor costs for first shift nurses and anesthesia providers. The strategy was based on using historical case duration data stored in a surgical services information system. Second, we estimated the incremental overtime labor costs achieved if our strategy was used for moving cases versus movement of cases by an OR manager who knew in advance exactly how long each case would last. We found that if our strategy was used to decide whether to move cases, then depending on parameter values, only 2.0 to 4.3 more min of overtime would be required per case than if the OR manager had perfect retrospective knowledge of case durations. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays, can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved.

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.

The National Model for Minority Education and Training Demonstration (NMMETD) Case Study

EPA Pesticide Factsheets

NMMETD targeted minority and indigent residents by educating homeowners about the management of onsite systems and assisting residents with funding options for managing, installing, and disseminating information about onsite wastewater systems.

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.

Development of a Prototype Continuity of Care Record with Context-Specific Links to Meet the Information Needs of Case Managers for Persons Living with HIV

PubMed Central

Cimino, James J.; Bakken, Suzanne

2012-01-01

Objectives (1) To develop a prototype Continuity of Care Record (CCR) with context-specific links to electronic HIV information resources; and (2) to assess case managers’ perceptions regarding the usability of the prototype. Methods We integrated context-specific links to HIV case management information resources into a prototype CCR using the Infobutton Manager and Librarian Infobutton Tailoring Environment (LITE). Case managers (N=9) completed a think-aloud protocol and the Computer System Usability Questionnaire (CSUQ) to evaluate the usability of the prototype. Verbalizations from the think-aloud protocol were summarized using thematic analysis. CSUQ data were analyzed with descriptive statistics. Results Although participants expressed positive comments regarding the usability of the prototype, the think-aloud protocol also identified the need for improvement in resource labels and for additional resources. On a scale ranging from 1 (strongly agree) to 7 (strongly disagree), the average CSUQ overall satisfaction was 2.25 indicating that users (n=9) were generally satisfied with the system. Mean CSUQ factor scores were: System Usefulness (M=2.13), Information Quality (M=2.46), and Interface Quality (M=2.26). Conclusion Our novel application of the Infobutton Manager and LITE in the context of case management for persons living with HIV in community-based settings resulted in a prototype CCR with infobuttons that met the majority of case managers’ information needs and received relatively positive usability ratings. Findings from this study inform future integration of context-specific links into CCRs and electronic health records and support their use for meeting end-users information needs. PMID:22632821

Employing the FITT framework to explore HIV case managers' perceptions of two electronic clinical data (ECD) summary systems.

PubMed

Schnall, Rebecca; Smith, Ann B; Sikka, Manik; Gordon, Peter; Camhi, Eli; Kanter, Timothy; Bakken, Suzanne

2012-10-01

Case managers facilitate continuity of care for persons living with HIV (PLWH) by coordination of resources and referrals to social services and medical care. The complexity of HIV care and associated comorbidities drives the need for medical and psychosocial care coordination, which may be achieved through health information exchange (HIE) systems. However, the use of HIE has not been well studied in the context of HIV services. The purpose of this descriptive qualitative study is to explore factors influencing case managers' adoption of electronic clinical data (ECD) summaries as an HIE strategy in HIV care through application of the "fit between individuals, task and technology" (FITT) framework. Focus group methodology was used to gather perceptions from 48 participants who provided direct case management services for PLWH in New York City. Questions addressed current quality and efficiency challenges to HIE utilization in the context of case management of PLWH as well as barriers and enablers to use of an ECD summary. Analysis of the data was guided by the FITT framework. Major themes by interaction type were: (1) task-technology fit - resources, time and workflow; (2) individual-task fit - training and technical support; and 3) individual-technology fit - ECD summary functionality, technical difficulties and the need of a computer for each end-user. Our findings provide evidence for the applicability of the FITT framework to explore case managers' perceptions of factors influencing the adoption of ECD summary systems for HIV care prior to actual implementation. Assessment of fit among individual, task, and technology and addressing the concerns identified prior to implementation is critical to successful adoption of health information technology as a strategy to improve quality and efficiency in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

What ethics for case managers? Literature review and discussion.

PubMed

Corvol, Aline; Moutel, Grégoire; Somme, Dominique

2016-11-01

Little is known about case managers' ethical issues and professional values. This article presents an overview of ethical issues in case managers' current practice. Findings are examined in the light of nursing ethics, social work ethics and principle-based biomedical ethics. A systematic literature review was performed to identify and analyse empirical studies concerning ethical issues in case management programmes. It was completed by systematic content analysis of case managers' national codes of ethics. Only nine empirical studies were identified, eight of them from North America. The main dilemmas were how to balance system goals against the client's interest and client protection against autonomy. Professional codes of ethics shared important similarities, but offered different responses to these two dilemmas. We discuss the respective roles of professional and organizational ethics. Further lines of research are suggested. © The Author(s) 2015.

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...

Case managers for older persons with multi-morbidity and their everyday work – a focused ethnography

PubMed Central

2013-01-01

Background Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis. Results An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs. PMID:24279695

Renewable Electricity-to-Grid Integration | Energy Systems Integration

Science.gov Websites

distribution management system (ADMS) use cases at the ESIF's national, vendor-neutral ADMS test bed. Example use cases include: Integration of transmission-to-building operations for demand response

The challenges of municipal solid waste management systems provided by public-private partnerships in mature tourist destinations: The case of Mallorca.

PubMed

Arbulú, Italo; Lozano, Javier; Rey-Maquieira, Javier

2016-05-01

This article analyzes the influence of tourism on the municipal solid waste management (MSWM) system taking as reference the case study of Mallorca, an internationally renowned destination. The characteristics of tourism such as seasonality and land scarcity, set interesting challenges to public-private partnerships related to MSWM system. The analysis of Mallorca's experience shows that land endowment strongly influences the choice of treatment technologies in tourism destinations. Furthermore, tourism seasonality significantly affects management costs which should be considered on PPP contracts. Finally, the tariff system in this kind of environmental PPPs in tourist destinations still need to improve to promote waste minimization and recycling. Copyright © 2016 Elsevier Ltd. All rights reserved.

Systems Engineering Case Studies: Synopsis of the Learning Principles

DTIC Science & Technology

2010-05-17

Engineering Case Study HST refers to the Hubble Space Telescope Systems Engineering Case Study TBMCS refers to the Theater Battle Management Core System...going to orbit undetected in spite of substantial evidence that could have been used to prevent this occurrence. TBMCS /1 Requirements Definition...baseline was volatile up to system acceptance, which took place after TBMCS passed operational test and evaluation. TBMCS /2 System Architecture The

A case study : the Las Vegas Freeway and Arterial Management System : use of a systems manager contractor to procure ITS

DOT National Transportation Integrated Search

2000-03-01

Procurement of Intelligent Transportation System (ITS) projects using Federal-aid funds can present challenges that are not typically observed in traditional transportation projects. Many roadway improvement projects involve the two-step "Design-Bid-...

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.

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.

Retrospective evaluation of prehospital triage, presentation, interventions and outcome in paediatric drowning managed by a physician staffed helicopter emergency medical service.

PubMed

Garner, Alan A; Barker, Claire L; Weatherall, Andrew D

2015-11-06

Drowning patients may benefit from the advanced airway management capabilities that can be provided by physician staffed helicopter emergency medical services. The aim of this study is to describe paediatric drowning patients treated by such a service examining tasking systems, initial physiology at the incident scene, survival and neurological outcome. Retrospective analysis of paediatric drowning victims over a 5- year period. Case identification system, patient age, site of drowning, presence or absence of cardiac output, first Glasgow Coma Scale (GCS) score and interventions were collected from prehospital notes, and survival and neurological outcomes from hospital and rehabilitation notes. The P-HEMS direct case identification system operating in parallel with a central control system identified all severe drowning cases but 3 of 7 cases (43%) were missed when the central control system operated in isolation. All severe drowning cases (22) identified for P-HEMS response were intubated and transported directly to a paediatric specialist centre. Intubation required adjuvant anaesthesia in 10 (45%) cases. All children with GCS greater than eight on arrival of the P-HEMS survived neurologically intact. Seven of eight children with a GCS between four and seven survived without neurological impairment and all children with a GCS greater than three survived. Four of twelve asystolic children survived including one child who at 18 months post drowning is neurologically normal. All children who survived had return of spontaneous circulation prior to arrival in the emergency department. P-HEMS played a significant role in the management of severe paediatric drowning in this case series. Requirement for P-HEMS only interventions were high and all identified cases were transferred directly to a paediatric specialist centre. Discontinuation of the P-HEMS direct case identication system that operated during the majority of the study period resulted in deterioration in system performance with some paediatric drowning cases subsequently not identified for P-HEMS response being transported to adult hospitals.

Logistics Management: Cases Studies,

DTIC Science & Technology

LOGISTICS , * MANAGEMENT PLANNING AND CONTROL), DECISION MAKING, INVENTORY CONTROL, SPARE PARTS, AIR FORCE EQUIPMENT, NAVAL AIRCRAFT, MAINTENANCE, DEPLOYMENT, SCHEDULING, SYSTEMS ENGINEERING, TEXTBOOKS

The work of case managers as experienced by older persons (75+) with multi-morbidity - a focused ethnography.

PubMed

Hjelm, Markus; Holst, Göran; Willman, Ania; Bohman, Doris; Kristensson, Jimmie

2015-12-17

Complex health systems make it difficult for older persons (75+) with multi-morbidity to achieve continuity of care. Case management could be one way to address this difficulty. Currently, there is a need to extend the knowledge regarding case management as experienced by those utilising the services, namely older persons (75+) with multi-morbidity. The study aimed to explore older persons' (75+) with multi-morbidity experiences of case managers. The study design was qualitative and used a focused ethnographic approach. Data was collected through individual interviews with 13 older persons and by participant observations with accompanying field notes, all conducted in 2012-2013. The data revealed four themes illustrating the older persons' experiences of case managers: 1) Someone providing me with a trusting relationship; 2) Someone assisting me; 3) Someone who is on my side; and 4) Someone I do not need at present. This study illustrates the importance of establishing trusting relationships between older persons and their case managers in order to truly provide assistance. The older persons valued the case managers acting as informed but unbiased facilitators. The findings could be of help in the development of case management interventions better designed for older persons with multi-morbidity.

48 CFR 49.105-3 - Termination case file.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Termination case file. 49.105-3 Section 49.105-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.105-3 Termination case file. The TCO responsible...

48 CFR 49.105-3 - Termination case file.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Termination case file. 49.105-3 Section 49.105-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.105-3 Termination case file. The TCO responsible...

48 CFR 49.105-3 - Termination case file.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Termination case file. 49.105-3 Section 49.105-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.105-3 Termination case file. The TCO responsible...

48 CFR 49.105-3 - Termination case file.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Termination case file. 49.105-3 Section 49.105-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.105-3 Termination case file. The TCO responsible...

48 CFR 49.105-3 - Termination case file.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Termination case file. 49.105-3 Section 49.105-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TERMINATION OF CONTRACTS General Principles 49.105-3 Termination case file. The TCO responsible...

Introducing Managers to Expert Systems.

ERIC Educational Resources Information Center

Finlay, Paul N.; And Others

1991-01-01

Describes a short course to expose managers to expert systems, consisting of (1) introductory lecture; (2) supervised computer tutorial; (3) lecture and discussion about knowledge structuring and modeling; and (4) small group work on a case study using computers. (SK)

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.

Appellate Courts - Alaska Court System

Science.gov Websites

Court Cases Appellate Case Management System Oral Argument Supreme Court Calendar, Court of Appeals , which contains the Alaska cases excerpted from P.2d and P.3d. The Pacific Reporter or the Alaska the Alaska cases excerpted from P.2d and P.3d. The Pacific Reporter or the Alaska Reporter is

Managing In-House Development of a Campus-Wide Information System

ERIC Educational Resources Information Center

Shurville, Simon; Williams, John

2005-01-01

Purpose: To show how a combination of hard and soft project and change management methodologies guided successful in-house development of a campus-wide information system. Design/methodology/approach: A case study of the methodologies and management structures that guided the development is presented. Findings: Applying a combination of the…

41 CFR 105-64.201 - How do I get access to my records?

Code of Federal Regulations, 2014 CFR

2014-01-01

... my records? 105-64.201 Section 105-64.201 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION Regional Offices-General Services...? You may request access to your record in person or by writing to the system manager or, in the case of...

41 CFR 105-64.201 - How do I get access to my records?

Code of Federal Regulations, 2012 CFR

2012-01-01

... my records? 105-64.201 Section 105-64.201 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION Regional Offices-General Services...? You may request access to your record in person or by writing to the system manager or, in the case of...

41 CFR 105-64.201 - How do I get access to my records?

Code of Federal Regulations, 2013 CFR

2013-07-01

... my records? 105-64.201 Section 105-64.201 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION Regional Offices-General Services...? You may request access to your record in person or by writing to the system manager or, in the case of...

Longitudinal associations between case management and supportive services use among black and Latina HIV-positive women in New York City.

PubMed

Halkitis, Perry N; Kupprat, Sandra A; Mukherjee, Preetika Pandey

2010-01-01

The literature analyzing the relationship between case management and supportive service use longitudinally among African American and Latina HIV-positive women is limited. This retrospective analysis of participant case management, supportive service, and medical charts sought to examine both descriptive and relational data on use of case management and supportive services over a 2-year period from 2002 to 2005 and to analyze moderating person- level or institution-level factors. The analyzed case management, supportive service, and medical charts revealed that participants interacted with their case manager four times and received 3.6 supportive services per month. Transportation, primary healthcare/medical specialists, and support groups were the services most used, with rates ranging from 70% to 80%. Using hierarchical linear modeling (HLM), the unconditional growth models showed that case management and supportive service use patterns remained constant over the 24-month period. Additionally, the multivariate unconditional model suggests a significant positive relationship between case management and supportive services. No moderation was indicated in the association between case management and supportive service use by person-level (e.g., mental illness, substance use) and institution-level (i.e., service delivery model) factors. Participants use supportive and case management services in a similar manner based on individual need. This synergistic relationship suggests that increases in either may result in retaining women in care. Implications for service delivery point to the need for skills building training for case managers, outreach workers, or system navigators to assist with short-term goals of establishing rapport and maintaining the client relationship, as this may lead to HIV-positive women accessing services. Additionally, outreach and engagement strategies need to be developed for those who typically underuse these services.

[Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

PubMed

Kawanishi, Chiaki

2016-01-01

In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate medical course, or hospitals) on a campus comprising 8,700 people, in which our problem-solving approach was able to achieve a certain degree of success in a majority of cases. Amid the increasing prevalence of mental ill-health and signs of worsening mental health problems in all areas of society, I look forward to the establishment of occupational mental health systems that are suited to medical institutions.

A Management-Decision-Oriented View of Medical School Information System Requirements

ERIC Educational Resources Information Center

Kutina, Kenneth L.; Lee, Edgar

1973-01-01

At Case Western Reserve University an interdisciplinary management team has been formed of educators and management specialists to effectively organize, plan and control the medical school. (Editor/PG)

[Case management in long-term care--the task of individual related and family-oriented support for people in need of care and its realization through the reform of long-term care insurance].

PubMed

Klie, Thomas; Monzer, Michael

2008-04-01

The introduction of standardized Case Management structures to improve coordination and cooperation of all involved in care, such as cost units, service providers, voluntary organizations, families and the different occupational categories involved in nursing, is the main concern of the current reform of German long-term care insurance. In this article, demands on Case Management in care are enunciated and the basics found in expert talks, needed for efficient support of care, assembled. In doing so, the role and function of Case Management is differentiated, the different levels (case, organizational and system levels) distinguished and options and conditions needed to settle such an organization are introduced.

Thinking About Taking The Leap? Hear From Those Who Did So...and Survived A Case Study: NASA Stennis Space Center Electronic Records Management

NASA Technical Reports Server (NTRS)

Albasini, Colby V.

2008-01-01

Increased visibility into records management: a) Partnered with NARA to provide electronic records management and Emergency Response training; b) Mandate all civil servants and records personnel attend training.Improve Disaster Recovery: a) TechDoc considered a vital system; b) All electronic documentation and records managed by our system available offsite.

Computer versus paper system for recognition and management of sepsis in surgical intensive care.

PubMed

Croft, Chasen A; Moore, Frederick A; Efron, Philip A; Marker, Peggy S; Gabrielli, Andrea; Westhoff, Lynn S; Lottenberg, Lawrence; Jordan, Janeen; Klink, Victoria; Sailors, R Matthew; McKinley, Bruce A

2014-02-01

A system to provide surveillance, diagnosis, and protocolized management of surgical intensive care unit (SICU) sepsis was undertaken as a performance improvement project. A system for sepsis management was implemented for SICU patients using paper followed by a computerized system. The hypothesis was that the computerized system would be associated with improved process and outcomes. A system was designed to provide early recognition and guide patient-specific management of sepsis including (1) modified early warning signs-sepsis recognition score (MEWS-SRS; summative point score of ranges of vital signs, mental status, white blood cell count; after every 4 hours) by bedside nurse; (2) suspected site assessment (vascular access, lung, abdomen, urinary tract, soft tissue, other) at bedside by physician or extender; (3) sepsis management protocol (replicable, point-of-care decisions) at bedside by nurse, physician, and extender. The system was implemented first using paper and then a computerized system. Sepsis severity was defined using standard criteria. In January to May 2012, a paper system was used to manage 77 consecutive sepsis encounters (3.9 ± 0.5 cases per week) in 65 patients (77% male; age, 53 ± 2 years). In June to December 2012, a computerized system was used to manage 132 consecutive sepsis encounters (4.4 ± 0.4 cases per week) in 119 patients (63% male; age, 58 ± 2 years). MEWS-SRS elicited 683 site assessments, and 201 had sepsis diagnosis and protocol management. The predominant site of infection was abdomen (paper, 58%; computer, 53%). Recognition of early sepsis tended to occur more using the computerized system (paper, 23%; computer, 35%). Hospital mortality rate for surgical ICU sepsis (paper, 20%; computer, 14%) was less with the computerized system. A computerized sepsis management system improves care process and outcome. Early sepsis is recognized and managed with greater frequency compared with severe sepsis or septic shock. The system has a beneficial effect as a clinical standard of care for SICU patients. Therapeutic study, level III.

Health and safety management systems: liability or asset?

PubMed

Bennett, David

2002-01-01

Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace.

Confronting uncertainty in wildlife management: performance of grizzly bear management.

PubMed

Artelle, Kyle A; Anderson, Sean C; Cooper, Andrew B; Paquet, Paul C; Reynolds, John D; Darimont, Chris T

2013-01-01

Scientific management of wildlife requires confronting the complexities of natural and social systems. Uncertainty poses a central problem. Whereas the importance of considering uncertainty has been widely discussed, studies of the effects of unaddressed uncertainty on real management systems have been rare. We examined the effects of outcome uncertainty and components of biological uncertainty on hunt management performance, illustrated with grizzly bears (Ursus arctos horribilis) in British Columbia, Canada. We found that both forms of uncertainty can have serious impacts on management performance. Outcome uncertainty alone--discrepancy between expected and realized mortality levels--led to excess mortality in 19% of cases (population-years) examined. Accounting for uncertainty around estimated biological parameters (i.e., biological uncertainty) revealed that excess mortality might have occurred in up to 70% of cases. We offer a general method for identifying targets for exploited species that incorporates uncertainty and maintains the probability of exceeding mortality limits below specified thresholds. Setting targets in our focal system using this method at thresholds of 25% and 5% probability of overmortality would require average target mortality reductions of 47% and 81%, respectively. Application of our transparent and generalizable framework to this or other systems could improve management performance in the presence of uncertainty.

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...

Application of A Mobile Platform-based System for the Management of Fundus Diease in Outpatient Settings.

PubMed

Dend, Xun; Li, Hong-Yan; Yin, Hong; Liang, Jian-Hong; Chen, Yi; Li, Xiao-Xin; Zhao, Ming-Wei

2016-08-01

Objective To evaluate the application of a mobile platform-based system in the management of fundus disease in outpatient settings. Methods In the outpatient departments of fundus disease,premature babies requiring eye examination under general anesthesia and adults requiring intraocular surgery were enrolled as the subjects. According to the existing clinical practices,we developed a system that met the requirements of clinical practices and optimized the clinical management. Based on the FileMaker database,the tablet computers were used as the mobile platform and the system could also be run in iPad and PC terminals.Results Since 2013,the system recorded 7500 cases of special examinations. Since July 2015,4100 cases of intravitreal drug injection were also recored in the system. Multiple-point and real-time reservation pattern increased the efficiency and opimize the clinical management. All the clinical data were digitalized. Conclusion The mobile platform-based system can increase the efficacy of examination and other clinical processes and standardize data collection;thus,it is feasible for the clinical practices in outpatient departments of ophthalmology.

HEALTH CARE GUIDE TO POLLUTION PREVENTION IMPLEMENTATION THROUGH ENVIRONMENTAL MANAGEMENT SYSTEMS

EPA Science Inventory

The Health Care Guide to Pollution Prevention Implementation through Environmental Management Systems provides example EMS procedures and forms used in four ISO 14001 EMS certified hospitals. The latest revisions include more EMS hospital case studies, more compliance resources, ...

Formal Foundations for Hierarchical Safety Cases

NASA Technical Reports Server (NTRS)

Denney, Ewen; Pai, Ganesh; Whiteside, Iain

2015-01-01

Safety cases are increasingly being required in many safety-critical domains to assure, using structured argumentation and evidence, that a system is acceptably safe. However, comprehensive system-wide safety arguments present appreciable challenges to develop, understand, evaluate, and manage, partly due to the volume of information that they aggregate, such as the results of hazard analysis, requirements analysis, testing, formal verification, and other engineering activities. Previously, we have proposed hierarchical safety cases, hicases, to aid the comprehension of safety case argument structures. In this paper, we build on a formal notion of safety case to formalise the use of hierarchy as a structuring technique, and show that hicases satisfy several desirable properties. Our aim is to provide a formal, theoretical foundation for safety cases. In particular, we believe that tools for high assurance systems should be granted similar assurance to the systems to which they are applied. To this end, we formally specify and prove the correctness of key operations for constructing and managing hicases, which gives the specification for implementing hicases in AdvoCATE, our toolset for safety case automation. We motivate and explain the theory with the help of a simple running example, extracted from a real safety case and developed using AdvoCATE.

Measuring benefits of protected area management: trends across realms and research gaps for freshwater systems.

PubMed

Adams, Vanessa M; Setterfield, Samantha A; Douglas, Michael M; Kennard, Mark J; Ferdinands, Keith

2015-11-05

Protected areas remain a cornerstone for global conservation. However, their effectiveness at halting biodiversity decline is not fully understood. Studies of protected area benefits have largely focused on measuring their impact on halting deforestation and have neglected to measure the impacts of protected areas on other threats. Evaluations that measure the impact of protected area management require more complex evaluation designs and datasets. This is the case across realms (terrestrial, freshwater, marine), but measuring the impact of protected area management in freshwater systems may be even more difficult owing to the high level of connectivity and potential for threat propagation within systems (e.g. downstream flow of pollution). We review the potential barriers to conducting impact evaluation for protected area management in freshwater systems. We contrast the barriers identified for freshwater systems to terrestrial systems and discuss potential measurable outcomes and confounders associated with protected area management across the two realms. We identify key research gaps in conducting impact evaluation in freshwater systems that relate to three of their major characteristics: variability, connectivity and time lags in outcomes. Lastly, we use Kakadu National Park world heritage area, the largest national park in Australia, as a case study to illustrate the challenges of measuring impacts of protected area management programmes for environmental outcomes in freshwater systems. © 2015 The Author(s).

Measuring benefits of protected area management: trends across realms and research gaps for freshwater systems

PubMed Central

Adams, Vanessa M.; Setterfield, Samantha A.; Douglas, Michael M.; Kennard, Mark J.; Ferdinands, Keith

2015-01-01

Protected areas remain a cornerstone for global conservation. However, their effectiveness at halting biodiversity decline is not fully understood. Studies of protected area benefits have largely focused on measuring their impact on halting deforestation and have neglected to measure the impacts of protected areas on other threats. Evaluations that measure the impact of protected area management require more complex evaluation designs and datasets. This is the case across realms (terrestrial, freshwater, marine), but measuring the impact of protected area management in freshwater systems may be even more difficult owing to the high level of connectivity and potential for threat propagation within systems (e.g. downstream flow of pollution). We review the potential barriers to conducting impact evaluation for protected area management in freshwater systems. We contrast the barriers identified for freshwater systems to terrestrial systems and discuss potential measurable outcomes and confounders associated with protected area management across the two realms. We identify key research gaps in conducting impact evaluation in freshwater systems that relate to three of their major characteristics: variability, connectivity and time lags in outcomes. Lastly, we use Kakadu National Park world heritage area, the largest national park in Australia, as a case study to illustrate the challenges of measuring impacts of protected area management programmes for environmental outcomes in freshwater systems. PMID:26460127

Project Risk Management in Educational Organizations: A Case from the Czech Republic

ERIC Educational Resources Information Center

Eger, Ludvík; Egerová, Dana

2016-01-01

The past 20 years have been a period of reforms for school systems in Visegrad countries. However, the successful implementation of educational reforms requires effective leaders and managers and, to produce effective leaders, changes in the system of leadership and management programmes need to be adopted. From 2004, the Czech Republic saw a…

Design and Development of an Identity Management System: The Minnesota State College-Southeast Technical Case Study

ERIC Educational Resources Information Center

Elhindi, Mohamed A.

2010-01-01

Historically, managing access to information systems (ISs) required direct interaction with a limited number of users. Increasingly, managing access involves handling an increased numbers of internal and external students, faculty, and staff as well as partners such as workforce development centers, the U.S. Department of Education, and the…

Information Technology Management Strategies to Implement Knowledge Management Systems

ERIC Educational Resources Information Center

McGee, Mary Jane Christy

2017-01-01

More than 38% of the U.S. public workforce will likely retire by 2030, which may result in a labor shortage. Business leaders may adopt strategies to mitigate knowledge loss within their organizations by capturing knowledge in a knowledge management system (KMS). The purpose of this single case study was to explore strategies that information…

Analysis of Risks in a Learning Management System: A Case Study in the Spanish National University of Distance Education (UNED)

ERIC Educational Resources Information Center

Vázquez-Cano, Esteban; Sevillano García, Ma. Luisa

2015-01-01

This article presents a research that examines the university students' risk perception when using a Learning Management System called "aLF" and implemented by the Spanish National University of Distance Education (UNED) for the development of its university distance studies. The development of comprehensive Learning Management Systems…

Consumers' and case managers' perceptions of mental health and community support service needs.

