ERIC Educational Resources Information Center
Abrahams, Ian; Reiss, Michael J.; Sharpe, Rachael
2014-01-01
Background: Despite the widespread use of practical work in school it has been recognised that more needs to be done to improve its effectiveness in developing conceptual understanding. The "Getting Practical" CPD (Continuing Professional Development) programme was designed to contribute towards an improvement in the effectiveness of…
Effective Practical Work in Primary Science: The Role of Empathy
ERIC Educational Resources Information Center
Abrahams, Ian; Reiss, Michael
2010-01-01
"Getting Practical-Improving practical work in science" is a government-funded programme intended to improve the effectiveness and affective value of practical work in school science in England. In order to evaluate the effectiveness of the programme in terms of achieving its aims, ten primary and twenty secondary schools have been…
NASA Astrophysics Data System (ADS)
Abrahams, Ian; Reiss, Michael J.; Sharpe, Rachael
2014-09-01
Background:Despite the widespread use of practical work in school it has been recognised that more needs to be done to improve its effectiveness in developing conceptual understanding. The 'Getting Practical' CPD (Continuing Professional Development) programme was designed to contribute towards an improvement in the effectiveness of practical work through initiating changes in teachers' predominantly 'hands-on' approach to practical work to one which manifests a more equitable balance between 'hands-on' and 'minds-on'. Purpose:To evaluate the impact of the Getting Practical: Improving Practical Work in Science CPD programme on teachers' ideas and practice in science practical work in primary and secondary schools in England. Programme description:The CPD programme was designed to improve the effectiveness of science practical work in developing conceptual understanding in primary and secondary schools in England. Sample:Ten teachers of primary science and 20 secondary science teachers. Design and methods:The study employed a condensed fieldwork strategy with data collected using interviews, observational field notes and pre- and post-CPD training observations in practical lessons within 30 schools. Results:Whilst the CPD programme was effective in getting teachers to reflect on the ideas associated with the Getting Practical programme, it was much less effective in bringing about changes in actual teaching practice.
ERIC Educational Resources Information Center
Star, Jon R.; Foegen, Anne; Larson, Matthew R.; McCallum, William G.; Porath, Jane; Zbiek, Rose Mary; Caronongan, Pia; Furgeson, Joshua,; Keating, Betsy; Lyskawa, Julia
2015-01-01
Mastering algebra is important for future math and postsecondary success. Educators will find practical recommendations for how to improve algebra instruction in the What Works Clearinghouse (WWC) practice guide, "Teaching Strategies for Improving Algebra Knowledge in Middle and High School Students". The methods and examples included in…
Embedding "Getting Practical" and ASE Improving Practical Work in Triple Science LSN Network
ERIC Educational Resources Information Center
Stephenson, Kay; Chapman, Georgina
2011-01-01
With the two-year pilot of "Getting Practical" drawing to a close, new ways to embed the key messages into existing CPD programmes are being sought. In "Embedding Getting Practical," the first author describes how she has been able to do this with the courses she is involved with. In "ASE Improving Practical Work in Triple Science LSN Network,"…
Robbins, Julie; Garman, Andrew N; Song, Paula H; McAlearney, Ann Scheck
2012-01-01
As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most process improvement strategies are associated with work practices for which solid evidence does exist. Evaluating improvement strategies in the context of evidence-based work practices can provide guidance about which strategies would work best for a given health care organization. We combined a literature review with analysis of key informant interview data collected from 5 case studies of high-performance work practices (HPWPs) in health care organizations. We explored the link between an evidence-based framework for HPWP use and 3 process improvement strategies: Hardwiring Excellence, Lean/Six Sigma, and Baldrige. We found that each of these process improvement strategies has not only strengths but also important gaps with respect to incorporating HPWPs involving engaging staff, aligning leaders, acquiring and developing talent, and empowering the front line. Given differences among these strategies, our analyses suggest that some may work better than others for individual health care organizations, depending on the organizations' current management systems. In practice, most organizations implementing improvement strategies would benefit from including evidence-based HPWPs to maximize the potential for process improvement strategies to increase value in health care.
Adapting total quality management for general practice: evaluation of a programme.
Lawrence, M; Packwood, T
1996-01-01
OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529
Practical ways to facilitate ergonomics improvements in occupational health practice.
Kogi, Kazutaka
2012-12-01
Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.
Understanding work contextual factors: a short-cut to evidence-based practice?
Wallin, Lars; Ewald, Uwe; Wikblad, Karin; Scott-Findlay, Shannon; Arnetz, Bengt B
2006-01-01
It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors. The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors. The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden. Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion. These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.
Improving the health care work environment: implications for research, practice, and policy.
Harrison, Michael I; Henriksen, Kerm; Hughes, Ronda G
2007-11-01
Despite the gains to date, we need better understanding of practices for implementing and sustaining improvements in health care work environments and further study of organizational conditions affecting implementation of improvements. Limiting work hours, improving schedules, and providing sleep hygiene training will help combat clinician fatigue. Hospital crowding can be reduced through systemwide improvement of patient flow and capacity management, coupled with management support, measurement, and reporting on crowding. Long-term solutions to nurse staffing shortfalls include process redesign to enhance efficiency. Improvement of organizational climate, human resource management, and interoccupational relations will also contribute to staff retention. Evidence-based enhancements to patient rooms and other physical features in hospitals contribute directly to safety and quality and also affect staff performance. POLICY: Landrigan and his colleagues call for external restrictions on residents' work shifts. Clarke examines prospects for mandated nursing-staff ratios. Public reporting on staffing, crowding, and other risks may incent change. Reporting and pay for performance require standardized measures of targeted conditions. Organizations promoting care quality can help spread safe work practices; they can also support collaborative learning and other strategies that may enhance implementation of improvements in work environments.
Taylor, Bev; Roberts, Sue; Smyth, Therese; Tulloch, Moira
2015-10-01
To raise nurse managers' critical awareness of practice problems; uncover practice constraints and improve work effectiveness. Nurse management requires skills and knowledge, underscored by emotional intelligence. The research improved participants' practice and personal insights. Purposive sampling targeted nurse managers interested in improving their practice. Three experienced female nurse managers met fortnightly in a group, for 1 hour, for 10 meetings. The methods included: writing and sharing de-identified journal reflections; critically analysing practice stories; identifying a thematic concern; generating action strategies; and instituting and revising the action plan. Phase One resulted in the identification of the issue of 'being drained by the intensity of nurse managers' work'. The participants adopted five strategies: debriefing problematic situations; deflecting multiple requests; diffusing issues; naming dysfunctional behaviours; and regrouping. In Phase Two, participants implemented and revised the action plan strategies, which resulted in them feeling less drained by their work. Strategies can lessen nurse managers' sense of personal depletion. However, strategies cannot guarantee success every time because the emotional intelligence is integral to nurse management. Action research and reflection assist nurse managers to improve their practice and develop their emotional intelligence. © 2014 John Wiley & Sons Ltd.
Terhaar, Mary F; Sylvia, Martha
2016-01-01
The aim of this investigation was to evaluate, monitor and manage the quality of projects conducted and work produced as evidence of scholarship upon completion of Doctor of Nursing Practice education. The Doctor of Nursing Practice is a relatively new degree which prepares nurses for high impact careers in diverse practice settings around the globe. Considerable variation characterises curricula across schools preparing Doctors of Nursing Practice. Accreditation assures curricula are focused on attainment of the Doctor of Nursing Practice essentials, yet outcomes have not been reported to help educators engage in programme improvement. This work has implications for nursing globally because translating strong evidence into practice is key to improving outcomes in direct care, leadership, management and education. The Doctor of Nursing Practice student learns to accomplish translation through the conduct of projects. Evaluating the rigour and results of these projects is essential to improving the quality, safety and efficacy of translation, improvements in care and overall system performance. A descriptive study was conducted to evaluate the scholarly products of Doctor of Nursing Practice education in one programme across four graduating classes. A total of 80 projects, conducted across the USA and around the globe, are described using a modification of the Uncertainty, Pace, Complexity Model. The per cent of students considered to have produced high quality work in relation to target expectations as well as the per cent that conducted means testing increased over the four study years. Evaluation of scope, complexity and rigour of scholarly work products has driven improvements in the curriculum and informed the work of faculty and advisors. Methods, evaluation and outcomes conformed around a set of expectations for scholarship and rigour have resulted in measurable outcomes, and quality publications have increased over time. © 2015 John Wiley & Sons Ltd.
Tuomi, Kaija; Vanhala, Sinikka; Nykyri, Erkki; Janhonen, Minna
2004-03-01
Rapid technological change and increased international competition have changed working life and work organizations. These changes may not be considered when researching employee work ability and well-being. This study investigates the impact of organizational practices, work demands and individual factors on work ability, organizational commitment and mental well-being of employees in the metal industry and retail trade. A follow-up study was conducted to examine these connections among 1389 employees (mean age 42 years at baseline) in 91 organizations. The first survey was conducted in 1998 and was repeated in 2000. Changes in organizational practices and the demands of work were strongly associated with changes in employee well-being. Work ability, organizational commitment and the mental well-being of employees were increased most if the opportunities for development and influence and the promotion of employee well-being were increased and if the supervisory support and organization of work were improved. Well-being also improved with less uncertainty at work and with decreasing mental and physical work demands. In addition physical exercise and affluence also had favourable effects. The results confirm that several features of organizational practices are strongly associated with employees' well-being. Organizational development is an important method of improving employees' work ability, commitment and well-being.
Muianga, Custodio; Rice, Carol; Lentz, Thomas; Lockey, James; Niemeier, Richard; Succop, Paul
2012-01-01
A systematic approach was developed to review, revise and adapt existing exposure control guidance used in developed countries for use in developing countries. One-page employee and multiple-page supervisor guidance sheets were adapted from existing documents using a logic framework and workers were trained to use the information to improve work practices. Interactive, hands-on training was delivered to 26 workers at five small-scale demolition projects in Maputo City, Mozambique, and evaluated. A pre-and-post walkthrough survey used by trained observers documented work practice changes. Worker feedback indicated that the training was effective and useful. Workers acquired knowledge (84% increase, p < 0.01) and applied the work practice guidance. The difference of proportions between use of work practice components before and after the intervention was statistically significant (p < 0.05). Changes in work practices following training included preplanning, use of wet methods and natural ventilation and end-of-task review. Respirable dust measurements indicated a reduction in exposure following training. Consistency in observer ratings and observations support the reliability and validity of the instruments. This approach demonstrated the short-term benefit of training in changing work practices; follow-up is required to determine the long-term impact on changes in work practices, and to evaluate the need for refresher training. PMID:22470296
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Ohta, Masanori; Eguchi, Yasumasa; Inoue, Tomohiro; Honda, Toru; Morita, Yusaku; Konno, Yoshimasa; Yamato, Hiroshi; Kumashiro, Masaharu
2015-01-01
Work ability is partly determined by physical and mental fitness. Bench step exercise can be practiced anywhere at any time. The aim of this study was to determine the effects of a bench step exercise on work ability by examining cardiovascular risk factors and oxidative stress. Thirteen volunteers working in a warehousing industry comprised the bench step exercise group (n=7) and the control group (n=6). The participants in the step exercise group were encouraged to practice the step exercise at home for 16 weeks. The step exercise improved glucose metabolism and antioxidative capacity and increased work ability by reducing absences from work and improving the prognosis of work ability. The improvement in work ability was related to a reduction in oxidative stress. These results suggest that a bench step exercise may improve work ability by reducing cardiovascular risk factors and oxidative stress.
Women in medicine: a four-nation comparison.
McMurray, Julia E; Cohen, May; Angus, Graham; Harding, John; Gavel, Paul; Horvath, John; Paice, Elisabeth; Schmittdiel, Julie; Grumbach, Kevin
2002-01-01
to determine the impact of increasing numbers of women in medicine on the physician work force in Australia, Canada, England, and the United States. We collected data on physician work force issues from professional organizations and government agencies in each of the 4 nations. Women now make up nearly half of all medical students in all 4 countries and 20% to 30% of all practicing physicians. Most are concentrated in primary care specialties and obstetrics/gynecology and are underrepresented in surgical training programs. Women physicians practice largely in urban settings and work 7 to 11 fewer hours per week than men do, for lower pay. Twenty percent to 50% of women primary care physicians are in part-time practice. Work force planners should anticipate larger decreases in physician full-time equivalencies than previously expected because of the increased number of women in practice and their tendency to work fewer hours and to be in part-time practice, especially in primary care. Responses to these changes vary among the 4 countries. Canada has developed a detailed database of work/family issues; England has pioneered flexible training schemes and reentry training programs; and Australia has joined consumers, physicians, and educators in improving training opportunities and the work climate for women. Improved access to surgical and subspecialty fields, training and practice settings that provide balance for work/family issues, and improved recruitment and retention of women physicians in rural areas will increase the contributions of women physicians.
Workplace road safety risk management: An investigation into Australian practices.
Warmerdam, Amanda; Newnam, Sharon; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark
2017-01-01
In Australia, more than 30% of the traffic volume can be attributed to work-related vehicles. Although work-related driver safety has been given increasing attention in the scientific literature, it is uncertain how well this knowledge has been translated into practice in industry. It is also unclear how current practice in industry can inform scientific knowledge. The aim of the research was to use a benchmarking tool developed by the National Road Safety Partnership Program to assess industry maturity in relation to risk management practices. A total of 83 managers from a range of small, medium and large organisations were recruited through the Victorian Work Authority. Semi-structured interviews aimed at eliciting information on current organisational practices, as well as policy and procedures around work-related driving were conducted and the data mapped onto the benchmarking tool. Overall, the results demonstrated varying levels of maturity of risk management practices across organisations, highlighting the need to build accountability within organisations, improve communication practices, improve journey management, reduce vehicle-related risk, improve driver competency through an effective workplace road safety management program and review organisational incident and infringement management. The findings of the study have important implications for industry and highlight the need to review current risk management practices. Copyright © 2016 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Peterson, Amelia
2016-01-01
As a systemic approach to improving educational practice through research, "What Works" has come under repeated challenge from alternative approaches, most recently that of improvement science. While "What Works" remains a dominant paradigm for centralized knowledge-building efforts, there is need to understand why this…
Professional Learning Communities: Teachers Working Collaboratively for Continuous Improvement
ERIC Educational Resources Information Center
Griffith, Louise Ann
2009-01-01
Current research indicates that a professional learning community (PLC) is an effective means for helping teachers to bridge the gap between research and practice. A PLC is a team of educators systematically working together to improve teaching practice and student learning. This study evaluated the PLC formed by teachers at a public elementary…
Wilper, Andrew P; Smith, Curtis Scott; Weppner, William
2013-09-16
The Accreditation Council for Graduate Medical Education (ACGME) requires that training programs integrate system-based practice (SBP) and practice-based learning and improvement (PBLI) into internal medicine residency curricula. CONTEXT AND SETTING: We instituted a seminar series and year-long-mentored curriculum designed to engage internal medicine residents in these competencies. Residents participate in a seminar series that includes assigned reading and structured discussion with faculty who assist in the development of quality improvement or research projects. Residents pursue projects over the remainder of the year. Monthly works in progress meetings, protected time for inquiry, and continued faculty mentorship guide the residents in their project development. Trainees present their work at hospital-wide grand rounds at the end of the academic year. We performed a survey of residents to assess their self-reported knowledge, attitudes and skills in SBP and PBLI. In addition, blinded faculty scored projects for appropriateness, impact, and feasibility. We measured resident self-reported knowledge, attitudes, and skills at the end of the academic year. We found evidence that participants improved their understanding of the context in which they were practicing, and that their ability to engage in quality improvement projects increased. Blinded faculty reviewers favorably ranked the projects' feasibility, impact, and appropriateness. The 'Curriculum of Inquiry' generated 11 quality improvement and research projects during the study period. Barriers to the ongoing work include a limited supply of mentors and delays due to Institutional Review Board approval. Hospital leadership recognizes the importance of the curriculum, and our accreditation manager now cites our ongoing work. A structured residency-based curriculum facilitates resident demonstration of SBP and practice-based learning and improvement. Residents gain knowledge and skills though this enterprise and hospitals gain access to trainees who help to solve ongoing problems and meet accreditation requirements.
ERIC Educational Resources Information Center
Thompson, Jerome; Soyibo, Kola
2002-01-01
Investigates whether the use of the combination of lecture, teacher demonstrations, class discussion, and student practical work in small groups significantly improved experimental subjects' attitudes to chemistry and understanding of electrolysis more than their control group counterparts who were not exposed to practical work. Examines whether…
The Role of School Technicians in Promoting Science through Practical Work
ERIC Educational Resources Information Center
Helliar, Anne T.; Harrison, Timothy G.
2011-01-01
This is a review of the role of practical work in UK's secondary school science lessons, the impact that practical work has in the promotion of science, the challenges created through use of non-specialist science teachers and a possible additional role for science technicians. The paper considers how improved deployment of suitably experienced…
Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula
2010-08-01
Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.
Traube, Dorian E; Pohle, Cara E; Barley, Melissa
2012-01-01
The field of social work is attuned to the need to incorporate evidence-based practice education into masters-level curriculum. One question remaining is how to integrate evidence-based practice in the foundation practice courses. Integration of evidence-based practice across the foundation-level curriculum coincides with the Council on Social Work Education's mandate that student's engage in research-informed practice and practice-informed research. Through a discussion of definitions, criticisms, and pedagogy across the allied fields of medicine, nursing, and social work the authors address the current status of evidence-based practice curriculum in foundation-level education. The authors incorporate the lessons learned from allied fields and a Masters of Social Work student's analyses of their experience of evidence-based practice learning to propose an adult-learner model to improve evidence-based practice pedagogy in Social Work.
Catalyzing Innovation in Social Work Practice
ERIC Educational Resources Information Center
Traube, Dorian E.; Begun, Stephanie; Okpych, Nathanael; Choy-Brown, Mimi
2017-01-01
Social innovation is defined by novelty and improvement. This definition requires social work practice to be more effective or efficient than preexisting alternatives. Practice innovation is accomplished by leveraging technical, social, and economic factors to generate novel interventions, diffusion or adoption of the interventions into broader…
Developing Student Assessment Related to a Workplacement: A Bridge between Practice and Improvement
ERIC Educational Resources Information Center
Vuoskoski, Pirjo; Poikela, Sari
2015-01-01
This paper explores the ways in which student assessment can be developed in higher education and work-related contexts to form a strong bridge between practice and improvement. Our aim is to provide a starting point for evaluation and improvement of assessment practices, which benefits the learners, instructors, and designers of the curricula, as…
Bhui, Kamaldeep; Dinos, Sokratis; Galant-Miecznikowska, Magdalena; de Jongh, Bertine; Stansfeld, Stephen
2016-01-01
Aims and method To identify causes of stress at work as well as individual, organisational and personal interventions used by employees to manage stress in public, private and non-governmental organizations (NGOs). Qualitative interviews were conducted with 51 employees from a range of organisations. Results Participants reported adverse working conditions and management practices as common causes of work stress. Stress-inducing management practices included unrealistic demands, lack of support, unfair treatment, low decision latitude, lack of appreciation, effort–reward imbalance, conflicting roles, lack of transparency and poor communication. Organisational interventions were perceived as effective if they improved management styles, and included physical exercise, taking breaks and ensuring adequate time for planning work tasks. Personal interventions used outside of work were important to prevent and remedy stress. Clinical implications Interventions should improve management practices as well as promoting personal interventions outside of the work setting. PMID:28377811
Working memory plasticity in old age: practice gain, transfer, and maintenance.
Li, Shu-Chen; Schmiedek, Florian; Huxhold, Oliver; Röcke, Christina; Smith, Jacqui; Lindenberger, Ulman
2008-12-01
Adult age differences in cognitive plasticity have been studied less often in working memory than in episodic memory. The authors investigated the effects of extensive working memory practice on performance improvement, transfer, and short-term maintenance of practice gains and transfer effects. Adults age 20-30 years and 70-80 years practiced a spatial working memory task with 2 levels of processing demands across 45 days for about 15 min per day. In both age groups and relative to age-matched, no-contact control groups, we found (a) substantial performance gains on the practiced task, (b) near transfer to a more demanding spatial n-back task and to numerical n-back tasks, and (c) 3-month maintenance of practice gains and near transfer effects, with decrements relative to postpractice performance among older but not younger adults. No evidence was found for far transfer to complex span tasks. The authors discuss neuronal mechanisms underlying adult age differences and similarities in patterns of plasticity and conclude that the potential of deliberate working memory practice as a tool for improving cognition in old age merits further exploration. Copyright (c) 2009 APA, all rights reserved.
Working appreciatively to improve services for children and families.
Onyett, Steve
2009-10-01
Service improvement approaches are described that specifically focus on appreciating the positive that individuals bring to contexts related to children and family services. This includes application of Solution-Focused approaches, Appreciative Inquiry and other approaches that promote a positive emotional climate and focus on what works. Their conceptual foundations are explored and particularly their value in supporting working well with complex adaptive systems. Specific applications described include leadership and management practice, work in school settings, engaging clinicians in healthcare improvement, establishing clinical networks, work with homeless youth, child protection and approaches to drawing out best practice and community development. The theme that unites is a focus on developing effective relationships at all levels and a pragmatic focus on what works so that we can find opportunities to do more of it.
Video observation in HIT development: lessons learned on benefits and challenges.
Høstgaard, Anna Marie; Bertelsen, Pernille
2012-08-22
Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings. A multiple case study including nine case studies conducted by DaCHI researchers 2004-2011 using audio-visual, non-participant video observation for data collection within different healthcare settings. In HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices. The video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.
ERIC Educational Resources Information Center
Welsch, Lauren A.; Rutledge, Carolyn; Hoch, Johanna M.
2017-01-01
Context: Athletic trainers are encouraged to work collaboratively with other health care professionals to improve patient outcomes. Interprofessional education (IPE) experiences for practicing clinicians should be developed to improve interprofessional collaborative practice postcertification. An outcome measure, such as the modified Readiness for…
Promotion of a healthy work life at small enterprises in Thailand by participatory methods.
Krungkraiwong, Sudthida; Itani, Toru; Amornratanapaichit, Ratanaporn
2006-01-01
The major problems of small enterprises include unfavourable working conditions and environment that affect safety and health of workers. The WISE (Work Improvement in Small Enterprises) methodology developed by the ILO has been widely applied to improve occupational safety and health in small enterprises in Thailand. The participatory methods building on local good practices and focusing on practicable improvements have proven effective in controlling the occupational hazards in these enterprises at their sources. As a result of applying the methods in small-scale industries, the frequency of occupational accidents was reduced and the working environment actually improved in the cases studied. The results prove that the participatory approach taken by the WISE activities is a useful and effective tool to make owner/managers and workers in small enterprises voluntarily improve their own working conditions and environment. In promoting a healthy work life at small enterprises in Thailand, it is important to further develop and spread the approach.
Findings of the Work Improvement on Board (WIB) programme by the Fishery Agency in Japan.
