Academics' Perceptions of the Challenges and Barriers to Implementing Research-Based Experiences for Undergraduates

ERIC Educational Resources Information Center

Brew, Angela; Mantai, Lilia

2017-01-01

How can universities ensure that strategic aims to integrate research and teaching through engaging students in research-based experiences be effectively realised within institutions? This paper reports on the findings of a qualitative study exploring academics' perceptions of the challenges and barriers to implementing undergraduate research.…

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

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

Murray, R.C.

1991-09-01

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

Collaboration to Achieve Whole School SEL across a Large, Urban District

ERIC Educational Resources Information Center

Porche, Michelle; Grossman, Jenny; Biro, Nova; MacKay, Nancy; Rivers, Sojourner

2014-01-01

Research on social and emotional learning (SEL) has largely focused on classroom interventions and student-­ and classroom­-level outcomes. Few studies have examined whole­-school and district-­level SEL implementations, or how to ensure that SEL programs are implemented effectively and sustained over time. This study examines both process…

The Common Core State Standards: School Reform at Three Suburban Middle Schools

ERIC Educational Resources Information Center

Morante-Brock, Sandra

2014-01-01

A growing body of research supports the idea that large scale school reform efforts often fail to create sustained change within the public school sector. Proponents of school reform argue that implementing school reform, effectively and with fidelity, can work to ensure the success of reform initiatives in public education. When implementing deep…

42 CFR 422.503 - General provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... oversight and control over the MA organization's policies and personnel to ensure that management actions... management aspects of the organization. (iii) At a minimum, an executive manager whose appointment and... effectiveness of the compliance programs. (C)(1) Each MA organization must establish and implement effective...

42 CFR 422.503 - General provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... oversight and control over the MA organization's policies and personnel to ensure that management actions... management aspects of the organization. (iii) At a minimum, an executive manager whose appointment and... effectiveness of the compliance programs. (C)(1) Each MA organization must establish and implement effective...

29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and officials in carrying out this subpart, including the issuance of guidelines and instructions... steps as may be appropriate to carry out the purposes and ensure the effective implementation of this...

29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and officials in carrying out this subpart, including the issuance of guidelines and instructions... steps as may be appropriate to carry out the purposes and ensure the effective implementation of this...

29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and officials in carrying out this subpart, including the issuance of guidelines and instructions... steps as may be appropriate to carry out the purposes and ensure the effective implementation of this...

Qualitative process evaluation of an Australian alcohol media literacy study: recommendations for designing culturally responsive school-based programs.

PubMed

Gordon, Chloe S; Kervin, Lisa K; Jones, Sandra C; Howard, Steven J

2017-02-02

Alcohol media literacy programs seek to mitigate the potentially harmful effects of alcohol advertising on children's drinking intentions and behaviours through equipping them with skills to challenge media messages. In order for such programs to be effective, the teaching and learning experiences must be tailored to their specific cultural context. Media in the Spotlight is an alcohol media literacy program aimed at 9 to 12 year old Australian children. This study evaluates the process and implementation of the program, outlining the factors that facilitated and inhibited implementation. From this evaluation, a pedagogical framework has been developed for health professionals implementing culturally responsive programs in school settings. Process measures included: semi-structured interviews with teachers before and after the program was implemented (n = 11 interviews), program evaluation questionnaires completed by children (n = 166), lesson observations completed by teachers (n = 35 observations), and reflective journal entries completed by the researcher (n = 44 entries). A thematic analysis approach was used to analyse all of the data sets using NVivo. Inductive coding was used, whereby the findings were derived from the research objectives and multiple readings and interpretations of the data. Five key pedagogical considerations were identified that facilitated implementation. These were: connecting to the students' life worlds to achieve cultural significance; empowering students with real-world skills to ensure relevance; ensuring programs are well structured with strong connections to the school curriculum; creating developmentally appropriate activities while providing a range of assessment opportunities; and including hands-on and interactive activities to promote student engagement. Three potential inhibitors to implementing the alcohol media literacy program in upper-elementary school classrooms were identified. These included topic sensitivities, classroom management challenges, and fitting new programs into already busy school schedules. Overall, the program content and individual lessons were well received by the teachers and students. The lessons learned from the development, implementation and evaluation of this program can provide health professionals with key pedagogical strategies for designing culturally responsive educational programs. Culturally responsive programs are critical for ensuring interventions are effective for their specific context.

The value of advocacy in promoting social change: implementing the new Domestic Violence Act in South Africa.

PubMed

Usdin, S; Christofides, N; Malepe, L; Maker, A

2000-11-01

South Africa's first democratic government passed the Domestic Violence Act (DVA) into law in 1998 as part of local and international commitments to protecting the human rights of women. Although the Act was welcomed as groundbreaking legislation, delays in implementing it led to increasing frustration. This paper describes an advocacy campaign conducted by the Soul City Institute for Health and Development Communication in partnership with the National Network on Violence against Women, to ensure the effective implementation of the DVA. Lessons from the campaign stress the importance of coalition building to draw on diverse strengths, and the use of a combination of advocacy tools, including lobbying, media advocacy and social mobilisation to achieve campaign goals. Given the critical role NGOs dealing with victims/survivors of domestic violence and the justice system played in lobbying for change and drafting the new law, their exclusion from the implementation process was ironic. While many advocacy efforts focus on the development of policy and legislation, ongoing efforts are needed to ensure effective implementation, the commitment of adequate resources and monitoring to identify gaps and propose new solutions. Our experience highlights the important role of policy advocates in connecting the multiple streams at play in the policy and legislative arena.

Typology of Delivery Quality: Latent Profile Analysis of Teacher Engagement and Delivery Techniques in a School-Based Prevention Intervention, "Keepin' It REAL" Curriculum

ERIC Educational Resources Information Center

Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.

2014-01-01

Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may…

Local Implementation Effectiveness of a Multi-Tier System of Support in Elementary School Settings

ERIC Educational Resources Information Center

Houlton, Terry P.

2017-01-01

Ensuring all students learn at high levels is demanding. Multi-tier systems of supports (MTSS) has shown promise as a way to promote high levels of learning for all students while catching students who are struggling to learn. However, implementing MTSS models in school districts and schools has seen its challenges. The context of an individual…

Implementing a University E-Learning Strategy: Levers for Change within Academic Schools

ERIC Educational Resources Information Center

Sharpe, Rhona; Benfield, Greg; Francis, Richard

2006-01-01

This paper describes the implementation of an e-learning strategy at a single higher education institution in terms of the levers used to promote effective uptake and ensure sustainable embedding. The focus of this work was at the level of the academic school using a range of change practices including the appointment of school-based learning…

Resistance Is Not Futile: An Experimental Analogue of the Effects of Consultee "Resistance" on the Consultant's Therapeutic Behavior in the Consultation Process--A Replication and Extension

ERIC Educational Resources Information Center

Cautilli, Joseph; Tillman, T. Chris; Axelrod, Saul; Dziewolska, Halina; Hineline, Philip

2006-01-01

In the school system, school psychologist serves a role as consultant to teachers in regard to children's behavioral problems (Bergan & Kratochwill, 1990). The defining feature of children's success is plan implementation (Bergan & Kratochwill, 1990). For school psychologists, ensuring consistent and accurate implementation of behavior strategies…

3 CFR 13535 - Executive Order 13535 of March 24, 2010. Ensuring Enforcement and Implementation of Abortion...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Enforcement and Implementation of Abortion Restrictions in the Patient Protection and Affordable Care Act... 13535 Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection and... that Federal funds are not used for abortion services (except in cases of rape or incest, or when the...

14 CFR 1203.202 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM NASA Information Security Program § 1203.202 Responsibilities. (a) The Chairperson, NASA Information Security...) Ensuring effective compliance with and implementation of “the Order” and the Information Security Oversight...

14 CFR 1203.202 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM NASA Information Security Program § 1203.202 Responsibilities. (a) The Chairperson, NASA Information Security...) Ensuring effective compliance with and implementation of “the Order” and the Information Security Oversight...

Steps to Ensure a Successful Implementation of Occupational Health and Safety Interventions at an Organizational Level

PubMed Central

Herrera-Sánchez, Isabel M.; León-Pérez, José M.; León-Rubio, José M.

2017-01-01

There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention’s effectiveness and for understanding how and why the intervention has been (un)successful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade. PMID:29375413

78 FR 77557 - Releasing Information; General Provisions; Accounting and Reporting Requirements; Reports of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

..., including controls for maintaining the confidentiality of borrower information. The system of internal... develop and implement an effective system of internal controls over the central data repository to ensure..., and maintain an effective system of internal controls over the data included in the report of accounts...

A Blueprint for Effectively Using RTI Intervention Block Time

ERIC Educational Resources Information Center

Higgins Averill, Orla; Baker, Diana; Rinaldi, Claudia

2014-01-01

Many schools have adopted schoolwide intervention blocks as a component of response-to-intervention (RTI) implementation to ensure that students who need intervention are receiving it. However, virtually no peer-reviewed guidance exists for helping teachers manage this time effectively. This article presents a blueprint for organizing intervention…

Tank waste remediation system privatization infrastructure program, configuration management implementation plan

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

Schaus, P.S.

This Configuration Management Implementation Plan (CMIP) was developed to assist in managing systems, structures, and components (SSCS), to facilitate the effective control and statusing of changes to SSCS, and to ensure technical consistency between design, performance, and operational requirements. Its purpose is to describe the approach Privatization Infrastructure will take in implementing a configuration management program, to identify the Program`s products that need configuration management control, to determine the rigor of control, and to identify the mechanisms for that control.

The Effects of the Implementation of Parent Coaching to Increase Quality of Life for Children and Families Affected by Autism Spectrum Disorder

ERIC Educational Resources Information Center

Bateman, Katherine J.

2017-01-01

As the prevalence of children diagnosed with autism continues to rise, the need for high quality parent coaching practices to ensure generalization of skills targeting in early intervention services is pronounced. This mixed methods study investigated the results of implementation of a parent coaching treatment package developed in alignment with…

Full Chain Benchmarking for Open Architecture Airborne ISR Systems: A Case Study for GMTI Radar Applications

DTIC Science & Technology

2015-09-15

middleware implementations via a common object-oriented software hierarchy, with library -specific implementations of the five GMTI benchmark ...Full-Chain Benchmarking for Open Architecture Airborne ISR Systems A Case Study for GMTI Radar Applications Matthias Beebe, Matthew Alexander...time performance, effective benchmarks are necessary to ensure that an ARP system can meet the mission constraints and performance requirements of

Strategy to Ensure Institutional Control Implementation at Superfund Sites

EPA Pesticide Factsheets

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

Guidelines for the management of hepatitis C in general practice: a semi-qualitative interview survey of GPs' views regarding content and implementation.

PubMed

Cullen, W; O'Leary, M; Langton, D; Stanley, J; Kelly, Y; Bury, G

2005-01-01

Hepatitis C is a common infection among people who attend GPs for methadone maintenance treatment. To determine the views of GPs towards clinical guidelines for the management of hepatitis C among current or former injecting drug users in advance of their implementation. A purposive sample of 14 GPs (10% of the total prescribing methadone at the time the guidelines were developed) was invited to review a pre-publication draft of the guidelines and interviewed regarding content, presentation, perceived barriers to implementation and suggested interventions to facilitate effective implementation of the guidelines. GPs indicated the guidelines were useful but suggested aspects of presentation should be clarified. Organisational issues were identified as the principal barriers to effective implementation, with the provision of additional nursing support the principal intervention suggested to facilitate implementation. Interviewing intended recipients may be an important step in ensuring clinical practice guidelines are effectively implemented.

Concept of JINR Corporate Information System

NASA Astrophysics Data System (ADS)

Filozova, I. A.; Bashashin, M. V.; Korenkov, V. V.; Kuniaev, S. V.; Musulmanbekov, G.; Semenov, R. N.; Shestakova, G. V.; Strizh, T. A.; Ustenko, P. V.; Zaikina, T. N.

2016-09-01

The article presents the concept of JINR Corporate Information System (JINR CIS). Special attention is given to the information support of scientific researches - Current Research Information System as a part of the corporate information system. The objectives of such a system are focused on ensuring an effective implementation and research by using the modern information technology, computer technology and automation, creation, development and integration of digital resources on a common conceptual framework. The project assumes continuous system development, introduction the new information technologies to ensure the technological system relevance.

Implementing an Antibiotic Stewardship Information System to Improve Hospital Infection Control: A Co-Design Process.

PubMed

Maia, Mélanie R; Simões, Alexandra; Lapão, Luís V

2018-01-01

HAITooL information system design and implementation was based on Design Science Research Methodology, ensuring full participation, in close collaboration, of researchers and a multidisciplinary team of healthcare professionals. HAITooL enables effective monitoring of antibiotic resistance, antibiotic use and provides an antibiotic prescription decision-supporting system by clinicians, strengthening the patient safety procedures. The design, development and implementation process reveals benefits in organizational and behavior change with significant success. Leadership commitment multidisciplinary team and mainly informaticians engagement was crucial to the implementation process. Participants' motivation and the final product delivery and evolution depends on that.

Implementation of a model of emergency care in an Australian hospital.

PubMed

Millichamp, Tracey; Bakon, Shannon; Christensen, Martin; Stock, Kate; Howarth, Sarah

2017-11-10

Emergency departments are characterised by a fast-paced, quick turnover and high acuity workload, therefore appropriate staffing is vital to ensure positive patient outcomes. Models of care are frameworks in which safe and effective patient-to-nurse ratios can be ensured. The aim of this study was to implement a supportive and transparent model of emergency nursing care that provides structure - regardless of nursing staff profile, business or other demands; improvement to nursing workloads; and promotes individual responsibility and accountability for patient care. A convergent parallel mixed-method approach was used. Quantitative data were analysed using descriptive statistics and the qualitative data used a thematic analysis to identify recurrent themes. Data post-implementation of the model of emergency nursing care indicate improved staff satisfaction in relation to workload, patient care and support structures. The development and implementation of a model of care in an emergency department improved staff workload and staff's perception of their ability to provide care. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

The tug-of-war: fidelity versus adaptation throughout the health promotion program life cycle.

PubMed

Bopp, Melissa; Saunders, Ruth P; Lattimore, Diana

2013-06-01

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

The struggle of translating science into action: Foundational concepts of implementation science

PubMed Central

Clay‐Williams, Robyn; Churruca, Kate; Shih, Patti; Hogden, Anne; Braithwaite, Jeffrey

2017-01-01

Abstract Rationale, aims, and objectives “Implementation science,” the scientific study of methods translating research findings into practical, useful outcomes, is contested and complex, with unpredictable use of results from routine clinical practice and different levels of continuing assessment of implementable interventions. The authors aim to reveal how implementation science is presented and understood in health services research contexts and clarify the foundational concepts: diffusion, dissemination, implementation, adoption, and sustainability, to progress knowledge in the field. Method Implementation science models, theories, and frameworks are critiqued, and their value for laying the groundwork from which to implement a study's findings is emphasised. The paper highlights the challenges of turning research findings into practical outcomes that can be successfully implemented and the need for support from change agents, to ensure improvements to health care provision, health systems, and policy. The paper examines how researchers create implementation plans and what needs to be considered for study outputs to lead to sustainable interventions. This aspect needs clear planning, underpinned by appropriate theoretical paradigms that rigorously respond to a study's aims and objectives. Conclusion Researchers might benefit from a return to first principles in implementation science, whereby applications that result from research endeavours are both effective and readily disseminated and where interventions can be supported by appropriate health care personnel. These should be people specifically identified to promote change in service organisation, delivery, and policy that can be systematically evaluated over time, to ensure high‐quality, long‐term improvements to patients' health. PMID:28371050

Legal framework for food fortification: examples from Vietnam and Indonesia.

PubMed

Dijkhuizen, Marjoleine Amma; Wieringa, Frank Tammo; Soekarjo, Damayanti; Van, Khan Tran; Laillou, Arnaud

2013-06-01

Food fortification is a cost-effective, powerful, and sustainable strategy to combat micronutrient deficiency, with the potential to reach large sections of the population with minimal cost and effort. However, the implementation of food fortification on a systematic and large scale, for instance in national programs, has often been challenging. This paper takes a closer look at food fortification efforts and legislation mechanisms in Vietnam and Indonesia in order to determine specific factors and components in the legal framework that are crucial to the success of fortification programs. Fortification efforts in Indonesia and Vietnam are evaluated using published data as well as unpublished data from detailed evaluation reports, and compared with respect to the specific circumstances, constraints, objectives and results in each country. The legal framework is a crucial factor for the success of food fortification programs, as it shapes to a large extent the implementation of food fortification. The legal framework is instrumental to ensure the quality, safety, availability, cost-effectiveness, and sustainability of food fortification. In the first place, the legal framework should specify the fortificants and fortification levels, as well as the food vehicles and the fortification procedures. In addition, it should ensure the commitment of policy makers and producers to fortification, regulate the costing, describe and ensure information and communication such as product labeling integrate social marketing into the implementation, and provide the means to monitor and enforce fortification. A clear public health objective, together with careful consideration of the choices and restrictions dictated by the specific national environments, will help to develop legal frameworks that optimize the potential success of food fortification strategies. The lessons from these experiences show that a mandatory approach to fortification, with costing, monitoring and enforcement, and social marketing clearly defined and well embedded in the legal framework and in the implementation structures, is the best foundation for an effective, sustainable, and feasible food fortification program.

Balancing exploration and exploitation in transferring research into practice: a comparison of five knowledge translation entity archetypes

PubMed Central

2013-01-01

Background Translating knowledge from research into clinical practice has emerged as a practice of increasing importance. This has led to the creation of new organizational entities designed to bridge knowledge between research and practice. Within the UK, the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) have been introduced to ensure that emphasis is placed in ensuring research is more effectively translated and implemented in clinical practice. Knowledge translation (KT) can be accomplished in various ways and is affected by the structures, activities, and coordination practices of organizations. We draw on concepts in the innovation literature—namely exploration, exploitation, and ambidexterity—to examine these structures and activities as well as the ensuing tensions between research and implementation. Methods Using a qualitative research approach, the study was based on 106 semi-structured, in-depth interviews with the directors, theme leads and managers, key professionals involved in research and implementation in nine CLAHRCs. Data was also collected from intensive focus group workshops. Results In this article we develop five archetypes for organizing KT. The results show how the various CLAHRC entities work through partnerships to create explorative research and deliver exploitative implementation. The different archetypes highlight a range of structures that can achieve ambidextrous balance as they organize activity and coordinate practice on a continuum of exploration and exploitation. Conclusion This work suggests that KT entities aim to reach their goals through a balance between exploration and exploitation in the support of generating new research and ensuring knowledge implementation. We highlight different organizational archetypes that support various ways to maintain ambidexterity, where both exploration and exploitation are supported in an attempt to narrow the knowledge gaps. The KT entity archetypes offer insights on strategies in structuring collaboration to facilitate an effective balance of exploration and exploitation learning in the KT process. PMID:24007259

Balancing exploration and exploitation in transferring research into practice: a comparison of five knowledge translation entity archetypes.

PubMed

Oborn, Eivor; Barrett, Michael; Prince, Karl; Racko, Girts

2013-09-05

Translating knowledge from research into clinical practice has emerged as a practice of increasing importance. This has led to the creation of new organizational entities designed to bridge knowledge between research and practice. Within the UK, the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) have been introduced to ensure that emphasis is placed in ensuring research is more effectively translated and implemented in clinical practice. Knowledge translation (KT) can be accomplished in various ways and is affected by the structures, activities, and coordination practices of organizations. We draw on concepts in the innovation literature--namely exploration, exploitation, and ambidexterity--to examine these structures and activities as well as the ensuing tensions between research and implementation. Using a qualitative research approach, the study was based on 106 semi-structured, in-depth interviews with the directors, theme leads and managers, key professionals involved in research and implementation in nine CLAHRCs. Data was also collected from intensive focus group workshops. In this article we develop five archetypes for organizing KT. The results show how the various CLAHRC entities work through partnerships to create explorative research and deliver exploitative implementation. The different archetypes highlight a range of structures that can achieve ambidextrous balance as they organize activity and coordinate practice on a continuum of exploration and exploitation. This work suggests that KT entities aim to reach their goals through a balance between exploration and exploitation in the support of generating new research and ensuring knowledge implementation. We highlight different organizational archetypes that support various ways to maintain ambidexterity, where both exploration and exploitation are supported in an attempt to narrow the knowledge gaps. The KT entity archetypes offer insights on strategies in structuring collaboration to facilitate an effective balance of exploration and exploitation learning in the KT process.

A Systematic Framework for Addressing Treatment Integrity in School Settings

ERIC Educational Resources Information Center

Kupzyk, Sara; Shriver, Mark D.

2016-01-01

School psychologists are tasked with ensuring treatment integrity because the level of intervention implementation affects decisions about student progress. Treatment integrity includes multiple dimensions that may impact the effectiveness of an intervention including adherence, dosage, quality, and engagement. Unfortunately, treatment integrity…

Application of Hazard Analysis Critical Control Point in the local manufacture of ready-to-use therapeutic foods (RUTFs).

PubMed

Henry, C Jeya K; Xin, Janice Lim Wen

2014-06-01

The local manufacture of ready-to-use therapeutic foods (RUTFs) is increasing, and there is a need to develop methods to ensure their safe production. We propose the application of Hazard Analysis Critical Control Point (HACCP) principles to achieve this goal. The basic principles of HACCP in the production of RUTFs are outlined. It is concluded that the implementation of an HACCP system in the manufacture of RUTFs is not only feasible but also attainable. The introduction of good manufacturing practices, coupled with an effective HACCP system, will ensure that RUTFs are produced in a cost-effective, safe, and hygienic manner.

How much does it cost to change the behavior of health professionals? A mathematical model and an application to academic detailing.

PubMed

Gandjour, Afschin; Lauterbach, Karl Wilhelm

2005-01-01

Several strategies have shown to be effective at enhancing the implementation of research findings in daily practice. These implementation strategies improve the delivery of preventive or therapeutic care by successfully educating health professionals. On the other hand, little is known about the costs of these implementation strategies. The goal of this article is to present a mathematical model that predicts implementation costs by using published data. As an important feature, the model portrays the relationship between the degree of treatment underuse and implementation costs. Two application examples of outreach programs for the prevention of stroke and coronary disease analyze the relevance of implementation costs with respect to the cost-effectiveness ratio and total costs. They demonstrate that implementation costs may have little impact on the cost-effectiveness ratio but may nevertheless be relevant to a 3rd-party payer who needs to stay within the budget and ensure that care is provided to a large underserved population. The model and its consideration of implementation costs may contribute to a more efficient use of health care resources.

Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline.

PubMed

Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar

2017-10-01

Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.

A Study of the Use of the Three-Minute Classrooom Walk-Through Observation Method for Determining the Implementation of New Instructional Strategies

ERIC Educational Resources Information Center

Notgrass, Patty J.

2012-01-01

Principals are responsible for ensuring the effectiveness of the instructional programs, including staff development, on their campuses. Instructional leaders must utilize practices that allow them to fulfill this responsibility. This qualitative, collective case study examined the effectiveness of the three-minute classroom walk-through…

Effectiveness of Instructional Design Model (Isman - 2011) in Developing the Planning Teaching Skills of Teachers College Students' at King Saud University

ERIC Educational Resources Information Center

Isman, Aytekin; Abanmy, Fahad AbdulAziz; Hussein, Hisham Barakat; Al Saadany, Mohammed Abdurrahman

2012-01-01

The new instructional design model (Isman - 2011) aims at planing, developing, implementing, evaluating, and organizing full learning activities effectively to ensure competent performance by students. The theoretical foundation of this model comes from behaviorism, cognitivism and constructivism views. And it's based on active learning. During…

Integrating Corporate Governance Concepts in the Classroom with the Risk Assessment Project

ERIC Educational Resources Information Center

Elson, Raymond J.; O'Callaghan, Susanne; Walker, John P.

2015-01-01

The recession of 2008 and the demise of established financial firms served as a reminder that effective corporate governance is important to ensure that businesses remain as going concern. One key area is the implementation of effective enterprise-wide risk management practices. The resulting regulatory oversight enacted through the Dodd Frank Act…

Special Education Teachers' Experiences with the AchieveNJ Act: A Generic Qualitative Inquiry

ERIC Educational Resources Information Center

Askins, Janene M.

2017-01-01

During the 2013-2014 school year, the New Jersey Department of Education established legislation which ensured a revision to the teacher evaluation system by attempting to accurately assess the effectiveness of teachers. The Teacher Effectiveness and Accountability for the Children of New Jersey Act (TEACHNJ) stimulated the implementation of the…

Dinosaurs or Dynamos? The Future of Campuses.

ERIC Educational Resources Information Center

Coor, Lattie

2000-01-01

Describes approaches Arizona State University is taking to ensure that the campus remains an effective educational instrument in the future. Making the "engaged institution" an integral part of metropolitan Phoenix is a priority that can be implemented through new types of partnerships with the community. (SLD)

Controversies in Antimicrobial Stewardship: Focus on New Rapid Diagnostic Technologies and Antimicrobials

PubMed Central

Wenzler, Eric; Wong, Jordan R.; Goff, Debra A.; Jankowski, Christopher A.; Bauer, Karri A.

2016-01-01

Antimicrobial stewardship programs (ASPs) are challenged with ensuring appropriate antimicrobial use while minimizing expenditures. ASPs have consistently demonstrated improved patient outcomes and significant cost reductions but are continually required to justify the costs of their existence and interventions due to the silo mentality often adopted by hospital administrators. As new technologies and antimicrobials emerge, ASPs are in a constant tug-of-war between providing optimal clinical outcomes and ensuring cost containment. Additionally, robust data on cost-effectiveness of new rapid diagnostic technologies and antimicrobials with subsequent ASP interventions to provide justification are lacking. As the implementation of an ASP will soon be mandatory for acute care hospitals in the United States, ASPs must find ways to justify novel interventions to align themselves with healthcare administrators. This review provides a framework for the justification of implementing a rapid diagnostic test or adding a new antimicrobial to formulary with ASP intervention, reviews approaches to demonstrating cost-effectiveness, and proposes methods for which ASPs may reduce healthcare expenditures via alternative tactics. PMID:27025521

Experiences from the implementation of a biosafety system in Slovenia.

PubMed

Milavec, Mojca; Racman, Darja Stanic

2007-09-01

The development and implementation of an effective national biosafety system is important for several key reasons: to ensure safe access to products of modern biotechnology, to build public confidence, to encourage the growth of domestic modern biotechnology, and to comply with international standards and agreements. There is no single best approach in the development and implementation of a national biosafety system and each country is faced with unique challenges. Slovenia is a small country and a new EU Member State. However, it has developed and implemented an efficient national biosafety system. The key elements of this system are administrative procedure, risk assessment, enforcement, and public participation and information.

An operational model for mainstreaming ecosystem services for implementation

PubMed Central

Cowling, Richard M.; Egoh, Benis; Knight, Andrew T.; O'Farrell, Patrick J.; Reyers, Belinda; Rouget, Mathieu; Roux, Dirk J.; Welz, Adam; Wilhelm-Rechman, Angelika

2008-01-01

Research on ecosystem services has grown markedly in recent years. However, few studies are embedded in a social process designed to ensure effective management of ecosystem services. Most research has focused only on biophysical and valuation assessments of putative services. As a mission-oriented discipline, ecosystem service research should be user-inspired and user-useful, which will require that researchers respond to stakeholder needs from the outset and collaborate with them in strategy development and implementation. Here we provide a pragmatic operational model for achieving the safeguarding of ecosystem services. The model comprises three phases: assessment, planning, and management. Outcomes of social, biophysical, and valuation assessments are used to identify opportunities and constraints for implementation. The latter then are transformed into user-friendly products to identify, with stakeholders, strategic objectives for implementation (the planning phase). The management phase undertakes and coordinates actions that achieve the protection of ecosystem services and ensure the flow of these services to beneficiaries. This outcome is achieved via mainstreaming, or incorporating the safeguarding of ecosystem services into the policies and practices of sectors that deal with land- and water-use planning. Management needs to be adaptive and should be institutionalized in a suite of learning organizations that are representative of the sectors that are concerned with decision-making and planning. By following the phases of our operational model, projects for safeguarding ecosystem services are likely to empower stakeholders to implement effective on-the-ground management that will achieve resilience of the corresponding social-ecological systems. PMID:18621695

77 FR 45616 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... for Building the Capacity of Community Based Organizations (CBOs) to Implement HIV Prevention Services... color. Building the capacity of community based organizations (CBOs) is a priority to ensure effective... (CDC) publishes a list of information collection requests under review by the Office of Management and...

48 CFR 313.301 - Government-wide commercial purchase card.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., Appendix B, “Improving the Management of Government Charge Card Programs;” GSA's SmartPay Program guidance; and HHS Purchase Card program standards. (2) The OPDIVs, through their designated Agency/Organization... training requirements to ensure effective implementation of the HHS purchase card program. (3) OPDIVs shall...

An Air Force Guide for Effective Meeting Management

DTIC Science & Technology

2011-05-01

The inspection program to ensure its sustainment has faced increasing workload requirements due to structural issues related to heavy use and aging...26 Data Sources /Format...aircraft availability, the High Velocity Maintenance (HVM) concept is being implemented to replace the current PDM process for heavy maintenance

Teacher Education: Of the People, by the People, and for the People.

ERIC Educational Resources Information Center

Clinton, Hillary Rodham

1985-01-01

Effective inservice programs are necessary to ensure that current reforms in education are properly implemented. Inservice programs must meet the needs of both the educational system and educators. Six basic policy assumptions dealing with what is needed in inservice education are discussed. (DF)

Implementing Participatory Research with an Urban American Indian Community: Lessons Learned

ERIC Educational Resources Information Center

Roberts, Erica B.; Jette, Shannon L.

2016-01-01

Objective: Participatory research has proven an effective method for improving health equity among American Indians/Alaska Natives (AI/ANs) by addressing power imbalances between communities and researchers, incorporating community knowledge and theory, ensuring mutual benefit and improving community capacity and programme sustainability. However,…

Training and certification program of the operating staff for a 90-day test of a regenerative life support system

NASA Technical Reports Server (NTRS)

1972-01-01

Prior to beginning a 90-day test of a regenerative life support system, a need was identified for a training and certification program to qualify an operating staff for conducting the test. The staff was responsible for operating and maintaining the test facility, monitoring and ensuring crew safety, and implementing procedures to ensure effective mission performance with good data collection and analysis. The training program was designed to ensure that each operating staff member was capable of performing his assigned function and was sufficiently cross-trained to serve at certain other positions on a contingency basis. Complicating the training program were budget and schedule limitations, and the high level of sophistication of test systems.

An Evaluation of "Bookworms": A Tiered Approach to K-5 Literacy and Its Effect on Reading Achievement

ERIC Educational Resources Information Center

Nacrelli, Cathy S.

2018-01-01

There is no debate that teaching students to read is an important goal of education. School districts have the challenging tasks of choosing an effective research-based reading program to implement and then ensuring that reading instruction results in improved reading achievement. The Spring Valley School District was faced with these challenges…

Implementing Maternal Death Surveillance and Response in Kenya: Incremental Progress and Lessons Learned

PubMed Central

Smith, Helen; Ameh, Charles; Godia, Pamela; Maua, Judith; Bartilol, Kigen; Amoth, Patrick; Mathai, Matthews; van den Broek, Nynke

2017-01-01

ABSTRACT Maternal death surveillance and response (MDSR) constitutes a quality improvement approach to identify how many maternal deaths occur, what the underlying causes of death and associated factors are, and how to implement actions to reduce the number of preventable stillbirths and maternal and neonatal deaths. This requires a coordinated approach, ensuring both national- and district-level stakeholders are enabled and supported and can implement MDSR in a “no name, no blame” environment. This field action report from Kenya provides an example of how MDSR can be implemented in a “real-life” setting by summarizing the experiences and challenges faced thus far by maternal death assessors and Ministry of Health representatives in implementing MDSR. Strong national leadership via a coordinating secretariat has worked well in Kenya. However, several challenges were encountered including underreporting of data, difficulties with reviewing the data, and suboptimal aggregation of data on cause of death. To ensure progress toward a full national enquiry of all maternal deaths, we recommend improving the notification of maternal deaths, ensuring regular audits and feedback at referral hospitals lead to continuous quality improvement, and strengthening community linkages with health facilities to expedite maternal death reporting. Ultimately, both a top-down and bottom-up approach is needed to ensure success of an MDSR system. Perinatal death surveillance and response is planned as a next phase of MDSR implementation in Kenya. To ensure the process continues to evolve into a full national enquiry of all maternal deaths, we recommend securing longer-term budget allocation and financial commitment from the ministry, securing a national legal framework for MDSR, and improving processes at the subnational level. PMID:28963171

75 FR 82254 - Action To Ensure Authority To Implement Title V Permitting Programs Under the Greenhouse Gas...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

...-AQ63 Action To Ensure Authority To Implement Title V Permitting Programs Under the Greenhouse Gas... this action, EPA is finalizing its proposed rulemaking to narrow EPA's previous approval of State title... raising the GHG thresholds that apply title V permitting to major sources in the affected States, this...

Monitoring process hygiene in Serbian retail establishments

NASA Astrophysics Data System (ADS)

Vesković Moračanin, S.; Baltić, T.; Milojević, L.

2017-09-01

The present study was conducted to estimate the effectiveness of sanitary procedures on food contact surfaces and food handlers’ hands in Serbian retail establishments. For that purpose, a total of 970 samples from food contact surfaces and 525 samples from workers’ hands were microbiologically analyzed. Results of total aerobic plate count and total Enterobacteriaceae count showed that the implemented washing and disinfection procedures, as a part of HACCP plans, were not effective enough in most retail facilities. Constant and intensive education of employees on proper implementation of sanitation procedures are needed in order to ensure food safety in the retail market.

Nurses aged over 50 and their perceptions of flexible working.

PubMed

Clendon, Jill; Walker, Léonie

2016-04-01

To explore the experiences and needs of older nurses in relation to flexible working and the barriers and facilitators to implementation within workplaces. An ageing nursing workforce and anticipated nursing workforce shortages require effective approaches to workforce retention. A mixed method approach (focus group and individual interviews) with nurses aged over 50 (n = 46) combined with analysis of district health board (DHB) flexible working policies. Participants had a good understanding of flexible working and recognised the importance of balancing their own needs with those of their organisation. Participants had legitimate reasons for making requests and became frustrated when turned down. They recommended job sharing, shorter shifts, no night shift and greater recognition of their work to improve retention. There was discrepancy between organisational policy (where this existed) and implementation. Organisations should review flexible working policies, ensuring these are understood and implemented at the unit level. Training of nurse managers is recommended. Nurse managers must recognise the individual needs of nurses, be cognisant of workplace policies regarding flexible working, ensure these are implemented consistently and make the effort to recognise the work of older nurses. © 2015 John Wiley & Sons Ltd.

78 FR 47217 - Proposed Supervisory Guidance on Implementing Dodd-Frank Act Company-Run Stress Tests for Banking...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

..., that are designed to ensure that its stress testing processes are effective in meeting the requirements... specific methodological practices. Consistent with this approach, this guidance sets general supervisory... use any specific methodological practices for their stress tests. Companies may use various practices...

Data for Action 2011: Empower with Data

ERIC Educational Resources Information Center

Data Quality Campaign, 2011

2011-01-01

Any policy proposal in education requires quality data to inform its development, implementation, and evaluation. In fact, the highest-profile education policy agendas currently discussed in states--ensuring that all students are taught by effective teachers and graduate from high school prepared for college and 21st-century careers--were…

Complying with physician gain-sharing restrictions.

PubMed

O'Hare, P K

1998-05-01

Many IDSs are considering implementing gain-sharing programs as a way to motivate their physicians to provide high-quality, cost-effective services. Before embarking on such programs, however, IDSs need to understand the legal requirements associated with such programs to ensure that the gain-sharing arrangement is in compliance with Federal law.

Provision of Adaptive Instruction: Implementation and Effects.

ERIC Educational Resources Information Center

Wang, Margaret C.

Despite increased interest in and acceptance of the concept and mandate of providing adaptive instruction to ensure schooling success for each student, a sizable gap exists between identification of specific educational practices and application of such practices in schools. The work described in this paper is aimed at examining the feasibility…

Ensuring the common for the goose: Implementing effective watershed policies

Treesearch

Hanna J. Cortner; Margaret A. Moote

2000-01-01

Addressing public and scientific concerns about human impacts on long-term ecological sustainability will require new approaches to resource management. These new approaches, which place considerable emphasis on management on the landscape or watershed scale, stress holistic and integrated science, meaningful public involvement to reflect changing social goals and...

Prioritizing Leadership: New Leaders' Federal Policy Platform

ERIC Educational Resources Information Center

New Leaders, 2014

2014-01-01

Principals are critical to the success of any school improvement effort--from increasing academic rigor toward college- and career-ready standards to teacher evaluation and support. They ensure this success by building a strong, shared vision and leading effective implementation for staff, students, and families. The federal government has an…

76 FR 75809 - Prior Label Approval System: Generic Label Approval

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... tracking and reporting systems; and (4) design and implement a survey of the effects of the limited generic... and poultry product inspection programs designed to assure consumers that meat and poultry products... mandatory features are designed to ensure that meat and poultry products are accurately and truthfully...

Predicting Response to Treatment in a Tier 2 Supplemental Vocabulary Intervention

ERIC Educational Resources Information Center

Kelley, Elizabeth; Leary, Emily; Goldstein, Howard

2018-01-01

Purpose: To effectively implement a response to intervention approach, there is a need for timely and specific information about student learning in response to treatment to ensure that treatment decisions are appropriate. This exploratory study examined responsivity to a supplemental, Tier 2 vocabulary intervention delivered to preschool children…

School-based smoking prevention: the teacher training process.

PubMed

Tortu, S; Botvin, G J

1989-03-01

Effective in-service teacher training must be regarded as a critical aspect of the implementation of any innovative school-based smoking prevention curriculum. Inadequate training or lack of training often leads to implementation failure, which, in turn, may be interpreted as program failure. To be effective, teacher training must include a presentation of the theory underlying the program, a demonstration of the skills to be learned, an opportunity to practice the new skills being taught, feedback, and coaching for application. Training activities must include a training workshop and ongoing consultation during the teacher's first experience with classroom implementation. Adequate preparation before the beginning of training will help to ensure that the necessary components are combined in a meaningful training sequence.

Quality management, a directive approach to patient safety.

PubMed

Ayuso-Murillo, Diego; de Andrés-Gimeno, Begoña; Noriega-Matanza, Concha; López-Suárez, Rafael Jesús; Herrera-Peco, Ivan

Nowadays the implementation of effective quality management systems and external evaluation in healthcare is a necessity to ensure not only transparency in activities related to health but also access to health and patient safety. The key to correctly implementing a quality management system is support from the managers of health facilities, since it is managers who design and communicate to health professionals the strategies of action involved in quality management systems. This article focuses on nursing managers' approach to quality management through the implementation of cycles of continuous improvement, participation of improvement groups, monitoring systems and external evaluation quality models (EFQM, ISO). The implementation of a quality management system will enable preventable adverse effects to be minimized or eliminated, and promote patient safety and safe practice by health professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

“Moving forward: a cross sectional baseline study of staff and student attitudes towards a totally smoke free university campus”

PubMed Central

2013-01-01

Background Baseline data were collected to inform the adoption, implementation and institutionalisation phases of a completely smoke free campus policy at a large Western Australian university with a diverse student and staff community. Methods An online survey was randomly emailed to staff and students to measure the attitudes towards and the acceptability and enforcement of the policy prior to implementation. In total, 969 respondents completed the survey. Results General attitudes towards smoking were negative. While smokers, ex-smokers and non-smokers were supportive of smoke free policy on campus, 65.7% of respondents felt the campus should be completely smoke free. Respondents indicated a smoke free policy should be stringently enforced. The majority of respondents reported that they had been exposed to second-hand smoke on campus (n = 768; 79.5%). Conclusion Theory of Organisational Change provides a useful framework to support the implementation of the completely smoke free policy in the University setting. The implementation process needs to consider the broad range of issues associated with implementing a completely smoke free policy and address issues such as safety of smokers, ensuring smokers are not marginalised and ensuring a comprehensive program is implemented. These baseline findings can be used to advocate for the implementation of a comprehensive range of strategies that recognise the addictive nature of tobacco smoking and address attitude and behaviour change, environmental adaptations and effective implementation of the policy. Administration should consider smokers and non-smokers when policy is implemented. PMID:23924040

Data-Driven Decision Making in Out-of-School Time Programs. Part 6 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Organization-Level Activities. Research-to-Results Brief. Publication #2009-34

ERIC Educational Resources Information Center

Bandy, Tawana; Burkhauser, Mary; Metz, Allison J. R.

2009-01-01

Although many program managers look to data to inform decision-making and manage their programs, high-quality program data may not always be available. Yet such data are necessary for effective program implementation. The use of high-quality data facilitates program management, reduces reliance on anecdotal information, and ensures that data are…

Pulmonary Nodule Management in Lung Cancer Screening: A Pictorial Review of Lung-RADS Version 1.0.

PubMed

Godoy, Myrna C B; Odisio, Erika G L C; Truong, Mylene T; de Groot, Patricia M; Shroff, Girish S; Erasmus, Jeremy J

2018-05-01

The number of screening-detected lung nodules is expected to increase as low-dose computed tomography screening is implemented nationally. Standardized guidelines for image acquisition, interpretation, and screen-detected nodule workup are essential to ensure a high standard of medical care and that lung cancer screening is implemented safely and cost effectively. In this article, we review the current guidelines for pulmonary nodule management in the lung cancer screening setting. Copyright © 2018 Elsevier Inc. All rights reserved.

Roadmap for High School Feedback Reports: Key Focus Areas to Ensure Quality Implementation. Data for Action

ERIC Educational Resources Information Center

Data Quality Campaign, 2014

2014-01-01

High school feedback reports let school and district leaders know where their students go after graduation and how well they are prepared for college and beyond. This roadmap discusses the seven key focus areas the Data Quality Campaign (DQC) recommends states work on to ensure quality implementation of high school feedback reports.

[Considerations on the development of nutrition-related guidelines by the World Health Organization and their implementation].