PubMed

Crane-Ross, D; Roth, D; Lauber, B G

2000-04-01

Consumers with serious and persistent mental illness (N = 385) and their case managers rated the amount of help needed and the amount of help received with mental health and community support services. Consumers also identified their primary source of help with each type of need. Results highlighted areas of agreement and disagreement between consumers' and case managers' perceptions. Consumers' reports revealed a strong reliance on sources of support outside the mental health system (e.g., family and friends) for many community support service needs, interpersonal needs, and crisis-related needs. In general, correlations between consumers' and case managers' ratings of help needed and help received were low. Consumers perceived the majority of their needs to be unmet; case managers perceived the majority of consumer needs to be overly met. Discussion focuses on the importance of increasing consensus between consumers and case managers regarding needs by including consumers in treatment planning and providing them with more information about available services. It is recommended that researchers and evaluators examine perceptions of help needed, help received, and sources of help when assessing service needs.

The revised WHO dengue case classification: does the system need to be modified?

PubMed

Hadinegoro, Sri Rezeki S

2012-05-01

There has been considerable debate regarding the value of both the 1997 and 2009 World Health Organization (WHO) dengue case classification criteria for its diagnosis and management. Differentiation between classic dengue fever (DF) and dengue haemorrhagic fever (DHF) or severe dengue is a key aspect of dengue case classification. The geographic expansion of dengue and its increased incidence in older age groups have contributed to the limited applicability of the 1997 case definitions. Clinical experience of dengue suggests that the illness presents as a spectrum of disease instead of distinct phases. However, despite the rigid grouping of dengue into DF, DHF and dengue shock syndrome (DSS), overlap between the different manifestations has often been observed, which has affected clinical management and triage of patients. The findings of the DENCO study evaluating the 1997 case definitions formed the basis of the revised 2009 WHO case definitions, which classified the illness into dengue with and without warning signs and severe dengue. Although the revised scheme is more sensitive to the diagnosis of severe dengue, and beneficial to triage and case management, there remain issues with its applicability. It is considered by many to be too broad, requiring more specific definition of warning signs. Quantitative research into the predictive value of these warning signs on patient outcomes and the cost-effectiveness of the new classification system is required to ascertain whether the new classification system requires further modification, or whether elements of both classification systems can be combined.

Case Studies of Ecological Integrative Information Systems: The Luquillo and Sevilleta Information Management Systems

NASA Astrophysics Data System (ADS)

San Gil, Inigo; White, Marshall; Melendez, Eda; Vanderbilt, Kristin

The thirty-year-old United States Long Term Ecological Research Network has developed extensive metadata to document their scientific data. Standard and interoperable metadata is a core component of the data-driven analytical solutions developed by this research network Content management systems offer an affordable solution for rapid deployment of metadata centered information management systems. We developed a customized integrative metadata management system based on the Drupal content management system technology. Building on knowledge and experience with the Sevilleta and Luquillo Long Term Ecological Research sites, we successfully deployed the first two medium-scale customized prototypes. In this paper, we describe the vision behind our Drupal based information management instances, and list the features offered through these Drupal based systems. We also outline the plans to expand the information services offered through these metadata centered management systems. We will conclude with the growing list of participants deploying similar instances.

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...

Case Study -- Improving Management Performance

ERIC Educational Resources Information Center

Stait, Norman

1970-01-01

The Knitting, Lace, and Net Industry Training Board in Great Britain is beginning to work with management training, using three firms for experimental pilot projects. The Board plans to introduce this management system throughout the industry. (MF)

Workflow technology: the new frontier. How to overcome the barriers and join the future.

PubMed

Shefter, Susan M

2006-01-01

Hospitals are catching up to the business world in the introduction of technology systems that support professional practice and workflow. The field of case management is highly complex and interrelates with diverse groups in diverse locations. The last few years have seen the introduction of Workflow Technology Tools, which can improve the quality and efficiency of discharge planning by the case manager. Despite the availability of these wonderful new programs, many case managers are hesitant to adopt the new technology and workflow. For a myriad of reasons, a computer-based workflow system can seem like a brick wall. This article discusses, from a practitioner's point of view, how professionals can gain confidence and skill to get around the brick wall and join the future.

Intelligent Transportation Systems in Work Zones - A Case Study: Work Zone Travel Time System. Reducing Congestion with the Use of a Traffic Management Contract Incentive during the Reconstruction of Arizona State Route 68

DOT National Transportation Integrated Search

2004-10-01

This case study is one in a series of documents that examines the use of Intelligent Transportation Systems (ITS) in work zones. This case study presents information gathered through interviews with key personnel on the Arizona State Route (SR) 68 pr...

Cost analysis of hospital material management systems.

PubMed

Egbelu, P J; Harmonosky, C M; Ventura, J A; O'Brien, W E; Sommer, H J

1998-01-01

Integrated healthcare material management begins with manufactures of medical/surgical supplies, uses distributors and ends at the point of use at hospitals. Recent material management philosophies in the healthcare industry, such as just-in-time and stockless systems, are yet to be fully evaluated. In order to evaluate the cost effectiveness of each type of material management technique, a cost model for hospital materials management has been designed. Several case scenarios are analyzed and results are reported.

Intermediate Outcomes, Strategies, and Challenges of Eight Healthy Start Projects

PubMed Central

Walker, Deborah Klein; Hargreaves, Margaret; Rosenbach, Margo

2008-01-01

Site visits were conducted for the evaluation of the national Healthy Start program to gain an understanding of how projects design and implement five service components (outreach, case management, health education, depression screening and interconceptional care) and four system components (consortium, coordination/collaboration, local health system action plan and sustainability) as well as program staff’s perceptions of these components’ influence on intermediate outcomes. Interviews with project directors, case managers, local evaluators, clinicians, consortium members, outreach/lay workers and other stakeholders were conducted during 3-day in-depth site visits with eight Healthy Start grantees. Grantees reported that both services and systems components were related to self-reported service achievements (e.g. earlier entry into prenatal care) and systems achievements (e.g. consumer involvement). Outreach, case management, and health education were perceived as the service components that contributed most to their achievements while consortia was perceived as the most influential systems component in reaching their goals. Furthermore, cultural competence and community voice were overarching project components that addressed racial/ethnic disparities. Finally, there was great variability across sites regarding the challenges they faced, with poor service availability and limited funding the two most frequently reported. Service provision and systems development are both critical for successful Healthy Start projects to achieve intermediate program outcomes. Unique contextual and community issues influence Healthy Start project design, implementation and reported accomplishments. All eight projects implement the required program components yet outreach, case management, and health education are cited most frequently for contributing to their perceived achievements. PMID:19011959

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.

Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

PubMed Central

Giménez-Campos, María Soledad; Villar-López, Julia; Faubel-Cava, Raquel; Donat-Castelló, Lucas; Valdivieso-Martínez, Bernardo; Soriano-Melchor, Elisa; Bahamontes-Mulió, Amparo; García-Gómez, Juan M.

2017-01-01

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity. PMID:28970745

Using systems thinking in patient safety: a case study on medicines management.

PubMed

Brimble, Mandy; Jones, Aled

2017-06-29

Systems thinking is used as a way of understanding behaviours and actions in complex healthcare organisations. An important premise of the concept is that every action in a system causes a reaction elsewhere in that system. These reactions can lead to unintended consequences, sometimes long after the original action, and so are not always attributed to them. This article applies systems thinking to a medicines management case study, to highlight how quality-improvement practitioners can use the approach to underpin planning and implementation of patient-safety initiatives. The case study is specific to transcribing in children's hospices, but the strategies can be applied to other areas. The article explains that, while root cause analysis tools are useful for identifying the cause of, and possible solutions to, problems, they need to be considered carefully in terms of unintended consequences, and how the system into which the solution is implemented can be affected by the change. Analysis of problems using a systems-thinking approach can help practitioners to develop robust and well informed business cases to present to decision makers.

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.

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.

CASE/A - COMPUTER AIDED SYSTEM ENGINEERING AND ANALYSIS, ECLSS/ATCS SERIES

NASA Technical Reports Server (NTRS)

Bacskay, A.

1994-01-01

Design and analysis of Environmental Control and Life Support Systems (ECLSS) and Active Thermal Control Systems (ATCS) for spacecraft missions requires powerful software that is flexible and responsive to the demands of particular projects. CASE/A is an interactive trade study and analysis tool designed to increase productivity during all phases of systems engineering. The graphics-based command-driven package provides a user-friendly environment in which the engineer can analyze the performance and interface characteristics of an ECLS/ATC system. The package is useful during all phases of a spacecraft design program, from initial conceptual design trade studies to the actual flight, including pre-flight prediction and in-flight anomaly analysis. The CASE/A program consists of three fundamental parts: 1) the schematic management system, 2) the database management system, and 3) the simulation control and execution system. The schematic management system allows the user to graphically construct a system model by arranging icons representing system components and connecting the components with physical fluid streams. Version 4.1 contains 51 fully coded and documented default component routines. New components can be added by the user through the "blackbox" component option. The database management system supports the storage and manipulation of component data, output data, and solution control data through interactive edit screens. The simulation control and execution system initiates and controls the iterative solution process, displaying time status and any necessary diagnostic messages. In addition to these primary functions, the program provides three other important functional areas: 1) model output management, 2) system utility commands, and 3) user operations logic capacity. The model output management system provides tabular and graphical output capability. Complete fluid constituent mass fraction and properties data (mass flow, pressure, temperature, specific heat, density, and viscosity) is generated at user-selected output intervals and stored for reference. The Integrated Plot Utility (IPU) provides plotting capability for all data output. System utility commands are provided to enable the user to operate more efficiently in the CASE/A environment. The user is able to customize a simulation through optional operations FORTRAN logic. This user-developed code is compiled and linked with a CASE/A model and enables the user to control and timeline component operating parameters during various phases of the iterative solution process. CASE/A provides for transient tracking of the flow stream constituents and determination of their thermodynamic state throughout an ECLSS/ATCS simulation, performing heat transfer, chemical reaction, mass/energy balance, and system pressure drop analysis based on user-specified operating conditions. The program tracks each constituent through all combination and decomposition states while maintaining a mass and energy balance on the overall system. This allows rapid assessment of ECLSS designs, the impact of alternate technologies, and impacts due to changes in metabolic forcing functions, consumables usage, and system control considerations. CASE/A is written in FORTRAN 77 for the DEC VAX/VMS computer series, and requires 12Mb of disk storage and a minimum paging file quota of 20,000 pages. The program operates on the Tektronix 4014 graphics standard and VT100 text standard. The program requires a Tektronix 4014 or later graphics terminal, third party composite graphics/text terminal, or personal computer loaded with appropriate VT100/TEK 4014 emulator software. The use of composite terminals or personal computers with popular emulation software is recommended for enhanced CASE/A operations and general ease of use. The program is available on an unlabeled 9-track 6250 BPI DEC VAX BACKUP format magnetic tape. CASE/A development began in 1985 under contract to NASA/Marshall Space Flight Center. The latest version (4.1) was released in 1990. Tektronix and TEK 4014 are trademarks of Tektronix, Inc. VT100 is a trademark of Digital Equipment Corporation.

48 CFR 750.7106 - Standards for deciding cases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Standards for deciding cases. 750.7106 Section 750.7106 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS Extraordinary Contractual Actions To Protect...

Assessing Organization Culture Readiness for Knowledge Management Implementation: The Case of Aeronautical Systems Center Directorate of Contracting

DTIC Science & Technology

2003-03-01

effective change management techniques (Gibson, Ivancevich , & Donnelly, 2001). Based on case study 15 research, KM projects require more...Englewood Cliffs, NJ: Prentice Hall. 1986. Gibson, J.L., J.M. Ivancevich , and J.H. Donnelly Jr. Organizations. (10th ed.). Boston: Irwin McGraw-Hill

Developing case managers for chronically ill children: Florida's registered nurse specialist program.

PubMed

Urbano, M T; vonWindeguth, B; Siderits, P; Parker, J; Studenic-Lewis, C

1991-01-01

This article describes the Florida Health and Rehabilitative Services/Children's Medical Services Nurse Specialist Program. This program is a statewide training and service delivery system designed to prepare selected nurses to provide comprehensive, family-centered case management services to children with special health care needs, within the home and community settings.

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2012 CFR

2012-10-01

... if the State has chosen to pay such incentives; (7) Maintaining accounts receivable on all amounts... interfacing with State financial management and expenditure information; (9) Accepting electronic case...) Providing management information on all IV-D cases under the State plan from initial referral or application...

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2014 CFR

2014-10-01

... if the State has chosen to pay such incentives; (7) Maintaining accounts receivable on all amounts... interfacing with State financial management and expenditure information; (9) Accepting electronic case...) Providing management information on all IV-D cases under the State plan from initial referral or application...

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2013 CFR

2013-10-01

... if the State has chosen to pay such incentives; (7) Maintaining accounts receivable on all amounts... interfacing with State financial management and expenditure information; (9) Accepting electronic case...) Providing management information on all IV-D cases under the State plan from initial referral or application...

Fidget Spinner Ingestions in Children-A Problem that Spun Out of Nowhere.

PubMed

Reeves, Patrick T; Nylund, Cade M; Noel, James M; Jones, David S; Chumpitazi, Bruno P; Milczuk, Henry A; Noel, R Adam

2018-06-01

The Consumer Product Safety Risk Management System's injury and potential injury database records 13 cases of fidget spinner ingestion since 2016. In addition to a database query, we report 3 additional cases of fidget spinner ingestion to describe patient presentations and subsequent management strategies. Published by Elsevier Inc.

77 FR 10525 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

...: Board of Governors of the Federal Reserve System. SUMMARY: On June 15, 1984, the Office of Management... Management and Budget, New Executive Office Building, Room 10235 725 17th Street NW., Washington, DC 20503 or...)). Such exemptions would be made on a case-by-case basis. Abstract: The data collected through the current...

Case Study on Project Risk Management Planning Based on Soft System Methodology

NASA Astrophysics Data System (ADS)

Lifang, Xie; Jun, Li

This paper analyzed the soft system characters of construction projects and the applicability on using Soft System Methodology (SSM) for risk analysis after a brief review of SSM. Taking a hydropower project as an example, it constructed the general frame of project risk management planning (PRMP) and established the Risk Management Planning (RMP) system from the perspective of the interests of co-ordination. This paper provided the ideas and methods for construction RMP under the win-win situation through the practice of SSM.

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

Enhancing communication by using the Coordinated Care Classification System.

PubMed

O'Neal, P V; Kozeny, D K; Garland, P P; Gaunt, S M; Gordon, S C

1998-07-01

Because of the changes in our healthcare system, some clinical nurse specialists (CNSs) are having to expand their traditional roles of clinician, educator, consultant, leader, and researcher to include case management activities. The CNSs at Promina Gwinnett Health System in Lawrenceville, Georgia, have combined CNS and case manager activities and have adopted the title "CNS/Outcomes Coordinator." The CNS/Outcomes Coordinator is responsible for coordinating patient care, promoting team collaboration, and facilitating communication. To inform the healthcare team of the CNS/Outcomes Coordinator's patient responsibilities, the CNS/Outcomes Coordinators developed a Coordinated Care Classification System. This article describes how coordinating patient care, promoting team collaboration, and facilitating communication can be enhanced by the use of a classification system.

DEVELOPING AN INTEGRATED MANAGEMENT SYSTEM FOR URBAN AND ENERGY PLANNING TOWARDS A LOW-CARBON CITY

NASA Astrophysics Data System (ADS)

Maeda, Hideto; Nakakubo, Toyohiko; Tokai, Akihiro

In this study, we developed an integrated management model that supports local government to make a promising energy saving measure on a block-scale combined with urban planning. We applied the model to Osaka city and estimated CO2 emissions from the residential and commercial buildings to 2050. The urban renewal cases selected in this study included advanced multipole accumulation case, normal multipole accumulation case, and actual trend continuation case. The energy saving options introduced in each case included all-electric HP system, micro grid system, and we also set the option where the greater CO2 reduction one is selected in each block. The results showed that CO2 emission in 2050 would be reduced by 54.8-57.6% relative to the actual condition by introducing the new energy system in all cases. In addition, the amount of CO2 reduction in actual trend continuation case was highest. The major factor was that the effect of CO2 emission reductions by installing the solar power generation panel was higher than the effect by utilizing heated water mutually on the high-density blocks in terms of total urban buildings' energy consumption.

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.

Enlightenment from ancient Chinese urban and rural stormwater management practices.

PubMed

Wu, Che; Qiao, Mengxi; Wang, Sisi

2013-01-01

Hundreds of years ago, the ancient Chinese implemented several outstanding projects to cope with the changing climate and violent floods. Some of these projects are still in use today. These projects evolved from the experience and knowledge accumulated through the long coexistence of people with nature. The concepts behind these ancient stormwater management practices, such as low-impact development and sustainable drainage systems, are similar to the technology applied in modern stormwater management. This paper presents the cases of the Hani Terrace in Yunnan and the Fushou drainage system of Ganzhou in Jiangxi. The ancient Chinese knowledge behind these cases is seen in the design concepts and the features of these projects. These features help us to understand better their applications in the contemporary environment. In today's more complex environment, integrating traditional and advanced philosophy with modern technologies is extremely useful in building urban and rural stormwater management systems in China.

Is It Ethical for Patents to Be Issued for the Computer Algorithms that Affect Course Management Systems for Distance Learning?

ERIC Educational Resources Information Center

Moreau, Nancy

2008-01-01

This article discusses the impact of patents for computer algorithms in course management systems. Referring to historical documents and court cases, the positive and negative aspects of software patents are presented. The key argument is the accessibility to algorithms comprising a course management software program such as Blackboard. The…

Clicking to Learn: A Case Study of Embedding Radio-Frequency Based Clickers in an Introductory Management Information Systems Course

ERIC Educational Resources Information Center

Nelson, Matthew L.; Hauck, Roslin V.

2008-01-01

The challenges associated with teaching a core introductory management information systems (MIS) course are well known (large class sizes serving a majority of non-MIS majors, sustaining student interests, encouraging class participation, etc.). This study offers a mechanism towards managing these challenges through the use of a simple and…

Metadata registry and management system based on ISO 11179 for cancer clinical trials information system

PubMed Central

Park, Yu Rang; Kim*, Ju Han

2006-01-01

Standardized management of data elements (DEs) for Case Report Form (CRF) is crucial in Clinical Trials Information System (CTIS). Traditional CTISs utilize organization-specific definitions and storage methods for Des and CRFs. We developed metadata-based DE management system for clinical trials, Clinical and Histopathological Metadata Registry (CHMR), using international standard for metadata registry (ISO 11179) for the management of cancer clinical trials information. CHMR was evaluated in cancer clinical trials with 1625 DEs extracted from the College of American Pathologists Cancer Protocols for 20 major cancers. PMID:17238675

[Regional health systems management: a case study in Rio Grande do Sul, Brazil].

PubMed

Lima, Juliano de Carvalho; Rivera, Francisco Javier Uribe

2006-10-01

This article analyzes the management system in a health district in the State of Rio Grande do Sul, Brazil, through qualitative analysis, using a case study as the methodology and macro-organization theory as the analytical framework. For the current management system in the 6th Health Region, a clear mission statement and wide acceptance by health workers are facilitating factors for the current organizational practices within the health system. Nevertheless, the way health coordinators are currently prioritizing their time has diverted necessary resources from critical problems towards more remedial issues. The 6th Health Region has encouraged social control (or public oversight) in order to improve accountability. However, there is room for improvement in quality assurance management, since there were no well-defined goals, objectives, or accountability. Decentralized consultancy provided to the municipalities and the funding model itself have both promoted decentralization and autonomy, although the strategy requires better regional integration and greater commitment in managerial practices.

Developing a database management system to support birth defects surveillance in Florida.

PubMed

Salemi, Jason L; Hauser, Kimberlea W; Tanner, Jean Paul; Sampat, Diana; Correia, Jane A; Watkins, Sharon M; Kirby, Russell S

2010-01-01

The value of any public health surveillance program is derived from the ways in which data are managed and used to improve the public's health. Although birth defects surveillance programs vary in their case volume, budgets, staff, and objectives, the capacity to operate efficiently and maximize resources remains critical to long-term survival. The development of a fully-integrated relational database management system (DBMS) can enrich a surveillance program's data and improve efficiency. To build upon the Florida Birth Defects Registry--a statewide registry relying solely on linkage of administrative datasets and unconfirmed diagnosis codes-the Florida Department of Health provided funding to the University of South Florida to develop and pilot an enhanced surveillance system in targeted areas with a more comprehensive approach to case identification and diagnosis confirmation. To manage operational and administrative complexities, a DBMS was developed, capable of managing transmission of project data from multiple sources, tracking abstractor time during record reviews, offering tools for defect coding and case classification, and providing reports to DBMS users. Since its inception, the DBMS has been used as part of our surveillance projects to guide the receipt of over 200 case lists and review of 12,924 fetuses and infants (with associated maternal records) suspected of having selected birth defects in over 90 birthing and transfer facilities in Florida. The DBMS has provided both anticipated and unexpected benefits. Automation of the processes for managing incoming case lists has reduced clerical workload considerably, while improving accuracy of working lists for field abstraction. Data quality has improved through more effective use of internal edits and comparisons with values for other data elements, while simultaneously increasing abstractor efficiency in completion of case abstraction. We anticipate continual enhancement to the DBMS in the future. While we have focused on enhancing the capacity of our DBMS for birth defects surveillance, many of the tools and approaches we have developed translate directly to other public health and clinical registries.

Heat transfer and thermal management of electric vehicle batteries with phase change materials

NASA Astrophysics Data System (ADS)

Ramandi, M. Y.; Dincer, I.; Naterer, G. F.

2011-07-01

This paper examines a passive thermal management system for electric vehicle batteries, consisting of encapsulated phase change material (PCM) which melts during a process to absorb the heat generated by a battery. A new configuration for the thermal management system, using double series PCM shells, is analyzed with finite volume simulations. A combination of computational fluid dynamics (CFD) and second law analysis is used to evaluate and compare the new system against the single PCM shells. Using a finite volume method, heat transfer in the battery pack is examined and the results are used to analyse the exergy losses. The simulations provide design guidelines for the thermal management system to minimize the size and cost of the system. The thermal conductivity and melting temperature are studied as two important parameters in the configuration of the shells. Heat transfer from the surroundings to the PCM shell in a non-insulated case is found to be infeasible. For a single PCM system, the exergy efficiency is below 50%. For the second case for other combinations, the exergy efficiencies ranged from 30-40%. The second shell content did not have significant influence on the exergy efficiencies. The double PCM shell system showed higher exergy efficiencies than the single PCM shell system (except a case for type PCM-1). With respect to the reference environment, it is found that in all cases the exergy efficiencies decreased, when the dead-state temperatures rises, and the destroyed exergy content increases gradually. For the double shell systems for all dead-state temperatures, the efficiencies were very similar. Except for a dead-state temperature of 302 K, with the other temperatures, the exergy efficiencies for different combinations are well over 50%. The range of exergy efficiencies vary widely between 15 and 85% for a single shell system, and between 30-80% for double shell systems.

Identification of Management Information System (MIS) Strategies Barriers in Higher Education Institutions through Multi-Criteria Decision Making (MCDM) Approach: Case Study of Ferdowsi University of Mashhad

ERIC Educational Resources Information Center

Hosseini, Mirza Hasan; Karimzadegan, Davood; Sazvar, Azam

2012-01-01

Each organization or company, regardless to its restrictions, purposes, and type of the activity, in order to fulfill and manage the duties is in need of various data and pieces of information. The aforesaid cases are generated by managers and employees and used by all the staffs. The manifest issue of current days is that organizations and…

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.

A reflective lens: applying critical systems thinking and visual methods to ecohealth research.

PubMed

Cleland, Deborah; Wyborn, Carina

2010-12-01

Critical systems methodology has been advocated as an effective and ethical way to engage with the uncertainty and conflicting values common to ecohealth problems. We use two contrasting case studies, coral reef management in the Philippines and national park management in Australia, to illustrate the value of critical systems approaches in exploring how people respond to environmental threats to their physical and spiritual well-being. In both cases, we used visual methods--participatory modeling and rich picturing, respectively. The critical systems methodology, with its emphasis on reflection, guided an appraisal of the research process. A discussion of these two case studies suggests that visual methods can be usefully applied within a critical systems framework to offer new insights into ecohealth issues across a diverse range of socio-political contexts. With this article, we hope to open up a conversation with other practitioners to expand the use of visual methods in integrated research.

Main Principles of the Perspective System of SNF Management in Russia - 13333

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

Baryshnikov, Mikhail

For the last several years the System of the Spent Nuclear Fuel management in Russia was seriously changed. The paper describes the main principles of the changes and the bases of the Perspective System of SNF Management in Russia. Among such the bases there are the theses with the interesting names like 'total knowledge', 'pollutant pays' and 'pay and forget'. There is also a brief description of the modern Russian SNF Management Infrastructure. And an outline of the whole System. The System which is - in case of Russia - is quite necessary to adjust SNF accumulation and to utilizemore » the nuclear heritage. (authors)« less

American Guild of Musical Artists: A Case for System Development, Data Modeling, and Analytics

ERIC Educational Resources Information Center

Harris, Ranida; Wedel, Thomas

2017-01-01

This article presents a case scenario that may be used in system analysis and design, database management, and business analytics classes. The case document includes realistic, detailed information on the operations at the American Guild of Musical Artists (AGMA). Examples of assignments for each class and suggested reading are presented. In each…

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.

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

University ERP Implementation in Germany: Qualitative Exploratory Case Study of Administrative Staff Experiences

ERIC Educational Resources Information Center

Thelen, Anja

2015-01-01

Enterprise Resource Planning (ERP) implementations are expensive, time-consuming, and often do not lead to the expected outcome of integrated IT systems. Many German universities are implementing ERP systems as Campus Management Systems (CMS) and a solution to any problem, need, or requirement the organization has. This exploratory case study…

Devolving HRM and HRD to Line managers: The Case of Hilton International's UK Hotels

ERIC Educational Resources Information Center

Maxwell, Gillian; Watson, Sandra

2004-01-01

This paper explores line manager responsibility for human resource management (HRM) and human resource development (HRD) in an international hotel organisation. The results identify a strong support system for line managers in relation to training and good relations with HR specialists. However, less evident is senior management support coupled…

77 FR 23543 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-19

...As required by the Privacy Act of 1974 (5 U.S.C. 552a(e)(4), (11)), notice is hereby given that the Department of Veterans Affairs (VA) is amending the system of records entitled ``Veterans Tracking Application (VTA).'' VA is amending the system of records by revising the System Name to ``Veterans Tracking Application (VTA)/Federal Case Management Tool (FCMT)'' and System Location to include the ``Federal Case Management Tool (FCMT).'' The VTA data will also be accessed using the FCMT. Further, the Routine Uses have been updated in conjunction with VA's Virtual Lifetime Electronic Record (VLER), to reflect the nature of electronic coordination that will fully support the users of this application. VA is republishing the system notice in its entirety.