Hisamune, Shuji; Kogi, Kazutaka
2015-01-01
Concerns are growing about the safety and health of seamen exposed to high risks while working on vessels. Their accident rate in 2013 was 9.9 per 1000 workers, 5 times higher than that in industry. In order to mitigate the risks of seamen, we developed the Work Improvement on Board (WIB) programme by applying participatory action-oriented training (PAOT) methods that have proven effective for reducing work-related risks in small enterprises, construction sites, and agriculture. We analysed which features of the WIB programme would be most effective for facilitating the planning and implementation of practical improvements on vessels. We examined action -oriented tools used, including a WIB action checklist and good examples, and practical improvements proposed by the participants in 1-day or half-day WIB workshops. To study the effectiveness of the WIB programme, we analysed 1121 replies of a questionnaire distributed to 1459 participants of the programme. We compared the types of improvements achieved and the improvement costs in the WIB programme with those in other PAOT programmes. The impact of the WIB programme on promoting primary prevention by seamen and fishermen was discussed. The action checklist listing practical improvements on board and good example photos apparently facilitated the planning and implementation of improvements feasible on board. The participating crews could propose readily applicable improvements of their vessels within short time. In the case of workshops held in 10 harbours between August and October 2014, participants coming from 110 vessels presented 228 improvement proposals which were mostly feasible at low cost. Among the 1121 questionnaire replies from participants of the WIB programme, over 75% evaluated the programme as necessary, practical and easy-to-understand. These positive results led to the adoption of the WIB programme for training fishermen and seamen on commercial vessels by the Fishery Agency and the Ministry of Land, Infrastructure, Transport and Tourism. The Fishery Agency adopted plans to improve the working environment on fishing vessels by training 500 fishermen per year in the WIB programme from 2013 to 2018. The participatory work improvement programme can work in vessels when it utilises in a flexible manner local good practices and low-cost improvements as guides. The use of action-oriented tools such as a WIB action checklist and good examples seems important. We recommend the wide use of WIB methods in occupational safety and health management systems on board vessels in Japan and other countries.
Improving patient care through work-based learning.
Chapman, Linda
To record post-registration community nurses' perceptions of the impact of work-based learning on the quality of patient care. Ten nurses were interviewed. Each interviewee, who had successfully completed work-based learning programmes, was asked to describe their impact on the quality of patient care. The participants valued work-based learning. Four themes emerged where work-based learning contributed to improving the quality of care: increased health promotion, increased access to services, increased patient choice and reduced risk of infection. The relevance of studies and distance learning materials were perceived to be the main aspects that influenced changes in practice. The study provides insight into how work-based learning helped staff develop practice. It highlights that time for learning and mentoring are paramount for changes in practice to occur through work-based learning. Further studies are required to establish the best structure and style of distance learning materials needed to meet the needs of post-registration community nurses.
Liu, Jun; Zhou, Hui; Yang, Xiaoqin
2017-02-18
The present study was performed to quantitatively examine nurse satisfaction, to investigate the associated factors influencing satisfaction, and to evaluate the effect of improvement measures based on these factors. A survey using the 38-item Chinese version of the Practice Environment Scale (CPPE-38) was performed in a university-affiliated tertiary hospital in Shanghai, China in 2013. Linear regression analysis was performed to screen for associated factors related to each CPPE-3 score and the total satisfaction score. Several improvement measures were established to improve nurse satisfaction, and the CPPE-38 survey was again performed in 2015 to evaluate the effect of these improvement measures. A total of 1,050 respondents were recruited in 2013, with a response rate of 87.6%. The total satisfaction score of the CPPE-38 was 2.99±0.64. The lowest score in a subscale of the CPPE-38 was 2.40±0.59 for interpersonal interaction and the highest score was 3.15±0.40 for internal work motivation. Work location was associated with scores for work motivation and total satisfaction, while the highest education degree was associated with scores for internal relationship and autonomy. The scores for internal work motivation, control over practice, interpersonal interaction, and internal relationship and autonomy were significantly improved in 2015 after two years of improvement efforts, while the total satisfaction score was not significantly different compared to the 2013 score. Working location and education degree were two factors correlated with CPPE-38 scores in our hospital. Humanistic concerns, continuing education, and pay raise may improve the practice satisfaction of nurses.
Ainalem, Ingrid; Berg, Agneta; Janlöv, Ann-Christin
2016-01-01
The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back—evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved. PMID:26783867
From Planning to Action: Government Initiatives for Improving School-Level Practice.
ERIC Educational Resources Information Center
Chapman, David W., Ed.; Mahlck, Lars O., Ed.; Smulders, Anna E. M., Ed.
This work examines ways central and regional education ministries can influence practices at the school level. Chapter 1, "Changing What Happens in Schools: Central-Level Initiatives to Improve School Practice," reviews common themes, concerns, problems, and emphases. Chapter 2, "Knowledge Utilization and the Process of Policy…
Experiences with online consultation systems in primary care: case study of one early adopter site
Casey, Michael; Shaw, Sara; Swinglehurst, Deborah
2017-01-01
Background There is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care. Aim To explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices. Design and setting Mixed methods case study in an inner-city general practice. Method The study was conducted through interviews with IT developers, clinicians, and administrative staff, and scrutiny of documents, websites, and demonstrator versions of Tele-Doc, followed by thematic analysis and discourse analysis. Results Three interrelated themes were identified: online consultation systems as innovation, managing the ‘messiness’ of general practice consultations, and redistribution of the work of general practice. These themes raise timely questions about what it means to consult in contemporary general practice. Uptake of Tele-Doc by patients was low. Much of the work of the consultation was redistributed to patients and administrators, sometimes causing misunderstandings. The ‘messiness’ of consultations was hard to eliminate. In-house training focused on the technical application rather than associated transformations to practice work that were not anticipated. GPs welcomed varied modes of consulting, but the aspiration of improved efficiency was not realised in practice. Conclusion Tele-Doc offers a new kind of consultation that is still being worked out in practice. It may offer convenience for patients with discrete, single problems, and a welcome variation to GPs’ workload. Tele-Doc’s potential for addressing more complex problems and achieving efficiency is less clear, and its adoption may involve unforeseeable consequences. PMID:28993306
Practice-based learning and improvement.
Moore, Donald E; Pennington, Floyd C
2003-01-01
Workplace learning is becoming increasingly important in all fields. While workplace learning in medicine, also called practice-based learning and improvement (PBLI) is not new, understanding how it works and how it fits with an individual physician's continuing professional development is new. In this article, we describe seven issues associated with PBLI and then pose questions for reflections, as continuing medical education (CME) planners consider working with PBLI.
Five Essential Practices for Communication: The Work of Instructional Coaches
ERIC Educational Resources Information Center
Walkowiak, Temple A.
2016-01-01
The work of instructional coaches, both general and discipline-specific, has become increasingly important as more schools rely on their leadership for improvements in teaching and learning. Much of their work hinges upon their effective communication with teachers and school administrators. This article outlines five practices for instructional…
Hoving, Jan L; Kok, Rob; Ketelaar, Sarah M; Smits, Paul B A; van Dijk, Frank J H; Verbeek, Jos H
2016-02-29
The uptake of evidence in practice by physicians, even if they are trained in the systematic method of evidence-based medicine (EBM), remains difficult to improve. The aim of this study was to explore perceptions and experiences of physicians doing disability evaluations regarding motivators and preconditions for the implementation of EBM in daily practice. This qualitative study was nested in a cluster randomized controlled trial (Trial registration NTR1767; 20-apr-2009) evaluating the effects of training in EBM. The 45 physicians that participated received a comprehensive 6-months training program in EBM of which the last course day included audio-recorded interviews in groups. During these interviews participating physicians discussed perceptions and experiences regarding EBM application in daily practice. In an iterative process we searched for common motivators or preconditions for the implementation of EBM. Three main concepts or themes emerged after analyzing the transcriptions of the discussions: 1) improved quality of physicians' actions, such as clients benefiting from the application of EBM; 2) improved work attractiveness of physicians; and 3) preconditions that have to be met in order to work in an evidence-based manner including professional competence, facilitating material conditions and organizational support and demands. Physicians trained in EBM are motivated to use EBM because they perceive it as a factor improving the quality of their work and making their work more attractive. In addition to personal investments and gains, organizational support should further facilitate the uptake of evidence in practice.
A Wider Role for Technicians in Science Practical Work with School Students?
ERIC Educational Resources Information Center
Helliar, Anne T.; Harrison, Timothy G.
2010-01-01
This paper reports the results of a study made on the impact of improved deployment of science technicians in the classroom could directly benefit students in practical science investigations. Science technicians are skilled individuals whose understanding of practical work is a valuable resource not being used of in support of students…
Wilper, Andrew P.; Smith, Curtis Scott; Weppner, William
2013-01-01
Background The Accreditation Council for Graduate Medical Education (ACGME) requires that training programs integrate system-based practice (SBP) and practice-based learning and improvement (PBLI) into internal medicine residency curricula. Context and setting We instituted a seminar series and year-long-mentored curriculum designed to engage internal medicine residents in these competencies. Methods Residents participate in a seminar series that includes assigned reading and structured discussion with faculty who assist in the development of quality improvement or research projects. Residents pursue projects over the remainder of the year. Monthly works in progress meetings, protected time for inquiry, and continued faculty mentorship guide the residents in their project development. Trainees present their work at hospital-wide grand rounds at the end of the academic year. We performed a survey of residents to assess their self-reported knowledge, attitudes and skills in SBP and PBLI. In addition, blinded faculty scored projects for appropriateness, impact, and feasibility. Outcomes We measured resident self-reported knowledge, attitudes, and skills at the end of the academic year. We found evidence that participants improved their understanding of the context in which they were practicing, and that their ability to engage in quality improvement projects increased. Blinded faculty reviewers favorably ranked the projects’ feasibility, impact, and appropriateness. The ‘Curriculum of Inquiry’ generated 11 quality improvement and research projects during the study period. Barriers to the ongoing work include a limited supply of mentors and delays due to Institutional Review Board approval. Hospital leadership recognizes the importance of the curriculum, and our accreditation manager now cites our ongoing work. Conclusions A structured residency-based curriculum facilitates resident demonstration of SBP and practice-based learning and improvement. Residents gain knowledge and skills though this enterprise and hospitals gain access to trainees who help to solve ongoing problems and meet accreditation requirements. PMID:24044686
Wilper, Andrew P; Smith, Curtis Scott; Weppner, William
2013-01-01
Background The Accreditation Council for Graduate Medical Education (ACGME) requires that training programs integrate system-based practice (SBP) and practice-based learning and improvement (PBLI) into internal medicine residency curricula. Context and setting We instituted a seminar series and year-long-mentored curriculum designed to engage internal medicine residents in these competencies. Methods Residents participate in a seminar series that includes assigned reading and structured discussion with faculty who assist in the development of quality improvement or research projects. Residents pursue projects over the remainder of the year. Monthly works in progress meetings, protected time for inquiry, and continued faculty mentorship guide the residents in their project development. Trainees present their work at hospital-wide grand rounds at the end of the academic year. We performed a survey of residents to assess their self-reported knowledge, attitudes and skills in SBP and PBLI. In addition, blinded faculty scored projects for appropriateness, impact, and feasibility. Outcomes We measured resident self-reported knowledge, attitudes, and skills at the end of the academic year. We found evidence that participants improved their understanding of the context in which they were practicing, and that their ability to engage in quality improvement projects increased. Blinded faculty reviewers favorably ranked the projects' feasibility, impact, and appropriateness. The 'Curriculum of Inquiry' generated 11 quality improvement and research projects during the study period. Barriers to the ongoing work include a limited supply of mentors and delays due to Institutional Review Board approval. Hospital leadership recognizes the importance of the curriculum, and our accreditation manager now cites our ongoing work. Conclusions A structured residency-based curriculum facilitates resident demonstration of SBP and practice-based learning and improvement. Residents gain knowledge and skills though this enterprise and hospitals gain access to trainees who help to solve ongoing problems and meet accreditation requirements.
Working Memory Underpins Cognitive Development, Learning, and Education
Cowan, Nelson
2014-01-01
Working memory is the retention of a small amount of information in a readily accessible form. It facilitates planning, comprehension, reasoning, and problem-solving. I examine the historical roots and conceptual development of the concept and the theoretical and practical implications of current debates about working memory mechanisms. Then I explore the nature of cognitive developmental improvements in working memory, the role of working memory in learning, and some potential implications of working memory and its development for the education of children and adults. The use of working memory is quite ubiquitous in human thought, but the best way to improve education using what we know about working memory is still controversial. I hope to provide some directions for research and educational practice. PMID:25346585
Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela
2016-01-01
The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.
Improving Collaboration Among Social Work and Nursing Students Through Interprofessional Simulation.
Kuehn, Mary Beth; Huehn, Susan; Smalling, Susan
2017-08-01
This project implemented first-time simulation with nursing and social work students. Students participated in a contextual learning experience through a patient simulation of interprofessional practice as a health care team member and reflection through debriefing and open response comments. Simulation offers a means to practice interprofessional collaboration prior to entering practice. Participants reported an increased understanding of the scope of practice of other team members through their reflections following simulation. In addition, participants reported increased comprehension of team dynamics and their relationship to improved patient care. Overall, the simulation encouraged development of the skills necessary to function as part of a collaborative, interprofessional team.
Lanham, Holly J; McDaniel, Reuben R; Crabtree, Benjamin F; Miller, William L; Stange, Kurt C; Tallia, Alfred F; Nutting, Paula
2009-09-01
Understanding the role of relationships health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Data were drawn from four large National Institutes of Health (NIH)-funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties.
Project-based teaching in health informatics: a course on health care quality improvement.
Moehr, J R; Berenji, G R; Green, C J; Kagolovsky, Y
2001-01-01
Teaching the skills and knowledge required in health informatics [1] is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in "Health Care Quality Improvement". Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.
School Improvement for Schools Facing Challenging Circumstances: A Review of Research and Practice.
ERIC Educational Resources Information Center
Potter, David; Reynolds, David; Chapman, Christopher
2002-01-01
Reviews the literature on what works in school improvement in the UK. Outlines the practices that appear to be necessary--in terms of organization, culture, leadership, and ethos--to improve the levels of effectiveness. Appended is an outline of a number of particularly effective school-improvement projects. (Contains 22 references.) (WFA)
Evans, Jamie; Fitch, Christopher; Collard, Sharon; Henderson, Claire
2018-04-27
In recent years, the UK debt collection industry has taken steps to improve its policies and practices in relation to customers with mental health problems. Little data, however, have been collected to evidence change. This paper examines whether the reported attitudes and practices of debt collection staff when working with customers with mental health problems have changed between 2010 and 2016. This paper draws on descriptive and regression analyses of two cross-sectional surveys of debt collection staff: one conducted in 2010 and one conducted in 2016. All variables analysed show statistically significant changes between 2010 and 2016 indicative of improved reported attitudes and practices. While results suggest an improvement in attitudes and practice may have occurred between 2010 and 2016, research is required to understand this potential shift, its likely causes, and concrete impact on customers.
Polansky, Maura
2013-01-01
A strong working relationship between advanced practice professionals (APPs) and supervising oncologists is essential for reducing medical errors, retaining employees, and improving work environments. Although there is rather limited data on the unique relationship of the APP and physician, fundamental communication skills-including open communication, mutual respect, establishing expectations, and working with mutual purpose-should be the foundation of these relationships. This paper addresses various aspects of relationship building between APPs and physicians with suggestions for establishing successful working relationships.
[A review of measures taken to improve organizational wellbeing in Italy].
Bentivenga, Rosina; Deitinger, Patrizia; Ghelli, Monica
2014-01-01
The Italian Decree Law D. Lgs. no. 81 dated 9 April 2008, dealing with the implementation of Article 1 of Law No. 123 dated 3 August 2007, on the topic of health and safety in the workplace, indicated that work-related stress (art. 28, section 1) was to be assessed in accordance with the European Agreement of 8 October 2004. It recalled the employer's legal obligation to safeguard workers' health and safety, and included psychosocial risk, in order to improve their wellbeing at work. The Decree Law specified that when risks had been assessed the employer could take all necessary measures, with reference to the "good practice", defined in the Law as organizational or procedural solutions coherent with current regulations and good technical rules, adopted voluntarily with the aim of promoting safety and health in the workplace by reducing risk and improving working conditions [...]" (art. 2, section 1 v); the practical solutions identified were to aim at eliminating, or at least reducing, psychosocial risk in the enterprise. On the basis of the studies most widely accepted in Europe and the indications issued by the European Agency for Safety and Health at Work, we identified the good practice measures adopted by companies in Italy and other countries. The aim was to make known some of the practical solutions regarding psychosocial risk that companies can put in place with a view to improving their workers' health and wellbeing. We examined measures related to the content and context of work. Measures affecting the work content mainly involved the workplace itself and equipment, work planning and working hours. For the work context the measures centered mostly on organizational function and culture, career progress, and home/work interface. In accordance with good safety practice, the practical measures taken by the enterprises examined cantered on some potentially stressful features of work, indicating the growing attention being paid to workers' wellbeing. However, organizational wellbeing is a multifaceted concept and the European Agency points out that measures taken must cover all the aspects of the work that appear particularly critical in risk assessment; from the primary prevention viewpoint, this means all the organizational aspects that might affect a person's wellbeing. As we become increasingly aware of the problems, and of the measures that have proved successful, it is to be hoped that further solutions will be identified and developed in organizations.
Backman, Chantal; Bruce, Natalie; Marck, Patricia; Vanderloo, Saskia
2016-01-01
The purpose of this quality improvement project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.
DOT National Transportation Integrated Search
2017-09-01
This project evaluated current nighttime work zone lighting practices for limited-access highways and primary routes in Virginia through (1) an on-site evaluation of lighting levels in work zones; (2) an illuminance characterization of various commer...
DOT National Transportation Integrated Search
2017-09-01
This project evaluated current nighttime work zone lighting practices for limited-access highways and primary routes in Virginia through (1) an on-site evaluation of lighting levels in work zones; (2) an illuminance characterization of various commer...
Navigating change: how outreach facilitators can help clinicians improve patient outcomes.
Laferriere, Dianne; Liddy, Clare; Nash, Kate; Hogg, William
2012-01-01
The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care. We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program. Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care. Outreach facilitation can be an effective method of assisting and supporting practices to make the changes necessary to improve processes and delivery of care. Multiple jurisdictions use outreach facilitation for system redesign, improved efficiencies, and advanced access. The development and implementation of quality improvement programs using practice facilitation can be challenging. Our research team has learned valuable lessons in developing tools, finding resources, and assisting practices to reach their quality improvement goals. These lessons can lead to improved experiences for the practices and overall improved outcomes for the patients they serve.
Coleman, Mary Thoesen; Nasraty, Soraya; Ostapchuk, Michael; Wheeler, Stephen; Looney, Stephen; Rhodes, Sandra
2003-05-01
The Accreditation Council for Graduate Medical Education (ACGME) recommends integrating improvement activities into residency training. A curricular change was designed at the Department of Family and Community Medicine, University of Louisville, to address selected ACGME competencies by incorporating practice-based improvement activities into the routine clinical work of family medicine residents. Teams of residents, faculty, and office staff completed clinical improvement projects at three ambulatory care training sites. Residents were given academic credit for participation in team meetings. After 6 months, residents presented results to faculty, medical students, other residents, and staff from all three training sites. Residents, staff, and faculty were recognized for their participation. Resident teams demonstrated ACGME competencies in practice-based improvement: Chart audits indicated improvement in clinical projects; quality improvement tools demonstrated analysis of root causes and understanding of the process; plan-do-study-act cycle worksheets demonstrated the change process. Improvement activities that affect patient care and demonstrate selected ACGME competencies can be successfully incorporated into the daily work of family medicine residents.
In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices
Sinsky, Christine A.; Willard-Grace, Rachel; Schutzbank, Andrew M.; Sinsky, Thomas A.; Margolius, David; Bodenheimer, Thomas
2013-01-01
We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life’s vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice. PMID:23690328
Learning about Practice from Practice: A Peer-Based Methodology
ERIC Educational Resources Information Center
Stanley, Tony
2014-01-01
A recommendation from the Social Work Task Force was that all employers of social workers should conduct a regular "health check" of the social work profession to learn from practice as part of a continuous cycle of improvement. This article documents how the London Borough of Tower Hamlets has gone about this. I describe the…
Groff-Paris, Lisa; Terhaar, Mary
2010-12-07
The strongest predictor of nurse job dissatisfaction and intent to leave is that of stress in the practice environment. Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment have been found to increase nurse satisfaction and decrease turnover. In this article we share our experience of developing a rapid-design process to change the approach to performance improvement so as to increase engagement, empowerment, effectiveness, and the quality of the professional practice environment. Meal and non-meal breaks were identified as the target area for improvement. Qualitative and quantitative data support the success of this project. We begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow's theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators Survey. We then describe our performance improvement project and share our conclusion and recommendations.
Best Practice in Motivation and Management in the Classroom. Second Edition
ERIC Educational Resources Information Center
Wiseman, Dennis G.; Hunt, Gilbert H.
2008-01-01
This text offers practical information and vicarious practice for both beginning as well as veteran teachers to become more knowledgeable, skilled, and effective in their work. Through study, application of what has been studied, and the analysis and evaluation of the end result of this application, teachers who care to improve can improve. And,…
Effective Online Lectures: Improving Practice through Design and Pedagogy
ERIC Educational Resources Information Center
Bese, Terry Lane
2016-01-01
The purpose of this research project was to improve the practice of using online lectures at a small private university. Using action research methodology, the researcher worked with a group of five university instructors to refine the use of online lectures through design and pedagogical practice. Beginning with a template or guide based on the…
Lanham, Holly J.; McDaniel, Reuben R.; Crabtree, Benjamin F.; Miller, William L.; Stange, Kurt C.; Tallia, Alfred F.; Nutting, Paul A.
2010-01-01
Background Understanding the role of relationships in health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Methods Data were drawn from four large National Institutes of Health (NIH)–funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Findings Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Discussion Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties. PMID:19769206
Can E-Learning Change Work Practices?
ERIC Educational Resources Information Center
Noesgaard, Signe Schack
2016-01-01
Stand-alone e-learning is unlikely to change work practices. This claim contrasts with a comprehensive body of research arguing that e-learning is at least as effective as face-to-face instruction in improving work performance. Such a comparison is, however, problematic. On the one hand, it relies on the premise that face-to-face instruction is…
Simulating Real Life: Enhancing Social Work Education on Alcohol Screening and Brief Intervention
ERIC Educational Resources Information Center
Osborne, Victoria A.; Benner, Kalea; Sprague, Debra J.; Cleveland, Ivy N.
2016-01-01
Social work students typically use role play with student colleagues to practice clinical intervention skills. Practice with simulated clients (SCs) rather than classmates changes the dynamics of the role play and may improve learning. This is the first known study to employ the SC model in substance use assessment in social work education. Social…
Embarking on performance improvement.
Brown, Bobbi; Falk, Leslie Hough
2014-06-01
Healthcare organizations should approach performance improvement as a program, not a project. The program should be led by a guidance team that identifies goals, prioritizes work, and removes barriers to enable clinical improvement teams and work groups to realize performance improvements. A healthcare enterprise data warehouse can provide the initial foundation for the program analytics. Evidence-based best practices can help achieve improved outcomes and reduced costs.
Primary Care Practice Transformation Is Hard Work
Crabtree, Benjamin F.; Nutting, Paul A.; Miller, William L.; McDaniel, Reuben R.; Stange, Kurt C.; Jaén, Carlos Roberto; Stewart, Elizabeth
2010-01-01
Background Serious shortcomings remain in clinical care in the United States despite widespread use of improvement strategies for enhancing clinical performance based on knowledge transfer approaches. Recent calls to transform primary care practice to a patient-centered medical home present even greater challenges and require more effective approaches. Methods Our research team conducted a series of National Institutes of Health funded descriptive and intervention projects to understand organizational change in primary care practice settings, emphasizing a complexity science perspective. The result was a developmental research effort that enabled the identification of critical lessons relevant to enabling practice change. Results A summary of findings from a 15-year program of research highlights the limitations of viewing primary care practices in the mechanistic terms that underlie current or traditional approaches to quality improvement. A theoretical perspective that views primary care practices as dynamic complex adaptive systems with “agents” who have the capacity to learn, and the freedom to act in unpredictable ways provides a better framework for grounding quality improvement strategies. This framework strongly emphasizes that quality improvement interventions should not only use a complexity systems perspective, but also there is a need for continual reflection, careful tailoring of interventions, and ongoing attention to the quality of interactions among agents in the practice. Conclusions It is unlikely that current strategies for quality improvement will be successful in transforming current primary care practice to a patient-centered medical home without a stronger guiding theoretical foundation. Our work suggests that a theoretical framework guided by complexity science can help in the development of quality improvement strategies that will more effectively facilitate practice change. PMID:20856145
Improvement of a Chemical Storage Room Ventilation System
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yousif, Emad; Al-Dahhan, Wedad; Abed, Rashed Nema
Scientists at universities across Iraq are actively working to report actual incidents and accidents occurring in their laboratories, as well as structural improvements made to improve safety and security, to raise awareness and encourage openness, leading to widespread adoption of robust Chemical Safety and Security (CSS) practices. This manuscript is the third in a series of five case studies describing laboratory incidents, accidents, and laboratory improvements. We summarize an improvement to the chemical storage room ventilation system at Al-Nahrain University to create and maintain a safe working atmosphere in an area where chemicals are stored and handled, using US andmore » European design practices, standards, and regulations.« less
Making Use of Theories about Literacy and Justice: Teachers Re-Searching Practice.