PubMed

Zamora, Gerardo; Meneses, Daniela; De-Regil, Luz Maria; Neufeld, Lynnette; Peña-Rosas, Juan Pablo; Sinisterra, Odalis Teresa

2015-03-01

The World Health Organization (WHO) follows a complex and rigorous process to develop global guidelines. With regard to nutrition-related guidelines, the joint participation of national authorities from Member States and their partners, including those of the social economy, is key to strengthening the process of evidence-informed guideline development and the subsequent implementation as part of national public health strategies. WHO puts forward a series of tools that can assist national authorities on health and social development in the elaboration of evidence-informed policies, considering their pertinence, relevance and implementability. This adoption and adaptation process must consider equity in order to avoid widening existing inequities. WHO global nutrition guidelines contribute to the effective implementation of nutrition interventions in Member States. Two experiences of implementation, one in Panama and one in Peru, exemplify this process. The paper ends by suggesting a deeper understanding and utilization of implementation research during programmes to identify what factors ensure effective interventions, appropriate scale up strategies and greater health equity.

Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs

PubMed Central

Fonjungo, Peter N.; Osmanov, Saladin; Kuritsky, Joel; Ndihokubwayo, Jean Bosco; Bachanas, Pam; Peeling, Rosanna W.; Timperi, Ralph; Fine, Glenn; Stevens, Wendy; Habiyambere, Vincent; Nkengasong, John N.

2016-01-01

Objective: The objective of the WHO/US President's Emergency Plan for AIDS Relief consultation was to discuss innovative strategies, offer guidance, and develop a comprehensive policy framework for implementing quality-assured HIV-related point-of-care testing (POCT). Methods: The consultation was attended by representatives from international agencies (WHO, UNICEF, UNITAID, Clinton Health Access Initiative), United States Agency for International Development, Centers for Disease Control and Prevention/President's Emergency Plan for AIDS Relief Cooperative Agreement Partners, and experts from more than 25 countries, including policy makers, clinicians, laboratory experts, and program implementers. Main outcomes: There was strong consensus among all participants that ensuring access to quality of POCT represents one of the key challenges for the success of HIV prevention, treatment, and care programs. The following four strategies were recommended: implement a newly proposed concept of a sustainable quality assurance cycle that includes careful planning; definition of goals and targets; timely implementation; continuous monitoring; improvements and adjustments, where necessary; and a detailed evaluation; the importance of supporting a cadre of workers [e.g. volunteer quality corps (Q-Corps)] with the role to ensure that the quality assurance cycle is followed and sustained; implementation of the new strategy should be seen as a step-wise process, supported by development of appropriate policies and tools; and joint partnership under the leadership of the ministries of health to ensure sustainability of implementing novel approaches. Conclusion: The outcomes of this consultation have been well received by program implementers in the field. The recommendations also laid the groundwork for developing key policy and quality documents for the implementation of HIV-related POCT. PMID:26807969

How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

NASA Astrophysics Data System (ADS)

ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

2017-10-01

Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

Evolution and Implementation of the NASA Robotic Conjunction Assessment Risk Analysis Concept of Operations

NASA Technical Reports Server (NTRS)

Newman, Lauri K.; Frigm, Ryan C.; Duncan, Matthew G.; Hejduk, Matthew D.

2014-01-01

Reacting to potential on-orbit collision risk in an operational environment requires timely and accurate communication and exchange of data, information, and analysis to ensure informed decision-making for safety of flight and responsible use of the shared space environment. To accomplish this mission, it is imperative that all stakeholders effectively manage resources: devoting necessary and potentially intensive resource commitment to responding to high-risk conjunction events and preventing unnecessary expenditure of resources on events of low collision risk. After 10 years of operational experience, the NASA Robotic Conjunction Assessment Risk Analysis (CARA) is modifying its Concept of Operations (CONOPS) to ensure this alignment of collision risk and resource management. This evolution manifests itself in the approach to characterizing, reporting, and refining of collision risk. Implementation of this updated CONOPS is expected to have a demonstrated improvement on the efficacy of JSpOC, CARA, and owner/operator resources.

The National Space Science Data Center: An operational perspective

NASA Technical Reports Server (NTRS)

Blitstein, Ronald; Green, James L.

1991-01-01

The National Space Science Data Center (NSSDC) manages over 110,000 data tapes with over 4,000 data sets. The size of the digital archive is approximately 6,000 GBytes and is expected to grow to more than 28,000 GBytes by 1995. The NSSDC is involved in several initiatives to better serve the scientific community and improve the management of current and future data holdings. These initiatives address the need to manage data to ensure ready access by the user and manage the media to ensure continuing accessibility and integrity of the data. An operational view of the NSSDC, outlining current policies and procedures that have been implemented to ensure the effective use of available resources to support service and mission goals, and maintain compliance with prescribed data management directives is presented.

The National Space Science Data Center: An operational perspective

NASA Technical Reports Server (NTRS)

Blitstein, Ronald; Green, James L.

1992-01-01

The National Space Science Data Center (NSSDC) manages over 110,000 data tapes with over 4,000 data sets. The size of the digital archive is approximately 6,000 GBytes and is expected to grow to more than 28,000 GBytes by 1995. The NSSDC is involved in several initiatives to better serve the scientific community and improve the management of current and future data holdings. These initiatives address the need to manage data to ensure ready access by the user and manage the media to ensure continuing accessibility and integrity of the data. This paper will present an operational view of the NSSDC, outlining current policies and procedures that were implemented to ensure the effective use of available resources to support service and mission goals, and maintain compliance with prescribed data management directives.

Supporting students with disabilities--promoting understanding amongst mentors in practice.

PubMed

Tee, Stephen; Cowen, Michelle

2012-01-01

Good practice demands a clinical practice culture positively disposed to students with disabilities. Equality legislation seeks to protect those with a disability from either direct or indirect discrimination. The balance between providing "reasonable adjustments" for the student, whilst ensuring "Fitness to Practice", and ultimate employability, requires a close partnership between higher education and practice mentors. This paper reports on the development and evaluation of a range of interactive resources, used in the preparation of mentors to help them address the specific learning needs of disabled students. The evaluation revealed the benefit of student 'stories' in helping mentors to understand the support needs of disabled students and ensure reasonable adjustments are implemented in compliance with disability legislation. The interactive resources have been helpful in promoting positive action towards disabled students' learning, empathic understanding of mental health issues and knowledge and skills acquisition in support of dyslexic students. Implementing reasonable adjustments in practice requires a close working partnership between HEI's and mentors who appreciate support in understanding the development and application of coping strategies to overcome disabilities. Effective preparation of mentors is essential to ensure that opportunities for disabled students to succeed are maximised. Copyright © 2011. Published by Elsevier Ltd.

The Implementation of an Automated Assessment Feedback and Quality Assurance System for ICT Courses

ERIC Educational Resources Information Center

Debuse, J.; Lawley, M.; Shibl, R.

2007-01-01

Providing detailed, constructive and helpful feedback is an important contribution to effective student learning. Quality assurance is also required to ensure consistency across all students and reduce error rates. However, with increasing workloads and student numbers these goals are becoming more difficult to achieve. An automated feedback…

Preliminary analysis of an integrated logistics system for OSSA payloads. Volume 2: OSSA integrated logistics support strategy

NASA Technical Reports Server (NTRS)

Palguta, T.; Bradley, W.; Stockton, T.

1988-01-01

The purpose is to outline an Office of Space Science and Applications (OSSA) integrated logistics support strategy that will ensure effective logistics support of OSSA payloads at an affordable life-cycle cost. Program objectives, organizational relationships, and implementation of the logistics strategy are discussed.

Changes in transcript expression patterns as a result of cryoprotectant treatment and liquid nitrogen exposure in Arabidopsis shoot tips

USDA-ARS?s Scientific Manuscript database

Cryopreservation methods have been implemented in genebanks worldwide as a strategy to ensure long-term, secure back-ups of critical collections of plant genetic resources. Effective and efficient cryopreservation methods are particularly necessary for collections of cultivars that are propagated ve...

Every Child Matters: Every Challenge Met?

ERIC Educational Resources Information Center

Straker, Katherine; Foster, Rob

2009-01-01

This article explores the impact of the Every Child Matters agenda on a group of multi-agency professionals with regard to a number of key issues--such as leadership, multi-agency collaboration, and individual practice. One of the main challenges concerning the successful implementation of the ECM agenda is to ensure that effective training is…

Appreciative Inquiry as a Method for Participatory Change in Secondary Schools in Lebanon

ERIC Educational Resources Information Center

Shuayb, Maha

2014-01-01

Appreciative inquiry is a strategy which takes a positive approach to organizational development. It aims to identify good practice, design effective development plans, and ensure implementation. This article examines the potentials and limitations of using the appreciative inquiry in a mixed methods research design for developing school…

Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014.

PubMed

Filia, Antonietta; Bella, Antonino; Cadeddu, Giovanna; Milia, Maria Rafaela; Del Manso, Martina; Rota, Maria Cristina; Magurano, Fabio; Nicoletti, Loredana; Declich, Silvia

2015-08-01

We report a measles outbreak in Sardinia, Italy, that originated in a cruise ship passenger. The outbreak showed extensive nosocomial transmission (44 of 80 cases). To minimize nosocomial transmission, health care facilities should ensure that susceptible health care workers are vaccinated against measles and should implement effective infection control procedures.

A Review of the Implementation of the "Better Behaviour-Better Learning" Report

ERIC Educational Resources Information Center

Her Majesty's Inspectorate of Education, 2005

2005-01-01

The promotion of pupils' self-discipline has been clearly highlighted as one of the National Priorities for Scottish education. This reflects the key role that establishing positive working relationships between pupils and staff is known to play in ensuring effective learning. Equally, this relationship also works in reverse. The quality of…

40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures

Code of Federal Regulations, 2012 CFR

2012-07-01

... the structure of the aquatic food web and the disequilibrium constant, are different at the site than..., the TMDL shall also indicate the point source effluent flows assumed in the analyses. Mass loading... more proximate sources interact or overlap, the combined effect must be evaluated to ensure that...

40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures

Code of Federal Regulations, 2014 CFR

2014-07-01

... the structure of the aquatic food web and the disequilibrium constant, are different at the site than..., the TMDL shall also indicate the point source effluent flows assumed in the analyses. Mass loading... more proximate sources interact or overlap, the combined effect must be evaluated to ensure that...

Ensuring Effective Impact of Continuing Professional Development: Saudi Science Teachers' Perspective

ERIC Educational Resources Information Center

Qablan, Ahmad; Mansour, Nassar; Alshamrani, Saeed; Aldahmash, Abdulwali; Sabbah, Saed

2015-01-01

Many researchers critique that continuing professional development programs in Saudi Arabia are neither well organized nor are systematic. This study came to assess the impact of CPD opportunities in the country to better suit the professional needs of Saudi science teachers and support them in implementing the reformed instructional practices.…

Pre-Service Teachers and Self-Efficacy: A Study in Contrast

ERIC Educational Resources Information Center

Colson, Tori; Sparks, Kelly; Berridge, Gina; Frimming, Renee; Willis, Clarissa

2017-01-01

With increased emphasis on student achievement in schools, teacher education programs are challenged to meet the demand for highly effective teachers. Ensuring that pre-service teachers feel confident in their ability to teach, prompted one Midwestern University to implement an extended student teaching placement. The idea behind this endeavor was…

Rethinking Online Discourse: Improving Learning through Discussions in the Online Classroom

ERIC Educational Resources Information Center

Johnson, Cass M.

2016-01-01

As colleges continue to expand online offerings, student participation within courses should be assessed to ensure that teachers can best implement effective, responsible lesson plans. This study examined discourse in an online classroom in order to gauge student participation by observing student-to-student and student-to-instructor exchanges…

The impact of clinical nurse specialists on clinical pathways in the application of evidence-based practice.

PubMed

Gurzick, Martha; Kesten, Karen S

2010-01-01

The purpose of this article was to address the call for evidence-based practice through the development of clinical pathways and to assert the role of the clinical nurse specialist (CNS) as a champion in clinical pathway implementation. In the current health care system, providing quality of care while maintaining cost-effectiveness is an ever-growing battle that institutions face. The CNS's role is central to meeting these demands. An extensive literature review has been conducted to validate the use of clinical pathways as a means of improving patient outcomes. This literature also suggests that clinical pathways must be developed, implemented, and evaluated utilizing validated methods including the use of best practice standards. Execution of clinical pathways should include a clinical expert, who has the ability to look at the system as a whole and can facilitate learning and change by employing a multitude of competencies while maintaining a sphere of influence over patient and families, nurses, and the system. The CNS plays a pivotal role in influencing effective clinical pathway development, implementation, utilization, and ongoing evaluation to ensure improved patient outcomes and reduced costs. This article expands upon the call for evidence-based practice through the utilization of clinical pathways to improve patient outcomes and reduce costs and stresses the importance of the CNS as a primary figure for ensuring proper pathway development, implementation, and ongoing evaluation. Copyright 2010 Elsevier Inc. All rights reserved.

[Using TRM to Enhance the Accuracy of Ventilator-Associated Pneumonia Preventive Measures Implemented by Neonatal Intensive Care Unit Medical Staffs].

PubMed

Huang, Yu-Ting; Huang, Chao-Ya; Su, Hsiu-Ya; Ma, Chen-Te

2018-06-01

Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the neonatal intensive care unit (NICU). The average VAP infection density was 4.7‰ in our unit between June and August 2015. The results of a status survey indicated that in-service education lacked specialization, leading to inadequate awareness among staffs regarding the proper care of newborns with VAP and a lack of related care guides. This, in turn, resulted in inconsistencies in care measures for newborns with VAP. To improve the accuracy of implementation of preventive measures for VAP among medical staffs and reduce the density of VAP infections in the NICU. Conduct a literature search and adopt medical team resources management methods; establish effective team communication; establish monitoring mechanisms and incentives; establish mandatory in-service specialization education contents and a VAP preventive care guide exclusively for newborns as a reference for medical staffs during care execution; install additional equipment and aids and set reminders to ensure the implementation of VAP preventive measures. The accuracy rate of preventive measure execution by medical staffs improved from 70.1% to 97.9% and the VAP infection density in the NICU decreased from 4.7‰ to 0.52‰. Team integration effectively improved the accuracy of implementation of VAP-prevention measures, reduced the density of VAP infections, enhanced quality of care, and ensured that newborns received care that was more in line with specialization needs.

A literature review for large-scale health information system project planning, implementation and evaluation.

PubMed

Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

2017-01-01

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

18 CFR 707.7 - Ensuring that environmental documents are actually considered in agency decisionmaking.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Ensuring that... Power and Water Resources WATER RESOURCES COUNCIL COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) Water Resources Council Implementing Procedures § 707.7 Ensuring that environmental documents are...

18 CFR 707.7 - Ensuring that environmental documents are actually considered in agency decisionmaking.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Ensuring that... Power and Water Resources WATER RESOURCES COUNCIL COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) Water Resources Council Implementing Procedures § 707.7 Ensuring that environmental documents are...

18 CFR 707.7 - Ensuring that environmental documents are actually considered in agency decisionmaking.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Ensuring that... Power and Water Resources WATER RESOURCES COUNCIL COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) Water Resources Council Implementing Procedures § 707.7 Ensuring that environmental documents are...

18 CFR 707.7 - Ensuring that environmental documents are actually considered in agency decisionmaking.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Ensuring that... Power and Water Resources WATER RESOURCES COUNCIL COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) Water Resources Council Implementing Procedures § 707.7 Ensuring that environmental documents are...

18 CFR 707.7 - Ensuring that environmental documents are actually considered in agency decisionmaking.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Ensuring that... Power and Water Resources WATER RESOURCES COUNCIL COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) Water Resources Council Implementing Procedures § 707.7 Ensuring that environmental documents are...

Organizational and technological insight as important factors for successful implementation of IT.

PubMed

Nikula, R E

1999-01-01

Politicians and hospital management in Sweden and Denmark focus on IT and especially Electronic Patient Record, EPR as a tool for changes that will lead to better economy as well as better quality and service to the patients. These changes are not direct effects of the new medium for patient records but indirect effects due to the possibilities embedded in the new technology. To ensure that the implementation is successful, i.e. leads to changes in organization structure and workflow, we need tools to prepare clinicians and management. The focus of this paper is the individual insight in technology and organization and it proposes a model to assess and categorize the possibilities of individuals and groups to participate in and make an implementation process powerful.

Challenges in the management of support and care programmes for child-headed households in South Africa.

PubMed

Human, Sarie P; van Rensburg, Gisela H

2011-10-01

The present study reports on data collected in a larger study on 'A situational analysis of child-headed households in South Africa'. The purpose of this study was to explore the management and control of available and required services, resources and safety nets for children in child-headed households. The significance of having a better understanding of the challenges, limitations but importance for government structures to manage and control programmes will enhance the implementation and maintenance of focused and sustainable support structures and programmes which will effectively address the needs of child-headed households. An exploratory and descriptive, quantitative survey was conducted to provide information on government structures at a national level and the nine provinces in South Africa. The population consisted of the Departments of Social Development, Education, Health and Agriculture, at both national and provincial levels. The main findings included a lack of clarity regarding the concept and definition of a child-headed household, lack of empirical data, a diversity of needs and challenges in terms of location and geographical distribution of available infrastructure and support systems; programmes that are not inclusive and integrated; and contradictions in the stipulations and implementation of existing policies and capacity and human resources shortages. It was concluded that the magnitude, uniqueness and complexity of the phenomenon necessitate effective and sound scientific management principles. This is achieved by providing legal clarity of the concept; developing relevant policies and ensuring effective implementation thereof; rigorous monitoring and evaluation based on comprehensive empirical data; and protecting the rights and safety of these children and ensuring an enabling environment for all stakeholders to address needs and challenges. The role of the nurse manager is to ensure a holistic approach to children living in child-headed households by acting as a facilitator, advocate, leader, coordinator and consultant. © 2011 Blackwell Publishing Ltd.

Designing a strategy to promote safe, innovative off-label use of medications.

PubMed

Ansani, Nicole; Sirio, Carl; Smitherman, Thomas; Fedutes-Henderson, Bethany; Skledar, Susan; Weber, Robert J; Zgheib, Nathalie; Branch, Robert

2006-01-01

Innovative off-label medication use (defined as prescribing with reasonable rationale for use, but insufficient evidence to allay safety, efficacy, and cost-effectiveness concerns, yet is not clinical research) is common practice and provides challenges to ensuring high-quality health care and patient safety. This article describes a strategy to promote policy and standardization of innovative off-label medication use, ensure oversight of patient safety, and prospectively assess efficacy. A multidisciplinary group developed a policy and process to regulate innovative off-label medication use that standardizes formulary review, maximizes peer expertise input, and minimizes institution liability by evaluating the effectiveness of use, promoting evidence-based practices, and ensuring ethical obligations to patients and society. This strategy has been implemented through institutional staff structure. The review process balances benefits/risks for biologically plausible therapy that lacks rigorous data support. The authors' strategy illustrates collaboration that enables a priori consideration for innovative off-label medication use while providing safety surveillance and outcomes monitoring.

Core principles of assessment in competency-based medical education.

PubMed

Lockyer, Jocelyn; Carraccio, Carol; Chan, Ming-Ka; Hart, Danielle; Smee, Sydney; Touchie, Claire; Holmboe, Eric S; Frank, Jason R

2017-06-01

The meaningful assessment of competence is critical for the implementation of effective competency-based medical education (CBME). Timely ongoing assessments are needed along with comprehensive periodic reviews to ensure that trainees continue to progress. New approaches are needed to optimize the use of multiple assessors and assessments; to synthesize the data collected from multiple assessors and multiple types of assessments; to develop faculty competence in assessment; and to ensure that relationships between the givers and receivers of feedback are appropriate. This paper describes the core principles of assessment for learning and assessment of learning. It addresses several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful assessor selection and training. It provides a reconceptualization of the role of psychometrics and articulates the importance of a group process in determining trainees' progress. In addition, it notes that, to reach its potential as a driver in trainee development, quality care, and patient safety, CBME requires effective information management and documentation as well as ongoing consideration of ways to improve the assessment system.

[Study on the fund to ensure the implementation of public function of province-level, city-level and county-level center of disease prevention and control in China].

PubMed

Chang, Feng-shui; Wang, Ying; Luo, Li; Sun, Mei

2005-11-01

To calculate the fund to ensure the implementation of public function of province-level, city-level and county-level center of disease prevention and control in China. The principle was to fulfill public function, promote professional efficiency and give a comprehensive attention to employee depletion. Basic data were collected by sample CDC investigation. Value of some special indicators was demonstrated by specialist group. Results To ensure the implementation of public function, a total of 15.7 billion Yen per year should be allocated to all province-level, city-level and county-level center of disease prevention and control. The personnel expenses was 8.4 billion Yen and the daily expenses was 7.4 billion Yen per year.

Sociocultural Behavior Research and Engineering in the Department of Defense Context

DTIC Science & Technology

2011-09-01

return on investment. Section IV provides a set of principles and practices to ensure that DoD investments are cost effective and have high...projects. The U.S. Army Training and Doctrine Command (TRADOC) Analysis Center (TRAC), the Naval Postgraduate School (NPS), the OSD’s Cost Assessment... cost -effectively allocating resources targeted toward relevant problems. The OSD HSCB Modeling Program is using that approach to rapidly implement a

Impact of Underwater Explosions on Concrete Bridge Foundations

DTIC Science & Technology

2016-06-01

www.theconstructioncivil.org/ [16] M. Aggour, A. Hachichi and M. Mayer, “Nondestructive evaluation of timber bridge piles,” in Proceedings of a Session a Structure Congress...detonation must be executed a safe distance from any critical infrastructure to ensure the survivability of the structure . This thesis implements...be executed a safe distance from any critical infrastructure to ensure the survivability of the structure . This thesis implements the Dynamic System

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

PubMed

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

2008-01-18

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

Enhancing Harmonization to Ensure Alignment of Partners, Implementation and Priorities for Provision of Quality Primary Healthcare to Communities in Rural Zambia.

PubMed

Goma, Fastone M

2017-01-01

This paper discusses the processes of harmonization of various approaches by partners that have been implemented in Zambia, in an attempt to overcome the fragmented implementation of Community based primary healthcare (CBPHC) systems strengthening, facilitated by multiple non-governmental organizations (NGOs) and donors, impeding country ownership and nationalization. To achieve equitable and sustained improvements in health, social and economic development outcomes for all, there is evidence that governments should consider building CBPHC systems based on three legs namely: 1. Front-line health workers trained, supervised and able to deliver services; 2. Community engagement through interactions to enhance community participation and Social Accountability for delivery of healthcare services; 3. Enabling environments through strengthening of community health systems. To realize a harmonized approach and alignments, the government and key stakeholders must uphold a common vision ensuring that all the three legs of CBPHC systems are implemented to scale. In evaluating the health system in Zambia and the related healthcare provision at community level, gaps were identified in the available mechanisms for the provision of quality CBPHC thus necessitating processes of harmonization, that include capacity building and orientations at all levels on importance of taking to scale the three legs of CBPHC systems, revision of the Community Health Strategy, and elaboration of Operational Guide for Neighbourhood Health Committees, clarifying the role of NHC as platform for community engagement and Community-Based Volunteers (CBVs). There is need for harmonization of health systems at national, provincial, district, zonal and communal levels to ensure the delivery of quality, cost-effective healthcare as close to the family as possible.

SAVY-4000 Surveillance and Life Extension Program Fiscal Year 2013 Annual Report

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

Stone, Timothy A.; Blair, Michael W.; Weis, Eric

2014-03-03

The Packaging Surveillance Program section of the DOE M441.1-1 /sup>1, Nuclear Material Packaging Manual (DOE, 2008) requires DOE contractors to “ensure that a surveillance program is established and implemented to ensure the nuclear material storage package continues to meet its design criteria.” In order to ensure continuing safe storage of nuclear material and the maximization of risk reduction, TA-55 has established a Surveillance Program to ensure storage container integrity for operations within its specified design life. The LANL SAVY-4000 Field Surveillance Plan2 defines the near-term field surveillance plan for SAVY-4000 containers as required by the Manual. A long-term surveillance planmore » will be established based on the results of the first several years of surveillance and the results of the lifetime extension studies as defined in the Accelerated Aging Plan3. This report details progress in positioning the Surveillance Program for successful implementation in FY14 and status of the Design Life Extension Program in terms of its implementation and data collection for FY13.« less

Requirements for the design and implementation of checklists for surgical processes.

PubMed

Verdaasdonk, E G G; Stassen, L P S; Widhiasmara, P P; Dankelman, J

2009-04-01

The use of checklists is a promising strategy for improving patient safety in all types of surgical processes inside and outside the operating room. This article aims to provide requirements and implementation of checklists for surgical processes. The literature on checklist use in the operating room was reviewed based on research using Medline, Pubmed, and Google Scholar. Although all the studies showed positive effects and important benefits such as improved team cohesion, improved awareness of safety issues, and reduction of errors, their number still is limited. The motivation of team members is considered essential for compliance. Currently, no general guidelines exist for checklist design in the surgical field. Based on the authors' experiences and on guidelines used in the aviation industry, requirements for the checklist design are proposed. The design depends on the checklist purpose, philosophy, and method chosen. The methods consist of the "call-do-response" approach," the "do-verify" approach, or a combination of both. The advantages and disadvantages of paper versus electronic solutions are discussed. Furthermore, a step-by-step strategy of how to implement a checklist in the clinical situation is suggested. The use of structured checklists in surgical processes is most likely to be effective because it standardizes human performance and ensures that procedures are followed correctly instead of relying on human memory alone. Several studies present promising and positive first results, providing a solid basis for further investigation. Future research should focus on the effect of various checklist designs and strategies to ensure maximal compliance.

A Review of Legal Decisions Relevant to Technical Standards Used in Pharmacy School Admissions

PubMed Central

2017-01-01

The implementation of an effective and legally sound technical standards procedure for pharmacy schools requires a proactive approach by admissions officers. Applicants with disabilities are accorded significant rights that must not be infringed during the admissions process in order to ensure compliance with applicable law. This article provides a review of applicable state cases, federal cases, and OCR decisions and guidance to help pharmacy schools identify procedures and implement technical standards into their admissions processes as required by ACPE Standards 2016. PMID:28381897

Modeling the prediction of business intelligence system effectiveness.

PubMed

Weng, Sung-Shun; Yang, Ming-Hsien; Koo, Tian-Lih; Hsiao, Pei-I

2016-01-01

Although business intelligence (BI) technologies are continually evolving, the capability to apply BI technologies has become an indispensable resource for enterprises running in today's complex, uncertain and dynamic business environment. This study performed pioneering work by constructing models and rules for the prediction of business intelligence system effectiveness (BISE) in relation to the implementation of BI solutions. For enterprises, effectively managing critical attributes that determine BISE to develop prediction models with a set of rules for self-evaluation of the effectiveness of BI solutions is necessary to improve BI implementation and ensure its success. The main study findings identified the critical prediction indicators of BISE that are important to forecasting BI performance and highlighted five classification and prediction rules of BISE derived from decision tree structures, as well as a refined regression prediction model with four critical prediction indicators constructed by logistic regression analysis that can enable enterprises to improve BISE while effectively managing BI solution implementation and catering to academics to whom theory is important.

The Role of Communication in Ensuring Sustained Behavior Change

EPA Pesticide Factsheets

Webinar series on communications strategies and methods addresses how communications tools can be used throughout the implementation of climate and clean energy programs to achieve behavior change and ensure sustained.

U.S. Department of Education, Office of Inspector General Semiannual Report to Congress, October 1, 1997-March 31, 1998.

ERIC Educational Resources Information Center

Office of Inspector General (ED), Washington, DC.

During the 6-month period ending March 31, 1998, the Office of Inspector General assisted the Department of Education in ensuring that taxpayer-funded federal education programs and operations are implemented efficiency, effectiveness, integrity and accountability. In the executive summary, under "Goal 1: Programs and Operations…

Challenge of Engaging All Students via Self-Paced Interactive Electronic Learning Tutorials for Introductory Physics

ERIC Educational Resources Information Center

DeVore, Seth; Marshman, Emily; Singh, Chandralekha

2017-01-01

As research-based, self-paced electronic learning tools become increasingly available, a critical issue educators encounter is implementing strategies to ensure that all students engage with them as intended. Here, we first discuss the effectiveness of electronic learning tutorials as self-paced learning tools in large enrollment brick and mortar…

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

PAQUETTE,D.E.; BENNETT,D.B.; DORSCH,W.R.

THE DEPARTMENT OF ENERGY ORDER 5400.1, GENERAL ENVIRONMENTAL PROTECTION PROGRAM, REQUIRES THE DEVELOPMENT AND IMPLEMENTATION OF A GROUNDWATER PROTECTION PROGRAM. THE BNL GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION PROVIDES AN OVERVIEW OF HOW THE LABORATORY ENSURES THAT PLANS FOR GROUNDWATER PROTECTION, MONITORING, AND RESTORATION ARE FULLY DEFINED, INTEGRATED, AND MANAGED IN A COST EFFECTIVE MANNER THAT IS CONSISTENT WITH FEDERAL, STATE, AND LOCAL REGULATIONS.

The Realization of the System Programme "Health Saving Education" in the Pedagogical University

ERIC Educational Resources Information Center

Nagovitsyn, Roman S.; Chigovskaya-Nazarova, Yanina A.; Miroshnichenko, Aleksey A.; Senator, Svetlana Y.

2018-01-01

The purpose of the article is to develop a system programme "Health saving education" on the basis of creating a structural model and model of management and ensuring health and preventive activities and experimentally prove the effectiveness of its implementation in the educational process of the university. The solution of research…

Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014

PubMed Central

Bella, Antonino; Cadeddu, Giovanna; Milia, Maria Rafaela; Del Manso, Martina; Rota, Maria Cristina; Magurano, Fabio; Nicoletti, Loredana; Declich, Silvia

2015-01-01

We report a measles outbreak in Sardinia, Italy, that originated in a cruise ship passenger. The outbreak showed extensive nosocomial transmission (44 of 80 cases). To minimize nosocomial transmission, health care facilities should ensure that susceptible health care workers are vaccinated against measles and should implement effective infection control procedures. PMID:26196266

Defense Health Care. Comprehensive Oversight Framework Needed to Help Ensure Effective Implementation of a Deployment Health Quality Assurance Program

DTIC Science & Technology

2007-06-01

Virus IPV Inactivated Poliovirus MMR Measles, Mumps, and Rubella This is a work of the U.S. government and is not subject to copyright protection...rubella), inactivated poliovirus (IPV), hepatitis B, and influenza (once per season). • Pass: all immunizations current • Fail: overdue for one or more

Findings from the Reading First Implementation Study, 2008-09

ERIC Educational Resources Information Center

Gamse, Beth; Boulay, Beth; Rulf-Fountain, Alyssa; Unlu, Fatih

2011-01-01

"The No Child Left Behind Act of 2001" (PL 107-110) established the Reading First Program (Title I, Part B, Subpart 1), a major federal initiative designed to help ensure that all children can read at or above grade level by the end of third grade. Reading First (RF) builds upon research indicating that effective reading instruction on…

Impact of a Teacher-as-Coach Model: Improving Paraprofessionals Fidelity of Implementation of Discrete Trial Training for Students with Moderate-to-Severe Developmental Disabilities

ERIC Educational Resources Information Center

Mason, Rose A.; Schnitz, Alana G.; Wills, Howard P.; Rosenbloom, Raia; Kamps, Debra M.; Bast, Darcey

2017-01-01

Ensuring educational progress for students with moderate-to-severe developmental disabilities requires exposure to well executed evidence-based practices. This necessitates that the special education workforce, including paraprofessionals, be well-trained. Yet evidence regarding effective training mechanisms for paraprofessionals is limited. A…

78 FR 50394 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Snapper-Grouper Fishery off the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... published in the Federal Register on August 2, 2013, regarding the implementation of management measures described in Amendment 22 to the Fishery Management Plan for the Snapper-Grouper Fishery in the South... to ensure there is adequate time to submit complete responses. DATES: This correction is effective...

Ensuring Every Child Matters: Issues and Implications for School Leadership

ERIC Educational Resources Information Center

Harris, Alma; Allen, Tracey

2009-01-01

This article considers the challenges and issues facing school leaders in the implementation of Every Child Matters. It outlines the factors that contribute to the effective delivery of Every Child Matters and outlines some of the barriers that make the delivery of this agenda more difficult. The article concludes that school leaders play a…

Simulation: The Effects of Simulation on High Stakes Testing in Undergradute Nursing Education

ERIC Educational Resources Information Center

Walters, Linda

2014-01-01

Many nursing programs use standardized testing packages in order to evaluate students' content mastery as well as predict probability of passing the National Council Licensure for Registered Nurses (NCLEX-RN). Instead of a diagnosis for weak content areas, programs implement testing policies in the belief that such policies ensure student success…

Schools Break the Mold to Produce Graduates Ready for Success in College and Careers.

ERIC Educational Resources Information Center

Southern Regional Education Board (SREB), 2011

2011-01-01

Schools are implementing new and effective strategies in an effort to graduate 90 percent of students and to ensure that graduates are prepared to succeed in college, advanced training and work. This newsletter describes how schools have redesigned their schedules, organizational structures and cultures in an effort to graduate 90 percent of…

Implementing high-performance work practices in healthcare organizations: qualitative and conceptual evidence.

PubMed

McAlearney, Ann Scheck; Robbins, Julie; Garman, Andrew N; Song, Paula H

2013-01-01

Studies across industries suggest that the systematic use of high-performance work practices (HPWPs) may be an effective but underused strategy to improve quality of care in healthcare organizations. Optimal use of HPWPs depends on how they are implemented, yet we know little about their implementation in healthcare. We conducted 67 key informant interviews in five healthcare organizations, each considered to have exemplary work practices in place and to deliver high-quality care, as part of an extensive study of HPWP use in healthcare. We analyzed interview transcripts inductively and deductively to examine why and how organizations implement HPWPs. We used an evidence-based model of complex innovation adoption to guide our exploration of factors that facilitate HPWP implementation. We found considerable variability in interviewees' reasons for implementing HPWPs, including macro-organizational (strategic level) and micro-organizational (individual level) reasons. This variability highlighted the complex context for HPWP implementation in many organizations. We also found that our application of an innovation implementation model helped clarify and categorize facilitators of HPWP implementation, thus providing insight on how these factors can contribute to implementation effectiveness. Focusing efforts on clarifying definitions, building commitment, and ensuring consistency in the application of work practices may be particularly important elements of successful implementation.

A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers

PubMed Central

Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar

2016-01-01

Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings. PMID:28670007

A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers.

PubMed

Dariotis, Jacinda K; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T; Mendelson, Tamar

2017-01-01

Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators - students and their classroom teachers - merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings.

The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso.

PubMed

Murray, Joanna; Remes, Pieter; Ilboudo, Rita; Belem, Mireille; Salouka, Souleymane; Snell, Will; Wood, Cathryn; Lavoie, Matthew; Deboise, Laurent; Head, Roy

2015-11-03

A 35-month cluster randomized controlled trial was conducted in Burkina Faso to test whether a radio campaign focused on child health, broadcast between March 2012 and January 2015, could reduce under-5 mortality. This paper describes the design and implementation of the mass media intervention in detail, including the Saturation+ principles that underpinned the approach, the creative process, the lessons learned, and recommendations for implementing this intervention at scale. The Saturation+ approach focuses on the 3 core principles of saturation (ensuring high exposure to campaign messages), science (basing campaign design on data and modeling), and stories (focusing the dramatic climax on the target behavior) to maximize the impact of behavior change campaigns. In Burkina Faso, creative partnerships with local radio stations helped us obtain free airtime in exchange for training and investing in alternative energy supplies to solve frequent energy problems faced by the stations. The campaign used both short spots and longer drama formats, but we consider the short spots as a higher priority to retain during scale-up, as they are more cost-effective than longer formats and have the potential to ensure higher exposure of the population to the messages. The implementation research synthesized in this paper is designed to enable the effective adoption and integration of evidence-based behavior change communication interventions into health care policy and practice. © Murray et al.

The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso

PubMed Central

Murray, Joanna; Remes, Pieter; Ilboudo, Rita; Belem, Mireille; Salouka, Souleymane; Snell, Will; Wood, Cathryn; Lavoie, Matthew; Deboise, Laurent; Head, Roy

2015-01-01

A 35-month cluster randomized controlled trial was conducted in Burkina Faso to test whether a radio campaign focused on child health, broadcast between March 2012 and January 2015, could reduce under-5 mortality. This paper describes the design and implementation of the mass media intervention in detail, including the Saturation+ principles that underpinned the approach, the creative process, the lessons learned, and recommendations for implementing this intervention at scale. The Saturation+ approach focuses on the 3 core principles of saturation (ensuring high exposure to campaign messages), science (basing campaign design on data and modeling), and stories (focusing the dramatic climax on the target behavior) to maximize the impact of behavior change campaigns. In Burkina Faso, creative partnerships with local radio stations helped us obtain free airtime in exchange for training and investing in alternative energy supplies to solve frequent energy problems faced by the stations. The campaign used both short spots and longer drama formats, but we consider the short spots as a higher priority to retain during scale-up, as they are more cost-effective than longer formats and have the potential to ensure higher exposure of the population to the messages. The implementation research synthesized in this paper is designed to enable the effective adoption and integration of evidence-based behavior change communication interventions into health care policy and practice. PMID:26681703

A three-dimensional wide-angle BPM for optical waveguide structures.

PubMed

Ma, Changbao; Van Keuren, Edward

2007-01-22

Algorithms for effective modeling of optical propagation in three- dimensional waveguide structures are critical for the design of photonic devices. We present a three-dimensional (3-D) wide-angle beam propagation method (WA-BPM) using Hoekstra's scheme. A sparse matrix algebraic equation is formed and solved using iterative methods. The applicability, accuracy and effectiveness of our method are demonstrated by applying it to simulations of wide-angle beam propagation, along with a technique for shifting the simulation window to reduce the dimension of the numerical equation and a threshold technique to further ensure its convergence. These techniques can ensure the implementation of iterative methods for waveguide structures by relaxing the convergence problem, which will further enable us to develop higher-order 3-D WA-BPMs based on Padé approximant operators.

A three-dimensional wide-angle BPM for optical waveguide structures

NASA Astrophysics Data System (ADS)

Ma, Changbao; van Keuren, Edward

2007-01-01

Algorithms for effective modeling of optical propagation in three- dimensional waveguide structures are critical for the design of photonic devices. We present a three-dimensional (3-D) wide-angle beam propagation method (WA-BPM) using Hoekstra’s scheme. A sparse matrix algebraic equation is formed and solved using iterative methods. The applicability, accuracy and effectiveness of our method are demonstrated by applying it to simulations of wide-angle beam propagation, along with a technique for shifting the simulation window to reduce the dimension of the numerical equation and a threshold technique to further ensure its convergence. These techniques can ensure the implementation of iterative methods for waveguide structures by relaxing the convergence problem, which will further enable us to develop higher-order 3-D WA-BPMs based on Padé approximant operators.

Implementation Evaluation in a Private Nonprofit Setting: A Mixed-Methods Approach

ERIC Educational Resources Information Center

Walker, Jacquelyn Ann

2013-01-01

Demand for quality service provision in the human services industry requires that private nonprofit organizations have the administrative and management capacities to ensure successful implementation and sustain staff development programs. Unfamiliarity with implementation challenges, and limited awareness of implementation strategies, can trigger…

Practical Team-Based Learning from Planning to Implementation

PubMed Central

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

2015-01-01

Team-based learning (TBL) helps instructors develop an active teaching approach for the classroom through group work. The TBL infrastructure engages students in the learning process through the Readiness Assessment Process, problem-solving through team discussions, and peer feedback to ensure accountability. This manuscript describes the benefits and barriers of TBL, and the tools necessary for developing, implementing, and critically evaluating the technique within coursework in a user-friendly method. Specifically, the manuscript describes the processes underpinning effective TBL development, preparation, implementation, assessment, and evaluation, as well as practical techniques and advice from authors’ classroom experiences. The paper also highlights published articles in the area of TBL in education, with a focus on pharmacy education. PMID:26889061

Challenges in the design and implementation of the Multicenter Uveitis Steroid Treatment (MUST) Trial--lessons for comparative effectiveness trials.

PubMed

Holbrook, Janet T; Kempen, John H; Prusakowski, Nancy A; Altaweel, Michael M; Jabs, Douglas A

2011-12-01

Randomized clinical trials (RCTs) are an important component of comparative effectiveness (CE) research because they are the optimal design for head-to-head comparisons of different treatment options. To describe decisions made in the design of the Multicenter Uveitis Steroid Treatment (MUST) Trial to ensure that the results would be widely generalizable. Review of design and implementation decisions and their rationale for the trial. The MUST Trial is a multicenter randomized controlled CE trial evaluating a novel local therapy (intraocular fluocinolone acetonide implant) versus the systemic therapy standard of care for noninfectious uveitis. Decisions made in protocol design in order to broaden enrollment included allowing patients with very poor vision and media opacity to enroll and including clinical sites outside the United States. The treatment protocol was designed to follow standard care. The primary outcome, visual acuity, is important to patients and can be evaluated in all eyes with uveitis. Other outcomes include patient-reported visual function, quality of life, and disease and treatment related complications. The trial population is too small for subgroup analyses that are of interest and the trial is being conducted at tertiary medical centers. CE trials require greater emphasis on generalizability than many RCTs but otherwise face similar challenges for design choices as any RCT. The increase in heterogeneity in patients and treatment required to ensure generalizability can be balanced with a rigorous approach to implementation, outcome assessment, and statistical design. This approach requires significant resources that may limit implementation in many RCTs, especially in clinical practice settings.

7 CFR 1491.2 - Administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... implementation leadership for FRPP; (2) Develop, maintain, and ensure that policies, guidelines, and procedures... CFR part 12; and (10) Provide leadership for establishing, implementing, and overseeing administrative...

7 CFR 1491.2 - Administration.

Code of Federal Regulations, 2011 CFR

2011-01-01

... implementation leadership for FRPP; (2) Develop, maintain, and ensure that policies, guidelines, and procedures... CFR part 12; and (10) Provide leadership for establishing, implementing, and overseeing administrative...

Challenges to the implementation of International Health Regulations (2005) on Preventing Infectious Diseases: experience from Julius Nyerere International Airport, Tanzania

PubMed Central

Bakari, Edith; Frumence, Gasto

2013-01-01

Background The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. Design A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Results Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. Conclusions JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy. PMID:23958240

Challenges to the implementation of International Health Regulations (2005) on preventing infectious diseases: experience from Julius Nyerere International Airport, Tanzania.

PubMed

Bakari, Edith; Frumence, Gasto

2013-08-16

The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

European union water policy--tasks for implementing "Water Framework Directive" in pre-accession countries.