Quality of Inpatient Pediatric Case Management for Four Leading Causes of Child Mortality at Six Government-Run Ugandan Hospitals

PubMed Central

Sears, David; Mpimbaza, Arthur; Kigozi, Ruth; Sserwanga, Asadu; Chang, Michelle A.; Kapella, Bryan K.; Yoon, Steven; Kamya, Moses R.; Dorsey, Grant; Ruel, Theodore

2015-01-01

Background A better understanding of case management practices is required to improve inpatient pediatric care in resource-limited settings. Here we utilize data from a unique health facility-based surveillance system at six Ugandan hospitals to evaluate the quality of pediatric case management and the factors associated with appropriate care. Methods All children up to the age of 14 years admitted to six district or regional hospitals over 15 months were included in the study. Four case management categories were defined for analysis: suspected malaria, selected illnesses requiring antibiotics, suspected anemia, and diarrhea. The quality of case management for each category was determined by comparing recorded treatments with evidence-based best practices as defined in national guidelines. Associations between variables of interest and the receipt of appropriate case management were estimated using multivariable logistic regression. Results A total of 30,351 admissions were screened for inclusion in the analysis. Ninety-two percent of children met criteria for suspected malaria and 81% received appropriate case management. Thirty-two percent of children had selected illnesses requiring antibiotics and 89% received appropriate antibiotics. Thirty percent of children met criteria for suspected anemia and 38% received appropriate case management. Twelve percent of children had diarrhea and 18% received appropriate case management. Multivariable logistic regression revealed large differences in the quality of care between health facilities. There was also a strong association between a positive malaria diagnostic test result and the odds of receiving appropriate case management for comorbid non-malarial illnesses - children with a positive malaria test were more likely to receive appropriate care for anemia and less likely for illnesses requiring antibiotics and diarrhea. Conclusions Appropriate management of suspected anemia and diarrhea occurred infrequently. Pediatric quality improvement initiatives should target deficiencies in care unique to each health facility, and interventions should focus on the simultaneous management of multiple diagnoses. PMID:25992620

The principles of effective case management of mental health services.

PubMed

Rapp, Charles A; Goscha, Richard J

2004-01-01

This paper identifies ten principles or active ingredients of case management that are common to interventions that produced statistically significant positive outcomes for people with serious psychiatric disabilities. Twenty-two studies employing experimental or quasi-experimental designs were selected for inclusion in this review. The use of the principles for systems design is briefly discussed. The term case management is used throughout this article because it is the term that is used in the studies reviewed. We acknowledge that this term is considered pejorative to many people with psychiatric disabilities. People with psychiatric disabilities are not "cases" and they do not need to be "managed." A more accurate reflection of what this service entails is that it is the services or resources that are managed in order to help people reach their goals. Until a more appropriate title becomes globally recognized, the term should be used with sensitivity to the negative connotations it carries.

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.

Complete duplication of collecting system in a horseshoe kidney presenting with recurrent urinary tract infections: report of an exceedingly rare congenital anomaly and review of literature.

PubMed

Mirzazadeh, Majid; Richards, Kyle A

2011-01-01

We report the fifth case in the English literature of a horseshoe kidney with a complete ureteral duplication. Our case is unique in that the previous four cases occurred in the presence of a ureterocele, whereas our patient lacked this anomaly. Further, our patient was managed conservatively, whereas the previous four patients were managed with surgery.

Information Systems Integration and Enterprise Application Integration (EAI) Adoption: A Case from Financial Services

ERIC Educational Resources Information Center

Lam, Wing

2007-01-01

Increasingly, organizations find that they need to integrate large number of information systems in order to support enterprise-wide business initiatives such as e-business, supply chain management and customer relationship management. To date, organizations have largely tended to address information systems (IS) integration in an ad-hoc manner.…

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…

Predicting the Adoption of E-Learning Management System: A Case of Selected Private Universities in Nigeria

ERIC Educational Resources Information Center

Nicholas-Omoregbe, Olanike Sharon; Azeta, Ambrose Agbon; Chiazor, Idowu Aigbovo; Omoregbe, Nicholas

2017-01-01

Despite the availability of studies on e-learning management system (eLMS) using information system models, its theoretical foundations have not yet captured social constructs that are peculiar to developing countries including Nigeria. This study was undertaken with the aim of investigating factors that could influence eLMS adoption in higher…

Anesthetic management of Costello syndrome: a case report.

PubMed

Williams, Christol

2014-04-01

Costello syndrome is a rare genetic disorder with an estimated 300 medical cases worldwide. Typical features that characterize this syndrome include short stature, macrocephaly, developmental delay, loose skin folds, distinctive coarse facial features, and multiorgan system anomalies. The following case report discusses the anesthetic management for a 3-year-old boy undergoing general anesthesia for a scheduled dental restoration, hydrocelectomy, inguinal hernia repair, and bilateral myringotomy with placement of pressure equalization tubes. A scarcity of literature for the anesthetic management of Costello syndrome (also known as faciocutaneoskeletal syndrome) exists. Utilizing an overview of the pertinent literature, clinical practice recommendations are suggested for the anesthetic implications of managing a pediatric patient with this rare syndrome.

Telehealth technology in case/disease management.

PubMed

Park, Eun-Jun

2006-01-01

Case managers can better coordinate and facilitate chronic illness care by adopting telehealth technology. This article overviews four major categories of telehealth technology based on patients' roles in self-management: surveillance, testing peripherals and messaging, decision support aids, and online support groups related to patients' subordinate, structured, collaborative, and autonomous roles, respectively. These various telehealth technologies should be selected on the basis of patients' care needs and preferences. Moreover, when they are integrated with other clinical information systems, case management practice can be better performed. However, the specific role functions and skill sets needed to be competent in telehealth environments have not yet been clearly identified. Considering role ambiguity and stress among telehealth clinicians, clarifying relevant roles is an urgent task.

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...

The Resilience of the "Corporate" in Post-Corporate Teacher Appraisal: A Case Study from Mauritius

ERIC Educational Resources Information Center

Luchoomun, Dharmadeo

2007-01-01

This article seeks to replace the traditional and authoritative staff appraisal at a case-study school by a concept of performance management depicted as the performance enhancement and peer appraisal of teachers. It is achieved by elaborating an open system of performance management where teachers are empowered within the existing vertical…

A safety management system for an offshore Azerbaijan Caspian Sea Project

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

Brasic, M.F.; Barber, S.W.; Hill, A.S.

1996-11-01

This presentation will describe the Safety Management System that Azerbaijan International Operating Company (AIOC) has structured to assure that Company activities are performed in a manner that protects the public, the environment, contractors and AIOC employees. The Azerbaijan International Oil Company is a consortium of oil companies that includes Socar, the state oil company of Azerbaijan, a number of major westem oil companies, and companies from Russia, Turkey and Saudi Arabia. The Consortium was formed to develop and produce a group of large oil fields in the Caspian Sea. The Management of AIOC, in starting a new operation in Azerbaijan,more » recognized the need for a formal HSE management system to ensure that their HSE objectives for AIOC activities were met. As a consortium of different partners working together in a unique operation, no individual partner company HSE Management system was appropriate. Accordingly AIOC has utilized the E & P Forum {open_quotes}Guidelines for the Development and Application of Health Safety and Environmental Management Systems{close_quotes} as the framework document for the development of the new AIOC system. Consistent with this guideline, AIOC has developed 19 specific HSE Management System Expectations for implementing its HSE policy and objectives. The objective is to establish and continue to maintain operational integrity in all AIOC activities and site operations. An important feature is the use of structured Safety Cases for the design engineering activity. The basis for the Safety Cases is API RP 75 and 14 J for offshore facilities and API RP 750 for onshore facilities both complimented by {open_quotes}Best International Oilfield Practice{close_quotes}. When viewed overall, this approach provides a fully integrated system of HSE management from design into operation.« less

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.

Multiple methods for multiple futures: Integrating qualitative scenario planning and quantitative simulation modeling for natural resource decision making

USGS Publications Warehouse

Symstad, Amy J.; Fisichelli, Nicholas A.; Miller, Brian W.; Rowland, Erika; Schuurman, Gregor W.

2017-01-01

Scenario planning helps managers incorporate climate change into their natural resource decision making through a structured “what-if” process of identifying key uncertainties and potential impacts and responses. Although qualitative scenarios, in which ecosystem responses to climate change are derived via expert opinion, often suffice for managers to begin addressing climate change in their planning, this approach may face limits in resolving the responses of complex systems to altered climate conditions. In addition, this approach may fall short of the scientific credibility managers often require to take actions that differ from current practice. Quantitative simulation modeling of ecosystem response to climate conditions and management actions can provide this credibility, but its utility is limited unless the modeling addresses the most impactful and management-relevant uncertainties and incorporates realistic management actions. We use a case study to compare and contrast management implications derived from qualitative scenario narratives and from scenarios supported by quantitative simulations. We then describe an analytical framework that refines the case study’s integrated approach in order to improve applicability of results to management decisions. The case study illustrates the value of an integrated approach for identifying counterintuitive system dynamics, refining understanding of complex relationships, clarifying the magnitude and timing of changes, identifying and checking the validity of assumptions about resource responses to climate, and refining management directions. Our proposed analytical framework retains qualitative scenario planning as a core element because its participatory approach builds understanding for both managers and scientists, lays the groundwork to focus quantitative simulations on key system dynamics, and clarifies the challenges that subsequent decision making must address.

Content and Workflow Management for Library Websites: Case Studies

ERIC Educational Resources Information Center

Yu, Holly, Ed.

2005-01-01

Using database-driven web pages or web content management (WCM) systems to manage increasingly diverse web content and to streamline workflows is a commonly practiced solution recognized in libraries today. However, limited library web content management models and funding constraints prevent many libraries from purchasing commercially available…

Mapping the literature of case management nursing.

PubMed

White, Pamela; Hall, Marilyn E

2006-04-01

Nursing case management provides a continuum of health care services for defined groups of patients. Its literature is multidisciplinary, emphasizing clinical specialties, case management methodology, and the health care system. This study is part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association. The study identifies core journals cited in case management literature and indexing services that access those journals. Three source journals were identified based on established criteria, and cited references from each article published from 1997 to 1999 were analyzed. Nearly two-thirds of the cited references were from journals; others were from books, monographs, reports, government documents, and the Internet. Cited journal references were ranked in descending order, and Bradford's Law of Scattering was applied. The many journals constituting the top two zones reflect the diversity of this field. Zone 1 included journals from nursing administration, case management, general medicine, medical specialties, and social work. Two databases, PubMed/MEDLINE and OCLC ArticleFirst, provided the best indexing coverage. Collections that support case management require a relatively small group of core journals. Students and health care professionals will need to search across disciplines to identify appropriate literature.

Algorithmic Case Pedagogy, Learning and Gender

ERIC Educational Resources Information Center

Bromley, Robert; Huang, Zhenyu

2015-01-01

Great investment has been made in developing algorithmically-based cases within online homework management systems. This has been done because publishers are convinced that textbook adoption decisions are influenced by the incorporation of these systems within their products. These algorithmic assignments are thought to promote learning while…

48 CFR 245.7203 - Assigning plant clearance case numbers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Q—Navy E—Air Force L—Marine Corps U—Defense Logistics Agency N—Defense Nuclear Agency M—National... case numbers. 245.7203 Section 245.7203 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Special Instructions 245...

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...

An expert system for municipal solid waste management simulation analysis

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

Hsieh, M.C.; Chang, N.B.

1996-12-31

Optimization techniques were usually used to model the complicated metropolitan solid waste management system to search for the best dynamic combination of waste recycling, facility siting, and system operation, where sophisticated and well-defined interrelationship are required in the modeling process. But this paper applied the Concurrent Object-Oriented Simulation (COOS), a new simulation software construction method, to bridge the gap between the physical system and its computer representation. The case study of Kaohsiung solid waste management system in Taiwan is prepared for the illustration of the analytical methodology of COOS and its implementation in the creation of an expert system.

Cost-effectiveness of nitrogen mitigation by alternative household wastewater management technologies.

PubMed

Wood, Alison; Blackhurst, Michael; Hawkins, Troy; Xue, Xiaobo; Ashbolt, Nicholas; Garland, Jay

2015-03-01

Household wastewater, especially from conventional septic systems, is a major contributor to nitrogen pollution. Alternative household wastewater management technologies provide similar sewerage management services but their life cycle costs and nitrogen flow implications remain uncertain. This paper addresses two key questions: (1) what are the total costs, nitrogen mitigation potential, and cost-effectiveness of a range of conventional and alternative municipal wastewater treatment technologies, and (2) what uncertainties influence these outcomes and how can we improve our understanding of these technologies? We estimate a household nitrogen mass balance for various household wastewater treatment systems and combine this mass balance with life cycle cost assessment to calculate the cost-effectiveness of nitrogen mitigation, which we define as nitrogen removed from the local watershed. We apply our methods to Falmouth, MA, where failing septic systems have caused heightened eutrophication in local receiving water bodies. We find that flushing and dry (composting) urine-diversion toilets paired with conventional septic systems for greywater management demonstrate the lowest life cycle cost and highest cost-effectiveness (dollars per kilogram of nitrogen removed from the watershed). Composting toilets are also attractive options in some cases, particularly best-case nitrogen mitigation. Innovative/advanced septic systems designed for high-level nitrogen removal are cost-competitive options for newly constructed homes, except at their most expensive. A centralized wastewater treatment plant is the most expensive and least cost-effective option in all cases. Using a greywater recycling system with any treatment technology increases the cost without adding any nitrogen removal benefits. Sensitivity analysis shows that these results are robust considering a range of cases and uncertainties. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Forest fire management to avoid unintended consequences: a case study of Portugal using system dynamics.

PubMed

Collins, Ross D; de Neufville, Richard; Claro, João; Oliveira, Tiago; Pacheco, Abílio P

2013-11-30

Forest fires are a serious management challenge in many regions, complicating the appropriate allocation to suppression and prevention efforts. Using a System Dynamics (SD) model, this paper explores how interactions between physical and political systems in forest fire management impact the effectiveness of different allocations. A core issue is that apparently sound management can have unintended consequences. An instinctive management response to periods of worsening fire severity is to increase fire suppression capacity, an approach with immediate appeal as it directly treats the symptom of devastating fires and appeases the public. However, the SD analysis indicates that a policy emphasizing suppression can degrade the long-run effectiveness of forest fire management. By crowding out efforts to preventative fuel removal, it exacerbates fuel loads and leads to greater fires, which further balloon suppression budgets. The business management literature refers to this problem as the firefighting trap, wherein focus on fixing problems diverts attention from preventing them, and thus leads to inferior outcomes. The paper illustrates these phenomena through a case study of Portugal, showing that a balanced approach to suppression and prevention efforts can mitigate the self-reinforcing consequences of this trap, and better manage long-term fire damages. These insights can help policymakers and fire managers better appreciate the interconnected systems in which their authorities reside and the dynamics that may undermine seemingly rational management decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Airport Managers' Perspectives on Security and Safety Management Systems in Aviation Operations: A Multiple Case Study

NASA Astrophysics Data System (ADS)

Brown, Willie L., Jr.

Global terrorism continues to persist despite the great efforts of various countries to protect and safely secure their citizens. As airports form the entry and exit ports of a country, they are one of the most vulnerable locations to terror attacks. Managers of international airports constantly face similar challenges in developing and implementing airport security protocols. Consequently, the technological advances of today have brought both positive and negative impacts on security and terrorism of airports, which are mostly managed by the airport managers. The roles of the managers have greatly increased over the years due to technological advances. The developments in technology have had different roles in security, both in countering terrorism and, at the same time, increasing the communication methods of the terrorists. The purpose of this qualitative multiple case study was to investigate the perspectives of airport managers with regard to societal security and social interactions in the socio-technical systems of the National Terrorism Advisory System (NTAS). Through the data gained regarding managers' perception and experiences, the researcher hoped to enable the development of security measures and policies that are appropriate for airports as socio-technical systems. The researcher conducted interviews with airport managers to gather relevant data to fulfill the rationale of the study. Ten to twelve airport managers based in three commercial aviation airports in Maryland, United States participated in the study. The researcher used a qualitative thematic analysis procedure to analyze the data responses of participants in the interview sessions.

Case Study of the U.S. Army’s Should-Cost Management Implementation

DTIC Science & Technology

2013-12-03

and Pelvic Protection Systems (PPS). After graduating from the Naval Postgraduate School, Major Choi will be assigned to the U.S. Army...Systems PMO Product/Project/Program Management Office PMT Program Management Training POA&M Plan of Action and Milestones POE Program Office...Intelligence, Electronic Warfare and Sensors  PEO Simulation, Training , and Instrumentation  JPEO Chemical and Biological Defense The researcher

Managing Multiple Sources of Information in an Independent K-12 Private School: A Case Study in a Student Information Systems Evaluation

ERIC Educational Resources Information Center

Yares, Ali Chava Kaufman

2010-01-01

Information is everywhere and finding the best method to manage it is a problem that all types of organizations have to deal with. Schools use Student Information Systems (SIS) to manage Student Data, Financial Information, Development, Human Resources, Admission, Financial Aid, Enrollment, Scheduling, and Health Information. A survey of 107…

Knowledge Management and Law Enforcement: An Examination of Knowledge Management Strategies of the Police Information System (POLNET) in the Turkish National Police

ERIC Educational Resources Information Center

Gultekin, Kubra

2009-01-01

This research study explores knowledge management (KM) in law enforcement, focusing on the POLNET system established by the Turkish National Police as a knowledge-sharing tool. This study employs a qualitative case study for exploratory and descriptive purposes. The qualitative data set came from semi-structured face-to-face and telephone…

A case study assessing opportunity costs and ecological benefits of streamside management zones and logging systems for eastern hardwood forests

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2006-01-01

Forest landowners, managers, loggers, land-use planners, and other decision and policy-makers need to understand the opportunity costs and ecological benefits associated with different widths of streamside management zones (SMZs). In this paper, a simulation model was used to assess the opportunity costs of SMZ retention for four different logging systems, two mature...

Using a personal digital assistant to document clinical pharmacy services in an intensive care unit.

PubMed

Lau, A; Balen, R M; Lam, R; Malyuk, D L

2001-07-01

Management Case Studies describe approaches to real-life management problems in health systems. Each installment is a brief description of a problem and how it was dealt with. The cases are intended to help readers deal with similar experiences in their own work sites. Problem solving, not hypothesis testing, is emphasized. Successful resolution of the management issue is not a criterion for publication--important lessons can be learned from failures, too.

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

PubMed

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

2017-03-09

Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence-based program like MISSION-Vet. ClinicalTrials.gov NCT01430741.

Tuberculosis genotyping information management system: enhancing tuberculosis surveillance in the United States.

PubMed

Ghosh, Smita; Moonan, Patrick K; Cowan, Lauren; Grant, Juliana; Kammerer, Steve; Navin, Thomas R

2012-06-01

Molecular characterization of Mycobacterium tuberculosis complex isolates (genotyping) can be used by public health programs to more readily identify tuberculosis (TB) transmission. The Centers for Disease Control and Prevention's National Tuberculosis Genotyping Service has offered M. tuberculosis genotyping for every culture-confirmed case in the United States since 2004. The TB Genotyping Information Management System (TB GIMS), launched in March 2010, is a secure online database containing genotype results linked with case characteristics from the national TB registry for state and local TB programs to access, manage and analyze these data. As of September 2011, TB GIMS contains genotype results for 89% of all culture-positive TB cases for 2010. Over 400 users can generate local and national reports and maps using TB GIMS. Automated alerts on geospatially concentrated cases with matching genotypes that may represent outbreaks are also generated by TB GIMS. TB genotyping results are available to enhance national TB surveillance and apply genotyping results to conduct TB control activities in the United States. Published by Elsevier B.V.

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

The Caterpillar Game: A Classroom Management System

ERIC Educational Resources Information Center

Floress, Margaret T.; Rock, Angela L.; Hailemariam, Assegedech

2017-01-01

A single-case experimental design was used to evaluate the effects of the Caterpillar Game, a classroom management system, on disruptive behavior in a general education first grade classroom. A multiple baseline design across settings was used to evaluate changes in student disruptive behavior and teacher praise. When the Caterpillar Game was…

Curriculum Management for Schools, Colleges, Business.

ERIC Educational Resources Information Center

English, Fenwick W.

What works and does not work in school systems, colleges, and businesses is discussed with a focus on curriculum in the schools and other organizations. Organizational studies were completed in several school systems nationwide. Ten chapters look at the following: (1) curriculum management (the case of the academy, what curriculum is, the nature…

Efficient Use of Information in Adaptive Management with an Application to Managing Recreation near Golden Eagle Nesting Sites

PubMed Central

Fackler, Paul L.; Pacifici, Krishna; Martin, Julien; McIntyre, Carol

2014-01-01

It is generally the case that a significant degree of uncertainty exists concerning the behavior of ecological systems. Adaptive management has been developed to address such structural uncertainty, while recognizing that decisions must be made without full knowledge of how a system behaves. This paradigm attempts to use new information that develops during the course of management to learn how the system works. To date, however, adaptive management has used a very limited information set to characterize the learning that is possible. This paper uses an extension of the Partial Observable Markov Decision Process (POMDP) framework to expand the information set used to update belief in competing models. This feature can potentially increase the speed of learning through adaptive management, and lead to better management in the future. We apply this framework to a case study wherein interest lies in managing recreational restrictions around golden eagle (Aquila chrysaetos) nesting sites. The ultimate management objective is to maintain an abundant eagle population in Denali National Park while minimizing the regulatory burden on park visitors. In order to capture this objective, we developed a utility function that trades off expected breeding success with hiker access. Our work is relevant to the management of human activities in protected areas, but more generally demonstrates some of the benefits of POMDP in the context of adaptive management. PMID:25098955

Case managers' expectations about employment for people with psychiatric disabilities.

PubMed

Abraham, Kristen M; Stein, Catherine H

2009-01-01

The importance of employment in lives of people with psychiatric disabilities is well documented. Yet, the role of case managers in facilitating or inhibiting employment opportunities for consumers is only beginning to be understood. This study examined the psychometric properties of a newly developed self-report measure designed to assess case managers' employment-related expectations of consumers. Psychometric properties of a 24-item self-report measure, Expectations for the Employability of People with Serious Mental Illness (EESMI), were examined using a sample of 107 case managers. EESMI items tap individual and social systems factors related to employment for people with psychiatric disabilities. Construct validity was assessed by relationships between EESMI scores and scores on measures of general expectations and opinions of people with serious mental illness, case manager burnout, and social desirability. EESMI consists of three empirically derived subscales with good internal consistency. Case managers' scores on EESMI correlated positively with scores on general expectations and opinions about people with mental illness scales and were generally unrelated to social desirability scores. EESMI scores were positively related to case managers' perceptions of the employability of consumers on their caseloads. EESMI is a psychometrically sound measure of mental health professionals' employment-related expectations of consumers. Reliable and valid assessment is basic to the study of mental health professionals' role in increasing employment opportunities for people with psychiatric disabilities. Study limitations and directions for future research are discussed.

Complete Duplication of Collecting System in a Horseshoe Kidney Presenting with Recurrent Urinary Tract Infections: Report of an Exceedingly Rare Congenital Anomaly and Review of Literature

PubMed Central

Mirzazadeh, Majid; Richards, Kyle A.

2011-01-01

We report the fifth case in the English literature of a horseshoe kidney with a complete ureteral duplication. Our case is unique in that the previous four cases occurred in the presence of a ureterocele, whereas our patient lacked this anomaly. Further, our patient was managed conservatively, whereas the previous four patients were managed with surgery. PMID:22224073

77 FR 2692 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-19

... of Management and Budget (OMB) Circular A-130, Appendix I, ``Federal Agency Responsibility for...; individuals interacting with DOC employees or management; current, former, and prospective DOC [[Page 2693... determination relative to criminal prosecution, civil, or administrative action; general case management...

Research on Risk Management and Power Supplying Enterprise Control

NASA Astrophysics Data System (ADS)

Shen, Jianfei; Wang, Yige

2017-09-01

This paper derived from the background that electric power enterprises strengthen their risk management under requirements of the government. For the power industry, we explained the risk management theory, analysed current macro environment as well as basic situation, then classified and interpreted the main risks. In a case study on a power bureau, we established a risk management system based on deep understanding about the characteristics of its organization system and risk management function. Then, we focused on risks in operation as well as incorrupt government construction to give a more effective framework of the risk management system. Finally, we came up with the problems and specific countermeasures in risk management, which provided a reference for other electric power enterprises.

Analysis and Perspective from the Complex Aerospace Systems Exchange (CASE) 2013

NASA Technical Reports Server (NTRS)

Jones, Kennie H.; Parker, Peter A.; Detweiler, Kurt N.; McGowan, Anna-Maria R.; Dress, David A.; Kimmel, William M.

2014-01-01

NASA Langley Research Center embedded four rapporteurs at the Complex Aerospace Systems Exchange (CASE) held in August 2013 with the objective to capture the essence of the conference presentations and discussions. CASE was established to provide a discussion forum among chief engineers, program managers, and systems engineers on challenges in the engineering of complex aerospace systems. The meeting consists of invited presentations and panels from industry, academia, and government followed by discussions among attendees. This report presents the major and reoccurring themes captured throughout the meeting and provides analysis and insights to further the CASE mission.

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.

Use of orbital floor steroids in the management of patients with uniocular non-necrotising scleritis.

PubMed Central

Hakin, K N; Ham, J; Lightman, S L

1991-01-01

Most cases of non-necrotising scleritis can be successfully treated with non-steroidal anti-inflammatory drugs. If these are ineffective, then high-dose systemic corticosteroids, with all their attendant side-effects, are usually required. We have used orbital floor injections of depot steroid in the management of nine patients with non-necrotising scleritis in an attempt to avoid the use of systemic steroids, or to allow the dose of steroids to be reduced while maintaining disease control. A temporary reduction in inflammation was achieved in all cases, which allowed the use of systemic steroids to be avoided altogether in two patients and delayed in the others. Non-steroidal anti-inflammatory drugs and systemic corticosteroids remain the mainstay of treatment for non-necrotising scleritis, but orbital floor injections may be a useful adjunct in certain cases. Images PMID:2043574

Management Control Systems in Not-for-Profit Organizations: A Case Study.

DTIC Science & Technology

1982-12-01

UNCLASSIFIED F/G 5/1 NL mhmmhhhhhmhmmum IEIIEEIIIIIEEE EIIIIIIIIIIIIl Diiit 1.1_I220 H- M141116 MICROCOPY RESOLUION4 TEST CHART 14ATIONAL BUREAU Of... test case. C. RESEARCH RET HODS The first phase of the study was a review of current literature on management control procedures and systems in...RESOLUTION TEST CHART NATIONAL BUREAU 0f SIANDARD 96% A I II a U a .1 ii IiU- I! IA i -~ - U I -..................... I I ~ 3 ,’u!nAA~~ -~~j ~; Eu ~ II 8I~ ~B

Systems Engineering Case Studies, Synopsis of the Learning Principles

DTIC Science & Technology

2009-08-24

TBMCS refers to the Theater Battle Management Core System Systems Engineering Case Study Peacekeeper refers to the Peacekeeper Intercontinental...primary mirror defect going to orbit undetected in spite of substantial evidence that could have been used to prevent this occurrence. TBMCS /1...The requirements baseline was volatile up to system acceptance, which took place after TBMCS passed operational test and evaluation. Approved for

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.