ERIC Educational Resources Information Center
Comber, Barbara
This paper explores the way teachers make use of and work on theory to disrupt and ultimately improve everyday educational practice. The paper argues that teachers working on and with theory can and do generate new forms of educative practices in the field of literacy education, which are based on explicit standpoints towards social justice in…
Engagement of groups in family medicine board maintenance of certification.
Fisher, Dena M; Brenner, Christopher J; Cheren, Mark; Stange, Kurt C
2013-01-01
The American Board of Medical Specialties' Performance in Practice ("Part IV") portion of Maintenance of Certification (MOC) requirement provides an opportunity for practicing physicians to demonstrate quality improvement (QI) competence. However, specialty boards' certification of one physician at a time does not tap into the potential of collective effort. This article shares learning from a project to help family physicians work in groups to meet their Part IV MOC requirement. A year-long implementation and evaluation project was conducted. Initially, 348 members of a regional family physician organization were invited to participate. A second path was established through 3 health care systems and a county-wide learning collaborative. Participants were offered (1) a basic introduction to QI methods, (2) the option of an alternative Part IV MOC module using a patient experience survey to guide QI efforts, (3) practice-level improvement coaching, (4) support for collaboration and co-learning, and (5) provision of QI resources. More physicians participated through group (66) than individual (12) recruitment, for a total of 78 physicians in 20 practices. Participation occurred at 3 levels: individual, intrapractice, and interpractice. Within the 1-year time frame, intrapractice collaboration occurred most frequently. Interpractice and system-level collaboration has begun and continues to evolve. Physicians felt that they benefited from access to a practice coach and group process. Practice-level collaboration, access to a practice coach, flexibility in choosing and focusing improvement projects, tailored support, and involvement with professional affiliations can enhance the Part IV MOC process. Specialty boards are likely to discover productive opportunities from working with practices, professional organizations, and health care systems to support intra- and interpractice collaborative QI work that uses Part IV MOC requirements to motivate practice improvement.
Lee, Soo-Jeong; Lee, Joung Hee
The study aim was to examine the relationships of organizational safety practices with nurses' perceptions about job and risk and experiences of work-related injury and symptoms. Nursing professions report high rates of work-related injuries. Organizational safety practices have been linked to workers' safety outcomes and perceptions about work. This study analyzed data from a random sample of 280 California RNs in a cross-sectional statewide survey. Data were collected by both postal and online surveys. Higher perceptions of organizational safety practices (safety climate, ergonomic practices, people-oriented culture) were significantly associated with lower physical workload, lower job strain, higher job satisfaction, lower risk perception, and lower work-related injury and symptom experiences. Ergonomic practices and people-oriented culture were associated with less intention of leaving job. Organizational safety practices may play a pivotal role in improving positive perceptions about jobs, reducing injury risks, and promoting nurse retention.
Job satisfaction of practice assistants in general practice in Germany: an observational study.
Goetz, Katja; Campbell, Stephen; Broge, Bjoern; Brodowski, Marc; Steinhaeuser, Jost; Wensing, Michel; Szecsenyi, Joachim
2013-08-01
Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction, staff characteristics and culture in general practice organizations. The study was based on data from the European Practice Assessment accreditation scheme for general practices and used an observational design. The study population consisted of 1158 practice assistants from 345 general practices across Germany. Job satisfaction was measured with the 10-item Warr-Cook-Wall questionnaire. Organizational culture was evaluated with four items. A linear regression analysis was performed in which each of the job satisfaction items was handled as dependent variable. Out of 1716 staff member questionnaires handed out to practice assistants, 1158 questionnaires were completed (response rate: 67.5%). Practice assistants were most satisfied with their colleagues and least satisfied with their income. Higher job satisfaction was associated with issues of organizational culture, particularly a good working atmosphere, opportunities to suggest and influence areas for improvement and clear responsibilities within the practice team. Prioritizing initiatives to maintain high levels of, or to improve the job satisfaction of practice assistants, is important for recruitment and retention. It will also help to improve working conditions for both practice assistants and GPs and create an environment to provide better quality care.
Troppmann, Kathrin M; Palis, Bryan E; Goodnight, James E; Ho, Hung S; Troppmann, Christoph
2009-08-01
Optimizing recruitment of the next surgical generation is paramount. Unfortunately, many nonsurgeons perceive surgeons' lifestyle as undesirable. It is unknown, however, whether the surgeons-important opinion makers about their profession-are indeed dissatisfied. We analyzed responses to a survey mailed to all surgeons who were certified by the American Board of Surgery in 1988, 1992, 1996, 2000, and 2004. We performed multivariate analyses to study career dissatisfaction and inability to achieve work-life balance, while adjusting for practice characteristics, demographics, and satisfaction with reimbursement. A total of 895 (25.5%) surgeons responded: mean age was 46 years; 80% were men; 88% were married; 86% had children; 45% were general surgeons; 72% were in urban practice; and 83% were in nonuniversity practice. Surgeons worked 64 hours per week; ideally, they would prefer to work 50 hours per week (median). Fifteen percent were dissatisfied with their careers. On multivariate analysis, significant (p < 0.05) risk factors were nonuniversity practice (odds ratio [OR] 3.3) and dissatisfaction with reimbursement (OR 5.9). Forty percent would not recommend a surgical career to their own children. On multivariate analysis, significant risk factors were nonuniversity practice (OR 2.5) and dissatisfaction with reimbursement (OR 3.4). In all, 33.5% did not achieve work-life balance. On multivariate analysis, dissatisfaction with reimbursement (OR 3.0) was a significant risk factor. Respondents' lives could be improved by "limiting emergency call" (77%), "diminishing litigation" (92%), and "improving reimbursement" (94%). Most surgeons are satisfied with their careers. Areas in need of improvement, particularly for nonuniversity surgeons, include reimbursement, work hours, and litigation. Strong local and national advocacy may not only improve career satisfaction, but could also render the profession more attractive for those contemplating a surgical career.
Doctor-patient relationships (DPR) in China.
Ma, Shaozhuang; Xu, Xuehu; Trigo, Virginia; Ramalho, Nelson J C
2017-03-20
Purpose The purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals' job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways. Design/methodology/approach Using a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study. Findings Commitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers' main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only. Practical implications DPR might be improved by applying commitment HR practices to increase healthcare professional's intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects' expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements. Originality/value This study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations among commitment HR practices, job satisfaction and DPR in the Chinese healthcare sector. The findings provide evidence to support the value of commitment HR practices in Chinese hospital context, and demonstrate the importance of effective HRM in improving both hospital managers and clinicians' work attitudes.
Heitkamp, Stefan J; Rüttermann, Stefan; Gerhardt-Szép, Susanne
2018-05-08
The aim of this study was to investigate the acceptance and assessment of work shadowing carried out by students and dentists in dental practices. Furthermore, the extent to which students perceive an improvement in their specialised, communication and social competencies, was to be examined. 61 dental students in their clinical semesters at a German university participated in work shadowing placements at 27 different general dental practices. Before beginning, they received checklists of various competencies that they self-assessed using school grades (from 1 = 'very good', to 6 = 'failed'), which they also repeated after completion. The dentists supplemented this with their external assessments. In addition, the students were requested to fill out a 54-item questionnaire and compose a freely-structured report after the work shadowing; the dentists filled out a questionnaire containing 16 items. The statistical analysis was carried out by means of the Friedman Test, including a post-hoc test (Bonferroni-Holm correction). The analysis showed a significant overall improvement in the students' self-assessed competencies by 0.71* ± 0.43 grades. With an average of 0.33* ± 0.36, the dentists' external assessment proved significantly higher than the self-assessment. The greatest improvements were perceived by the students in the areas of accounting (1.17* ± 0.77), practice organisation (1.05* ± 0.61) and dentist's discussions (0.94* ±0.80) [*p < 0.05]. The students confirmed experiencing an expansion of knowledge, an improvement in their communication skills and indicated a high degree of satisfaction in regard to the dentists (school grade 1.58 ± 0.93). A maximum amount of satisfaction towards the work shadow students was demonstrated by the dentists, and this form of teaching was assessed with a school grade of 1.69 ± 0.89. Both students and dental practitioners demonstrated a high level of satisfaction in regard to the work shadowing. The students felt their knowledge had increased, viewed the dentists as motivating role models and acknowledged a significant improvement in their specialised, communication and social competencies. Work shadowing in dental teaching practices presents a sensible addition to academic teaching at a university.
Shannon, Kay; McKenzie-Green, Barbara
2016-01-01
Challenges facing healthcare assistants in aged residential care are a focus of global debate. These challenges involve remuneration, education, skill mix, work conditions and organisational structures. We enter the discussion by acknowledging current work, education and remuneration for healthcare assistants. We then consider the supervisory relationships between registered nurses (RNs), enrolled nurses (ENs) and healthcare assistants, educational levels for RNs, ENs and healthcare assistants, and the interplay between organisation and practice in aged residential care. We suggest that improving work for the healthcare assistant has the potential to lead change in all role levels. Discussion paper. We argue that adjustments to work structures, education and skill advancement of RNs, ENs and healthcare assistants could improve staff working conditions and clarify practice boundaries. The ultimate result is likely to be an improvement to quality of care and the life of residents in aged residential care.
Ross, Robert H; Callas, Peter W; Sargent, Jesse Q; Amick, Benjamin C; Rooney, Ted
2006-12-01
Work related musculoskeletal disorders (WRMSDs) remain costly. The Worker-Based Outcomes Assessment System (WBOAS) is an injury treatment improvement tool. Its purpose is to increase treatment effectiveness and decrease the cost of care delivered in Occupational Health Service clinics. The study used a non-randomized (parallel cohort) control trial design to test the effects on injured employee outcomes of augmenting the standard care delivered by physical and occupational therapists (PT/OTs) with the WBOAS. The WBOAS works by putting patient-reported functional health status, pain symptom, and work role performance outcomes data into the hands of PT/OTs and their patients. Test clinic therapists were trained to incorporate WBOAS trends data into standard practice. Control clinic therapists delivered standard care alone. WBOAS-augmented PT/OT care did improve (p< or =.05) physical functioning and new injury/re-injury avoidance and, on these same dimensions, cost-adjusted outcome. It did not improve (p>.05) mental health or pain symptoms or return-to-work or stay-at-work success nor, on these same dimensions, cost-adjusted outcome. Training PT/OTs to incorporate patient-reported health status, pain symptom, and work role performance outcomes trends data into standard practice does appear to improve treatment effectiveness and cost on some (e.g. physical functioning) but not other (e.g. mental health, pain symptoms) outcomes.
ERIC Educational Resources Information Center
Carter, Kimberly; Swanke, Jayme; Stonich, Jessica; Taylor, Stephanie; Witzke, Morgan; Binetsch, Michael
2018-01-01
The use of simulated instruction is a growing trend in social work education. This study examined the effectiveness of simulated instruction with undergraduate social work students. In this mixed methods study, the extent to which simulated instruction improved self-efficacy and practice readiness was assessed. Results of the study suggest that…
Acquainting Future Office Employees with Productivity-Improvement Techniques.
ERIC Educational Resources Information Center
Quible, Zane K.
1982-01-01
Examines factors affecting productivity (government regulations, energy costs, decline in the work ethic, capital investment, number of service workers, work force characteristics, management practices, and unions), and techniques to improve productivity (employee involvement, job structure, communication, flexitime, employee upgrading, incentive…
Hwang, Jee-In; Park, Hyeoun-Ae
2015-07-01
This study investigated individual and work-related factors associated with nurses' perceptions of evidence-based practice (EBP) and quality improvement (QI), and the relationships between evidence-based practice, quality improvement and clinical errors. Understanding the factors affecting evidence-based practice and quality improvement activities and their relationships with clinical errors is important for designing strategies to promote evidence-based practice, quality improvement and patient safety. A cross-sectional survey was conducted with 594 nurses in two Korean teaching hospitals using the evidence-based practice Questionnaire and quality improvement scale developed in this study. Four hundred and forty-three nurses (74.6%) returned the completed survey. Nurses' ages and educational levels were significantly associated with evidence-based practice scores whereas age and job position were associated with quality improvement scores. There were positive, moderate correlations between evidence-based practice and quality improvement scores. Nurses who had not made any clinical errors during the past 12 months had significantly higher quality improvement skills scores than those who had. The findings indicated the necessity of educational support regarding evidence-based practice and quality improvement for younger staff nurses who have no master degrees. Enhancing quality improvement skills may reduce clinical errors. Nurse managers should consider the characteristics of their staff when implementing educational and clinical strategies for evidence-based practice and quality improvement. © 2013 John Wiley & Sons Ltd.
Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period
Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.
2014-01-01
Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P < .001). Conclusion: QI principles were used by a multidisciplinary team to improve the quality of care for patients with glioma during the perioperative period. Leadership involvement, ongoing dialogue across departments, and reporting of system performance were important for sustaining process improvements. PMID:25294392
Factors Affecting Social Workers' Inclusion of Animals in Practice
ERIC Educational Resources Information Center
Risley-Curtiss, Christina; Rogge, Mary E.; Kawam, Elisa
2013-01-01
Experts suggest that social work practitioners can improve their client service with a more thorough understanding of the impact of other animals on individuals and families. Studies indicate that some social work practitioners are including animals in their practices through assessment and interventions. Little is known about what factors…
A Statewide Analysis of RNs' Intention To Leave Their Position.
ERIC Educational Resources Information Center
Rambur, Betty; Palumbo, Mary Val; McIntosh, Barbara; Mongeon, Joan
2003-01-01
Secondary analysis of registered nurse work force data from Vermont (n=4,418, 85% response) identified predictors of intention to leave current position. Differences in intention vary by educational attainment, hours worked, gender, practice role, and practice activity. Improving retention will require increased attention to compensation,…
ERIC Educational Resources Information Center
Bitter, Catherine; O'Day, Jennifer; Gubbins, Paul; Socias, Miguel
2009-01-01
A core assumption of the San Diego City Schools (SDCS) reform effort was that improved instructional practices, aligned with a balanced literacy approach, would be effective in improving student outcomes. This article explores this hypothesis by presenting findings from an analysis of classroom instruction data collected in 101 classrooms in 9…
Blacker, Susan; Head, Barbara A; Jones, Barbara L; Remke, Stacy S; Supiano, Katherine
2016-01-01
The importance of interprofessional collaboration in achieving high quality outcomes, improving patient quality of life, and decreasing costs has been growing significantly in health care. Palliative care has been viewed as an exemplary model of interprofessional care delivery, yet best practices in both interprofessional education (IPE) and interprofessional practice (IPP) in the field are still developing. So, too, is the leadership of hospice and palliative care social workers within IPE and IPP. Generating evidence regarding best practices that can prepare social work professionals for collaborative practice is essential. Lessons learned from practice experiences of social workers working in hospice and palliative care can inform educational efforts of all professionals. The emergence of interprofessional education and competencies is a development that is relevant to social work practice in this field. Opportunities for hospice and palliative social workers to demonstrate leadership in IPE and IPP are presented in this article.
Untangling practice redesign from disease management: how do we best care for the chronically ill?
Coleman, Katie; Mattke, Soeren; Perrault, Patrick J; Wagner, Edward H
2009-01-01
In the past 10 years, a wide spectrum of chronic care improvement interventions has been tried and evaluated to improve health outcomes and reduce costs for chronically ill individuals. On one end of the spectrum are disease-management interventions--often organized by commercial vendors--that work with patients but do little to engage medical practice. On the other end are quality-improvement efforts aimed at redesigning the organization and delivery of primary care and better supporting patient self-management. This qualitative review finds that carve-out disease management interventions that target only patients may be less effective than those that also work to redesign care delivery. Imprecise nomenclature and poor study design methodology limit quantitative analysis. More innovation and research are needed to understand how disease-management components can be more meaningfully embedded within practice to improve patient care.
ERIC Educational Resources Information Center
Grima-Farrell, Christine
2014-01-01
The knowledge and practices associated with improved outcomes for readers have yielded converging evidence about practices associated with improved reading outcomes for primary students. This considerable intervention knowledge can be beneficial for English teachers working with struggling secondary readers. Fluency is one critical element that…
Innovation in ambulatory care: a collaborative approach to redesigning the health care workplace.
Johnson, Paula A; Bookman, Ann; Bailyn, Lotte; Harrington, Mona; Orton, Piper
2011-02-01
To improve the quality of patient care and work satisfaction of the physicians and staff at an ambulatory practice that had recently started an innovative model of clinical care for women. The authors used an inclusive process, collaborative interactive action research, to engage all physicians and staff members in assessing and redesigning their work environment. Based on key barriers to working effectively and integrating work and family identified in that process, a pilot project with new work practices and structures was developed, implemented, and evaluated. The work redesign process established cross-occupational care teams in specific clinical areas. Members of the teams built skills in assessing clinical operations in their practice areas, developed new levels of collaboration, and constructed new models of distributed leadership. The majority of participants reported an improvement in how their area functioned. Integrating work and family/personal life-particularly practices around flexible work arrangements-became an issue for team discussion and solutions, not a matter of individual accommodation by managers. By engaging the workforce, collaborative interactive action research can help achieve lasting change in the health care workplace and increase physicians' and staff members' work satisfaction. This "dual agenda" may be best achieved through a collaborative process where cross-occupational teams are responsible for workflow and outcomes and where the needs of patients and providers are integrated.
Chinese primary care physicians and work attitudes.
Shi, Leiyu; Hung, Li-Mei; Song, Kuimeng; Rane, Sarika; Tsai, Jenna; Sun, Xiaojie; Li, Hui; Meng, Qingyue
2013-01-01
China passed a landmark health care reform in 2009, aimed at improving health care for all citizens by strengthening the primary care system, largely through improvements to infrastructure. However, research has shown that the work attitudes of primary care physicians (PCPs) can greatly affect the stability of the overall workforce and the quality and delivery of health care. The purpose of this study is to investigate the relationship between reported work attitudes of PCPs and their personal, work, and educational characteristics. A multi-stage, complex sampling design was employed to select a sample of 434 PCPs practicing in urban and rural primary care settings, and a survey questionnaire was administered by researchers with sponsorship from the Ministry of Health. Four outcome measures describing work attitudes were used, as well as a number of personal-, work-, and practice-related factors. Findings showed that although most PCPs considered their work as important, a substantial number also reported large workloads, job pressure, and turnover intentions. Findings suggest that policymakers should focus on training and educational opportunities for PCPs and consider ways to ease workload pressures and improve salaries. These policy improvements must accompany reform efforts that are already underway before positive changes in reduced disparities and improved health outcomes can be realized in China.
Swiger, Pauline A; Patrician, Patricia A; Miltner, Rebecca S Susie; Raju, Dheeraj; Breckenridge-Sproat, Sara; Loan, Lori A
2017-09-01
The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. A narrative review of quantitative studies. PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI. Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. Published by Elsevier Ltd.
Booth, Andrew; Carroll, Christopher
2015-01-01
Increasing recognition of the role and value of theory in improvement work in healthcare offers the prospect of capitalising upon, and consolidating, actionable lessons from synthesis of improvement projects and initiatives. We propose that informed use of theory can (i) provide a mechanism by which to collect and organise data from a body of improvement work, (ii) offer a framework for analysis and identification of lessons learnt and (iii) facilitate an evaluation of the feasibility, effectiveness and acceptability of improvement programmes. Improvement practitioners can benefit from using an underpinning external structure as a lens by which to examine the specific achievements of their own projects alongside comparable initiatives led by others. We demonstrate the utility of a method known as ‘best fit framework synthesis’ (BFFS) in offering a ubiquitous and versatile means by which to collect, analyse and evaluate improvement work in healthcare. First reported in 2011, BFFS represents a pragmatic, flexible approach to integrating theory with findings from practice. A deductive phase, where a review team seeks to accommodate a substantial part of the data, is followed by an inductive phase, in which the team explores data not accommodated by the framework. We explore the potential for BFFS within improvement work by drawing upon the evidence synthesis methodology literature and practical examples of improvement work reported in BMJ Quality and Safety (2011–2015). We suggest four variants of BFFS that may have particular value in synthesising a body of improvement work. We conclude that BFFS, alongside other approaches that seek to optimise the contribution of theory to improvement work, represents one important enabling mechanism by which to establish the rigour and scientific credentials of the emerging discipline of ‘improvement science’. PMID:26306609
Cockburn, Lynn; Fanfon, Timothy N; Bramall, Alexa; Ngole, Eta M; Kuwoh, Pius; Anjonga, Emmanuel; Difang, Brenda M E; Kiani, Shirin; Muso, Petra S; Trivedi, Navjyot; Sama, Julius; Teboh, Sylvian
2014-01-01
Although the adherence to stroke guidelines in high-income countries has been shown to be associated with improved patient outcomes, the research, development and implementation of rehabilitation related guidelines in African countries is lacking. The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG) for the management and rehabilitation of stroke in adult patients in Cameroon. A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context. The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group's recommendations aimed at encouraging others to consider similar projects. This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.
Teaching Performance Improvement: An Opportunity for Continuing Medical Education
ERIC Educational Resources Information Center
Staker, Larry V.
2003-01-01
Practicing physicians generally are not engaged in either the methods of performance improvement for health care or the measurement and reporting of clinical outcomes. The principal reasons are lack of compensation for such work, the perception that the work of performance improvement adds no value and is a waste of time, the lack of knowledge and…
Pastoral Care and Mindfulness: A Teaching Practice
ERIC Educational Resources Information Center
Strongman, Luke
2017-01-01
From the earliest modern academic literature of industrial organization, supervision education and training, managerial considerations involve leveraging to improve the work of the supervisor and supervisee, and accentuating the value added opportunities for work improvement (Dawson, 1926, pp. 293-295). Reflecting the incorporation of the…
Kabir, Ashraful; Maitrot, Mathilde Rose Louise
2017-01-01
Nutritional status differs between infants and young children living in slum and non-slum conditions-infants and young children living in City Corporation slums are likely to have worse nutritional status compared to those from non-slums. Furthermore, families in slums tend to engage female labor in cash-earning activities as a survival strategy; hence, a higher percentage of mothers stay at work. However, little is known about feeding practices for infants and young children in families with working mothers in slums. This study aims to understand the factors that determine feeding practices for infants and young children living in families with working mothers in Dhaka slums. This study adopted a qualitative approach. Sixteen In-depth Interviews, five Key Informant Interviews, and Focused Group Discussions were conducted with family members, community leaders, and program staff. Method triangulation and thematic analyses were conducted. Feeding practices for infants and young children in families with working mothers are broadly determined by mothers' occupation, basis civic facilities, and limited family buying capacity. Although mothers have good nutritional knowledge, they negotiate between work and feeding their infants and young children. Household composition, access to cooking facilities, and poverty level were also found to be significant determining factors. The results suggest a trade-off between mothers' work and childcare. The absence of alternative care support in homes and/or work places along with societal factors outweighs full benefits of project interventions. Improving alternative childcare support could reduce the burden of feeding practice experienced by working mothers and may improve nutritional outcomes.