PubMed

Sözen, Seval; Avcioglu, Ebru; Ozabali, Asli; Görgun, Erdem; Orhon, Derin

2003-08-01

Water Framework Directive aiming to maintain and improve the aquatic environment in the EU was launched by the European Parliament in 2000. According to this directive, control of quantity is an ancillary element in securing good water quality and therefore measures on quantity, serving the objective of ensuring good quality should also be established. Accordingly, it is a comprehensive and coordinated package that will ensure all European waters to be protected according to a common standard. Therefore, it refers to all other Directives related to water resources management such as Urban Wastewater Treatment Directive Nitrates Directive, Drinking Water Directive, Integrated Pollution Prevention Control etc. Turkey, as a candidate state targeting full-membership, should comply the necessary preparations for the implementation of the "Water Framework Directive" as soon as possible. In this study, the necessary legislative, political, institutional, and technical attempts of the pre-accession countries have been discussed and effective recommendations have been offered for future activities in Turkey.

Does implementing a development plan for user participation in a mental hospital change patients' experience? A non-randomized controlled study.

PubMed

Rise, Marit B; Steinsbekk, Aslak

2015-10-01

Governments in several countries attempt to strengthen user participation through instructing health-care organizations to implement user participation initiatives. There is, however, little knowledge on the effect on patients' experience from comprehensive plans for enhancing user participation in whole health service organizations. To investigate whether implementing a development plan intending to enhance user participation in a mental hospital had any effect on the patients' experience of user participation. A non-randomized controlled study including patients in three mental hospitals in Central Norway, one intervention hospital and two control hospitals. A development plan intended to enhance user participation was implemented in the intervention hospital as a part of a larger reorganizational process. The plan included establishment of a patient education centre and a user office, purchase of user expertise, appointment of contact professionals for next of kin and improvement of the centre's information and the professional culture. Perceptions of Care, Inpatient Treatment Alliance Scale and questions made for this study. A total of 1651 patients participated. Implementing a development plan in a mental hospital intending to enhance user participation had no significant effect on the patients' experience of user participation. The lack of effect can be due to inappropriate initiatives or challenges in implementation processes. Further research should ensure that initiatives and implementation processes are appropriate to impact the patients' experience. © 2013 John Wiley & Sons Ltd.

Preparing Principals to Raise Student Achievement: Implementation and Effects of the New Leaders Program in Ten Districts. Research Report

ERIC Educational Resources Information Center

Gates, Susan M.; Hamilton, Laura S.; Martorell, Paco; Burkhauser, Susan; Heaton, Paul; Pierson, Ashley; Baird, Matthew; Vuollo, Mirka; Li, Jennifer J.; Lavery, Diana Catherine; Harvey, Melody; Gu, Kun

2014-01-01

New Leaders is a nonprofit organization with a mission to ensure high academic achievement for all students by developing outstanding school leaders to serve in urban schools. Its premise is that a combination of preparation and improved working conditions for principals, especially greater autonomy, would lead to improved student outcomes. Its…

Implementation of Financial Sustainability in Organizations through Valuation of Financial Leverage Effect in Russian Practice of Financial Management

ERIC Educational Resources Information Center

Ashmarina, Svetlana I.; Zotova, Anna S.; Smolina, Ekaterina S.

2016-01-01

The article considers the need of ensuring the sustainable development of organizations in the unstable external environment; financial sustainability which is understood as the optimal structure of funding sources of a business entity is proved to be the most significant factor of sustainable development. The article proves that the index of…

Financial management of a hospice program.

PubMed

Simione, Robert J; Simione, Kathleen A

2002-07-01

Agencies interested in starting hospice programs or maximizing the benefits of existing programs need to implement and maintain accurate and effective internal cost accounting systems. Once established, a cost accounting system provides the administrators of the hospice program with information to prepare budget projections, perform break-even analysis, and develop other reports to assist in making sound business decisions to ensure success.

The Correlation of Data-Driven Instruction to Teacher-Effectiveness, Teacher-Collaboration, and Teacher-Satisfaction

ERIC Educational Resources Information Center

Shaw, Rhonda R.

2017-01-01

Education reform is inevitable; however, the journey of reform must ensure that educators are equipped to meet the diverse needs of all children within the classrooms throughout. Data-driven decision making is going to be the driving force for making that happen. This mixed model research was designed to show how implementing data-driven…

45 CFR 261.62 - What must a State do to verify the accuracy of its work participation information?

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Do We Ensure the Accuracy of Work... internal controls to ensure compliance with the procedures; and (5) Submit to the Secretary for approval... countable work activity; and (5) A description of the internal controls that the State has implemented to...

Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges.

PubMed

Fowkes, Freya J I; Draper, Bridget L; Hellard, Margaret; Stoové, Mark

2016-12-12

The global health community is currently transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Unfortunately, progress towards maternal, newborn and infant health MDGs has lagged significantly behind other key health goals, demanding a renewed global effort in this key health area. The World Health Organization and other institutions heralded integrated antenatal care (ANC) as the best way to address the inter-related health issues of HIV, tuberculosis (TB) and malaria in the high risk groups of pregnant women and infants; integrated ANC services also offer a mechanism to address slow progress towards improved maternal health. There is remarkably limited evidence on best practice approaches of program implementation, acceptability and effectiveness for integrated ANC models targeting multiple diseases. Here, we discuss current integrated ANC global guidelines and the limited literature describing integrated ANC implementation and evidence for their role in addressing HIV, malaria and TB during pregnancy in sub-Saharan Africa. We highlight the paucity of data on the effectiveness of integrated ANC models and identify significant structural barriers in the health system (funding, infrastructure, distribution, human resources), the adoption system (limited buy-in from implementers, leadership, governance) and, in the broader context, patient-centred barriers (fear, stigma, personal burdens) and barriers in funding structures. We highlight recommendations for action and discuss avenues for the global health community to develop systems to integrate multiple disease programs into ANC models of care that better address these three priority infectious diseases. With the current transition to the SDGs and concerns regarding the failure to meet maternal health MDGs, the global health community, researchers, implementers and funding bodies must work together to ensure the establishment of quality operational and implementation research to inform integrated ANC models. It is imperative that the global health community engages in a timely discussion about such implementation innovations and instigates appropriate actions to ensure advances in maternal health are sufficient to meet applicable SDGs.

Compliance and Verification of Standards and Labelling Programs in China: Lessons Learned

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

Saheb, Yamina; Zhou, Nan; Fridley, David

2010-06-11

After implementing several energy efficiency standards and labels (30 products covered by MEPS, 50 products covered by voluntary labels and 19 products by mandatory labels), the China National Institute of Standardization (CNIS) is now implementing verification and compliance mechanism to ensure that the energy information of labeled products comply with the requirements of their labels. CNIS is doing so by organizing check testing on a random basis for room air-conditioners, refrigerators, motors, heaters, computer displays, ovens, and self -ballasted lamps. The purpose of the check testing is to understand the implementation of the Chinese labeling scheme and help local authoritiesmore » establishing effective compliance mechanisms. In addition, to ensure robustness and consistency of testing results, CNIS has coordinated a round robin testing for room air conditioners. Eight laboratories (Chinese (6), Australian (1) and Japanese (1)) have been involved in the round robin testing and tests were performed on four sets of samples selected from manufacturer?s production line. This paper describes the methodology used in undertaking both check and round robin testing, provides analysis of testing results and reports on the findings. The analysis of both check and round robin testing demonstrated the benefits of a regularized verification and monitoring system for both laboratories and products such as (i) identifying the possible deviations between laboratories to correct them, (ii) improving the quality of testing facilities, (iii) ensuring the accuracy and reliability of energy label information in order to strength the social credibility of the labeling program and the enforcement mechanism in place.« less

Compliance and Verification of Standards and Labeling Programs in China: Lessons Learned

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

Saheb, Yamina; Zhou, Nan; Fridley, David

2010-08-01

After implementing several energy efficiency standards and labels (30 products covered by MEPS, 50 products covered by voluntary labels and 19 products by mandatory labels), the China National Institute of Standardization (CNIS) is now implementing verification and compliance mechanism to ensure that the energy information of labeled products comply with the requirements of their labels. CNIS is doing so by organizing check testing on a random basis for room air-conditioners, refrigerators, motors, heaters, computer displays, ovens, and self -ballasted lamps. The purpose of the check testing is to understand the implementation of the Chinese labeling scheme and help local authoritiesmore » establishing effective compliance mechanisms. In addition, to ensure robustness and consistency of testing results, CNIS has coordinated a round robin testing for room air conditioners. Eight laboratories (Chinese (6), Australian (1) and Japanese (1)) have been involved in the round robin testing and tests were performed on four sets of samples selected from manufacturer's production line. This paper describes the methodology used in undertaking both check and round robin testing, provides analysis of testing results and reports on the findings. The analysis of both check and round robin testing demonstrated the benefits of a regularized verification and monitoring system for both laboratories and products such as (i) identifying the possible deviations between laboratories to correct them, (ii) improving the quality of testing facilities, (iii) ensuring the accuracy and reliability of energy label information in order to strength the social credibility of the labeling program and the enforcement mechanism in place.« less

A strategic approach to public health workforce development and capacity building.

PubMed

Dean, Hazel D; Myles, Ranell L; Spears-Jones, Crystal; Bishop-Cline, Audriene; Fenton, Kevin A

2014-11-01

In February 2010, CDC's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention (NCHHSTP) formally institutionalized workforce development and capacity building (WDCB) as one of six overarching goals in its 2010-2015 Strategic Plan. Annually, workforce team members finalize an action plan that lays the foundation for programs to be implemented for NCHHSTP's workforce that year. This paper describes selected WDCB programs implemented by NCHHSTP during the last 4 years in the three strategic goal areas: (1) attracting, recruiting, and retaining a diverse and sustainable workforce; (2) providing staff with development opportunities to ensure the effective and innovative delivery of NCHHSTP programs; and (3) continuously recognizing performance and achievements of staff and creating an atmosphere that promotes a healthy work-life balance. Programs have included but are not limited to an Ambassador Program for new hires, career development training for all staff, leadership and coaching for mid-level managers, and a Laboratory Workforce Development Initiative for laboratory scientists. Additionally, the paper discusses three overarching areas-employee communication, evaluation and continuous review to guide program development, and the implementation of key organizational and leadership structures to ensure accountability and continuity of programs. Since 2010, many lessons have been learned regarding strategic approaches to scaling up organization-wide public health workforce development and capacity building. Perhaps the most important is the value of ensuring the high-level strategic prioritization of this issue, demonstrating to staff and partners the importance of this imperative in achieving NCHHSTP's mission. Published by Elsevier Inc.

Government of Canada Initiatives in Support of the Joint Convention

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

Brown, P.A.; Metcalfe, D.E.; Lojk, R.

The Government of Canada strongly supported international efforts to bring into force the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (the Joint Convention), and was the second country to ratify it. The Joint Convention places a number of obligations on Contracting Parties aimed at achieving and maintaining a high level of safety worldwide in spent fuel and radioactive waste management, ensuring that effective defenses against potential hazards are in place during all management stages, preventing accidents with radiological consequences and mitigating their consequences should they occur. In addition to establishingmore » and maintaining a modem regulatory framework and an independent regulatory body through the 2000 Nuclear Safety and Control Act, the Government of Canada has implemented a number of initiatives that address its responsibilities and serve to further enhance Canada's compliance with the Joint Convention. For nuclear fuel waste, the Government of Canada brought into force the Nuclear Fuel Waste Act in 2002 to require waste owners to develop, fund, organize and implement a long-term solution for Canada's nuclear fuel waste. The Act clearly reserves for Government the decision on the solution to be implemented in the best interests of Canadians, as well as oversight to ensure that waste owners are fulfilling their responsibilities. In the case of low-level radioactive waste, long-term solutions are being developed to ensure the protection of health, safety, and the environment, both now and in the future. Regarding uranium mine and mill tailings, current operators have state-of-the-art waste management facilities in place. The Government of Canada works with provincial governments to ensure that any potential abandoned or legacy mines sites where no owner can be held responsible are safely decommissioned and managed over the long term. (authors)« less

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

PubMed Central

Osaro, Erhabor; Chima, Njemanze

2014-01-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness. PMID:25182941

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

PubMed

Osaro, Erhabor; Chima, Njemanze

2014-06-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

45 CFR 153.350 - Risk adjustment data validation standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... implementation of any risk adjustment software and ensure proper validation of a statistically valid sample of... respect to implementation of risk adjustment software or as a result of data validation conducted pursuant... implementation of risk adjustment software or data validation. ...

DOD Civilian Personnel. Intelligence Personnel System Incorporates Safeguards, but Opportunities Exist for Improvement

DTIC Science & Technology

2009-12-01

high standards of integrity, conduct, and concern for the public interest. 5. The Federal work force should be used efficiently and effectively . 6...NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Government Accountability Office,441 G Street...in its implementation of DCIPS, DOD has taken some positive steps to incorporate 10 internal safeguards to help ensure the fair, effective , and

DOD Financial Management: Improvements Needed in Army’s Efforts to Ensure the Reliability of Its Statement of Budgetary Resources

DTIC Science & Technology

2014-05-01

a cost- effective approach for achieving audit readiness. To help minimize the inefficient use of resources when previously identified deficiencies...System (GFEBS) emphasizing the implementation of effective business processes. However, the Army did not fully complete certain tasks in accordance...represent material portions of future SBRs and, if not auditable, will likely affect the Army’s ability to achieve audit readiness goals as planned

RADIOPROTECTION CAMPAIGN AND CARD: EDUCATIONAL STRATEGIES THAT REDUCE CHILDREN'S EXCESSIVE EXPOSURE TO RADIOLOGICAL EXAMS.

PubMed

Bernardo, Mônica Oliveira; Almeida, Fernando Antonio de; Morgado, Flavio

2017-01-01

To analyze the results of an initiative aimed at improving the reasonable use of radiological examinations, ensuring their technical quality, implementing a radioprotection campaign that includes training of the professional team, and introducing the radioprotection card for children under 12 years old as a tool for parents and doctors to control children's exposure to radiation. The study was held in a health care insurance system covering 140,000 people. A radioprotection campaign was implemented according to Image Gently • protocols, ensuring the lowest dose of radiation and the quality of examinations, and the radioprotection card was implemented. To assess the effectiveness of these actions, the number of radiological examinations performed at the pediatric emergency room in a period of one year preceding the campaign was compared with the number of radiological examinations performed one year after the campaign. The campaign was well accepted by all professionals, families, and patients involved. In the year following the implementation of radioprotection strategies, there was a 22% reduction of radiological examinations performed at the pediatric emergency room. There was also a 29% reduction in the request of two or more radiological examinations for the same child or examinations with two or more incidences. The campaign and the radioprotection card for children under 12 years old proved to be feasible strategies and correlated with a reduction in radiological examinations requested and performed at the pediatric emergency room.

An empirical assessment of implementation, adaptation, and tailoring: the evaluation of CDC's National Diffusion of VOICES/VOCES.

PubMed

Harshbarger, Camilla; Simmons, Gretchen; Coelho, Helen; Sloop, Kira; Collins, Charles

2006-08-01

The Centers for Disease Control and Prevention (CDC), through its Diffusion of Effective Behavioral Interventions (DEBI) program, trained over 260 agencies on VOICES/VOCES between August 2003 and April 2005. ORC Macro conducted interviews with agency staff 3 months after receiving VOICES/VOCES training. This article discusses the diffusion of VOICES/VOCES; agencies' adoption, adaptation, and implementation of this intervention; and needs for ongoing proactive technical assistance (TA) for agencies to successfully integrate behavioral interventions into their programs. The vastmajority of agencies implemented VOICES/VOCES with fidelity to the core elements, and agencies successfully adapted the intervention to make it more appealing to target populations. TA is needed for interventions to be successfully adapted and implemented with fidelity to the core elements, and to ensure program sustainability. More effective interventions of short duration and minimum complexity to easily match with existing resources and conditions of agency capacity among HIV prevention providers in the community are needed.

Implementing Innovations in Global Women's, Children's, and Adolescents' Health: Realizing the Potential for Implementation Science.

PubMed

Peterson, Herbert B; Haidar, Joumana; Fixsen, Dean; Ramaswamy, Rohit; Weiner, Bryan J; Leatherman, Sheila

2018-03-01

The launch of the United Nations Sustainable Development Goals and the new Secretary General's Global Strategy for Women's, Children's, and Adolescents' Health are a window of opportunity for improving the health and well-being of women, children, and adolescents in the United States and around the world. Realizing the full potential of this historic moment will require that we improve our ability to successfully implement life-saving and life-enhancing innovations, particularly in low-resource settings. Implementation science, a new and rapidly evolving field that addresses the "how-to" component of providing sustainable quality services at scale, can make an important contribution on this front. A synthesis of the implementation science evidence indicates that three interrelated factors are required for successful, sustainable outcomes at scale: 1) effective innovations, 2) effective implementation, and 3) enabling contexts. Implementation science addresses the interaction among these factors to help make innovations more usable, to build ongoing capacity to assure the effective implementation of these innovations, and to ensure enabling contexts to sustain their full and effective use in practice. Improving access to quality services will require transforming health care systems and, therefore, much of the focus of implementation science in global health is on improving the ability of health systems to serve as enabling contexts. The field of implementation science is inherently interdisciplinary and academe will need to respond by facilitating collaboration among scientists from relevant disciplines, including evaluation, improvement, and systems sciences. Platforms and programs to facilitate collaborations among researchers, practitioners, policymakers, and funders are likewise essential.

The need for targeted implementation research to improve coverage of basic vaccines and introduction of new vaccines.

PubMed

Arora, Narendra K; Lal, Altaf A; Hombach, Joachim M; Santos, Jose I; Bhutta, Zulfiqar A; Sow, Samba O; Greenwood, Brian

2013-04-18

The Decade of Vaccines Collaboration (DoVC) Research and Development (R&D) Working Group identified implementation research as an important step toward achieving high vaccine coverage and the uptake of desirable new vaccines. The R&D Working Group noted that implementation research is highly complex and requires participation of stakeholders from diverse backgrounds to ensure effective planning, execution, interpretation, and adoption of research outcomes. Unlike other scientific disciplines, implementation research is highly contextual and depends on social, cultural, geographic, and economic factors to make the findings useful for local, national, and regional applications. This paper presents the broad framework for implementation research in support of immunization and sets out a series of research questions developed through a Delphi process (during a DoVC-supported workshop in Sitges, Spain) and a literature review. Copyright © 2013 Elsevier Ltd. All rights reserved.

'Pedometers cost buttons': the feasibility of implementing a pedometer based walking programme within the community

PubMed Central

2011-01-01

Background Recent studies have suggested that walking interventions may be effective (at least in the short term) at increasing physical activity amongst those people who are the most inactive. This is a leading objective of contemporary public health policy in the UK and worldwide. However, before committing money from limited budgets to implement walking interventions more widely in the community, policymakers will want to know whether similar impacts can be expected and whether any changes will be required to the process to ensure uptake and success. This paper utilises the findings from a recent community-based pedometer study (Walking for Wellbeing in the West - WWW) undertaken in Glasgow, Scotland to address issues of feasibility. Methods An economic analysis of the WWW study assessed the costs of the interventions (minimal and maximal) and combined these with the effects to present incremental cost-effectiveness ratios (cost/person achieving the target of an additional 15,000 steps/week). A qualitative evaluation, involving focus group discussions with WWW participants and short interviews with members of the WWW research team, explored perceived benefits and barriers associated with walking, as well as the successful aspects and challenges associated with the interventions. Results The incremental cost effectiveness associated with the interventions was estimated as £92 and £591 per person achieving the target for the minimal and maximal interventions respectively. The qualitative evaluation gave insight into the process by which the results were achieved, and identified several barriers and facilitators that would need to be addressed before implementing the interventions in the wider community, in order to ensure their effective transfer. These included assessing the impact of the relationship between researchers and participants on the results, and the motivational importance of monitoring and assessing performance. Conclusions The results suggest that pedometer based walking interventions may be considered cost-effective and suitable for implementation within the wider community. However, several research gaps remain, including the importance and impact of the researcher/participant relationship, the impact of assessment on motivation and effectiveness, and the longer term impact on physical and mental health, resource utilisation and quality of life. Trial registration Current Control Trials Ltd ISRCTN88907382 PMID:21453509

Design and implementation of population-based specialty care programs.

PubMed

Botts, Sheila R; Gee, Michael T; Chang, Christopher C; Young, Iris; Saito, Logan; Lyman, Alfred E

2017-09-15

The development, implementation, and scaling of 3 population-based specialty care programs in a large integrated healthcare system are reviewed, and the role of clinical pharmacy services in ensuring safe, effective, and affordable care is highlighted. The Kaiser Permanente (KP) integrated healthcare delivery model allows for rapid development and expansion of innovative population management programs involving pharmacy services. Clinical pharmacists have assumed integral roles in improving the safety and effectiveness of high-complexity, high-cost care for specialty populations. These roles require an appropriate practice scope and are supported by an advanced electronic health record with disease registries and electronic surveillance tools for care-gap identification. The 3 specialty population programs described were implemented to address variation or unrecognized gaps in care for at-risk specialty populations. The Home Phototherapy Program has leveraged internal partnerships with clinical pharmacists to improve access to cost-effective nonpharmacologic interventions for psoriasis and other skin disorders. The Multiple Sclerosis Care Program has incorporated clinical pharmacists into neurology care in order to apply clinical guidelines in a systematic manner. The KP SureNet program has used clinical pharmacists and data analytics to identify opportunities to prevent drug-related adverse outcomes and ensure timely follow-up. Specialty care programs improve quality, cost outcomes, and the patient experience by appropriating resources to provide systematic and targeted care to high-risk patients. KP leverages an integration of people, processes, and technology to develop and scale population-based specialty care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The future of radiology augmented with Artificial Intelligence: A strategy for success.

PubMed

Liew, Charlene

2018-05-01

The rapid development of Artificial Intelligence/deep learning technology and its implementation into routine clinical imaging will cause a major transformation to the practice of radiology. Strategic positioning will ensure the successful transition of radiologists into their new roles as augmented clinicians. This paper describes an overall vision on how to achieve a smooth transition through the practice of augmented radiology where radiologists-in-the-loop ensure the safe implementation of Artificial Intelligence systems. Copyright © 2018 Elsevier B.V. All rights reserved.

Quality assurance planning for lunar Mars exploration

NASA Technical Reports Server (NTRS)

Myers, Kay

1991-01-01

A review is presented of the tools and techniques required to meet the challenge of total quality in the goal of traveling to Mars and returning to the moon. One program used by NASA to ensure the integrity of baselined requirements documents is configuration management (CM). CM is defined as an integrated management process that documents and identifies the functional and physical characteristics of a facility's systems, structures, computer software, and components. It also ensures that changes to these characteristics are properly assessed, developed, approved, implemented, verified, recorded, and incorporated into the facility's documentation. Three principal areas are discussed that will realize significant efficiencies and enhanced effectiveness, change assessment, change avoidance, and requirements management.

Mineral supply for sustainable development requires resource governance.

PubMed

Ali, Saleem H; Giurco, Damien; Arndt, Nicholas; Nickless, Edmund; Brown, Graham; Demetriades, Alecos; Durrheim, Ray; Enriquez, Maria Amélia; Kinnaird, Judith; Littleboy, Anna; Meinert, Lawrence D; Oberhänsli, Roland; Salem, Janet; Schodde, Richard; Schneider, Gabi; Vidal, Olivier; Yakovleva, Natalia

2017-03-15

Successful delivery of the United Nations sustainable development goals and implementation of the Paris Agreement requires technologies that utilize a wide range of minerals in vast quantities. Metal recycling and technological change will contribute to sustaining supply, but mining must continue and grow for the foreseeable future to ensure that such minerals remain available to industry. New links are needed between existing institutional frameworks to oversee responsible sourcing of minerals, trajectories for mineral exploration, environmental practices, and consumer awareness of the effects of consumption. Here we present, through analysis of a comprehensive set of data and demand forecasts, an interdisciplinary perspective on how best to ensure ecologically viable continuity of global mineral supply over the coming decades.

Mineral supply for sustainable development requires resource governance

USGS Publications Warehouse

Ali, Saleem H.; Giurco, Damien; Arndt, Nicholas; Nickless, Edmund; Brown, Graham; Demetriades, Alecos; Durrheim, Ray; Enriquez, Maria Amélia; Kinnaird, Judith; Littleboy, Anna; Meinert, Lawrence D.; Oberhänsli, Roland; Salem, Janet; Schodde, Richard; Schneider, Gabi; Vidal, Olivier; Yakovleva, Natalia

2017-01-01

Successful delivery of the United Nations sustainable development goals and implementation of the Paris Agreement requires technologies that utilize a wide range of minerals in vast quantities. Metal recycling and technological change will contribute to sustaining supply, but mining must continue and grow for the foreseeable future to ensure that such minerals remain available to industry. New links are needed between existing institutional frameworks to oversee responsible sourcing of minerals, trajectories for mineral exploration, environmental practices, and consumer awareness of the effects of consumption. Here we present, through analysis of a comprehensive set of data and demand forecasts, an interdisciplinary perspective on how best to ensure ecologically viable continuity of global mineral supply over the coming decades.

Mineral supply for sustainable development requires resource governance

NASA Astrophysics Data System (ADS)

Ali, Saleem H.; Giurco, Damien; Arndt, Nicholas; Nickless, Edmund; Brown, Graham; Demetriades, Alecos; Durrheim, Ray; Enriquez, Maria Amélia; Kinnaird, Judith; Littleboy, Anna; Meinert, Lawrence D.; Oberhänsli, Roland; Salem, Janet; Schodde, Richard; Schneider, Gabi; Vidal, Olivier; Yakovleva, Natalia

2017-03-01

Successful delivery of the United Nations sustainable development goals and implementation of the Paris Agreement requires technologies that utilize a wide range of minerals in vast quantities. Metal recycling and technological change will contribute to sustaining supply, but mining must continue and grow for the foreseeable future to ensure that such minerals remain available to industry. New links are needed between existing institutional frameworks to oversee responsible sourcing of minerals, trajectories for mineral exploration, environmental practices, and consumer awareness of the effects of consumption. Here we present, through analysis of a comprehensive set of data and demand forecasts, an interdisciplinary perspective on how best to ensure ecologically viable continuity of global mineral supply over the coming decades.

77 FR 47800 - Adoption of Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... recommendations designed to ensure that agencies satisfy the existing requirements in the most efficient and... make decisions on their implementation. The Conference based these recommendations on research reports... sweeping measures designed to ensure that agencies' regulations advance legitimate goals, such as Executive...

Scaling up HIV viral load - lessons from the large-scale implementation of HIV early infant diagnosis and CD4 testing.

PubMed

Peter, Trevor; Zeh, Clement; Katz, Zachary; Elbireer, Ali; Alemayehu, Bereket; Vojnov, Lara; Costa, Alex; Doi, Naoko; Jani, Ilesh

2017-11-01

The scale-up of effective HIV viral load (VL) testing is an urgent public health priority. Implementation of testing is supported by the availability of accurate, nucleic acid based laboratory and point-of-care (POC) VL technologies and strong WHO guidance recommending routine testing to identify treatment failure. However, test implementation faces challenges related to the developing health systems in many low-resource countries. The purpose of this commentary is to review the challenges and solutions from the large-scale implementation of other diagnostic tests, namely nucleic-acid based early infant HIV diagnosis (EID) and CD4 testing, and identify key lessons to inform the scale-up of VL. Experience with EID and CD4 testing provides many key lessons to inform VL implementation and may enable more effective and rapid scale-up. The primary lessons from earlier implementation efforts are to strengthen linkage to clinical care after testing, and to improve the efficiency of testing. Opportunities to improve linkage include data systems to support the follow-up of patients through the cascade of care and test delivery, rapid sample referral networks, and POC tests. Opportunities to increase testing efficiency include improvements to procurement and supply chain practices, well connected tiered laboratory networks with rational deployment of test capacity across different levels of health services, routine resource mapping and mobilization to ensure adequate resources for testing programs, and improved operational and quality management of testing services. If applied to VL testing programs, these approaches could help improve the impact of VL on ART failure management and patient outcomes, reduce overall costs and help ensure the sustainable access to reduced pricing for test commodities, as well as improve supportive health systems such as efficient, and more rigorous quality assurance. These lessons draw from traditional laboratory practices as well as fields such as logistics, operations management and business. The lessons and innovations from large-scale EID and CD4 programs described here can be adapted to inform more effective scale-up approaches for VL. They demonstrate that an integrated approach to health system strengthening focusing on key levers for test access such as data systems, supply efficiencies and network management. They also highlight the challenges with implementation and the need for more innovative approaches and effective partnerships to achieve equitable and cost-effective test access. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Terrorism preparedness: Web-based resource management and the TOPOFF 3 exercise.

PubMed

Jacobs, Lenworth M; Burns, Karyl J

2006-03-01

The bombings of London on July 7, 2005 highlight the need for continued vigilance and readiness to respond to terrorist attacks. Trauma centers need to be at the core of preparedness activities. The State of Connecticut has taken a lead in preparedness and was selected as a site for the US Department of Homeland Security's Top Officials Three Exercise (TOPOFF 3), the largest and most extensive antiterrorism drill ever conducted. All 32 acute care hospitals in Connecticut took part in the drill. The simulated attacks were designed to test all aspects of emergency preparedness including the ability of hospitals to treat large numbers of victims and effectively monitor and implement mechanisms for surge capacity. In Connecticut, TOPOFF 3 tested the Bioterrorism Preparedness Web Application that was designed to be the primary communication and resource management tool during a terrorist event or public health emergency. This paper describes: 1) the impetus for the State of Connecticut Department of Public Health's Bioterrorism Preparedness Web Application; 2) the strategies used to ensure its readiness and appropriate utilization during a public health emergency; and 3) its use for communication and resource management by the Department of Public Health and the acute care hospitals during TOPOFF 3. The Bioterrorism Preparedness Web Application was successfully implemented and used during TOPOFF 3 to assess surge capacity and other resources. Careful development and implementation of the Web application, or any communication system, as well as training and regular practice are required to ensure effective use during a public health emergency.

Implementation of Rapid Molecular Infectious Disease Diagnostics: the Role of Diagnostic and Antimicrobial Stewardship.

PubMed

Messacar, Kevin; Parker, Sarah K; Todd, James K; Dominguez, Samuel R

2017-03-01

New rapid molecular diagnostic technologies for infectious diseases enable expedited accurate microbiological diagnoses. However, diagnostic stewardship and antimicrobial stewardship are necessary to ensure that these technologies conserve, rather than consume, additional health care resources and optimally affect patient care. Diagnostic stewardship is needed to implement appropriate tests for the clinical setting and to direct testing toward appropriate patients. Antimicrobial stewardship is needed to ensure prompt appropriate clinical action to translate faster diagnostic test results in the laboratory into improved outcomes at the bedside. This minireview outlines the roles of diagnostic stewardship and antimicrobial stewardship in the implementation of rapid molecular infectious disease diagnostics. Copyright © 2017 American Society for Microbiology.

The SLMTA programme: Transforming the laboratory landscape in developing countries

PubMed Central

Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.

2014-01-01

Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335

32 CFR 57.5 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... services to infants, toddlers and children. (4) Ensure the implementation of procedural safeguards... a DoD-wide comprehensive child-find system to identify eligible infants, toddlers, and children ages... Defense (GC, DoD) and the Secretaries of the Military Departments: (i) Ensure that eligible infants and...

32 CFR 57.5 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... services to infants, toddlers and children. (4) Ensure the implementation of procedural safeguards... a DoD-wide comprehensive child-find system to identify eligible infants, toddlers, and children ages... Defense (GC, DoD) and the Secretaries of the Military Departments: (i) Ensure that eligible infants and...

32 CFR 57.5 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... services to infants, toddlers and children. (4) Ensure the implementation of procedural safeguards... a DoD-wide comprehensive child-find system to identify eligible infants, toddlers, and children ages... Defense (GC, DoD) and the Secretaries of the Military Departments: (i) Ensure that eligible infants and...

32 CFR 57.5 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... services to infants, toddlers and children. (4) Ensure the implementation of procedural safeguards... a DoD-wide comprehensive child-find system to identify eligible infants, toddlers, and children ages... Defense (GC, DoD) and the Secretaries of the Military Departments: (i) Ensure that eligible infants and...

32 CFR 57.5 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... services to infants, toddlers and children. (4) Ensure the implementation of procedural safeguards... a DoD-wide comprehensive child-find system to identify eligible infants, toddlers, and children ages... Defense (GC, DoD) and the Secretaries of the Military Departments: (i) Ensure that eligible infants and...

49 CFR 601.3 - General responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... management of FTA-sponsored projects; representing the Administration before civil courts and administrative... Office of Civil Rights. Directed by a Director for Civil Rights, this office ensures full implementation of civil rights and equal opportunity initiatives by all recipients of FTA assistance, and ensures...

49 CFR 601.3 - General responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... management of FTA-sponsored projects; representing the Administration before civil courts and administrative... Office of Civil Rights. Directed by a Director for Civil Rights, this office ensures full implementation of civil rights and equal opportunity initiatives by all recipients of FTA assistance, and ensures...

49 CFR 601.3 - General responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... management of FTA-sponsored projects; representing the Administration before civil courts and administrative... Office of Civil Rights. Directed by a Director for Civil Rights, this office ensures full implementation of civil rights and equal opportunity initiatives by all recipients of FTA assistance, and ensures...

49 CFR 601.3 - General responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... management of FTA-sponsored projects; representing the Administration before civil courts and administrative... Office of Civil Rights. Directed by a Director for Civil Rights, this office ensures full implementation of civil rights and equal opportunity initiatives by all recipients of FTA assistance, and ensures...

Pressure ulcer prevention in frail older people.

PubMed

Barry, Maree; Nugent, Linda

2015-12-16

Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork.

Implementing a regional oncology information system: approach and lessons learned.

PubMed

Evans, W K; Ashbury, F D; Hogue, G L; Smith, A; Pun, J

2014-10-01

Paper-based medical record systems are known to have major problems of inaccuracy, incomplete data, poor accessibility, and challenges to patient confidentiality. They are also an inefficient mechanism of record-sharing for interdisciplinary patient assessment and management, and represent a major problem for keeping current and monitoring quality control to facilitate improvement. To address those concerns, national, regional, and local health care authorities have increased the pressure on oncology practices to upgrade from paper-based systems to electronic health records. Here, we describe and discuss the challenges to implementing a region-wide oncology information system across four independent health care organizations, and we describe the lessons learned from the initial phases that are now being applied in subsequent activities of this complex project. The need for change must be shared across centres to increase buy-in, adoption, and implementation. It is essential to establish physician leadership, commitment, and engagement in the process. Work processes had to be revised to optimize use of the new system. Culture change must be included in the change management strategy. Furthermore, training and resource requirements must be thoroughly planned, implemented, monitored, and modified as required for effective adoption of new work processes and technology. Interfaces must be established with multiple existing electronic systems across the region to ensure appropriate patient flow. Periodic assessment of the existing project structure is necessary, and adjustments are often required to ensure that the project meets its objectives. The implementation of region-wide oncology information systems across different health practice locations has many challenges. Leadership is essential. A strong, collaborative information-sharing strategy across the region and with the supplier is essential to identify, discuss, and resolve implementation problems. A structure that supports project management and accountability contributes to success.

Implementation lessons for school food policies and marketing restrictions in the Philippines: a qualitative policy analysis.

PubMed

Reeve, Erica; Thow, Anne Marie; Bell, Colin; Engelhardt, Katrin; Gamolo-Naliponguit, Ella Cecilia; Go, John Juliard; Sacks, Gary

2018-01-23

The school environment can enhance children's skills, knowledge and behaviours in relation to healthy eating. However, in many countries, unhealthy foods are commonly available in schools, and children can be exposed to aggressive marketing by the food industry. Taking the perspective of policymakers, this study aimed to identify barriers and enablers to effective school food policy development and implementation in the Philippines. In May 2016, semi-structured interviews were conducted with 21 policymakers and stakeholders involved in school food policymaking and implementation in the Philippines. The Health Policy Analysis Triangle was used to identify interview questions and to guide the thematic analysis. These included the political and socio-environmental context, strengths and limitations of existing policy content, roles and behaviours of actors, implementation processes, policy outcomes, and opportunities to improve policy coherence. The Department of Education's policy 'Orders' represented a relatively strong policy framework for the education sector of the Philippines. However, a lack of human and financial resources for implementation, planning, and policy enforcement limited the impact of the policy on the healthiness of school food provision. Ambiguity in policy wording allowed a wide interpretation of the foods eligible to be provided in schools, and led to difficulties in effective monitoring and enforcement. Food companies used existing relationships with schools to promote their brands and compromise the establishment of a stronger food policy agenda. We found a motivated group of actors engaging in policy-oriented learning and advocating for a stronger policy alternative so as to improve the school food environment. The adoption of policy mechanisms being used to promote healthy dietary practices in the school setting will be strengthened by more robust implementation planning processes, and resources to support implementation and enforcement. Policymakers should ensure policy language clearly and unequivocally promotes healthier food and beverage options. Steps should be taken to achieve policy coherence by ensuring the objectives of one agency or institution are not undermining that of any others. Where there is reliance on the private sector for school resources, safeguards should be established to protect against conflicts of interest.

77 FR 48173 - Comment Request for Information Collection for Monitoring Implementation of Changes to State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-13

... Collection for Monitoring Implementation of Changes to State Unemployment Insurance (UI) Programs, Extension... to Scott Gibbons, Office of Unemployment Insurance, Employment and Training Administration, U.S... responsibility for ensuring that states implement the extension and modifications to the Emergency Unemployment...

44 CFR 80.17 - Project implementation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Project implementation. 80.17... RELOCATION FOR OPEN SPACE Post-Award Requirements § 80.17 Project implementation. (a) Hazardous materials. The subgrantee shall take steps to ensure it does not acquire or include in the project properties...

44 CFR 80.17 - Project implementation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Project implementation. 80.17... RELOCATION FOR OPEN SPACE Post-Award Requirements § 80.17 Project implementation. (a) Hazardous materials. The subgrantee shall take steps to ensure it does not acquire or include in the project properties...

44 CFR 80.17 - Project implementation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Project implementation. 80.17... RELOCATION FOR OPEN SPACE Post-Award Requirements § 80.17 Project implementation. (a) Hazardous materials. The subgrantee shall take steps to ensure it does not acquire or include in the project properties...

Assessment approaches in massive open online courses: Possibilities, challenges and future directions

NASA Astrophysics Data System (ADS)

Xiong, Yao; Suen, Hoi K.

2018-03-01

The development of massive open online courses (MOOCs) has launched an era of large-scale interactive participation in education. While massive open enrolment and the advances of learning technology are creating exciting potentials for lifelong learning in formal and informal ways, the implementation of efficient and effective assessment is still problematic. To ensure that genuine learning occurs, both assessments for learning (formative assessments), which evaluate students' current progress, and assessments of learning (summative assessments), which record students' cumulative progress, are needed. Providers' more recent shift towards the granting of certificates and digital badges for course accomplishments also indicates the need for proper, secure and accurate assessment results to ensure accountability. This article examines possible assessment approaches that fit open online education from formative and summative assessment perspectives. The authors discuss the importance of, and challenges to, implementing assessments of MOOC learners' progress for both purposes. Various formative and summative assessment approaches are then identified. The authors examine and analyse their respective advantages and disadvantages. They conclude that peer assessment is quite possibly the only universally applicable approach in massive open online education. They discuss the promises, practical and technical challenges, current developments in and recommendations for implementing peer assessment. They also suggest some possible future research directions.

Implementation and utilization of a comprehensive information network in an integrated private not-for-profit regional health care system

NASA Astrophysics Data System (ADS)

Long, James M., III

1995-10-01

The capacity to access, integrate, and analyze demographic, financial, and clinical data within a regional health care system represents an opportunity to ensure and enhance clinical quality and to reduce costs in a carefully planned and controlled manner. Properly used, such capability should improve health care delivery for local populations and provide the institution with a level of integration of services achieved by few health care organizations. The Baptist Health System (BHS), based in Birmingham, Alabama, is currently standardizing operating procedures among its various components and implementing a comprehensive, enterprise-wide information network. Clinical quality improvement and case management are being promulgated throughout the enterprise using a continuum-of-care model developed internally. Having successfully completed a pilot project using teleconferences for core lectures in internal medicine between two large teaching hospitals, BHS is taking advantage of enterprise- wide teleconference capability using a combination of fiberoptic (T3) and standard digital telephone (T1) transmission to speed installation and reduce the cost of implementation into two office buildings and eleven hospitals. The information system will serve to prepare BHS for the advent of managed care and other anticipated changes in health care, while ensuring continued ability to deliver high quality, cost-effective medical and health-related services.

Design and Implementation of Green Construction Scheme for a High-rise Residential Building Project

NASA Astrophysics Data System (ADS)

Zhou, Yong; Huang, You Zhen

2018-06-01

This paper mainly studies the green construction scheme of a high-rise residential building project. From "four sections one environmental protection", saving material, water saving, energy saving, economical use of land and environmental protection conduct analysis and research. Adopting scientific, advanced, reasonable and economical construction technology measures, implementing green construction method. Promoting energy-saving technologies in buildings, ensuring the sustainable use of resources, Maximum savings of resources and energy, increase energy efficiency, to reduce pollution, reducing the adverse environmental impact of construction activities, ensure construction safety, build sustainable buildings.

The adoption of IT security standards in a healthcare environment.

PubMed

Gomes, Rui; Lapão, Luís Velez

2008-01-01

Security is a vital part of daily life to Hospitals that need to ensure that the information is adequately secured. In Portugal, more CIOs are seeking that their hospital IS departments are properly protecting information assets from security threats. It is imperative to take necessary measures to ensure risk management and business continuity. Security management certification provides just such a guarantee, increasing patient and partner confidence. This paper introduces one best practice for implementing four security controls in a hospital datacenter infrastructure (ISO27002), and describes the security assessment for implementing such controls.

Implementing AORN recommended practices for minimally invasive surgery: part I.

PubMed

Morton, Paula J

2012-09-01

This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Research design issues for evaluating complex multicomponent interventions in neighborhoods and communities.