A hybrid simulation approach for integrating safety behavior into construction planning: An earthmoving case study.

PubMed

Goh, Yang Miang; Askar Ali, Mohamed Jawad

2016-08-01

One of the key challenges in improving construction safety and health is the management of safety behavior. From a system point of view, workers work unsafely due to system level issues such as poor safety culture, excessive production pressure, inadequate allocation of resources and time and lack of training. These systemic issues should be eradicated or minimized during planning. However, there is a lack of detailed planning tools to help managers assess the impact of their upstream decisions on worker safety behavior. Even though simulation had been used in construction planning, the review conducted in this study showed that construction safety management research had not been exploiting the potential of simulation techniques. Thus, a hybrid simulation framework is proposed to facilitate integration of safety management considerations into construction activity simulation. The hybrid framework consists of discrete event simulation (DES) as the core, but heterogeneous, interactive and intelligent (able to make decisions) agents replace traditional entities and resources. In addition, some of the cognitive processes and physiological aspects of agents are captured using system dynamics (SD) approach. The combination of DES, agent-based simulation (ABS) and SD allows a more "natural" representation of the complex dynamics in construction activities. The proposed hybrid framework was demonstrated using a hypothetical case study. In addition, due to the lack of application of factorial experiment approach in safety management simulation, the case study demonstrated sensitivity analysis and factorial experiment to guide future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementing a Quality Management Framework in a Higher Education Organisation: A Case Study

ERIC Educational Resources Information Center

O'Mahony, Kim; Garavan, Thomas N.

2012-01-01

Purpose: This paper aims to report and analyse the lessons learned from a case study on the implementation of a quality management system within an IT Division in a higher education (HE) organisation. Design/methodology/approach: The paper is based on a review of the relevant literatures and the use of primary sources such as document analysis,…

The Best of Times and the Worst of Times: Research Managed as a Performance Economy--The Australian Case. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Marginson, Simon

This study examined the character of the emerging systems of corporate management in Australian universities and their effects on academic and administrative practices, focusing on relations of power. Case studies were conducted at 17 individual universities of various types. In each institution, interviews were conducted with senior…

Making the case for OWTS management: lessons from case studies and research

NASA Astrophysics Data System (ADS)

Rahm, B.; Woods, F.; Hwang, S.; Walter, M. T.; Grantham, D. G.; Riha, S. J.

2016-12-01

On-site wastewater treatment systems (OWTS) are used in 20-25% of homes in the United States and can be an efficient and cost-effective alternative to conventional centralized systems. However, OWTS also represent a source of non-point nutrient, pathogen, and micro-contaminant pollution to surface and groundwater if they are poorly designed, sited and/or maintained. Despite their ubiquity and potential to negatively impact water resources, the contribution of OWTS to local and regional water contamination issues is poorly understood. There are no federal regulations or uniform standards for the operation, maintenance, and management of these systems. The effectiveness of educational programs and best management practices developed by the US Environmental Protection Agency, along with local and regional governments, remains uncertain. Here we describe attempts to increase our knowledge of the state of OWTS in relation to water resources and their management. Specifically, we summarize 1) efforts to modernize a NY State-wide inventory of residential OWTS using GIS-based tools; 2) research aimed at better understanding the impact of OWTS on surface and ground water in 5 upstate NY counties across a gradient of land uses; 3) lessons learned from 13 case studies of municipal OWTS management programs across the US; and 4) observations on the roles of data, education and policy in creating and evaluating successful municipal OWTS management programs. Initial results show that total numbers of OWTS in NY State continue to grow, particularly in areas associated with ex-urban migration. Research into the relationship between OWTS and nutrient and pathogen contamination in ground and surface waters, respectively, suggests location-specific variation. This has implications for management approaches: preventing failure of any individual OWTS may be just as effective as programs attempting to bring all OWTS up to a high level of performance. Case studies of management programs, which we assess using a set of policy-related criteria, suggest that approaches differ according to local regulations, stakeholder values, and other environmental, economic, and social factors.

A new costing model in hospital management: time-driven activity-based costing system.

PubMed

Öker, Figen; Özyapıcı, Hasan

2013-01-01

Traditional cost systems cause cost distortions because they cannot meet the requirements of today's businesses. Therefore, a new and more effective cost system is needed. Consequently, time-driven activity-based costing system has emerged. The unit cost of supplying capacity and the time needed to perform an activity are the only 2 factors considered by the system. Furthermore, this system determines unused capacity by considering practical capacity. The purpose of this article is to emphasize the efficiency of the time-driven activity-based costing system and to display how it can be applied in a health care institution. A case study was conducted in a private hospital in Cyprus. Interviews and direct observations were used to collect the data. The case study revealed that the cost of unused capacity is allocated to both open and laparoscopic (closed) surgeries. Thus, by using the time-driven activity-based costing system, managers should eliminate the cost of unused capacity so as to obtain better results. Based on the results of the study, hospital management is better able to understand the costs of different surgeries. In addition, managers can easily notice the cost of unused capacity and decide how many employees to be dismissed or directed to other productive areas.

Elementary School Leaders' Perceptions of Their Roles in Managing School Curriculum: A Case Study

ERIC Educational Resources Information Center

Shahadan, Azuraida; Oliver, Ron

2016-01-01

The implementation of the Malaysian National Education Blueprint in 2012 has expanded headmasters' responsibilities and roles in managing schools. The goal is to stabilize and strengthen the primary school education system, which brings tremendous pressure to bear on the headmasters charged with managing schools, especially in managing the school…

Technical Elements, Demonstration Projects, and Fiscal Models in Medicaid Managed Care for People with Developmental Disabilities.

ERIC Educational Resources Information Center

Kastner, Theodore A.; Walsh, Kevin K.; Criscione, Teri

1997-01-01

Presents a general model of the structure and functioning of managed care and describes elements (provider networks, fiscal elements, risk estimation, case-mix, management information systems, practice parameters, and quality improvement) critical to people with developmental disabilities. Managed care demonstration projects and a hypothetical…

Filter membrane-based automated therapeutic plasma exchange: a report of two cases from Nigeria.

PubMed

Arogundade, Fatiu A; Sanusi, Abubakr A; Akinbodewa, Akinwunmi A; Hassan, Muzamil O; Omotosho, Bolanle O; Balogun, Rasheed A; Akinsola, Adewale

2013-02-01

These case reports demonstrated the diagnostic dilemma encountered in patients with systemic lupus erythematosus and thrombotic thrombocytopenic purpura particularly in settings with limited diagnostic facilities and laboratory support. The similarities in the diagnostic criteria for both conditions make clear distinction as well as management decisions difficult. We present the difficulties encountered with both the diagnosis and the management of these two patients that were managed in our facility. Copyright © 2013 Wiley Periodicals, Inc.

Correlation between provider computer experience and accuracy of electronic anesthesia charting A pilot study and performance improvement project

DTIC Science & Technology

2017-03-20

information management systems (AIMS), a subset of electronic medical records (EMR) (Stonemetz & Dutton, 2014). By contrast, about 75 percent of anesthesia...of distraction caused by the anesthesia information management system (AIMS). Peterfreund et al. (2011) attributed their 92% increase in... information into an Excel spreadsheet, coded by the participant research identification number. Using the Innovian Case Manager application, the

Crisis Intervention and the Military Family: A Model Installation Program.

DTIC Science & Technology

1988-03-07

abuse to less serious problems like budget management and good parenting techniques. Family dysfunction is defined in two categories: High and low...serious problems like budget management and good parenting techniques. Family dysfunction is defined in two categories: High and low intensity conflict. The...system activated to deal with the problem through the Family N, Advocacy Case Management Team. It is an excellent system that protects, helps and

Biologically-Inspired Concepts for Self-Management of Complexity

NASA Technical Reports Server (NTRS)

Sterritt, Roy; Hinchey, G.

2006-01-01

Inherent complexity in large-scale applications may be impossible to eliminate or even ameliorate despite a number of promising advances. In such cases, the complexity must be tolerated and managed. Such management may be beyond the abilities of humans, or require such overhead as to make management by humans unrealistic. A number of initiatives inspired by concepts in biology have arisen for self-management of complex systems. We present some ideas and techniques we have been experimenting with, inspired by lesser-known concepts in biology that show promise in protecting complex systems and represent a step towards self-management of complexity.

[A review on urban metabolism research based on physical space entities for environmental management].

PubMed

Liu, Ye; Liu, Dan

2015-07-01

Urban metabolism is a basic theory for coping with global environmental problems, which is coherent with the aims of national environmental management. This paper analyzed the concept of urban metabolism, and pointed out the meaning for urban metabolism in physical space entities; reviewed the current methods for urban metabolism and its merits and shortages; analyzed the system boundaries, connotation, and methodologies; and summarized the advances on urban meta-bolism practices in physical space entities. At last, we made conclusions that there were shortages, including conception system, basic theory system, and interdisciplinary integrated theory system in current urban metabolism research, and the current cases studied in urban metabolism were limited and not suitable to the harmony development between society, economy, and environment. In the future, we need to strengthen comparison between different case studies from different countries, develop the prior modes of typical urban metabolism research, identify the mechanism for urban ecosystem, and strengthen the spatial decision support system of environmental management taking urban spatial entity spaces as units.

A clinical economics workstation for risk-adjusted health care cost management.

PubMed Central

Eisenstein, E. L.; Hales, J. W.

1995-01-01

This paper describes a healthcare cost accounting system which is under development at Duke University Medical Center. Our approach differs from current practice in that this system will dynamically adjust its resource usage estimates to compensate for variations in patient risk levels. This adjustment is made possible by introducing a new cost accounting concept, Risk-Adjusted Quantity (RQ). RQ divides case-level resource usage variances into their risk-based component (resource consumption differences attributable to differences in patient risk levels) and their non-risk-based component (resource consumption differences which cannot be attributed to differences in patient risk levels). Because patient risk level is a factor in estimating resource usage, this system is able to simultaneously address the financial and quality dimensions of case cost management. In effect, cost-effectiveness analysis is incorporated into health care cost management. PMID:8563361

Integrating management tools and concepts to develop an estuarine planning support system: A case study of the Humber Estuary, Eastern England.

PubMed

Lonsdale, Jemma-Anne; Weston, Keith; Barnard, Steve; Boyes, Suzanne J; Elliott, Michael

2015-11-15

Estuaries are important because of their multiple uses and users which often makes them challenging to manage since management must strike a balance between the needs of users, the estuaries' ecological and economic value and the context of multiple legislative drivers. To facilitate management we have therefore developed an Estuarine Planning Support System (EPSS) framework using the Humber Estuary, Eastern England, as a case study which integrates the current legislation tools and concepts. This integrated EPSS framework is an improvement on previous approaches for assessing cumulative impacts as it takes into account legislative drivers, management tools and other mechanisms for controlling plans/projects specific to the estuary. It therefore enables managers and users to assess and address both the current state and the way in which a new industrial, port or urban development could impact an estuary in an accessible and understandable framework. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Preparing Safety Cases for Operating Outside Prescriptive Fatigue Risk Management Regulations.

PubMed

Gander, Philippa; Mangie, Jim; Wu, Lora; van den Berg, Margo; Signal, Leigh; Phillips, Adrienne

2017-07-01

Transport operators seeking to operate outside prescriptive fatigue management regulations are typically required to present a safety case justifying how they will manage the associated risk. This paper details a method for constructing a successful safety case. The method includes four elements: 1) scope (prescriptive rules and operations affected); 2) risk assessment; 3) risk mitigation strategies; and 4) monitoring ongoing risk. A successful safety case illustrates this method. It enables landing pilots in 3-pilot crews to choose the second or third in-flight rest break, rather than the regulatory requirement to take the third break. Scope was defined using a month of scheduled flights that would be covered (N = 4151). These were analyzed in the risk assessment using existing literature on factors affecting fatigue to estimate the maximum time awake at top of descent and sleep opportunities in each break. Additionally, limited data collected before the new regulations showed that pilots flying at landing chose the third break on only 6% of flights. A prospective survey comparing subjective reports (N = 280) of sleep in the second vs. third break and fatigue and sleepiness ratings at top of descent confirmed that the third break is not consistently superior. The safety case also summarized established systems for fatigue monitoring, risk assessment and hazard identification, and multiple fatigue mitigation strategies that are in place. Other successful safety cases have used this method. The evidence required depends on the expected level of risk and should evolve as experience with fatigue risk management systems builds.Gander P, Mangie J, Wu L, van den Berg M, Signal L, Phillips A. Preparing safety cases for operating outside prescriptive fatigue risk management regulations. Aerosp Med Hum Perform. 2017; 88(7):688-696.

Disease management: a leap of faith to lower-cost, higher-quality health care.

PubMed

Short, Ashley; Mays, Glen; Mittler, Jessica

2003-10-01

With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.

Systemic Lupus Erythematosus Presenting as Refractory Thrombotic Thrombocytopenic Purpura: A Diagnostic and Management Challenge. A Case Report and Concise Review of the Literature.

PubMed

Abu-Hishmeh, Mohammad; Sattar, Alamgir; Zarlasht, Fnu; Ramadan, Mohamed; Abdel-Rahman, Aisha; Hinson, Shante; Hwang, Caroline

2016-10-25

BACKGROUND Thrombotic thrombocytopenic purpura (TTP) is one of the thrombotic microangiopathic (TMA) syndromes, caused by severely reduced activity of the vWF-cleaving protease ADAMTS13. Systemic lupus erythematosus (SLE), on the other hand, is an autoimmune disease that affects various organs in the body, including the hematopoietic system. SLE can present with TMA, and differentiating between SLE and TTP in those cases can be very challenging, particularly in patients with no prior history of SLE. Furthermore, an association between these 2 diseases has been described in the literature, with most of the TTP cases occurring after the diagnosis of SLE. In rare cases, TTP may precede the diagnosis of SLE or occur concurrently. CASE REPORT We present a case of a previously healthy 34-year-old female who presented with dizziness and flu-like symptoms and was found to have thrombocytopenia, hemolytic anemia, and schistocytes in the peripheral smear. She was subsequently diagnosed with TTP and started on plasmapheresis and high-dose steroids, but without a sustained response. A diagnosis of refractory TTP was made, and she was transferred to our facility for further management. Initially, the patient was started on rituximab, but her condition continued to deteriorate, with worsening thrombocytopenia. Later, she also fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) criteria for diagnosis of SLE. Treatment of TTP in SLE patients is generally similar to that in the general population, but in refractory cases there are few reports in the literature that show the efficacy of cyclophosphamide. We started our patient on cyclophosphamide and noticed a sustained improvement in the platelet count in the following weeks. CONCLUSIONS Thrombotic thrombocytopenic purpura is a life-threatening hematological emergency which must be diagnosed and treated in a timely manner. Refractory cases of TTP have been described in the literature, but without clear evidence-based guidelines for its management, and is solely based on expert opinion and previous case reports. Further studies are needed to establish guidelines for its management. We present this case to highlight the role that cyclophosphamide might carry in those cases and to be a foundation for these future studies.

Polio Eradication Initiative contribution in strengthening immunization and integrated disease surveillance data management in WHO African region, 2014.

PubMed

Poy, Alain; Minkoulou, Etienne; Shaba, Keith; Yahaya, Ali; Gaturuku, Peter; Dadja, Landoh; Okeibunor, Joseph; Mihigo, Richard; Mkanda, Pascal

2016-10-10

The PEI Programme in the WHO African region invested in recruitment of qualified staff in data management, developing data management system and standards operating systems since the revamp of the Polio Eradication Initiative in 1997 to cater for data management support needs in the Region. This support went beyond polio and was expanded to routine immunization and integrated surveillance of priority diseases. But the impact of the polio data management support to other programmes such as routine immunization and disease surveillance has not yet been fully documented. This is what this article seeks to demonstrate. We reviewed how Polio data management area of work evolved progressively along with the expansion of the data management team capacity and the evolution of the data management systems from initiation of the AFP case-based to routine immunization, other case based disease surveillance and Supplementary immunization activities. IDSR has improved the data availability with support from IST Polio funded data managers who were collecting them from countries. The data management system developed by the polio team was used by countries to record information related to not only polio SIAs but also for other interventions. From the time when routine immunization data started to be part of polio data management team responsibility, the number of reports received went from around 4000 the first year (2005) to >30,000 the second year and to >47,000 in 2014. Polio data management has helped to improve the overall VPD, IDSR and routine data management as well as emergency response in the Region. As we approach the polio end game, the African Region would benefit in using the already set infrastructure for other public health initiative in the Region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Beneficial effects on water management of simple hydraulic structures in wetland systems: the Vallevecchia case study, Italy.

PubMed

Carrer, G M; Bonato, M; Smania, D; Barausse, A; Comis, C; Palmeri, L

2011-01-01

Conflicting water uses in coastal zones demand integrated approaches to achieve sustainable water resources management, protecting water quality while allowing those human activities which rely upon aquatic ecosystem services to thrive. This case study shows that the creation and simple management of hydraulic structures within constructed wetlands can markedly reduce the non-point pollution from agriculture and, simultaneously, benefit agricultural activities, particularly during hot and dry periods. The Vallevecchia wetland system is based on a reclaimed 900 ha-large drainage basin in Northern Italy, where droughts recently impacted agriculture causing water scarcity and saltwater intrusion. Rainwater and drained water are recirculated inside the system to limit saltwater intrusion, provide irrigation water during dry periods and reduce the agricultural nutrient loads discharged into the bordering, eutrophic Adriatic Sea. Monitoring (2003-2009) of water quality and flows highlights that the construction (ended in 2005) of a gated spillway to control the outflow, and of a 200,000 m3 basin for water storage, dramatically increased the removal of nutrients within the system. Strikingly, this improvement was achieved with a minimal management effort, e.g., each year the storage basin was filled once: a simple management of the hydraulic structures would greatly enhance the system efficiency, and store more water to irrigate and limit saltwater intrusion.

Care for the case manager: balancing your wheel of life.

PubMed

Crowell, D M

1998-01-01

The case manager's role in our complex health care system is demanding and draining without some self-reflective attention. The Wheel of Life is a key tool for individuals to assess how well they are leading a fully balanced life. The eight aspects of a balanced life--values, self-care, work, relationships, leisure, relaxation, exercise, and centering--are explained and discussed. A self-reflective activity is presented that encourages readers to assess their current life balance. This focused clarification of personal and professional life will facilitate a more fully balanced life with rewards for case managers as individuals, and for their family, clients, and the health care organization.

Integrated care: theory to practice.

PubMed

Stokes, Jonathan; Checkland, Kath; Kristensen, Søren Rud

2016-10-01

'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. We look at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. We suggest realistic expectations of what integration of care alone can achieve and additional research questions. © The Author(s) 2016.

Hospital branding in Italy: A pilot study based on the case method.

PubMed

Esposito, Annamaria

2017-01-01

The article investigates if, and in affirmative case how, Italian hospitals are managing corporate brand communication. Thanks to results of qualitative research, this article offers insights on Italian hospital branding. The pilot study based in the case method is to be considered a starting point for wider investigations on this topic, and it is useful for managers and practitioners who want to understand the role of corporate brand in hospital communication management and to connect health care professionals with the audience in a meaningful way in those countries in which the health care system is a mix of both public and private institutions.

Case management in capitated long-term care

PubMed Central

Zawadski, Rick T.; Eng, Catherine

1988-01-01

For a very impaired population needing multiple interrelated services, the case management approach used by On Lok Senior Health Services in San Francisco, California, produces a responsive, flexible service system. Case management in On Lok's consolidated model has three key characteristics: (1) a true multidisciplinary team of medical as well as nonmedical personnel who separately assess, then, as a group, plan with the client and/or the family the services to be given; (2) use of the same team to assess needs and deliver services; and (3) team access to a potentially unlimited array of services, with freedom to adapt or create needed services. PMID:10312976

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.

The Caterpillar Game: A SW-PBIS Aligned Classroom Management System

ERIC Educational Resources Information Center

Floress, Margaret T.; Jacoby, Amber L.

2017-01-01

The Caterpillar Game is a classroom management system that is aligned with School-wide Positive Behavioral Interventions and Supports standards. A single-case, multiple-baseline design was used to evaluate the effects of the Caterpillar Game on disruptive student behavior and teacher praise. Three classrooms were included in the study (preschool,…

Database Management Systems: A Case Study of Faculty of Open Education

ERIC Educational Resources Information Center

Kamisli, Zehra

2004-01-01

We live in the information and the microelectronic age, where technological advancements become a major determinant of our lifestyle. Such advances in technology cannot possibly be made or sustained without concurrent advancement in management systems (5). The impact of computer technology on organizations and society is increasing as new…

Application of Total Quality Management System in Thai Primary Schools

ERIC Educational Resources Information Center

Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

2015-01-01

The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

Computerized Information Management in Long-Term Care: A Case Study. Technical Report No. 303.

ERIC Educational Resources Information Center

Zawadski, Rick T.; Gee, Stephen

This technical report describes the computerized information management system used at the Community Care Organization for Dependent Adults (CCODA) of the On Lok Senior Health Services in San Francisco's Chinatown (California). A background perspective on information systems in business, government, hospitals, and local community service agencies…

Integrating a Learning Management System with a Student Assignments Digital Repository. A Case Study

ERIC Educational Resources Information Center

Díaz, Javier; Schiavoni, Alejandra; Osorio, María Alejandra; Amadeo, Ana Paola; Charnelli, María Emilia

2013-01-01

The integration of different platforms and information Systems in the academic environment is highly important and quite a challenge within the field of Information Technology. This integration allows for higher resource availability and improved interaction among intervening actors. In the field of e-Learning, where Learning Management Systems…

"It's not my problem" (yet). With readmissions under the microscope, CIOs know chronic disease management is moving front and center.

PubMed

Lawrence, Daphne

2009-09-01

Chronic disease management is a system initiative, not just for primary care or ambulatory. The business case is currently poor for chronic disease management, but may soon change due to reform. Chronic disease management can help prevent costly readmissions. Care management plans are often a component of an EMR.

Analysis and design of hospital management information system based on UML

NASA Astrophysics Data System (ADS)

Ma, Lin; Zhao, Huifang; You, Shi Jun; Ge, Wenyong

2018-05-01

With the rapid development of computer technology, computer information management system has been utilized in many industries. Hospital Information System (HIS) is in favor of providing data for directors, lightening the workload for the medical workers, and improving the workers efficiency. According to the HIS demand analysis and system design, this paper focus on utilizing unified modeling language (UML) models to establish the use case diagram, class diagram, sequence chart and collaboration diagram, and satisfying the demands of the daily patient visit, inpatient, drug management and other relevant operations. At last, the paper summarizes the problems of the system and puts forward an outlook of the HIS system.

Design of a case management model for people with chronic disease (Heart Failure and COPD). Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA-icE-PRO Study).

PubMed

Morales-Asencio, Jose M; Martin-Santos, Francisco J; Morilla-Herrera, Juan C; Fernández-Gallego, Magdalena Cuevas; Celdrán-Mañas, Miriam; Navarro-Moya, Francisco J; Rodríguez-Salvador, Maria M; Muñoz-Ronda, Francisco J; Gonzalo-Jiménez, Elena; Carrasco, Almudena Millán

2010-12-02

Chronic diseases account for nearly 60% of deaths around the world. The extent of this silent epidemic has not met determined responses in governments, policies or professionals in order to transform old Health Care Systems, configured for acute diseases. There is a large list of research about alternative models for people with chronic conditions, many of them with an advanced practice nurse as a key provider, as case management. But some methodological concerns raise, above all, the design of the intervention (intensity, frequency, components, etc). General: To develop the first and second phases (theorization and modeling) for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure) and their caregivers. 1) To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2) To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3) To know the information processing and its utilization in their interactions with health care providers. 4) To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5) To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6) To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7) To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives, an expert consensus through Delphi technique, on the possible interventions yielded from the first phase. The study will be developed in the provinces of Almería, Málaga and Granada in the Southern Spain, from patients included in the Andalusian Health Care Service database with the diagnosis of COPD or Heart Failure, with the collaboration of case manager nurses and general practitioners for the assessment of their suitability to inclusion criteria. Patients and caregivers will be interviewed in their homes or their Health Centers, with their family or their case manager nurse as mediator. First of a series of studies intended to design a case-management service for people with heart failure and COPD, in the Andalusian Health Care System, where case management has been implemented since 2002. Accordingly with the steps of a theoretical model for complex interventions, in this study, theorization and intervention modeling phases will be developed.

42 CFR 438.114 - Emergency and poststabilization services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... severe pain) that a prudent layperson, who possesses an average knowledge of health and medicine, could... management system regardless of whether the case manager referred the enrollee to the provider that furnishes...

42 CFR 438.114 - Emergency and poststabilization services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... severe pain) that a prudent layperson, who possesses an average knowledge of health and medicine, could... management system regardless of whether the case manager referred the enrollee to the provider that furnishes...

42 CFR 438.114 - Emergency and poststabilization services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... severe pain) that a prudent layperson, who possesses an average knowledge of health and medicine, could... management system regardless of whether the case manager referred the enrollee to the provider that furnishes...

42 CFR 438.114 - Emergency and poststabilization services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... severe pain) that a prudent layperson, who possesses an average knowledge of health and medicine, could... management system regardless of whether the case manager referred the enrollee to the provider that furnishes...

Financial modeling/case-mix analysis.

PubMed

Heck, S; Esmond, T

1983-06-01

The authors describe a case mix system developed by users which goes beyond DRG requirements to respond to management's clinical/financial data needs for marketing, planning, budgeting and financial analysis as well as reimbursement. Lessons learned in development of the system and the clinical/financial base will be helpful to those currently contemplating the implementation of such a system or evaluating available software.

Qualitative and Quantitative Pedigree Analysis: Graph Theory, Computer Software, and Case Studies.

ERIC Educational Resources Information Center

Jungck, John R.; Soderberg, Patti

1995-01-01

Presents a series of elementary mathematical tools for re-representing pedigrees, pedigree generators, pedigree-driven database management systems, and case studies for exploring genetic relationships. (MKR)

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

[Anesthetic management of tracheobronchial stent insertion in patients who underwent laser resection, balloon dilatation and tracheostomy in advance].

PubMed

Hirai, Akiko; Hirose, Yoshifumi; Gamoh, Masahiro; Satoh, Minako

2005-10-01

We report successful management of tracheobronchial stent insertion under general anesthesia. In thirty-two cases, tracheobronchial stent insertion was performed under general anesthesia. The technique for airway management was chosen depending on the type of stent or the constriction level of the airway portion. We employed tracheostomy in order to avoid repeated intubations during the insertion of Dumon or Dynamic stent. In case of severe airway stenosis, laser resection or balloon dilatation was performed before stent insertion. We had 32 successful cases in 36 trials. Four trials failed due to insufficient expansion in one, mismatches of stent angle in one and pneumomediastinum in one. There was no exacerbation of respiratory condition in failed cases. There was no case who needed percutaneous cardiopulmonary support system. We managed tracheobronchial stent insertion under general anesthesia. Both the airway expansion by laser resection or balloon dilatation before stent insertion and also the insertion of Dumon or Dynamic stent through a tracheostomy were helpful strategies. These techniques facilitated more definitive airway maintenance and stable anesthetic management.