2014-01-01
Background Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what factors within the nursing work environment are of influence. The main focus of this research was to comprehend the views of Dutch nurses on how their work and their work environment contribute to positive patient experiences. Methods A descriptive qualitative research design was used to collect data. Four focus groups were conducted, one each with 6 or 7 registered nurses in mental health care, hospital care, home care and nursing home care. A total of 26 nurses were recruited through purposeful sampling. The interviews were audiotaped, transcribed and subjected to thematic analysis. Results The nurses mentioned essential elements that they believe would improve patient experiences of the quality of nursing care: clinically competent nurses, collaborative working relationships, autonomous nursing practice, adequate staffing, control over nursing practice, managerial support and patient-centred culture. They also mentioned several inhibiting factors, such as cost-effectiveness policy and transparency goals for external accountability. Nurses feel pressured to increase productivity and report a high administrative workload. They stated that these factors will not improve patient experiences of the quality of nursing care. Conclusions According to participants, a diverse range of elements affect patient experiences of the quality of nursing care. They believe that incorporating these elements into daily nursing practice would result in more positive patient experiences. However, nurses work in a healthcare context in which they have to reconcile cost-efficiency and accountability with their desire to provide nursing care that is based on patient needs and preferences, and they experience a conflict between these two approaches. Nurses must gain autonomy over their own practice in order to improve patient experiences. PMID:24923663
Kogi, Kazutaka
2006-01-01
Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.
Combining Project Management Methods: A Case Study of Dlstributed Work Practices
NASA Astrophysics Data System (ADS)
Backlund, Per; Lundell, Björn
The increasing complexity of information systems development (ISD) projects call for improved project management practices. This, together with an endeavour to improve the success rate of ISD projects (Lyytinen and Robey 1999; Cooke-Davies 2002; White and Fortune 2002), has served as drivers for various efforts in process improvement such as the introduction of new development methods (Fitzgerald 1997; Iivari and Maansaari 1998).
Sparer, Emily H; Boden, Leslie I; Sorensen, Glorian; Dennerlein, Jack T; Stoddard, Anne; Wagner, Gregory R; Nagler, Eve M; Hashimoto, Dean M; Hopcia, Karen; Sabbath, Erika L
2018-05-29
We examined relationships between organizational policies and practices (OPPs) (safety practices, ergonomic practices, and people-oriented culture) and work limitations in a sample of hospital workers. We used the 6-item Work Limitations Questionnaire (WLQ) to assess workers' perceptions of health-related work limitations. Self-reported OPPs and the WLQ were collected from workers in Boston, Massachusetts (n = 1277). We conducted random-intercept multi-level logistic regression models for each OPP using stepwise selection of covariates. As the unit-average ergonomic practice score increased by one, the odds of a worker reporting work limitations decreased by approximately 39% (P-value = 0.018), adjusted for job title, age, and body mass index. A similar relationship existed for people-oriented culture (P-value = 0.038). The association between safety practices and work limitations was similar, but not statistically significant. This study demonstrated the importance of workplace OPPs. OPPs that promote positive and supportive environments and that foster improvements in ergonomics may help reduce work limitations. © 2018 Wiley Periodicals, Inc.
Maternal return to paid work and breastfeeding practices in Bangkok, Thailand.
Aikawa, Tomomi; Pavadhgul, Patcharanee; Chongsuwat, Rewadee; Sawasdivorn, Siraporn; Boonshuyar, Chaweewon
2015-03-01
This study explored the association between mothers' work-related factors and breastfeeding practices in Bangkok, Thailand. Data were collected from 84 working mothers with a child aged 6 to 24 months who visited the breastfeeding mobile clinic at a nursery goods exhibition. Thai interviewers collected data using a structured questionnaire. Analysis of the data showed that exclusive breastfeeding for 3 months was 78.6%, and for 6 months it was 38.1%. Mothers who returned to work 3 months or more after giving birth exclusively breastfed more than the mothers who returned to work in less than 3 months (crude odds ratio [OR] = 4.26, 95% confidence interval [CI] = 1.39-13.05; adjusted OR = 4.15, 95% CI = 1.15-14.95). Moreover, mothers who worked at self-employed or family-owned businesses and some mothers working at private companies showed tendencies of returning to work in less than 3 months. Results suggest that longer maternity leave would help extend the duration of exclusive breastfeeding. In addition, the improvement of a breastfeeding supportive environment in the workplace would be valuable and may be an effective means to improve breastfeeding practices and infant health. © 2011 APJPH.
Horner, Ronnie D; Matthews, Gerald; Yi, Michael S
2012-08-01
Physician work intensity, although a major factor in determining the payment for medical services, may potentially affect patient health outcomes including quality of care and patient safety, and has implications for the redesign of medical practice to improve health care delivery. However, to date, there has been minimal research regarding the relationship between physician work intensity and either patient outcomes or the organization and management of medical practices. A theoretical model on physician work intensity will provide useful guidance to such inquiries. To describe an initial conceptual model to facilitate further investigations of physician work intensity. A conceptual model of physician work intensity is described using as its theoretical base human performance science relating to work intensity. For each of the theoretical components, we present relevant empirical evidence derived from a review of the current literature. The proposed model specifies that the level of work intensity experienced by a physician is a consequence of the physician performing the set of tasks (ie, demands) relating to a medical service. It is conceptualized that each medical service has an inherent level of intensity that is experienced by a physician as a function of factors relating to the physician, patient, and medical practice environment. The proposed conceptual model provides guidance to researchers as to the factors to consider in studies of how physician work intensity impacts patient health outcomes and how work intensity may be affected by proposed policies and approaches to health care delivery.
Vernik, N V; Ivantsova, M A; Yashin, D I
2015-01-01
To evaluate the ways of reduction complications during endoscopic procedures based on principals of professional ethics and improving the quality of working area. Data of fundamental literature, evidence based medicine, science publications and internet portals. Deontology is the fundamental principle of medical practice and one of the main factors of professional effectiveness. Complications in endoscopy are often the investigations of deviation from the deontological principals. The whole number of psychological factors influences on professional activity of endoscopists, where the emotional "burn-out" syndrome (EBS) occupies one of the main places. Prophylactic and timely relief of EBS serves improvement of the practical work quality. Creation of favorable working area is the strategically important task in prophylactics of endoscopy complications. The questions of practical realization of deontological principles in endoscopy are the subject of further discussion.
ERIC Educational Resources Information Center
O'Brien, Nick
2010-01-01
This article describes LabSkills, a revolutionary teaching tool to improve practical science in schools. LabSkills offers the chance to help improve the exposure that the average Key Stage 5 (age 16-19) student has to practical work. This is a huge area for development being highlighted by universities who are seeing a worryingly growing trend in…
ERIC Educational Resources Information Center
Burgess, Tyrrell; Swann, Joanna
2003-01-01
Addresses the question of why Karl Popper's work has been disregarded or rejected for educational improvement and suggests a series of impediments to an acceptance of Popper's ideas. Outlines a set of principle which if adopted as a basis for practice could lead to significant improvement. (EV)
Improving the Teaching of Evidence-Based Practice: Challenges and Priorities
ERIC Educational Resources Information Center
Soydan, Haluk
2007-01-01
This article explores some of the main challenges of improving the teaching of evidence-based practice in schools of social work. The priority challenges are the needs for a general professional cultural shift, for adequate curricula, to overcome the controversy of scientific methodology, to better understand the state of the art of the…
Evidence and Impact: How Scholarship Can Improve Policy and Practice
ERIC Educational Resources Information Center
Lingenfelter, Paul E.
2011-01-01
Researchers, policy makers, and practitioners share a sincere interest in improving the human condition. Academics may be tempted to fault irrationality, ideology, or ignorance for the failure of research to inform policy and practice more powerfully, but policy makers and practitioners want academics to tell them "what works" in order to find a…
System Leadership for School Improvement: A Developing Concept and Set of Practices
ERIC Educational Resources Information Center
Dimmock, Clive
2016-01-01
System leadership is a developing concept and practice increasingly seen as a tool for school improvement, as policymakers switch from traditional top-down reform to professional models of schools working collaboratively. System leadership is being championed by the Scottish College for Educational Leadership (SCEL), but is still in its infancy in…
Arthur, Darren P
2015-01-01
This article focuses on culturally sensitive clinical issues related to best practices with lesbian, gay, bisexual, transgender (LGBT) elder patients at end-of-life (EOL) at key points in the therapeutic relationship. Vital concepts, including practice evaluation and clinical skills, are presented through a cultural and oncology lens. There is a paucity of LGBT research and literature as well as a shortfall of MSW graduate school education specific to social work palliative and end-of-life care (PELC) practice with LGBT elders. The content of this article is designed to be adapted and used as an educational tool for institutions, agencies, graduate programs, medical professions, social work, and students. Learning the unique elements of LGBT cultural history and their implications on EOL care can improve social work practice. This article provides an examination from assessment and engagement basics to advance care planning incorporating specific LGBT EOL issues.
Relationship between nurses' practice environments and nursing outcomes in Turkey.
Topçu, I; Türkmen, E; Badır, A; Göktepe, N; Miral, M; Albayrak, S; Kebapçı, A; Serbest, Ş; Özcan, D
2016-06-01
This study aimed to understand nursing practice environment characteristics in Istanbul-area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work. A well-known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey. This cross-sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection. Almost half of nurses suffered from high-level burnout related to emotional exhaustion and personal accomplishment, and one-third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention. There was a relationship between poor practice environments and nursing outcomes in Turkey. The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments. Poor practice environments, high-level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes. Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes. © 2016 International Council of Nurses.
Cornes, Michelle; Manthorpe, Jill; Hennessy, Catherine; Anderson, Sarah; Clark, Michael; Scanlon, Christopher
2014-11-01
Within homelessness services recent policy developments have highlighted the need for integration and improved collaborative working and also, the need for "Psychologically Informed Environments" (PIES) in which workers are better equipped to manage the "complex trauma" associated with homelessness. Drawing on the findings of an evaluation of a multi-site development programme, this paper demonstrates how both these policy aspirations might be implemented through a single delivery vehicle (a community of practice). The paper describes how organizational, educational and psychosocial theory was used to inform programme design and reflects on the utility of these approaches in the light of the evaluation findings. It is reported that communities of practice can deliver significant performance gains in terms of building collaborative relationships and opening-up opportunities for interprofessional education and learning. Filling an important knowledge gap, it also suggested how (professional) participation in a community of practice might work to improve outcomes for service users. Most likely we see those outcomes as being linked to tackling exclusion by sustaining the workforce itself, that is in motivating workers to remain engaged and thinking positively in what is an emotionally challenging and stressful job role.
Gunathunga, M W
2016-10-17
Cognitive ergonomics in the work place has become a serious concern with the need to keep people happy at work while maintaining high productivity. Hence, it is worth exploring how the outcomes of lifestyle-based mind development programs can bring about happiness in workplace while keeping productivity and quality of services high. The objective of the present work was to test a body-mind technique to improve cognitive ergonomics in a health care work setting. Principal investigator explored many body-mind techniques before selecting the present method of "insight meditation" which he mastered before applying it on a group of scholars who made it a part of their lifestyle. Later it was introduced to a sample of 500 volunteer health personnel in the western province to generate a ripple effect of happiness at work. Initial qualitative information indicated improvement of some aspects of cognitive ergonomics among those who practiced it. There was a relief from stress during the practice sessions and improvements in the commitment to work and in team spirit. A demand was observed for further training. A quasi-experimental study to test the improvements is underway. Health workers showed interest in the mind training and potential benefits to individuals and the institutions were observed.
Schonberger, Robert B; Barash, Paul G; Lagasse, Robert S
2015-08-01
Since 2006, the Surgical Care Improvement Project (SCIP) has promoted 3 perioperative antibiotic recommendations designed to reduce the incidence of surgical site infections. Despite good evidence for the efficacy of these recommendations, the efforts of SCIP have not measurably improved the rates of surgical site infections. We offer 3 arguments as to why SCIP has fallen short of expectations. We then suggest a reorientation of quality improvement efforts to focus less on reporting, and incentivizing adherence to imperfect metrics, and more on creating local and regional quality collaboratives to educate clinicians about how to improve practice. Ultimately, successful quality improvement projects are behavioral interventions that will only succeed to the degree that they motivate individual clinicians, practicing within a particular context, to do the difficult work of identifying failures and iteratively working toward excellence.
Schonberger, Robert B.; Barash, Paul G.; Lagasse, Robert S.
2015-01-01
Since 2006, the Surgical Care Improvement Project (SCIP) has promoted three perioperative antibiotic recommendations designed to reduce the incidence of surgical-site infections. Despite good evidence for the efficacy of these recommendations, SCIP's efforts have not measurably improved rates of surgical site-infections. We offer three arguments as to why SCIP has fallen-short of expectations. We then suggest a reorientation of quality improvement efforts to focus less on reporting, and incentivizing adherence to imperfect metrics, and more on creating local and regional quality collaboratives to educate clinicians about how to improve practice. Ultimately, successful quality improvement projects are behavioral interventions that will only succeed to the degree that they motivate individual clinicians, practicing within a particular context, to do the difficult work of identifying failures and iteratively working toward excellence. PMID:26197373
Collaborative field research and training in occupational health and ergonomics.
Kogi, K
1998-01-01
Networking collaborative research and training in Asian developing countries includes three types of joint activities: field studies of workplace potentials for better safety and health, intensive action training for improvement of working conditions in small enterprises, and action-oriented workshops on low-cost improvements for managers, workers, and farmers. These activities were aimed at identifying workable strategies for making locally adjusted improvements in occupational health and ergonomics. Many improvements have resulted as direct outcomes. Most these improvements were multifaceted, low-cost, and practicable using local skills. Three common features of these interactive processes seem important in facilitating realistic improvements: 1) voluntary approaches building on local achievements; 2) the use of practical methods for identifying multiple improvements; and 3) participatory steps for achieving low-cost results first. The effective use of group work tools is crucial. Stepwise training packages have thus proven useful for promoting local problem-solving interventions based on voluntary initiatives.
Cuellar, Alison; Krist, Alex H; Nichols, Len M; Kuzel, Anton J
2018-04-01
Physicians have joined larger groups and hospital systems in the face of multiple environmental challenges. We examine whether there are differences across practice ownership in self-reported work environment, a practice culture of learning, psychological safety, and burnout. Using cross-sectional data from staff surveys of small and medium-size practices that participated in EvidenceNOW in Virginia, we tested for differences in work environment, culture of learning, psychological safety, and burnout by practice type. We conducted weighted multivariate linear regression of outcomes on ownership, controlling for practice size, specialty mix, payer mix, and whether the practice was located in a medically underserved area. We further analyzed clinician and staff responses separately. Participating were 104 hospital-owned and 61 independent practices and 24 federally qualified health centers (FQHCs). We analyzed 2,005 responses from practice clinicians and staff, a response rate of 49%. Working in a hospital-owned practice was associated with favorable ratings of work environment, psychological safety, and burnout compared with independent practices. When we examined separately the responses of clinicians vs staff, however, the association appears to be largely driven by staff. Hospital ownership was associated with positive perceptions of practice work environment and lower burnout for staff relative to independent ownership, whereas clinicians in FQHCs perceive a more negative, less joyful work environment and burnout. Our findings are suggestive that clinician and nonclinician staff perceive practice adaptive reserve differently, which may have implications for creating the energy for ongoing quality improvement work. © 2018 Annals of Family Medicine, Inc.
Exploring deliberate practice in medicine: how do physicians learn in the workplace?
van de Wiel, Margje W J; Van den Bossche, Piet; Janssen, Sandra; Jossberger, Helen
2011-03-01
Medical professionals need to keep on learning as part of their everyday work to deliver high-quality health care. Although the importance of physicians' learning is widely recognized, few studies have investigated how they learn in the workplace. Based on insights from deliberate practice research, this study examined the activities physicians engage in during their work that might further their professional development. As deliberate practice requires a focused effort to improve performance, the study also examined the goals underlying this behaviour. Semi-structured interviews were conducted with 50 internal medicine physicians: 19 residents, 18 internists working at a university hospital, and 13 working at a non-university hospital. The results showed that learning in medical practice was very much embedded in clinical work. Most relevant learning activities were directly related to patient care rather than motivated by competence improvement goals. Advice and feedback were sought when necessary to provide this care. Performance standards were tied to patients' conditions. The patients encountered and the discussions with colleagues about patients were valued most for professional development, while teaching and updating activities were also valued in this respect. In conclusion, physicians' learning is largely guided by practical experience rather than deliberately sought. When professionals interact in diagnosing and treating patients to achieve high-quality care, their experiences contribute to expertise development. However, much could be gained from managing learning opportunities more explicitly. We offer suggestions for increasing the focus on learning in medical practice and further research.
Simple Practice Doesn't Always Make Perfect: Evidence from the Worked Example Effect
ERIC Educational Resources Information Center
Booth, Julie L.; McGinn, Kelly M.; Young, Laura K.; Barbieri, Christina
2015-01-01
Findings from the fields of cognitive science and cognitive development propose a variety of evidence-based principles for improving learning. One such recommendation is that instead of having students practice solving long strings of problems on their own after a lesson, worked-out examples of problem solutions should be incorporated into…
Improving work-life balance: what can employers and employees do?
Herrera, Manuela
2013-12-14
Effective time management can play a big part in reducing stress for busy vets, but too often miscommunication between practice employers and employees can make it harder to achieve a good work-life balance. Manuela Herrera reports on a session at the BVA Congress which considered what vets can do to facilitate better time management in practice.
A framework and a measurement instrument for sustainability of work practices in long-term care
2011-01-01
Background In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices after implementation. The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization. Methods The exploratory methodological design consisted of three phases: a) framework development; b) instrument development; and c) field testing in former improvement teams in a quality improvement program for health care (N teams = 63, N individual = 112). Data were collected not until at least one year had passed after implementation. Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach's alpha coefficient. A long and a short version of the instrument are proposed. Results The χ2- difference test of the -2 Log Likelihood estimates demonstrated that the hierarchical two factor model with routinization and institutionalization as separate constructs showed a better fit than the one factor model (p < .01). Secondly, construct validity of the instrument was strong as indicated by the high factor loadings of the items. Finally, the internal consistency of the subscales was good. Conclusions The theoretical framework offers a valuable starting point for the analysis of sustainability on the level of actual changed work practices. Even though the two dimensions routinization and institutionalization are related, they are clearly distinguishable and each has distinct value in the discussion of sustainability. Finally, the subscales conformed to psychometric properties defined in literature. The instrument can be used in the evaluation of improvement projects. PMID:22087884
de Merich, D; Pellicci, M; Serignoli, R
2010-01-01
Within the intelligence support and training to small and medium-sized enterprises (SMEs) and promoting a culture of health and safety at work, ISPESL is engaged on two fundamental pillars of activity: Consolidation of the national surveillance system of injuries through the promotion of methods and tools for the reconstruction of the dynamics incidental identification of causal determinants, with the aim of improving the capabilities of risk assessment of systems to prevent corporate. The promotion of good working practices, as Focal Point of the European Health and Safety at Work in Bilbao, the goal is to support prevention activities by providing business application examples of measures for improvement (technical, organizational, procedural) made in the proposing firms and validated by a technical appraisal conducted by ISPESL. Among the methodologies and tools that can be made available to companies in the operational management of health and safety in work activities, the approach to analyze and evaluate the behavior implemented by all persons within the company (managers, employees, workers) is a the most innovative preventive strategies that can be implemented to correct any improper practices behavioral wrongly tolerated in everyday work practice. The experience of Crown Aerosol Italy, the program "STOP TO ACCIDENTS, 2009 Best Practices award in the competition on the theme" Risk Assessment ", aims to demonstrate how the application of a method for monitoring behavior at work, shared in its planning with all those business, has not only reached but would assist the organization has developed at an individual level greater awareness and sense of responsibility also to their colleagues, by promoting good working practices.
"Getting Practical" and the National Network of Science Learning Centres
ERIC Educational Resources Information Center
Chapman, Georgina; Langley, Mark; Skilling, Gus; Walker, John
2011-01-01
The national network of Science Learning Centres is a co-ordinating partner in the Getting Practical--Improving Practical Work in Science programme. The principle of training provision for the "Getting Practical" programme is a cascade model. Regional trainers employed by the national network of Science Learning Centres trained the cohort of local…
Commentary: Moving from Practice to Research, and Back
ERIC Educational Resources Information Center
Yohalem, Nicole; Tseng, Vivian
2015-01-01
It is a widely accepted idea that knowledge from research needs to be better integrated into practice. Considerable energy is dedicated to strengthening the flow of research to practice. Less attention, however, has been paid to strengthening the ways researchers can learn from practice to improve their work. In this commentary, we draw on our…
Maitrot, Mathilde Rose Louise
2017-01-01
Background Nutritional status differs between infants and young children living in slum and non-slum conditions—infants and young children living in City Corporation slums are likely to have worse nutritional status compared to those from non-slums. Furthermore, families in slums tend to engage female labor in cash-earning activities as a survival strategy; hence, a higher percentage of mothers stay at work. However, little is known about feeding practices for infants and young children in families with working mothers in slums. This study aims to understand the factors that determine feeding practices for infants and young children living in families with working mothers in Dhaka slums. Methods This study adopted a qualitative approach. Sixteen In-depth Interviews, five Key Informant Interviews, and Focused Group Discussions were conducted with family members, community leaders, and program staff. Method triangulation and thematic analyses were conducted. Results Feeding practices for infants and young children in families with working mothers are broadly determined by mothers’ occupation, basis civic facilities, and limited family buying capacity. Although mothers have good nutritional knowledge, they negotiate between work and feeding their infants and young children. Household composition, access to cooking facilities, and poverty level were also found to be significant determining factors. Conclusion The results suggest a trade-off between mothers’ work and childcare. The absence of alternative care support in homes and/or work places along with societal factors outweighs full benefits of project interventions. Improving alternative childcare support could reduce the burden of feeding practice experienced by working mothers and may improve nutritional outcomes. PMID:28207894
Teacher Quality Roadmap: Improving Policies and Practices in the Miami-Dade County Public Schools
ERIC Educational Resources Information Center
National Council on Teacher Quality, 2012
2012-01-01
In partnership with the Urban League of Greater Miami, the National Council on Teacher Quality (NCTQ) released "Teacher Quality Roadmap: Improving Policies and Practices in Miami," an in-depth study of the work rules Miami-Dade teachers. This look at the state of teacher policies in Miami-Dade County Public Schools explores the…
ERIC Educational Resources Information Center
Mintrop, Heinrich; Trujillo, Tina
2007-01-01
In search for the practical relevance of accountability systems for school improvement, we ask whether practitioners traveling between the worlds of system-designated high and low-performing schools would detect tangible differences by observing concrete behaviors, looking at student work, or inquiring about teacher, administrator, or student…
ERIC Educational Resources Information Center
Schuch, Linda, Ed.
2004-01-01
"Viewpoints" is a multimedia package containing two audio CDs and a short, informative booklet. This volume of "Viewpoints" focuses on using scientifically based practices to improve student achievement and teacher effectiveness. The audio CDs provide the voices, or viewpoints, of various leaders from the education field who have worked closely…
Improving Business School Courses by Applying Lean Principles and Practices
ERIC Educational Resources Information Center
Emiliani, M. L.