PubMed

Komro, Kelli A; Flay, Brian R; Biglan, Anthony; Wagenaar, Alexander C

2016-03-01

Major advances in population health will not occur unless we translate existing knowledge into effective multicomponent interventions, implement and maintain these in communities, and develop rigorous translational research and evaluation methods to ensure continual improvement and sustainability. We discuss challenges and offer approaches to evaluation that are key for translational research stages 3 to 5 to advance optimized adoption, implementation, and maintenance of effective and replicable multicomponent strategies. The major challenges we discuss concern (a) multiple contexts of evaluation/research, (b) complexity of packages of interventions, and (c) phases of evaluation/research questions. We suggest multiple alternative research designs that maintain rigor but accommodate these challenges and highlight the need for measurement systems. Longitudinal data collection and a standardized continuous measurement system are fundamental to the evaluation and refinement of complex multicomponent interventions. To be useful to T3-T5 translational research efforts in neighborhoods and communities, such a system would include assessments of the reach, implementation, effects on immediate outcomes, and effects of the comprehensive intervention package on more distal health outcomes.

What Will It Take To Ensure Implementation? A Content Literacy Dilemma.

ERIC Educational Resources Information Center

Rafferty, Cathleen D.

A study attempted to determine a variety of facilitating and militating elements that influence Content Area Literacy/Learning Teaching Strategies (CAL/LTS) implementation. It investigated the impact of various contextual or ecological features embedded within the student teaching experience on student teachers' ability to implement various…

Low-Cost Rapid Usability Testing: Its Application in Both Product Development and System Implementation.

PubMed

Kushniruk, Andre; Borycki, Elizabeth

2017-01-01

In recent years there has been considerable discussion around the need for certification and regulation of healthcare information technology (IT). In particular, the usability of the products being developed needs to be evaluated. This has included the application of standards designed to ensure the process of system development is user-centered and takes usability into consideration while a product is being developed. In addition to this, in healthcare, organizations in the United States and Europe have also addressed the need and requirement for product certification. However, despite these efforts there are continued reports of unusable and unsafe implementations. In this paper we discuss the need to not only include (and require) usability testing in the one-time development process of health IT products (such as EHRs), but we also argue for the need to additionally develop specific usability standards and requirements for usability testing during the implementation of vendor products (i.e. post product development) in healthcare settings. It is further argued that health IT products that may have been certified regarding their development process will still require application of usability testing in the process of implementing them in real hospital settings in order to ensure usability and safety. This is needed in order to ensure that the final result of both product development and implementation processes take into account and apply the latest usability principles and methods.

WLCG Monitoring Consolidation and further evolution

NASA Astrophysics Data System (ADS)

Saiz, P.; Aimar, A.; Andreeva, J.; Babik, M.; Cons, L.; Dzhunov, I.; Forti, A.; di Girolamo, A.; Karavakis, E.; Litmaath, M.; Magini, N.; Magnoni, L.; de los Rios, H. Martin; Roiser, S.; Sciaba, A.; Schulz, M.; Tarragon, J.; Tuckett, D.

2015-12-01

The WLCG monitoring system solves a challenging task of keeping track of the LHC computing activities on the WLCG infrastructure, ensuring health and performance of the distributed services at more than 170 sites. The challenge consists of decreasing the effort needed to operate the monitoring service and to satisfy the constantly growing requirements for its scalability and performance. This contribution describes the recent consolidation work aimed to reduce the complexity of the system, and to ensure more effective operations, support and service management. This was done by unifying where possible the implementation of the monitoring components. The contribution also covers further steps like the evaluation of the new technologies for data storage, processing and visualization and migration to a new technology stack.

DOT report for implementing OMB's information dissemination quality guidelines

DOT National Transportation Integrated Search

2002-08-01

Consistent with The Office of : Management and Budgets (OMB) Guidelines (for Ensuring and Maximizing the Quality, : Objectivity, Utility, and Integrity of Information Disseminated by Federal Agencies) : implementing Section 515 of the Treasury and...

Enhanced method of fast re-routing with load balancing in software-defined networks

NASA Astrophysics Data System (ADS)

Lemeshko, Oleksandr; Yeremenko, Oleksandra

2017-11-01

A two-level method of fast re-routing with load balancing in a software-defined network (SDN) is proposed. The novelty of the method consists, firstly, in the introduction of a two-level hierarchy of calculating the routing variables responsible for the formation of the primary and backup paths, and secondly, in ensuring a balanced load of the communication links of the network, which meets the requirements of the traffic engineering concept. The method provides implementation of link, node, path, and bandwidth protection schemes for fast re-routing in SDN. The separation in accordance with the interaction prediction principle along two hierarchical levels of the calculation functions of the primary (lower level) and backup (upper level) routes allowed to abandon the initial sufficiently large and nonlinear optimization problem by transiting to the iterative solution of linear optimization problems of half the dimension. The analysis of the proposed method confirmed its efficiency and effectiveness in terms of obtaining optimal solutions for ensuring balanced load of communication links and implementing the required network element protection schemes for fast re-routing in SDN.

Management mechanisms for development of personnel professional competencies at a loading and haulage company

NASA Astrophysics Data System (ADS)

Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.

2018-05-01

The necessity for development a management mechanism for development of personnel professional competencies at a loading and haulage company in order to ensuring the compliance of competencies with labor functions, regulated by the current professional standards, is substantiated. A functional diagram of the organizational and technical system of the loading and haulage company was developed, that includes the interaction mechanism between the personnel and the objects of the main production. The problem of algorithm development to assess the correspondence of communicative competencies and labor functions of loading and haulage companies, ensuring the achievement of the management goal with a minimum risk of an emergency situation or an accident, was set and solved. The idea of management problem solving consists in the operational development and implementation of anticipatory measures at each deviation in personnel actions from normative or target indicators. The dependence of the risk of imbalance of communicative competences and labor functions in a given period of time is established. The effectiveness of the developed and implemented mechanism is confirmed by the positive dynamics of the test results.

Bio-markers: traceability in food safety issues.

PubMed

Raspor, Peter

2005-01-01

Research and practice are focusing on development, validation and harmonization of technologies and methodologies to ensure complete traceability process throughout the food chain. The main goals are: scale-up, implementation and validation of methods in whole food chains, assurance of authenticity, validity of labelling and application of HACCP (hazard analysis and critical control point) to the entire food chain. The current review is to sum the scientific and technological basis for ensuring complete traceability. Tracing and tracking (traceability) of foods are complex processes due to the (bio)markers, technical solutions and different circumstances in different technologies which produces various foods (processed, semi-processed, or raw). Since the food is produced for human or animal consumption we need suitable markers to be stable and traceable all along the production chain. Specific biomarkers can have a function in technology and in nutrition. Such approach would make this development faster and more comprehensive and would make possible that food effect could be monitored with same set of biomarkers in consumer. This would help to develop and implement food safety standards that would be based on real physiological function of particular food component.

So you think you've designed an effective recruitment protocol?

PubMed

Green, Cara; Vandall-Walker, Virginia

2017-03-22

Background Recruiting acutely ill patients to participate in research can be challenging. This paper outlines the difficulties the first author encountered in a study and the steps she took to overcome problems with research ethics, gain access to participants and implement a recruitment protocol in multiple hospitals. It also compares these steps with literature related to recruitment. Aim To inform and inspire neophyte researchers about the need for planning and resilience when dealing with recruitment challenges in multiple hospitals. Discussion The multiple enablers and barriers to the successful implementation of a hospital-based study recruitment protocol are explored based on a neophyte researcher's optimistic assumptions about this stage of the study. Conclusions Perseverance, adequately planning for contingencies, and accepting the barriers and challenges to recruitment are essential for completing one's research study and ensuring fulfilment as a researcher. Implications for practice Healthcare students carrying out research require adequate knowledge about conducting hospital-based, patient research to inform their recruitment plan. Maximising control over recruitment, allowing for adequate time to conduct data collection, and maintaining a good work ethic will help to ensure success.

Federal procurement metrication appropriateness and methods

NASA Astrophysics Data System (ADS)

Coella, M. A.

1982-09-01

This study was designed to provide the USMB with a clearer understanding of the basic relationships between the Federal procurement process and private sector suppliers. This was done to gain an understanding of the ways in which Federal procurement can encourage and accommodate initiatives of the private sector and to ensure that the effects of conversion on the Federal and private sectors are understood prior to implementation of procurement decisions and actions.

On emissions trading, toxic debt and the Australian power market

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

Simshauser, Paul

2009-03-15

Implementation of emissions trading will have profound effects on the financial stability of coal generators. While the impact on equity capital is well understood, the potential fallout in the market for project finance is not. During the current global financial crisis, the form and quantum of transitional assistance to coal generators will be crucial to ensure ongoing participation of domestic and foreign project banks in the power markets. (author)

Implementing an Effective and Efficient System to Manage the National School Lunch Program in a Private PreK-12 School: An Action Research Study

ERIC Educational Resources Information Center

Rafidi, Jessica A.

2012-01-01

To ensure the health of children in the United States, and to encourage the domestic consumption of nutritious agricultural commodities, President Harry S. Truman signed the National School Lunch Act. The Act, a federally assisted meal program established as a national security measure, was signed on June 4, 1946. Today, the National School Lunch…

Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

PubMed

Missoni, Eduardo

2013-01-01

In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Advancing Cervical Cancer Prevention in India: Implementation Science Priorities

PubMed Central

Madsen, Emily; Porterfield, Deborah; Varghese, Beena

2013-01-01

Cervical cancer is the leading cause of cancer mortality in India, accounting for 17% of all cancer deaths among women aged 30 to 69 years. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025, but there are few large-scale, organized cervical cancer prevention programs in the country. We conducted a review of the cervical cancer prevention research literature and programmatic experiences in India to summarize the current state of knowledge and practices and recommend research priorities to address the gap in services. We found that research and programs in India have demonstrated the feasibility and acceptability of cervical cancer prevention efforts and that screening strategies requiring minimal additional human resources and laboratory infrastructure can reduce morbidity and mortality. However, additional evidence generated through implementation science research is needed to ensure that cervical cancer prevention efforts have the desired impact and are cost-effective. Specifically, implementation science research is needed to understand individual- and community-level barriers to screening and diagnostic and treatment services; to improve health care worker performance; to strengthen links among screening, diagnosis, and treatment; and to determine optimal program design, outcomes, and costs. With a quarter of the global burden of cervical cancer in India, there is no better time than now to translate research findings to practice. Implementation science can help ensure that investments in cervical cancer prevention and control result in the greatest impact. PMID:24217555

The art of successful implementation of psychosocial interventions in residential dementia care: a systematic review of the literature based on the RE-AIM framework.

PubMed

Boersma, Petra; van Weert, Julia C M; Lakerveld, Jeroen; Dröes, Rose-Marie

2015-01-01

In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined. A systematic literature search was undertaken in PubMed, PsycINFO, and Cinahl, followed by a hand search for key papers. The included publications were mapped based on the dimensions of the RE-AIM framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Fifty-four papers met the inclusion criteria and described various psychosocial interventions. A distinction was made between studies that used one and studies that used multiple implementation strategies. This review shows that to improve their knowledge, caregivers needed at least multiple implementation strategies, only education is not enough. For increasing a more person-centered attitude, different types of knowledge transfer can be effective. Little consideration is given to the adoption of the method by caregivers and to the long-term sustainability (maintenance). This review shows that in order to successfully implement a psychosocial method the use of multiple implementation strategies is recommended. To ensure sustainability of a psychosocial care method in daily nursing home care, innovators as well as researchers should specifically pay attention to the dimensions Adoption, Implementation, and Maintenance of the RE-AIM implementation framework.

Implementation of national comprehensive cancer network evidence-based guidelines to prevent and treat cancer-related infections.

PubMed

Wood, Sylvia K; Payne, Judith K

2012-06-01

Clinical practice guidelines are an important result of evidence-based research. However, current clinical practice remains out of step with the rapid pace of research advancements. Often, decades pass before research is translated into clinical practice. The National Comprehensive Cancer Network (NCCN) has created evidence-based clinical guidelines to promote effective clinical practice. Formerly, the NCCN established guidelines to reduce cancer-related infections only for neutropenic patients; however, they have expanded their guidelines beyond neutropenia to prevent and treat cancer-related infections. Implementing scientific evidence into clinical practice is challenging and complex, and healthcare professionals should understand barriers to implementing clinical practice guidelines to ensure successful translation into practice. This article provides a brief review of NCCN guidelines and describes common barriers encountered during implementation. In addition, a conceptual framework is offered to help identify and address potential concerns before and after adoption of guidelines.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program.

PubMed

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-10-26

Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Managing laboratory automation in a changing pharmaceutical industry

PubMed Central

Rutherford, Michael L.

1995-01-01

The health care reform movement in the USA and increased requirements by regulatory agencies continue to have a major impact on the pharmaceutical industry and the laboratory. Laboratory management is expected to improve effciency by providing more analytical results at a lower cost, increasing customer service, reducing cycle time, while ensuring accurate results and more effective use of their staff. To achieve these expectations, many laboratories are using robotics and automated work stations. Establishing automated systems presents many challenges for laboratory management, including project and hardware selection, budget justification, implementation, validation, training, and support. To address these management challenges, the rationale for project selection and implementation, the obstacles encountered, project outcome, and learning points for several automated systems recently implemented in the Quality Control Laboratories at Eli Lilly are presented. PMID:18925014

From Classification to Causality: Advancing Understanding of Mechanisms of Change in Implementation Science.

PubMed

Lewis, Cara C; Klasnja, Predrag; Powell, Byron J; Lyon, Aaron R; Tuzzio, Leah; Jones, Salene; Walsh-Bailey, Callie; Weiner, Bryan

2018-01-01

The science of implementation has offered little toward understanding how different implementation strategies work. To improve outcomes of implementation efforts, the field needs precise, testable theories that describe the causal pathways through which implementation strategies function. In this perspective piece, we describe a four-step approach to developing causal pathway models for implementation strategies. First, it is important to ensure that implementation strategies are appropriately specified. Some strategies in published compilations are well defined but may not be specified in terms of its core component that can have a reliable and measureable impact. Second, linkages between strategies and mechanisms need to be generated. Existing compilations do not offer mechanisms by which strategies act, or the processes or events through which an implementation strategy operates to affect desired implementation outcomes. Third, it is critical to identify proximal and distal outcomes the strategy is theorized to impact, with the former being direct, measurable products of the strategy and the latter being one of eight implementation outcomes (1). Finally, articulating effect modifiers, like preconditions and moderators, allow for an understanding of where, when, and why strategies have an effect on outcomes of interest. We argue for greater precision in use of terms for factors implicated in implementation processes; development of guidelines for selecting research design and study plans that account for practical constructs and allow for the study of mechanisms; psychometrically strong and pragmatic measures of mechanisms; and more robust curation of evidence for knowledge transfer and use.

A Culturally Responsive Approach to Improving Replication of a Youth Sexual Health Program.

PubMed

Mwaria, Mercy; Chen, ChiaChing; Coppola, Nanci; Maurice, Ingrid; Phifer, Mary

2016-11-01

Youth-serving agencies continually turn to evidence-based interventions that have been empirically assessed for effectiveness in influencing young people's lives, particularly those living in communities with considerable health inequities. Replicating promising evidence-based interventions requires thoughtful adaptation and modification to better fit participants' sociocultural context and to enhance their learning experiences. Due to the restrictive nature of a replication model, adaptations to the intervention curriculum must be minimized during full implementation. Implementers must find innovative ways to ensure content is relevant and engaging to participants without altering core elements of the curriculum. This article describes practical best practice strategies used in implementing a sexual health education program among socioculturally diverse youth in a northeastern city in the United States. The implementing agency applied Richard, Brown and Forde's framework for culturally responsive pedagogy as a heuristic approach to describe the application of implementation practices across three dimensions: institutional, personal, and instructional. The results not only highlight successful culturally responsive practices that enhanced the implementation process but also acknowledge areas in which such practices proved daunting to implement. © 2016 Society for Public Health Education.

Models of evaluation of public joint-stock property management

NASA Astrophysics Data System (ADS)

Yakupova, N. M.; Levachkova, S.; Absalyamova, S. G.; Kvon, G.

2017-12-01

The paper deals with the models of evaluation of performance of both the management company and the individual subsidiaries on the basis of a combination of elements and multi-parameter and target approaches. The article shows that due to the power of multi-dimensional and multi-directional indicators of financial and economic activity it is necessary to assess the degree of achievement of the objectives with the use of multivariate ordinal model as a set of indicators, ordered by growth so that the maintenance of this order on a long interval of time will ensure the effective functioning of the enterprise in the long term. It is shown that these models can be regarded as the monitoring tools of implementation of strategies and guide the justification effectiveness of implementation of management decisions.

Earthdata Search Client: Usability Review Process, Results, and Implemented Changes, Using Earthdata Search Client as a Case Study

NASA Technical Reports Server (NTRS)

Siarto, Jeff; Reese, Mark; Shum, Dana; Baynes, Katie

2016-01-01

User experience and visual design are greatly improved when usability testing is performed on a periodic basis. Design decisions should be tested by real users so that application owners can understand the effectiveness of each decision and identify areas for improvement. It is important that applications be tested not just once, but as a part of a continuing process that looks to build upon previous tests. NASA's Earthdata Search Client has undergone a usability study to ensure its users' needs are being met and that users understand how to use the tool efficiently and effectively. This poster will highlight the process followed for usability study, the results of the study, and what has been implemented in light of the results to improve the application's interface.

Regulatory Control of Sealed Sources in Germany including Regulations Regarding Spent and Disused Sources - 13176

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

Dollan, Ralph; Haeusler, Uwe; Czarwinski, Renate

2013-07-01

Effective regulatory control is essential to ensure the safe and secure use of radioactive material and the appropriate management of radioactive waste. To ensure a sustainable control of high radioactive sources, the European Commission published the Council Directive 2003/122/EURATOM on the control of high-activity sealed radioactive sources and orphan sources, which had to be transferred into national legislation by all member states of the European Union. Major requirement of the Directive is a system to ensure traceability of high-activity sealed sources from 'cradle to grave' as well as the provision to take back disused sources by the supplier or manufacturer.more » With the Act on high-activity sealed radioactive sources Germany implemented the requirements of the Directive 2003/122/EURATOM and established a national registry of high-activity sealed sources in 2006. Currently, about 27.000 high-activity sealed sources are recorded in this national registry. (authors)« less

76 FR 53376 - Definition of Solid Waste

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... regulated under subtitle C of the Resource Conservation and Recovery Act. The purpose of these proposed revisions is to ensure that the recycling regulations, as implemented, encourage reclamation in a way that... Resource Conservation and Recovery Act (76 FR 44094). The purpose of these proposed revisions is to ensure...

Strategies and Systems-Level Interventions to Combat or Prevent Drug Counterfeiting: A Systematic Review of Evidence Beyond Effectiveness.

PubMed

Fadlallah, Racha; El-Jardali, Fadi; Annan, Farah; Azzam, Hayat; Akl, Elie A

2016-01-01

A recent systematic review suggested that drug registrations and onsite quality inspections may be effective in reducing the prevalence of counterfeit and substandard drugs. However, simply replicating the most effective interventions is problematic, as it denotes implementing the intervention without further adaptation. The aim was to systematically review the evidence beyond effectiveness for systems-level interventions to combat or prevent drug counterfeiting. We conducted an extensive search, including an electronic search of 14 databases. We included studies examining the efficiency, feasibility, reliability, and economic outcomes of the interventions, as well as barriers and facilitators to their implementation. Two reviewers selected eligible studies and abstracted data in duplicate and independently. We synthesized the results narratively, stratified by type of intervention. Of 10,220 captured citations, 19 met our inclusion criteria. The findings suggest that the following may strengthen regulatory measures (e.g., registration): minimizing drug diversion, enhancing lines of communications, ensuring feedback on drug quality, and promoting strict licensing criteria. There is evidence that onsite quality surveillance and inspection systems may be efficient and cost-effective for preliminary testing of large samples of drugs. Laws and legislation need to be specific to counterfeit drugs, include firm penalties, address online purchasing of drugs, and be complemented by education of judges and lawyers. Public awareness and education should rely on multiple platforms and comprehensive and dedicated content. While product authentication technologies may be efficient and reliable in detecting counterfeit drugs in the supply chain, they require a strong information system infrastructure. As for pharmacovigilance systems, it is critical to tackle the issue of underreporting, to enhance their chances of success. Several factors are critical to the successful design and implementation of systems-level interventions to combat or prevent drug counterfeiting. Policymakers need to take these into consideration to ensure success of these interventions.

Implementing clinical guidelines for chronic obstructive pulmonary disease: barriers and solutions

PubMed Central

Overington, Jeff D.; Huang, Yao C.; Abramson, Michael J.; Brown, Juliet L.; Goddard, John R.; Bowman, Rayleen V.; Fong, Kwun M.

2014-01-01

Chronic obstructive pulmonary disease (COPD) is a complex chronic lung disease characterised by progressive fixed airflow limitation and acute exacerbations that frequently require hospitalisation. Evidence-based clinical guidelines for the diagnosis and management of COPD are now widely available. However, the uptake of these COPD guidelines in clinical practice is highly variable, as is the case for many other chronic disease guidelines. Studies have identified many barriers to implementation of COPD and other guidelines, including factors such as lack of familiarity with guidelines amongst clinicians and inadequate implementation programs. Several methods for enhancing adherence to clinical practice guidelines have been evaluated, including distribution methods, professional education sessions, electronic health records (EHR), point of care reminders and computer decision support systems (CDSS). Results of these studies are mixed to date, and the most effective ways to implement clinical practice guidelines remain unclear. Given the significant resources dedicated to evidence-based medicine, effective dissemination and implementation of best practice at the patient level is an important final step in the process of guideline development. Future efforts should focus on identifying optimal methods for translating the evidence into everyday clinical practice to ensure that patients receive the best care. PMID:25478199

A strategic approach for Water Safety Plans implementation in Portugal.

PubMed

Vieira, Jose M P

2011-03-01

Effective risk assessment and risk management approaches in public drinking water systems can benefit from a systematic process for hazards identification and effective management control based on the Water Safety Plan (WSP) concept. Good results from WSP development and implementation in a small number of Portuguese water utilities have shown that a more ambitious nationwide strategic approach to disseminate this methodology is needed. However, the establishment of strategic frameworks for systematic and organic scaling-up of WSP implementation at a national level requires major constraints to be overcome: lack of legislation and policies and the need for appropriate monitoring tools. This study presents a framework to inform future policy making by understanding the key constraints and needs related to institutional, organizational and research issues for WSP development and implementation in Portugal. This methodological contribution for WSP implementation can be replicated at a global scale. National health authorities and the Regulator may promote changes in legislation and policies. Independent global monitoring and benchmarking are adequate tools for measuring the progress over time and for comparing the performance of water utilities. Water utilities self-assessment must include performance improvement, operational monitoring and verification. Research and education and resources dissemination ensure knowledge acquisition and transfer.

Evidence-based, multidisciplinary approach to the development of a crotalidae polyvalent antivenin (CroFab) protocol at a university hospital.

PubMed

Weant, Kyle A; Johnson, Peter N; Bowers, Rebecca C; Armitstead, John A

2010-03-01

Several thousand people are bitten annually by venomous snakes in the US. While the development of ovine Crotalidae polyvalent immune Fab antivenin (FabAV) for Crotalinae snakebite envenomations has greatly changed the way this clinical presentation is treated, multiple issues complicate its use. From patient assessment and evaluation, to medication preparation and administration, to the management of adverse drug reactions, the use of this antidote carries with it multiple points of possible medication variances. The inappropriate use of this agent can result in adverse patient consequences and a significant financial burden for both the hospital and the patient. To describe an evidence-based, multidisciplinary approach that was taken to ensure optimal, safe, and cost-effective treatment of patients with FabAV. Following an analysis of the available literature, a multidisciplinary committee was formed to construct a protocol for use of FabAV. This group included clinical pharmacists, pharmacy administrators, emergency medicine physicians who specialized in wilderness medicine and pharmacy residents. A multidisciplinary FabAV usage protocol was constructed and implemented to ensure appropriate patient evaluation, FabAV use and preparation, monitoring, and follow-up. This protocol was based on the available literature and the expert opinion of the committee. Through the use of a 24-hour in-house pharmacy resident on-call system, clinical pharmacy services were provided to ensure a multidisciplinary approach to the care of these patients emergently. Although limited, initial data show that this approach is effective and may result in substantial cost savings. Initial results from implementation of a protocol for use of FabAV have limited inappropriate use, reduced medication wastage, and decreased costs.

Indian Child Welfare Act Proceedings. Final rule.

PubMed

2016-06-14

This final rule adds a new subpart to the Department of the Interior's (Department) regulations implementing the Indian Child Welfare Act (ICWA), to improve ICWA implementation. The final rule addresses requirements for State courts in ensuring implementation of ICWA in Indian child-welfare proceedings and requirements for States to maintain records under ICWA.

From Theory to Practice: An Illustrative Case for Selecting Evidence-Based Practices and Building Implementation Capacity in Three Canadian Health Jurisdictions

ERIC Educational Resources Information Center

Duda, Michelle A.; Riopelle, Richard J.; Brown, Jacquie

2013-01-01

Using principles of Applied Implementation Science, this paper examines strategies for systematically selecting and operationalising National clinical practice guidelines and intentionally creating implementation supports to ensure high fidelity use and sustainable application and outcomes. In the spirit of participatory action research, key…

Pay-for-Performance in Education: An Issue Brief for Business Leaders.

ERIC Educational Resources Information Center

National Alliance of Business, Inc., Washington, DC.

Implementing pay-for-performance salary structures has been used successfully in business and can result in benefits for educational systems when implemented along with other compensation reforms. Business leaders can help in the implementation of teacher pay-for-performance systems in the following ways: (1) ensure that pay-for-performance plans…

Doctoral Education--Taking Salzburg Forward: Implementation and New Challenges

ERIC Educational Resources Information Center

European University Association, 2016

2016-01-01

The purpose of this document is to provide guidelines for the continued implementation of reforms in doctoral education building on the Salzburg Principles and Recommendations. It is directed at university leaders who want to continue and deepen the implementation of Salzburg at the strategic level, ensuring a consistent, institution-wide approach…

76 FR 28934 - Approval and Disapproval and Promulgation of State Implementation Plan Revisions; Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... implementation of any SIP provision, the state has responsibility for ensuring adequate implementation of such... Responsibilities of Department. The Montana Board of Environmental Review (BER) oversees the Montana DEQ, including... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2010-0298; FRL-9308-5] Approval and...

78 FR 16679 - Center for Drug Evaluation and Research Medical Policy Council; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... Council to ensure better coordination of medical policy development and implementation within CDER and... and implementation. II. Range of Medical Policy Issues To Be Considered FDA envisions a variety of... to other products; or Strategies for implementation of a new policy. III. Establishment of a Docket...

Opportunities for improving the efficiency of paediatric HIV treatment programmes

PubMed Central

Revill, Paul A.; Walker, Simon; Mabugu, Travor; Nathoo, Kusum J.; Mugyenyi, Peter; Kekitinwa, Adeodata; Munderi, Paula; Bwakura-Dangarembizi, Mutsawashe; Musiime, Victor; Bakeera-Kitaka, Sabrina; Nahirya-Ntege, Patricia; Walker, A. Sarah; Sculpher, Mark J.; Gibb, Diana M.

2015-01-01

Objectives: To conduct two economic analyses addressing whether to: routinely monitor HIV-infected children on antiretroviral therapy (ART) clinically or with laboratory tests; continue or stop cotrimoxazole prophylaxis when children become stabilized on ART. Design and methods: The ARROW randomized trial investigated alternative strategies to deliver paediatric ART and cotrimoxazole prophylaxis in 1206 Ugandan/Zimbabwean children. Incremental cost-effectiveness and value of implementation analyses were undertaken. Scenario analyses investigated whether laboratory monitoring (CD4+ tests for efficacy monitoring; haematology/biochemistry for toxicity) could be tailored and targeted to be delivered cost-effectively. Cotrimoxazole use was examined in malaria-endemic and non-endemic settings. Results: Using all trial data, clinical monitoring delivered similar health outcomes to routine laboratory monitoring, but at a reduced cost, so was cost-effective. Continuing cotrimoxazole improved health outcomes at reduced costs. Restricting routine CD4+ monitoring to after 52 weeks following ART initiation and removing toxicity testing was associated with an incremental cost-effectiveness ratio of $6084 per quality-adjusted life-year (QALY) across all age groups, but was much lower for older children (12+ years at initiation; incremental cost-effectiveness ratio = $769/QALY). Committing resources to improve cotrimoxazole implementation appears cost-effective. A healthcare system that could pay $600/QALY should be willing to spend up to $12.0 per patient-year to ensure continued provision of cotrimoxazole. Conclusion: Clinically driven monitoring of ART is cost-effective in most circumstances. Routine laboratory monitoring is generally not cost-effective at current prices, except possibly CD4+ testing amongst adolescents initiating ART. Committing resources to ensure continued provision of cotrimoxazole in health facilities is more likely to represent an efficient use of resources. PMID:25396263

The iPad and mobile technology revolution: benefits and challenges for individuals who require augmentative and alternative communication.

PubMed

McNaughton, David; Light, Janice

2013-06-01

The iPad and other mobile technologies provide powerful new tools to potentially enhance communication for individuals with developmental disabilities, acquired neurogenic disorders, and degenerative neurological conditions. These mobile technologies offer a number of potential benefits, including: (a) increased awareness and social acceptance of augmentative and alternative communication (AAC), (b) greater consumer empowerment in accessing AAC solutions, (c) increased adoption of AAC technologies, (d) greater functionality and interconnectivity, and (e) greater diffusion of AAC research and development. However, there remain a number of significant challenges that must be addressed if these benefits are to be fully realized: (a) to ensure the focus is on communication, not just technology, (b) to develop innovative models of AAC service delivery to ensure successful outcomes, (c) to ensure ease of access for all individuals who require AAC, and, (d) to maximize AAC solutions to support a wide variety of communication functions. There is an urgent need for effective collaboration among key stakeholders to support research and development activities, and to ensure the successful implementation of mobile technologies to enhance communication outcomes for individuals who require AAC and their families.

Evaluating the impact of equity focused health impact assessment on health service planning: three case studies.

PubMed

Harris-Roxas, Ben; Haigh, Fiona; Travaglia, Joanne; Kemp, Lynn

2014-09-05

Health impact assessment has been identified internationally as a mechanism to ensure potential health impacts and health equity impacts of proposals are considered before implementation. This paper looks at the impact of three equity focused health impact assessments (EFHIAs) of health service plans on subsequent decision-making and implementation, and then utilises these findings to test and refine an existing conceptual framework for evaluating the impact and effectiveness of health impact assessments for use in relation to EFHIAs. Case study analysis of three EFHIAs conducted on health sector plans in New South Wales, Australia. Data was drawn from 14 semi-structured interviews and the analysis of seven related documents (draft plans and EFHIA reports). The case studies showed that the EFHIAs all had some impact on the decision-making about the plans and their implementation, most clearly in relation to participants' understandings of equity and in the development of options for modifying service plans to ensure this was addressed. The timing of the EFHIA and individual responses to the EFHIA process and its recommendations were identified as critical factors influencing the impact of the EFHIAs. Several modifications to the conceptual framework are identified, principally adding factors to recognise the role individuals play in influencing the impact and effectiveness of EFHIAs. EFHIA has the potential to improve the consideration of health equity in health service planning processes, though a number of contextual and individual factors affect this. Current approaches can be strengthened by taking into account personal and organisational responses to the EFHIA process.

Do national drug control laws ensure the availability of opioids for medical and scientific purposes?

PubMed Central

Brown, Marty Skemp; Maurer, Martha A

2014-01-01

Abstract Objective To determine whether national drug control laws ensure that opioid drugs are available for medical and scientific purposes, as intended by the 1972 Protocol amendment to the 1961 Single Convention on Narcotic Drugs. Methods The authors examined whether the text of a convenience sample of drug laws from 15 countries: (i) acknowledged that opioid drugs are indispensable for the relief of pain and suffering; (ii) recognized that government was responsible for ensuring the adequate provision of such drugs for medical and scientific purposes; (iii) designated an administrative body for implementing international drug control conventions; and (iv) acknowledged a government’s intention to implement international conventions, including the Single Convention. Findings Most national laws were found not to contain measures that ensured adequate provision of opioid drugs for medical and scientific purposes. Moreover, the model legislation provided by the United Nations Office on Drugs and Crime did not establish an obligation on national governments to ensure the availability of these drugs for medical use. Conclusion To achieve consistency with the Single Convention, as well as with associated resolutions and recommendations of international bodies, national drug control laws and model policies should be updated to include measures that ensure drug availability to balance the restrictions imposed by the existing drug control measures needed to prevent the diversion and nonmedical use of such drugs. PMID:24623904

Automated selection of synthetic biology parts for genetic regulatory networks.

PubMed

Yaman, Fusun; Bhatia, Swapnil; Adler, Aaron; Densmore, Douglas; Beal, Jacob

2012-08-17

Raising the level of abstraction for synthetic biology design requires solving several challenging problems, including mapping abstract designs to DNA sequences. In this paper we present the first formalism and algorithms to address this problem. The key steps of this transformation are feature matching, signal matching, and part matching. Feature matching ensures that the mapping satisfies the regulatory relationships in the abstract design. Signal matching ensures that the expression levels of functional units are compatible. Finally, part matching finds a DNA part sequence that can implement the design. Our software tool MatchMaker implements these three steps.

76 FR 82189 - Fisheries of the Northeastern United States; Summer Flounder, Scup, and Black Sea Bass Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... forwarding recommendations to NMFS to implement revised summer flounder and scup specifications. The exact... views this as the only tenable solution to implement measures that ensure overfishing does not occur...

Evaluation of complete streets policy implementation by metropolitan planning organizations.

DOT National Transportation Integrated Search

2015-09-01

Over the last ten years, communities around the country have begun to implement comprehensive reforms : designed to ensure that roadway users of all ages and abilities can safely utilize the transportation system. : This complete streets policy frame...

Proposal for the Development of a Standardized Protocol for Assessing the Economic Costs of HIV Prevention Interventions

PubMed Central

Pinkerton, Steven D.; Pearson, Cynthia R.; Eachus, Susan R.; Berg, Karina M.; Grimes, Richard M.

2008-01-01

Summary Maximizing our economic investment in HIV prevention requires balancing the costs of candidate interventions against their effects and selecting the most cost-effective interventions for implementation. However, many HIV prevention intervention trials do not collect cost information, and those that do use a variety of cost data collection methods and analysis techniques. Standardized cost data collection procedures, instrumentation, and analysis techniques are needed to facilitate the task of assessing intervention costs and to ensure comparability across intervention trials. This article describes the basic elements of a standardized cost data collection and analysis protocol and outlines a computer-based approach to implementing this protocol. Ultimately, the development of such a protocol would require contributions and “buy-in” from a diverse range of stakeholders, including HIV prevention researchers, cost-effectiveness analysts, community collaborators, public health decision makers, and funding agencies. PMID:18301128

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

PubMed

Wu, K J

2018-02-01

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

Dissemination: Bringing Translational Research to Completion

PubMed Central

Park, Daniel J.; Burke, Janice P.

2013-01-01

Despite the availability of innovative health care research, a gap exists between research-generated knowledge and the utilization of that knowledge in real-world practice settings. This article examines the transition from research to implementation in the context of the dissemination of A. Jean Ayres’ sensory integration procedures and of the challenges currently facing the University of Southern California Well Elderly Studies research team. Drawing from the emerging field of implementation science, this article discusses how researchers can develop an implementation plan to more easily translate evidence into practice. Such plans should address the intervention’s reach (i.e., its capacity to penetrate into the intended target population), the settings for which it is applicable, the leaders who will encourage practitioner uptake, stakeholder groups, and challenges to dissemination. By taking action to ensure the more effective dissemination of research-generated knowledge, researchers can increase the likelihood that their interventions will lead to improvements in practice and more effective care for consumers. PMID:23433273

Using Effective Professional Development Sessions to Implement Change in Curriculum and Classroom Practices: My Story as a Teacher at Exmouth District High School, WA's Remotest District High

ERIC Educational Resources Information Center

Bedford, Susie

2005-01-01

Teaching in a remote town has its drawbacks with regard to Professional Development (PD), which becomes extremely costly, so each staff member is probably limited to one decent PD once a year. This means choosing PD extremely carefully to ensure "value for money" and hopefully that it will provide the teacher concerned with…

Implementation of the DoD Diversity and Inclusion Strategic Plan: A Framework for Change through Accountability

DTIC Science & Technology

2013-01-01

including the Civil Rights Act of 1964, federal regulations , and court decisions. The military component of DoD is granted some exceptions from EEOC rules...laws, regulations , and directives; communicating effectively to internal as well as external stakeholders; and coordinating efforts to ensure...Commission ( EEOC ) requirements and evaluate existing internal requirements. Using the results of this evaluation and with an eye toward the eventual

Measurement control workshop instructional materials

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

Gibbs, Philip; Harvel, Charles; Clark, John

2012-09-01

An essential element in an effective nuclear materials control and accountability (MC&A) program is the measurement of the nuclear material as it is received, moved, processed and shipped. Quality measurement systems and methodologies determine the accuracy of the accountability values. Implementation of a measurement control program is essential to ensure that the measurement systems and methodologies perform as expected. A measurement control program also allows for a determination of the level of confidence in the accounting values.

Land Management Agencies: Restoring Fish Passage Through Culverts on Forest Service and BLM Lands in Oregon and Washington Could Take Decades

DTIC Science & Technology

2001-11-01

provides the foundation for implementing stream and river enhancement projects, timber sales, and road building and decommissioning projects. According...monitoring of project results to ensure they are successful. For example, Oregon’s Rogue River Basin Fish Access Team, composed of local stakeholders...across the Rogue River basin. Potential techniques suggested to determine effectiveness include spawning and snorkeling (underwater observation

Building Sustainable Professional Development Programs: Applying Strategies From Implementation Science to Translate Evidence Into Practice.

PubMed

Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E

2017-01-01

Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.

Effects of organizational context on Lean implementation in five hospital systems.

PubMed

Harrison, Michael I; Paez, Kathryn; Carman, Kristin L; Stephens, Jennifer; Smeeding, Lauren; Devers, Kelly J; Garfinkel, Steven

2016-01-01

Despite broad agreement among researchers about the value of examining how context shapes implementation of improvement programs and projects, limited attention has been paid to contextual effects on implementation of Lean. To help reduce gaps in knowledge of effects of intraorganizational context, we researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. All projects aimed at improving clinical care delivery. On the basis of the literature on Lean, innovation, and quality improvement, we developed a framework of factors likely to affect Lean implementation and outcomes. Drawing on the framework, we conducted semistructured interviews and applied qualitative codes to the transcribed interviews. Available documents, data, and observations supplemented the interviews. We constructed case studies of Lean implementation in each organization, compared implementation across organizations, and compared the 12 projects. Intraorganizational characteristics affecting organization-wide Lean initiatives and often also shaping project outcomes included CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, alignment of the Lean initiative with the organizational mission, dedication of resources and experts to Lean, staff training before and during projects, establishment of measurable and relevant project targets, planning of project sequences that enhance staff capabilities and commitment without overburdening them, and ensuring communication between project members and other affected staff. Dependence of projects on inputs of new information technology was a barrier to project success. Incremental implementation of Lean produced reported improvements in operational efficiency and occasionally in care quality. However, even under the relatively favorable circumstances prevailing in our study sites, incremental implementation did not readily change organizational culture. This study should alert researchers, managers, and teachers of management to ways that contexts shape Lean implementation and may affect other types of process redesign and quality improvement.

Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement.

PubMed

Ovretveit, John; Mittman, Brian; Rubenstein, Lisa; Ganz, David A

2017-10-09

Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.

76 FR 33419 - Nationally Recognized Statistical Rating Organizations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... documentation of the internal control structure) or should the factors focus on the design (i.e., establishment... related to implementing them. a. Controls reasonably designed to ensure that a newly developed methodology... U.S.C. 78o-7(r)(1)(A). b. Controls reasonably designed to ensure that a newly developed methodology...

Ensuring Good Character and Civic Education: Connecting through Service Learning

ERIC Educational Resources Information Center

Shumer, Robert; Lam, Carolina; Laabs, Bonnie

2012-01-01

Character and citizenship education are part of the vision of many countries, including Singapore. Ensuring they are implemented in academic environments, service learning has been shown to be a natural bridge between the two. Research has shown that service learning, when done well, produces outcomes related to character development and…

And Then a Miracle Occurs! Ensuring the Successful Implementation of Enterpisewide EPSS and E-Learning from Day One.

ERIC Educational Resources Information Center

Stone, Deborah L.; Villachica, Steven W.

2003-01-01

Provides suggestions to ensure the success of electronic performance support systems (EPSS) and electronic learning, including creating hybrid solutions; aligning EPSS with business objectives and performance requirements; change management efforts; and rapid application development to lower costs, shrink schedules, and improve quality.…

21 CFR 212.20 - What activities must I perform to ensure drug quality?

Code of Federal Regulations, 2014 CFR

2014-04-01

... operations. You must oversee production operations to ensure that each PET drug meets the requirements of the... of a PET drug. (c) Specifications and processes. You must approve or reject, before implementation..., and purity of a PET drug. You must demonstrate that any change does not adversely affect the identity...

21 CFR 212.20 - What activities must I perform to ensure drug quality?

Code of Federal Regulations, 2012 CFR

2012-04-01

... operations. You must oversee production operations to ensure that each PET drug meets the requirements of the... of a PET drug. (c) Specifications and processes. You must approve or reject, before implementation..., and purity of a PET drug. You must demonstrate that any change does not adversely affect the identity...

21 CFR 212.20 - What activities must I perform to ensure drug quality?

Code of Federal Regulations, 2013 CFR

2013-04-01

... operations. You must oversee production operations to ensure that each PET drug meets the requirements of the... of a PET drug. (c) Specifications and processes. You must approve or reject, before implementation..., and purity of a PET drug. You must demonstrate that any change does not adversely affect the identity...

Strengthening the revenue cycle: a 4-step method for optimizing payment.

PubMed

Clark, Jonathan J

2008-10-01

Four steps for enhancing the revenue cycle to ensure optimal payment are: *Establish key performance indicator dashboards in each department that compare current with targeted performance; *Create proper organizational structures for each department; *Ensure that high-performing leaders are hired in all management and supervisory positions; *Implement efficient processes in underperforming operations.

12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

Code of Federal Regulations, 2010 CFR

2010-01-01

... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will: (a...

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...

Code of Federal Regulations, 2014 CFR

2014-07-01

... ensuring that scholarship recipients become successful teachers in high-need schools? 611.52 Section 611.52... teachers in high-need schools? In implementing its approved project, the grantee must— (a) Provide...) Upon graduation, scholarship recipients are able to secure teaching positions in high-need schools of...

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...

Code of Federal Regulations, 2013 CFR

2013-07-01

... ensuring that scholarship recipients become successful teachers in high-need schools? 611.52 Section 611.52... teachers in high-need schools? In implementing its approved project, the grantee must— (a) Provide...) Upon graduation, scholarship recipients are able to secure teaching positions in high-need schools of...