TRADITIONAL CANISTER-BASED OPEN WASTE MANAGEMENT SYSTEM VERSUS CLOSED SYSTEM: HAZARDOUS EXPOSURE PREVENTION AND OPERATING THEATRE STAFF SATISFACTION.

PubMed

Horn, M; Patel, N; MacLellan, D M; Millard, N

2016-06-01

Exposure to blood and body fluids is a major concern to health care professionals working in operating rooms (ORs). Thus, it is essential that hospitals use fluid waste management systems that minimise risk to staff, while maximising efficiency. The current study compared the utility of a 'closed' system with a traditional canister-based 'open' system in the OR in a private hospital setting. A total of 30 arthroscopy, urology, and orthopaedic cases were observed. The closed system was used in five, four, and six cases, respectively and the open system was used in nine, two, and four cases, respectively. The average number of opportunities for staff to be exposed to hazardous fluids were fewer for the closed system when compared to the open during arthroscopy and urology procedures. The open system required nearly 3.5 times as much staff time for set-up, maintenance during procedures, and post-procedure disposal of waste. Theatre staff expressed greater satisfaction with the closed system than with the open. In conclusion, compared with the open system, the closed system offers a less hazardous and more efficient method of disposing of fluid waste generated in the OR.

Case for real-time systems development - Quo vadis?

NASA Technical Reports Server (NTRS)

Erb, Dona M.

1991-01-01

The paper focuses on the distinctive issues of computer-aided software engineering (CASE) products for the development of real-time systems. CASE technologies and associated standardization efforts are evolving from sets of conflicting interests. The majority of case products are intended for use in the development of management information systems. CASE products to support the development of large, complex real-time systems must provide additional capabilities. Generic concerns include the quality of the implementation of the required method for the phase of the system's development and whether the vendor is stable and committed to evolving the products in parallel with nonproprietary standards. The CASE market is undergoing considerable consolidation. The paper describes the major forces, cooperating entities, and remaining uncertainties that need to be weighed in near-term CASE procurements to limit risk of loss of investment in project time, trianing, and money.

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…

Mapping the literature of case management nursing

PubMed Central

White, Pamela; Hall, Marilyn E.

2006-01-01

Objectives: Nursing case management provides a continuum of health care services for defined groups of patients. Its literature is multidisciplinary, emphasizing clinical specialties, case management methodology, and the health care system. This study is part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association. The study identifies core journals cited in case management literature and indexing services that access those journals. Methods: Three source journals were identified based on established criteria, and cited references from each article published from 1997 to 1999 were analyzed. Results: Nearly two-thirds of the cited references were from journals; others were from books, monographs, reports, government documents, and the Internet. Cited journal references were ranked in descending order, and Bradford's Law of Scattering was applied. The many journals constituting the top two zones reflect the diversity of this field. Zone 1 included journals from nursing administration, case management, general medicine, medical specialties, and social work. Two databases, PubMed/MEDLINE and OCLC ArticleFirst, provided the best indexing coverage. Conclusion: Collections that support case management require a relatively small group of core journals. Students and health care professionals will need to search across disciplines to identify appropriate literature. PMID:16710470

TelePain: Primary Care Chronic Pain Management through Weekly Didactic and Case-based Telementoring.

PubMed

Flynn, Diane M; Eaton, Linda H; McQuinn, Honor; Alden, Ashley; Meins, Alexa R; Rue, Tessa; Tauben, David J; Doorenbos, Ardith Z

2017-12-01

Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation. The intervention involves a didactic presentation based on the Joint Pain Education Curriculum followed by patient case presentations and multi-disciplinary discussion via videoconference by clinicians working in the military health system. A panel of pain specialists representing pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, health psychology, pharmacology, nursing, and complementary and integrative pain management provide pain management recommendations for each patient case. We use the Pain Assessment Screening Tool and Outcomes Registry (PASTOR) to measure patient outcomes, including pain, sleep, fatigue, anxiety, and depression. This article reports some of the challenges and lessons learned during early implementation of the TelePain intervention. Weekly telephone meetings among the multisite research team were instrumental in problem solving, identifying problem areas, and developing solutions. Solutions for recruitment challenges included additional outreach and networking to military health providers, both building on.

Focus on patient safety all day, every day.

PubMed

2015-06-01

Case managers may think their job doesn't involve patient safety, but they promote safety by ensuring a safe discharge and are in a position to see safety breaches and mistakes all over the hospital. CMS includes discharge planning in its worksheets for surveyors to use to assess a hospital's compliance with Medicare Conditions of Participation. Because they work with patients from admission to discharge, case managers know which clinicians are competent, those who are not, and may observe safety breaches like failure to wash hands and leaving the catheter in too long. Case managers should spend enough time with their patients to know their situations at home and their support systems and use the information to create workable and safe discharge plans. Hospitals should create an environment and a culture where case managers and other clinicians feel comfortable speaking up when they see safety breaches.

New control concepts for uncertain water resources systems: 1. Theory

NASA Astrophysics Data System (ADS)

Georgakakos, Aris P.; Yao, Huaming

1993-06-01

A major complicating factor in water resources systems management is handling unknown inputs. Stochastic optimization provides a sound mathematical framework but requires that enough data exist to develop statistical input representations. In cases where data records are insufficient (e.g., extreme events) or atypical of future input realizations, stochastic methods are inadequate. This article presents a control approach where input variables are only expected to belong in certain sets. The objective is to determine sets of admissible control actions guaranteeing that the system will remain within desirable bounds. The solution is based on dynamic programming and derived for the case where all sets are convex polyhedra. A companion paper (Yao and Georgakakos, this issue) addresses specific applications and problems in relation to reservoir system management.

Tuberculosis detection and the challenges of integrated care in rural China: A cross-sectional standardized patient study.

PubMed

Sylvia, Sean; Xue, Hao; Zhou, Chengchao; Shi, Yaojiang; Yi, Hongmei; Zhou, Huan; Rozelle, Scott; Pai, Madhukar; Das, Jishnu

2017-10-01

Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China's health system-characterized by a movement toward "integrated care" and promotion of initial contact with grassroots providers-will affect the care of TB patients. Unannounced standardized patients (SPs) presenting with classic pulmonary TB symptoms were deployed in 3 provinces of China in July 2015. The SPs successfully completed 274 interactions across all 3 tiers of China's rural health system, interacting with providers in 46 village clinics, 207 township health centers, and 21 county hospitals. Interactions between providers and standardized patients were assessed against international and national standards of TB care. Using a lenient definition of correct management as at least a referral, chest X-ray or sputum test, 41% (111 of 274) SPs were correctly managed. Although there were no cases of empirical anti-TB treatment, antibiotics unrelated to the treatment of TB were prescribed in 168 of 274 interactions or 61.3% (95% CI: 55%-67%). Correct management proportions significantly higher at county hospitals compared to township health centers (OR 0.06, 95% CI: 0.01-0.25, p < 0.001) and village clinics (OR 0.02, 95% CI: 0.0-0.17, p < 0.001). Correct management in tests of knowledge administered to the same 274 physicians for the same case was 45 percentage points (95% CI: 37%-53%) higher with 24 percentage points (95% CI: -33% to -15%) fewer antibiotic prescriptions. Relative to the current system, where patients can choose to bypass any level of care, simulations suggest that a system of managed referral with gatekeeping at the level of village clinics would reduce proportions of correct management from 41% to 16%, while gatekeeping at the level of the township hospital would retain correct management close to current levels at 37%. The main limitations of the study are 2-fold. First, we evaluate the management of a one-time new patient presenting with presumptive TB, which may not reflect how providers manage repeat patients or more complicated TB presentations. Second, simulations under alternate policies require behavioral and statistical assumptions that should be addressed in future applications of this method. There were significant quality deficits among village clinics and township health centers in the management of a classic case of presumptive TB, with higher proportions of correct case management in county hospitals. Poor clinical performance does not arise only from a lack of knowledge, a phenomenon known as the "know-do" gap. Given significant deficits in quality of care, reforms encouraging first contact with lower tiers of the health system can improve efficiency only with concomitant improvements in appropriate management of presumptive TB patients in village clinics and township health centers.

Quality improvement in basic histotechnology: the lean approach.

PubMed

Clark, David

2016-01-01

Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

A Decision-Support System for Sustainable Water Distribution System Planning.

PubMed

Freund, Alina; Aydin, Nazli Yonca; Zeckzer, Dirk; Hagen, Hans

2017-01-01

An interactive decision-support system (DSS) can help experts prepare water resource management plans for decision makers and stakeholders. The design of the proposed prototype incorporates visualization techniques such as circle views, grid layout, small multiple maps, and node simplification to improve the data readability of water distribution systems. A case study with three urban water management and sanitary engineering experts revealed that the proposed DSS is satisfactory, efficient, and effective.

Teaching Case: Using Excel to Make Strategic Managerial Decisions

ERIC Educational Resources Information Center

Jacobs, Aimee; Robinson, David F.; DePaolo, Concetta A.

2016-01-01

This case involves actual data from a student managed café that serves as a learning laboratory for a college of business. The student team that manages the café has never had access to precise data from a point of sale system until this semester. However, once they downloaded the raw data from the cash register they were unable to make sense of…

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas.

PubMed

Watkins, David W; de Moraes, Márcia M G Alcoforado; Asbjornsen, Heidi; Mayer, Alex S; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M; Önal, Hayri; da Nobrega Germano, Bruna

2015-12-01

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production-from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas

NASA Astrophysics Data System (ADS)

Watkins, David W.; de Moraes, Márcia M. G. Alcoforado; Asbjornsen, Heidi; Mayer, Alex S.; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G.; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M.; Önal, Hayri; da Nobrega Germano, Bruna

2015-12-01

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production—from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Management System for Engineering Ethics

NASA Astrophysics Data System (ADS)

Yashiro, Tomonari

In the context of independent profession based societies, ethics charter/codes of professional bodies have significant influence on the conduct of engineers. Contrarily in Japan, most of active engineers are in-house and feel immediate identity as the member of firm or institution, rather than professional bodies. Therefore, establishment and operation of engineering ethics management system (E2ms) is essential for incentive to make innovative and ethical decision with confidence. The paper introduces the outline of the educational kit for E2ms developed by the author. The kit aims to enhance ability of management relevant to E2ms. The kit also involves ten cases for case method teaching. The test use of the kit indicates the potential to create satisfactory educational achievement.

Managing Complex Change in Clinical Study Metadata

PubMed Central

Brandt, Cynthia A.; Gadagkar, Rohit; Rodriguez, Cesar; Nadkarni, Prakash M.

2004-01-01

In highly functional metadata-driven software, the interrelationships within the metadata become complex, and maintenance becomes challenging. We describe an approach to metadata management that uses a knowledge-base subschema to store centralized information about metadata dependencies and use cases involving specific types of metadata modification. Our system borrows ideas from production-rule systems in that some of this information is a high-level specification that is interpreted and executed dynamically by a middleware engine. Our approach is implemented in TrialDB, a generic clinical study data management system. We review approaches that have been used for metadata management in other contexts and describe the features, capabilities, and limitations of our system. PMID:15187070

[AC-STB: dedicated software for managed healthcare of chronic headache patients].

PubMed

Wallasch, T-M; Bek, J; Pabel, R; Modahl, M; Demir, M; Straube, A

2009-04-01

This paper examines a new approach to managed healthcare where a network of care providers exchanges patient information through the internet. Integrating networks of clinical specialists and general care providers promises to achieve qualitative and economic improvements in the German healthcare system. In practice, problems related to patient management and data exchange between the managing clinic and assorted caregivers arise. The implementation and use of a cross-spectrum computerized solution for the management of patients and their care is the key for a successful managed healthcare system. This paper documents the managed healthcare of chronic headache patients and the development of an IT-solution capable of providing distributed patient care and case management.

Integrated and adaptive management of water resources: Tensions, legacies, and the next best thing

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

Engle, Nathan L.; Johns, Owen R.; Lemos, Maria Carmen

2011-02-01

Integrated water resources management (IWRM) and adaptive management (AM) are two institutional and management paradigms designed to address shortcomings within water systems governance – the limits of hierarchical water institutional arrangements in the case of IWRM and the challenge of making water management decisions under uncertainty in the case of AM. Recently, there has been a trend to merge these paradigms to address the growing complexity of stressors shaping water management, such as globalization and climate change. However, because many of these joint approaches have received little empirical attention, questions remain about how they might work (or not) in practice.more » Here, we explore a few of these issues using empirical research carried out in Brazil. We focus on highlighting the potentially negative interactions, tensions, and tradeoffs between different institutions/mechanisms perceived as desirable as research and practice attempt to make water systems management simultaneously integrated and adaptive. Our examples pertain mainly on the use of techno-scientific knowledge in water management and governance in Brazil’s IWRM model and how it relates to participation, democracy, deliberation, diversity, and adaptability. We show that a legacy of technical and hierarchical management has shaped the integration of management, and subsequently, the degree to which management might also be adaptive. While integrated systems may be more legitimate and accountable than top-down command and control ones, the mechanisms of IWRM may be at odds with the flexible, experimental, and self-organizing nature of AM.« less

Safety management by walking around (SMBWA): a safety intervention program based on both peer and manager participation.

PubMed

Luria, Gil; Morag, Ido

2012-03-01

"Management by walking around" (MBWA) is a practice that has aroused much interest in management science and practice. The purpose of this study is to demonstrate adaptation of this practice to safety management. We describe a three-year long case study that collected empirical data in which a modified MBWA was practiced in order to improve safety in a semiconductor fabrication facility. The main modification involved integrating an information system with the MBWA in order to create a practice that would generate safety leadership development and an organizational safety learning mechanism, while promoting employee safety participation. The results of the case study demonstrate that the SMBWA practice facilitated thousands of tours in which safety leadership behaviors were practiced by managers and by employees (employees performed five times as many tours as managers). The information system collected information about safety behaviors and safety conditions that could not otherwise be obtained. Thus, this study presents a new organizational safety practice SMBWA, and demonstrates the ways in which SMBWA may improve safety in organizations. Copyright © 2011 Elsevier Ltd. All rights reserved.

The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children's service systems.

PubMed

Glisson, Charles; Dukes, Denzel; Green, Philip

2006-08-01

This study examines the effects of the Availability, Responsiveness, and Continuity (ARC) organizational intervention strategy on caseworker turnover, climate, and culture in a child welfare and juvenile justice system. Using a pre-post, randomized blocks, true experimental design, 10 urban and 16 rural case management teams were randomly assigned to either the ARC organizational intervention condition or to a control condition. The culture and climate of each case management team were assessed at baseline and again after the one-year organizational intervention was completed. In addition, caseworker turnover was assessed by identifying caseworkers on the sampled teams who quit their jobs during the year. Hierarchical Linear Models (HLM) analyses indicate that the ARC organizational intervention reduced the probability of caseworker turnover by two-thirds and improved organizational climate by reducing role conflict, role overload, emotional exhaustion, and depersonalization in both urban and rural case management teams. Organizational intervention strategies can be used to reduce staff turnover and improve organizational climates in urban and rural child welfare and juvenile justice systems. This is important because child welfare and juvenile justice systems in the U.S.A. are plagued by high turnover rates, and there is evidence that high staff turnover and poor organizational climates negatively affect service quality and outcomes in these systems.

Safety management for polluted confined space with IT system: a running case.

PubMed

Hwang, Jing-Jang; Wu, Chien-Hsing; Zhuang, Zheng-Yun; Hsu, Yi-Chang

2015-01-01

This study traced a deployed real IT system to enhance occupational safety for a polluted confined space. By incorporating wireless technology, it automatically monitors the status of workers on the site and upon detected anomalous events, managers are notified effectively. The system, with a redefined standard operations process, is running well at one of Formosa Petrochemical Corporation's refineries. Evidence shows that after deployment, the system does enhance the safety level by real-time monitoring the workers and by managing well and controlling the anomalies. Therefore, such technical architecture can be applied to similar scenarios for safety enhancement purposes.

Making intelligent systems team players: Case studies and design issues. Volume 1: Human-computer interaction design

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Woods, David D.; Potter, Scott S.; Johannesen, Leila; Holloway, Matthew; Forbus, Kenneth D.

1991-01-01

Initial results are reported from a multi-year, interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. The objective is to achieve more effective human-computer interaction (HCI) for systems with real time fault management capabilities. Intelligent fault management systems within the NASA were evaluated for insight into the design of systems with complex HCI. Preliminary results include: (1) a description of real time fault management in aerospace domains; (2) recommendations and examples for improving intelligent systems design and user interface design; (3) identification of issues requiring further research; and (4) recommendations for a development methodology integrating HCI design into intelligent system design.

Diagnostic challenges in tuberculous otitis media.

PubMed

Tang, I P; Prepageran, N; Ong, C A; Puraviappan, P

2010-08-01

To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases. We report four cases of tuberculous otitis media with different clinical presentations, encountered between 1998 and 2002. None of the cases showed improvement with local or systemic antibiotics. The diagnosis, complications and management of these cases are discussed. A high index of clinical suspicion of tuberculous otitis media is required in patients who do not respond to standard antibiotic therapy for (nontuberculous) chronic middle-ear infection. Early diagnosis and treatment of tuberculous otitis media is important to avoid irreversible complications, surgical intervention and propagation of the disease.

A system dynamics approach for hospital waste management in a city in a developing country: the case of Nablus, Palestine.

PubMed

Al-Khatib, Issam A; Eleyan, Derar; Garfield, Joy

2016-09-01

Hospitals and health centers provide a variety of healthcare services and normally generate hazardous waste as well as general waste. General waste has a similar nature to that of municipal solid waste and therefore could be disposed of in municipal landfills. However, hazardous waste poses risks to public health, unless it is properly managed. The hospital waste management system encompasses many factors, i.e., number of beds, number of employees, level of service, population, birth rate, fertility rate, and not in my back yard (NIMBY) syndrome. Therefore, this management system requires a comprehensive analysis to determine the role of each factor and its influence on the whole system. In this research, a hospital waste management simulation model is presented based on the system dynamics technique to determine the interaction among these factors in the system using a software package, ithink. This model is used to estimate waste segregation as this is important in the hospital waste management system to minimize risk to public health. Real data has been obtained from a case study of the city of Nablus, Palestine to validate the model. The model exhibits wastes generated from three types of hospitals (private, charitable, and government) by considering the number of both inpatients and outpatients depending on the population of the city under study. The model also offers the facility to compare the total waste generated among these different types of hospitals and anticipate and predict the future generated waste both infectious and non-infectious and the treatment cost incurred.

TERSSE: Definition of the Total Earth Resources System for the Shuttle Era. Volume 5: Detailed system requirements: Two case studies

NASA Technical Reports Server (NTRS)

1974-01-01

Major resource management missions to be performed by the TERSSE are examined in order to develop an understanding of the form and function of a system designed to perform an operational mission. Factors discussed include: resource manager (user) functions, methods of performing their function, the information flows and information requirements embodied in their function, and the characteristics of the observation system which assists in the management of the resource involved. The missions selected for study are: world crop survey and land resources management. These missions are found to represent opposite ends of the TERSSE spectrum and to support the conclusion that different missions require different systems and must be analyzed in detail to permit proper system development decisions.

Understanding service disengagement from the perspective of case managers.

PubMed

Stanhope, Victoria; Henwood, Benjamin F; Padgett, Deborah K

2009-04-01

Disengagement from services by persons experiencing homelessness and co-occurring disorders challenges the mental health system and the frontline providers who build clinical relationships that end prematurely. This qualitative study explored how case managers understand and respond to disengagement. This study was conducted at four programs serving persons with co-occurring disorders experiencing homelessness. The qualitative design used a case study approach based on in-depth interviews with 18 case managers about 29 cases of disengagement. The study compared their accounts with predisengagement interviews when available and the postdeparture residential status of consumers. Themes were derived by independent coding and consensus. Case managers attributed disengagement primarily to substance relapse and a preference for alternative living arrangements. The following themes emerged: seeing disengagement as part of their work, believing disengagement to be poor decision making on the part of the consumer, and coping with the revolving-door syndrome. The majority of consumers experienced homelessness after disengagement. The study illustrated the challenge of building hope-instilling relationships with consumers when faced with the reality of frequent disengagement. In an era of recovery-oriented services and consumer choice, case managers need support when faced with consumer decisions to leave treatment settings. Greater program flexibility may also help to reduce disengagement.

Safeguarding Copyrighted Contents: Digital Libraries and Intellectual Property Management. CWRU's Rights Management System.

ERIC Educational Resources Information Center

Alrashid, Tareq M.; Barker, James A.; Christian, Brian S.; Cox, Steven C.; Rabne, Michael W.; Slotta, Elizabeth A.; Upthegrove, Luella R.

1998-01-01

Describes Case Western Reserve University's (CWRU's) digital library project that examines the networked delivery of full-text materials and high-quality images to provide students excellent supplemental instructional resources delivered directly to their dormitory rooms. Reviews intellectual property (IP) management requirements and describes…

How District Leaders Use Knowledge Management to Influence Principals' Instructional Leadership

ERIC Educational Resources Information Center

McGloughlin, Denise Marie

2016-01-01

The study of knowledge management, an integrated system of an organization's culture, conditions, and structure, as applied to educational institutions is limited. It was not known how district leaders use knowledge management to influence principals' instructional leadership performance. The purpose of this qualitative single-case study was to…

Improving Performance of the System Safety Function at Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Kiessling, Ed; Tippett, Donald D.; Shivers, Herb

2004-01-01

The Columbia Accident Investigation Board (CAIB) determined that organizational and management issues were significant contributors to the loss of Space Shuttle Columbia. In addition, the CAIB observed similarities between the organizational and management climate that preceded the Challenger accident and the climate that preceded the Columbia accident. To prevent recurrence of adverse organizational and management climates, effective implementation of the system safety function is suggested. Attributes of an effective system safety program are presented. The Marshall Space Flight Center (MSFC) system safety program is analyzed using the attributes. Conclusions and recommendations for improving the MSFC system safety program are offered in this case study.

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.

Knowledge Management within the Medical University.

PubMed

Rauzina, Svetlana Ye; Tikhonova, Tatiana A; Karpenko, Dmitriy S; Bogopolskiy, Gennady A; Zarubina, Tatiana V

2015-01-01

The aim of the work is studying the possibilities of ontological engineering in managing of medical knowledge. And also practical implementation of knowledge management system (KMS) in medical university. The educational process model is established that allows analyzing learning results within time scale. Glossary sub-system has been developed; ontologies of educational disciplines are constructed; environment for setup and solution of situational cases is established; ontological approach to assess competencies is developed. The possibilities of the system for solving situation tasks have been described. The approach to the evaluation of competence has been developed.

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.

Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy?

PubMed Central

2012-01-01

Background Malaria case management is a key strategy for malaria control. Effective coverage of parasite-based malaria diagnosis (PMD) remains limited in malaria endemic countries. This study assessed the health system's capacity to absorb PMD at primary health care facilities in Uganda. Methods In a cross sectional survey, using multi-stage cluster sampling, lower level health facilities (LLHF) in 11 districts in Uganda were assessed for 1) tools, 2) skills, 3) staff and infrastructure, and 4) structures, systems and roles necessary for the implementing of PMD. Results Tools for PMD (microscopy and/or RDTs) were available at 30 (24%) of the 125 LLHF. All LLHF had patient registers and 15% had functional in-patient facilities. Three months’ long stock-out periods were reported for oral and parenteral quinine at 39% and 47% of LLHF respectively. Out of 131 health workers interviewed, 86 (66%) were nursing assistants; 56 (43%) had received on-job training on malaria case management and 47 (36%) had adequate knowledge in malaria case management. Overall, only 18% (131/730) Ministry of Health approved staff positions were filled by qualified personnel and 12% were recruited or transferred within six months preceding the survey. Of 186 patients that received referrals from LLHF, 130(70%) had received pre-referral anti-malarial drugs, none received pre-referral rectal artesunate and 35% had been referred due to poor response to antimalarial drugs. Conclusion Primary health care facilities had inadequate human and infrastructural capacity to effectively implement universal parasite-based malaria diagnosis. The priority capacity building needs identified were: 1) recruitment and retention of qualified staff, 2) comprehensive training of health workers in fever management, 3) malaria diagnosis quality control systems and 4) strengthening of supply chain, stock management and referral systems. PMID:22920954

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.

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.

Environmental Management Systems for Educational Institutions: A Case Study of Teri University, New Delhi

ERIC Educational Resources Information Center

Jain, Suresh; Pant, Pallavi

2010-01-01

Purpose: The purpose of this paper is to put forth a model for implementation of an environmental management system (EMS) in institutes of higher education in India. Design/methodology/approach: The authors carried out initial environmental review (IER) and strengths, weaknesses, opportunities and threats (SWOT) analysis to identify the major…

Migrating Learning Management Systems: A Case of a Large Public University

ERIC Educational Resources Information Center

Such, Brenda L. R.; Ritzhaupt, Albert D.; Thompson, George S.

2017-01-01

In the past 20 years, institutions of higher education have made major investments in Learning Management Systems (LMSs). As institutions have integrated the LMS into campus culture, the potential of migrating to not only an upgraded version of the LMS, but also an entirely different LMS, has become a reality. This qualitative research study…

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…

Feasibility Study on the Use of Computer Managed Learning in Secondary Schools in the U.S.A.

ERIC Educational Resources Information Center

Charp, Sylvia

A brief description of computer managed instruction (CMI), including its applications and capabilities, introduces case studies of schools in the United States that are using three different CMI systems. The first system discussed is the Comprehensive Achievement Monitoring (CAM) Program, which was developed by a small school district (Hopkins,…

A Hybrid Approach for Selecting a Course Management System: A Case Study

ERIC Educational Resources Information Center

Aggarwal, Anil; Adlakha, Veena; Ross, Terry

2012-01-01

The Internet is creating exciting opportunities for universities and their stakeholders. Universities are experimenting with different modes of education. E-learning is one such mode, where students can learn from any place at any time, as long as they have an Internet connection. A course management system (CMS) facilitates e-learning, making it…

A Business Case Analysis to Determine the Feasibility of a Scrub Management System at Brooke Army Medical Center

DTIC Science & Technology

2009-03-07

Designated Areas lor Scrub Issue i : FHSI 2. I West ?. Cardiac Cath Lab> 4. Cardiology Radiology 5. Centralized Materiel Services 6. CCUs...Scrub Management System 37 BAMC Memo 52-2 4-. Neiirosnrgciy Clinic 15. Bum Tinuma Unit 46 Cinq Rullis -4". 9J V School -IS. Veterinary Clinic

Exotic encounters with dental implants: managing complications with unidentified systems.