2004-01-01
Describes the application of lean principles and practices to the design and delivery of a graduate business course on leadership taken by part-time working professional students in a classroom setting. The principal objectives were to improve consistency between what was taught in the course and how the course was taught, eliminate waste, improve…
ERIC Educational Resources Information Center
Haas, Eric; Goldman, Julie; Faltis, Christian
2018-01-01
Improving the writing of middle-school English learners can improve their academic thinking, literacy, and content knowledge. The Writing Reform and Innovation for Teaching Excellence (WRITE) program uses six high-leverage writing practices and develops teacher capacity through professional learning activities anchored in the group grading of…
Dickinson, L Miriam; Dickinson, W Perry; Nutting, Paul A; Fisher, Lawrence; Harbrecht, Marjie; Crabtree, Benjamin F; Glasgow, Russell E; West, David R
2015-04-01
Efforts to improve primary care diabetes management have assessed strategies across heterogeneous groups of patients and practices. However, there is substantial variability in how well practices implement interventions and achieve desired outcomes. To examine practice contextual features that moderate intervention effectiveness. Secondary analysis of data from a cluster randomized trial of three approaches for implementing the Chronic Care Model to improve diabetes care. Forty small to mid-sized primary care practices participated, with 522 clinician and staff member surveys. Outcomes were assessed for 822 established patients with a diagnosis of type 2 diabetes who had at least one visit to the practice in the 18 months following enrollment. The primary outcome was a composite measure of diabetes process of care, ascertained by chart audit, regarding nine quality measures from the American Diabetes Association Physician Recognition Program: HgA1c, foot exam, blood pressure, dilated eye exam, cholesterol, nephropathy screen, flu shot, nutrition counseling, and self-management support. Data from practices included structural and demographic characteristics and Practice Culture Assessment survey subscales (Change Culture, Work Culture, Chaos). Across the three implementation approaches, demographic/structural characteristics (rural vs. urban + .70(p = .006), +2.44(p < .001), -.75(p = .004)); Medicaid: < 20 % vs. ≥ 20 % (-.20(p = .48), +.75 (p = .08), +.60(p = .02)); practice size: < 4 clinicians vs. ≥ 4 clinicians (+.56(p = .02), +1.96(p < .001), +.02(p = .91)); practice Change Culture (high vs. low: -.86(p = .048), +1.71(p = .005), +.34(p = .22)), Work Culture (high vs. low: -.67(p = .18), +2.41(p < .001), +.67(p = .005)) and variability in practice Change Culture (high vs. low: -.24(p = .006), -.20(p = .0771), -.44(p = .0019) and Work Culture (high vs. low: +.56(p = .3160), -1.0(p = .008), -.25 (p = .0216) were associated with trajectories of change in diabetes process of care, either directly or differentially by study arm. This study supports the need for broader use of methodological approaches to better examine contextual effects on implementation and effectiveness of quality improvement interventions in primary care settings.
OVERVIEW OF THE ACTIVITIES OF THE NUCLEAR ENERGY AGENCY WORKING GROUP ON EXTERNAL EVENTS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nakoski, John A.; Smith, Curtis L.; Kim, Min Kyu
The Orgranisation for Economic Cooperation and Development (OECD) Nuclear Energy Agency (NEA) has established a Working Group on External Events (WGEV) that provides a forum for subject matter experts from the nuclear industry and regulators to improve the understanding and treatment of external hazards that would support the continued safety performance of nuclear installations, and improve the effectiveness of regulatory practices, in NEA member countries. This report provides a description of the ongoing work of the WGEV. The work of the WGEV includes the collection of information and conducting a workshop on severe weather and storm surge that brought togethermore » a diverse group of subject matter experts to identify commendable practices related to the treatment of severe weather and storm surge consideration in regulatory and operational decision-making. Other work of the WGEV includes looking at science-based screening of external events that are factored into decisions on the safe operation of nuclear facilities; and identification of commendable practices and knowledge gaps on riverine flooding.« less
NASA Astrophysics Data System (ADS)
García Moreno, R.; Gameda, S.; Diaz Alvarez, M. C.; Selasie, Y. G.
2012-04-01
Agriculture in Ethiopia is one of first priority since close to 10 In this context, the Ethiopian crop production faces to the following soil management challenges: lack of updated soil data, macro and micro nutrient depletion, acidity, salinity and soil surface erosion and crusting. One of the biggest issues is the loss of arable land, above 137 T/yr, reaching during some particularly dried periods until 300 T/yr. In this context, the authors constituted a working group of experts from Spanish and Ethiopian universities, local producers and international and governmental organisms to analyse the problems related to the different agro ecological zones found in Ethiopia and the management practices of different local producers. The study produced the trends to implement in the different areas to improve soil management practices in order to contribute to increase the crop production mainly to achieve food security problems. The analyse produced different working fields for the next years for addressing soil degradation, improving land resources management practices, increasing agricultural productivity, updating the available soil data, developing an international program of education, transferring of knowledge from similar study cases and implementing economical tools to help producers to assure income after severe edapho-climatic events. The practical work and the projects developed for the next period is addressed to smallholder farms belonging to the different 34 agro ecological zones identified in Ethiopia, each of them with very specific environmental, cultural and soil management practices.
Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim; Miksch, Antje; Ose, Dominik; Campbell, Stephen M; Goetz, Katja
2013-08-05
Job satisfaction and organizational attributes in primary care teams are important issues as they affect clinical outcomes and the quality of health care provided. As practice assistants are an integral part of these teams it is important to gain insight into their views on job satisfaction and organizational attributes. The aim of this study was to evaluate the job satisfaction of practice assistants and the organizational attributes within their general practices in Germany and to explore the existence of possible associations. This observational study was based on a job satisfaction survey and measurement of organizational attributes in general practices in the German federal state of Baden-Wuerttemberg. Job satisfaction was measured with the 10-item 'Warr-Cook-Wall job satisfaction scale'. Organizational attributes were evaluated with the 21-items 'survey of organizational attributes for primary care' (SOAPC). Linear regression analyses were performed in which each of SOAPC scales and the overall score of SOAPC was treated as outcome variables. 586 practice assistants out of 794 respondents (73.8%) from 234 general practices completed the questionnaire. Practice assistants were mostly satisfied with their colleagues and least of all satisfied with their income and recognition for their work. The regression analysis showed that 'freedom of working method' and 'recognition of work', the employment status of practice assistants and the mode of practice were almost always significantly associated with each subscale and overall score of SOAPC. Job satisfaction is highly associated with different aspects of organizational attributes for primary care ('communication', 'decision-making' and 'stress'). Consequently, improved job satisfaction could lead to a better-organized primary care team. This implication should be investigated directly in further intervention studies with a special focus on improving the recognition for work and income.
2014-01-01
Background Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. Methods Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. Results Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists’ interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one’s own role, as well as improvements in overall treatment and outcome. Conclusions This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists’ themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they work, and the wider systems. PMID:24884757
Risikko, Tanja; Remes, Jouko; Hassi, Juhani
2008-01-01
Cold is a typical environmental risk factor in outdoor work in northern regions. It should be taken into account in a company's occupational safety, health and quality systems. A development process for improving cold risk management at the Finnish Maritime Administration (FMA) was carried out by FMA and external experts. FMA was to implement it. Three years after the development phase, the outcomes and implementation were evaluated. The study shows increased awareness about cold work and few concrete improvements. Concrete improvements in occupational safety and health practices could be seen in the pilot group. However, organization-wide implementation was insufficient, the main reasons being no organization-wide practices, unclear process ownership, no resources and a major reorganization process. The study shows a clear need for expertise supporting implementation. The study also presents a matrix for analyzing the process.
Arar, Nedal H.; Noel, Polly H.; Leykum, Luci; Zeber, John E.; Romero, Raquel; Parchman, Michael L.
2012-01-01
Background Implementing improvement programs to enhance quality of care within primary care clinics is complex, with limited practical guidance available to help practices during the process. Understanding how improvement strategies can be implemented in primary care is timely given the recent national movement towards transforming primary care into patient-centered medical homes (PCMH). This study examined practice members’ perceptions of the opportunities and challenges associated with implementing changes in their practice. Methods Semi-structured interviews were conducted with a purposive sample of 56 individuals working in 16 small, community-based primary care practices. The interview consisted of open-ended questions focused on participants’ perceptions of: (1) practice vision, (2) perceived need for practice improvement, and (3) barriers that hinder practice improvement. The interviews were conducted at the participating clinics and were tape-recorded, transcribed, and content analyzed. Results Content analysis identified two main domains for practice improvement related to: (1) the process of care, and (2) patients’ involvement in their disease management. Examples of desired process of care changes included improvement in patient tracking/follow-up system, standardization of processes of care, and overall clinic documentations. Changes related to the patients’ involvement in their care included improving (a) health education, and (b) self care management. Among the internal barriers were: staff readiness for change, poor communication, and relationship difficulties among team members. External barriers were: insurance regulations, finances and patient health literacy. Practice Implications Transforming their practices to more patient-centered models of care will be a priority for primary care providers. Identifying opportunities and challenges associated with implementing change is critical for successful improvement programs. Successful strategy for enhancing the adoption and uptake of PCMH elements should leverage areas of concordance between practice members’ perceived needs and planned improvement efforts. PMID:22186171
Colleague to Colleague: Deepening Instructional Practice
ERIC Educational Resources Information Center
Gullen, Kristine; Chaffee, Martin
2012-01-01
Collaborative dialogue about instructional practices is essential to the growth of the education profession. To determine what effective instruction is and how to improve their own instructional practice, educators must clarify and publicly state their beliefs about instruction, teaching, and leadership. This is messy and complex work, and to…
Angelin, Anna
2015-01-01
Service users have lacked substantial influence, access, and participation in social work education in Norway and Sweden. In this article the author presents comparative analyses of two participatory projects that have developed and implemented practices that integrate service users into academic social work education and empower service users. The Norwegian HUSK project and the Social Work as Mobilization and Entrepreneurship course, also known as the "Mobilization course," at Lund University in Sweden demonstrate collaboration between research, social work education, and service users. The conclusions focus on the importance of the empowering processes by including recognition and dialogue, co-learning in practice, and the use of neutral venues to ensure effective user participation. The inclusion of service users in social work education can improve both practice and education.
Making Education Work for Hispanic Americans: Some Promising Community-Based Practices.
ERIC Educational Resources Information Center
Orum, Lori S.
This paper describes the work of the National Council of La Raza to improve education for Hispanic students and their families. It provides an overview of the council's Innovative Education Project, an effort to demonstrate and evaluate effective models for use by affiliated community-based organizations to improve educational outcomes for…
"What Works": Recommendations on Improving Academic Experiences and Outcomes for Black Males
ERIC Educational Resources Information Center
Howard, Tyrone C.; Douglas, Ty-Ron, M. O.; Warren, Chezare A.
2016-01-01
This brief presents the most significant recommendations based on a review of key findings from research presented in this special issue. The authors offer what they believe to be the most important considerations of what works for improving Black male school achievement in the domains of research, practice, and policy.
Make a Path for Evaluation: 10 Stepping Stones Help Leaders Build Solid Practices
ERIC Educational Resources Information Center
Champion, Robby
2015-01-01
If professional learning leaders are looking for a clear path lined with models of best program evaluation practices, they will become tangled in the weeds. After working for several decades to help professional learning leaders and their teams improve programs and evaluations, the author has observed several habits of mind and work that can make…
2010-09-02
The Clinical Audit Support Centre supports audit projects that improve patient care and enhance service delivery. Its staff work with healthcare and other professionals to deliver practical and user-friendly, quality-improvement materials.
Corporate working in health visiting: a concept analysis.
Houston, A M; Clifton, J
2001-05-01
The aim of this paper is to examine individualized health visiting care and compare it to corporate working within a consensual management style. Corporate working has been discussed and used in many different ways since the idea first came to light at the end of the 1980s. Resource management makes it an appealing model, however, analysing how corporate working functions in the practice setting reveals the complexity of this method of service provision. This paper is based on a method of practice developed by health visitors in Haywards Heath, West Sussex, who implemented the process. The article examines individualized health visiting care and compares it to corporate working within a consensual management style. Important in this analysis are the elements of reflexivity, active listening, reflection and the application of 'praxis' within the corporate caseload approach. Rogers' evolutionary concept model was used to illuminate and explain the different ways of delivering the health visiting service. There are benefits in working corporately: shared workload, increased professional support and improved accountability. Alongside the integrated supervision of this model is the opportunity offered to practitioners to innovate. This offsets any initial difficulty experienced in setting up this method and makes it a worthwhile change of style in health visiting practice. Improved service delivery, enhanced professional growth and increased opportunity for public health work can be demonstrated as outcomes of this model. For professionals this method may prevent 'burn-out', enhance practice and increase innovation in health visiting practice. Using this method as a blueprint, practitioners can develop their own style of corporate working that offers a service that is equitable, proactive, efficient and accessible to clients.
Development of an Instrument to Measure Students' Attitudes towards Piano Practice
ERIC Educational Resources Information Center
Umuzdas, Mehmet Serkan
2015-01-01
Practicing the piano is a systematic part of the instrument-learning process. It contains all development practices from the analysis of the work to the improvement of performance. Students usually practice the piano as a preparation for performing in courses, exams, or on stage and they do it individually. The mentality which emerges during the…
Booth, Andrew; Carroll, Christopher
2015-11-01
Increasing recognition of the role and value of theory in improvement work in healthcare offers the prospect of capitalising upon, and consolidating, actionable lessons from synthesis of improvement projects and initiatives. We propose that informed use of theory can (i) provide a mechanism by which to collect and organise data from a body of improvement work, (ii) offer a framework for analysis and identification of lessons learnt and (iii) facilitate an evaluation of the feasibility, effectiveness and acceptability of improvement programmes. Improvement practitioners can benefit from using an underpinning external structure as a lens by which to examine the specific achievements of their own projects alongside comparable initiatives led by others. We demonstrate the utility of a method known as 'best fit framework synthesis' (BFFS) in offering a ubiquitous and versatile means by which to collect, analyse and evaluate improvement work in healthcare. First reported in 2011, BFFS represents a pragmatic, flexible approach to integrating theory with findings from practice. A deductive phase, where a review team seeks to accommodate a substantial part of the data, is followed by an inductive phase, in which the team explores data not accommodated by the framework. We explore the potential for BFFS within improvement work by drawing upon the evidence synthesis methodology literature and practical examples of improvement work reported in BMJ Quality and Safety (2011-2015). We suggest four variants of BFFS that may have particular value in synthesising a body of improvement work. We conclude that BFFS, alongside other approaches that seek to optimise the contribution of theory to improvement work, represents one important enabling mechanism by which to establish the rigour and scientific credentials of the emerging discipline of 'improvement science'. 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.
Opening the black box of ethics policy work: evaluating a covert practice.
Frolic, Andrea; Drolet, Katherine; Bryanton, Kim; Caron, Carole; Cupido, Cynthia; Flaherty, Barb; Fung, Sylvia; McCall, Lori
2012-01-01
Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the "black box" of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews.
Focus First on Outcomes: When Planning Change, Improved Student Learning Is the Ultimate Goal
ERIC Educational Resources Information Center
Bradley, Janice; Munger, Linda; Hord, Shirley
2015-01-01
Educators working to achieve changes in classroom teaching practices that lead to improvement in student learning need to gain clarity in where they are going--what they want to accomplish. Teachers in a professional learning community need a road map as they begin learning and applying a new practice to ensure they reach their intended goal…
Chiang, Hui-Ying; Hsiao, Ya-Chu; Lee, Huan-Fang
Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices. Increasing nurses' attention to patient safety by improving these predictors is recommended.
Is Tutoring Teaching? Exploring Tutoring's Potential to Improve Mathematics Teacher Education
ERIC Educational Resources Information Center
Rasche, Alexander N.
2017-01-01
This study investigated the tutoring practices of mathematics tutors working in one university tutoring center and the corresponding rationale exhibited by the mathematics tutors. This study illustrates how the tutoring practices of mathematics tutors align with the Eight Mathematics Teaching Practices outlined in NCTM's recent publication…
Stanton, Robert; Happell, Brenda; Reaburn, Peter
2015-04-01
Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population. © 2015 Australian College of Mental Health Nurses Inc.
Best practices for INDOT-funded work zone police patrols.
DOT National Transportation Integrated Search
2012-12-01
Transportation agencies across the U.S. are expending a great deal of effort to improve highway work zone safety. Among those efforts : is a special fund for work zone enforcement established by the Indiana Department of Transportation (INDOT). The a...
General practitioners and sickness certification for injury in Australia.
Mazza, Danielle; Brijnath, Bianca; Singh, Nabita; Kosny, Agnieszka; Ruseckaite, Rasa; Collie, Alex
2015-08-15
Strong evidence supports an early return to work after injury as a way to improve recovery. In Australia, General Practitioners (GPs) see about 96 % of injured workers, making them the main gatekeepers to workers' entitlements. Most people with compensable injuries in Australia are certified as "unfit to work" by their GP, with a minority of patients certified for modified work duties. The reasons for this apparent dissonance between evidence and practice remain unexplored. Little is known about the factors that influence GP sickness certification behaviour in Australia. The aim of this study is to describe the factors influencing Australian GPs certification practice through qualitative interviews with four key stakeholders. From September to December 2012, 93 semi-structured interviews were undertaken in Melbourne, Australia. Participants included GPs, injured workers, employers and compensation agents. Data were thematically analysed. Five themes describing factors influencing GP certification were identified: 1. Divergent stakeholder views about the GP's role in facilitating return to work; 2. Communication between the four stakeholder groups; 3. Conflict between the stakeholder groups; 4. Allegations of GPs and injured workers misusing the compensation system and 5. The layout and content of the sickness certificate itself. By exploring GP certification practice from the perspectives of four key stakeholders, this study suggests that certification is an administrative and clinical task underpinned by a host of social and systemic factors. The findings highlight opportunities such as practice guideline development and improvements to the sickness certificate itself that may be targeted to improve GP sickness certification behaviour and return to work outcomes in an Australian context.
Driving R&D for the Next Generation Work Truck; NREL (National Renewable Energy Laboratory)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Melendez, M.
2015-03-04
Improvements in medium- and heavy-duty work truck energy efficiency can dramatically reduce the use of petroleum-based fuels and the emissions of greenhouse gases. The National Renewable Energy Laboratory (NREL) is working with industry partners to develop fuel-saving, high-performance vehicle technologies, while examining fleet operational practices that can simulateneously improve fuel economy, decrease emissions, and support bottom-line goals.
HIV and the decriminalization of sex work in New Zealand.
Healy, Catherine
2006-12-01
The decriminalization of sex work in New Zealand will protect the rights of sex workers and improve their working conditions and general well-being. It will also improve HIV prevention programs. In this article, which is based on a presentation at a "learning from practice" session at the conference, Catherine Healy describes the situation prior to decriminalization, and discusses the features of the new law and accompanying guidelines.
DOT National Transportation Integrated Search
2006-01-01
The project focuses on two major issues - the improvement of current work zone design practices and an analysis of : vehicle interarrival time (IAT) and speed distributions for the development of a digital computer simulation model for : queues and t...
Nurses' perceptions of their professional practice environment: a cross-sectional study.
Cao, Yingjuan; DiGiacomo, Michelle; Salamonson, Yenna; Li, Ye; Huai, Baosha; Davidson, Patricia M
2015-12-01
To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. Globally, the environments in which nurses work influence the quality of nursing practice and health care. A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2·66-3·05. All subscales except work motivation (3·05, standard deviation: 0·44) scored less than 3·0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factors is important in optimising work place environments. © 2015 John Wiley & Sons Ltd.
Computer ergonomics: the medical practice guide to developing good computer habits.
Hills, Laura
2011-01-01
Medical practice employees are likely to use computers for at least some of their work. Some sit several hours each day at computer workstations. Therefore, it is important that members of your medical practice team develop good computer work habits and that they know how to align equipment, furniture, and their bodies to prevent strain, stress, and computer-related injuries. This article delves into the field of computer ergonomics-the design of computer workstations and work habits to reduce user fatigue, discomfort, and injury. It describes practical strategies medical practice employees can use to improve their computer work habits. Specifically, this article describes the proper use of the computer workstation chair, the ideal placement of the computer monitor and keyboard, and the best lighting for computer work areas and tasks. Moreover, this article includes computer ergonomic guidelines especially for bifocal and progressive lens wearers and offers 10 tips for proper mousing. Ergonomically correct posture, movements, positioning, and equipment are all described in detail to enable the frequent computer user in your medical practice to remain healthy, pain-free, and productive.
Dreischulte, Tobias; Guthrie, Bruce
2017-01-01
Objective To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Design Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Setting Ten (30%) primary care practices participating in the trial from Scotland, UK. Results Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Conclusions Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. Trial registration number NCT01425502. PMID:28283493
Grant, Aileen; Dreischulte, Tobias; Guthrie, Bruce
2017-03-10
To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Ten (30%) primary care practices participating in the trial from Scotland, UK. Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. NCT01425502. 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/.
McClelland, Mark Stephen; Lazar, Danielle; Sears, Vickie; Wilson, Marcia; Siegel, Bruce; Pines, Jesse M
2011-12-01
Over the past decade, emergency departments (ED) have encountered major challenges due to increased crowding and a greater public focus on quality measurement and quality improvement. Responding to these challenges, many EDs have worked to improve their processes and develop new and innovative models of care delivery. Urgent Matters has contributed to ED quality and patient flow improvement by working with hospitals throughout the United States. Recognizing that EDs across the country are struggling with many of the same issues, Urgent Matters-a program funded by the Robert Wood Johnson Foundation (RWJF)-has sought to identify, develop, and disseminate innovative approaches, interventions, and models to improve ED flow and quality. Using a variety of techniques, such as learning networks (collaboratives), national conferences, e-newsletters, webinars, best practices toolkits, and social media, Urgent Matters has served as a thought leader and innovator in ED quality improvement initiatives. The Urgent Matters Seven Success Factors were drawn from the early work done by program participants and propose practical guidelines for implementing and sustaining ED improvement activities. This article chronicles the history, activities, lessons learned, and future of the Urgent Matters program. © 2011 by the Society for Academic Emergency Medicine.
CASH--an innovative approach to sustainable OSH improvement at workplace.
Pingle, S; Shanbhag, S
2006-01-01
Occupational health department of a large private enterprise located in India launched Project CASH--Change Agents for Safety and Health, at manufacturing units of the enterprise to bring about a positive change in work environment and improvement in work practices to reduce occupational health risk. Multidisciplinary teams of change agents were constituted and were given intensive training inputs. Reduction in exposure to noise, dust and heat stress were identified as specific objectives after a baseline survey of the work environment. Occupational safety and health knowledge and training was imparted to all field personnel to improve their work practices and attitudes. The focus of the actions was on engineering control measures and process engineering changes necessary for workplace improvement. Noise levels were reduced by an average of more than 9dBA in most of the top ten high noise locations. Out of two locations identified for dust exposure, one was fully eliminated and dust levels at other location were significantly reduced. Heat stress was reduced in all three identified locations with an average reduction of more than 3 degrees C in WBGT levels. Thus, final evaluation of workplace environments revealed significant reduction in exposure to all identified agents, viz noise, dust and heat fulfilling the project objectives. Educating and empowering the team led to reduction of occupational health risks in the work environment. There was positive attitudinal and behavioural change in safety and occupational health awareness & practices among employees. The monetary savings resulting from improvements far outweighed the investments. Success of this pilot project was followed up with further similar projects and their number has grown in geometric proportion for the last three years indicating the sustainability of the project.
Evidence-Based Best Practices for Outpatient Management of Warfarin.
Rose, Adam J; Vaiana, Mary
2018-06-01
Many best practices have been described for organizing a clinic to manage warfarin. Although these practices may have face validity, they may not be based on empirical analysis. Here, we describe our decade-long effort to apply the Structure-Process-Outcome model of quality measurement as a basis for measuring and improving outpatient warfarin management in the Veterans Health Administration. The purpose of the article is to raise awareness of this body of work with pharmacists who could potentially incorporate the findings of this work into their own practice settings. We conclude with concrete suggestions for immediate implementation in clinical settings.
Iowa Journal of School Social Work, 1993-1995.
ERIC Educational Resources Information Center
Andreasen, Sara A., Ed.; Froyen, Gary, Ed.; McCullagh, Cheryl, Ed.; Harrington, Danette, Ed.