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...

Code of Federal Regulations, 2011 CFR

2011-07-01

... ensuring that scholarship recipients become successful teachers in high-need schools? 611.52 Section 611.52... teachers in high-need schools? In implementing its approved project, the grantee must— (a) Provide...) Upon graduation, scholarship recipients are able to secure teaching positions in high-need schools of...

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...

Code of Federal Regulations, 2012 CFR

2012-07-01

... ensuring that scholarship recipients become successful teachers in high-need schools? 611.52 Section 611.52... teachers in high-need schools? In implementing its approved project, the grantee must— (a) Provide...) Upon graduation, scholarship recipients are able to secure teaching positions in high-need schools of...

45 CFR 153.350 - Risk adjustment data validation standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Risk adjustment data validation standards. 153.350... validation standards. (a) General requirement. The State, or HHS on behalf of the State, must ensure proper implementation of any risk adjustment software and ensure proper validation of a statistically valid sample of...

45 CFR 153.350 - Risk adjustment data validation standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Risk adjustment data validation standards. 153.350... validation standards. (a) General requirement. The State, or HHS on behalf of the State, must ensure proper implementation of any risk adjustment software and ensure proper validation of a statistically valid sample of...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

Implementing a Peer Mentoring Model in the Clemson Eportfolio Program

ERIC Educational Resources Information Center

Ring, Gail L.

2015-01-01

Since the implementation of the ePortfolio Program in 2006, Clemson University has incorporated peer review for the formative feedback process. One of the challenges with this large-scale implementation has been ensuring that all work is reviewed and constructive feedback is provided in a timely manner. In this article, I discuss the strategies…

76 FR 28195 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Sunland Park 1-Hour...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... Promulgation of Air Quality Implementation Plans; New Mexico; Sunland Park 1-Hour Ozone Maintenance Plan AGENCY... the New Mexico State Implementation Plan (SIP). The revision consists of a maintenance plan for Sunland Park, New Mexico developed to ensure continued attainment of the 8-hour ozone National Ambient Air...

Factors Preventing the Successful Implementation of Information Systems: Case of the Elementary Public Education in Mexico

ERIC Educational Resources Information Center

Patiño, Israel

2015-01-01

This paper aims to identify the factors that impede the successful implementation of information systems in the case of primary public education for the systematization of administrative and operational processes. Once identified and diagnosed the cause, the proposal is made, in order to ensure that implementation. This aided with scientific…

78 FR 27891 - Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for the 1997 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-13

... provision, the state has responsibility for ensuring adequate implementation of such plan provision. a... implementation of any plan provision are provided in MCA 75-2-112, Power and Responsibilities of Department. The... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2011-0724; FRL-9812-9] Promulgation of...

Trade law and alcohol regulation: what role for a global Alcohol Marketing Code?

PubMed

Mitchell, Andrew D; Casben, Jessica

2017-01-01

Following calls for restrictions and bans on alcohol advertising, and in light of the tobacco industry's challenge to Australia's tobacco plain packaging measure, a tobacco control measure finding support in the World Health Organization (WHO) Framework Convention on Tobacco Control, this paper considers what role, if any, an international alcohol marketing code might have in preventing or reducing the risk of challenges to domestic alcohol marketing restrictions under trade rules. Narrative review of international trade and health instruments and international trade court judgements regarding alcohol products and marketing restrictions. The experience of European trade courts in the litigation of similar measures suggests that World Trade Organization rules have sufficient flexibility to support the implementation of alcohol marketing restrictions. However, the experience also highlights the possibility that public health measures have disproportionate and unjustifiable trade effects and that the ability of a public health measure to withstand a challenge under trade rules will turn on its particular design and implementation. Measures implemented pursuant to international public health instruments are not immune to trade law challenges. Close collaboration between health policymakers, trade officials and lawyers, from as early as the research stage in the development of a measure to ensure a robust evidence base, will ensure the best chance of regulatory survival for an international marketing code. © 2016 Society for the Study of Addiction.

Using the CER Hub to ensure data quality in a multi-institution smoking cessation study.

PubMed

Walker, Kari L; Kirillova, Olga; Gillespie, Suzanne E; Hsiao, David; Pishchalenko, Valentyna; Pai, Akshatha Kalsanka; Puro, Jon E; Plumley, Robert; Kudyakov, Rustam; Hu, Weiming; Allisany, Art; McBurnie, MaryAnn; Kurtz, Stephen E; Hazlehurst, Brian L

2014-01-01

Comparative effectiveness research (CER) studies involving multiple institutions with diverse electronic health records (EHRs) depend on high quality data. To ensure uniformity of data derived from different EHR systems and implementations, the CER Hub informatics platform developed a quality assurance (QA) process using tools and data formats available through the CER Hub. The QA process, implemented here in a study of smoking cessation services in primary care, used the 'emrAdapter' tool programmed with a set of quality checks to query large samples of primary care encounter records extracted in accord with the CER Hub common data framework. The tool, deployed to each study site, generated error reports indicating data problems to be fixed locally and aggregate data sharable with the central site for quality review. Across the CER Hub network of six health systems, data completeness and correctness issues were prevalent in the first iteration and were considerably improved after three iterations of the QA process. A common issue encountered was incomplete mapping of local EHR data values to those defined by the common data framework. A highly automated and distributed QA process helped to ensure the correctness and completeness of patient care data extracted from EHRs for a multi-institution CER study in smoking cessation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Street-level workers' inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey.

PubMed

Ridde, Valéry; Leppert, Gerald; Hien, Hervé; Robyn, Paul Jacob; De Allegri, Manuela

2018-01-08

Street-level workers play a key role in public health policies in Africa, as they are often the ones to ensure their implementation. In Burkina Faso, the State formulated two different user-fee exemption policies for indigents, one for deliveries (2007), and one for primary healthcare (2009). The objective of this study was to measure and understand the determinants of street-level workers' knowledge and application of these exemption measures. We used cross-sectional data collected between October 2013 and March 2014. The survey targeted 1521 health workers distributed in 498 first-line centres, 18 district hospitals, 5 regional hospitals, and 11 private or other facilities across 24 districts. We used four different random effects models to identify factors associated with knowledge and application of each of the above-mentioned exemption policies. Only 9.2% of workers surveyed knew of the directive exempting the worst-off, and only 5% implemented it. Knowledge and application of the delivery exemption were higher, with 27% of all health workers being aware of the delivery exemption directive and 24.2% applying it. Mobile health workers were found to be consistently more likely to apply both exemptions. Health workers who were facility heads were significantly more likely to know about the indigent exemption for primary health care and to apply it. Health workers in districts with higher proportions of very poor people were significantly more likely to know about and apply the delivery exemption. Nearly 60% of respondents indicated either 5% or 10% as the percentage of people they would deem adequate to target for exemption. This quantitative study confirmed earlier qualitative results on the importance of training and informing health workers and monitoring the measures targeting equity, to ensure compliance with government directives. The local context (e.g., hierarchy, health system, interventions) and the ideas that street-level workers have about the policy instruments can influence their effective implementation. Methods for remunerating health workers and health centres also need to be adapted to ensure equity measures are applied to achieve universal healthcare.

[Modern operations management in workflow operation. Spectrum of responsibilities and challenges for the future].

PubMed

Riedl, S

2002-02-01

The operating unit is one of the cost-intensive facilities in a surgical clinic with a pacemaking function for most of the internal procedures. The power of performance of the operating unit is based on the co-operation of all disciplines and professions involved. The key to management of the operating unit is not only to co-ordinate the daily procedures, but also to interact with support personnel. To ensure successful OR management, the internal structure of the OR must fit the clinical tasks and the available quantity of personnel in each profession must be co-ordinated. Sufficient utilization of resources and equipment must be guaranteed without cost-intensive over-capacities and patient flow must be orientated to OR capacities. The development of such a business structure requires the management to clearly define the goal, to know the actual on-site data in detail with regard to the idiosyncratic workings of each speciality and to clearly assign the competence of each member of the team working in the OR. Co-ordination of the operating unit is the main task of OR management, which must ensure the following: transparent and co-ordinated schedule management in the various operative specialities, goal-directed changes of the schedule with incorporation of emergencies, as well as effective organization of staff. In order to realize these tasks, it is reasonable to implement interdisciplinary rules of procedures. In addition, the assignment of a neutral decision-making body within the OR and the creation of an information center for all OR personnel. The challenge of OR organization in the future is to implement more effective documentation systems and active controlling within the OR. One can ensure adequate utilization of resources in the OR with prospectively oriented planning. Better transparence of operations in the OR contributes to increased efficiency. Implementation of quality management is the foundation for a successfully operating surgical hospital. Not only the productivity of individual members of the staff, but also the precise documentation of the quality of results will become important parameters in a successful surgical hospital, whose nucleus is the OR.

Implementing Pay-for-Performance in the Neonatal Intensive Care Unit

PubMed Central

Profit, Jochen; Zupancic, John A. F.; Gould, Jeffrey B.; Petersen, Laura A.

2011-01-01

Pay-for-performance initiatives in medicine are proliferating rapidly. Neonatal intensive care is a likely target for these efforts because of the high cost, available databases, and relative strength of evidence for at least some measures of quality. Pay-for-performance may improve patient care but requires valid measurements of quality to ensure that financial incentives truly support superior performance. Given the existing uncertainty with respect to both the effectiveness of pay-for-performance and the state of quality measurement science, experimentation with pay-for-performance initiatives should proceed with caution and in controlled settings. In this article, we describe approaches to measuring quality and implementing pay-for-performance in the NICU setting. PMID:17473099

Gainsharing Strategies, Physician Champions, Getting Physician Buy In.

PubMed

Anoushiravani, Afshin A; Nunley, Ryan M

2017-06-01

As healthcare spending continues to outpace economic growth, legislators and healthcare economists have explored many processes aimed at improving efficiency and reducing waste. Gainsharing or the general concept that organizations and their employees can work together to continually improve outcomes at reduced expenditures in exchange for a portion of the savings has been shown to be effective within the healthcare system. Although gainsharing principles may be applicable to healthcare organizations and their physician partners, specific parameters should be followed when implementing these arrangements. This article will discuss 10 gainsharing strategies aimed at properly aligning healthcare organizations and physicians, which if followed will ensure the successful implementation of gainsharing initiatives. Copyright © 2017. Published by Elsevier Inc.

Ethical considerations in the implementation of nutrigenetics/nutrigenomics.

PubMed

Hurlimann, Thierry; Robitaille, Julie; Vohl, Marie-Claude; Godard, Béatrice

2017-01-01

Awareness of ethical issues that may be raised by the implementation of nutrigenetic/nutrigenomic (NGx) testing and personalized nutrition, at an individual or a public health level, is crucial to ensure the latter's sound and effective implementation. NGx tests that are currently offered or developed have different natures and scopes. We provide an example of NGx testing on the MTHFR gene to illustrate the current challenges when it comes to grasp the meaning of the results of such testing. In addition, NGx testing is developed within an evolving landscape of new genomic technologies and occurs at a time when public health policies mainly focus on preventive and predictive healthcare, with an emphasis on increased individual responsibility. The ethical issues raised by such a context and the genetic nature of NGx testing both should be carefully evaluated.

Towards ensuring gender equity.

PubMed

Basu, A

1996-01-01

All people should participate in the development process. Many, however, remain excluded from the benefits of development. For example, women are privy to only a small share of developmental opportunities. The goals of equality, development, and peace were stated during the Fourth World Conference on Women held in Beijing in September 1995. The author considers whether women truly have equitable access to literacy, education, food, nutrition, health, employment, and the political and economic decision making process. She stresses that the goals pronounced at the Fourth World Conference on Women must be backed up with the necessary resources, including institutions established at the local, state, and national levels to ensure that the objectives are implemented and the implementation is monitored. The author further argues that in order for women to achieve equality with men, all girls must have access to primary and secondary schools; basic literacy is inadequate. Moreover, gender stereotyping must be avoided and gender sensitization ensured at all levels.

Technical aspects of quality assurance in radiation oncology

PubMed Central

Saw, CB; Ferenci, MS; Wanger, H

2008-01-01

The technical aspects of quality assurance (QA) in radiation oncology as practice in the United States will be reviewed and updated in the spirit of offering the experience to the radiation oncology communities in the Asia-Pacific region. The word “technical” is used to express the organisational components or processes and not the materials within the QA program. A comprehensive QA program in radiation oncology will have an official statement declaring the quality plan for effective patient care services it provides in a document. The QA program will include all aspects of patient care: physical, clinical, and medical aspects of the services. The document will describe the organisational structure, responsibilities, checks and procedures, and resources allocated to ensure the successful implementation of the quality of patient management. Regulatory guidelines and guidelines from accreditation agencies should be incorporated in the QA program to ensure compliance. The organisational structure will have a multidisciplinary QA committee that has the authority to evaluate continuously the effectiveness of the QA program to provide prompt corrective recommendations and to request feedback as needed to monitor the response. The continuous monitoring aspects require meetings to be held at regular intervals with the minutes of the meetings officially recorded and documented. To ensure that a QA program is effective, the program itself should be audited for quality at regular intervals at least annually. It has been recognised that the current QA program has not kept abreast with the rapid implementation of new and advanced radiation therapy technologies with the most recent in image-based radiation therapy technology. The societal bodies (ASTRO and AAPM) and federal agency (NCI) acknowledge this inadequacy and have held workshops to address this issue. The challenges for the societal bodies and federal agency are numerous that include (a) the prescriptive methodology used may not be appropriate for currently implemented new technologies, (b) resources are becoming scarce, (c) advanced radiation therapy technologies have been introduced too rapidly, (d) advances in radiation therapy technologies have become too sophisticated and specialised with each therapy modality having its own separate set of equipment, for example its own dose planning software, computer system and dose delivery systems requiring individualised QA procedures. At the present time, industrial engineers are being recruited to assist in devising a methodology that is broad-based and more process-oriented risk-based formulation of QA in radiation oncology. PMID:21611011

Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions.

PubMed

Scurlock-Evans, Laura; Upton, Penney; Upton, Dominic

2014-09-01

Despite clear benefits of the Evidence-Based Practice (EBP) approach to ensuring quality and consistency of care, its uptake within physiotherapy has been inconsistent. Synthesise the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation. Literature concerning physiotherapists' practice between 2000 and 2012 was systematically searched using: Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature Plus, American Psychological Association databases, Medline, Journal Storage, and Science Direct. Reference lists were searched to identify additional studies. Thirty-two studies, focusing either on physiotherapists' EBP knowledge, attitudes or implementation, or EBP interventions in physiotherapy were included. One author undertook all data extraction and a second author reviewed to ensure consistency and rigour. Synthesis was organised around the themes of EBP barriers/enablers, attitudes, knowledge/skills, use and interventions. Many physiotherapists hold positive attitudes towards EBP. However, this does not necessarily translate into consistent, high-quality EBP. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP. Only studies published in the English language, in peer-reviewed journals were included, thereby introducing possible publication bias. Furthermore, narrative synthesis may be subject to greater confirmation bias. There is no "one-size fits all" approach to enhancing EBP implementation; assessing organisational culture prior to designing interventions is crucial. Although some interventions appear promising, further research is required to explore the most effective methods of supporting physiotherapists' adoption of EBP. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

33 CFR 385.9 - Implementation principles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the Plan at specific time intervals during implementation. Interim targets to evaluate progress on... accordance with § 385.39. Interim goals and interim targets shall be consistent with each other. (c... ensure that new information resulting from changed or unforeseen circumstances, new scientific and...

33 CFR 385.9 - Implementation principles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the Plan at specific time intervals during implementation. Interim targets to evaluate progress on... accordance with § 385.39. Interim goals and interim targets shall be consistent with each other. (c... ensure that new information resulting from changed or unforeseen circumstances, new scientific and...

33 CFR 385.9 - Implementation principles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the Plan at specific time intervals during implementation. Interim targets to evaluate progress on... accordance with § 385.39. Interim goals and interim targets shall be consistent with each other. (c... ensure that new information resulting from changed or unforeseen circumstances, new scientific and...

33 CFR 385.9 - Implementation principles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the Plan at specific time intervals during implementation. Interim targets to evaluate progress on... accordance with § 385.39. Interim goals and interim targets shall be consistent with each other. (c... ensure that new information resulting from changed or unforeseen circumstances, new scientific and...

Facilitators and Hindrances of Implementing Colorectal Cancer Screening Intervention Among Vietnamese Americans.

PubMed

Sin, Mo-Kyung; Yip, Mei-Po; Kimura, Amanda; Tu, Shin-Ping

Little is published about the factors that facilitate and hinder the intervention implementation process. The aim of this study was to examine factors that facilitated and hindered the implementation of a culturally appropriate colorectal cancer screening intervention targeting Vietnamese Americans in a Federally Qualified Health Center located in the Puget Sound area of Washington. Three focus group discussions (2 during the implementation phase and 1 during the maintenance phase) with the medical assistants (N = 13) who were the intervention implementation agents were conducted at the Federally Qualified Health Center. Three research team members independently analyzed the data using content analysis and then compared for agreement. We reread and recoded the transcripts until consensus was reached. The themes were clustered by similar codes and categorized into 4 groups, each including facilitators and hindrances of implementation: identification of implementation agents, implementation environment, intervention recipients, and the colorectal cancer screening intervention. Facilitators included medical assistants' high motivation with a positive attitude toward the intervention, team approach, and simplicity of the intervention, whereas hindrances included lack of time, forgetfulness, staff turnover, and language barriers. The findings emphasized the importance of supporting implementation agents to ensure effective intervention program implementation. Oncology nurses need to particularly take into consideration the evidence-based findings when planning any intervention programs.

Strengthening decentralized primary healthcare planning in Nigeria using a quality improvement model: how contexts and actors affect implementation.

PubMed

Eboreime, Ejemai Amaize; Nxumalo, Nonhlanhla; Ramaswamy, Rohit; Eyles, John

2018-05-08

Quality improvement models have been applied across various levels of health systems with varying success leading to scepticisms about effectiveness. Health systems are complex, influenced by contexts and characterized by numerous interests. Thus, a shift in focus from examining whether improvement models work, to understanding why, when and where they work most effectively is essential. Nigeria introduced DIVA (Diagnose-Intervene-Verify-Adjust) as a model to strengthen decentralized PHC planning. However, implementation has been poorly sustained. This article explores the role of actors and context in implementation and sustainability of DIVA in two local government areas (LGAs) in Nigeria. We employed an integrated mixed method approach in which qualitative data was used in conjunction with quantitative to understand effects of actors and contexts on implementation outcomes. We analysed policy documents and conducted interviews with PHC managers. Then using the Model for Understanding Success in Quality (MUSIQ), we measured contextual factors affecting implementation of DIVA in the selected LGAs. The LGAs scored 117.42 and 104.67 out of 168 points on the MUSIQ scale, respectively, indicating contextual barriers exist. Both have strong DIVA team attributes, but these could not independently ensure quality implementation. Although external support accounted for the greatest contextual disparities, the utmost implementation challenges relate to subnational government leadership, management, financial and technical support. Although higher levels of government may set visionary goals for PHC, interventions are potentially skewed towards donor interests at lower (implementation) levels. Thus, subnational political will is a key determinant of quality implementation. Consequently, advocacy for responsible and accountable political governance is essential in comparable decentralized contexts.

Disseminating and implementing guidelines: article 13 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

PubMed

Grimshaw, Jeremy M; Schünemann, Holger J; Burgers, Jako; Cruz, Alvaro A; Heffner, John; Metersky, Mark; Cook, Deborah

2012-12-01

Professional societies, like many other organizations around the world, have recognized the need to use rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the thirteenth of a series of 14 articles that were prepared to advise guideline developers in respiratory and other diseases. This article focuses on current concepts and research evidence about how to disseminate and implement guidelines optimally on a national and international level to improve quality of care. In this article we address the following questions: What frameworks can aid guideline dissemination and implementation; what are the effects of different guideline dissemination and implementation strategies; and, what is the role of guideline developers in guideline dissemination and implementation? We identified existing systematic reviews and relevant methodological research. Our conclusions are based on evidence from published literature, experience from guideline developers, and workshop discussions. The Knowledge to Action cycle proposed by Graham and colleagues (J Contin Educ Health Prof 2006;26:13-24) provides a useful framework for planning dissemination and implementation activities that emphasize the need for tailored approaches based on an assessment of local barriers. There are a broad range of interventions that are generally effective at improving the uptake of evidence. The best intervention depends on likely barriers, available resources, and other practical considerations. Financial interventions (such as pay for performance) appear to be as effective as other interventions that aim to change professional behavior. Guideline developers who do not have responsibility for guideline implementation in their jurisdiction should support those with responsibility for implementation by considering the "implementability" of their guidelines.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program

PubMed Central

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-01-01

Background and objectives Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. Methods The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. Results This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Conclusion Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity. PMID:17067388

Reconciling research and implementation in micro health insurance experiments in India: study protocol for a randomized controlled trial

PubMed Central

2011-01-01

Background Microinsurance or Community-Based Health Insurance is a promising healthcare financing mechanism, which is increasingly applied to aid rural poor persons in low-income countries. Robust empirical evidence on the causal relations between Community-Based Health Insurance and healthcare utilisation, financial protection and other areas is scarce and necessary. This paper contains a discussion of the research design of three Cluster Randomised Controlled Trials in India to measure the impact of Community-Based Health Insurance on several outcomes. Methods/Design Each trial sets up a Community-Based Health Insurance scheme among a group of micro-finance affiliate families. Villages are grouped into clusters which are congruous with pre-existing social groupings. These clusters are randomly assigned to one of three waves of implementation, ensuring the entire population is offered Community-Based Health Insurance by the end of the experiment. Each wave of treatment is preceded by a round of mixed methods evaluation, with quantitative, qualitative and spatial evidence on impact collected. Improving upon practices in published Cluster Randomised Controlled Trial literature, we detail how research design decisions have ensured that both the households offered insurance and the implementers of the Community-Based Health Insurance scheme operate in an environment replicating a non-experimental implementation. Discussion When a Cluster Randomised Controlled Trial involves randomizing within a community, generating adequate and valid conclusions requires that the research design must be made congruous with social structures within the target population, to ensure that such trials are conducted in an implementing environment which is a suitable analogue to that of a non-experimental implementing environment. PMID:21988774

Reconciling research and implementation in micro health insurance experiments in India: study protocol for a randomized controlled trial.

PubMed

Doyle, Conor; Panda, Pradeep; Van de Poel, Ellen; Radermacher, Ralf; Dror, David M

2011-10-11

Microinsurance or Community-Based Health Insurance is a promising healthcare financing mechanism, which is increasingly applied to aid rural poor persons in low-income countries. Robust empirical evidence on the causal relations between Community-Based Health Insurance and healthcare utilisation, financial protection and other areas is scarce and necessary. This paper contains a discussion of the research design of three Cluster Randomised Controlled Trials in India to measure the impact of Community-Based Health Insurance on several outcomes. Each trial sets up a Community-Based Health Insurance scheme among a group of micro-finance affiliate families. Villages are grouped into clusters which are congruous with pre-existing social groupings. These clusters are randomly assigned to one of three waves of implementation, ensuring the entire population is offered Community-Based Health Insurance by the end of the experiment. Each wave of treatment is preceded by a round of mixed methods evaluation, with quantitative, qualitative and spatial evidence on impact collected. Improving upon practices in published Cluster Randomised Controlled Trial literature, we detail how research design decisions have ensured that both the households offered insurance and the implementers of the Community-Based Health Insurance scheme operate in an environment replicating a non-experimental implementation. When a Cluster Randomised Controlled Trial involves randomizing within a community, generating adequate and valid conclusions requires that the research design must be made congruous with social structures within the target population, to ensure that such trials are conducted in an implementing environment which is a suitable analogue to that of a non-experimental implementing environment. © 2011 Doyle et al; licensee BioMed Central Ltd.

Implementation of Section 255 of the Telecommunications Act of 1996: access to telecommunications services, telecommunications equipment, and customer premises equipment by persons with disabilities--FCC. Notice of proposed rulemaking.

PubMed

1998-05-22

This Notice of Proposed Rulemaking (NPRM) is an important step in the Commission's effort to increase the accessibility of telecommunications services and equipment to Americans with disabilities. The NPRM proposes a framework for implementing section 255 of the Communications Act of 1934 (Act), which requires telecommunications equipment manufacturers and service providers to ensure that their equipment and services are accessible to persons with disabilities, to the extent it is readily achievable to do so. In addition, if accessibility is not readily achievable, section 255 requires manufacturers and service providers to ensure compatibility with existing peripheral devices or specialized customer premises equipment commonly used by individuals with disabilities to achieve access, to the extent it is readily achievable to do so. The NPRM first explores the Commission's legal authority to establish rules implementing section 255. The NPRM then seeks comment on the interpretation of specific statutory terms that are relevant to the proceeding. Finally, the NPRM seeks comment on proposals to implement and enforce the requirement that telecommunications equipment and services be made accessible to the extent readily achievable. The actions proposed in the NPRM are needed to ensure that people with disabilities are not left behind in the telecommunications revolution and consequently isolated from contemporary life.

Improving Professional Development to Enhance Reading Outcomes for Students in Special Education.

PubMed

Lemons, Christopher J; Otaiba, Stephanie Al; Conway, Sheila J; Mellado De La Cruz, Veronica

2016-12-01

The purpose of this article is to focus specifically on professional development that is needed to ensure that preservice and in-service teachers are prepared to deliver intensive intervention to enhance reading outcomes of students in special education. Our aim is to provide recommendations to ensure that special educators are prepared to design and implement data-based individualization in the area of reading. We highlight what special educators need to know to implement data-based individualization and provide recommendations for improving professional development using findings from federally funded projects. Implications for practice and next steps for research and policy are provided. © 2016 Wiley Periodicals, Inc.

An adaptive transmission protocol for managing dynamic shared states in collaborative surgical simulation.

PubMed

Qin, J; Choi, K S; Ho, Simon S M; Heng, P A

2008-01-01

A force prediction algorithm is proposed to facilitate virtual-reality (VR) based collaborative surgical simulation by reducing the effect of network latencies. State regeneration is used to correct the estimated prediction. This algorithm is incorporated into an adaptive transmission protocol in which auxiliary features such as view synchronization and coupling control are equipped to ensure the system consistency. We implemented this protocol using multi-threaded technique on a cluster-based network architecture.

Gunshot identification system by integration of open source consumer electronics

NASA Astrophysics Data System (ADS)

López R., Juan Manuel; Marulanda B., Jose Ignacio

2014-05-01

This work presents a prototype of low-cost gunshots identification system that uses consumer electronics in order to ensure the existence of gunshots and then classify it according to a previously established database. The implementation of this tool in the urban areas is to set records that support the forensics, hence improving law enforcement also on developing countries. An analysis of its effectiveness is presented in comparison with theoretical results obtained with numerical simulations.

Essential considerations in developing attention control groups in behavioral research.

PubMed

Aycock, Dawn M; Hayat, Matthew J; Helvig, Ashley; Dunbar, Sandra B; Clark, Patricia C

2018-06-01

Attention control groups strengthen randomized controlled trials of behavioral interventions, but researchers need to give careful consideration to the attention control activities. A comparative effectiveness research framework provides an ideal opportunity for an attention control group as a supplement to standard care, so participants potentially receive benefit regardless of group assignment. The anticipated benefit of the control condition must be independent of the study outcome. Resources needed for attention control activities need to be carefully considered and ethical considerations carefully weighed. In this paper we address nine considerations for the design and implementation of attention control groups: (1) ensure attention control activities are not associated with the outcome; (2) avoid contamination of the intervention or control group; (3) design comparable control and intervention activities; (4) ensure researcher training to adequately administer both treatment arms; (5) design control activities to be interesting and acceptable to participants; (6) evaluate attention control activities; (7) consider additional resources needed to implement attention control activities; (8) quantifying the effects of attention control and intervention groups; and (9) ethical considerations with attention control groups. Examples from the literature and ongoing research are presented. Careful planning for the attention control group is as important as for the intervention group. Researchers can use the considerations presented here to assist in planning for the best attention control group for their study. © 2018 Wiley Periodicals, Inc.

Knowledge translation and implementation in spinal cord injury: a systematic review.

PubMed

Noonan, V K; Wolfe, D L; Thorogood, N P; Park, S E; Hsieh, J T; Eng, J J

2014-08-01

To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions.

Implementing a pressure ulcer prevention bundle in an adult intensive care.

PubMed

Tayyib, Nahla; Coyer, Fiona; Lewis, Peter A

2016-12-01

The incidence of pressure ulcers (PUs) in intensive care units (ICUs) is high and numerous strategies have been implemented to address this issue. One approach is the use of a PU prevention bundle. However, to ensure success care bundle implementation requires monitoring to evaluate the care bundle compliance rate, and to evaluate the effectiveness of implementation strategies in facilitating practice change. The aims of this study were to appraise the implementation of a series of high impact intervention care bundle components directed at preventing the development of PUs, within ICU, and to evaluate the effectiveness of strategies used to enhance the implementation compliance. An observational prospective study design was used. Implementation strategies included regular education, training, audit and feed-back and the presence of a champion in the ICU. Implementation compliance was measured along four time points using a compliance checklist. Of the 60 registered nurses (RNs) working in the critical care setting, 11 participated in this study. Study participants demonstrated a high level of compliance towards the PU prevention bundle implementation (78.1%), with 100% participant acceptance. No significant differences were found between participants' demographic characteristics and the compliance score. There was a significant effect for time in the implementation compliance (Wilks Lambda=0.29, F (3, 8)=6.35, p<0.016), indicating that RNs needed time to become familiar with the bundle and routinely implement it into their practice. PU incidence was not influenced by the compliance level of participants. The implementation strategies used showed a positive impact on compliance. Assessing and evaluating implementation compliance is critical to achieve a desired outcome (reduction in PU incidence). This study's findings also highlighted that while RNs needed time to familiarise themselves with the care bundle elements, their clinical practice was congruent with the bundle elements. Copyright © 2016 Elsevier Ltd. All rights reserved.

Non-perturbative calculation of orbital and spin effects in molecules subject to non-uniform magnetic fields

NASA Astrophysics Data System (ADS)

Sen, Sangita; Tellgren, Erik I.

2018-05-01

External non-uniform magnetic fields acting on molecules induce non-collinear spin densities and spin-symmetry breaking. This necessitates a general two-component Pauli spinor representation. In this paper, we report the implementation of a general Hartree-Fock method, without any spin constraints, for non-perturbative calculations with finite non-uniform fields. London atomic orbitals are used to ensure faster basis convergence as well as invariance under constant gauge shifts of the magnetic vector potential. The implementation has been applied to investigate the joint orbital and spin response to a field gradient—quantified through the anapole moments—of a set of small molecules. The relative contributions of orbital and spin-Zeeman interaction terms have been studied both theoretically and computationally. Spin effects are stronger and show a general paramagnetic behavior for closed shell molecules while orbital effects can have either direction. Basis set convergence and size effects of anapole susceptibility tensors have been reported. The relation of the mixed anapole susceptibility tensor to chirality is also demonstrated.

Determinants of treatment plan implementation in multidisciplinary team meetings for patients with chronic diseases: a mixed-methods study

PubMed Central

Raine, Rosalind; Xanthopoulou, Penny; Wallace, Isla; Nic a’ Bháird, Caoimhe; Lanceley, Anne; Clarke, Alex; Livingston, Gill; Prentice, Archie; Ardron, Dave; Harris, Miriam; King, Michael; Michie, Susan; Blazeby, Jane M; Austin-Parsons, Natalie; Gibbs, Simon; Barber, Julie

2014-01-01

Objective Multidisciplinary team (MDT) meetings are assumed to produce better decisions and are extensively used to manage chronic disease in the National Health Service (NHS). However, evidence for their effectiveness is mixed. Our objective was to investigate determinants of MDT effectiveness by examining factors influencing the implementation of MDT treatment plans. This is a proxy measure of effectiveness, because it lies on the pathway to improvements in health, and reflects team decision making which has taken account of clinical and non-clinical information. Additionally, this measure can be compared across MDTs for different conditions. Methods We undertook a prospective mixed-methods study of 12 MDTs in London and North Thames. Data were collected by observation of 370 MDT meetings, interviews with 53 MDT members, and from 2654 patient medical records. We examined the influence of patient-related factors (disease, age, sex, deprivation, whether their preferences and other clinical/health behaviours were mentioned) and MDT features (as measured using the ‘Team Climate Inventory’ and skill mix) on the implementation of MDT treatment plans. Results The adjusted odds (or likelihood) of implementation was reduced by 25% for each additional professional group represented at the MDT meeting. Implementation was more likely in MDTs with clear goals and processes and a good ‘Team Climate’ (adjusted OR 1.96; 95% CI 1.15 to 3.31 for a unit increase in Team Climate Inventory (TCI) score). Implementation varied by disease category, with the lowest adjusted odds of implementation in mental health teams. Implementation was also lower for patients living in more deprived areas (adjusted odds of implementation for patients in the most compared with least deprived areas was 0.60, 95% CI 0.39 to 0.91). Conclusions Greater multidisciplinarity is not necessarily associated with more effective decision making. Explicit goals and procedures are also crucial. Decision implementation should be routinely monitored to ensure the equitable provision of care. PMID:24915539

Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

PubMed

Mudumbai, Seshadri C

2016-01-01

Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

Clinical engagement: improving healthcare together.

PubMed

Riches, E; Robson, B

2014-02-01

Clinical engagement can achieve lasting change in the delivery of healthcare. In October 2011, Healthcare Improvement Scotland formulated a clinical engagement strategy to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in its health improvement and public assurance activities. The strategy was developed using a 90-day process, combining an evidence base of best practice and feedback from semi-structured interviews and focus groups. The strategy aims to create a culture where clinicians view working with Healthcare Improvement Scotland as a worthwhile venture, which offers a number of positive benefits such as training, career development and research opportunities. The strategy works towards developing a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders whereby clinicians' contributions are recognised in a non-financial reward system. To do this, the organisation needs a sustainable infrastructure and an efficient, cost-effective approach to clinical engagement. There are a number of obstacles to achieving successful clinical engagement and these must be addressed as key drivers in its implementation. The implementation of the strategy is supported by an action and resource plan, and its impact will be monitored by a measurement plan to ensure the organisation reviews its approaches towards clinical engagement.

Contracting for Asbestos Abatement: What You Need to Know.

ERIC Educational Resources Information Center

Bittle, Edgar H.; McAllister, Jane B.

1990-01-01

School districts are required to determine if asbestos-containing materials exist at school facilities and design and implement asbestos abatement. Reviews how to select a contractor, draft the contract, and ensure its proper implementation by complying with the law and avoiding liability. (MLF)

Past Accomplishments and Future Challenges

ERIC Educational Resources Information Center

Danielson, Louis; Doolittle, Jennifer; Bradley, Renee

2005-01-01

Three broad issues continue to dramatically impact the education of children with specific learning disabilities (SLD): (1) the development and implementation of scientifically defensible methods of identification; (2) the development and implementation of scientific interventions to ensure that children with SLD have access to and make progress…

Completing advance directives for health care decisions: getting to yes.

PubMed

Shewchuk, T R

1998-09-01

The concept of advance directives for health care decision making has been judicially condoned, legislatively promoted, and systematically implemented by health care institutions, yet the execution rate of advance directives remains low. Physicians should discuss with their patients advance care planning generally and end-of-life issues specifically, preferably when patients are in good health and not when they face an acute medical crisis. The physician-hospital relationship poses particular challenges for the optimal implementation of advance directives that must be addressed. Hospital administrators must improve education of patients and physicians on the value of such documents as well as internal mechanisms to ensure better implementation of directives. Health insurance plans may be better able to ensure optimal gathering and implementation of directives. Patients must become more familiar and more comfortable with advance care planning and the reality of death and dying issues. Full acceptance of the value of directives ultimately rests on achieving full participation of all involved--providers, patients, families, and payors--in this most profound process.

Implementing guidelines in nursing homes: a systematic review.

PubMed

Diehl, Heinz; Graverholt, Birgitte; Espehaug, Birgitte; Lund, Hans

2016-07-25

Research on guideline implementation strategies has mostly been conducted in settings which differ significantly from a nursing home setting and its transferability to the nursing home setting is therefore limited. The objective of this study was to systematically review the effects of interventions to improve the implementation of guidelines in nursing homes. A systematic literature search was conducted in the Cochrane Library, CINAHL, Embase, MEDLINE, DARE, HTA, CENTRAL, SveMed + and ISI Web of Science from their inception until August 2015. Reference screening and a citation search were performed. Studies were eligible if they evaluated any type of guideline implementation strategy in a nursing home setting. Eligible study designs were systematic reviews, randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted-time-series studies. The EPOC risk of bias tool was used to evaluate the risk of bias in the included studies. The overall quality of the evidence was rated using GRADE. Five cluster-randomised controlled trials met the inclusion criteria, evaluating a total of six different multifaceted implementation strategies. One study reported a small statistically significant effect on professional practice, and two studies demonstrated small to moderate statistically significant effects on patient outcome. The overall quality of the evidence for all comparisons was low or very low using GRADE. Little is known about how to improve the implementation of guidelines in nursing homes, and the evidence to support or discourage particular interventions is inconclusive. More implementation research is needed to ensure high quality of care in nursing homes. PROSPERO 2014: CRD42014007664.

Enhancing the use of research in health-promoting, anti-racism policy.

PubMed

Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret

2017-07-11

The Localities Embracing and Accepting Diversity (LEAD) programme was established to improve the health of ethnic minority communities through the reduction of racial discrimination. Local governments in the state of Victoria, Australia, were at the forefront of LEAD implementation in collaboration with leading state and national organisations. Key aims included expanding the available evidence regarding effective anti-racism interventions and facilitating the uptake of this evidence in organisational policies and practices. One rural and one metropolitan local government areas were selected to participate in LEAD. Key informant interviews and discussions were conducted with individuals who had participated in LEAD implementation and members of LEAD governance structures. Data were also collected on programme processes and implementation, partnership formation and organisational assessments. The LEAD model demonstrated both strengths and weaknesses in terms of facilitating the use of evidence in a complex, community-based health promotion initiative. Representation of implementing, funding and advisory bodies at different levels of governance enabled the input of technical advice and guidance alongside design and implementation. The representation structure assisted in ensuring the development of a programme that was acceptable to all partners and informed by the best available evidence. Simultaneous evaluation also enhanced perceived validity of the intervention, allowed for strategy correction when necessary and supported the process of double-loop organisational learning. However, due to the model's demand for simultaneous and intensive effort by various organisations, when particular elements of the intervention were not functional, there was a considerable loss of time and resources across the partner organisations. The complexity of the model also presented a challenge in ensuring clarity regarding roles, functions and the direction of the programme. The example of LEAD provides guidance on mechanisms to strengthen the entry of evidence into complex community-based health promotion programmes. The paper highlights some of the strengths and weaknesses of the LEAD model and implications for practical collaboration between policymakers, implementers and researchers.

Systems modelling and simulation in health service design, delivery and decision making.

PubMed

Pitt, Martin; Monks, Thomas; Crowe, Sonya; Vasilakis, Christos

2016-01-01

The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation.

PubMed

Hadjistavropoulos, Thomas; Williams, Jaime; Kaasalainen, Sharon; Hunter, Paulette V; Savoie, Maryse L; Wickson-Griffiths, Abigail

2016-01-01

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis. Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so. Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted. Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain. Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices. Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

The "Som la Pera" intervention: sustainability capacity evaluation of a peer-led social-marketing intervention to encourage healthy lifestyles among adolescents.

PubMed

Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Prades-Tena, Jordi; Kettner, Helle; Arola, Lluis; Giralt, Montse; Solà, Rosa

2018-02-10

Sustainability capacity, always considered a challenge, is the ability to maintain effective long-term intervention in a community. The aim of the study was to improve the sustainability capacity of effective "Som la Pera," a school-based, peer-led, social-marketing intervention that encourages healthy diet and physical activity, in low socioeconomic adolescents from Spain. The sustainability capacity was analyzed by a "programme sustainability assessment tool (PSAT)" comprising eight domains: political support, funding stability, partnerships, organizational capacity, programme evaluation, programme adaptation, communications, and strategic planning. Each domain was evaluated from 1 (no or to a small extent) to 7 points (to a great extent). The final score for sustainability capacity was the mean of the eight domain scores. The PSAT was assessed by nine professionals (researchers, staff members, and stakeholders) at two periods during intervention implementation: end of the first year (January 2015) and end of the second year (September 2015). At the end of the first year, strategic planning (4.43 ± 1.98) and funding stability (4.38 ± 1) were considered deficient domains, and at the end of the second year, these domains had improved by 1.67 points (p =.043) and 0.59 points (p = .159), respectively. The funding stability increase was not significant because only one of the five specific items, "policies implemented to ensure sustained funding," improved by 1.08 points (p = .036). The sustainability capacity final score was 5.93 ± 1.13. The sustainability capacity assessment during the intervention allows its improvement before the programme expires, ensuring the long-term implementation of the "Som la Pera" intervention programme to encourage healthy lifestyles in adolescents. © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Exploring Implementation and Fidelity of Evidence-Based Behavioral Interventions for HIV Prevention: Lessons Learned From the Focus on Kids Diffusion Case Study

PubMed Central

Galbraith, Jennifer S.; Stanton, Bonita; Boekeloo, Bradley; King, Winifred; Desmond, Sharon; Howard, Donna; Black, Maureen M.; Carey, James W.

2014-01-01

Evidence-based interventions (EBIs) are used in public health to prevent HIV infection among youth and other groups. EBIs include core elements, features that are thought to be responsible for the efficacy of interventions. The authors evaluate experiences of organizations that adopted an HIV-prevention EBI, Focus on Kids (FOK), and their fidelity to the intervention’s eight core elements. A cross-sectional telephone survey was administered to 34 staff members from organizations that had previously implemented FOK. Questions assessed how the organization adhered to, adapted, dropped, or altered the intervention. None of the organizations implemented all eight core elements. This study underscores the importance for HIV intervention researchers to clearly identify and describe core elements. More effort is needed to reflect the constraints practitioners face in nonresearch settings. To ensure intervention effectiveness, additional research and technical assistance are needed to help organizations implement HIV prevention EBIs with fidelity. PMID:18445739

"In my house": laying the foundation for youth HIV prevention in the Black church.