PubMed

Mattheos, N; Janda, M Schittek

2012-06-01

As the application of dental implants increases worldwide, so is the number of technical and biological complications that general dental practitioners will be called to manage, while maintaining implant patients. In addition, the greater patient mobility encountered today combined with a growing trend of 'dental implant tourism' will very often result in situations where the dentist is requested to deal with complications in implants placed elsewhere and which sometimes might be of an 'exotic' system one cannot directly recognize. Such a situation can pose significant challenges to even experienced clinicians. The challenges are not only in the scientific field, but often include professional and ethical implications. This case report will discuss strategies for the management of implant complications in cases of unidentified implant systems. Critical factors in such situations would be the clinician's experience and special training, the correct radiographic technique, as well as access to the appropriate tools and devices. © 2012 Australian Dental Association.

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.

[Surgical management of solitary eosinophilic granuloma of the calvaria. Two case reports].

PubMed

Berhouma, M; Krichen, W; Chamseddine, A; Jemel, H

2009-12-01

Langerhans cell histiocytosis is a systemic disease resulting from the oligoclonal proliferation of Langerhans cells, occurring most commonly in children and young adults. The focal form of the disease, also known as eosinophilic granuloma, most frequently involves the calvaria. We present two cases of calvarial eosinophilic granulomas that were surgically removed. These tumors are reputed to have an excellent prognosis, even if local recurrences and systemic dissemination can occur during the follow-up. The authors discuss the pathogenesis and the evolutive profile but also the therapeutic management of solitary eosinophilic granuloma of the calvaria.

KEY ITEMS OF INNOVATION MANAGEMENT IN THE PRIMARY HEALTHCARE CENTRES CASE STUDY: FINLAND.

PubMed

Aslani, Alireza; Zolfagharzadeh, Mohammad Mahdi; Naaranoja, Marja

2015-09-01

Trends such as aging populations, excess costs, rising public expectations, and progress in medical science and technologies point out the necessity of adaptation and development of innovation in the healthcare systems particularly in developed countries. The main objective of this article is to review diffusion of innovation in the healthcare sector. Different types of innovation, diffusion characteristics, and adoption mechanisms are the subjects that are discussed in the selected case study, Finland. Finally, the key items of innovation management in the Finnish health system are introduced. The results can be implemented in other countries as well.

What Does Industry Really Want in a Knowledge Management System? A Longitudinal Study of Taiwanese Case

NASA Astrophysics Data System (ADS)

Yang, Liang-Chih; Lu, Hsi-Peng

This paper depicts a longitudinal investigation of knowledge management system development from industrial perspectives. Snapshots on three surveys (2002, 2006, and 2010) of Taiwanese companies were conducted and compared, which is to explore the perceived understandings and requirements for the applications of a knowledge management system.From the surveys, it was found that the most useful applications were document management, knowledge search and retrieval, and knowledge repository and map. The emerging applications were expert management, document security, and knowledge automation such as auto-classification, auto-abstract and auto-keyword generation. The most wanted services along with KMS were consulting service, success story-sharing, and modularization while deploying knowledge management system in the enterprises. The trends and transformation of a KM system were also collected and analyzed. We suggest that a company should use different knowledge management approach according to its corporate main business function. Combing intellectual capital theories proposed by other researchers, we categorize knowledge management focus as staff-centric, system-centric, and customer-centric knowledge from industrial perspectives.

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

The HSE management system in practice-implementation

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

Primrose, M.J.; Bentley, P.D.; Sykes, R.M.

1996-11-01

This paper sets out the necessary strategic issues that must be dealt with when setting up a management system for HSE. It touches on the setting of objectives using a form of risk matrix and the establishment of corporate risk tolerability levels. Such issue management is vital but can be seen as yet another corporate HQ initiative. It must therefore be linked, and made relevant to those in middle management tasked with implementing the system and also to those at risk {open_quote}at the sharp end{close_quote} of the business. Setting acceptance criteria is aimed at demonstrating a necessary and sufficient levelmore » of control or coverage for those hazards considered as being within the objective setting of the Safety or HSE Case. Critical risk areas addressed via the Safety Case, within Shell companies at least, must show how this coverage is extended to critical health and environmental issues. Methods of achieving this are various ranging from specific Case deliverables (like the Hazard Register and Accountability Matrices) through to the incorporation of topics from the hazard analysis in toolbox talks and meetings. Risk analysis techniques are increasingly seen as complementary rather than separate with environmental assessments, health risk assessment sand safety risk analyses taking place together and results being considered jointly. The paper ends with some views on the way ahead regarding the linking of risk decisions to target setting at the workplace and views on how Case information may be retrieved and used on a daily basis.« less

Risk management and measuring productivity with POAS--point of act system.

PubMed

Akiyama, Masanori; Kondo, Tatsuya

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 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, Material, Money and Information 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.

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.

Urbanization, Extreme Events, and Health: The Case for Systems Approaches in Mitigation, Management, and Response.

PubMed

Siri, José Gabriel; Newell, Barry; Proust, Katrina; Capon, Anthony

2016-03-01

Extreme events, both natural and anthropogenic, increasingly affect cities in terms of economic losses and impacts on health and well-being. Most people now live in cities, and Asian cities, in particular, are experiencing growth on unprecedented scales. Meanwhile, the economic and health consequences of climate-related events are worsening, a trend projected to continue. Urbanization, climate change and other geophysical and social forces interact with urban systems in ways that give rise to complex and in many cases synergistic relationships. Such effects may be mediated by location, scale, density, or connectivity, and also involve feedbacks and cascading outcomes. In this context, traditional, siloed, reductionist approaches to understanding and dealing with extreme events are unlikely to be adequate. Systems approaches to mitigation, management and response for extreme events offer a more effective way forward. Well-managed urban systems can decrease risk and increase resilience in the face of such events. © 2015 APJPH.

Subacute and non-acute casemix in Australia.

PubMed

Lee, L A; Eagar, K M; Smith, M C

1998-10-19

The costs of subacute care (palliative care, rehabilitation medicine, psychogeriatrics, and geriatric evaluation and management) and non-acute care (nursing home, convalescent and planned respite care) are not adequately described by existing casemix classifications. The predominant treatment goals in subacute care are enhancement of quality of life and/or improvement in functional status and, in non-acute care, maintenance of current health and functional status. A national classification system for this area has now been developed--the Australian National Sub-Acute and Non-Acute Patient Classification System (AN-SNAP). The AN-SNAP system, based on analysis of over 30,000 episodes of care, defines four case types of subacute care (palliative care, rehabilitation, psychogeriatric care, and geriatric evaluation and management and one case type of non-acute care (maintenance care), and classifies both overnight and ambulatory care. The AN-SNAP system reflects the goal of management--a change in functional status or improvement in quality of life--rather than the patient's diagnosis. It will complement the existing AN-DRG classification.

[Recommendations for the control of documents and the establishment of a documentary system].

PubMed

Vinner, E

2013-06-01

The quality management system that must be implemented in a MBL to meet the requirements of the standard NF EN ISO 15189 is based, among other things, on the creation and use by staff of a documentary system approved and updated. This documentary system is constituted by external documents (standards, suppliers' documents...) and internal documents (quality manual, procedures, instructions, technical and quality recordings...). A procedure of the documentary system control must be formalized. The documentary system should be modeled in order to identify the various procedures to be drafted and the incurred risks in the case a document would be missing in this system. Each document must be indexed in a unique way and document management must be carried out rigorously. The use of document management software is a great help to manage the life cycle of documents.

The Agway Management Development Program: Design and Implementation

ERIC Educational Resources Information Center

Barth, Anthony L.; Engfer, Robert T.

1977-01-01

Focus is on the Agway (a farm supply and food marketing cooperative) retail store system in this informational case history and how-to approach for designing, developing, and implementing a formal corporate management program. (Editor/TA)

Liquefied petroleum gas cold burn sustained while refueling a car.

PubMed

Scarr, Bronwyn; Mitra, Biswadev; Maini, Amit; Cleland, Heather

2010-02-01

There have been few cases of cold burn related to the exposure of liquid petroleum gas (LPG). We present the case of a young woman exposed to LPG while refueling her car who sustained partial thickness burns to the dorsum of her hand. Contact with LPG leaking from a pressurized system causes tissue damage because of cold injury. Immediate management of LPG is extrapolated from the management of frostbite. The increasing use of LPG mandates an awareness of prevention strategies and management principles in the setting of adverse events.

A Reporting System to Protect the Human Rights of People Living with HIV and Key Populations.

PubMed

Williamson, R Taylor; Fiscian, Vivian; Olson, Ryan Ubuntu; Poku, Fred Nana; Whittal, Joseph

2017-12-01

People living with HIV and key populations face human rights violations that affect their access to health services, relationships in their communities, housing options, and employment. To address these violations, government and civil society organizations in Ghana developed a discrimination reporting system managed by the Commission on Human Rights and Administrative Justice that links people living with HIV and key populations to legal services. This article presents findings on how Ghanaian stakeholders built this reporting system and discusses preliminary data on its impact. To organize our analysis, we used a conceptual framework that outlines the legal frameworks that protect human rights, the institutions that promote access to justice, and the mechanisms that link people living with HIV and key populations to legal services. Using in-depth interviews, we show that targeted technical assistance increased stakeholders' knowledge of issues that affect people living with HIV and key populations, strengthened these stakeholders' commitment to address discrimination, streamlined case management systems, and improved relationships between civil society and the government. Through case review, we find that most discrimination happens when accessing government services, inside communities and families, and in the workplace. Finally, we describe implications for other human rights commissions that are considering using a reporting system to protect human rights, including using legal frameworks, developing case management systems, and working with civil society.

Using foresight methods to anticipate future threats: the case of disease management.

PubMed

Ma, Sai; Seid, Michael

2006-01-01

We describe a unique foresight framework for health care managers to use in longer-term planning. This framework uses scenario-building to envision plausible alternate futures of the U.S. health care system and links those broad futures to business-model-specific "load-bearing" assumptions. Because the framework we describe simultaneously addresses very broad and very specific issues, it can be easily applied to a broad range of health care issues by using the broad framework and business-specific assumptions for the particular case at hand. We illustrate this method using the case of disease management, pointing out that although the industry continues to grow rapidly, its future also contains great uncertainties.

Acute pesticide poisoning: a proposed classification tool.

PubMed

Thundiyil, Josef G; Stober, Judy; Besbelli, Nida; Pronczuk, Jenny

2008-03-01

Cases of acute pesticide poisoning (APP) account for significant morbidity and mortality worldwide. Developing countries are particularly susceptible due to poorer regulation, lack of surveillance systems, less enforcement, lack of training and inadequate access to information systems. Previous research has demonstrated wide variability in incidence rates for APP. This is possibly due to inconsistent reporting methodology and exclusion of occupational and non-intentional poisonings. The purpose of this document is to create a standard case definition to facilitate the identification and diagnosis of all causes of APP, especially at the field level, rural clinics and primary health-care systems. This document is a synthesis of existing literature and case definitions that have been previously proposed by other authors around the world. It provides a standardized case definition and classification scheme for APP into categories of probable, possible and unlikely/unknown cases. Its use is intended to be applicable worldwide to contribute to identification of the scope of existing problems and thus promote action for improved management and prevention. By enabling a field diagnosis for APP, this standardized case definition may facilitate immediate medical management of pesticide poisoning and aid in estimating its incidence.

Microscope-Integrated OCT Feasibility and Utility With the EnFocus System in the DISCOVER Study.

PubMed

Runkle, Anne; Srivastava, Sunil K; Ehlers, Justis P

2017-03-01

To evaluate the feasibility and utility of a novel microscope-integrated intraoperative optical coherence tomography (OCT) system. The DISCOVER study is an investigational device study evaluating microscope-integrated intraoperative OCT systems for ophthalmic surgery. This report focuses on subjects imaged with the EnFocus prototype system (Leica Microsystems/Bioptigen, Morrisville, NC). OCT was performed at surgeon-directed milestones. Surgeons completed a questionnaire after each case to evaluate the impact of OCT on intraoperative management. Fifty eyes underwent imaging with the EnFocus system. Successful imaging was obtained in 46 of 50 eyes (92%). In eight cases (16%), surgical management was changed based on intraoperative OCT findings. In membrane peeling procedures, intraoperative OCT findings were discordant from the surgeon's initial impression in seven of 20 cases (35%). This study demonstrates the feasibility of microscope-integrated intraoperative OCT using the Bioptigen EnFocus system. Intraoperative OCT may provide surgeons with additional information that may influence surgical decision-making. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:216-222.]. Copyright 2017, SLACK Incorporated.

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.

Comparing Management Approaches for Automatic Test Systems: A Strategic Missile Case Study

DTIC Science & Technology

2005-03-01

ground up, and is commonly conducted following five methods : ethnography , grounded theory , case study , phenomenological study , and biography...traditions frequently used (Creswell, 1998:5). The five traditions are biography, phenomenological study , grounded theory study , ethnography , and... Ethnography Biography Case Study Grounded Theory

A Study to Develop Alternative Approaches for Implementing Product Line Management in the South Texas Veterans Health Care System

DTIC Science & Technology

1997-05-01

Transformation of the Veterans Healthcare System." Department of Veterans Affairs, Washington, D.C., March, 1996. 88 Kotler , Philip . "Managing...time lines are developed so management and staff can begin thinking about business from a different perspective (Manning 1987,29). Philip Lathrop...organized around product lines will the full effects of this approach be known. 86 WORKS CITED Benz, Philip D., and Janet Burnham. "Case Study

Community control of health services. Dr. Martin Luther King, Jr. Health Center's community management system.

PubMed

Tichy, N M; Taylor, J I

1976-01-01

This article presents the case of Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of control, namely, management, without experiencing destructive conflicts and the deterioration of health services.

Architecture design of the national plant treasure management information system based on GIS: a case study of Gugong Date Garden in Hebei province

NASA Astrophysics Data System (ADS)

Shen, Shaoling; Li, Renjie; Shen, Dongdong; Tong, Chunyan; Fu, Xueqing

2007-06-01

"Gugong Date Garden", lies in Juguan Village, Qijiawu County, Huanghua City, China. It is the largest forest of winter date in this world, which is the longest in history, largest in area and best in quality and it is also included in the first group of national main protected units of botanic cultural relics. However, it is lacking of uniform management platform and modes. According to the specific characteristics of botanic cultural relics preservation, the author sets up the "Plant Treasure Management Information System" for "Gugong Date Garden", based on the Geographic information system (GIS), Internet, database and virtual reality technologies, along with the idea of modern customer management systems. This system is designed for five types of users, named system administrators, cultural relic supervisors, researchers, farmers and tourists, with the aim of realizing integrated managements of ancient trees' protection, scientific researches, tourism and explorations altogether, so as to make better management, protection, and utilizations.

Oral bullous lichen planus: Case report and review of management

PubMed Central

Patil, Archana; Prasad, Shiva; Ashok, L.; Sujatha, G. P.

2012-01-01

A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus. PMID:23293497

Decision support environment for medical product safety surveillance.

PubMed

Botsis, Taxiarchis; Jankosky, Christopher; Arya, Deepa; Kreimeyer, Kory; Foster, Matthew; Pandey, Abhishek; Wang, Wei; Zhang, Guangfan; Forshee, Richard; Goud, Ravi; Menschik, David; Walderhaug, Mark; Woo, Emily Jane; Scott, John

2016-12-01

We have developed a Decision Support Environment (DSE) for medical experts at the US Food and Drug Administration (FDA). The DSE contains two integrated systems: The Event-based Text-mining of Health Electronic Records (ETHER) and the Pattern-based and Advanced Network Analyzer for Clinical Evaluation and Assessment (PANACEA). These systems assist medical experts in reviewing reports submitted to the Vaccine Adverse Event Reporting System (VAERS) and the FDA Adverse Event Reporting System (FAERS). In this manuscript, we describe the DSE architecture and key functionalities, and examine its potential contributions to the signal management process by focusing on four use cases: the identification of missing cases from a case series, the identification of duplicate case reports, retrieving cases for a case series analysis, and community detection for signal identification and characterization. Published by Elsevier Inc.

Putting flow-ecology relationships into practice: A decision-support system to assess fish community response to water-management scenarios

USGS Publications Warehouse

Cartwright, Jennifer M.; Caldwell, Casey; Nebiker, Steven; Knight, Rodney

2017-01-01

This paper presents a conceptual framework to operationalize flow–ecology relationships into decision-support systems of practical use to water-resource managers, who are commonly tasked with balancing multiple competing socioeconomic and environmental priorities. We illustrate this framework with a case study, whereby fish community responses to various water-management scenarios were predicted in a partially regulated river system at a local watershed scale. This case study simulates management scenarios based on interactive effects of dam operation protocols, withdrawals for municipal water supply, effluent discharges from wastewater treatment, and inter-basin water transfers. Modeled streamflow was integrated with flow–ecology relationships relating hydrologic departure from reference conditions to fish species richness, stratified by trophic, reproductive, and habitat characteristics. Adding a hypothetical new water-withdrawal site was predicted to increase the frequency of low-flow conditions with adverse effects for several fish groups. Imposition of new reservoir release requirements was predicted to enhance flow and fish species richness immediately downstream of the reservoir, but these effects were dissipated further downstream. The framework presented here can be used to translate flow–ecology relationships into evidence-based management by developing decision-support systems for conservation of riverine biodiversity while optimizing water availability for human use.

Unintended adverse consequences of a clinical decision support system: two cases.

PubMed

Stone, Erin G

2018-05-01

Many institutions have implemented clinical decision support systems (CDSSs). While CDSS research papers have focused on benefits of these systems, there is a smaller body of literature showing that CDSSs may also produce unintended adverse consequences (UACs). Detailed here are 2 cases of UACs resulting from a CDSS. Both of these cases were related to external systems that fed data into the CDSS. In the first case, lack of knowledge of data categorization in an external pharmacy system produced a UAC; in the second case, the change of a clinical laboratory instrument produced the UAC. CDSSs rely on data from many external systems. These systems are dynamic and may have changes in hardware, software, vendors, or processes. Such changes can affect the accuracy of CDSSs. These cases point to the need for the CDSS team to be familiar with these external systems. This team (manager and alert builders) should include members in specific clinical specialties with deep knowledge of these external systems.

Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment – Web-SP

PubMed Central

Zary, Nabil; Johnson, Gunilla; Boberg, Jonas; Fors, Uno GH

2006-01-01

Background The Web-based Simulation of Patients (Web-SP) project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP) in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines. Results The Web-SP system was constructed to support easy authoring, management and presentation of virtual patient cases. The case authoring environment was found to facilitate for teachers to create full-fledged patient cases without the assistance of computer specialists. Web-SP was successfully implemented at several universities by taking into account key factors such as cost, access, security, scalability and flexibility. Pilot evaluations in medical, dentistry and pharmacy courses shows that students regarded Web-SP as easy to use, engaging and to be of educational value. Cases adapted for all three disciplines were judged to be of significant educational value by the course leaders. Conclusion The Web-SP system seems to fulfil the aim of providing a common generic platform for creation, management and evaluation of web-based virtual patient cases. The responses regarding the authoring environment indicated that the system might be user-friendly enough to appeal to a majority of the academic staff. In terms of implementation strengths, Web-SP seems to fulfil most needs from course directors and teachers from various educational institutions and disciplines. The system is currently in use or under implementation in several healthcare disciplines at more than ten universities worldwide. Future aims include structuring the exchange of cases between teachers and academic institutions by building a VP library function. We intend to follow up the positive results presented in this paper with other studies looking at the learning outcomes, critical thinking and patient management. Studying the potential of Web-SP as an assessment tool will also be performed. More information about Web-SP: PMID:16504041

Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment--Web-SP.

PubMed

Zary, Nabil; Johnson, Gunilla; Boberg, Jonas; Fors, Uno G H

2006-02-21

The Web-based Simulation of Patients (Web-SP) project was initiated in order to facilitate the use of realistic and interactive virtual patients (VP) in medicine and healthcare education. Web-SP focuses on moving beyond the technology savvy teachers, when integrating simulation-based education into health sciences curricula, by making the creation and use of virtual patients easier. The project strives to provide a common generic platform for design/creation, management, evaluation and sharing of web-based virtual patients. The aim of this study was to evaluate if it was possible to develop a web-based virtual patient case simulation environment where the entire case authoring process might be handled by teachers and which would be flexible enough to be used in different healthcare disciplines. The Web-SP system was constructed to support easy authoring, management and presentation of virtual patient cases. The case authoring environment was found to facilitate for teachers to create full-fledged patient cases without the assistance of computer specialists. Web-SP was successfully implemented at several universities by taking into account key factors such as cost, access, security, scalability and flexibility. Pilot evaluations in medical, dentistry and pharmacy courses shows that students regarded Web-SP as easy to use, engaging and to be of educational value. Cases adapted for all three disciplines were judged to be of significant educational value by the course leaders. The Web-SP system seems to fulfil the aim of providing a common generic platform for creation, management and evaluation of web-based virtual patient cases. The responses regarding the authoring environment indicated that the system might be user-friendly enough to appeal to a majority of the academic staff. In terms of implementation strengths, Web-SP seems to fulfil most needs from course directors and teachers from various educational institutions and disciplines. The system is currently in use or under implementation in several healthcare disciplines at more than ten universities worldwide. Future aims include structuring the exchange of cases between teachers and academic institutions by building a VP library function. We intend to follow up the positive results presented in this paper with other studies looking at the learning outcomes, critical thinking and patient management. Studying the potential of Web-SP as an assessment tool will also be performed. More information about Web-SP: http://websp.lime.ki.se.

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…

Communication and implementation of GIS data in fire management: a case study

Treesearch

Kenneth G. Boykin; Douglas I. Boykin; Rusty Stovall; Ryan Whitaker

2008-01-01

Remotely sensed data and Geographical Information Systems (GIS) can be an effective tool in fire management. For the inclusion of these tools, fire management and research personnel must be effective in communication regarding needs and limitations of the data and implementing that data at various scales. A number of personnel can be involved within fire management...

X-framework: Space system failure analysis framework

NASA Astrophysics Data System (ADS)

Newman, John Steven

Space program and space systems failures result in financial losses in the multi-hundred million dollar range every year. In addition to financial loss, space system failures may also represent the loss of opportunity, loss of critical scientific, commercial and/or national defense capabilities, as well as loss of public confidence. The need exists to improve learning and expand the scope of lessons documented and offered to the space industry project team. One of the barriers to incorporating lessons learned include the way in which space system failures are documented. Multiple classes of space system failure information are identified, ranging from "sound bite" summaries in space insurance compendia, to articles in journals, lengthy data-oriented (what happened) reports, and in some rare cases, reports that treat not only the what, but also the why. In addition there are periodically published "corporate crisis" reports, typically issued after multiple or highly visible failures that explore management roles in the failure, often within a politically oriented context. Given the general lack of consistency, it is clear that a good multi-level space system/program failure framework with analytical and predictive capability is needed. This research effort set out to develop such a model. The X-Framework (x-fw) is proposed as an innovative forensic failure analysis approach, providing a multi-level understanding of the space system failure event beginning with the proximate cause, extending to the directly related work or operational processes and upward through successive management layers. The x-fw focus is on capability and control at the process level and examines: (1) management accountability and control, (2) resource and requirement allocation, and (3) planning, analysis, and risk management at each level of management. The x-fw model provides an innovative failure analysis approach for acquiring a multi-level perspective, direct and indirect causation of failures, and generating better and more consistent reports. Through this approach failures can be more fully understood, existing programs can be evaluated and future failures avoided. The x-fw development involved a review of the historical failure analysis and prevention literature, coupled with examination of numerous failure case studies. Analytical approaches included use of a relational failure "knowledge base" for classification and sorting of x-fw elements and attributes for each case. In addition a novel "management mapping" technique was developed as a means of displaying an integrated snapshot of indirect causes within the management chain. Further research opportunities will extend the depth of knowledge available for many of the component level cases. In addition, the x-fw has the potential to expand the scope of space sector lessons learned, and contribute to knowledge management and organizational learning.

Factors related to treatment refusal in Taiwanese cancer patients.

PubMed

Chiang, Ting-Yu; Wang, Chao-Hui; Lin, Yu-Fen; Chou, Shu-Lan; Wang, Ching-Ting; Juang, Hsiao-Ting; Lin, Yung-Chang; Lin, Mei-Hsiang

2015-01-01

Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (p<0.001), poor performance(p<0.001), changes in medical condition (p<0.001), timing of case manager contact (p=.026), the methods by which case manager contact patients (p<0.001) and the frequency that case managers contact patients (≥10times) (p=0.016). Cancer patients who refuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.

Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers' use of information in decision-making: experience from Cape Town, South Africa.

PubMed

Scott, Vera; Gilson, Lucy

2017-09-15

Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers' use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. Central governance shaped what information and knowledge was valued - and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential knowledge to make locally-appropriate and responsive decisions, and to perform the people management tasks required. Despite central level influences, modes of governance operating at the subdistrict level had influence over what information was valued, generated and used locally. Strengthening local level managers' ability to create enabling environments is an important leverage point in supporting informed local decision-making, and, in turn, translating national policies and priorities, including equity goals, into appropriate service delivery practices.

Modular life cycle assessment of municipal solid waste management.

PubMed

Haupt, M; Kägi, T; Hellweg, S

2018-05-31

Life cycle assessment (LCA) is commonly applied to examine the environmental performance of waste management systems. The system boundaries are, however, often limited to either one tonne of material or to specific waste treatments and are, therefore, lacking a systems perspective. Here, a framework is proposed to assess complete waste management systems based on actual waste flows, assessed with a detailed material flow analysis (MFA) in a modular MFA/LCA approach. The transformation of the MFA into a product-process-matrix facilitates a direct link between MFA and LCA, therefore allowing for the assessment of variations in flows. To allow for an up-to-date and geographically specific assessment, 190 LCA modules were set up based on primary industrial data and the ecoinvent database. The LCA modules show where there have been improvements in different recycling processes over the past years (e.g. for paper recycling) and highlight that, from an environmental perspective, closed-loop recycling is not always preferable to open-loop recycling. In a case study, the Swiss municipal solid waste management system, of which there is already a detailed MFA, was modeled using the new LCA modules and applying the modular MFA/LCA approach. Five different mass flow distribution scenarios for the Swiss municipal solid waste management system were assessed to show the environmental impact of political measures and to test the sensitivity of the results to key parameters. The results of the case study highlight the importance of the dominant fractions in the overall environmental impacts assessment; while the metal fraction has the highest impact on a per kilogram basis, paper, cardboard, glass and mixed municipal solid waste were found to dominate the environmental impacts of the Swiss waste management system due to their mass. The scenarios also highlight the importance of the energy efficiency of municipal solid waste incineration plants and the credits from material substitution as key variables. In countries with advanced waste management systems such as Switzerland, there is limited improvement potential with further increases in recycling rates. In these cases, the focus of political measures should be laid on (i) the utilization of secondary materials in applications where they replace high-impact primary production, and (ii) an increased recovery of energy in waste-to-energy plants. Copyright © 2018. Published by Elsevier Ltd.

How reframing a water management issue across scales and levels impacts on perceptions of justice and injustice

NASA Astrophysics Data System (ADS)

Patrick, M. J.; Syme, G. J.; Horwitz, P.