1995-01-01
This annual serial publication of the Iowa School Social Workers' Association is dedicated to extending knowledge and improving practice of social work in educational settings. Volume six contains the following articles: (1) "A Self-Report Questionnaire For Group Work: Monitoring the Outcome of Group Work Intervention with Special Education…
NASA Technical Reports Server (NTRS)
Easton, John W.; Struk, Peter M.
2012-01-01
The Component Repair Experiment-1 (CRE-1) examines the capability for astronauts to perform electronics repair tasks in space. The goal is to determine the current capabilities and limits for the crew, and to make recommendations to improve and expand the range of work that astronauts may perform. CRE-1 provided two-layer, functional circuit boards and replacement components, a small tool kit, written and video training materials, and 1 hr of hands on training for the crew slated to perform the experiment approximately 7 months prior to the mission. Astronauts Michael Fincke and Sandra Magnus performed the work aboard the International Space Station (ISS) in February and March 2009. The astronauts were able to remove and replace components successfully, demonstrating the feasibility of performing component-level electronics repairs within a spacecraft. Several unsuccessful tasks demonstrated areas in need of improvement. These include improved and longer training prior to a mission, an improved soldering iron with a higher operating temperature and steady power source, video training and practice boards for refresher work or practice before a repair, and improved and varied hand tools and containment system.
Disturbing the Pedagogical Status Quo: LLN and Vocational Teachers Working Together
ERIC Educational Resources Information Center
Black, Stephen; Yasukawa, Keiko
2013-01-01
When language, literacy and numeracy (LLN) teachers work together with vocational teachers as a team, not only do students improve their course outcomes in terms of completions and employment, but the pedagogical practices of both teachers can change and improve. In this article, we begin to explore some of the issues and provide examples of…
Partnering with Your Transplant Team
... used as a stepping stone to improving your economic condition. Work incentives are designed to help people ... to improving patient care through epidemiologic, clinical, and economic research that shapes medical policies and practices. Our ...
[Changing to a career in general practice - a qualitative study reveals motives of specialists].
Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth
2016-12-01
In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of the challenges of ageing and family life. A major finding was that without the slim-lined program, the majority of participants would not have changed their career. The slim-lined training program in general practice attracts experienced medical doctors. Specialists decide to change career because of the particular ways of working in general practice and with the intention to improve their daily work as a physician, either to improve individual working conditions and/or to improve their individual curative work profile. In addition, specialists are attracted by the concept of self-employment in general practice. Therefore, appreciation of the specific ways of working in general practice as well as management skills are most important during the reduced 2-year training. Further studies should investigate if facilitating a career switch to general practice is a good way to improve the shortage of general practitioners. Copyright © 2016. Published by Elsevier GmbH.
Factors affecting social workers' inclusion of animals in practice.
Risley-Curtiss, Christina; Rogge, Mary E; Kawam, Elisa
2013-04-01
Experts suggest that social work practitioners can improve their client service with a more thorough understanding of the impact of other animals on individuals and families. Studies indicate that some social work practitioners are including animals in their practices through assessment and interventions. Little is known about what factors contribute to this inclusion, especially because there is a lack of attention in social work education and research to animal-human relationships. This study used logistical regression to examine the impact of certain demographic, knowledge, and practice variables on the inclusion of animals in social work practice. Findings include that knowing other social workers who include animals in practice and primary client population served were significant for inclusion of animals in assessment, animal-assisted intervention, and treating clients for animal abuse or loss of an animal. Although practitioners' having a companion animal was positively related to including animals in interventions and treating clients for loss of an animal, contributing to animal welfare through volunteering at shelters or financially contributing to animal groups did not have an effect on inclusion of animals in practice. Implications for these and other findings are discussed, and recommendations for social work research, education, and practice are offered.
Nursing Student Work-Study Internship Program: An Academic Partnership.
Wallace, Jonalyn
2016-06-01
A large northern California-based integrated health system and five universities partnered to conduct an innovative work-study internship program designed to address the education-to-practice gap for nursing students. The nursing student work-study intern-ship program provides prelicensure nursing students with a paid internship in the health system. Interns are exposed to the realities of clinical practice and master learned skills working under the supervision of an RN preceptor. Work-study interns reported that participation in the program exposed them to new clinical situations, helped them integrate clinical knowledge and critical thinking skills, improved prioritization and time management skills, and expanded their communication skills within the interprofessional team. Interns cited feeling better equipped to safely and effectively transition into the new graduate role. The nursing student work-study program shows how an academic practice partnership can address the education-to-practice gap in an innovative manner. [J Nurs Educ. 2016;55(6):357-359.]. Copyright 2016, SLACK Incorporated.
Gallagher, Ruth M; Gallagher, Helen C
2012-05-01
Despite their common history, there are many cultural, attitudinal and practical differences between the professions of medicine and pharmacy that ultimately influence patient care and health outcomes. While poor communication between doctors and pharmacists is a major cause of medical errors, it is clear that effective, deliberate doctor-pharmacist collaboration within certain clinical settings significantly improves patient care. This may be particularly true for those patients with chronic illnesses and/or requiring regular medication reviews. Moreover, in hospitals, clinical and antibiotic pharmacists are successfully influencing prescribing and infection control policy. Under the new Irish Pharmacy Act (2007), pharmacists are legally obliged to provide pharmaceutical care to their patients, thus fulfilling a more patient-centred role than their traditional 'dispensing' one. However, meeting this obligation relies on the existence of good doctor-pharmacist working relationships, such that inter-disciplinary teamwork in monitoring patients becomes the norm in all healthcare settings. As discussed here, efforts to improve these relationships must focus on the strategic introduction of agreed changes in working practices between the two professions and on educational aspects of pharmaceutical care. For example, standardized education of doctors/medical students such that they learn to prescribe in an optimal manner and ongoing inter-professional education of doctors and pharmacists in therapeutics, are likely to be of paramount importance. Here, insights into the types of factors that help or hinder the improvement of these working relationships and the importance of education and agreed working practices in defining the separate but inter-dependent professions of pharmacy and medicine are reviewed and discussed.
New systems of work organization and workers' health.
Kompier, Michiel A J
2006-12-01
This paper aims at identifying major changes in and around work organizations, their effects upon job characteristics and the health and well-being of today's employees, and related research challenges. Increased internationalization and competition, increased utilization of information and communication technology, the changing workforce configuration, and flexibility and new organizational practices are considered. As work has changed from physical to mental in nature, job characteristics have changed significantly. Meanwhile work and family life have blended. New systems of work organization have become more prevalent, but they do not represent a radical change across the whole economy. New practices may have an adverse impact upon job characteristics, but their effects depend on their design, implementation, and management. Research recommendations include improved monitoring of changes in work organization and studies into their health and safety consequences, intervention studies, studies into the motivating potential of modern work practices, studies of marginalized workers and workers in less developed countries, and "mechanism studies".
Practice Options and Decision Making for Dental Students.
ERIC Educational Resources Information Center
Manski, Richard J.
1987-01-01
One dental school implemented in its fourth-year curriculum an intensive simulation exercise to teach students the application of fundamental economic concepts such as capital costs, leasehold improvements, operating expenses, working capital, and financial risk in dental practice. (MSE)
Improving Teaching and Teachers: A "Generative Dance"?
ERIC Educational Resources Information Center
Lampert, Magdalene
2012-01-01
Working on teaching as a collective practice--understanding it, specifying it, and improving it--is crucially important and too often ignored. But setting up a choice between improving teaching and improving teachers is problematic for several reasons. To begin with, it seems that the very methods Hiebert and Morris outline for improving teaching…
Teacher Compensation: Standard Practices and Changes in Wisconsin. WCER Working Paper No. 2016-5
ERIC Educational Resources Information Center
Kimball, Steven M.; Heneman, Herbert G., III.; Worth, Robin; Arrigoni, Jessica; Marlin, Daniel
2016-01-01
Over many decades, teachers' compensation has been determined through standard practices, commonly represented by the single salary schedule. While these practices served districts well in a number of respects, many argue that new forms of teacher pay could provide powerful levers for changing teacher performance and improving student achievement…
Technical Report: Guide Details Best Practices in Photovoltaic System
Operations and Maintenance | Solar Research | NREL Guide Details Best Practices in Photovoltaic A best-practices report on photovoltaic (PV) operations and maintenance (O&M) released by NREL and the PV O&M Working Group provides valuable insights on improving the performance of PV systems
Working through the Practice Architectures of First Year University Mathematics Teaching
ERIC Educational Resources Information Center
Balatti, Jo; Belward, Shaun
2012-01-01
This paper describes how a group of university lecturers are adopting an action research approach to improve the learning experience of students in first year mathematics. Using the three categories of saying/thinking, doing, and relating (Kemmis, 2009) to explore practice, it describes the new practices of the action research team, the…
Linking Theory and Practice: Teacher Research in History and Geography Classrooms
ERIC Educational Resources Information Center
Admiraal, Wilfried; Buijs, Maartje; Claessens, Wout; Honing, Terence; Karkdijk, Jan
2017-01-01
The impact of scholarly research in education on the educational practice in secondary school is low. Academics examine problems that teachers in school perceive as irrelevant, want to publish in peer-reviewed journals instead of disseminate their work, and aim at generalizing insights rather than improving school practice. Teacher research might…
Improving the Students' Study Practices through the Principled Design of Research Probes
ERIC Educational Resources Information Center
Aleahmad, Turadig
2012-01-01
A key challenge of the learning sciences is moving research results into practice. Educators on the front lines perceive little value in the outputs of education research and demand more "usable knowledge". This work explores the potential instead of usable artifacts to translate knowledge into practice, adding scientists as stakeholders…
Motivational Interviewing: An Evidence-Based Practice for Improving Student Practice Skills
ERIC Educational Resources Information Center
Hohman, Melinda; Pierce, Paloma; Barnett, Elizabeth
2015-01-01
Motivational interviewing (MI) is an evidence-based communication method to assist clients in resolving their ambivalence regarding change. With a school emphasis on evidence-based practice and learning outcomes, a social work department implemented a semester-long course on MI. The purpose of this study was to determine baseline skills and…
Using Lean in the Flipped Classroom for At Risk Students
ERIC Educational Resources Information Center
Flumerfelt, Shannon; Green, Greg
2013-01-01
Schools are working to improve achievement through the examination of instructional practice and the use of instructional technology. This article provides informed commentary on the state of school reform and the need for continuous improvement, instructional improvement and instructional technology improvement. It also presents advocacy for the…
Learning from Instructional Rounds
ERIC Educational Resources Information Center
City, Elizabeth A.
2011-01-01
Instructional rounds are a disciplined way for educators to work together to improve a school's instructional core. The practice combines three common elements of improvement: classroom observation, an improvement strategy, and a network. Instructional rounds differ from supervision and evaluation in that people doing rounds learn something…
Wright, Nicola; Jordan, Melanie; Kane, Eddie
2014-09-01
This article takes mental health and prisons as its two foci. It explores the links between social and structural aspects of the penal setting, the provision of mental healthcare in prisons, and mental health work in this environment. This analysis utilises qualitative interview data from prison-based fieldwork undertaken in Her Majesty׳s Prison Service, England. Two themes are discussed: (1) the desire and practicalities of doing mental health work and (2) prison staff as mental health work allies. Concepts covered include equivalence, training, ownership, informal communication, mental health knowledge, service gatekeepers, case identification, and unmet need. Implications for practice are (1) the mental health knowledge and understanding of prison wing staff could be appraised and developed to improve mental healthcare and address unmet need. Their role as observers and gatekeepers could be considered. (2) The realities of frontline mental health work for clinicians in the penal environment should be embraced and used to produce and implement improved policy and practice guidance, which is in better accord with the actuality of the context - both socially and structurally. Copyright © 2014 Elsevier Ltd. All rights reserved.
Improving Night Work Zone Traffic Control
DOT National Transportation Integrated Search
1999-08-01
The purpose of this study was to examine traffic control for night work zones from the perspective of both transportation agencies and motorists. This was accomplished by investigating practices of state departments of transportation (DOTs), identify...
Factors influencing evidence-based practice in prosthetics and orthotics.
Andrysek, Jan; Christensen, James; Dupuis, Annie
2011-03-01
The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources. The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Cross sectional survey. An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada. A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice. Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice. This study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.
Different paths to high-quality care: three archetypes of top-performing practice sites.
Feifer, Chris; Nemeth, Lynne; Nietert, Paul J; Wessell, Andrea M; Jenkins, Ruth G; Roylance, Loraine; Ornstein, Steven M
2007-01-01
Primary care practices use different approaches in their quest for high-quality care. Previous work in the Practice Partner Research Network (PPRNet) found that improved outcomes are associated with strategies to prioritize performance, involve staff, redesign elements of the delivery system, make patients active partners in guideline adherence, and use tools embedded in the electronic medical record. The aim of this study was to examine variations in the adoption of improvements among sites achieving the best outcomes. This study used an observational case study design. A practice-level measure of adherence to clinical guidelines was used to identify the highest performing practices in a network of internal and family medicine practices participating in a national demonstration project. We analyzed qualitative and quantitative information derived from project documents, field notes, and evaluation questionnaires to develop and compare case studies. Nine cases are described. All use many of the same improvement strategies. Differences in the way improvements are organized define 3 distinct archetypes: the Technophiles, the Motivated Team, and the Care Enterprise. There is no single approach that explains the superior performance of high-performing practices, though each has adopted variations of PPRNet's improvement model. Practices will vary in their path to high-quality care. The archetypes could prove to be a useful guide to other practices selecting an overall quality improvement approach.
Differentiating Instruction: Providing the Right Kinds of Worked Examples for Individual Students
ERIC Educational Resources Information Center
Booth, Julie L.; Koedinger, Kenneth R.; Newton, Kristie J.; Lange, Karin E.
2013-01-01
A plethora of laboratory studies have shown that including the study of worked examples during problem-solving practice improves learning (Sweller, 1999; Sweller & Cooper, 1985). While most worked-example research focuses on the use of correct examples, recent work suggests that asking children to explain a combination of correct and incorrect…
ERIC Educational Resources Information Center
Morsy, Leila; Rothstein, Richard
2015-01-01
Recent developments in employment practices have increased the prevalence of non-standard work schedules--non-daytime shifts in which most hours do not fall between 8 a.m. and 4 p.m., when shifts rotate, or when schedules vary weekly or otherwise. For example, computer software now enables retail, restaurant, service, and other firms to predict…
Evaluation of Promoting Roadside Revegetation: An Integrated Approach to Establishing Native Plants
DOT National Transportation Integrated Search
2017-12-01
This report documents an evaluation of outcomes associated with Roadside Revegetation: A Practical Guide to Working with Native Plants, a 2007 guide encouraging agencies to adopt improved roadside revegetation practices.(1) It should be of interest t...
Dos Santos Alves, Daniela Fernanda; da Silva, Dirceu; de Brito Guirardello, Edinêis
2017-01-01
To assess correlations between the characteristics of the nursing practice environment, job outcomes and safety climate. The nursing practice environment is critical to the well-being of professionals and to patient safety, as highlighted by national and international studies; however, there is a lack of evidence regarding this theme in paediatric units. A cross-sectional study, in two paediatric hospitals in Brazil, was conducted from December 2013 to February 2014. For data collection, we used the Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and the Maslach Burnout Inventory, and for analysis Spearman's correlation coefficient and structural equation modelling were used. Two hundred and sixty-seven professional nurses participated in the study. Autonomy, control over the work environment and the relationship between nursing and medical staff are factors associated with job outcomes and safety climate and can be considered their predictors. Professional nurses with greater autonomy, good working relationships and control over their work environment have lower levels of emotional exhaustion, higher job satisfaction, less intention of leaving the job and the safety climate is positive. Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses. © 2016 John Wiley & Sons Ltd.
Freedman, Darcy A; Blake, Christine E; Liese, Angela D
2013-01-01
Access to nutritious foods is limited in disenfranchised communities in the United States. Policies are beginning to focus on improving nutritious food access in these contexts; yet, few theories are available to guide this work. We developed a conceptual model of nutritious food access based on the qualitative responses of food consumers in 2 different regions of the American South. Five domains (economic, service delivery, spatial-temporal, social, and personal) and related dimensions of nutritious food access were identified. The conceptual model provides practical guidance to researchers, policy makers, and practitioners working to improve nutritious food access in communities.
Human factors systems approach to healthcare quality and patient safety
Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.
2013-01-01
Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724
FREEDMAN, DARCY A.; BLAKE, CHRISTINE E.; LIESE, ANGELA D.
2014-01-01
Access to nutritious foods is limited in disenfranchised communities in the United States. Policies are beginning to focus on improving nutritious food access in these contexts; yet, few theories are available to guide this work. We developed a conceptual model of nutritious food access based on the qualitative responses of food consumers in 2 different regions of the American South. Five domains (economic, service delivery, spatial–temporal, social, and personal) and related dimensions of nutritious food access were identified. The conceptual model provides practical guidance to researchers, policy makers, and practitioners working to improve nutritious food access in communities. PMID:24563605
Williams, Caroline
2010-09-01
To critically review the work-based learning literature and explore the implications of the findings for the development of work-based learning programmes. With NHS budgets under increasing pressure, and challenges to the impact of classroom-based learning on patient outcomes, work-based learning is likely to come under increased scrutiny as a potential solution. Evidence from higher education institutions suggests that work-based learning can improve practice, but in many cases it is perceived as little more than on-the-job training to perform tasks. The CINAHL database was searched using the keywords work-based learning, work-place learning and practice-based learning. Those articles that had a focus on post-registration nursing were selected and critically reviewed. Using the review of the literature, three key issues were explored. Work-based learning has the potential to change practice. Learning how to learn and critical reflection are key features. For effective work-based learning nurses need to take control of their own learning, receive support to critically reflect on their practice and be empowered to make changes to that practice. A critical review of the literature has identified essential considerations for the implementation of work-based learning. A change in culture from classroom to work-based learning requires careful planning and consideration of learning cultures. To enable effective work-based learning, nurse managers need to develop a learning culture in their workplace. They should ensure that skilled facilitation is provided to support staff with critical reflection and effecting changes in practice. CONTRIBUTION TO NEW KNOWLEDGE: This paper has identified three key issues that need to be considered in the development of work-based learning programmes. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
The 1996 High Schools That Work Assessment: Good News, Bad News and Hope. Research Brief.
ERIC Educational Resources Information Center
Bottoms, Gene
Implementation of the High Schools That Work (HSTW) key practices improved achievement for career-bound students in these four ways: (1) HSTW sites showed significant improvement in average reading and math scores; (2) the percentage of career- bound students meeting HSTW performance goals in 1994 and 1996 increased from 33% to 43% in reading and…
Kyrkjebø, J M; Hanssen, T A; Haugland, B Ø
2001-12-01
To evaluate a programme introducing quality improvement (QI) in nursing education. Betanien College of Nursing and clinical practices at hospitals in Bergen. 52 nursing students from a second year class working in 16 groups undertaking hospital based practical studies. Second year nursing students were assigned to follow a patient during a day's work and to record the processes of care from the patient's perspective. Data collected included waiting times, patient information, people in contact with the patient, investigations, and procedures performed. Students also identified aspects of practice that could be improved. They then attended a 2 day theoretical introductory course in QI and each group produced flow charts, cause/effect diagrams, and outlines of quality goals using structure, process, and results criteria to describe potential improvements. Each group produced a report of their findings. Main measures-A two-part questionnaire completed by the students before and after the intervention was used to assess the development of their understanding of QI. Evidence that students could apply a range of QI tools and techniques in the specific setting of a hospital ward was assessed from the final reports of their clinical attachments. The students had a significantly better knowledge of QI after the introductory course and group work than before it, and most students indicated that they considered the topic highly relevant for their later career. They reported that it was quite useful to observe one patient throughout one shift and, to some extent, they learned something new. Students found the introductory course and working in groups useful, and most thought the programme should be included in the curriculum for other nursing students. They considered it important for nurses in general to have knowledge about QI, indicating a high perceived relevance of the course. All 16 groups delivered reports of their group work which were approved by the tutors. Through the reports, all the groups demonstrated knowledge and ability to apply tools and techniques in their practical studies in a hospital setting. The introduction of a short experience-based programme into the practical studies of second year nursing students enabled them to learn about the concepts, tools, and techniques of continuous QI in a way that should provide them with the skills to undertake it as part of routine practice.
Lennox, Laura; Doyle, Cathal; Reed, Julie E
2017-01-01
Objectives Although improvement initiatives show benefits to patient care, they often fail to sustain. Models and frameworks exist to address this challenge, but issues with design, clarity and usability have been barriers to use in healthcare settings. This work aimed to collaborate with stakeholders to develop a sustainability tool relevant to people in healthcare settings and practical for use in improvement initiatives. Design Tool development was conducted in six stages. A scoping literature review, group discussions and a stakeholder engagement event explored literature findings and their resonance with stakeholders in healthcare settings. Interviews, small-scale trialling and piloting explored the design and tested the practicality of the tool in improvement initiatives. Setting National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL). Participants CLAHRC NWL improvement initiative teams and staff. Results The iterative design process and engagement of stakeholders informed the articulation of the sustainability factors identified from the literature and guided tool design for practical application. Key iterations of factors and tool design are discussed. From the development process, the Long Term Success Tool (LTST) has been designed. The Tool supports those implementing improvements to reflect on 12 sustainability factors to identify risks to increase chances of achieving sustainability over time. The Tool is designed to provide a platform for improvement teams to share their own views on sustainability as well as learn about the different views held within their team to prompt discussion and actions. Conclusion The development of the LTST has reinforced the importance of working with stakeholders to design strategies which respond to their needs and preferences and can practically be implemented in real-world settings. Further research is required to study the use and effectiveness of the tool in practice and assess engagement with the method over time. PMID:28947436
Practice development: implementing a change of practice as a team.
Covill, Carl; Hope, Angela
2012-08-01
Practice development (PD), as a framework for multiprofessional working, has immense potential, specifically within change management and the clinical governance agenda. It has been acknowledged as a vehicle for 'continuous improvement'. This article discusses PD through collaborative working using the example of a case study on change of practice in falls reduction within a localised community setting. The process is underpinned by a PD framework and facilitated by leaders of PD within a university setting. The article identifies that PD frameworks are conducive to developing leadership and management roles within a democratic process. The article discusses the potential for multiprofessional PD within the locality and further afield.
Torrey, William C; Bond, Gary R; McHugo, Gregory J; Swain, Karin
2012-09-01
Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers. This study investigated domains of implementation activities and correlated them to implementation success during a large national evidence-based practice implementation project. Implementation success was correlated with active leadership strategically devoted to redesigning the flow of work and reinforcing implementation through measurement and feedback. Relative attention to workforce development was negatively correlated with implementation. Active leaders should focus on redesigning the flow of work to support the implementation and on reinforcing program improvements.
2016-10-01
MILITARY TRAUMA SYSTEM: WORKING TOWARDS IMPROVED OUTCOMES by April J. Dunlevy, Maj, USAF, NC A Research Report Submitted to the Faculty In...developed to aid in efforts to provide safe , effective and efficient care. One barrier to this goal is the current national shortage of physician...healthcare system. 5 Preface I have been working in healthcare for 24 years, practicing in both civilian and military facilities
Pelletreau, Karen N; Knight, Jennifer K; Lemons, Paula P; McCourt, Jill S; Merrill, John E; Nehm, Ross H; Prevost, Luanna B; Urban-Lurain, Mark; Smith, Michelle K
2018-06-01
Helping faculty develop high-quality instruction that positively affects student learning can be complicated by time limitations, a lack of resources, and inexperience using student data to make iterative improvements. We describe a community of 16 faculty from five institutions who overcame these challenges and collaboratively designed, taught, iteratively revised, and published an instructional unit about the potential effect of mutations on DNA replication, transcription, and translation. The unit was taught to more than 2000 students in 18 courses, and student performance improved from preassessment to postassessment in every classroom. This increase occurred even though faculty varied in their instructional practices when they were teaching identical materials. We present information on how this faculty group was organized and facilitated, how members used student data to positively affect learning, and how they increased their use of active-learning instructional practices in the classroom as a result of participation. We also interviewed faculty to learn more about the most useful components of the process. We suggest that this professional development model can be used for geographically separated faculty who are interested in working together on a known conceptual difficulty to improve student learning and explore active-learning instructional practices.