PubMed

Lightfoot, Alexandra F; Woods, Briana A; Jackson, Melvin; Riggins, Linda; Krieger, Kathleen; Brodie, Kimberly; Gray, Phyllis; Howard, Daniel L

2012-01-01

This article describes the process our community-academic partnership used to lay the groundwork for successful implementation of an adolescent-focused, evidence-based HIV/AIDS prevention curriculum in two Black churches. We highlight the challenges encountered and lessons learned in building a relationship with two churches, garnering the pastor's support, and implementing the curriculum within church youth groups. We engaged a Community Advisory Board (CAB) made up of youth, parents, and diverse faith leaders to ensure community relevance and guide project development, implementation, and evaluation. Using a community-based participatory research (CBPR) approach helped us to (1) engage diverse, intergenerational community members, (2) initiate a "culturally humble" process to build relationships with faith leaders, (3) remain responsive to stakeholder concerns, and (4) open the door to HIV prevention in the Black church. Finding effective and responsive ways to implement HIV/AIDS prevention in faith settings is facilitated by engaging diverse partners throughout the research process.

Information system equality for food security--implementation of the food safety control system in Taiwan.

PubMed

Chen, Shaun C; Hsu, Guoo-Shyng Wang; Chiu, Chihwei P

2009-01-01

Food security plays a central role in governing agricultural policies in Taiwan. In addition to overuse or the illegal use of pesticide, meat leanness promoters, animal drugs and melamine in the food supply; as well as foodborne illness draws the greatest public concern due to incidents that occur every year in Taiwan. The present report demonstrates the implementation of a food safety control system in Taiwan. In order to control foodborne outbreaks effectively, the central government of the Department of Health of Taiwan launched the food safety control system which includes both the good hygienic practice (GHP) and the HACCP plan, in the last decade. From 1998 to the present, 302 food affiliations that implemented the system have been validated and accredited by a well-established audit system. The implementation of a food safety control system in compliance with international standards is of crucial importance to ensure complete safety and the high quality of foods, not only for domestic markets, but also for international trade.

The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

PubMed

Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

2012-02-10

To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

Exploring compassion: implications for contemporary nursing. Part 2.

PubMed

Straughair, Collette

A range of contemporary political and professional literature endorse the principle of compassion in nursing as a core and underpinning philosophy fundamental to the profession. However, despite pledges to ensure that compassion lies at the heart of nursing, the concept has not been clearly defined. It is evident that uncovering the true meaning is complex and challenging owing to its subjective nature. In light of this, several implications must be considered. Effective student nurse recruitment is essential to ensure that the most appropriate individuals are selected. Contemporary marketing campaigns must be implemented, and recruitment strategies developed, which consider specific values and attitudes. Service user involvement in recruitment and selection, curriculum planning and learning and teaching strategies, and post-qualification education, can enhance nurses' understanding of the patient perspective and make headway in embedding compassion as a core nursing value. Additionally, effective role modelling in practice which demonstrates high-quality compassionate nursing care is essential. Nurses must be adequately supported in the clinical environment to facilitate compassionate behaviours and clinical leadership at all levels must uphold political and professional pledges to achieve this. Consideration of these implications for practice is essential to ensure that nurses are able to respond to patients with humanity and kindness, and deliver high-quality, compassionate care to all.

Use of mobile devices in community health care: barriers and solutions to implementation.

PubMed

Turner, Christopher

2016-02-01

Mobile devices allow clinicians to access electronic clinical systems away from traditional base locations. They have contributed to increased productivity and efficiency, and clinical staff also cite benefits to patient care. A selection of NHS trusts have participated in a national pilot to explore the benefits and drawbacks of this technology. Clinical engagement with frontline staff is essential to ensure the staff feel valued, listened to, and fully involved to ensure any change to existing practice is successful. Moreover, the training needs of the workforce require careful consideration. The provision of information technology (IT) support services is fundamental to ensure that staff receive the necessary assistance with any functionality issues they may experience with mobile devices to minimise the effect on clinical practice. Variability in internet connectivity may present as a challenge to clinical staff, and the benefits of complimentary offline working solutions should be considered. Barriers to the successful use of mobile devices should be reported as this may have a negative clinical effect on the safe delivery of patient care. Clinical staff need to be mindful of their obligations in relation to information governance, and should appreciate that the same consideration needs to be given to both paper and electronic records.

Random Time Identity Based Firewall In Mobile Ad hoc Networks

NASA Astrophysics Data System (ADS)

Suman, Patel, R. B.; Singh, Parvinder

2010-11-01

A mobile ad hoc network (MANET) is a self-organizing network of mobile routers and associated hosts connected by wireless links. MANETs are highly flexible and adaptable but at the same time are highly prone to security risks due to the open medium, dynamically changing network topology, cooperative algorithms, and lack of centralized control. Firewall is an effective means of protecting a local network from network-based security threats and forms a key component in MANET security architecture. This paper presents a review of firewall implementation techniques in MANETs and their relative merits and demerits. A new approach is proposed to select MANET nodes at random for firewall implementation. This approach randomly select a new node as firewall after fixed time and based on critical value of certain parameters like power backup. This approach effectively balances power and resource utilization of entire MANET because responsibility of implementing firewall is equally shared among all the nodes. At the same time it ensures improved security for MANETs from outside attacks as intruder will not be able to find out the entry point in MANET due to the random selection of nodes for firewall implementation.

Block-Level Added Redundancy Explicit Authentication for Parallelized Encryption and Integrity Checking of Processor-Memory Transactions

NASA Astrophysics Data System (ADS)

Elbaz, Reouven; Torres, Lionel; Sassatelli, Gilles; Guillemin, Pierre; Bardouillet, Michel; Martinez, Albert

The bus between the System on Chip (SoC) and the external memory is one of the weakest points of computer systems: an adversary can easily probe this bus in order to read private data (data confidentiality concern) or to inject data (data integrity concern). The conventional way to protect data against such attacks and to ensure data confidentiality and integrity is to implement two dedicated engines: one performing data encryption and another data authentication. This approach, while secure, prevents parallelizability of the underlying computations. In this paper, we introduce the concept of Block-Level Added Redundancy Explicit Authentication (BL-AREA) and we describe a Parallelized Encryption and Integrity Checking Engine (PE-ICE) based on this concept. BL-AREA and PE-ICE have been designed to provide an effective solution to ensure both security services while allowing for full parallelization on processor read and write operations and optimizing the hardware resources. Compared to standard encryption which ensures only confidentiality, we show that PE-ICE additionally guarantees code and data integrity for less than 4% of run-time performance overhead.

10 CFR 1045.4 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... declassification of RD and FRD in accordance with the Atomic Energy Act; (2) In coordination with the DoD, develop regulations to implement the RD and FRD classification system; (3) Determine whether nuclear-related information is RD; (4) Oversee agency implementation of the RD and FRD classification system to ensure...

10 CFR 1045.4 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... declassification of RD and FRD in accordance with the Atomic Energy Act; (2) In coordination with the DoD, develop regulations to implement the RD and FRD classification system; (3) Determine whether nuclear-related information is RD; (4) Oversee agency implementation of the RD and FRD classification system to ensure...

10 CFR 1045.4 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... declassification of RD and FRD in accordance with the Atomic Energy Act; (2) In coordination with the DoD, develop regulations to implement the RD and FRD classification system; (3) Determine whether nuclear-related information is RD; (4) Oversee agency implementation of the RD and FRD classification system to ensure...

10 CFR 1045.4 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... declassification of RD and FRD in accordance with the Atomic Energy Act; (2) In coordination with the DoD, develop regulations to implement the RD and FRD classification system; (3) Determine whether nuclear-related information is RD; (4) Oversee agency implementation of the RD and FRD classification system to ensure...

10 CFR 1045.4 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... declassification of RD and FRD in accordance with the Atomic Energy Act; (2) In coordination with the DoD, develop regulations to implement the RD and FRD classification system; (3) Determine whether nuclear-related information is RD; (4) Oversee agency implementation of the RD and FRD classification system to ensure...

28 CFR 63.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... through the A-95 review process if subject to that process. In addition, notices of actions shall be... special problems, e.g., levees and other protection works, erosion, subsidence, sink holes, ice jams... action. (h) Review the implementation and post implementation phase of the proposed action to ensure that...

44 CFR 10.12 - Pre-implementation actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Pre-implementation actions. (a) Decision-making. The Regional Administrator shall ensure that... integrated into the decision-making process. Because of the diversity of FEMA, it is not feasible to describe in this part the decision-making process for each of the various FEMA programs. Proposals and actions...

Managing the pharmaceutical industry-health system interface.

PubMed

Zarowitz, B J; Muma, B; Coggan, P; Davis, G; Barkley, G L

2001-12-01

Direct-to-consumer advertising, media, and Internet marketing to physicians and patients, as well as enticing marketing strategies, are used by the pharmaceutical industry to ensure market share growth of new drugs. Our health system adopted a strict vendor policy governing detailing and sampling activities of pharmaceutical representatives, but realized that further analysis of vendor influence in our system was needed. An assessment of tangible benefits, ethical concerns, and financial liabilities and gains was conducted to reassess the need for further vendor restriction. Based on our findings, several recommendations have been made. Medical practices and health systems are encouraged to establish and enforce explicit vendor policies, measure their effectiveness, partner proactively with representatives to deliver a drug-detailing message consistent with system initiatives, monitor and regulate continuing medical education funding, and implement strategies to ensure appropriate drug use.

Effective Usability Engineering in Healthcare: A Vision of Usable and Safer Healthcare IT.

PubMed

Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth

2017-01-01

Persistent problems with healthcare IT that is unusable and unsafe have been reported worldwide. In this paper we present our vision for deploying usability engineering in healthcare in a more substantive way in order to improve the current situation. The argument will be made that stronger and more substantial efforts need to be made to bring multiple usability engineering methods to bear on points in both system design and deployment (and not just as a one-time effort restricted to software product development). In addition, improved processes for ensuring the usability of commercial vendor-based systems being implemented in healthcare organizations need to be addressed. A discussion will also be provided on challenges and barriers that will need to be overcome to ensure that the heatlhcare IT that is released is both usable and safe.

Effective Web and Desktop Retrieval with Enhanced Semantic Spaces

NASA Astrophysics Data System (ADS)

Daoud, Amjad M.

We describe the design and implementation of the NETBOOK prototype system for collecting, structuring and efficiently creating semantic vectors for concepts, noun phrases, and documents from a corpus of free full text ebooks available on the World Wide Web. Automatic generation of concept maps from correlated index terms and extracted noun phrases are used to build a powerful conceptual index of individual pages. To ensure scalabilty of our system, dimension reduction is performed using Random Projection [13]. Furthermore, we present a complete evaluation of the relative effectiveness of the NETBOOK system versus the Google Desktop [8].

Single Event Effects mitigation with TMRG tool

NASA Astrophysics Data System (ADS)

Kulis, S.

2017-01-01

Single Event Effects (SEE) are a major concern for integrated circuits exposed to radiation. There have been several techniques proposed to protect circuits against radiation-induced upsets. Among the others, the Triple Modular Redundancy (TMR) technique is one of the most popular. The purpose of the Triple Modular Redundancy Generator (TMRG) tool is to automatize the process of triplicating digital circuits freeing the designer from introducing the TMR code manually at the implementation stage. It helps to ensure that triplicated logic is maintained through the design process. Finally, the tool streamlines the process of introducing SEE in gate level simulations for final verification.

Assessment Problems and Ensuring of Decent Work in the Russian Regions

ERIC Educational Resources Information Center

Simonova, Marina V.; Sankova, Larisa V.; Mirzabalaeva, Farida I.; Shchipanova, Dina Ye.; Dorozhkin, Vladimir E.

2016-01-01

The relevance of the research problem is inspired by the need to ensure decent work principles in Russia. The purpose of this article is to develop evaluation methodologies and identify areas to implement key principles of decent work at the regional level in modern Russia. A leading approach to study this problem is the development of a new…

Department of Education Educator Equity Initiative

ERIC Educational Resources Information Center

Lindsey, Kevin

2014-01-01

On July 7, 2014, the U.S. Department of Education announced plans to enforce a provision of the 2001 No Child Left Behind (NCLB) Act meant to ensure that every student is taught by a great teacher and attends a school run by great administrators. The provision requires states to develop and implement plans to ensure that no subgroup of students is…

Roadmap for Teacher Access to Student-Level Longitudinal Data: Key Focus Areas to Ensure Quality Implementation. Data for Action

ERIC Educational Resources Information Center

Data Quality Campaign, 2014

2014-01-01

Teachers have access to information about the students in their classrooms each year, but schools and districts often cannot provide teachers with longitudinal data (or data linked over time). Given resource constraints in schools and districts, states are best positioned to ensure that teachers have secure access to their students' longitudinal…

Constant voltage and constant current control implementation for electric vehicles (evs) wireless charger

NASA Astrophysics Data System (ADS)

Tampubolon, Marojahan; Pamungkas, Laskar; Hsieh, Yao Ching; Chiu, Huang Jen

2018-04-01

This paper presents the implementation of Constant Voltage (CV) and Constant Current (CC) control for a wireless charger system. A battery charging system needs these control modes to ensure the safety of the battery and the effectiveness of the charging system. Here, the wireless charger system does not employ any post-regulator stage to control the output voltage and output current of the charger. But, it uses a variable frequency control incorporated with a conventional PI control. As a result, the size and the weight of the system are reduced. This paper discusses the brief review of the SS-WPT, control strategy and implementation of the CV and CC control. Experimental hardware with 2kW output power has been performed and tested. The results show that the proposed CV and CC control method works well with the system.

Best practices in tobacco control in the South-East Asia Region.

PubMed

Zolty, B C; Sinha, P K; Sinha, D N

2012-01-01

The tobacco epidemic is an increasing threat to public health with the tobacco burden particularly high in WHO's South-East Asia Region (SEAR). The Region has many obstacles to tobacco control, but despite these challenges, significant progress has been made in many countries. Although much work still needs to be done, SEAR countries have nevertheless implemented strong and often innovative tobacco control measures that can be classified as "best practices," with some setting global precedents. The best practice measures implemented in SEAR include bans on gutka, reducing tobacco imagery in movies, and warning about the dangers of tobacco. In a time of scarce resources, countries in SEAR and elsewhere must ensure that the most effective and cost-efficient measures are implemented. It is hoped that countries can learn from these examples and as appropriate, adapt these measures to their own specific cultural, social and political realities.

Implementing a quantum cloning machine in separate cavities via the optical coherent pulse as a quantum communication bus

NASA Astrophysics Data System (ADS)

Zhu, Meng-Zheng; Ye, Liu

2015-04-01

An efficient scheme is proposed to implement a quantum cloning machine in separate cavities based on a hybrid interaction between electron-spin systems placed in the cavities and an optical coherent pulse. The coefficient of the output state for the present cloning machine is just the direct product of two trigonometric functions, which ensures that different types of quantum cloning machine can be achieved readily in the same framework by appropriately adjusting the rotated angles. The present scheme can implement optimal one-to-two symmetric (asymmetric) universal quantum cloning, optimal symmetric (asymmetric) phase-covariant cloning, optimal symmetric (asymmetric) real-state cloning, optimal one-to-three symmetric economical real-state cloning, and optimal symmetric cloning of qubits given by an arbitrary axisymmetric distribution. In addition, photon loss of the qubus beams during the transmission and decoherence effects caused by such a photon loss are investigated.

The quest to standardize hemodialysis care.

PubMed

Hegbrant, Jörgen; Gentile, Giorgio; Strippoli, Giovanni F M

2011-01-01

A large global dialysis provider's core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence-based guidelines and clinical protocols; consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner, incorporating information on interclinic and intercountry variations; and revising targets, guidelines and clinical protocols based on sound scientific data. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice; and auditing of clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety. Copyright © 2011 S. Karger AG, Basel.

The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives.

PubMed

Stergiou-Kita, Mary; Pritlove, Cheryl; van Eerd, Dwayne; Holness, Linn D; Kirsh, Bonnie; Duncan, Andrea; Jones, Jennifer

2016-06-01

With improvements in screening, diagnosis, and treatment, the number of persons surviving cancer and staying at or returning to work is increasing. While workplace accommodations optimize workers' abilities to participate in the workforce, there has been little in-depth investigation of the types of accommodations reported to have been provided to cancer survivors and the processes relevant to ensuring their successful implementation. We employed an exploratory qualitative method and conducted 40 semi-structured interviews with three groups: (i) cancers survivors (n = 16), (ii) health/vocational service providers (n = 16), and (iii) employer representatives (n = 8) to explore return to work and accommodation processes, successes, and challenges. An inductive thematic analysis approach was used to analyze the data. Four types of accommodations were recommended: (1) graduated return to work plans and flexible scheduling, (2) modification of work duties and performance expectations, (3) retraining and supports at the workplace, and (4) modification of the physical work environment and/or the provision of adaptive aids/technologies. Processes relevant to ensuring effective accommodations included: (1) developing knowledge about accommodations, (2) employer's ability to accommodate, (3) negotiating reasonable accommodations, (4) customizing accommodations, and (5) implementing and monitoring accommodation plans. Accommodation challenges included: (1) survivors' fears requesting accommodations, (2) developing clear and specific accommodations, (3) difficult to accommodate jobs, and (4) workplace challenges, including strained pre-cancer workplace relationships, insufficient/inflexible workplace policies, employer concerns regarding productivity and precedent setting, and limited modified duties. Accommodations need to be customized and clearly linked to survivors' specific job demands, work context, and available workplace supports. Survivors need to feel comfortable disclosing the need for accommodations. Ongoing communication and monitoring are required to ensure accommodations are implemented and changes made to the return to work plan as required. The provision of appropriate workplace accommodations can enhance survivors' abilities to stay or return to work.

Response to Intervention and Continuous School Improvement: Using Data, Vision, and Leadership to Design, Implement, and Evaluate a Schoolwide Prevention System

ERIC Educational Resources Information Center

Bernhardt, Victoria L.; Hebert, Connie L.

2011-01-01

Ensure the success of your school and improve the learning of "all" students by implementing Response-to-Intervention (RTI) as part of a continuous school improvement (CSI) process. This book shows you how to get your entire staff working together to design, implement, and evaluate a schoolwide prevention system. With specific examples, CSI expert…

Implementation of the Web-based laboratory

NASA Astrophysics Data System (ADS)

Ying, Liu; Li, Xunbo

2005-12-01

With the rapid developments of Internet technologies, remote access and control via Internet is becoming a reality. A realization of the web-based laboratory (the W-LAB) was presented. The main target of the W-LAB was to allow users to easily access and conduct experiments via the Internet. While realizing the remote communication, a system, which adopted the double client-server architecture, was introduced. It ensures the system better security and higher functionality. The experimental environment implemented in the W-Lab was integrated by both virtual lab and remote lab. The embedded technology in the W-LAB system as an economical and efficient way to build the distributed infrastructural network was introduced. Furthermore, by introducing the user authentication mechanism in the system, it effectively secures the remote communication.

The implementation of a Hazard Analysis and Critical Control Point management system in a peanut butter ice cream plant.

PubMed

Hung, Yu-Ting; Liu, Chi-Te; Peng, I-Chen; Hsu, Chin; Yu, Roch-Chui; Cheng, Kuan-Chen

2015-09-01

To ensure the safety of the peanut butter ice cream manufacture, a Hazard Analysis and Critical Control Point (HACCP) plan has been designed and applied to the production process. Potential biological, chemical, and physical hazards in each manufacturing procedure were identified. Critical control points for the peanut butter ice cream were then determined as the pasteurization and freezing process. The establishment of a monitoring system, corrective actions, verification procedures, and documentation and record keeping were followed to complete the HACCP program. The results of this study indicate that implementing the HACCP system in food industries can effectively enhance food safety and quality while improving the production management. Copyright © 2015. Published by Elsevier B.V.

Implementing a 6-day physiotherapy service in rehabilitation: exploring staff perceptions.

PubMed

Caruana, Erin L; Kuys, Suzanne S; Clarke, Jane; Brauer, Sandra G

2017-11-20

Objective Australian weekend rehabilitation therapy provision is increasing. Staff engagement optimises service delivery. The present mixed-methods process evaluation explored staff perceptions regarding implementation of a 6-day physiotherapy service in a private rehabilitation unit. Methods All multidisciplinary staff working in the rehabilitation unit were surveyed regarding barriers, facilitators and perceptions of the effect of a 6-day physiotherapy service on length of stay (LOS) and patient goal attainment at three time points: before and after implementation, as well as after modification of a 6-day physiotherapy service. Descriptive statistics and thematic analysis was used to analyse the data. Results Fifty-one staff (50%) responded. Before implementation, all staff identified barriers, the most common being staffing (62%) and patient selection (29%). After implementation, only 30% of staff identified barriers, which differed to those identified before implementation, and included staff rostering and experience (20%), timing of therapy (10%) and increasing the allocation of patients (5%). Over time, staff perceptions changed from being unsure to being positive about the effect of the 6-day service on LOS and patient goal attainment. Conclusion Staff perceived a large number of barriers before implementation of a 6-day rehabilitation service, but these did not eventuate following implementation. Staff perceived improved LOS and patient goal attainment after implementation of a 6-day rehabilitation service incorporating staff feedback. What is known about this topic? Rehabilitation weekend services improve patient quality of life and functional independence while reducing LOS. What does this study add? Staff feedback during implementation and modification of new services is important to address potential barriers and ensure staff satisfaction and support. What are the implications for practitioners? Staff engagement and open communication are important to successfully implement a new service in rehabilitation.

Assessment of the U.S. Department of Defense Efforts to Develop an Effective Medical Logistics System within the Afghan National Security Forces

DTIC Science & Technology

2011-06-14

aggressively to strengthen measures aimed at ensuring a successful ANSF transition. Ongoing actions include: • Working with CURE International and the ANSF...sustainability include the following ongoing actions: • Working with CURE International and the MoD and MoI to complete, promulgate and implement Standards of Care...approximately June-August 2011. In addition, NTM-A/CSTC-A previously awarded an approximately $1.57M contract with the NGO CURE International to

Proctorship and mentoring: Its backbone and application in robotic surgery.

PubMed

Santok, Glen Denmer; Raheem, Ali Abdel; Kim, Lawrence Hc; Chang, Kidon; Chung, Byung Ha; Choi, Young Deuk; Rha, Koon Ho

2016-12-01

In pursuit of continuing medical education in robotic surgery, several forms of training have been implemented. This variable application of curriculum has brought acquisition of skills in a heterogeneous and unstandardized fashion from different parts of the world. Recently, efforts have been made to provide cost effective and well-structured curricula with the aim of bridging the gap between formal fellowship training and short courses. Proctorship training has been implicated on some curriculum to provide excellent progression during the learning curve while ensuring patient safety.

Methodology to identify risk-significant components for inservice inspection and testing

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

Anderson, M.T.; Hartley, R.S.; Jones, J.L. Jr.

1992-08-01

Periodic inspection and testing of vital system components should be performed to ensure the safe and reliable operation of Department of Energy (DOE) nuclear processing facilities. Probabilistic techniques may be used to help identify and rank components by their relative risk. A risk-based ranking would allow varied DOE sites to implement inspection and testing programs in an effective and cost-efficient manner. This report describes a methodology that can be used to rank components, while addressing multiple risk issues.

Sexual Assault: Actions Needed to Improve DOD’s Prevention Strategy and to Help Ensure It Is Effectively Implemented

DTIC Science & Technology

2015-11-01

assault is a crime that devastates victims and has a far- reaching negative impact for DOD because it undermines DOD’s core values, degrades...must take place to achieve the greatest, and most lasting impact . Figure 1: CDC’s Model of Four Domains in Which Risk and Protective Factors Can...associating with sexually aggressive and delinquent peers and having an emotionally unsupportive familial environment as possible influences on the

Fracture resistance behaviour of gamma-irradiation sterilized cortical bone protected with a ribose pre-treatment

NASA Astrophysics Data System (ADS)

Woodside, Carman Mitchell

Structural bone allograft reconstructions are often implemented to repair large skeletal defects. To ensure the biological safety of the patient, allograft material is routinely sterilized with gamma-irradiation prior to implantation. The sterilization process damages the tissue, specifically the collagen protein network, leading to severe losses in the mechanical properties of the bone. Our lab has begun developing a ribose pre-treatment that can protect bone from these harmful effects. The goals of the present study were to develop a method to measure the fracture toughness of bone, an important clinical failure mode, and implement it to determine the effectiveness of the ribose pre-treatment on fracture toughness. We have shown that the ribose pre-treatment is successful at protecting some of the original fracture toughness of sterilized bone, and that the connectivity of the collagen network is an important contributor to the fracture resistance of bone.

How treating the patient with diabetes can enhance your practice: recommendations for practice management.

PubMed

Levin, Roger P

2003-10-01

The ability of dental practices to remain productive and profitable over time depends on their capacity to serve patients comprehensively. The increasing diversity in the patient population demands that practices customize services to ensure exceptional care for all patients. This diversity is particularly prevalent in patient subpopulations with unique medical conditions and treatment needs, such as patients with diabetes. Proper and effective management of patients with diabetes requires that the practice evaluate all aspects of patient interaction. Systems need to be customized so that all procedures and patient communication scripts are implemented consistently to meet the distinct needs of patients with diabetes. A significant return on investment in customized systems can be realized if the practice implements effective marketing strategies to both attract this population of patients and brand the practice as a unique and specialized service provider.

National Cost-effectiveness of ASHRAE Standard 90.1-2010 Compared to ASHRAE Standard 90.1-2007

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

Thornton, Brian; Halverson, Mark A.; Myer, Michael

Pacific Northwest National Laboratory (PNNL) completed this project for the U.S. Department of Energy’s (DOE’s) Building Energy Codes Program (BECP). DOE’s BECP supports upgrading building energy codes and standards, and the states’ adoption, implementation, and enforcement of upgraded codes and standards. Building energy codes and standards set minimum requirements for energy-efficient design and construction for new and renovated buildings, and impact energy use and greenhouse gas emissions for the life of buildings. Continuous improvement of building energy efficiency is achieved by periodically upgrading energy codes and standards. Ensuring that changes in the code that may alter costs (for building components,more » initial purchase and installation, replacement, maintenance and energy) are cost-effective encourages their acceptance and implementation. ANSI/ASHRAE/IESNA Standard 90.1 is the energy standard for commercial and multi-family residential buildings over three floors.« less

Cost-effectiveness of ASHRAE Standard 90.1-2010 Compared to ASHRAE Standard 90.1-2007

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

Thornton, Brian A.; Halverson, Mark A.; Myer, Michael

Pacific Northwest National Laboratory (PNNL) completed this project for the U.S. Department of Energy’s (DOE’s) Building Energy Codes Program (BECP). DOE’s BECP supports upgrading building energy codes and standards, and the states’ adoption, implementation, and enforcement of upgraded codes and standards. Building energy codes and standards set minimum requirements for energy-efficient design and construction for new and renovated buildings, and impact energy use and greenhouse gas emissions for the life of buildings. Continuous improvement of building energy efficiency is achieved by periodically upgrading energy codes and standards. Ensuring that changes in the code that may alter costs (for building components,more » initial purchase and installation, replacement, maintenance and energy) are cost-effective encourages their acceptance and implementation. ANSI/ASHRAE/IESNA Standard 90.1 is the energy standard for commercial and multi-family residential buildings over three floors.« less

Development of Safe and Effective Botanical Dietary Supplements

PubMed Central

2015-01-01

Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug–botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements. PMID:26125082

Synthetic Biology and Human Health: Potential Applications for Spaceflight

NASA Technical Reports Server (NTRS)

Karouia, Fathi; Carr, Christopher; Cai, Yizhi; Chen, Y.; Grenon, Marlene; Larios-Sanz, Maia; Jones, Jeffrey A.; Santos, Orlando

2011-01-01

Human space travelers experience a unique environment that affects homeostasis and physiologic adaptation. Spaceflight-related changes have been reported in the musculo-skeletal, cardiovascular, neurovestibular, endocrine, and immune systems. The spacecraft environment further subjects the traveler to noise and gravitational forces, as well as airborne chemical, microbiological contaminants, and radiation exposure. As humans prepare for longer duration missions effective countermeasures must be developed, verified, and implemented to ensure mission success. Over the past ten years, synthetic biology has opened new avenues for research and development in areas such as biological control, biomaterials, sustainable energy production, bioremediation, and biomedical therapies. The latter in particular is of great interest to the implementation of long-duration human spaceflight capabilities. This article discusses the effects of spaceflight on humans, and reviews current capabilities and potential needs associated with the health of the astronauts where synthetic biology could play an important role in the pursuit of space exploration.

Project LEEWAY for Single Parents. PY95 Final Detailed Report.

ERIC Educational Resources Information Center

Lee Coll., Baytown, TX.

Project LEEWAY was implemented in July 1992 at Lee College, in Texas, to recruit low-income, academically disadvantaged single parents, displaced homemakers, and single pregnant women into nontraditional technical programs and provide necessary support services to ensure success. This report describes the implementation, components, and results of…

Tips for Ensuring Successful Software Implementation

ERIC Educational Resources Information Center

Weathers, Robert

2013-01-01

Implementing an enterprise-level, mission-critical software system is an infrastructure project akin to other sizable projects, such as building a school. It's costly and complex, takes a year or more to complete, requires the collaboration of many different parties, involves uncertainties, results in a long-lived asset requiring ongoing…

78 FR 58186 - Approval and Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

... Approval and Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for the 1997...) submissions from the State of Colorado to demonstrate that the SIP meets the infrastructure requirements of... NAAQS is promulgated, review their SIPs to ensure that they meet infrastructure requirements. The State...

78 FR 73445 - Disapproval, Approval and Promulgation of Air Quality Implementation Plan Revisions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-06

...] Disapproval, Approval and Promulgation of Air Quality Implementation Plan Revisions; Infrastructure... State of Wyoming to demonstrate that the SIP meets the infrastructure requirements of the Clean Air Act... revised NAAQS is promulgated, review their SIPs to ensure that they meet infrastructure requirements. The...

13 CFR 102.21 - Agency employees responsible for the Privacy Act of 1974.

Code of Federal Regulations, 2011 CFR

2011-01-01

... systems of records in that office. (c) Senior Agency Official for Privacy is SBA's Chief Information Officer (CIO) who has overall responsibility and accountability for ensuring the SBA's implementation of...) Chief, Freedom of Information/Privacy Acts (FOI/PA) Office oversees and implements the record access...

13 CFR 102.21 - Agency employees responsible for the Privacy Act of 1974.

Code of Federal Regulations, 2014 CFR

2014-01-01

... systems of records in that office. (c) Senior Agency Official for Privacy is SBA's Chief Information Officer (CIO) who has overall responsibility and accountability for ensuring the SBA's implementation of...) Chief, Freedom of Information/Privacy Acts (FOI/PA) Office oversees and implements the record access...

13 CFR 102.21 - Agency employees responsible for the Privacy Act of 1974.

Code of Federal Regulations, 2013 CFR

2013-01-01

... systems of records in that office. (c) Senior Agency Official for Privacy is SBA's Chief Information Officer (CIO) who has overall responsibility and accountability for ensuring the SBA's implementation of...) Chief, Freedom of Information/Privacy Acts (FOI/PA) Office oversees and implements the record access...

13 CFR 102.21 - Agency employees responsible for the Privacy Act of 1974.

Code of Federal Regulations, 2012 CFR

2012-01-01

... systems of records in that office. (c) Senior Agency Official for Privacy is SBA's Chief Information Officer (CIO) who has overall responsibility and accountability for ensuring the SBA's implementation of...) Chief, Freedom of Information/Privacy Acts (FOI/PA) Office oversees and implements the record access...

Commentary: The Tyranny of Time and the Reality Principle

ERIC Educational Resources Information Center

Gersten, Russell

2016-01-01

Each of the five articles in this special issue gets "into the weeds" in terms of studying actual classroom or school implementation of evidence-based or promising practices. Virtually all confront the issue of logistics and establishing an infrastructure for ensuring adequate implementation. In general, those studies that ask teachers…

Aspects of operational radiation protection during dismantling of nuclear facilities relevant for the estimation of internal doses.

PubMed

Labarta, T

2007-01-01

Operational radiation protection of workers during the dismantling of nuclear facilities is based on the same radiation protection principles as that applied in its exploitation period with the objective of ensuring proper implementation of the as-low-as-reasonably-achievable (ALARA) principle. These principles are: prior determination of the nature and magnitude of radiological risk; classification of workplaces and workers depending on the risks; implementation of control measures; monitoring of zones and working conditions, including, if necessary, individual monitoring. From the experiences and the lessons learned during the dismantling processes carried out in Spain, several important aspects in the practical implementation of these principles that directly influence and ensure an adequate prevention of exposures and the estimation of internal doses are pointed out, with special emphasis on the estimation of internal doses due to transuranic intakes.

Impact of formulary restriction with prior authorization by an antimicrobial stewardship program

PubMed Central

Reed, Erica E.; Stevenson, Kurt B.; West, Jessica E.; Bauer, Karri A.; Goff, Debra A.

2013-01-01

In an era of increasing antimicrobial resistance and few antimicrobials in the developmental pipeline, many institutions have developed antimicrobial stewardship programs (ASPs) to help implement evidence-based (EB) strategies for ensuring appropriate utilization of these agents. EB strategies for accomplishing this include formulary restriction with prior authorization. Potential limitations to this particular strategy include delays in therapy, prescriber pushback, and unintended increases in use of un-restricted antimicrobials; however, our ASP found that implementing prior authorization for select antimicrobials along with making a significant effort to educate clinicians on criteria for use ensured more appropriate prescribing of these agents, hopefully helping to preserve their utility for years to come. PMID:23154323

Impact of formulary restriction with prior authorization by an antimicrobial stewardship program.

PubMed

Reed, Erica E; Stevenson, Kurt B; West, Jessica E; Bauer, Karri A; Goff, Debra A

2013-02-15

In an era of increasing antimicrobial resistance and few antimicrobials in the developmental pipeline, many institutions have developed antimicrobial stewardship programs (ASPs) to help implement evidence-based (EB) strategies for ensuring appropriate utilization of these agents. EB strategies for accomplishing this include formulary restriction with prior authorization. Potential limitations to this particular strategy include delays in therapy, prescriber pushback, and unintended increases in use of un-restricted antimicrobials; however, our ASP found that implementing prior authorization for select antimicrobials along with making a significant effort to educate clinicians on criteria for use ensured more appropriate prescribing of these agents, hopefully helping to preserve their utility for years to come.

A qualitative analysis of success stories from Michiana Coordinated School Health Leadership institute participants.

PubMed

Dewitt, Natalie; Lohrmann, David K; O'Neill, James; Clark, Jeffrey K

2011-12-01

The purpose of this study was to detect and document common themes among success stories, along with challenges, as related by participants in the Michiana Coordinated School Health Leadership Institute. Four-member teams from 18 Michigan and Indiana school districts participated in semiannual Institute workshops over a 3-year period and were tasked with implementing Coordinated School Health Programs (CSHPs). Qualitative methods were used to generate themes from interviews. Data were gathered through a combined survey/interview process related to programmatic successes, evidence of success, and implementation challenges. One participant from 11 of 18 participating school districts completed the survey/interview. Each participant reported at least 1 success that had a positive effect on students and/or staff, many of which were related to the federally mandated wellness policy. With some notable exceptions, success was based on subjective judgments rather than systematically collected data. Unanimous expression of time constraints and being overworked in their current positions constituted major challenges. Although the Institute required only process evaluation, some participants collected outcome data, a task that is important in validating the benefits of CSHPs. Most districts were not able to hire the recommended coordinator to ensure implementation of health program planning initially developed during the institute. Encouragingly, at the time of data collection many teams were still acting to ensure health programming remained a priority. Nevertheless, without the network of social support provided by the Institute, some respondents struggled to maintain momentum. © 2011, American School Health Association.

The effect of transforming care at the bedside initiative on healthcare teams' work environments.

PubMed

Lavoie-Tremblay, Mélanie; O'Conner, Patricia; Harripaul, Anastasia; Biron, Alain; Ritchie, Judith; Lavigne, Genevieve L; Baillargeon, Sophie; Ringer, Justin; Macgibbon, Brenda; Taylor-Ducharme, Sharon; Sourdif, Jacynthe

2014-02-01

Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments. The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments. A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units. Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant. TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support. © 2013 Sigma Theta Tau International.

Preferred drug lists: potential impact on healthcare economics.

PubMed

Ovsag, Kimberly; Hydery, Sabrina; Mousa, Shaker A

2008-01-01

To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare. We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included "drug lists," "prior authorization," "prior approval," and "Medicaid." We added terms such as "influence use of other healthcare services," "quality of care," and "overall economic impact." We mainly used primary sources. Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c) the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact. The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care.

Maximizing the Implementation Quality of Evidence-Based Preventive Interventions in Schools: A Conceptual Framework

PubMed Central

Domitrovich, Celene E.; Bradshaw, Catherine P.; Poduska, Jeanne M.; Hoagwood, Kimberly; Buckley, Jacquelyn A.; Olin, Serene; Romanelli, Lisa Hunter; Leaf, Philip J.; Greenberg, Mark T.; Ialongo, Nicholas S.

2011-01-01

Increased availability of research-supported, school-based prevention programs, coupled with the growing national policy emphasis on use of evidence-based practices, has contributed to a shift in research priorities from efficacy to implementation and dissemination. A critical issue in moving research to practice is ensuring high-quality implementation of both the intervention model and the support system for sustaining it. The paper describes a three-level framework for considering the implementation quality of school-based interventions. Future directions for research on implementation are discussed. PMID:27182282

Management and integration of engineering and construction activities: Lessons learned from the AP1000{sup R} nuclear power plant China project

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

McCullough, M. C.; Ebeling-Koning, D.; Evans, M. C.

2012-07-01

The lessons learned during the early phase of design engineering and construction activities for the AP1000 China Project can be applied to any project involving multiple disciplines and multiple organizations. Implementation of a first-of-a-kind design to directly support construction activities utilizing resources assigned to design development and design delivery creates challenges with prioritization of activities, successful closure of issues, and communication between site organizations and the home office. To ensure successful implementation, teams were assigned and developed to directly support construction activities including prioritization of activities, site communication and ensuring closure of site emergent issues. By developing these teams, themore » organization is better suited to meet the demands of the construction schedule while continuing with design evolution of a standard plant and engineering delivery for multiple projects. For a successful project, proper resource utilization and prioritization are key for overcoming obstacles and ensuring success of the engineering organization. (authors)« less

Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique's SLMTA story.

PubMed

Masamha, Jessina; Skaggs, Beth; Pinto, Isabel; Mandlaze, Ana Paula; Simbine, Carolina; Chongo, Patrina; de Sousa, Leonardo; Kidane, Solon; Yao, Katy; Luman, Elizabeth T; Samogudo, Eduardo

2014-01-01

Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH) laboratory structure. This article outlines the steps followed to establish a national framework for quality improvement and embedding the SLMTA programme within existing MOH laboratory systems. The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and seven from partner organisations) conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist), workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented. The six laboratories demonstrated substantial improvement in audit scores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation. Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that country leadership, ownership and institutionalisation can set the stage for programme success and sustainability.

Changing how and what children learn in school with computer-based technologies.

PubMed

Roschelle, J M; Pea, R D; Hoadley, C M; Gordin, D N; Means, B M

2000-01-01

Schools today face ever-increasing demands in their attempts to ensure that students are well equipped to enter the workforce and navigate a complex world. Research indicates that computer technology can help support learning, and that it is especially useful in developing the higher-order skills of critical thinking, analysis, and scientific inquiry. But the mere presence of computers in the classroom does not ensure their effective use. Some computer applications have been shown to be more successful than others, and many factors influence how well even the most promising applications are implemented. This article explores the various ways computer technology can be used to improve how and what children learn in the classroom. Several examples of computer-based applications are highlighted to illustrate ways technology can enhance how children learn by supporting four fundamental characteristics of learning: (1) active engagement, (2) participation in groups, (3) frequent interaction and feedback, and (4) connections to real-world contexts. Additional examples illustrate ways technology can expand what children learn by helping them to understand core concepts in subjects like math, science, and literacy. Research indicates, however, that the use of technology as an effective learning tool is more likely to take place when embedded in a broader education reform movement that includes improvements in teacher training, curriculum, student assessment, and a school's capacity for change. To help inform decisions about the future role of computers in the classroom, the authors conclude that further research is needed to identify the uses that most effectively support learning and the conditions required for successful implementation.

Managing the health effects of temperature in response to climate change: challenges ahead.

PubMed

Huang, Cunrui; Barnett, Adrian G; Xu, Zhiwei; Chu, Cordia; Wang, Xiaoming; Turner, Lyle R; Tong, Shilu

2013-04-01

Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion. We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public's health from heat events and climate change. Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified. The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions.

Task Force Report 4. Report of the Task Force on Marketing and Communications

PubMed Central

Dickinson, John C.; Evans, Kenneth L.; Carter, Jan; Burke, Kevin

2004-01-01

BACKGROUND To ensure the success of the proposed New Model of family medicine and to create a better understanding of the nature and role of family medicine, an effective communications plan must be developed and implemented. This Future of Family Medicine task force report proposes strategies for communicating the role of family physicians within medicine, as well as to purchasers, consumers, and other entities. METHODS After reviewing the findings from the research conducted for the Future of Family Medicine project, the task force presents a preliminary brand-positioning strategy for family medicine messages. Based on this strategy, the task force identifies 5 major audiences to which family medicine communications should be directed. A consistent method was used to determine optimum strategies to address each audience: defining the audience, assessing the literature and other pertinent evidence, identifying the communication objectives, determining the key messages, developing brand promises, and proposing strategies and tactics to support the messages and objectives. Preliminary communications plans are then presented for each of the 5 target audiences. MAJOR FINDINGS It is important that the organizations involved in family medicine make a multiyear commitment of resources to implement and support an aggressive communications strategy, which is based on key messages to target audiences. A concerted effort is particularly needed to address the declining interest among medical students in the specialty. Implementing a comprehensive family medicine career development program may be one effective strategy to reverse this trend. To help eliminate the current confusion among the public regarding family medicine and to promote clarity and consistency in terminology, the specialty should replace the name family practice with family medicine and a new graphic symbol for the discipline of family medicine should be developed. CONCLUSION As a discipline, family medicine has failed to formulate and deliver a compelling message. New communications strategies must be implemented that will reach audiences in terms they understand and care about and in ways that convey a sense of the exciting role family physicians will play in the future. By actively implementing the communications plans described in this report, the specialty can enhance the impact and help ensure the widespread implementation of the proposed New Model of family medicine.

Strategic thinking.