2014-11-01

Social justice is a key outcome of water allocation, management and governance. It is commonly expressed in water policies and strategies in terms of achieving equitable distribution of water resources. In complex multi-level systems just and unjust outcomes can result from the same water allocation decision. In some cases a just outcome at one level may cause an injustice at another level for the same or a different set of stakeholders. The manner in which a water management issue is framed and reframed across different levels within a system influences stakeholder perceptions of whether a water allocation decision is just or unjust, which in turn influences the successful adoption and implementation of such a decision. This paper utilises a case study from the Murray-Darling Basin in Australia to illustrate how reframing a water management issue across multiple scales and levels can help understand stakeholders' perceptions of justice and injustice. In this case study two scales are explored, an institutional and an organisational scale; each comprising levels at the federal, basin, state and region. The water management issue of domestic and stock dams was tracked through the various scales and levels and illustrated how reframing an issue at different levels can influence the analysis of just or equitable outcomes. The case study highlights the need to treat justice in water allocation as an ever evolving problem of the behaviour of a social system rather than the meeting of static principles of what is 'right'. This points to the importance of being attentive to the dynamic and dialogical nature of justice when dealing with water allocation issues across scales and levels of water governance.

Analytical method of waste allocation in waste management systems: Concept, method and case study

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

Bergeron, Francis C., E-mail: francis.b.c@videotron.ca

Waste is not a rejected item to dispose anymore but increasingly a secondary resource to exploit, influencing waste allocation among treatment operations in a waste management (WM) system. The aim of this methodological paper is to present a new method for the assessment of the WM system, the “analytical method of the waste allocation process” (AMWAP), based on the concept of the “waste allocation process” defined as the aggregation of all processes of apportioning waste among alternative waste treatment operations inside or outside the spatial borders of a WM system. AMWAP contains a conceptual framework and an analytical approach. Themore » conceptual framework includes, firstly, a descriptive model that focuses on the description and classification of the WM system. It includes, secondly, an explanatory model that serves to explain and to predict the operation of the WM system. The analytical approach consists of a step-by-step analysis for the empirical implementation of the conceptual framework. With its multiple purposes, AMWAP provides an innovative and objective modular method to analyse a WM system which may be integrated in the framework of impact assessment methods and environmental systems analysis tools. Its originality comes from the interdisciplinary analysis of the WAP and to develop the conceptual framework. AMWAP is applied in the framework of an illustrative case study on the household WM system of Geneva (Switzerland). It demonstrates that this method provides an in-depth and contextual knowledge of WM. - Highlights: • The study presents a new analytical method based on the waste allocation process. • The method provides an in-depth and contextual knowledge of the waste management system. • The paper provides a reproducible procedure for professionals, experts and academics. • It may be integrated into impact assessment or environmental system analysis tools. • An illustrative case study is provided based on household waste management in Geneva.« less

A new data management system for the French National Registry of human alveolar echinococcosis cases.

PubMed

Charbonnier, Amandine; Knapp, Jenny; Demonmerot, Florent; Bresson-Hadni, Solange; Raoul, Francis; Grenouillet, Frédéric; Millon, Laurence; Vuitton, Dominique Angèle; Damy, Sylvie

2014-01-01

Alveolar echinococcosis (AE) is an endemic zoonosis in France due to the cestode Echinococcus multilocularis. The French National Reference Centre for Alveolar Echinococcosis (CNR-EA), connected to the FrancEchino network, is responsible for recording all AE cases diagnosed in France. Administrative, epidemiological and medical information on the French AE cases may currently be considered exhaustive only on the diagnosis time. To constitute a reference data set, an information system (IS) was developed thanks to a relational database management system (MySQL language). The current data set will evolve towards a dynamic surveillance system, including follow-up data (e.g. imaging, serology) and will be connected to environmental and parasitological data relative to E. multilocularis to better understand the pathogen transmission pathway. A particularly important goal is the possible interoperability of the IS with similar European and other databases abroad; this new IS could play a supporting role in the creation of new AE registries. © A. Charbonnier et al., published by EDP Sciences, 2014.

A new data management system for the French National Registry of human alveolar echinococcosis cases

PubMed Central

Charbonnier, Amandine; Knapp, Jenny; Demonmerot, Florent; Bresson-Hadni, Solange; Raoul, Francis; Grenouillet, Frédéric; Millon, Laurence; Vuitton, Dominique Angèle; Damy, Sylvie

2014-01-01

Alveolar echinococcosis (AE) is an endemic zoonosis in France due to the cestode Echinococcus multilocularis. The French National Reference Centre for Alveolar Echinococcosis (CNR-EA), connected to the FrancEchino network, is responsible for recording all AE cases diagnosed in France. Administrative, epidemiological and medical information on the French AE cases may currently be considered exhaustive only on the diagnosis time. To constitute a reference data set, an information system (IS) was developed thanks to a relational database management system (MySQL language). The current data set will evolve towards a dynamic surveillance system, including follow-up data (e.g. imaging, serology) and will be connected to environmental and parasitological data relative to E. multilocularis to better understand the pathogen transmission pathway. A particularly important goal is the possible interoperability of the IS with similar European and other databases abroad; this new IS could play a supporting role in the creation of new AE registries. PMID:25526544

How general dentists could manage a patient with oral lichen planus.

PubMed

Robledo-Sierra, J; van der Waal, I

2018-03-01

The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment.

Decision support system for drinking water management

NASA Astrophysics Data System (ADS)

Janža, M.

2012-04-01

The problems in drinking water management are complex and often solutions must be reached under strict time constrains. This is especially distinct in case of environmental accidents in the catchment areas of the wells that are used for drinking water supply. The beneficial tools that can help decision makers and make program of activities more efficient are decision support systems (DSS). In general they are defined as computer-based support systems that help decision makers utilize data and models to solve unstructured problems. The presented DSS was developed in the frame of INCOME project which is focused on the long-term stable and safe drinking water supply in Ljubljana. The two main water resources Ljubljana polje and Barje alluvial aquifers are characterized by a strong interconnection of surface and groundwater, high vulnerability, high velocities of groundwater flow and pollutant transport. In case of sudden pollution, reactions should be very fast to avoid serious impact to the water supply. In the area high pressures arising from urbanization, industry, traffic, agriculture and old environmental burdens. The aim of the developed DSS is to optimize the activities in cases of emergency water management and to optimize the administrative work regarding the activities that can improve groundwater quality status. The DSS is an interactive computer system that utilizes data base, hydrological modelling, and experts' and stakeholders' knowledge. It consists of three components, tackling the different abovementioned issues in water management. The first one utilizes the work on identification, cleaning up and restoration of illegal dumpsites that are a serious threat to the qualitative status of groundwater. The other two components utilize the predictive capability of the hydrological model and scenario analysis. The user interacts with the system by a graphical interface that guides the user step-by-step to the recommended remedial measures. Consequently, the acquisition of information to support the water management's decisions is simplified and faster, thus contributing to more efficient water management and a safer supply of drinking water.

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…

The MORPG-Based Learning System for Multiple Courses: A Case Study on Computer Science Curriculum

ERIC Educational Resources Information Center

Liu, Kuo-Yu

2015-01-01

This study aimed at developing a Multiplayer Online Role Playing Game-based (MORPG) Learning system which enabled instructors to construct a game scenario and manage sharable and reusable learning content for multiple courses. It used the curriculum of "Introduction to Computer Science" as a study case to assess students' learning…

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.

Managing Marginal School Employees: Applying Standards-Based Performance Measures

ERIC Educational Resources Information Center

Fields, Lynette; Reck, Brianne; Egley, Robert

2006-01-01

This book contains a collection of case studies that provide a variety of situations in managing or working with marginal employees in a school system. Managing Marginal School Employees will serve as a primary or companion text for administrator candidates or current administrators that include dilemmas for the student to think about, discuss,…

Identifying challenges and opportunities for improved nutrient management through U.S.D.A's Dairy Agroecosystem Working Group

USDA-ARS?s Scientific Manuscript database

Nutrient management is a priority of U.S. dairy farms, although specific concerns vary across regions and management systems. To elucidate challenges and opportunities to improving nutrient use efficiencies, the USDA’s Dairy Agroecosystems Working Group investigated 10 case studies of confinement (i...

An alert system for triggering different levels of coastal management urgency: Tunisia case study using rapid environmental assessment data.

PubMed

Price, A R G; Jaoui, K; Pearson, M P; Jeudy de Grissac, A

2014-03-15

Rapid environmental assessment (REA) involves scoring abundances of ecosystems/species groups and magnitude of pressures, concurrently, using the same logarithmic (0-6) assessment scale. We demonstrate the utility of REA data for an alert system identifying different levels of coastal management concern. Thresholds set for abundances/magnitudes, when crossed, trigger proposed responses. Kerkennah, Tunisia, our case study, has significant natural assets (e.g. exceptional seagrass and invertebrate abundances), subjected to varying levels of disturbance and management concern. Using REA thresholds set, fishing, green algae/eutrophication and oil occurred at 'low' levels (scores 0-1): management not (currently) necessary. Construction and wood litter prevailed at 'moderate' levels (scores 2-4): management alerted for (further) monitoring. Solid waste densities were 'high' (scores 5-6): management alerted for action; quantities of rubbish were substantial (20-200 items m⁻¹ beach) but not unprecedented. REA is considered a robust methodology and complementary to other rapid assessment techniques, environmental frameworks and indicators of ecosystem condition. Copyright © 2014 Elsevier Ltd. All rights reserved.

Communication and collaboration among return-to-work stakeholders.

PubMed

Russell, Elizabeth; Kosny, Agnieszka

2018-05-17

Workers who are injured or become ill on the job are best able to return-to-work when stakeholders involved in their case collaborate and communicate. This study examined health care providers' and case managers' engagement in rehabilitation and return-to-work following workplace injury or illness. In-depth interviews were conducted with 97 health care providers and 34 case managers in four Canadian provinces about their experiences facilitating rehabilitation and return-to-work, and interacting with system stakeholders. A qualitative thematic content analysis demonstrated two key findings. Firstly, stakeholders were challenged to collaborate as a result of: barriers to interdisciplinary and cross-professional communication; philosophical differences about the timing and appropriateness of return-to-work; and confusion among health care providers about the workers' compensation system. Secondly, these challenges adversely affected the co-ordination of patient care, and consequentially, injured workers often became information conduits, and effective and timely treatment and return-to-work was sometimes negatively impacted. Communication challenges between health care providers and case managers may negatively impact patient care and alienate treating health care providers. Discussion about role clarification, the appropriateness of early return-to-work, how paperwork shapes health care providers' role expectations, and strengthened inter-professional communication are considered. Implications for Rehabilitation Administrative and conceptual barriers in workers' compensation systems challenge collaboration and communication between health care providers and case managers. Injured workers may become conduits of incorrect information, resulting in adversarial relationships, overturned health care providers' recommendations, and their disengagement from rehabilitation and return-to-work. Stakeholders should clarify the role of health care providers during rehabilitation and return-to-work and the appropriateness of early return-to-work to mitigate recurring challenges. Communication procedures between health care specialists may disrupt these challenges, increasing the likelihood of timely and effective rehabilitation and return-to-work.

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.

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.

A Case-Based Approach Improves Science Students' Experimental Variable Identification Skills

ERIC Educational Resources Information Center

Grunwald, Sandra; Hartman, Andrew

2010-01-01

Incorporation of experimental case studies into the laboratory curriculum increases students' abilities to identify experimental variables that affect the outcome of an experiment. Here the authors describe how such case studies were incorporated using an online course management system into a biochemistry laboratory curriculum and the assessment…

Developing Use Cases for Evaluation of ADMS Applications to Accelerate Technology Adoption: Preprint

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

Veda, Santosh; Wu, Hongyu; Martin, Maurice

Grid modernization for the distribution systems comprise of the ability to effectively monitor and manage unplanned events while ensuring reliable operations. Integration of Distributed Energy Resources (DERs) and proliferation of autonomous smart controllers like microgrids and smart inverters in the distribution networks challenge the status quo of distribution system operations. Advanced Distribution Management System (ADMS) technologies are being increasingly deployed to manage the complexities of operating distribution systems. The ability to evaluate the ADMS applications in specific utility environments and for future scenarios will accelerate wider adoption of the ADMS and will lower the risks and costs of their implementation.more » This paper addresses the first step - identify and define the use cases for evaluating these applications. The applications that are selected for this discussion include Volt-VAr Optimization (VVO), Fault Location Isolation and Service Restoration (FLISR), Online Power Flow (OLPF)/Distribution System State Estimation (DSSE) and Market Participation. A technical description and general operational requirements for each of these applications is presented. The test scenarios that are most relevant to the utility challenges are also addressed.« less

InteractInteraction mechanism of emergency response in geological hazard perception and risk management: a case study in Zhouqu county

NASA Astrophysics Data System (ADS)

Qi, Yuan; Zhao, Hongtao

2017-04-01

China is one of few several natural disaster prone countries, which has complex geological and geographical environment and abnormal climate. On August 8, 2010, a large debris flow disaster happened in Zhouqu Country, Gansu province, resulting in more than 1700 casualties and more than 200 buildings damaged. In order to percept landslide and debris flow, an early warning system was established in the county. Spatial information technologies, such as remote sensing, GIS, and GPS, play core role in the early warning system, due to their functions in observing, analyzing, and locating geological disasters. However, all of these spatial information technologies could play an important role only guided by the emergency response mechanism. This article takes the establishment of Zhouqu Country's Disaster Emergency Response Interaction Mechanism (DERIM) as an example to discuss the risk management of country-level administrative units. The country-level risk management aims to information sharing, resources integration, integrated prevention and unified command. Then, nine subsystems support DERIM, which included disaster prevention and emergency data collection and sharing system, joint duty system, disaster verification and evaluation system, disaster consultation system, emergency warning and information release system, emergency response system, disaster reporting system, plan management system, mass prediction and prevention management system. At last, an emergency command platform in Zhouqu Country built up to realize DERIM. The core mission of the platform consists of daily management of disaster, monitoring and warning, comprehensive analysis, information release, consultation and decision-making, emergency response, etc. Five functional modules, including module of disaster information management, comprehensive monitoring module (geological monitoring, meteorological monitoring, water conservancy and hydrological monitoring), alarm management module, emergency command and disaster dispatching management module are developed on the basis of this platform. Based on the internet technology, an web-based office platform is exploited for the nodes scattered in departments and towns, which includes daily business, monitoring and warning, alarm notification, alarm recording, personnel management and update in disaster region, query and analysis of real-time observation data, etc. The platform experienced 3 years' test of the duty in flood period since 2013, and two typical disaster cases during this period fully illustrates the effectiveness of the DERIM and the emergency command platform.

Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

PubMed

Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

2009-03-01

Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

Otic Langerhans' Cell Histiocytosis in an Adult: A Case Report and Review of the Literature

PubMed Central

Gungadeen, Anil; Kullar, Peter; Yates, Philip

2013-01-01

Objective. To present a case of otic Langerhans' cell histiocytosis in an adult. Also included the diagnosis and management of the condition and a review of the relevant literature. Case Report. We report a case of a 41-year-old man with a history of persistent unilateral ear discharge associated with an aural polyp. Radiological imaging showed bony lesions of the skull and a soft-tissue mass within the middle ear. Histological analysis of the polyp demonstrated Langerhans' cell histiocytosis. His otological symptoms were completely resolved with the systemic therapy. Conclusions. Otic Langerhans' cell histiocytosis can present in adults. Persistent ear symptoms along with evidence of soft-tissue masses within the ear and bony lesions of the skull or elsewhere should prompt the otolaryngologists to include Langerhans' cell histiocytosis in their differential diagnosis. Management should be with systemic therapy rather than local surgical treatment. PMID:23762704

Many-Objective Robust Decision Making: Managing Water in a Deeply Uncertain World of Change (Invited)

NASA Astrophysics Data System (ADS)

Reed, P. M.

2013-12-01

Water resources planning and management has always required the consideration of uncertainties and the associated system vulnerabilities that they may cause. Despite the long legacy of these issues, our decision support frameworks that have dominated the literature over the past 50 years have struggled with the strongly multiobjective and deeply uncertain nature of water resources systems. The term deep uncertainty (or Knightian uncertainty) refers to factors in planning that strongly shape system risks that maybe unknown and even if known there is a strong lack of consensus on their likelihoods over decadal planning horizons (population growth, financial stability, valuation of resources, ecosystem requirements, evolving water institutions, regulations, etc). In this presentation, I will propose and demonstrate the many-objective robust decision making (MORDM) framework for water resources management under deep uncertainty. The MORDM framework will be demonstrated using an urban water portfolio management test case. In the test case, a city in the Lower Rio Grande Valley managing population and drought pressures must cost effectively maintain the reliability of its water supply by blending permanent rights to reservoir inflows with alternative strategies for purchasing water within the region's water market. The case study illustrates the significant potential pitfalls in the classic Cost-Reliability conception of the problem. Moreover, the proposed MORDM framework exploits recent advances in multiobjective search, visualization, and sensitivity analysis to better expose these pitfalls en route to identifying highly robust water planning alternatives.

The Future of Electronic Reserves and the Presence of Librarians in Content Management Systems: A Case Study at Manhattan College

ERIC Educational Resources Information Center

Handfield, Amy E.

2017-01-01

This article addresses the development of electronic reserves within academic libraries. Libraries have been offering electronic reserve services on separate platforms since the 1990s (Austin, 2013). However, since the integration of campus-wide content management systems (CMSs), the need for a library reserves platform that is independent from an…

Wireless battery management control and monitoring system

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

Zumstein, James M.; Chang, John T.; Farmer, Joseph C.

A battery management system using a sensor inside of the battery that sensor enables monitoring and detection of various events in the battery and transmission of a signal from the sensor through the battery casing to a control and data acquisition module by wireless transmission. The detection of threshold events in the battery enables remedial action to be taken to avoid catastrophic events.

Migration of Data from One Library Management System to Another: A Case Study in India

ERIC Educational Resources Information Center

Matoria, Ram Kumar; Upadhyay, P. K.

2005-01-01

Purpose: To share the experiences gained during the migration of library data from one library management system (LibSys[TM]) to another (e-Granthalaya[TM]). Design/methodology/approach: The paper describes the step-by-step approach taken to migrate the existing library data to the new software. The paper also discusses the peculiarities of the…

Response of a depleted sagebrush steppe riparian system to grazing control and woody plantings

Treesearch

Warren P. Clary; Nancy L. Shaw; Jonathan G. Dudley; Victoria A. Saab; John W. Kinney; Lynda C. Smithman

1996-01-01

To find out if a depleted riparian system in the sagebrush steppe of eastern Oregon would respond quickly to improved management, five management treatments were applied for 7 years, ranging from ungrazed to heavily grazed treatments, including in some cases, planting of woody species. While the results varied, all treatments were too limited to significantly restore...

Library Subject Guides: A Content Management Case Study at the Open University, UK

ERIC Educational Resources Information Center

Wales, Tim

2005-01-01

Purpose: To share the experiences and challenges faced by the Open University Library (OUL) in developing a content management (CM) system for its subject guides. Design/methodology/approach: A summary of multi-format subject guide production at the OUL is provided to justify the decision to develop a new system for their production using a…

Using a Learning Management System to Personalise Learning for Primary School Students

ERIC Educational Resources Information Center

Edmunds, Bronwyn; Hartnett, Maggie

2014-01-01

This paper reports on one aspect of a descriptive multiple-case study which set out to explore the role of a learning management system (LMS) in personalising learning for students from the perspective of three teachers in one primary school in New Zealand. The intention was to provide insight into the role the LMS could play in classrooms when…

Globalization of healthcare: case management in a 21st-century world.

PubMed

Craig, Kathy; Beichl, Lisa

2009-01-01

This article explains the current state of the global healthcare market with respect to international medical travel (medical tourism) and worldwide provider sourcing. Emphasis is placed on the traditional twin pillars of oversight: program accreditation and branding affiliation. These are discussed for their main strength, which is their ability to operate at a system-strata level. This strength also represents a primary weakness from the international patient's perspective, which is the functional gap between systemic oversight and bedside surveillance. International case management (ICM) is identified as the right conduit of patient-level service delivery that fills the gap between system and bedside. The ICM professional is introduced and defined as the provider of patient-centered quality and safety improvements, who coordinates and collaborates using international network connections and culture-sensitive in-country communication skills. The article's information is useful for healthcare practitioners who want to learn about the global medical marketplace. Practitioners who are preparing to or who already have business enterprises associated with the global healthcare market will also find the information helpful. Explanations and content are useful to case management generalists, specialists, and business developers. The content is intended for uptake by interested parties within and outside the healthcare practice arena. All research and syntheses were executed by the authors. Sources included business correspondences, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. Clinical competencies stem from the international practice experiences of one author (K. Craig). International health insurance, economics, and financing expertise stems from other author (L. Beichl). This article launches the platform for development of checklists, tools, and guidelines for international case management practice. The article focuses on (1) the examination of traditional quality safeguards of accreditation and branding and (2) the introduction of patient-centered ICM practices. The article aims to identify sources of risk for individual medical consumers who travel across national borders to seek medical care and methods of risk mitigation, especially international case management.

Case Management Directors

PubMed Central

Bankston White, Cheri; Birmingham, Jackie

2015-01-01

Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations that include payer, provider, and regulatory agencies. At the same time, they must also develop the skills to positively influence the revenue cycle and financial health of both the organization for which they work and those to whom they transition patients. Implications for Case Management: A director of case management with responsibility for transitions of care has more power and influence over patient safety than is commonly known. Few of the directors who are drawn from clinical case management or other leadership positions and thrust into this role are prepared to navigate within the organization, much less across the whole spectrum of payer, provider, and monitoring organizations. Yet the external focus of the director's role continues to grow in importance as the health care industry evolves and more focus is placed on population management and relationships with payers and community providers. PMID:25700135

From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study.

PubMed

Jacobs, Bart; Thomé, Jean-Marc; Overtoom, Rob; Sam, Sam Oeun; Indermühle, Lorenz; Price, Neil

2010-05-01

Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period-notably the development of performance indicators and targets and the performance monitoring.

The connection between long-term and short-term risk management strategies: examples from land-use planning and emergency management in four European case studies

NASA Astrophysics Data System (ADS)

Prenger-Berninghoff, K.; Cortes, V. J.; Sprague, T.; Aye, Z. C.; Greiving, S.; Głowacki, W.; Sterlacchini, S.

2014-04-01

The need for continuous adaptation to complex and unforeseen events requires enhancing the links between planning and preparedness phases to reduce future risks in the most efficient way. In this context, the legal-administrative and cultural context has to be taken into account. This is why four case study areas of the CHANGES1 project (Nehoiu Valley in Romania, Ubaye Valley in France, Val Canale in Italy, and Wieprzówka catchment in Poland) serve as examples to highlight currently implemented risk management strategies for land-use planning and emergency preparedness. The strategies described in this paper were identified by means of exploratory and informal interviews in each study site. Results reveal that a dearth or, in very few cases, a weak link exists between spatial planners and emergency managers. Management strategies could benefit from formally intensifying coordination and cooperation between emergency services and spatial planning authorities. Moreover, limited financial funds urge for a more efficient use of resources and better coordination towards long-term activities. The research indicates potential benefits to establishing or, in some cases, strengthening this link and provides suggestions for further development in the form of information and decision support systems as a key connection point. Aside from the existent information systems for emergency management, it was found that a common platform, which integrates involvement of these and other relevant actors could enhance this connection and address expressed stakeholder needs. 1 Marie Curie ITN CHANGES - Changing Hydro-meteorological Risks as Analyzed by a New Generation of European Scientists.

Data Grid Management Systems

NASA Technical Reports Server (NTRS)

Moore, Reagan W.; Jagatheesan, Arun; Rajasekar, Arcot; Wan, Michael; Schroeder, Wayne

2004-01-01

The "Grid" is an emerging infrastructure for coordinating access across autonomous organizations to distributed, heterogeneous computation and data resources. Data grids are being built around the world as the next generation data handling systems for sharing, publishing, and preserving data residing on storage systems located in multiple administrative domains. A data grid provides logical namespaces for users, digital entities and storage resources to create persistent identifiers for controlling access, enabling discovery, and managing wide area latencies. This paper introduces data grids and describes data grid use cases. The relevance of data grids to digital libraries and persistent archives is demonstrated, and research issues in data grids and grid dataflow management systems are discussed.

Integrated waste and water management system

NASA Technical Reports Server (NTRS)

Murray, R. W.; Sauer, R. L.

1986-01-01

The performance requirements of the NASA Space Station have prompted a reexamination of a previously developed integrated waste and water management system that used distillation and catalytic oxydation to purify waste water, and microbial digestion and incineration for waste solids disposal. This system successfully operated continuously for 206 days, for a 4-man equivalent load of urine, feces, wash water, condensate, and trash. Attention is given to synergisms that could be established with other life support systems, in the cases of thermal integration, design commonality, and novel technologies.

[Evaluation of the Oran university hospital information system].

PubMed

Chougrani, Saada; Ouhadj, Salah; Agag, Fouzia

2013-01-01

Oran university hospital has been operating since 2010. It is a public institution that must assess the resources required to achieve institutional goals integrated into the strategic objectives defined in the hospital development project. Implementation of this project could be supported, among other things, by a strong and efficient hospital information system. Three investigations were conducted: 1- evaluation of the hospital information system, 2- assessment of the quality of the hospital discharge summary reports, 3- assessment of the quality of medical records. The six components of the hospital information system (resources, indicators, sources, management, quality and dissemination and use of data) were clearly present but not satisfactory with a score ranging from 25 to 50% of the total score. The scores by component were as follows: 36% for resources, 37% for indicators, 42% for patient records, 19% for data management and 27% for the dissemination of information. The overall completeness of medical records was 85.2%. Completeness by group of variables gave the following results: 66% for medical information, 54% for the patient's stay and 38% for information relating to the patient's discharge. Hospital discharge summary reports were available in 59.8% of cases, but were blank in 4% of cases. The critical variable, the principal diagnosis was found in 51% of cases. The correct principal diagnosis rate was 33.3%. The deficiencies observed for content and data management raise real questions concerning data management at Oran university hospital as part of a real managerial approach.

Adaptive management of rangeland systems

USGS Publications Warehouse

Allen, Craig R.; Angeler, David G.; Fontaine, Joseph J.; Garmestani, Ahjond S.; Hart, Noelle M.; Pope, Kevin L.; Twidwell, Dirac

2017-01-01

Adaptive management is an approach to natural resource management that uses structured learning to reduce uncertainties for the improvement of management over time. The origins of adaptive management are linked to ideas of resilience theory and complex systems. Rangeland management is particularly well suited for the application of adaptive management, having sufficient controllability and reducible uncertainties. Adaptive management applies the tools of structured decision making and requires monitoring, evaluation, and adjustment of management. Adaptive governance, involving sharing of power and knowledge among relevant stakeholders, is often required to address conflict situations. Natural resource laws and regulations can present a barrier to adaptive management when requirements for legal certainty are met with environmental uncertainty. However, adaptive management is possible, as illustrated by two cases presented in this chapter. Despite challenges and limitations, when applied appropriately adaptive management leads to improved management through structured learning, and rangeland management is an area in which adaptive management shows promise and should be further explored.