Applying organizational science to health care: a framework for collaborative practice.
Dow, Alan W; DiazGranados, Deborah; Mazmanian, Paul E; Retchin, Sheldon M
2013-07-01
Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration.In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader's integration into a team's usual work) and formality (a leader's responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes.
Applying Organizational Science to Health Care: A Framework for Collaborative Practice
Dow, Alan W.; DiazGranados, Deborah; Mazmanian, Paul E.; Retchin, Sheldon M.
2013-01-01
Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration. In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader’s integration into a team’s usual work) and formality (a leader’s responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes. PMID:23702530
The scope of private practice nursing in an Australian sample.
Wilson, Anne; Averis, Andrea; Walsh, Ken
2004-01-01
The changing Australian health care system is creating new opportunities for nurses who work directly with clients in private practice settings. This study examines the scope of practice of a cohort of nurses in private practice. In a questionnaire sent to 106 self-employed nurse entrepreneurs, questions were asked pertaining to the participants' scope of practice, their clients, the types of services offered, and their fee structures. Questions about scope of practice were divided into domains of clinical practice, business consultancy, education, and research. Quantitative and qualitative data were collected for a final sample 54 eligible responses. Participants had been in private practice for an average of 7.6 years (range: 1-20) and reported a mean of 21 years of nursing experience (range: 4-42) before entering private practice. Over half held diplomas in specialty areas. Most participants reported clinical practice, consultancy, or education as the primary work domain; research was much less important as a work activity. Nurses reported difficulties with building client base and receiving adequate fees for service, particularly in clinical practice. Increasing awareness within the nursing profession and health sector about various aspects of private practice nursing could improve service quality for their clients.
The research potential of practice nurses.
Davies, Jacqueline; Heyman, Bob; Bryar, Rosamund; Graffy, Jonathan; Gunnell, Caroline; Lamb, Bryony; Morris, Lana
2002-09-01
Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and staff retention, and answer real questions.
Applying Best Practices to Florida Local Government Retrofit Programs
DOE Office of Scientific and Technical Information (OSTI.GOV)
McIlvaine, J.; Sutherland, K.
In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the 'current best practices.' A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This case study describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less
Applying Best Practices to Florida Local Government Retrofit Programs, Central Florida (Fact Sheet)
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less
Applying Best Practices to Florida Local Government Retrofit Programs
DOE Office of Scientific and Technical Information (OSTI.GOV)
McIlvaine, J.; Sutherland, K.
In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less
ERIC Educational Resources Information Center
Kilburn, M. Rebecca, Ed.
2014-01-01
The Promising Practices Network (PPN) on Children, Families and Communities (www.promisingpractices.net) began as a partnership between four state-level organizations that help public and private organizations improve the well-being of children and families. The PPN website, archived in June 2014, featured summaries of programs and practices that…
Reforming Only Half: A Study of Practice-Based Teacher Education in Traditional Field Placements
ERIC Educational Resources Information Center
Francis, Anthony Tuf
2017-01-01
Practice-based teacher education is poised to improve teacher education by focusing on interns' enactment of complex teaching practices and helping them develop these professional skills. However, much of this work has yet to study the trajectory of learning between university training and field experiences. This article explores seven history and…
Links between Conflict Management Research and Practice
ERIC Educational Resources Information Center
Roloff, Michael E.
2009-01-01
This paper explicates the implications of my research on conflict management for self improvement and for practitioners who work to improve the conflict management of others. I also note how my experiences with practitioners have informed my research.
Silvestre, Maria Asuncion A; Mannava, Priya; Corsino, Marie Ann; Capili, Donna S; Calibo, Anthony P; Tan, Cynthia Fernandez; Murray, John C S; Kitong, Jacqueline; Sobel, Howard L
2018-03-31
To determine whether intrapartum and newborn care practices improved in 11 large hospitals between 2008 and 2015. Secondary data analysis of observational assessments conducted in 11 hospitals in 2008 and 2015. Eleven large government hospitals from five regions in the Philippines. One hundred and seven randomly sampled postpartum mother-baby pairs in 2008 and 106 randomly sampled postpartum mothers prior to discharge from hospitals after delivery. A national initiative to improve quality of newborn care starting in 2009 through development of a standard package of intrapartum and newborn care services, practice-based training, formation of multidisciplinary hospital working groups, and regular assessments and meetings in hospitals to identify actions to improve practices, policies and environments. Quality improvement was supported by policy development, health financing packages, health facility standards, capacity building and health communication. Sixteen intrapartum and newborn care practices. Between 2008 and 2015, initiation of drying within 5 s of birth, delayed cord clamping, dry cord care, uninterrupted skin-to-skin contact, timing and duration of the initial breastfeed, and bathing deferred until 6 h after birth all vastly improved (P<0.001). The proportion of newborns receiving hygienic cord handling and the hepatitis B birth dose decreased by 11-12%. Except for reduced induction of labor, inappropriate maternal care practices persisted. Newborn care practices have vastly improved through an approach focused on improving hospital policies, environments and health worker practices. Maternal care practices remain outdated largely due to the ineffective didactic training approaches adopted for maternal care.
Designing and Assessing Productive Group Work in Secondary Schools
ERIC Educational Resources Information Center
Vaca, Javier; Lapp, Diane; Fisher, Douglas
2011-01-01
A history teacher examines what is successful and not successful in group work in his high school classroom and gives concrete suggestions for improving group practice. Topics discussed include preparing students for group work, supporting collaboration, inviting critical analysis, and assessing both group and individual performance. (Contains 2…
University Students' Conceptions and Practice of Collaborative Work on Writing
ERIC Educational Resources Information Center
Mutwarasibo, Faustin
2013-01-01
Collaborative work is widely regarded as a valuable tool in the development of student-centred learning. Its importance can be viewed in two ways: First of all, when students are regularly exposed to collaborative work (i.e. pair work or group work) they are likely to develop or improve a range of communication and interpersonal skills. It is also…
Improving work environments in health care: test of a theoretical framework.
Rathert, Cheryl; Ishqaidef, Ghadir; May, Douglas R
2009-01-01
In light of high levels of staff turnover and variability in the quality of health care, much attention is currently being paid to the health care work environment and how it potentially relates to staff, patient, and organizational outcomes. Although some attention has been paid to staffing variables, more attention must be paid to improving the work environment for patient care. The purpose of this study was to empirically explore a theoretical model linking the work environment in the health care setting and how it might relate to work engagement, organizational commitment, and patient safety. This study also explored how the work environment influences staff psychological safety, which has been show to influence several variables important in health care. Clinical care providers at a large metropolitan hospital were surveyed using a mail methodology. The overall response rate was 42%. This study analyzed perceptions of staff who provided direct care to patients. Using structural equation modeling, we found that different dimensions of the work environment were related to different outcome variables. For example, a climate for continuous quality improvement was positively related to organizational commitment and patient safety, and psychological safety partially mediated these relationships. Patient-centered care was positively related to commitment but negatively related to engagement. Health care managers need to examine how organizational policies and practices are translated into the work environment and how these influence practices on the front lines of care. It appears that care provider perceptions of their work environments may be useful to consider for improvement efforts.
Innes, Ev; Crowther, Amber; Fonti, Fiona; Quayle, Leonie
2010-01-01
OBJECTIVE/PARTICIPANTS: This report describes a project undertaken by three final (4th) year occupational therapy undergraduate students from the University of Sydney, Australia, in their final fieldwork placement. The project involved women from a Chinese background who worked on market gardens across the Sydney Basin. Its purpose was to identify musculoskeletal risks in the work environment and work practices of a selected group of seven Cantonese-speaking women working on market gardens in the Western Sydney region. The approaches used in the project reflected a risk management approach, and involved background research, initial interviews, task analysis, hazard identification, risk assessment, data analysis, identification of key issues, and developing recommendations, in collaboration with participants and consultation with professionals. The key issues identified as contributing factors to musculoskeletal pain and injuries were: (1) work practices (long work hours, repetitive work); (2) biomechanical factors (repetitive and sustained work postures, poor manual handling practices) and limited training; (3) ergonomics of the equipment used; (4) fatigue. Two priority areas for intervention were identified: (1) pain management, and (2) preventative strategies (improving both the work environment and work practices). Recommendations were made in collaboration with the women, and in consultation with health professionals.
2014-01-01
Background The shortage of physicians is an evolving problem throughout the world. In this study we aimed to identify to what extent junior doctors’ training and working conditions determine their intention to leave clinical practice after residency training. Methods A prospective cohort study was conducted in 557 junior doctors undergoing residency training in German hospitals. Self-reported specialty training conditions, working conditions and intention to leave clinical practice were measured over three time points. Scales covering training conditions were assessed by structured residency training, professional support, and dealing with lack of knowledge; working conditions were evaluated by work overload, job autonomy and social support, based on the Demand–Control–Support model. Multivariate ordinal logistic regression analyses with random intercept for longitudinal data were applied to determine the odds ratio of having a higher level of intention to leave clinical practice. Results In the models that considered training and working conditions separately to predict intention to leave clinical practice we found significant baseline effects and change effects. After modelling training and working conditions simultaneously, we found evidence that the change effect of job autonomy (OR 0.77, p = .005) was associated with intention to leave clinical practice, whereas for the training conditions, only the baseline effects of structured residency training (OR 0.74, p = .017) and dealing with lack of knowledge (OR 0.74, p = .026) predicted intention to leave clinical practice. Conclusions Junior doctors undergoing specialty training experience high workload in hospital practice and intense requirements in terms of specialty training. Our study indicates that simultaneously improving working conditions over time and establishing a high standard of specialty training conditions may prevent junior doctors from considering leaving clinical practice after residency training. PMID:24942360
Miller, Melissa A; Krein, Sarah L; George, Christine T; Watson, Sam R; Hyzy, Robert C; Iwashyna, Theodore J
2013-08-01
Spontaneous awakening trials (SATs) improve outcomes in mechanically ventilated patients, but implementation remains erratic. We examined variation in reported practice, prevalence of attitudes and fears regarding spontaneous awakening trials, and organizational practices associated with routine implementation of spontaneous awakening trials in an ICU quality improvement collaborative. Written survey. Michigan Health and Hospital Association's Keystone ICU, a quality improvement collaborative of 73 hospitals. Attendees of the yearly Keystone ICU meeting, January 2011, including nurses, physicians, hospital administrators, and other healthcare professionals. Respondents were asked about institutional characteristics, spontaneous awakening trial practice, attitudes and barriers regarding spontaneous awakening trials, and organizational cultural characteristics that might influence SAT practice. The association of organizational cultural characteristics and attitudes with reported spontaneous awakening trial use was evaluated using logistic regression. Three hundred nineteen participants attended the meeting. The survey response rate was 83.4%. Respondents reported wide variation in approach to spontaneous awakening trial performance and patient selection. 48.6% of respondents reported regular spontaneous awakening trial use, defined as greater than 75% of mechanically ventilated patients undergoing spontaneous awakening trials each day. In bivariable analysis, addressing sedation goals routinely in rounds and having spontaneous awakening trials as part of unit culture were positively associated with regular spontaneous awakening trial use, whereas the perception that spontaneous awakening trials increased short-term adverse effects, staff fears of spontaneous awakening trials, and the perception that spontaneous awakening trials are hard work were negatively associated with regular spontaneous awakening trial use. In multivariable analysis, only addressing sedation in rounds (odds ratio, 2.85 [95% CI, 1.55-5.23]), incorporation of spontaneous awakening trials into unit culture (odds ratio, 3.36 [95% CI, 1.75-6.43]), and the perception that spontaneous awakening trials are hard work (odds ratio, 0.53 [95% CI, 0.30-0.96]) remained statistically significantly associated with regular spontaneous awakening trial use. Respondents in managerial positions were less likely to perceive spontaneous awakening trials as hard work (odds ratio, 0.44 [95% CI, 0.22-0.85]). Even in a motivated statewide quality improvement collaborative, spontaneous awakening trial practice varies widely and concerns persist regarding spontaneous awakening trials. Cultural practices may counteract the effect of concerns regarding spontaneous awakening trials and are associated with increased performance of this beneficial intervention. Patient selection should be a focus for continuing medical education. Differences in perception of work between management and staff may also be a focus for improved communication.
Creating quality practice environments: not easy, but essential.
Winslow, Wendy
2004-01-01
Quality practice environments for registered nurses correlate positively with job satisfaction, productivity, recruitment, retention and client outcomes. However, when registered nurses work in environments that do not enable them to consistently meet their nursing practice standards, patient safety is jeopardized. This article describes the development of Canada's first guidelines for a quality practice environment for registered nurses in all practice environments. It is a tool healthcare leaders can use to improve the practice environment of all health professionals and to promote patient safety.
Kelz, Rachel R; Sellers, Morgan M; Reinke, Caroline E; Medbery, Rachel L; Morris, Jon; Ko, Clifford
2013-12-01
The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI). In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement. There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements. Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education. Copyright © 2013 American College of Surgeons. All rights reserved.
Exploring incentives for RNs to return to practice: a partial solution to the nursing shortage.
Langan, Joanne C; Tadych, Rita A; Kao, Chia-Chan
2007-01-01
Although many have suggested strategies to resolve the nursing shortage, few have considered inactive RNs. This pilot study investigated reasons why nurses leave the practice, the type of work environment and resources necessary to entice RNs to return to practice, and the specific skills required to assist RNs in feeling confident and competent to return to practice. Herzberg's Two-Factor Theory was used to study motivation and hygiene factors enticing RNs to practice. A screening questionnaire was sent to 1,004 randomly selected RNs in Missouri to determine who were licensed but not practicing. Fifty-two full questionnaires were mailed and 33 (63%) were returned. Quantitative data were analyzed using SPSS, whereas qualitative data were coded and analyzed using manifest content analysis. The lack of motivators such as recognition of one's work and achievements was one reason why RNs left the practice. The hygiene factors of money, improved working conditions, refresher courses, and health insurance would motivate RNs to return to practice. Those wishing to entice inactive nurses to practice will need to offer sign-on bonuses or make the hourly wages and benefits package very competitive. This study indicates that nurses value flexible working hours, part-time opportunities, consideration of family lives, and positive relationships with administrators.
Improving compliance with requirements on junior doctors' hours
Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E
2003-01-01
Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942
Using data to improve medical practice by measuring processes and outcomes of care.
Nelson, E C; Splaine, M E; Godfrey, M M; Kahn, V; Hess, A; Batalden, P; Plume, S K
2000-12-01
The purpose of this article is to help clinicians expand their use of data to improve medical practice performance and to do improvement research. Clinical practices can be viewed as small, complex organizations (microsystems) that produce services for specific patient populations. These services can be greatly improved by embedding measurement into the flow of daily work in the practice. WHY DO IT?: Four good reasons to build measures into daily medical practice are to (1) diagnose strengths and weaknesses in practice performance; (2) improve and innovate in providing care and services using improvement research; (3) manage patients and the practice; and (4) evaluate changes in results over time. It is helpful to have a "physiological" model of a medical practice to analyze the practice, to manage it, and to improve it. One model views clinical practices as microsystems that are designed to generate desired health outcomes for specific subsets of patients and to use resources efficiently. This article provides case study examples to show what an office-based practice might look like if it were using front-line measurement to improve care and services most of the time and to conduct clinical improvement research some of the time. WHAT ARE THE PRINCIPLES FOR USING DATA TO IMPROVE PROCESSES AND OUTCOMES OF CARE?: Principles reflected in the case study examples--such as "Keep Measurement Simple. Think Big and Start Small" and "More Data Is Not Necessarily Better Data. Seek Usefulness, Not Perfection, in Your Measures"--may help guide the development of data to study and improve practice. HOW CAN A PRACTICE START TO USE DATA TO IMPROVE CARE AND CONDUCT IMPROVEMENT RESEARCH?: Practical challenges are involved in starting to use data for enhancing care and improvement research. To increase the odds for success, it would be wise to use a change management strategy to launch the startup plan. Other recommendations include "Establish a Sense of Urgency. (Survival Is Not Mandatory)" and "Create the Guiding Coalition. (A Small, Devoted Group of People Can Change the World)." Over the long term, we must transform thousands of local practice cultures so that useful data are used every day in countless ways to assist clinicians, support staff, patients, families, and communities.
Olander, Ellinor; Coates, Rose; Brook, Judy; Ayers, Susan; Salmon, Debra
2018-02-09
This multi-method evaluation assessed the perceived impact of interprofessional workshops targeting enhanced collaboration between healthcare professionals who care for women during and after pregnancy. Current policy recommends partnership working to improve care for women and babies, however, there is little interprofessional education in this area. Five one-day workshops were delivered to 18 healthcare professionals (47.4% of the 38 healthcare professionals registered). The workshop was evaluated through questionnaires before and after the workshop measuring attitudes and willingness towards collaboration; observations of the workshops by a researcher and follow-up interviews 2 months' post-workshop to explore changes in practice. Workshops were attended by midwives, health visitors (trained nurses specialising in community care for children 0-5 years), dietitians, nurses, a general practitioner and a breastfeeding specialist. Attitudes and willingness to participate in interprofessional collaborative practice improved after the workshop. Observations made at the workshop included engaged participants who reported numerous barriers towards collaboration. Follow-up contact with 12 participants identified several examples of collaboration in practice resulting from workshop attendance. These findings suggest that the workshops influenced attendees to change their practice towards more collaborative working. Future work needs to confirm these results with more participants.
NASA Astrophysics Data System (ADS)
Lei, Bing; Liu, Wei; Shi, Jianhua; Yao, Tianfu; Wang, Wei; Hu, Haojun
2017-08-01
The Students Innovation Training Program (SITP) has become an effective method to impel the teaching reform and improve undergraduate's innovative practical ability in Chinese colleges and universities, which is quite helpful for students to understand the social requirement, to grasp the basic means of scientific research and to improve their innovative practical ability and team work spirit. In this paper, three problems have been analyzed and discussed based on our organizing and instructing experience of SITP in recent years. Firstly, the SITP is a synthetically training project, and it is quite suitable to cultivate the students' innovative practical ability. Because SITP is similar to the real scientific research activity, and both of them include the steps of project application, solution design, research implementation and project summary etc. By making great efforts to these basic training steps, the undergraduates' innovative practical ability has been improved systemically. Secondly, a new talents cultivation system has been constructed based on SITP by integrating the subject competitions, graduation design and other conventional training activities, which is quite good to improve the training quality and decrease the total training class hours. Thirdly, a series of long-term effective operation and management guidelines have been established to ensure the SITP work normally, including doing a good job of project evaluation, setting up a reward and punishment system and creating a good atmosphere for innovation. In conclusion, great efforts have been made to enhance undergraduates' innovative ability, and the research results will provide useful reference for improving the training effects and reforming talents cultivating mode further.
Recognition of Tacit Skills: Sustaining Learning Outcomes in Adult Learning and Work Re-Entry
ERIC Educational Resources Information Center
Evans, Karen; Kersh, Natasha; Kontiainen, Seppo
2004-01-01
This paper is based on the project "Recognition of Tacit Skills and Knowledge in Work Re-entry" carried out as a part of the ESRC-funded Research Network "Improving Incentives to Learning in the Workplace". The network aims to contribute to improved practice among a wide range of practitioners. The study has investigated the part played by tacit…
Implementation Science Supports Core Clinical Competencies: An Overview and Clinical Example.
Kirchner, JoAnn E; Woodward, Eva N; Smith, Jeffrey L; Curran, Geoffrey M; Kilbourne, Amy M; Owen, Richard R; Bauer, Mark S
2016-12-08
Instead of asking clinicians to work faster or longer to improve quality of care, implementation science provides another option. Implementation science is an emerging interdisciplinary field dedicated to studying how evidence-based practice can be adopted into routine clinical care. This article summarizes principles and methods of implementation science, illustrates how they can be applied in a routine clinical setting, and highlights their importance to practicing clinicians as well as clinical trainees. A hypothetical clinical case scenario is presented that explains how implementation science improves clinical practice. The case scenario is also embedded within a real-world implementation study to improve metabolic monitoring for individuals prescribed antipsychotics. Context, recipient, and innovation (ie, the evidence-based practice) factors affected improvement of metabolic monitoring. To address these factors, an external facilitator and a local quality improvement team developed an implementation plan involving a multicomponent implementation strategy that included education, performance reports, and clinician follow-up. The clinic remained compliant with recommended metabolic monitoring at 1-year follow up. Implementation science improves clinical practice by addressing context, recipient, and innovation factors and uses this information to develop and utilize specific strategies that improve clinical practice. It also enriches clinical training, aligning with core competencies by the Accreditation Council for Graduate Medical Education and American Boards of Medical Specialties. By learning how to change clinical practice through implementation strategies, clinicians are more able to adapt in complex systems of practice. © Copyright 2016 Physicians Postgraduate Press, Inc.
Reading Deeply for Disciplinary Awareness and Political Judgment
ERIC Educational Resources Information Center
Staudinger, Alison
2017-01-01
What happens when students become better readers? Cultivating deep reading habits in students to help them navigate disciplinary cultures respects student autonomy. Scholarly literature predicts that three linked practices improve student reading: practice with feedback, explicit in-class work on reading strategies, and disciplinary norm…
Faculty Research and Publication Practices
ERIC Educational Resources Information Center
Zoellner, Kate; Hines, Samantha; Keenan, Teressa; Samson, Sue
2015-01-01
Understanding faculty work practices can translate into improved library services. This study documents how education and behavioral science faculty locate, retrieve, and use information resources for research and writing and how they publish and store their research materials. The authors interviewed twelve professors using a structured interview…
Locatelli, Sara M; LaVela, Sherri L
2015-01-01
Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.
Improving Teaching and Learning in Science and Mathematics.
ERIC Educational Resources Information Center
Treagust, David F., Ed.; And Others
The underlying theme of this book illustrates how constructivist ideas can be used by science and mathematics educators for research and the further improvement of educational practice. Authors from various parts of the world describe their work investigating students' conceptions, improving teaching and curricula, and enhancing teacher education…
"I Can Do Better": Exploring Purposeful Improvement in Daily Clinical Work
ERIC Educational Resources Information Center
Mylopoulos, Maria; Farhat, Walid
2015-01-01
Clinicians' purposeful improvement of practice is vital to maintaining excellence in patient care. This activity is understood as a core competency of adaptive expertise. As part of a broader program of research exploring adaptive expertise in healthcare, this study explored purposeful improvement in paediatric minimally invasive surgery. A…
Social work practice in the digital age: therapeutic e-mail as a direct practice methodology.
Mattison, Marian
2012-07-01
The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.
Audiology and speech-language pathology practice in Saudi Arabia.
Alanazi, Ahmad A
2017-01-01
Audiology and speech-language pathology (SLP) are relatively new professions in Saudi Arabia. The idea of establishing new audiology and SLP programs in some education facilities has become popular across Saudi Arabia; yet, only four undergraduate and graduate programs are currently available. This study aimed to explore the fields of audiology and SLP in Saudi Arabia, obtain demography of audiologists and Speech-language pathologists (SLPs), understand their current practices, and identify their perspective on what both professions need to improve. A cross-sectional mixed methods study design was used to address the aim of this study. Two online surveys were prepared and distributed to reach a large number of audiologists and SLPs. Both surveys consisted of close- and open-ended questions and primarily focused on three categories demography, audiology or SLP practices, and audiologists' or SLPs' perspective on their professions in Saudi Arabia. A total of 23 audiologists and 37 SLPs completed the surveys (age range = 21-50 years). The majority of respondents were from Riyadh with different academic qualifications and working experiences. Various practices were noticed among audiologists and SLPs who mainly worked in hospitals. Several suggestions regarding the development of audiology and SLP education and practice in Saudi Arabia are discussed. This study provides useful information about audiology and SLP education and practices in Saudi Arabia. Collaborative work between stakeholders to achieve high-quality educational and practical standards is critical. National database, clinical guidelines and policies should be developed, employed, and supervised. Further research is needed to improve education and practice of both professions in Saudi Arabia.