PubMed

Waters, Adele

As part of the Care campaign, nurse leaders and patients' representatives drew up ten 'priorities for action' that should be implemented by all healthcare providers. Second on the list is ensuring staffing levels are adequate. This article shows there is increasing understanding of the direct link between numbers of nursing staff and quality of care. Evidence-based tools are vital, given the imperative to ensure patient safety in a time of cost-cutting.

[Equal Opportunities for Care in Obstetrics - A Quantitative Survey of Accessibility in Obstetric Departments in Austria].

PubMed

Schildberger, B; Ortner, N; Zenzmaier, C; König-Bachmann, M

2016-04-01

In everyday life women with disabilities are facing different challenges and discriminatory aspects. Especially the issue of pregnancy and motherhood is still critically discussed and subject to taboo. The aim of the present study is to survey the extent of structural measures on the one hand and additional specific service offers on the other hand that have been implemented in order to ensure accessibility and equitable care for women with disabilities in the obstetric departments in Austria. Data were collected by a self-developed non-standardised questionnaire, evaluating existing or implemented structural measures and specific service offerings that ensure accessibility. Data collection and analysis were performed using the online survey application "LimeSurvey" and SPSS, respectively. The survey data reveal that the obstetric departments largely conform to the requirements of the different building regulations. Additional measures or adaptations of the inventory for women with mobility or sensory impairments are at the discretion of the institution and thus are hardly implemented. Despite the small sample size it becomes obvious that the obstetric departments in Austria lack in many regards structures that ensure accessibility to care, nursing, counselling and support for women with sensory impairments or limited mobility. © Georg Thieme Verlag KG Stuttgart · New York.

Family presence during trauma activations and medical resuscitations in a pediatric emergency department: an evidence-based practice project.

PubMed

Kingsnorth, Jennifer; O'Connell, Karen; Guzzetta, Cathie E; Edens, Jacki Curreri; Atabaki, Shireen; Mecherikunnel, Anne; Brown, Kathleen

2010-03-01

The existing family presence literature indicates that implementation of a family presence policy can result in positive outcomes. The purpose of our evidence-based practice project was to evaluate a family presence intervention using the 6 A's of the evidence cycle (ask, acquire, appraise, apply, analyze, and adopt/adapt). For step 1 (ask), we propose the following question: Is it feasible to implement a family presence intervention during trauma team activations and medical resuscitations in a pediatric emergency department using national guidelines to ensure appropriate family member behavior and uninterrupted patient care? Regarding steps 2 through 4 (acquire, appraise, and apply), our demonstration project was conducted in a pediatric emergency department during the implementation of a new family presence policy. Our family presence intervention incorporated current appraisal of literature and national guidelines including family screening, family preparation, and use of family presence facilitators. We evaluated whether it was feasible to implement the steps of our intervention and whether the intervention was safe in ensuring uninterrupted patient care. With regard to step 5 (analyze), family presence was evaluated in 106 events, in which 96 families were deemed appropriate and chose to be present. Nearly all families (96%) were screened before entering the room, and all were deemed appropriate candidates. Facilitators guided the family during all events. One family presence event was terminated. In all cases patient care was not interrupted. Regarding step 6 (adopt/adapt), our findings document the feasibility of implementing a family presence intervention in a pediatric emergency department while ensuring uninterrupted patient care. We have adopted family presence as a standard practice. This project can serve as the prototype for others. Copyright (c) 2010 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Knowledge translation and implementation in spinal cord injury: a systematic review

PubMed Central

Noonan, VK; Wolfe, DL; Thorogood, NP; Park, SE; Hsieh, JT; Eng, JJ

2015-01-01

Objective To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. Methods MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. Results A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. Conclusion The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions. PMID:24796445

A model of therapist competencies for the empirically supported interpersonal psychotherapy for adolescent depression.

PubMed

Sburlati, Elizabeth S; Lyneham, Heidi J; Mufson, Laura H; Schniering, Carolyn A

2012-06-01

In order to treat adolescent depression, a number of empirically supported treatments (ESTs) have been developed from both the cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT-A) frameworks. Research has shown that in order for these treatments to be implemented in routine clinical practice (RCP), effective therapist training must be generated and provided. However, before such training can be developed, a good understanding of the therapist competencies needed to implement these ESTs is required. Sburlati et al. (Clin Child Fam Psychol Rev 14:89-109, 2011) developed a model of therapist competencies for implementing CBT using the well-established Delphi technique. Given that IPT-A differs considerably to CBT, the current study aims to develop a model of therapist competencies for the implementation of IPT-A using a similar procedure as that applied in Sburlati et al. (Clin Child Fam Psychol Rev 14:89-109, 2011). This method involved: (1) identifying and reviewing an empirically supported IPT-A approach, (2) extracting therapist competencies required for the implementation of IPT-A, (3) consulting with a panel of IPT-A experts to generate an overall model of therapist competencies, and (4) validating the overall model with the IPT-A manual author. The resultant model offers an empirically derived set of competencies necessary for effectively treating adolescent depression using IPT-A and has wide implications for the development of therapist training, competence assessment measures, and evidence-based practice guidelines. This model, therefore, provides an empirical framework for the development of dissemination and implementation programs aimed at ensuring that adolescents with depression receive effective care in RCP settings. Key similarities and differences between CBT and IPT-A, and the therapist competencies required for implementing these treatments, are also highlighted throughout this article.

Facilitators and barriers for the adoption, implementation and monitoring of child safety interventions: a multinational qualitative analysis.

PubMed

Scholtes, Beatrice; Schröder-Bäck, Peter; MacKay, J Morag; Vincenten, Joanne; Förster, Katharina; Brand, Helmut

2017-06-01

The efficiency and effectiveness of child safety interventions are determined by the quality of the implementation process. This multinational European study aimed to identify facilitators and barriers for the three phases of implementation: adoption, implementation and monitoring (AIM process). Twenty-seven participants from across the WHO European Region were invited to provide case studies of child safety interventions from their country. Cases were selected by the authors to ensure broad coverage of injury issues, age groups and governance level of implementation (eg, national, regional or local). Each participant presented their case and provided a written account according to a standardised template. Presentations and question and answer sessions were recorded. The presentation slides, written accounts and the notes taken during the workshops were analysed using thematic content analysis to elicit facilitators and barriers. Twenty-six cases (from 26 different countries) were presented and analysed. Facilitators and barriers were identified within eight general themes, applicable across the AIM process: management and collaboration; resources; leadership; nature of the intervention; political, social and cultural environment; visibility; nature of the injury problem and analysis and interpretation. The importance of the quality of the implementation process for intervention effectiveness, coupled with limited resources for child safety makes it more difficult to achieve successful actions. The findings of this study, divided by phase of the AIM process, provide practitioners with practical suggestions, where proactive planning might help increase the likelihood of effective implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Theory-Based Interventions Combining Mental Simulation and Planning Techniques to Improve Physical Activity: Null Results from Two Randomized Controlled Trials.

PubMed

Meslot, Carine; Gauchet, Aurélie; Allenet, Benoît; François, Olivier; Hagger, Martin S

2016-01-01

Interventions to assist individuals in initiating and maintaining regular participation in physical activity are not always effective. Psychological and behavioral theories advocate the importance of both motivation and volition in interventions to change health behavior. Interventions adopting self-regulation strategies that foster motivational and volitional components may, therefore, have utility in promoting regular physical activity participation. We tested the efficacy of an intervention adopting motivational (mental simulation) and volitional (implementation intentions) components to promote a regular physical activity in two studies. Study 1 adopted a cluster randomized design in which participants ( n = 92) were allocated to one of three conditions: mental simulation plus implementation intention, implementation intention only, or control. Study 2 adopted a 2 (mental simulation vs. no mental simulation) × 2 (implementation intention vs. no implementation intention) randomized controlled design in which fitness center attendees ( n = 184) were randomly allocated one of four conditions: mental simulation only, implementation intention only, combined, or control. Physical activity behavior was measured by self-report (Study 1) or fitness center attendance (Study 2) at 4- (Studies 1 and 2) and 19- (Study 2 only) week follow-up periods. Findings revealed no statistically significant main or interactive effects of the mental simulation and implementation intention conditions on physical activity outcomes in either study. Findings are in contrast to previous research which has found pervasive effects for both intervention strategies. Findings are discussed in light of study limitations including the relatively small sample sizes, particularly for Study 1, deviations in the operationalization of the intervention components from previous research and the lack of a prompt for a goal intention. Future research should focus on ensuring uniformity in the format of the intervention components, test the effects of each component alone and in combination using standardized measures across multiple samples, and systematically explore effects of candidate moderators.

Theory-Based Interventions Combining Mental Simulation and Planning Techniques to Improve Physical Activity: Null Results from Two Randomized Controlled Trials

PubMed Central

Meslot, Carine; Gauchet, Aurélie; Allenet, Benoît; François, Olivier; Hagger, Martin S.

2016-01-01

Interventions to assist individuals in initiating and maintaining regular participation in physical activity are not always effective. Psychological and behavioral theories advocate the importance of both motivation and volition in interventions to change health behavior. Interventions adopting self-regulation strategies that foster motivational and volitional components may, therefore, have utility in promoting regular physical activity participation. We tested the efficacy of an intervention adopting motivational (mental simulation) and volitional (implementation intentions) components to promote a regular physical activity in two studies. Study 1 adopted a cluster randomized design in which participants (n = 92) were allocated to one of three conditions: mental simulation plus implementation intention, implementation intention only, or control. Study 2 adopted a 2 (mental simulation vs. no mental simulation) × 2 (implementation intention vs. no implementation intention) randomized controlled design in which fitness center attendees (n = 184) were randomly allocated one of four conditions: mental simulation only, implementation intention only, combined, or control. Physical activity behavior was measured by self-report (Study 1) or fitness center attendance (Study 2) at 4- (Studies 1 and 2) and 19- (Study 2 only) week follow-up periods. Findings revealed no statistically significant main or interactive effects of the mental simulation and implementation intention conditions on physical activity outcomes in either study. Findings are in contrast to previous research which has found pervasive effects for both intervention strategies. Findings are discussed in light of study limitations including the relatively small sample sizes, particularly for Study 1, deviations in the operationalization of the intervention components from previous research and the lack of a prompt for a goal intention. Future research should focus on ensuring uniformity in the format of the intervention components, test the effects of each component alone and in combination using standardized measures across multiple samples, and systematically explore effects of candidate moderators. PMID:27899904

Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.

PubMed

Kondo, Karli K; Damberg, Cheryl L; Mendelson, Aaron; Motu'apuaka, Makalapua; Freeman, Michele; O'Neil, Maya; Relevo, Rose; Low, Allison; Kansagara, Devan

2016-04-01

Over the last decade, various pay-for-performance (P4P) programs have been implemented to improve quality in health systems, including the VHA. P4P programs are complex, and their effects may vary by design, context, and other implementation processes. We conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of P4P. We searched PubMed, PsycINFO, and CINAHL through April 2014, and reviewed reference lists. We included trials and observational studies of P4P implementation. Two investigators abstracted data and assessed study quality. We interviewed P4P researchers to gain further insight. Among 1363 titles and abstracts, we selected 509 for full-text review, and included 41 primary studies. Of these 41 studies, 33 examined P4P programs in ambulatory settings, 7 targeted hospitals, and 1 study applied to nursing homes. Related to implementation, 13 studies examined program design, 8 examined implementation processes, 6 the outer setting, 18 the inner setting, and 5 provider characteristics. Results suggest the importance of considering underlying payment models and using statistically stringent methods of composite measure development, and ensuring that high-quality care will be maintained after incentive removal. We found no conclusive evidence that provider or practice characteristics relate to P4P effectiveness. Interviews with 14 KIs supported limited evidence that effective P4P program measures should be aligned with organizational goals, that incentive structures should be carefully considered, and that factors such as a strong infrastructure and public reporting may have a large influence. There is limited evidence from which to draw firm conclusions related to P4P implementation. Findings from studies and KI interviews suggest that P4P programs should undergo regular evaluation and should target areas of poor performance. Additionally, measures and incentives should align with organizational priorities, and programs should allow for changes over time in response to data and provider input.

Implementing Evidence-Based Programs: Lessons Learned from the Field

ERIC Educational Resources Information Center

Powers, Jane; Maley, Mary; Purington, Amanda; Schantz, Karen; Dotterweich, Jutta

2015-01-01

Evidence-based programs (EBPs) are used in many health promotion efforts to ensure that the intended positive behavioral and health outcomes will be achieved. However, because EBPs are developed and tested in research settings, the contextual elements of real world implementation play an important role in their successful delivery in communities.…

24 CFR 983.102 - Housing accessibility for persons with disabilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Housing accessibility for persons...) and implementing regulations at 24 CFR part 8. The PHA shall ensure that the percentage of accessible.... 794), as implemented by HUD's regulations at 24 CFR part 8, subpart C. (b) Design and construction...

Implementing Ethics Policies in Developing Countries: Ploughing on Parched Ground?

ERIC Educational Resources Information Center

Mazonde, Isaac N.; Jackson-Malete, Jose; Sugarman, Jeremy

2007-01-01

It is globally expected that universities will ensure that policies guiding researchers' conduct are in place and adhered to. This expectation is not waived in developing countries. Successful implementation of an ethics policy is facilitated by an appropriate national regulatory framework on which to base the argument for compliance. However, it…

Employment Status, Teaching Load, and Student Performance in Online Community College Courses

ERIC Educational Resources Information Center

Salley, Witt; Shaw, Melanie

2015-01-01

A continued need exists for community college administrators to develop and implement strategies to ensure sufficient staffing to meet demand for online courses and promote student success. The problem this study addressed was threefold. First, online instructors in the local setting are overextended and are consequently unable to implement best…

Eight Conditions Influencing the Implementation of Educational Rights.

ERIC Educational Resources Information Center

Thomas, R. Murray

The extent to which claims to educational rights are actually fulfilled in a society depends on a variety of conditions. There are eight conditions that can contribute to a society's falling short in the implementation of those rights. The conditions include: (1) complacency--failure to take steps toward ensuring that the right is honored in…

An Update on Student Authentication: Implementation in Context

ERIC Educational Resources Information Center

McNabb, Lori

2010-01-01

This article discusses the implementation this year of the Department of Education's Higher Education Opportunity Act of 2008 (HEOA), which requires accreditors to ensure that an institution that offers distance or correspondence education has a process in place to establish that a student who registers in a course or program is also the same…

Implementing the Early Childhood Development Teacher Training Framework in Uganda: Gains and Challenges

ERIC Educational Resources Information Center

Ejuu, Godfrey

2012-01-01

Training of quality early childhood development (ECD) teachers is paramount in ensuring quality ECD service provision. This exploratory study focuses on the gains and challenges met in the implementation of the Uganda ECD teacher training framework. Data were obtained using questionnaires and interviews from principals and tutors of ECD teacher…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (SOPS) (UA-G-1.0)

EPA Science Inventory

The purpose of this SOP is to establish a uniform format for the preparation of SOPs. Use of these protocols ensures consistent implementation of project tasks, documents the preparation and implementation of the procedures used, describes quality control measures and the limits...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR RECEIPT OF EQUIPMENT AND IMPLEMENTATION SUPPLIES (UA-G-5.0)

EPA Science Inventory

The purpose of this SOP is to outline procedures for the receipt of equipment and field implementation supplies at the NHEXAS Arizona research project. This procedure was followed to ensure consistent data custody, storage, transfer, and analysis of a high quality during the Ari...

75 FR 18061 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Control of Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... Promulgation of Air Quality Implementation Plans; Texas; Control of Air Pollution From Motor Vehicles AGENCY... Chapter 114, Control of Air Pollution from Motor Vehicles. These revisions consist of the new Rebate Grant... air pollution regulations and control strategies to ensure that air quality meets the National Ambient...

The Introduction of Standardized External Testing in Ukraine: Challenges and Successes

ERIC Educational Resources Information Center

Kovalchuk, Serhiy; Koroliuk, Svitlana

2012-01-01

Standardized external testing (SET) began to be implemented in Ukraine in 2008 as an instrument for combating corruption in higher education and ensuring fair university admission. This article examines the conditions and processes that led to the introduction of SET, overviews its implementation over three years (2008-10), analyzes SET and…

29 CFR 1960.6 - Designation of agency safety and health officials.

Code of Federal Regulations, 2010 CFR

2010-07-01

... safety and health policy and program to carry out the provisions of section 19 of the Act, Executive... implementation of the agency policy and program as required by section 19 of the Act, Executive Order 12196, and... safety and health staff, equipment, materials, and training required to ensure implementation of an...

78 FR 48806 - Approval and Promulgation of Implementation Plans; Tennessee; Infrastructure Requirements for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

... Promulgation of Implementation Plans; Tennessee; Infrastructure Requirements for the 2008 Lead National Ambient... infrastructure requirements of the Clean Air Act (CAA or Act) for the 2008 Lead national ambient air quality... ``infrastructure'' SIP. TDEC certified that the Tennessee SIP contains provisions that ensure the 2008 Lead NAAQS...

Effects of performance feedback and coaching on the problem-solving process: Improving the integrity of implementation and enhancing student outcomes

NASA Astrophysics Data System (ADS)

Lundahl, Allison A.

Schools implementing Response to Intervention (RtI) procedures frequently engage in team problem-solving processes to address the needs of students who require intensive and individualized services. Because the effectiveness of the problem-solving process will impact the overall success of RtI systems, the present study was designed to learn more about how to strengthen the integrity of the problem-solving process. Research suggests that school districts must ensure high quality training and ongoing support to enhance the effectiveness, acceptability, and sustainability of the problem-solving process within an RtI model; however, there is a dearth of research examining the effectiveness of methods to provide this training and support. Consequently, this study investigated the effects of performance feedback and coaching strategies on the integrity with which teams of educators conducted the problem-solving process in schools. In addition, the relationships between problem-solving integrity, teacher acceptability, and student outcomes were examined. Results suggested that the performance feedback increased problem-solving procedural integrity across two of the three participating schools. Conclusions about the effectiveness of the (a) coaching intervention and (b) interventions implemented in the third school were inconclusive. Regression analyses indicated that the integrity with which the teams conducted the problem-solving process was a significant predictor of student outcomes. However, the relationship between problem-solving procedural integrity and teacher acceptability was not statistically significant.

Case Studies in Modelling, Control in Food Processes.

PubMed

Glassey, J; Barone, A; Montague, G A; Sabou, V

This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

Intelligence by mechanics.

PubMed

Blickhan, Reinhard; Seyfarth, Andre; Geyer, Hartmut; Grimmer, Sten; Wagner, Heiko; Günther, Michael

2007-01-15

Research on the biomechanics of animal and human locomotion provides insight into basic principles of locomotion and respective implications for construction and control. Nearly elastic operation of the leg is necessary to reproduce the basic dynamics in walking and running. Elastic leg operation can be modelled with a spring-mass model. This model can be used as a template with respect to both gaits in the construction and control of legged machines. With respect to the segmented leg, the humanoid arrangement saves energy and ensures structural stability. With the quasi-elastic operation the leg inherits the property of self-stability, i.e. the ability to stabilize a system in the presence of disturbances without sensing the disturbance or its direct effects. Self-stability can be conserved in the presence of musculature with its crucial damping property. To ensure secure foothold visco-elastic suspended muscles serve as shock absorbers. Experiments with technically implemented leg models, which explore some of these principles, are promising.

The Patient Self-Determination Act. A matter of life and death.

PubMed

Kelley, K

1995-03-01

The Patient Self-Determination Act (PSDA) is a federal law, and compliance is mandatory. It is the purpose of this act to ensure that a patient's right to self-determination in health care decisions be communicated and protected. Through advance directives--the living will and the durable power of attorney--the right to accept or reject medical or surgical treatment is available to adults while competent, so that in the event that such adults become incompetent to make decisions, they would more easily continue to control decisions affecting their health care. Without advance directives and the proper adherence to such directives, former President Richard Nixon and former First Lady Jacqueline Kennedy Onassis might still be alive today, in persistent vegetative states. This article examines the history of the act, its importance to each individual, the clinical, ethical and legal issues, and the role of health care professionals in effectively implementing and ensuring compliance of the PSDA.

Total Diet Studies as a Tool for Ensuring Food Safety

PubMed Central

Lee, Joon-Goo; Kim, Sheen-Hee; Kim, Hae-Jung

2015-01-01

With the diversification and internationalization of the food industry and the increased focus on health from a majority of consumers, food safety policies are being implemented based on scientific evidence. Risk analysis represents the most useful scientific approach for making food safety decisions. Total diet study (TDS) is often used as a risk assessment tool to evaluate exposure to hazardous elements. Many countries perform TDSs to screen for chemicals in foods and analyze exposure trends to hazardous elements. TDSs differ from traditional food monitoring in two major aspects: chemicals are analyzed in food in the form in which it will be consumed and it is cost-effective in analyzing composite samples after processing multiple ingredients together. In Korea, TDSs have been conducted to estimate dietary intakes of heavy metals, pesticides, mycotoxins, persistent organic pollutants, and processing contaminants. TDSs need to be carried out periodically to ensure food safety. PMID:26483881

Yucca Mountain Biological Resources Monitoring Program; Annual report, FY91

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

NONE

1992-01-01

The US Department of Energy (DOE) is required by the Nuclear Waste Policy Act of 1982 (as amended in 1987) to study and characterize Yucca Mountain as a possible site for a geologic repository for high-level nuclear waste. During site characterization, the DOE will conduct a variety of geotechnical, geochemical, geological, and hydrological studies to determine the suitability of Yucca Mountain as a repository. To ensure that site characterization activities (SCA) do not adversely affect the Yucca Mountain area, an environmental program has been implemented to monitor and mitigate potential impacts and to ensure that activities comply with applicable environmentalmore » regulations. This report describes the activities and accomplishments during fiscal year 1991 (FY91) for six program areas within the Terrestrial Ecosystem component of the YMP environmental program. The six program areas are Site Characterization Activities Effects, Desert Tortoises, Habitat Reclamation, Monitoring and Mitigation, Radiological Monitoring, and Biological Support.« less

Twenty-five years of the WHO vaccines prequalification programme (1987-2012): lessons learned and future perspectives.

PubMed

Dellepiane, Nora; Wood, David

2015-01-01

The World Health Organization (WHO) vaccines prequalification programme was established in 1987. It is a service provided to United Nations procurement agencies to ensure that the vaccines supplied through these agencies are consistently safe and effective under conditions of use in national immunization programmes. This review describes the purpose and aims of the programme, its evolution during 25 years of existence, its added value, and its role in the context of the WHO strategy to ensure the global availability of vaccines of assured quality. The rationale for changes introduced during the implementation of the programme is provided. The paper also discusses the resources involved, both human and financial, its performance, strengths and weaknesses and steps taken to maximize its efficiency. This historical perspective is used to inform proposed future changes to the service. Copyright © 2013 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

Will the new Australian health privacy law provide adequate protection?

PubMed

Bomba, David; Hallit, George

2002-01-01

Amendments to the original Privacy Act (1988) come at a key point in time, as a national medical record system looms on the Australian horizon. Changes to The Privacy Act have the potential to define a level of information privacy prior to the implementation of such a system. We have therefore collected expert opinions on the ability of the Health Privacy Guidelines (enacted in December 2001 under The Privacy Act and hereafter more specifically known as Health Privacy Legislation) to ensure the privacy and security of patient information. We conclude that the legislation is flawed in its capacity to withstand an increasingly corporatised health sector. Deficiencies in consent requirements, together with feeble enforcement capabilities, mean The Legislation cannot effectively ensure that personally identifiable information will not end up in corporate third party hands. To significantly bolster the new legislation, we argue that it should be supplemented with explicit health data legislation and privacy auditing.

Student experiences across multiple flipped courses in a single curriculum.

PubMed

Khanova, Julia; Roth, Mary T; Rodgers, Jo Ellen; McLaughlin, Jacqueline E

2015-10-01

The flipped classroom approach has garnered significant attention in health professions education, which has resulted in calls for curriculum-wide implementations of the model. However, research to support the development of evidence-based guidelines for large-scale flipped classroom implementations is lacking. This study was designed to examine how students experience the flipped classroom model of learning in multiple courses within a single curriculum, as well as to identify specific elements of flipped learning that students perceive as beneficial or challenging. A qualitative analysis of students' comments (n = 6010) from mid-course and end-of-course evaluations of 10 flipped courses (in 2012-2014) was conducted. Common and recurring themes were identified through systematic iterative coding and sorting using the constant comparison method. Multiple coders, agreement through consensus and member checking were utilised to ensure the trustworthiness of findings. Several themes emerged from the analysis: (i) the perceived advantages of flipped learning coupled with concerns about implementation; (ii) the benefits of pre-class learning and factors that negatively affect these benefits, such as quality and quantity of learning materials, as well as overall increase in workload, especially in the context of multiple concurrent flipped courses; (iii) the role of the instructor in the flipped learning environment, particularly in engaging students in active learning and ensuring instructional alignment, and (iv) the need for assessments that emphasise the application of knowledge and critical thinking skills. Analysis of data from 10 flipped courses provided insight into common patterns of student learning experiences specific to the flipped learning model within a single curriculum. The study points to the challenges associated with scaling the implementation of the flipped classroom across multiple courses. Several core elements critical to the effective design and implementation of the flipped classroom model are identified. © 2015 John Wiley & Sons Ltd.

Effective factor of virtual team: Resolving communication breakdown in IBS construction project

NASA Astrophysics Data System (ADS)

Pozin, Mohd Affendi Ahmad; Nawi, Mohd. Nasrun Mohd.

2016-08-01

Currently, rapid development of information technology has provided new opportunities to organisation toward increasing the effectiveness of collaboration and teamwork management. Thus the virtual team approach has been implemented in numerous of field. However, there is limited study of virtual team in construction project management. Currently IBS project is still based on traditional construction process which is isolation team working environment. Therefore this approach has been declared as a main barrier to ensure cooperative working relation in term of communication and information in between project stakeholders. Thus, this paper through literature review is attempted to present a discussion of the virtual team approach toward IBS project in developing effective team communication during construction project.

We have the programme, what next? Planning the implementation of an injury prevention programme

PubMed Central

Donaldson, Alex; Lloyd, David G; Gabbe, Belinda J; Cook, Jill

2017-01-01

Background and aim The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. Methods An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. Results An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. Conclusions A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context. PMID:26787739

[Regulatory Program for Medical Devices in Cuba: experiences and current challenges].

PubMed

Pereira, Dulce María Martínez; Rodríguez, Yadira Álvarez; Valdés, Yamila Cedeño; Ribas, Silvia Delgado

2016-05-01

Regulatory control of medical devices in Cuba is conducted through a system based on the Regulatory Program for Medical Devices as a way to ensure the safety, efficacy, and effectiveness of these technologies, which are in use by the National Health System. This program was launched in 1992, when the Regulations for State Evaluation and Registration of Medical Devices were approved. Its successive stages and the merging of regulatory activities for drugs and medical equipment have meant progress toward stronger, more transparent strategies and greater control of industry and the National Health System. Throughout its course the Cuban program has met with challenges and difficulties that it has addressed by drawing on its own experiences. During the new period, the greatest challenges revolve around ensuring that regulatory systems incorporate scientific evaluation, risk levels, maximum rigor through the use of technical standards, and the implementation of international recommendations, together with the application of the ISO 13485 certification scheme, enhanced market monitoring, and classification of medical devices in accordance with their relevance to the country's national health policies. From the regional standpoint, the greatest challenge lies in working toward regulatory convergence. The Collaborating Centre for the Regulation of Health Technologies will support the proposed regulatory strategy and established regional priorities, in particular in connection with the implementation of actions involving medical devices.

[Designing and implementation of a web-based quality monitoring system for plasma glucose measurement in multicenter population study].

PubMed

Liu, Yong; Wang, Limin; Pang, Richard; Mo, Nanxun; Hu, Yan; Deng, Qian; Hu, Zhaohui

2015-05-01

The aim of this paper is to describe the designing and implementation of a web-based plasma glucose measurement quality monitoring system to assess the analytical quality of plasma glucose measurements in multicenter population study and provide evidence for the future studies. In the chronic non-communicable disease and related factor surveillance in China, a web based quality monitoring system for plasma glucose measurement was established to conduct evaluation on plasma glucose monitoring quality and effectiveness in 302 surveillance centers, including quality control data entry, transmission and feedback. The majority of the surveillance centers met the quality requirements and passed the evaluation of reproducibility and precision of plasma glucose measurement, only a few centers required intensive training and re-assessment. In order to ensure the completeness and reliability of plasma glucose measurement in the surveillance centers, the establishment of web-based plasma glucose measurement quality control system can facilitate the identification of the qualified surveillance centers and evaluation of plasma glucose measurement quality in different regions. Communication and training are important in ensuring plasma glucose measurement quality. It is necessary to further improve this web-based plasma glucose measurement quality monitoring system in the future to reduce the method specific plasma glucose measurement bias.

Health promotion in Brazil.

PubMed

Buss, Paulo Marchiori; de Carvalho, Antonio Ivo

2007-01-01

The evolution of health promotion within the Brazilian health system is examined, including an assessment of the intersectoral and development policies that have influenced the process. Particular attention is paid to the legal characteristics of the Unified Health System. Human resources formation and research initiatives in health promotion are outlined, with a summary of the obstacles that need to be overcome in order to ensure the effective implementation of health promotion in the future. Up to the end of the 20th Century health promotion was not used as a term in the Brazilian public heath context. Health promoting activities were concentrated in the area of health education, although targeting the social determinants of health and the principle of intersectoral action were part of the rhetoric. The situation has changed during the last decade, with the publication of a national policy of health promotion, issued by the Ministry of Health and jointly implemented with the States and Municipals Health Secretaries. More recently there has been a re-emergence of the discourse on the social determinants of health and the formation of intersectoral public policies as the basis of a comprehensive health promotion. Health promotion infrastructure, particularly around human resources and financing, requires strengthening in order to ensure capacity and sustainability in health promotion practice.

Policy challenges and approaches for the conservation of mangrove forests in Southeast Asia.

PubMed

Friess, Daniel A; Thompson, Benjamin S; Brown, Ben; Amir, A Aldrie; Cameron, Clint; Koldewey, Heather J; Sasmito, Sigit D; Sidik, Frida

2016-10-01

Many drivers of mangrove forest loss operate over large scales and are most effectively addressed by policy interventions. However, conflicting or unclear policy objectives exist at multiple tiers of government, resulting in contradictory management decisions. To address this, we considered four approaches that are being used increasingly or could be deployed in Southeast Asia to ensure sustainable livelihoods and biodiversity conservation. First, a stronger incorporation of mangroves into marine protected areas (that currently focus largely on reefs and fisheries) could resolve some policy conflicts and ensure that mangroves do not fall through a policy gap. Second, examples of community and government comanagement exist, but achieving comanagement at scale will be important in reconciling stakeholders and addressing conflicting policy objectives. Third, private-sector initiatives could protect mangroves through existing and novel mechanisms in degraded areas and areas under future threat. Finally, payments for ecosystem services (PES) hold great promise for mangrove conservation, with carbon PES schemes (known as blue carbon) attracting attention. Although barriers remain to the implementation of PES, the potential to implement them at multiple scales exists. Closing the gap between mangrove conservation policies and action is crucial to the improved protection and management of this imperiled coastal ecosystem and to the livelihoods that depend on them. © 2016 Society for Conservation Biology.

Screening, diagnosis, and treatment of post-traumatic stress disorder.

PubMed

Wisco, Blair E; Marx, Brian P; Keane, Terence M

2012-08-01

Post-traumatic stress disorder (PTSD) is a prevalent problem among military personnel and veterans. Identification of effective screening tools, diagnostic technologies, and treatments for PTSD is essential to ensure that all individuals in need of treatment are offered interventions with proven efficacy. Well-validated methods for screening and diagnosing PTSD are now available, and effective pharmacological and psychological treatments can be offered. Despite these advances, many military personnel and veterans do not receive evidence-based care. We review the literature on screening, diagnosis, and treatment of PTSD in military populations, and discuss the challenges to implementing the best evidence-based practices in clinical settings.

An introduction to implementation science for the non-specialist.

PubMed

Bauer, Mark S; Damschroder, Laura; Hagedorn, Hildi; Smith, Jeffrey; Kilbourne, Amy M

2015-09-16

The movement of evidence-based practices (EBPs) into routine clinical usage is not spontaneous, but requires focused efforts. The field of implementation science has developed to facilitate the spread of EBPs, including both psychosocial and medical interventions for mental and physical health concerns. The authors aim to introduce implementation science principles to non-specialist investigators, administrators, and policymakers seeking to become familiar with this emerging field. This introduction is based on published literature and the authors' experience as researchers in the field, as well as extensive service as implementation science grant reviewers. Implementation science is "the scientific study of methods to promote the systematic uptake of research findings and other EBPs into routine practice, and, hence, to improve the quality and effectiveness of health services." Implementation science is distinct from, but shares characteristics with, both quality improvement and dissemination methods. Implementation studies can be either assess naturalistic variability or measure change in response to planned intervention. Implementation studies typically employ mixed quantitative-qualitative designs, identifying factors that impact uptake across multiple levels, including patient, provider, clinic, facility, organization, and often the broader community and policy environment. Accordingly, implementation science requires a solid grounding in theory and the involvement of trans-disciplinary research teams. The business case for implementation science is clear: As healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science plays a critical role in supporting these efforts.

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

Farren Hunt

Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for fiscal year (FY) 2013. Results of the FY 2012 annual effectiveness review demonstrated that the INL’s ISMS program was significantly strengthened. Actions implemented by the INL demonstrate that the overall Integrated Safety Management System is sound and ensures safemore » and successful performance of work while protecting workers, the public, and environment. This report also provides several opportunities for improvement that will help further strengthen the ISM Program and the pursuit of safety excellence. Demonstrated leadership and commitment, continued surveillance, and dedicated resources have been instrumental in maturing a sound ISMS program. Based upon interviews with personnel, reviews of assurance activities, and analysis of ISMS process implementation, this effectiveness review concludes that ISM is institutionalized and is “Effective”.« less

Improving contact layer patterning using SEM contour based etch model

NASA Astrophysics Data System (ADS)

Weisbuch, François; Lutich, Andrey; Schatz, Jirka; Hertzsch, Tino; Moll, Hans-Peter

2016-10-01

The patterning of the contact layer is modulated by strong etch effects that are highly dependent on the geometry of the contacts. Such litho-etch biases need to be corrected to ensure a good pattern fidelity. But aggressive designs contain complex shapes that can hardly be compensated with etch bias table and are difficult to characterize with standard CD metrology. In this work we propose to implement a model based etch compensation method able to deal with any contact configuration. With the help of SEM contours, it was possible to get reliable 2D measurements particularly helpful to calibrate the etch model. The selections of calibration structures was optimized in combination with model form to achieve an overall errRMS of 3nm allowing the implementation of the model in production.

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.

Advanced Metering Installations – A Perspective from Federal Sites

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

Earni, Shankar

2016-05-02

This report is intended to provide guidance to the United States Department of Energy (DOE) and other federal agencies to highlight some of the existing practices related to advanced building metering systems. This study identified some of the existing actions related to advanced meter data and proposes how advanced metered data can be employed to develop robust cost effective measurement and verification (M&V) strategies. This report proposes an integrated framework on how advanced meter data can be used to identify energy conservation opportunities and to develop proactive M&V strategies to ensure that the savings for energy projects are being realized.more » This information will help improve metering, feedback, and dashboard implementations for reducing energy use at DOE facilities, based on lessons learned from various advanced metering implementations.« less

Finding Your Way™: a collaborative approach to increase awareness of missing person events among persons with dementia.

PubMed

Hillier, Loretta M; Harvey, David; Conway, Cathy; Hunt, Jocelyn; Hoffman, Ron

2016-04-01

To describe an innovative community-wide program aimed at increasing awareness of risks of missing person events among persons with dementia targeting various cultural groups and to present preliminary evaluation findings. Review of program records to describe program implementation and a community partner survey. Over 23 months, 386 partnerships were established to implement the program; 941 awareness-raising sessions were conducted reaching 23,495 individuals. There is an upward trend in number of sessions conducted in various languages and attendance. Community partners' (>85%) responded positively to the program and consultation process. This partnership experience demonstrates the effectiveness of a collaborative approach to the development and widespread dissemination of information and resource materials aimed at ensuring the safety of a vulnerable population.

Challenges to Implementing Communicable Disease Surveillance in New York City Evacuation Shelters After Hurricane Sandy, November 2012

PubMed Central

Ridpath, Alison D.; Bregman, Brooke; Jones, Lucretia; Reddy, Vasudha; Waechter, HaeNa

2015-01-01

Hurricane Sandy hit New York City (NYC) on October 29, 2012. Before and after the storm, 73 temporary evacuation shelters were established. The total census of these shelters peaked at approximately 6,800 individuals. Concern about the spread of communicable diseases in shelters prompted the NYC Department of Health and Mental Hygiene (DOHMH) to rapidly develop a surveillance system to report communicable diseases and emergency department transports from shelters. We describe the implementation of this system. Establishing effective surveillance in temporary shelters was challenging and required in-person visits by DOHMH staff to ensure reporting. After system establishment, surveillance data were used to identify some potential disease clusters. For the future, we recommend pre-event planning for disease surveillance. PMID:25552754

Model Guided Design and Development Process for an Electronic Health Record Training Program

PubMed Central

He, Ze; Marquard, Jenna; Henneman, Elizabeth

2016-01-01

Effective user training is important to ensure electronic health record (EHR) implementation success. Though many previous studies report best practice principles and success and failure stories, current EHR training is largely empirically-based and often lacks theoretical guidance. In addition, the process of training development is underemphasized and underreported. A white paper by the American Medical Informatics Association called for models of user training for clinical information system implementation; existing instructional development models from learning theory provide a basis to meet this call. We describe in this paper our experiences and lessons learned as we adapted several instructional development models to guide our development of EHR user training. Specifically, we focus on two key aspects of this training development: training content and training process. PMID:28269940

A modified theoretical framework to assess implementation fidelity of adaptive public health interventions.

PubMed

Pérez, Dennis; Van der Stuyft, Patrick; Zabala, Maríadel Carmen; Castro, Marta; Lefèvre, Pierre

2016-07-08

One of the major debates in implementation research turns around fidelity and adaptation. Fidelity is the degree to which an intervention is implemented as intended by its developers. It is meant to ensure that the intervention maintains its intended effects. Adaptation is the process of implementers or users bringing changes to the original design of an intervention. Depending on the nature of the modifications brought, adaptation could either be potentially positive or could carry the risk of threatening the theoretical basis of the intervention, resulting in a negative effect on expected outcomes. Adaptive interventions are those for which adaptation is allowed or even encouraged. Classical fidelity dimensions and conceptual frameworks do not address the issue of how to adapt an intervention while still maintaining its effectiveness. We support the idea that fidelity and adaptation co-exist and that adaptations can impact either positively or negatively on the intervention's effectiveness. For adaptive interventions, research should answer the question how an adequate fidelity-adaptation balance can be reached. One way to address this issue is by looking systematically at the aspects of an intervention that are being adapted. We conducted fidelity research on the implementation of an empowerment strategy for dengue prevention in Cuba. In view of the adaptive nature of the strategy, we anticipated that the classical fidelity dimensions would be of limited use for assessing adaptations. The typology we used in the assessment-implemented, not-implemented, modified, or added components of the strategy-also had limitations. It did not allow us to answer the question which of the modifications introduced in the strategy contributed to or distracted from outcomes. We confronted our empirical research with existing literature on fidelity, and as a result, considered that the framework for implementation fidelity proposed by Carroll et al. in 2007 could potentially meet our concerns. We propose modifications to the framework to assess both fidelity and adaptation. The modified Carroll et al.'s framework we propose may permit a comprehensive assessment of the implementation fidelity-adaptation balance required when implementing adaptive interventions, but more empirical research is needed to validate it.

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

34 CFR 75.210 - General selection criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for research activities, and the use of appropriate theoretical and methodological tools, including... project implementation, and the use of appropriate methodological tools to ensure successful achievement...

Systematic reviews and knowledge translation.

PubMed Central

Tugwell, Peter; Robinson, Vivian; Grimshaw, Jeremy; Santesso, Nancy

2006-01-01

Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings. PMID:16917652

Systematic reviews and knowledge translation.

PubMed

Tugwell, Peter; Robinson, Vivian; Grimshaw, Jeremy; Santesso, Nancy

2006-08-01

Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings.

Determining the Optimal Number of Core Needle Biopsy Passes for Molecular Diagnostics.

PubMed

Hoang, Nam S; Ge, Benjamin H; Pan, Lorraine Y; Ozawa, Michael G; Kong, Christina S; Louie, John D; Shah, Rajesh P

2018-03-01

The number of core biopsy passes required for adequate next-generation sequencing is impacted by needle cut, needle gauge, and the type of tissue involved. This study evaluates diagnostic adequacy of core needle lung biopsies based on number of passes and provides guidelines for other tissues based on simulated biopsies in ex vivo porcine organ tissues. The rate of diagnostic adequacy for pathology and molecular testing from lung biopsy procedures was measured for eight operators pre-implementation (September 2012-October 2013) and post-implementation (December 2013-April 2014) of a standard protocol using 20-gauge side-cut needles for ten core biopsy passes at a single academic hospital. Biopsy pass volume was then estimated in ex vivo porcine muscle, liver, and kidney using side-cut devices at 16, 18, and 20 gauge and end-cut devices at 16 and 18 gauge to estimate minimum number of passes required for adequate molecular testing. Molecular diagnostic adequacy increased from 69% (pre-implementation period) to 92% (post-implementation period) (p < 0.001) for lung biopsies. In porcine models, both 16-gauge end-cut and side-cut devices require one pass to reach the validated volume threshold to ensure 99% adequacy for molecular characterization, while 18- and 20-gauge devices require 2-5 passes depending on needle cut and tissue type. Use of 20-gauge side-cut core biopsy needles requires a significant number of passes to ensure diagnostic adequacy for molecular testing across all tissue types. To ensure diagnostic adequacy for molecular testing, 16- and 18-gauge needles require markedly fewer passes.

A Coordinated Patient Transport System for ICU Patients Requiring Surgery: Impact on Operating Room Efficiency and ICU Workflow.