Apollo management: A key to the solution of the social-economical dilemma - The transferability of space-travel managerial techniques to the civil sector

NASA Technical Reports Server (NTRS)

Puttkamer, J. V.

1973-01-01

An analysis has been conducted to find out whether the management techniques developed in connection with the Apollo project could be used for dealing with such urgent problems of modern society as the crisis of the cities, the increasing environmental pollution, and the steadily growing traffic. Basic concepts and definitions of program and system management are discussed together with details regarding the employment of these concepts in connection with the solution of the problems of the Apollo program. Principles and significance of a systems approach are considered, giving attention to planning, system analysis, system integration, and project management. An application of the methods of project management to the problems of the civil sector is possible if the special characteristics of each particular case are taken into account.

Simulation of demand-response power management in smart city

NASA Astrophysics Data System (ADS)

Kadam, Kshitija

Smart Grids manage energy efficiently through intelligent monitoring and control of all the components connected to the electrical grid. Advanced digital technology, combined with sensors and power electronics, can greatly improve transmission line efficiency. This thesis proposed a model of a deregulated grid which supplied power to diverse set of consumers and allowed them to participate in decision making process through two-way communication. The deregulated market encourages competition at the generation and distribution levels through communication with the central system operator. A software platform was developed and executed to manage the communication, as well for energy management of the overall system. It also demonstrated self-healing property of the system in case a fault occurs, resulting in an outage. The system not only recovered from the fault but managed to do so in a short time with no/minimum human involvement.

Multidisciplinary COPD disease management program: impact on clinical outcomes.

PubMed

Morganroth, Melvin; Pape, Ginger; Rozenfeld, Yelena; Heffner, John E

2016-01-01

We hypothesized performance improvement interventions would improve COPD guideline-recommended care and decrease COPD exacerbations in primary care clinic practices. We initiated a performance improvement project in 12 clinics to improve COPD outcomes incorporating physician education, case management, web-based decision support (CareManager(TM)), and performance feedback. We collected baseline and one-year follow up data on 242 patients who had COPD with acute exacerbations. We analyzed data by two methods. First, the 12 clinics were cluster randomized to 4 intervention (117 patients) and 8 control (125 patients) clinics which all had access to CareManager(TM) but only intervention clinic physicians received case management, academic detailing, and decision support assistance. Exacerbation rates and guideline adherence were compared. Second, data from all 12 clinics were pooled in a quasi-experimental design comparing baseline and post-implementation of CareManager(TM) to determine the value of system-wide performance improvement during the study period. In the randomized analysis, baseline demographics were similar. No differences (p = 0.79) occurred in exacerbation rates between intervention and control clinics although both groups had decreased numbers of exacerbations from baseline to follow up (p < 0.05). The pooled data from all 12 clinics demonstrated a reduction (p < 0.05) in mean exacerbations/patient from 2.3 (CI 2.0-2.6) during baseline to 1.4 (CI 1.1-1.7) at one-year follow up. Emergency department visits and hospitalizations/patient decreased (p = 0.003). Patients naïve at study start to depression screening, pneumococcal vaccination, inhaled control medications or smoking cessation had fewer (p < 0.05) exacerbations after these interventions. We observed no difference in exacerbation rates between clinics receiving case management, academic detailing, and ongoing assistance with decision support and controls. Implementation of a web-based disease management system (CareManager(TM)) along with health system-wide COPD performance improvement efforts was associated with fewer COPD exacerbations and increased adherence to guideline recommendations.

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

SLFP: a stochastic linear fractional programming approach for sustainable waste management.

PubMed

Zhu, H; Huang, G H

2011-12-01

A stochastic linear fractional programming (SLFP) approach is developed for supporting sustainable municipal solid waste management under uncertainty. The SLFP method can solve ratio optimization problems associated with random information, where chance-constrained programming is integrated into a linear fractional programming framework. It has advantages in: (1) comparing objectives of two aspects, (2) reflecting system efficiency, (3) dealing with uncertainty expressed as probability distributions, and (4) providing optimal-ratio solutions under different system-reliability conditions. The method is applied to a case study of waste flow allocation within a municipal solid waste (MSW) management system. The obtained solutions are useful for identifying sustainable MSW management schemes with maximized system efficiency under various constraint-violation risks. The results indicate that SLFP can support in-depth analysis of the interrelationships among system efficiency, system cost and system-failure risk. Copyright © 2011 Elsevier Ltd. All rights reserved.

Orbiter/Space lab momentum management for POP orientations

NASA Technical Reports Server (NTRS)

Cox, J. W.

1974-01-01

An angular momentum management scheme applicable to the orbiter/spacelab is described. The basis of the scheme is to periodically maneuver the vehicle through a small angle thereby using the gravity gradient torque to dump momentum from the control moment gyro (CMG) control system. The orbiter is operated with its principal vehicle axis perpendicular to the orbital plane. Numerous case runs were conducted on the hybrid simulation and representative cases are included.

Teaching medical management and operations engineering for systems-based practice to radiology residents.

PubMed

Brandon, Catherine J; Mullan, Patricia B

2013-03-01

To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice. A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions. Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology. Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

How general dentists could manage a patient with oral lichen planus

PubMed Central

Robledo-Sierra, Jairo

2018-01-01

Background The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Material and Methods Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. Results: In most cases, the dentist should be able to establish a correct diagnosis. Results In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. Conclusions General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment. Key words:Oral mucosal disease, oral lichen planus. PMID:29476684

Livestock grazing and wildlife: developing compatabilities.

Treesearch

Martin Vavra

2005-01-01

Livestock grazing has been considered detrimental to wildlife habitat. Managed gazing programs, however, have the potential to maintain habitat diversity and quality. In cases in which single-species management predominates (sage-grouse [Centrocercus urophasianus] or elk [Cervus elaphus nelsoni] winter range), grazing systems...

Banking on Enterprise E-Learning.

ERIC Educational Resources Information Center

Gold, Martha

2003-01-01

The last in a five-part series of case studies on how large organizations are using and measuring enterprise-wide electronic learning tells how PNC Bank made the most of its learning management system to upgrade employee skills through a competence manager application. (JOW)

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

Development of a GIS-based spill management information system.

PubMed

Martin, Paul H; LeBoeuf, Eugene J; Daniel, Edsel B; Dobbins, James P; Abkowitz, Mark D

2004-08-30

Spill Management Information System (SMIS) is a geographic information system (GIS)-based decision support system designed to effectively manage the risks associated with accidental or intentional releases of a hazardous material into an inland waterway. SMIS provides critical planning and impact information to emergency responders in anticipation of, or following such an incident. SMIS couples GIS and database management systems (DBMS) with the 2-D surface water model CE-QUAL-W2 Version 3.1 and the air contaminant model Computer-Aided Management of Emergency Operations (CAMEO) while retaining full GIS risk analysis and interpretive capabilities. Live 'real-time' data links are established within the spill management software to utilize current meteorological information and flowrates within the waterway. Capabilities include rapid modification of modeling conditions to allow for immediate scenario analysis and evaluation of 'what-if' scenarios. The functionality of the model is illustrated through a case study of the Cheatham Reach of the Cumberland River near Nashville, TN.

Clinical results of HIS, RIS, PACS integration using data integration CASE tools

NASA Astrophysics Data System (ADS)

Taira, Ricky K.; Chan, Hing-Ming; Breant, Claudine M.; Huang, Lu J.; Valentino, Daniel J.

1995-05-01

Current infrastructure research in PACS is dominated by the development of communication networks (local area networks, teleradiology, ATM networks, etc.), multimedia display workstations, and hierarchical image storage architectures. However, limited work has been performed on developing flexible, expansible, and intelligent information processing architectures for the vast decentralized image and text data repositories prevalent in healthcare environments. Patient information is often distributed among multiple data management systems. Current large-scale efforts to integrate medical information and knowledge sources have been costly with limited retrieval functionality. Software integration strategies to unify distributed data and knowledge sources is still lacking commercially. Systems heterogeneity (i.e., differences in hardware platforms, communication protocols, database management software, nomenclature, etc.) is at the heart of the problem and is unlikely to be standardized in the near future. In this paper, we demonstrate the use of newly available CASE (computer- aided software engineering) tools to rapidly integrate HIS, RIS, and PACS information systems. The advantages of these tools include fast development time (low-level code is generated from graphical specifications), and easy system maintenance (excellent documentation, easy to perform changes, and centralized code repository in an object-oriented database). The CASE tools are used to develop and manage the `middle-ware' in our client- mediator-serve architecture for systems integration. Our architecture is scalable and can accommodate heterogeneous database and communication protocols.

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.

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.

Recovery Audit Contractor medical necessity readiness: one health system's journey.

PubMed

Scott, Judith A; Camden, Mindy

2011-01-01

To develop a sustainable approach to Recovery Audit Contractor medical necessity readiness that mitigates the regulatory and financial risks of the organization. Acute care hospitals. Utilizing the model for improvement and plan-do-study-act methodology, this health system designed and implemented a medical necessity case management program. We focused on 3 areas for improvement: medical necessity review accuracy, review timeliness, and physician adviser participation for secondary reviews. Over several months, we improved accuracy and timeliness of our medical necessity reviews while also generating additional inpatient revenue for the health system. We successfully enhanced regulatory compliance and reduced our financial risks associated with Recovery Audit Contractor medical necessity audits. A successful medical necessity case management program can not only enhance regulatory compliance and reduce the amount of payments recouped by Medicare, but also generate additional inpatient revenue for your organization. With health care reform and accountable care organizations on the horizon, hospitals must find ways to protect and enhance revenue in order to carry out their missions. This is one way for case managers to help in that cause, to advocate for the care of their patients, and to bring value to the organization.

Developing Enterprise E-Learning at Kodak.

ERIC Educational Resources Information Center

Gold, Martha

2003-01-01

The third in a five-part series of case studies on enterprisewide electronic learning describes how Kodak's approach to a global learning management system integrated 80 discrete human resource systems into one. (JOW)

Low-thrust chemical orbit to orbit propulsion system propellant management study

NASA Technical Reports Server (NTRS)

Dergance, R. H.

1980-01-01

Propellant requirements, tankage configurations, preferred propellant management techniques, propulsion systems weights, and technology deficiencies for low thrust expendable propulsion systems are examined. A computer program was utilized which provided a complete propellant inventory (including boil-off for cryogenic cases), pressurant and propellant tank dimensions for a given ullage, pressurant requirements, insulation requirements, and miscellaneous masses. The output also includes the masses of all tanks; the mass of the insulation, engines and other components; total wet system and burnout mass; system mass fraction; total impulse and burn time.

Optical surgical navigation system causes pulse oximeter malfunction.

PubMed

Satoh, Masaaki; Hara, Tetsuhito; Tamai, Kenji; Shiba, Juntaro; Hotta, Kunihisa; Takeuchi, Mamoru; Watanabe, Eiju

2015-01-01

An optical surgical navigation system is used as a navigator to facilitate surgical approaches, and pulse oximeters provide valuable information for anesthetic management. However, saw-tooth waves on the monitor of a pulse oximeter and the inability of the pulse oximeter to accurately record the saturation of a percutaneous artery were observed when a surgeon started an optical navigation system. The current case is thought to be the first report of this navigation system interfering with pulse oximetry. The causes of pulse jamming and how to manage an optical navigation system are discussed.

Evaluation of a digital drainage system (Thopaz) in over 250 cases at a single site: A retrospective case-control study.

PubMed

Arai, Hiromasa; Tajiri, Michihiko; Kameda, Yohei; Shiino, Kimihisa; Ando, Kohei; Okudela, Koji; Masuda, Munetaka

2018-04-01

The aim of this study was to evaluate the efficacy of the Thopaz system, a new drainage system in management of general thoracic surgery, based on a review of our clinical practice and a comparison of the utility of the Thopaz device compared with a standard drainage system. A review of 540 thoracic surgeries at our hospital was performed. These cases were divided into 275 treated with the Thopaz system from April 2014 to March 2015 and 265 treated with a standard system from April 2013 to March 2014. The characteristics of patients and outcomes after surgery were compared in these 2 groups. The characteristics of the patients were similar in the 2 groups. Outcomes after surgery, including types of operation, period of chest tube placement, chest tube reinsertion rate and clamping test rate also did not differ significantly between the groups. The non-inferiority of the Thopaz system compared to a standard system was verified statistically. With advantages of providing objective data as a small portable system, in addition to the quietness of the unit and the ease of setup and operation, Thopaz system is likely to become mainstream in postoperative management in general thoracic surgery. © 2017 John Wiley & Sons Ltd.

Water Resources Management and Hydrologic Design Under Uncertain Climate Change Scenarios

NASA Astrophysics Data System (ADS)

Teegavarapu, R. S.

2008-05-01

The impact of climate change on hydrologic design and management of water resource systems could be one of the important challenges faced by future practicing hydrologists and water resources managers. Many water resources managers currently rely on the historical hydrological data and adaptive real-time operations without consideration of the impact of climate change on major inputs influencing the behavior of hydrologic systems and the operating rules. Issues such as risk, reliability and robustness of water resources systems under different climate change scenarios were addressed in the past. However, water resources management with the decision maker's preferences attached to climate change has never been dealt with. This presentation discusses issues related to impacts of climate change on water resources management and application of a soft-computing approach, fuzzy set theory, for climate-sensitive management of water resources systems. A real-life case study example is presented to illustrate the applicability of soft-computing approach for handling the decision maker's preferences in accepting or rejecting the magnitude and direction of climate change.

Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

PubMed

Stokes, Jonathan; Panagioti, Maria; Alam, Rahul; Checkland, Kath; Cheraghi-Sohi, Sudeh; Bower, Peter

2015-01-01

An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group). Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately), and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14). A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36) and long-term (0.35, 0.04 to 0.66). Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care. This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and considered also the effects of key moderators. Current results do not support case management as an effective model, especially concerning reduction of secondary care use or total costs. We consider reasons for lack of effect and highlight key research questions for the future. The review protocol is available as part of the PROSPERO database (registration number: CRD42014010824).

Case Management Directors

PubMed Central

Bankston-White, Cheri; Birmingham, Jackie

2015-01-01

Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their responsibilities and impact. They must find opportunities for themselves and their departments to learn and stay current as the regulatory environment continues to change. Providing a list of functions for which they are responsible, practical strategies for carrying them out, and places to go for help and information can help hospital case management directors operate with the confidence and knowledge they need to influence the quality and safety of patient care for the entire care team and to provide the best possible interactions with patients and family members. PMID:25629731

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation

PubMed Central

Jit, Mark; Stagg, Helen R; Aldridge, Robert W; White, Peter J

2011-01-01

Objective To assess the cost effectiveness of the Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis. Design Economic evaluation using a discrete, multiple age cohort, compartmental model of treated and untreated cases of active tuberculosis. Setting London, United Kingdom. Population Hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service (48 mobile screening unit cases, 188 cases referred for case management support, and 180 cases referred for loss to follow-up), and 252 passively presenting controls from London’s enhanced tuberculosis surveillance system. Main outcome measures Incremental costs, quality adjusted life years (QALYs), and cost effectiveness ratios for the Find and Treat service. Results The model estimated that, on average, the Find and Treat service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. The service has a net cost of £1.4 million/year and, under conservative assumptions, gains 220 QALYs. The incremental cost effectiveness ratio was £6400-£10 000/QALY gained (about €7300-€11 000 or $10 000-$16 000 in September 2011). The two Find and Treat components were also cost effective, even in unfavourable scenarios (mobile screening unit (for undiagnosed cases), £18 000-£26 000/QALY gained; case management support team, £4100-£6800/QALY gained). Conclusions Both the screening and case management components of the Find and Treat service are likely to be cost effective in London. The cost effectiveness of the mobile screening unit in particular could be even greater than estimated, in view of the secondary effects of infection transmission and development of antibiotic resistance. PMID:22067473

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation.

PubMed

Jit, Mark; Stagg, Helen R; Aldridge, Robert W; White, Peter J; Abubakar, Ibrahim

2011-09-14

To assess the cost effectiveness of the Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis. Economic evaluation using a discrete, multiple age cohort, compartmental model of treated and untreated cases of active tuberculosis. London, United Kingdom. Population Hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service (48 mobile screening unit cases, 188 cases referred for case management support, and 180 cases referred for loss to follow-up), and 252 passively presenting controls from London's enhanced tuberculosis surveillance system. Incremental costs, quality adjusted life years (QALYs), and cost effectiveness ratios for the Find and Treat service. The model estimated that, on average, the Find and Treat service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. The service has a net cost of £1.4 million/year and, under conservative assumptions, gains 220 QALYs. The incremental cost effectiveness ratio was £6400-£10,000/QALY gained (about €7300-€11,000 or $10,000-$16 000 in September 2011). The two Find and Treat components were also cost effective, even in unfavourable scenarios (mobile screening unit (for undiagnosed cases), £18,000-£26,000/QALY gained; case management support team, £4100-£6800/QALY gained). Both the screening and case management components of the Find and Treat service are likely to be cost effective in London. The cost effectiveness of the mobile screening unit in particular could be even greater than estimated, in view of the secondary effects of infection transmission and development of antibiotic resistance.

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.

Effects of an Incentive Based Budgeting System on Institutional Performance Indicators: An Exploratory Longitudinal Case Study of a Public University

ERIC Educational Resources Information Center

Willett, Michael S.

2013-01-01

The purpose of this exploratory longitudinal case study was to examine how the implementation of an Incentive Based Budgeting (IBB) system (i.e., Responsibility-Centered Management [RCM]) affected selected institutional performance indicators at the campus level and two comparable schools at a large Mid-Western public University. The value of…

Early intervention reduces morbidity in extravasation injuries from 'lighter fuel' injection.

PubMed

Thaha, M A; McKinnell, T H; Graham, K E; Naasan, A N

2007-01-01

Injection of 'lighter fuel' with suicidal intent is rare. Extravasation of the chemical may rarely cause systemic toxicity, but usually it results in extensive soft tissue damage. Such injuries when managed by the traditional expectant policy are associated with considerable morbidity. Early aggressive surgical management using 'saline flush out' limits the tissue damage by stopping the natural progression of the chemical mediated injury and the subsequent inflammatory response, thereby allowing better skin preservation and functional outcome in these cases. We report a case of 'lighter fuel' subcutaneous extravasation injury managed by 'saline flush out' technique soon after presentation.

Cost-effectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario.

PubMed

Xie, Bin; da Silva, Orlando; Zaric, Greg

2012-01-01

To evaluate the incremental cost-effectiveness of a system-based approach for the management of neonatal jaundice and the prevention of kernicterus in term and late-preterm (≥35 weeks) infants, compared with the traditional practice based on visual inspection and selected bilirubin testing. Two hypothetical cohorts of 150,000 term and late-preterm neonates were used to compare the costs and outcomes associated with the use of a system-based or traditional practice approach. Data for the evaluation were obtained from the case costing centre at a large teaching hospital in Ontario, supplemented by data from the literature. The per child cost for the system-based approach cohort was $176, compared with $173 in the traditional practice cohort. The higher cost associated with the system-based cohort reflects increased costs for predischarge screening and treatment and increased postdischarge follow-up visits. These costs are partially offset by reduced costs from fewer emergency room visits, hospital readmissions and kernicterus cases. Compared with the traditional approach, the cost to prevent one kernicterus case using the system-based approach was $570,496, the cost per life year gained was $26,279, and the cost per quality-adjusted life year gained was $65,698. The cost to prevent one kernicterus case using the system-based approach is much lower than previously reported in the literature.

Cost-effectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario

PubMed Central

Xie, Bin; da Silva, Orlando; Zaric, Greg

2012-01-01

OBJECTIVE: To evaluate the incremental cost-effectiveness of a system-based approach for the management of neonatal jaundice and the prevention of kernicterus in term and late-preterm (≥35 weeks) infants, compared with the traditional practice based on visual inspection and selected bilirubin testing. STUDY DESIGN: Two hypothetical cohorts of 150,000 term and late-preterm neonates were used to compare the costs and outcomes associated with the use of a system-based or traditional practice approach. Data for the evaluation were obtained from the case costing centre at a large teaching hospital in Ontario, supplemented by data from the literature. RESULTS: The per child cost for the system-based approach cohort was $176, compared with $173 in the traditional practice cohort. The higher cost associated with the system-based cohort reflects increased costs for predischarge screening and treatment and increased postdischarge follow-up visits. These costs are partially offset by reduced costs from fewer emergency room visits, hospital readmissions and kernicterus cases. Compared with the traditional approach, the cost to prevent one kernicterus case using the system-based approach was $570,496, the cost per life year gained was $26,279, and the cost per quality-adjusted life year gained was $65,698. CONCLUSION: The cost to prevent one kernicterus case using the system-based approach is much lower than previously reported in the literature. PMID:23277747

When More is Less: The Case of Disconnected Information Systems in Indonesian Public Health Facilities

NASA Astrophysics Data System (ADS)

Wahid, Fathul; Teduh Dirgahayu, Raden; Hamzah, Almed; Setiaji, Hari

2018-03-01

The clear majority of previous studies have found that the absence of information systems to properly manage data is one of the main challenges in improving public health management. The present study offers an alternate perspective, revealing other emerging problems in cases where there are many information systems in place but without sufficient orchestration. The national government of Indonesia has been coercive in its implementation of various information systems without involving users at public health facilities, which has created many problems on the ground. The problems identified relate to the quality of the disconnected information systems currently in use, the lack of human resource development, unclear procedures, uncoordinated reports and the absence of an incentive scheme. The present study also highlights some practical implications, including the use of a more holistic perspective in designing and developing an integrated public health information infrastructure.

SCIENCE FOR INTEGRATED WATERSHED MANAGEMENT: A MULTI-SCALE EXPERIMENTAL CASE STUDY LINKING LAND USE MANAGEMENT PRACTICES AND WATER QUALITY IN SOUTHERN OHIO

EPA Science Inventory

Although it is routine for watershed management programs to coincide the monitoring of land use impacts and water quality at different spatial scales, rarely are the data collected in a manner to elucidate the linkages among ecological systems across a drainage network. There rem...

Business Continuity Management Plan

DTIC Science & Technology

2014-12-01

organization ( Shaw , 2004). Navy Supply Systems Command (NAVSUP) does not have a framework that can help develop a business continuity management (BCM...cites two case studies that demonstrate how an organization mitigated issues during catastrophic events that led to disruptions to their business ...www.uschamber.com/sites/default/files/legacy/ issues /defense/files/guideli nesbc.pdf Comprehensive Emergency Management Associates. (2006). Business continuity

Stormwater Management for TMDLs in an Arid Climate: A Case Study Application of SUSTAIN in Albuquerque, New Mexico

EPA Science Inventory

The U.S. Environmental Protection Agency’s (EPA’s) Office of Research and Development and U.S. EPA Region 6 conducted a study that evaluated the use of best management practices (BMPs) for stormwater management in an arid climate. The System for Urban Stormwater Treatment and An...

Public Management Reform without Managers: The Case of German Public Schools

ERIC Educational Resources Information Center

Mintrop, Rick

2015-01-01

Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…

Design of customer knowledge management system for Aglaonema Nursery in South Tangerang, Indonesia

NASA Astrophysics Data System (ADS)

Sugiarto, D.; Mardianto, I.; Dewayana, TS; Khadafi, M.

2017-12-01

The purpose of this paper is to describe the design of customer knowledge management system to support customer relationship management activities for an aglaonema nursery in South Tangerang, Indonesia. System. The steps were knowledge identification (knowledge about customer, knowledge from customer, knowledge for customer), knowledge capture, codification, analysis of system requirement and create use case and activity diagram. The result showed that some key knowledge were about supporting customer in plant care (know how) and types of aglaonema including with the prices (know what). That knowledge for customer then codified and shared in knowledge portal website integrated with social media. Knowledge about customer were about customers and their behaviour in purchasing aglaonema. Knowledge from customer were about feedback, favorite and customer experience. Codified knowledge were placed and shared using content management system based on wordpress.

Mental models of a water management system in a green building.

PubMed

Kalantzis, Anastasia; Thatcher, Andrew; Sheridan, Craig

2016-11-01

This intergroup case study compared users' mental models with an expert design model of a water management system in a green building. The system incorporates a constructed wetland component and a rainwater collection pond that together recycle water for re-use in the building and its surroundings. The sample consisted of five building occupants and the cleaner (6 users) and two experts who were involved with the design of the water management system. Users' mental model descriptions and the experts' design model were derived from in-depth interviews combined with self-constructed (and verified) diagrams. Findings from the study suggest that there is considerable variability in the user mental models that could impact the efficient functioning of the water management system. Recommendations for improvements are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of AIHA ISO 9001-based occupational health and safety management system guidance document with a manufacturer's occupational health and safety assessment instrument.

PubMed

Dyjack, D T; Levine, S P; Holtshouser, J L; Schork, M A

1998-06-01

Numerous manufacturing and service organizations have integrated or are considering integration of their respective occupational health and safety management and audit systems into the International Organization for Standardization-based (ISO) audit-driven Quality Management Systems (ISO 9000) or Environmental Management Systems (ISO 14000) models. Companies considering one of these options will likely need to identify and evaluate several key factors before embarking on such efforts. The purpose of this article is to identify and address the key factors through a case study approach. Qualitative and quantitative comparisons of the key features of the American Industrial Hygiene Association ISO-9001 harmonized Occupational Health and Safety Management System with The Goodyear Tire & Rubber Co. management and audit system were conducted. The comparisons showed that the two management systems and their respective audit protocols, although structured differently, were not substantially statistically dissimilar in content. The authors recommend that future studies continue to evaluate the advantages and disadvantages of various audit protocols. Ideally, these studies would identify those audit outcome measures that can be reliably correlated with health and safety performance.

Development of a Medicaid Behavioral Health Case-Mix Model

ERIC Educational Resources Information Center

Robst, John

2009-01-01

Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several…

Surgical treatment of chronic mandibular dislocation--report of a case.

PubMed

Bakardjiev, Angel G; Atanasov, Dimitar T

2002-01-01

Chronic dislocation of the temporomandibular jaw (TMJ) can result from lax joint ligaments and parafunctioning joints; it can also be a consequence of a systemic connective tissue disorder. The authors report a case of hypermobile joint syndrome in combination with mitral valve prolapse. The case was managed by osteosynthesis using modified titanium plate.

Real Time Locations Systems or Outsourcing: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Khumalo, Floyd

2013-01-01

Information Technology has transformed almost all aspects of modern healthcare and is playing a vital role in the administration of hospitals around the world. This case study examines one hospital's struggle to solve crucial operational problems related to the efficient management of medical equipment inventory. This case study is the result of…

The Use of Social Networking and Learning Management Systems in English Language Teaching in Higher Education

ERIC Educational Resources Information Center

Dogoriti, Evriklea; Pange, Jenny; Anderson, Gregory S.

2014-01-01

Purpose: The use of web-enhanced teaching of the English as a foreign language in higher education in Greece is addressed in this case study which examines the student's perceptions of online instruction using Moodle as a learning management system (LMS), with and without the use of Facebook (FB) as an adjunctive learning platform. The merging of…