PubMed

Brown, Michael J; Kor, Daryl J; Curry, Timothy B; Marmor, Yariv; Rohleder, Thomas R

2015-01-01

Transfer of intensive care unit (ICU) patients to the operating room (OR) is a resource-intensive, time-consuming process that often results in patient throughput inefficiencies, deficiencies in information transfer, and suboptimal nurse to patient ratios. This study evaluates the implementation of a coordinated patient transport system (CPTS) designed to address these issues. Using data from 1,557 patient transfers covering the 2006-2010 period, interrupted time series and before and after designs were used to analyze the effect of implementing a CPTS at Mayo Clinic, Rochester. Using a segmented regression for the interrupted time series, on-time OR start time deviations were found to be significantly lower after the implementation of CPTS (p < .0001). The implementation resulted in a fourfold improvement in on-time OR starts (p < .01) while significantly reducing idle OR time (p < .01). A coordinated patient transfer process for moving patient from ICUs to ORs can significantly improve OR efficiency, reduce nonvalue added time, and ensure quality of care by preserving appropriate care provider to patient ratios.

Adaptive control of dual-arm robots

NASA Technical Reports Server (NTRS)

Seraji, H.

1987-01-01

Three strategies for adaptive control of cooperative dual-arm robots are described. In the position-position control strategy, the adaptive controllers ensure that the end-effector positions of both arms track desired trajectories in Cartesian space despite unknown time-varying interaction forces exerted through the load. In the position-hybrid control strategy, the adaptive controller of one arm controls end-effector motions in the free directions and applied forces in the constraint directions, while the adaptive controller of the other arm ensures that the end-effector tracks desired position trajectories. In the hybrid-hybrid control strategy, the adaptive controllers ensure that both end-effectors track reference position trajectories while simultaneously applying desired forces on the load. In all three control strategies, the cross-coupling effects between the arms are treated as disturbances which are rejected by the adaptive controllers while following desired commands in a common frame of reference. The adaptive controllers do not require the complex mathematical model of the arm dynamics or any knowledge of the arm dynamic parameters or the load parameters such as mass and stiffness. The controllers have simple structures and are computationally fast for on-line implementation with high sampling rates.

Challenges in designing an All-Wales professional development programme to empower ward sisters and charge nurses.

PubMed

Jasper, Melanie A; Grundy, Lynne; Curry, Esther; Jones, Lynne

2010-09-01

To discuss the challenges of designing a professional development programme for ward managers working in in-patient facilities in Wales. In 2008, the Minister of Health launched the Free to Lead, Free to Care initiative to empower ward managers. One work-stream involved the creation of a universal professional development programme to ensure they had the skills and knowledge to function effectively in their roles in the newly restructured NHS in Wales. A collaborative, staged approach, involving multiple stakeholders, resulted in the design of a programme founded in principles of action and work-based learning tailored to the needs of the individual in attaining accredited competencies. Achieving buy-in and ownership from stakeholders are essential to ensure standardization and consistency of implementation of a universal programme. Shared responsibility and acceptance of key principles underpinning an individualized, work-based programme are fundamental to ensuring equity of outcome achievement. IMPLICATIONS FOR MANAGEMENT: Managerially facilitated cultural change is needed to embed individual work-based professional development programmes in the clinical environment, with practitioners supported through a variety of learning strategies appropriate to their learning needs. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

So near, yet so far: tobacco dependence treatment for pregnant women.

PubMed

Barker, Dianne; Orleans, Tracy; Halpin, Helen; Barry, Matthew

2004-04-01

Almost one-half million babies in the United States are born yearly to women who report smoking while pregnant. Almost all of these pregnant women have access to prenatal care, through federally financed health clinics, state and county health programs, or private providers. However, many pregnant smokers are unlikely to receive any type of counseling or assistance to help them stop smoking--despite the availability of evidence-based treatment and the considerable return on investment. This article recommends four next steps to ensure that tobacco dependence treatment is available for all pregnant women. These steps are (a). expanding Medicaid coverage for, and promotion of, effective counseling services for pregnant smokers, (b). improving health care systems by building the capacity of prenatal providers and health care systems to deliver effective treatments, (c). encouraging purchasers of private and public health benefit packages to demand coverage for, and promotion of, effective counseling services for pregnant smokers, and (d). redirecting state resources to ensure a statewide system of care for pregnant smokers. Implementation of these steps requires leadership, diligence, and action by the public health community--as well as ongoing monitoring to assess progress in improving coverage, capacity, and coordination.

An orthogonal return method for linearly polarized beam based on the Faraday effect and its application in interferometer

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

Chen, Benyong, E-mail: chenby@zstu.edu.cn; Zhang, Enzheng; Yan, Liping

2014-10-15

Correct return of the measuring beam is essential for laser interferometers to carry out measurement. In the actual situation, because the measured object inevitably rotates or laterally moves, not only the measurement accuracy will decrease, or even the measurement will be impossibly performed. To solve this problem, a novel orthogonal return method for linearly polarized beam based on the Faraday effect is presented. The orthogonal return of incident linearly polarized beam is realized by using a Faraday rotator with the rotational angle of 45°. The optical configuration of the method is designed and analyzed in detail. To verify its practicabilitymore » in polarization interferometry, a laser heterodyne interferometer based on this method was constructed and precision displacement measurement experiments were performed. These results show that the advantage of the method is that the correct return of the incident measuring beam is ensured when large lateral displacement or angular rotation of the measured object occurs and then the implementation of interferometric measurement can be ensured.« less

Implementing Governance for a New Era: An Action Plan for Higher Education Trustees

ERIC Educational Resources Information Center

American Council of Trustees and Alumni, 2014

2014-01-01

"Implementing Governance for a New Era" is an action plan to assist college and university trustees in reforming higher education. Delivered to more than 16,000 college and university trustees in November 2014, the plan provides details on how trustees properly represent the public by ensuring students receive a quality education at a…

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR RECEIPT OF EQUIPMENT AND FIELD IMPLEMENTATION SUPPLIES (UA-G-5.0)

EPA Science Inventory

The purpose of this SOP is to outline procedures for the receipt of equipment and field implementation supplies for the Arizona Border Study. This procedure was followed to ensure consistent data custody, storage, transfer, and analysis of a high quality during the Arizona NHEXA...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (SOPS) (UA-G-1.0)

EPA Science Inventory

The purpose of this SOP is to establish a uniform format for the preparation of SOPs. Use of these protocols ensures consistent implementation of project tasks, documents the preparation and implementation of the procedures used, describes quality control measures and the limits...

Customizing a Research-Based Reading Practice: Balancing the Importance of Implementation Fidelity with Professional Judgment

ERIC Educational Resources Information Center

McMaster, Kristen L.; Jung, Pyung-Gang; Brandes, Dana; Pinto, Viveca; Fuchs, Douglas; Kearns, Devin; Lemons, Christopher; Sáenz, Laura; Yen, Loulee

2014-01-01

Teachers are often asked to implement research-based instructional programs with fidelity and to ensure that all students reach high academic standards. These requests sometimes conflict when teachers find that not all their students are benefiting from the research-backed programs. In this article, we suggest that researchers and teachers can…

78 FR 36440 - Approval and Promulgation of Implementation Plans; Tennessee; 110(a)(1) and (2) Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... Lead National Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA). ACTION... the requirements of sections 110(a)(1) and (2) of the Clean Air Act (CAA or Act) for the 2008 Lead... that ensure the 2008 Lead NAAQS are implemented, enforced, and maintained in Tennessee. With the...

Shut Out: Denial of Education to Homeless Children.

ERIC Educational Resources Information Center

Friedman, Lorraine; Christiansen, Guy

The Stewart B. McKinney Act of 1987 was intended to remove barriers and ensure access to education for homeless children. But despite a 1988 consent decree, the United States Department of Education (DOE) has failed to comply with its statutory duties to implement the Act, the states have also failed to implement the Act adequately, and homeless…

Educating APNs for Implementing the Guidelines for Adolescents in "Bright Futures: Guidelines of Health Supervision of Infants, Children, and Adolescents."

ERIC Educational Resources Information Center

Porter, Cornelia P.; Pender, Nola J.; Hayman, Laura L.; Armstrong, Myrna L.; Riesch, Susan K.; Lewis, Mary Ann

1997-01-01

Discusses recommendations for preparing advanced practice nurses (APNs) to implement guidelines of a health curriculum: (1) ensuring age-appropriate teaching; (2) emphasizing the complex relationships of race/ethnicity, socioeconomic status, and gender; (3) reinforcing the self-care and resilience of adolescents; and (4) examining transitions…

Evaluating Your Program. Supported Education: A Promising Practice. Evidence-Based Practices KIT (Knowledge Informing Transformation)

ERIC Educational Resources Information Center

Unger, Karen V.

2011-01-01

Key stakeholders who implement Supported Education may find themselves asking two questions: (1) Has Supported Education been implemented as planned?; and (2) Has Supported Education resulted in the expected outcomes? Asking these two questions and using the answers to help improve Supported Education are critical for ensuring the success of one's…

'Virtual' central business office: how UMMS improved revenue cycle performance.

PubMed

Henciak, Bill; Fontaine, Christine; Fields, Keith; Parks, Stacy

2010-06-01

Based on its experience with implementing a virtual central business office, UMMS recommends the following steps to ensure the success of such an initiative: Define the process flow for the organization's day-today revenue cycle operations prior to implementation. Then select best practices and milestones for managing accounts. Identify any possible technology issues that could arise during implementation prior to go live. Hold a midproject debriefing with staff. Develop an organizational chart that details who is responsible for handling issues that arise during implementation and afterward.

Three decades of the WHO code and marketing of infant formulas.

PubMed

Forsyth, Stewart

2012-05-01

The International Code of Marketing of Breast Milk Substitutes states that governments, non-governmental organizations, experts, consumers and industry need to cooperate in activities aimed at improving infant nutrition. However, the evidence from the last three decades is that of a series of disputes, legal proceedings and boycotts. The purpose of this review is to assess the overall progress in the implementation of the Code and to examine the problematic areas of monitoring, compliance and governance. There are continuing issues of implementation, monitoring and compliance which predominantly reflect weak governance. Many Member States have yet to fully implement the Code recommendations and most States do not have adequate monitoring and reporting mechanisms. Application of the Code in developed countries may be undermined by a lack of consensus on the WHO recommendation of 6 months exclusive breastfeeding. There is evidence of continuing conflict and acrimony, especially between non-government organizations and industry. Measures need to be taken to encourage the Member States to implement the Code and to establish the governance systems that will not only ensure effective implementation and monitoring of the Code, but also deliver the Code within a spirit of participation, collaboration and trust.

Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program - Recommendations for Public Alerts Via Cell Phones

NASA Astrophysics Data System (ADS)

DeGroot, R. M.; Long, K.; Strauss, J. A.

2017-12-01

The United States Geological Survey (USGS) and its partners are developing the ShakeAlert Earthquake Early Warning System for the West Coast of the United States. To be an integral part of successful implementation, ShakeAlert engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education and communication efforts. The ShakeAlert Joint Committee for Communication, Education, and Outreach (JCCEO), is identifying, developing, and cultivating partnerships with ShakeAlert stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on ShakeAlert, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive a ShakeAlert warning. In February 2017, the JCCEO convened the Warning Message Focus Group (WMFG) to provide findings and recommendations to the Alliance for Telecommunications Industry Solutions on the use of earthquake early warning message content standards for public alerts via cell phones. The WMFG represents communications, education, and outreach stakeholders from various sectors including ShakeAlert regional coordinators, industry, emergency managers, and subject matter experts from the social sciences. The group knowledge was combined with an in-depth literature review to ensure that all groups who could receive the message would be taken into account. The USGS and the participating states and agencies acknowledge that the implementation of ShakeAlert is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

From Board to Bedside: How the Application of Financial Structures to Safety and Quality Can Drive Accountability in a Large Health Care System.

PubMed

Austin, J Matthew; Demski, Renee; Callender, Tiffany; Lee, K H Ken; Hoffman, Ann; Allen, Lisa; Radke, Deborah A; Kim, Yungjin; Werthman, Ronald J; Peterson, Ronald R; Pronovost, Peter J

2017-04-01

As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety. The four components implemented by Johns Hopkins Medicine were governance, accountability, reporting of consolidated quality performance statements, and auditing. Governance is provided by the health system's Patient Safety and Quality Board Committee, which reviews goals and strategy for patient safety and quality, reviews quarterly performance for each entity, and holds organizational leaders accountable for performance. An accountability plan includes escalating levels of review corresponding to the number of months an entity misses the defined performance target for a measure. A consolidated quality statement helps inform the Patient Safety and Quality Board Committee and leadership on key quality and safety issues. An audit evaluates the efficiency and effectiveness of processes for data collection, validation, and storage, as to ensure the accuracy and completeness of quality measure reporting. If hospitals and health systems truly want to prioritize improvements in safety and quality, they will need to create a performance management system that ensures data validity and supports performance accountability. Without valid data, it is difficult to know whether a performance gap is due to data quality or clinical quality. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Conformance Testing: Measurement Decision Rules

NASA Technical Reports Server (NTRS)

Mimbs, Scott M.

2010-01-01

The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to provide assurance to the customer that end products meet specifications. Measuring devices, often called measuring and test equipment (MTE), are used to provide the evidence of product conformity to specified requirements. Unfortunately, processes that employ MTE can become a weak link to the overall QMS if proper attention is not given to the measurement process design, capability, and implementation. Documented "decision rules" establish the requirements to ensure measurement processes provide the measurement data that supports the needs of the QMS. Measurement data are used to make the decisions that impact all areas of technology. Whether measurements support research, design, production, or maintenance, ensuring the data supports the decision is crucial. Measurement data quality can be critical to the resulting consequences of measurement-based decisions. Historically, most industries required simplistic, one-size-fits-all decision rules for measurements. One-size-fits-all rules in some cases are not rigorous enough to provide adequate measurement results, while in other cases are overly conservative and too costly to implement. Ideally, decision rules should be rigorous enough to match the criticality of the parameter being measured, while being flexible enough to be cost effective. The goal of a decision rule is to ensure that measurement processes provide data with a sufficient level of quality to support the decisions being made - no more, no less. This paper discusses the basic concepts of providing measurement-based evidence that end products meet specifications. Although relevant to all measurement-based conformance tests, the target audience is the MTE end-user, which is anyone using MTE other than calibration service providers. Topics include measurement fundamentals, the associated decision risks, verifying conformance to specifications, and basic measurement decisions rules.

Preferred drug lists: Potential impact on healthcare economics

PubMed Central

Ovsag, Kimberly; Hydery, Sabrina; Mousa, Shaker A

2008-01-01

Objectives To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare. Methods We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included “drug lists,” “prior authorization,” “prior approval,” and “Medicaid.” We added terms such as “influence use of other healthcare services,” “quality of care,” and “overall economic impact.” We mainly used primary sources. Results Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c)the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact. Conclusions The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care. PMID:18561515

The Influence of Nutrition Labeling and Point-of-Purchase Information on Food Behaviours.

PubMed

Volkova, Ekaterina; Ni Mhurchu, Cliona

2015-03-01

Point-of-purchase information on packaged food has been a highly debated topic. Various types of nutrition labels and point-of-purchase information have been studied to determine their ability to attract consumers' attention, be well understood and promote healthy food choices. Country-specific regulatory and monitoring frameworks have been implemented to ensure reliability and accuracy of such information. However, the impact of such information on consumers' behaviour remains contentious. This review summarizes recent evidence on the real-world effectiveness of nutrition labels and point-of-purchase information.

Shared decision making as part of value based care: New U.S. policies challenge our readiness.

PubMed

Spatz, Erica S; Elwyn, Glyn; Moulton, Benjamin W; Volk, Robert J; Frosch, Dominick L

2017-06-01

Shared decision making in the United States is increasingly being recognized as part of value-based care. During the last decade, several state and federal initiatives have linked shared decision making with reimbursement and increased protection from litigation. Additionally, private and public foundations are increasingly funding studies to identify best practices for moving shared decision making from the research world into clinical practice. These shifts offer opportunities and challenges for ensuring effective implementation. Copyright © 2017. Published by Elsevier GmbH.

An in-depth analysis of pharmaceutical regulation in the Republic of Moldova

PubMed Central

2014-01-01

Objective Regulation of the pharmaceutical system is a crucial, yet often neglected, component in ensuring access to safe and effective medicines. The aim of this study was to provide an in-depth analysis of the existing pharmaceutical regulation, including recent changes, in the Republic of Moldova. Methods Data from field work conducted by the World Health Organization (WHO) together with a review of policy documents and quantitative secondary data analysis was used to achieve this aim. Results This analysis identified several ways in which pharmaceutical regulation affects availability of quality medicines in the Republic of Moldova. These include lack of full implementation bioequivalence requirements for generics registration, incomplete implementation of good manufacturing practices and no implementation of good distribution practices, use of quality control instead of quality assurance as a method to ensure quality of medicines, frequent change of power within the Medicines and Medical Devices Agency (MMDA) leading to lack of long-term strategy and plans, conflict of interest between the different functions of the MMDA, the lack of sufficient funding for the MMDA to conduct its activities and to invest in continuous training of its staff (particularly inspectors) and very weak post-marketing control. Notably, several improvements have been recently introduced, including a roadmap for change for the MMDA, the introduction of good manufacturing practices and the drafting of a quality manual for the Agency. Conclusion Based on these findings the authors propose a set of priority actions to address existing gaps and draw lessons learned from other countries. PMID:25848544

Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program

NASA Astrophysics Data System (ADS)

DeGroot, R. M.; Strauss, J. A.; Given, D. D.; Cochran, E. S.; Burkett, E. R.; Long, K.

2016-12-01

Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing an EEW system for the West Coast of the United States. To be an integral part of successful implementation, EEW engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education efforts. Our presentation outlines how the USGS and its partners will approach this effort in the context of the EEW system through the work of a multistate and multiagency committee that participates in the design, implementation, and evaluation of a portfolio of programs and products. This committee, referred to as the ShakeAlert Joint Committee for Communication, Education, and Outreach (ShakeAlert CEO), is working to identify, develop, and cultivate partnerships with EEW stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on EEW, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the EEW alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive an EEW warning. The USGS and the participating states and agencies acknowledge that the implementation of EEW is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

Mainstreaming gender equality in the sustainable development process: 1992-1996.

PubMed

1997-01-01

One of the major contributions of Economic Commission for Africa (ECA) in the mainstreaming of gender equality into a sustainable development process was organizing the 5th African Regional Conference on Women in November 1994, in which a comprehensive policy document was formulated and adopted by all African governments. The policy contained in a document entitled the African Platform for Action (APA), which promotes the advancement of women through sustainable development. Its recommendations are being implemented together with the Global Platform for Action (GPA). To ensure the implementation of APA and GPA, ECA has set up various monitoring and implementation-coordinating groups such as the African Regional Coordinating Committee and the African Women's Communications and Development Network. In addition, ECA also facilitated the creation of the African Women Committee for Peace in November 1996, which will ensure the participation of women in the peace process at the highest level. All work programs of the ECA are expected to mainstream gender in their plans and activities.

Implementation of Enterprise Imaging Strategy at a Chinese Tertiary Hospital.

PubMed

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

2018-01-04

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

36 CFR 907.1 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... systematic and timely approaches which will ensure the integrated use of the natural and social sciences and... projects implementing the Plan; (e) Invite the cooperation and encourage the participation, where...

36 CFR 907.1 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... systematic and timely approaches which will ensure the integrated use of the natural and social sciences and... projects implementing the Plan; (e) Invite the cooperation and encourage the participation, where...

Managing the Health Effects of Temperature in Response to Climate Change: Challenges Ahead

PubMed Central

Barnett, Adrian G.; Xu, Zhiwei; Chu, Cordia; Wang, Xiaoming; Turner, Lyle R.; Tong, Shilu

2013-01-01

Background: Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion. Objectives: We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public’s health from heat events and climate change. Discussion: Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified. Conclusions: The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions. PMID:23407064

Primary care clinical practice guidelines in South Africa: qualitative study exploring perspectives of national stakeholders.

PubMed

Kredo, Tamara; Abrams, Amber; Young, Taryn; Louw, Quinette; Volmink, Jimmy; Daniels, Karen

2017-08-29

Clinical practice guidelines (CPGs) are common tools in policy and clinical practice informing clinical decisions at the bedside, governance of health facilities, health insurer and government spending, and patient choices. South Africa's health sector is transitioning to a national health insurance system, aiming to build on other primary health care initiatives to transform the previously segregated, inequitable services. Within these plans CPGs are an integral tool for delivering standardised and cost effective care. Currently, there is no accepted standard approach to developing, adapting or implementing CPGs efficiently or effectively in South Africa. We explored the current players; drivers; and the context and processes of primary care CPG development from the perspective of stakeholders operating at national level. We used a qualitative approach. Sampling was initially purposeful, followed by snowballing and further sampling to reach representivity of primary care service providers. Individual in-depth interviews were recorded and transcribed verbatim. We used thematic content analysis to analyse the data. We conducted 37 in-depth interviews from June 2014-July 2015. We found CPG development and implementation were hampered by lack of human and funding resources for technical and methodological work; fragmentation between groups, and between national and provincial health sectors; and lack of agreed systems for CPG development and implementation. Some CPG contributors steadfastly work to improve processes aiming to enhance communication, use of evidence, and transparency to ensure credible guidance is produced. Many interviewed had shared values, and were driven to address inequity, however, resource gaps were perceived to create an enabling environment for commercial interests or personal agendas to drive the CPG development process. Our findings identified strengths and gaps in CPG development processes, and a need for national standards to guide CPG development and implementation. Based on our findings and suggestions from participants, a possible way forward would be for South Africa to have a centrally coordinated CPG unit to address these needs and aspects of fragmentation by devising processes that support collaboration, transparency and credibility across sectors and disciplines. Such an initiative will require adequate resourcing to build capacity and ensure support for the delivery of high quality CPGs for South African primary care.

Health coaching in primary care: a feasibility model for diabetes care.

PubMed

Liddy, Clare; Johnston, Sharon; Nash, Kate; Ward, Natalie; Irving, Hannah

2014-04-03

Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches' capacity to perform their role. It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention.

Educational technology for millennial dental hygiene students: a survey of U.S. dental hygiene programs.

PubMed

Beebe, Catherine R R; Gurenlian, JoAnn R; Rogo, Ellen J

2014-06-01

A growing body of literature suggests that today's learners have changed and education must change as well since Millennial generation students expect technology to be used in their coursework. This study sought to determine what educational technology is being used in U.S. dental hygiene programs, what student and faculty perceptions are of the effectiveness of technology, and what barriers exist to implementing educational technology. A stratified random sample of 120 entry-level dental hygiene programs nationwide were invited to participate in a survey. Fourteen programs participated, yielding a pool of 415 potential individual participants; out of those, eighty-four student and thirty-eight faculty respondents were included in the analysis, a total of 122. Results were analyzed using descriptive statistics and a Mann-Whitney U test (p<0.05). Faculty and student respondents agreed on the effectiveness of educational technology in all areas except clickers and wikis. The faculty members tended to rate the effectiveness of educational technology higher than did the students. The greatest perceived barrier to implementing technology was technical difficulties. This study suggests that support services should be available to faculty and students to ensure successful implementation of technology. Dental hygiene educators have adopted many types of educational technology, but more data are needed to determine best practices.

Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

PubMed

Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

2006-01-01

Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

Pharmacists' views on implementing a disease state management program for low back pain.

PubMed

Abdel Shaheed, Christina; Maher, Christopher G; Williams, Kylie A; McLachlan, Andrew J

2016-01-01

Pharmacists have the potential to take a lead role in the primary care management of people with acute low back pain. The aim of this study was to investigate pharmacists' views on implementing a care program for people with acute low back pain in the community pharmacy. Recruitment of pharmacists for this study took place between July 2012 and March 2013. A convenience sample of 30 pharmacists who collaborated in recruiting participants for a low back pain clinical trial in Sydney (n=15 pharmacist recruiters and n=15 non-recruiters) completed an open-ended questionnaire. There was no marked variation in responses between the two groups. Participating pharmacists were receptive to the idea of implementing a care program for people with low back pain, highlighting the need for adequate reimbursement and adequate training of staff to ensure it is successful. Pharmacists identified that the follow up of people receiving such a service is dependent on several factors such as effective reminder systems and the proximity of patients to the pharmacy.

2017 Guidelines for the management of arterial hypertension in primary health care in Portuguese-speaking countries.

PubMed

Oliveira, Gláucia Maria Moraes de; Mendes, Miguel; Malachias, Marcus Vinícius Bolívar; Morais, João; Filho, Osni Moreira; Coelho, Armando Serra; Capingana, Daniel Pires; Azevedo, Vanda; Soares, Irenita; Menete, Alda; Ferreira, Beatriz; Soares, Miryan Bandeira Dos Prazeres Cassandra; Fernandes, Mário

2017-11-01

The World Health Organization goal's to reduce mortality due to chronic non-communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost-effective population interventions to reduce chronic non-communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese-speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

The role of organizational culture and leadership in water safety plan implementation for improved risk management.

PubMed

Summerill, Corinna; Pollard, Simon J T; Smith, Jennifer A

2010-09-15

Appropriate implementation of WSPs offers an important opportunity to engage in and promote preventative risk management within water utilities. To ensure success, the whole organization, especially executive management, need to be advocates. Illustrated by two case studies, we discuss the influence of organizational culture on buy-in and commitment to public health protection and WSPs. Despite an internal desire to undertake risk management, some aspects of organizational culture prevented these from reaching full potential. Enabling cultural features included: camaraderie; competition; proactive, involved leaders; community focus; customer service mentality; transparency; accountability; competent workforce; empowerment; appreciation of successes, and a continual improvement culture. Blocking features included: poor communication; inflexibility; complacency; lack of awareness, interest or reward and coercion. We urge water utilities to consider the influence of organizational culture on the success and sustainability of WSP adoption, and better understand how effective leadership can mould culture to support implementation. Copyright 2010 Elsevier B.V. All rights reserved.

The experience of implementing a 'TB village' for a pastoralist population in Cherrati, Ethiopia.

PubMed

Tayler-Smith, K; Khogali, M; Keiluhu, K; Jemmy, J-P; Ayada, L; Weyeyso, T; Issa, A M; De Maio, G; Harries, A D; Zachariah, R

2011-10-01

In Cherrati District, Somali Regional State (SRS), Ethiopia, despite a high burden of tuberculosis (TB), TB control activities are virtually absent. The majority of the population is pastoralist with a mobile lifestyle. TB care and treatment were offered using a 'TB village' approach that included traditional style residential care, community empowerment and awareness raising, provision of essential social amenities and essential food and non-food items. To describe 1) key aspects of the implementation of the TB village approach, 2) TB treatment outcomes and 3) the lessons learnt during implementation. Descriptive study. A total of 297 patients entered the TB village between September 2006 and October 2008; 271 (91%) patients were treated successfully, nine (3%) defaulted and 13 (4%) died. For pastoralist populations, a TB village approach may be effective for improving access to TB care, ensuring proper adherence to treatment and achieving good overall TB outcomes. The successes and challenges of this approach are discussed.

A way to motivate Danish GPs to implement a new national service.

PubMed

Kristensen, Alice; Wengler, Bente

2012-01-01

The Common Medicine card (CMC) is a new national service in Denmark which aim is to ensure better patient care and minimize medication errors. All health professionals as well as authorities have to use this system. CMC requires changing the organization of work for both physicians and clinical staff in General Practice (GP). Commissioning of CMC in GP requires a significant effort beyond the technical installation of the solution. Finding the right way to implement a new service in a busy GP has been the main focus of the national project organization MedCom. MedCom has in collaboration with the five regions in Denmark, established a joint plan and has created an implementation model contraining various initiatives including "after hours" meetings for each service provider of EMR (Electronic Medicine Records) in order to disseminate and support the new CMC service. This paper shows the status of the "after hours" meetings effect in dissemination of CMC from August to November 2011.

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

PubMed

American Pharmacists Association; Bough, Marcie

2011-01-01

To develop an improved risk evaluation and mitigation strategies (REMS) system for maximizing effective and safe patient medication use while minimizing burden on the health care delivery system. 34 stakeholders gathered October 6-7, 2010, in Arlington, VA, for the REMS Stakeholder Meeting, convened by the American Pharmacists Association (APhA). Participants included national health care provider associations, including representatives for physicians, physician assistants, nurses, nurse practitioners, and pharmacists, as well as representatives for patient advocates, drug distributors, community pharmacists (chain and independent), drug manufacturer associations (brand, generic, and biologic organizations), and health information technology, standards, and safety organizations. Staff from the Food and Drug Administration (FDA) Center for Drug Evaluation and Research participated as observers. The meeting built on themes from the APhA's 2009 REMS white paper. The current REMS environment presents many challenges for health care providers due to the growing number of REMS programs and the lack of standardization or similarities among various REMS programs. A standardized REMS process that focuses on maximizing patient safety and minimizing impacts on patient access and provider implementation could offset these challenges. A new process that includes effective provider interventions and standardized tools and systems for implementing REMS programs may improve patient care and overcome some of the communication issues providers and patients currently face. Metrics could be put in place to evaluate the effectiveness of REMS elements. By incorporating REMS program components into existing technologies and data infrastructures, achieving REMS implementation that is workflow neutral and minimizes administrative burden may be possible. An appropriate compensation model could ensure providers have adequate resources for patient care and REMS implementation. Overall, stakeholders should continue to work collaboratively with FDA and manufacturers to improve REMS program design and implementation issues. A workable REMS system will require effective patient interventions, standardized elements that limit barriers to implementation for both patients and providers, standardized yet flexible implementation strategies, use of existing technologies in practice settings, increased opportunities for provider input early in REMS design processes, improved communication strategies and awareness of program requirements, and viable provider compensation models needed to offset costs to implement and comply with REMS program requirements.

Managing symptoms during cancer treatments: evaluating the implementation of evidence-informed remote support protocols

PubMed Central

2012-01-01

Background Management of cancer treatment-related symptoms is an important safety issue given that symptoms can become life-threatening and often occur when patients are at home. With funding from the Canadian Partnership Against Cancer, a pan-Canadian steering committee was established with representation from eight provinces to develop symptom protocols using a rigorous methodology (CAN-IMPLEMENT©). Each protocol is based on a systematic review of the literature to identify relevant clinical practice guidelines. Protocols were validated by cancer nurses from across Canada. The aim of this study is to build an effective and sustainable approach for implementing evidence-informed protocols for nurses to use when providing remote symptom assessment, triage, and guidance in self-management for patients experiencing symptoms while undergoing cancer treatments. Methods A prospective mixed-methods study design will be used. Guided by the Knowledge to Action Framework, the study will involve (a) establishing an advisory knowledge user team in each of three targeted settings; (b) assessing factors influencing nurses’ use of protocols using interviews/focus groups and a standardized survey instrument; (c) adapting protocols for local use, ensuring fidelity of the content; (d) selecting intervention strategies to overcome known barriers and implementing the protocols; (e) conducting think-aloud usability testing; (f) evaluating protocol use and outcomes by conducting an audit of 100 randomly selected charts at each of the three settings; and (g) assessing satisfaction with remote support using symptom protocols and change in nurses’ barriers to use using survey instruments. The primary outcome is sustained use of the protocols, defined as use in 75% of the calls. Descriptive analysis will be conducted for the barriers, use of protocols, and chart audit outcomes. Content analysis will be conducted on interviews/focus groups and usability testing with comparisons across settings. Discussion Given the importance of patient safety, patient-centered care, and delivery of quality services, learning how to effectively implement evidence-informed symptom protocols in oncology healthcare services is essential for ensuring safe, consistent, and effective care for individuals with cancer. This study is likely to have a significant contribution to the delivery of remote oncology services, as well as influence symptom management by patients at home. PMID:23164244

Keeping the Spirit of Community Partnerships Alive in the Scale Up of HIV/AIDS Prevention: Critical Reflections on the Roll Out of DEBI (Diffusion of Effective Behavioral Interventions)

PubMed Central

Pinto, Rogério M.; Hunter, Joyce; Rapkin, Bruce; Remien, Robert H.

2009-01-01

DEBI, or the Diffusion of Effective Behavioral Interventions is the largest centralized effort to diffuse evidence-based prevention science to fight HIV/AIDS in the United States. DEBI seeks to ensure that the most effective science-based prevention interventions are widely implemented across the country in community-based organizations. Thus, this is a particularly timely juncture in which to critically reflect on the extent to which known principles of community collaboration have guided key processes associated with the DEBI rollout. We review the available evidence on how the dissemination of packaged interventions is necessary but not sufficient for ensuring the success of technology transfer. We consider additional principles that are vital for successful technology transfer, which were not central considerations in the rollout of the DEBI initiative. These issues are: (1) community perceptions of a top-down mode of dissemination; (2) the extent to which local innovations are being embraced, bolstered, or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Consideration of these additional factors is necessary in order to effectively document, manage, and advance the science of dissemination and technology transfer in centralized prevention efforts within and outside of HIV/AIDS. PMID:18612809

The cost-savings of implementing kangaroo mother care in Nicaragua.

PubMed

Broughton, Edward I; Gomez, Ivonne; Sanchez, Nieves; Vindell, Concepción

2013-09-01

To examine the costs of implementing kangaroo mother care (KMC) in a referral hospital in Nicaragua, including training, implementation, and ongoing operating costs, and to estimate the economic impact on the Nicaraguan health system if KMC were implemented in other maternity hospitals in the country. After receiving clinical training in KMC, the implementation team trained their colleagues, wrote guidelines for clinicians and education material for parents, and ensured adherence to the new guidelines. The intervention began September 2010 The study compared data on infant weight, medication use, formula consumption, incubator use, and hospitalization for six months before and after implementation. Cost data were collected from accounting records of the implementers and health ministry formularies. A total of 46 randomly selected infants before implementation were compared to 52 after implementation. Controlling for confounders, neonates after implementation had lower lengths of hospitalization by 4.64 days (P = 0.017) and 71% were exclusively breastfed (P < 0.001). The intervention cost US$ 23 113 but the money saved with shorter hospitalization, elimination of incubator use, and lower antibiotic and infant formula costs made up for this expense in 1 - 2 months. Extending KMC to 12 other facilities in Nicaragua is projected to save approximately US$ 166 000 (based on the referral hospital incubator use estimate) or US$ 233 000 after one year (based on the more conservative incubator use estimate). Treating premature and low-birth-weight infants in Nicaragua with KMC implemented as a quality improvement program saves money within a short period even without considering the beneficial health effects of KMC. Implementation in more facilities is strongly recommended.

Greening EPA

EPA Pesticide Factsheets

EPA ensures its buildings and practices reflect our mission by implementing strategies to reduce the environmental impact of its facilities and operations by building sustainable structures and improving the energy efficiency of older buildings.

10 CFR 440.16 - Minimum program requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... implement procedures to ensure that: (a) No dwelling unit may be weatherized without documentation that the... and providing weatherization assistance to: (1) Elderly persons; (2) Persons with disabilities; (3...

10 CFR 440.16 - Minimum program requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... implement procedures to ensure that: (a) No dwelling unit may be weatherized without documentation that the... and providing weatherization assistance to: (1) Elderly persons; (2) Persons with disabilities; (3...

42 CFR 73.17 - Records.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Accurate, current inventory for each select agent (including viral genetic elements, recombinant nucleic... individual or entity must implement a system to ensure that all records and data bases created under this...

Smart Grids and their Applicability for the Development of the Electricity Sector for Colombia in the year 2050

NASA Astrophysics Data System (ADS)

Viola, J.; Aceros, C.

2016-07-01

Smart Grids are a technology that can be used to implement a sustainable energy scheme of a country. Therefore, this paper proposes the development of a prospective analysis of Smart Grids as a tool to ensure energetic security in Colombia in 2050. Using LEAP software, a base scenario for Colombian energy demand has developed according to current policies, with a time horizon from 2012 to 2050. The energy analysis is based on three scenarios, taking into account the impact of cogeneration in the residential and industrial sector using renewable energy and the power quality indicators. The results show that the implementation of Smart Grids generate energy savings and increasing the coverage of the national electricity system, ensuring energetic security of the country by 2050.

Safeguarding Confidentiality in Electronic Health Records.

PubMed

Shenoy, Akhil; Appel, Jacob M

2017-04-01

Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health. Features of one institutional model are described that may illustrate the efforts to both ensure adequate transparency and ensure patient confidentiality. Trust and the therapeutic alliance are critical to the provider-patient relationship and quality healthcare services. All of the benefits of an EHR are only possible if patients retain confidence in the security and accuracy of their medical records.

Lessons Learned From Dissemination of Evidence-Based Interventions for HIV Prevention.

PubMed

Collins, Charles B; Sapiano, Tobey N

2016-10-01

In 1999, IOM issued a report that recommended that the Centers for Disease Control and Prevention should disseminate evidence-based HIV prevention interventions (EBIs) to be implemented by health departments, community-based organizations, drug treatment centers, and clinics. Based on these recommendations, the Diffusion of Effective Behavioral Interventions Project was initiated in 2000 and began disseminating interventions into public health practice. For 15 years, the Centers for Disease Control and Prevention has disseminated 29 EBIs to more than 11,300 agencies. Lessons were identified during the 15 years of implementation regarding successful methods of dissemination of EBIs. Lessons around selecting interventions for dissemination, developing a dissemination infrastructure including a resource website (https://effectiveinterventions.cdc.gov), and engagement with stakeholders are discussed. A continuous development approach ensured that intervention implementation materials, instructions, and technical assistance were all tailored to the needs of end users, focus populations, and agency capacities. Six follow-up studies demonstrated that adopters of EBIs were able to obtain comparable outcomes to those of the original efficacy research. The Diffusion of Effective Behavioral Interventions Project may offer guidance for other large, national, evidence-based public health dissemination projects. Published by Elsevier Inc.

Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry

PubMed Central

Basketter, David A.; Kruszewski, Francis H.; Mathieu, Sophie; Kirchner, Donald Bruce; Panepinto, Anthony; Fieldsend, Mark; Siegert, Volker; Barnes, Fiona; Bookstaff, Robert; Simonsen, Merete; Concoby, Beth

2015-01-01

Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes. PMID:25692928

Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry.

PubMed

Basketter, David A; Kruszewski, Francis H; Mathieu, Sophie; Kirchner, Donald Bruce; Panepinto, Anthony; Fieldsend, Mark; Siegert, Volker; Barnes, Fiona; Bookstaff, Robert; Simonsen, Merete; Concoby, Beth

2015-01-01

Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes.

Improving preventive health services training in chiropractic colleges part II: enhancing outcomes through improved training and accountability processes.

PubMed

Globe, Gary; Redwood, Daniel; Brantingham, James W; Hawk, Cheryl; Terre, Lisa; Globe, Denise; Mayer, Stephan

2009-01-01

Over the past decade, chiropractic colleges have introduced clinical prevention services (CPS) training. This has included an updated public health curriculum and procedures for student interns to determine the need for preventive services and to provide these services directly or through referral to other health professionals. The purpose of this study was to evaluate the effect of a program to train chiropractic interns to deliver CPS to patients. Program evaluation used retrospective chart review, comparing the proportion of patients receiving CPS recommendations before and after implementation of the program. The main outcome measures were the percentage of appropriate CPS recommendations based upon chart reviews. Chart reviews in 2006 indicated appropriate CPS recommendations in 47.4% of cases (295/623). Chart reviews in 2007, after an additional year of sustained implementation of procedures to ensure intern and faculty accountability, showed appropriate counseling recommendations in 87% of files (137/156). Requiring interns to attend didactic presentations on CPS had no measurable effect on their performance. Major improvements occurred after a series of clinically relevant training interventions; new forms and audit procedures were implemented to increase intern and clinical faculty accountability.

Conceptualizing clinical nurse leader practice: an interpretive synthesis.

PubMed

Bender, Miriam

2016-01-01

The Institute of Medicine's Future of Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific clinical nurse leader practices influencing documented quality outcomes remain unclear. Lack of practice clarity limits the ability to articulate, implement and measure clinical nurse leader-specific practice and quality outcomes. Interpretive synthesis design and grounded theory analysis were used to develop a theoretical understanding of clinical nurse leader practice that can facilitate systematic and replicable implementation across health-care settings. The core phenomenon of clinical nurse leader practice is continuous clinical leadership, which involves four fundamental activities: facilitating effective ongoing communication; strengthening intra and interprofessional relationships; building and sustaining teams; and supporting staff engagement. Clinical nurse leaders continuously communicate and develop relationships within and across professions to promote and sustain information exchange, engagement, teamwork and effective care processes at the microsystem level. Clinical nurse leader-integrated care delivery systems highlight the benefits of nurse-led models of care for transforming health-care quality. Managers can use this study's findings to frame an implementation strategy that addresses theoretical domains of clinical nurse leader practice to help ensure practice success. © 2015 John Wiley & Sons Ltd.

Language Rights: A Framework for Ensuring Social Equity in Planning and Implementing National-Education Policies

ERIC Educational Resources Information Center

Hossain, Tania; Pratt, Cornelius B.

2008-01-01

Background: An important issue in the discourse on language rights is the degree to which they influence the development and implementation of language policies or perpetuate inequalities in many language situations. Skutnabb-Kangas (1996, 2002a, 2002b) and May (2000), for example, have argued that language rights offer a reasonable framework for…

Moving beyond Compliance: Promoting Research-Based Professional Discretion in the Implementation of the Common Core State Standards in English Language Arts

ERIC Educational Resources Information Center

Woodard, Rebecca; Kline, Sonia

2015-01-01

State- and local-level mandates are currently being implemented to ensure strict compliance to the new national Common Core State Standards for English Language Arts (CCSS for ELA) and related assessments. These standards provide many potential opportunities to improve literacy education nationally and locally. However, the CCSS for ELA will…

34th Annual Report to Congress on the Implementation of the "Individuals with Disabilities Education Act," 2012

ERIC Educational Resources Information Center

Office of Special Education and Rehabilitative Services, US Department of Education, 2014

2014-01-01

The 34th Annual Report to Congress on the Implementation of the "Individuals with Disabilities Education Act," 2012 describes our nation's progress in: (1) providing a free appropriate public education (FAPE) for all children with disabilities; (2) ensuring that the rights of children with disabilities and their parents are protected;…

35th Annual Report to Congress on the Implementation of the "Individuals with Disabilities Education Act," 2013

ERIC Educational Resources Information Center

Office of Special Education and Rehabilitative Services, US Department of Education, 2014

2014-01-01

The 35th Annual Report to Congress on the Implementation of the "Individuals with Disabilities Education Act," 2013 describes the nation's progress in (1) providing a free appropriate public education (FAPE) for all children with disabilities, (2) ensuring that the rights of children with disabilities and their parents are protected, (3)…

76 FR 21639 - Finding of Substantial Inadequacy of Implementation Plan; Call for Utah State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-18

..., but stated that they believed the comment period was too short. Some commenters complained that the... and protection is ensured as long as the limits are met. Consistent with this premise, the CAA and our...--did not serve to change the terms of an approved SIP. (d) Comment: EPA's proposed SIP call is...