Advancing Social Work Education for Health Impact.
Browne, Teri; Keefe, Robert H; Ruth, Betty J; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie
2017-12-01
Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy.
Using evidence-based leadership initiatives to create a healthy nursing work environment.
Nayback-Beebe, Ann M; Forsythe, Tanya; Funari, Tamara; Mayfield, Marie; Thoms, William; Smith, Kimberly K; Bradstreet, Harry; Scott, Pamela
2013-01-01
In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.
Volker, Nerida; Williams, Lauren T; Davey, Rachel C; Cochrane, Thomas; Clancy, Tanya
2017-02-24
The reorientation of primary health care towards prevention is fundamental to addressing the rising burden of chronic disease. However, in Australia, cardiovascular disease prevention practice in primary health care is not generally consistent with existing guidelines. The Model for Prevention study was a whole-of-system cardiovascular disease prevention intervention, with one component being enhanced lifestyle modification support and addition of a health coaching service in the general practice setting. To determine the feasibility of translating intervention outcomes into real world practice, implementation work done by stakeholders was examined using Normalisation Process Theory as a framework. Data was collected through interviews with 40 intervention participants and included general practitioners, practice nurses, practice managers, lifestyle advisors and participants. Data analysis was informed by normalisation process theory constructs. Stakeholders were in agreement that, while prevention is a key function of general practice, it was not their usual work. There were varying levels of engagement with the intervention by practice staff due to staff interest, capacity and turnover, but most staff reconfigured their work for required activities. The Lifestyle Advisors believed staff had varied levels of interest in and understanding of, their service, but most staff felt their role was useful. Patients expanded their existing relationships with their general practice, and most achieved their lifestyle modification goals. While the study highlighted the complex nature of the change required, many of the new or enhanced processes implemented as part of the intervention could be scaled up to improve the systems approach to prevention. Overcoming the barriers to change, such as the perception of CVD prevention as a 'hard sell', is going to rely on improving the value proposition for all stakeholders. The study provided a detailed understanding of the work required to implement a complex cardiovascular disease prevention intervention within general practice. The findings highlighted the need for multiple strategies that engage all stakeholders. Normalisation process theory was a useful framework for guiding change implementation.
An explorative study of factors contributing to the job satisfaction of primary care midwives.
Warmelink, J Catja; Hoijtink, Kirsten; Noppers, Marloes; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K
2015-04-01
the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. a qualitative analysis was used, based on the constructivist/interpretative paradigm. Three open-ended questions in written or online questionnaire, analysed to identify factors that are linked with job satisfaction, were as follows: 'What are you very satisfied with, in your work as a midwife?', 'What would you most like to change about your work as a midwife?' and 'What could be improved in your work?'. 20 of the 519 primary care practices in the Netherlands in May 2010 were included. at these participating practices 99 of 108 midwives returned a written or online questionnaire. in general, most of the participating primary care midwives were satisfied with their job. The factors positively associated with their job satisfaction were their direct contact with clients, the supportive co-operation and teamwork with immediate colleagues, the organisation of and innovation within their practice group and the independence, autonomy, freedom, variety and opportunities that they experienced in their work. Regarding improvements, the midwives desired a reduction in non-client-related activities, such as paperwork and meetings. They wanted a lower level of work pressure, and a reduced case-load in order to have more time to devote to individual clients׳ needs. Participants identified that co-operation with other partners in the health care system could also be improved. our knowledge, our study is the first explorative study on factors associated with job satisfaction of primary care midwives. While there are several studies on job satisfaction in health care; little is known about the working conditions of midwives in primary care settings. Although the participating primary care midwives in the Netherlands were satisfied with their job, areas for improvement were identified. The results of our study can be relevant for countries that have a comparable obstetric system as in the Netherlands, or are implementing or scaling up midwifery-led care. Copyright © 2015 Elsevier Ltd. All rights reserved.
Interdisciplinary Interactions During R&D and Early Design of Large Engineered Systems
NASA Technical Reports Server (NTRS)
McGowan, Anna-Maria Rivas
2014-01-01
Designing Large-Scale Complex Engineered Systems (LaCES) such as aircraft and submarines requires the input of thousands of engineers and scientists whose work is proximate in neither time nor space. Comprehensive knowledge of the system is dispersed among specialists whose expertise is in typically one system component or discipline. This study examined the interactive work practices among such specialists seeking to improve engineering practice through a rigorous and theoretical understanding of current practice. This research explored current interdisciplinary practices and perspectives during R&D and early LaCES design and identified why these practices and perspectives prevail and persist. The research design consisted of a three-fold, integrative approach that combined an open-ended survey, semi-structured interviews, and ethnography. Significant empirical data from experienced engineers and scientists in a large engineering organization were obtained and integrated with theories from organization science and engineering. Qualitative analysis was used to obtain a holistic, contextualized understanding. The over-arching finding is that issues related to cognition, organization, and social interrelations mostly dominate interactions across disciplines. Engineering issues, such as the integration of hardware or physics-based models, are not as significant. For example, organization culture is an important underlying factor that guided researchers more toward individual sovereignty over cross-disciplinarity. The organization structure and the engineered system architecture also serve as constraints to the engineering work. Many differences in work practices were observed, including frequency and depth of interactions, definition or co-construction of requirements, clarity or creation of the system architecture, work group proximity, and cognitive challenges. Practitioners are often unaware of these differences resulting in confusion and incorrect assumptions regarding work expectations. Cognitively, the enactment and coconstruction of knowledge are the fundamental tasks of the interdisciplinary interactions. Distributed and collective cognition represent most of the efforts. Argument, ignorance, learning, and creativity are interrelated aspects of the interactions that cause discomfort but yield benefits such as problem mitigation, broader understanding, and improved system design and performance. The quality and quantity of social interrelations are central to all work across disciplines with reciprocity, respectful engagement, and heedful interrelations being significant to the effectiveness of the engineering and scientific work.
Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan
2015-08-01
The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.
Pachoud, B; Llorca, P M; Azorin, J M; Dubertret, C; de Pierrefeu, I; Gaillard, R; Franck, N
2015-12-01
Getting and keeping a job are not only one of the criteria of recovery from schizophrenia, but are also one of its main means. Indeed, recovery is partly defined by the ability to work. Despite the lack of data in France about employment of people with schizophrenia, it is widely acknowledged that the employment rate of people with schizophrenia remains quite low, and frequently it is only an employment in sheltered workshops, not on the regular work market. International research data show that it is possible to improve significantly this employment rate, with an appropriate support, that is precisely defined by the current researches, and that is quickly spreading in most developed countries. The aim of this paper is to present, on the basis of a broad current literature review, the key predictive factors of the return to work for people with schizophrenia, and the strategies to optimize vocational services. It will appear that there are several ways to improve practices and interventions in France to support work integration. To begin with individual factors of work integration, dependant on each person, the clinical state and the cognitive skills (in a broad sense, including social cognition and metacognition) are to be taken into account, and optimized by means of the association of a finely tuned pharmacological treatment and psychosocial interventions such as cognitive remediation adjusted to the person's specific needs. The other main kind of factors is environmental factors, particularly the kind of vocational support, which turns out to have a major impact not only on job acquisition, but importantly also on job tenure. The most effective vocational services are based on the "Place and train" model, and even more precisely on the Individual Placement and Support (IPS) model, that allows to the majority of people with a severe mental illness (more than 50%) to obtain a competitive employment after 6 to 18 months of individualized support. This approach is now widely recommended as "an evidence-based practice" of rehabilitation. It is important to promote in France the development of this kind of practice, already implemented as an experiment by few militant and involved associations. This development remains in France slow and delayed (compared to the practices in the other European countries) because of the lack of public funding. It implies an evolution of the social and medico-social practices, taking into account current research data, and assessing the outcomes of their practices in order to improve them. The employment specialist (sometimes called also the "job coach") turns out to play a key role, emphasized by current research, implying, among many other tasks, to coordinate the net of people supporting the work integration, including the clinical team, the employer and the colleagues of the workplace. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
[How to promote the respect of good infusion practices by meeting health care professionals?].
Le Reste, C; Fiedler, A; Dubois, S; Dewailly, A; Le Du, I; Cogulet, V
2016-05-01
Health care professionals often forget that there are risks associated with infusion therapy even if it is a common care. In order to assess this practice and to draw potential improvement actions, an audit of local gravity-flow intravenous infusion practices was conducted. The audit, based on a grid including 66 items from the medical prescription to the end of the infusion therapy administration, was conducted in the 6 units which use the most gravity-flow intravenous infusion devices. A multidisciplinary working group was created to decide and organize priority corrective measures in order to improve infusion practices and quality of healthcare. The audit enabled to observe 90hours of nurse's practices (96 infusions) and highlighted heterogeneity in infusion, in some cases inappropriate infusion practices and misuse of infusion devices. We found 4 main issues: labelling infusion therapy, training of health care professionals on good practices, support the purchase of infusion pumps and standardize perfusion line. An interactive educational program for nurses (workshops) was organized to enhance the respect of good practices: infusion identification at any time, respect of hygiene rules, flow rate regulation by counting drops, appropriate use of pumps and flow rate regulators. The audit drew up work priorities. The workshops made easier exchanges between professionals and had a warm welcome that's why it is essential to carry on such training. This collaborative approach between pharmacists, nurses, hygienists and biomedical technicians contribute to drug management improvement and promote optimal patient care. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.
Training and certification of work schedule managers may improve shift scheduling practices
DOT National Transportation Integrated Search
2011-02-01
The Federal Railroad Administration (FRA) Human Factors Research and Development (R&D) Program : sponsored the implementation of a strategic job analysis to investigate the job of work schedule managers : (WSMs) across a diverse range of industries t...
ERIC Educational Resources Information Center
Bailey, Thomas; Bashford, Joanne; Boatman, Angela; Squires, John; Weiss, Michael; Doyle, William; Valentine, Jeffrey C.; LaSota, Robin; Polanin, Joshua R.; Spinney, Elizabeth; Wilson, Wesley; Yelde, Martha; Young, Sarah H.
2016-01-01
This practice guide presents six evidence-based recommendations for college and university faculty, administrators, and advisors working to improve the success of students academically underprepared for college. Each recommendation includes an overview of the practice, a summary of evidence used in support of the evidence rating, guidance on how…
Moule, Pam; Clompus, Susan; Fieldhouse, Jon; Ellis-Jones, Julie; Barker, Jacqueline
2018-05-25
Underuse of anticoagulants in atrial fibrillation is known to increase the risk of stroke and is an international problem. The National Institute for Health Care and Excellence guidance CG180 seeks to reduce atrial fibrillation related strokes through prescriptions of Non-vitamin K antagonist Oral Anticoagulants. A quality improvement programme was established by the West of England Academic Health Science Network (West of England AHSN) to implement this guidance into General Practice. A realist evaluation identified whether the quality improvement programme worked, determining how and in what circumstances. Six General Practices in 1 region, became the case study sites. Quality improvement team, doctor, and pharmacist meetings within each of the General Practices were recorded at 3 stages: initial planning, review, and final. Additionally, 15 interviews conducted with the practice leads explored experiences of the quality improvement process. Observation and interview data were analysed and compared against the initial programme theory. The quality improvement resources available were used variably, with the training being valued by all. The initial programme theories were refined. In particular, local workload pressures and individual General Practitioner experiences and pre-conceived ideas were acknowledged. Where key motivators were in place, such as prior experience, the programme achieved optimal outcomes and secured a lasting quality improvement legacy. The employment of a quality improvement programme can deliver practice change and improvement legacy outcomes when particular mechanisms are employed and in contexts where there is a commitment to improve service. © 2018 John Wiley & Sons, Ltd.
School Self-Evaluation for School Improvement: What Works and Why?
ERIC Educational Resources Information Center
Chapman, Christopher; Sammons, Pamela
2013-01-01
The idea that schools can impact positively on student outcomes is a crucial driver in the rise of interest in school improvement research and practice. This review focuses on school self-evaluation for school improvement. School self-evaluation can be a fundamental force in achieving school improvement and this review establishes what the key…
Financial Capability in Early Social Work Practice: Lessons for Today.
Stuart, Paul H
2016-10-01
During the profession's first decades, social workers tried to improve their clients’ financial capability (FC). This article describes the methods used by early social workers who attempted to enhance the FC of their clients, based on contemporary descriptions of their practice. Social workers initially emphasized thrift, later adding more sophisticated consideration of the cost of foods, rent, and other necessities. Social work efforts were furthered by home economists, who served as specialists in nutrition, clothing, interior design, and other topics related to homemaking. Early home economists included specialists in nutrition and family budgeting; these specialists worked with social services agencies to provide a financial basis for family budgets and assisted clients with family budgeting. Some agencies engaged home economists as consultants and as direct providers of instruction on home budgets for clients. By the 1930s, however, social work interest in family budget problems focused on the psychological meaning of low income to the client, rather than in measures to increase client FC. Consequently, social workers’ active engagement with family budget issues—engagement that characterized earlier decades—faded. These early efforts can inform contemporary practice as social workers are once again concerned about improving their clients’ FC.
Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting
2017-01-01
With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.
Networking grassroots efforts to improve safety and health in informal economy workplaces in Asia.
Kawakami, Tsuyoshi
2006-01-01
Many workers in Asia are in the informal economy. They often work in substandard conditions, exposed to hazards in the workplace. Learning from the recent successes of participatory training programmes to improve safety and health in Asia, the ILO has strengthened its partnership efforts with local people to improve safety and health of informal economy workplaces. The target groups were: (1) home workplaces in Cambodia and Thailand, (2) salt fields and fishing villages in Cambodia where many young workers are working, and (3) small construction sites in Cambodia, Laos, Mongolia, Thailand and Vietnam. The walk-through survey results showed that the workers and owners in the target informal economy workplaces had the strong will to improve safety and health at their own initiatives and needed practical support. In the participatory, action-oriented training workshops carried out, the participated workers and owners were able to identify their priority safety and health actions. Commonly identified were clear and safe transport ways, safer handling of hazardous substances, basic welfare needs such as drinking water and sanitary toilets, and work posture. The follow-up visits confirmed that many of the proposed actions were actually taken by using low-cost available materials. These positive changes were possible by applying the participatory training tools such as illustrated checklists and extensive use of photographs showing local good examples and placing emphasis on facilitator roles of trainers. In conclusion, the target informal economy workplaces in Asia made positive changes in safety and health through the participatory, action-oriented training focusing on local initiative and low-cost improvement measures. Local network support mechanisms to share lessons from good practices played essential roles in encouraging the voluntary implementation of practical improvement actions. It is important to increase our joint efforts to reach more informal economy workplaces in industrially developing countries and provide practical support measures focusing on local self-help initiatives.
Professional Learning through Everyday Work: How Finance Professionals Self-Regulate Their Learning
ERIC Educational Resources Information Center
Littlejohn, Allison; Milligan, Colin; Fontana, Rosa Pia; Margaryan, Anoush
2016-01-01
Professional learning is a critical component of ongoing improvement and innovation and the adoption of new practices in the workplace. Professional learning is often achieved through learning embedded in everyday work tasks. However, little is known about how professionals self-regulate their learning through regular work activities. This paper…
Hoving, J L; Zoer, I; van der Meer, M; van der Straaten, Y; Logtenberg-Rutten, C; Kraak-Put, S; de Vries, N; Tak, P P; Sluiter, J K; Frings-Dresen, M H W
2014-01-01
To evaluate the feasibility of an e-health intervention in rheumatology practice for employees with rheumatoid arthritis (RA) who experience problems with work functioning. Twenty-three out of 90 patients with RA from a hospital rheumatology department, invited by letter, participated in a feasibility study. The 3-month internet e-health programme consisted of a self-management programme using a three-step problem-solving strategy: (step 1) analyse your work problems and opportunities; (step 3) identify solutions; and (step 3) work out a strategy (action plan). Support and personal feedback was provided by a rheumatology nurse. Patients completed assignments, received information, and actively worked on their goals. The main feasibility outcome included satisfaction with the programme. Other feasibility outcomes included usefulness, suitability, website use, and work functioning measured at baseline and/or 3 months using questionnaires, semi-structured interviews, and website data. In total, 95% of the participants were satisfied with the programme, and 96% thought the programme was useful for working RA patients and would recommend the programme to other working RA patients (91%). On the website, all patients at least partially completed the assignments in step 1 and 12 patients completed at least one assignment in step 3. Patients judged the website as well arranged with clear tasks. Patients worked on a range of (individual) goals, resolving work challenges using different strategies and actions. The e-health intervention is a feasible intervention for rheumatology practice justifying further effectiveness evaluation while allowing for further improvements in the selection of RA patients and shaping the intervention.
Nursing Practice Environment and Outcomes for Oncology Nursing
Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.
2012-01-01
Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101
[Automation and organization of technological process of urinalysis].
Kolenkin, S M; Kishkun, A A; Kol'chenko, O L
2000-12-01
Results of introduction into practice of a working model of industrial technology of laboratory studies and KONE Specific Supra and Miditron M devices are shown as exemplified by clinical analysis of the urine. This technology helps standardize all stages and operations, improves the efficiency of quality control of laboratory studies, rationally organizes the work at all stages of the process, creates a system for permanent improvement of the efficiency of investigations at the preanalytical, analytical, and postanalytical stages of technological process of laboratory studies. As a result of introduction of this technology into laboratory practice, violations of quality criteria of clinical urinalysis decreased from 15 to 8% at the preanalytical stage and from 6 to 3% at the analytical stage. Automation of the analysis decreased the need in reagents 3-fold and improved the productivity at the analytical stage 4-fold.
Green shoots of recovery: a realist evaluation of a team to support change in general practice.
Bartlett, Maggie; Basten, Ruth; McKinley, Robert K
2017-02-08
A multidisciplinary support team for general practice was established in April 2014 by a local National Health Service (NHS) England management team. This work evaluates the team's effectiveness in supporting and promoting change in its first 2 years, using realist methodology. Primary care in one area of England. Semistructured interviews were conducted with staff from 14 practices, 3 key senior NHS England personnel and 5 members of the support team. Sampling of practice staff was purposive to include representatives from relevant professional groups. The team worked with practices to identify areas for change, construct action plans and implement them. While there was no specified timescale for the team's work with practices, it was tailored to each. In realist evaluations, outcomes are contingent on mechanisms acting in contexts, and both an understanding of how an intervention leads to change in a socially constructed system and the resultant changes are outcomes. The principal positive mechanisms leading to change were the support team's expertise and its relationships with practice staff. The 'external view' provided by the team via its corroborative and normalising effects was an important mechanism for increasing morale in some practice contexts. A powerful negative mechanism was related to perceptions of 'being seen as a failing practice' which included expressions of 'shame'. Outcomes for practices as perceived by their staff were better communication, improvements in patients' access to appointments resulting from better clinical and managerial skill mix, and improvements in workload management. The support team promoted change within practices leading to signs of the 'green shoots of recovery' within the time frame of the evaluation. Such interventions need to be tailored and responsive to practices' needs. The team's expertise and relationships between team members and practice staff are central to success. 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/.
A participatory approach to health promotion for informal sector workers in Thailand
Manothum, Aniruth; Rukijkanpanich, Jittra
2010-01-01
Abstract: Background: This study aims to promote occupational health in the informal sector in Thailand by using a participatory approach. The success of the intervention is based on an evaluation of the informal sector workers, a) knowledge, attitudes, and behaviors in occupational health and safety, b) work practice improvement, and c) working condition improvement. Methods: This study applies the Participatory Action Research (PAR) method. The participants of the study consisted of four local occupations in different regions of Thailand, including a ceramic making group in the North, a plastic weaving group in the Central region, a blanket making group in the Northeast, and a pandanus weaving group in the South. Data was collected using both qualitative and quantitative methods through questionnaires, industrial hygiene instruments, and group discussions. Results: The results showed that the working conditions of the informal sector were improved to meet necessary standards after completing the participatory process. Also, the post-test average scores on 1) the occupational health and safety knowledge, attitudes and behaviors measures and 2) the work practice improvement measures were significantly higher than the pre-test average scores (P less than 0.05). Conclusions: The results demonstrate that the participatory approach is an effective tool to use when promoting the health safety of the informal sector and when encouraging the workers to voluntarily improve the quality of their own lives. PMID:21483207
Achieving organizational change in pediatric pain management
Dowden, Stephanie; McCarthy, Maria; Chalkiadis, George
2008-01-01
BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices. OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital. DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party. RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described. CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement. PMID:18719714
Learning organisations: the challenge of finding a safe space in a climate of accountability.
McKee, Anne
2017-03-01
The effects of health policy reforms over a twenty-five year period have changed the NHS as a place in which to work and learn. Some of these changes have had unintentional consequences for learning in the workplace. A recent King's Fund contribution to quality improvement debates included an extensive review of NHS policies encouraging change 'from within' the NHS and renewed calls to develop learning organisations there. I draw upon an action research project designed to develop learning organisations in primary care to locate quality improvement debates amid the realities of practice. The project identified key challenges primary care practices encountered to protect time and space for this form of work based learning, even when they recognised the need for it and wanted to engage in it. Implications for policy makers, primary care practices and health professional educationalists are identified.
A work-based learning approach for clinical support workers on mental health inpatient wards.
Kemp, Philip; Gilding, Moorene; Seewooruttun, Khooseal; Walsh, Hannah
2016-09-14
Background With a rise in the number of unqualified staff providing health and social care, and reports raising concerns about the quality of care provided, there is a need to address the learning needs of clinical support workers. This article describes a qualitative evaluation of a service improvement project that involved a work-based learning approach for clinical support workers on mental health inpatient wards. Aim To investigate and identify insights in relation to the content and process of learning using a work-based learning approach for clinical support workers. Method This was a qualitative evaluation of a service improvement project involving 25 clinical support workers at the seven mental health inpatient units in South London and Maudsley NHS Foundation Trust. Three clinical skills tutors were appointed to develop, implement and evaluate the work-based learning approach. Four sources of data were used to evaluate this approach, including reflective journals, qualitative responses to questionnaires, three focus groups involving the clinical support workers and a group interview involving the clinical skills tutors. Data were analysed using thematic analysis. Findings The work-based learning approach was highly valued by the clinical support workers and enhanced learning in practice. Face-to-face learning in practice helped the clinical support workers to develop practice skills and reflective learning skills. Insights relating to the role of clinical support workers were also identified, including the benefits of face-to-face supervision in practice, particularly in relation to the interpersonal aspects of care. Conclusion A work-based learning approach has the potential to enhance care delivery by meeting the learning needs of clinical support workers and enabling them to apply learning to practice. Care providers should consider how the work-based learning approach can be used on a systematic, organisation-wide basis in the context of budgetary restrictions.
Educational Change, Baldrige, and Schlechty
ERIC Educational Resources Information Center
Vaszauskas, Jim
2011-01-01
This article explores the relationship between research on educational change, the Baldrige continuous improvement framework, and Schlechty's (2002) WOW school standards articulated in "Working on the Work". Each of Schlechty's standards are examined and examples from practicing educators who have been trained in continuous improvement…
House, Peter J; Hartfield, Karen; Nicola, Bud; Bogan, Sharon L
2014-01-01
The Community-Oriented Public Health Practice (COPHP) program, a 2-year in-residence MPH degree program in the University of Washington School of Public Health, has partnered with Public Health-Seattle & King County (PHSKC) since 2002 to create a mutually beneficial set of programs to improve teaching and address community-based public health problems in a practice setting. The COPHP program uses a problem-based learning approach that puts students in small groups to work on public health problems. Both University of Washington-based and PHSKC-based faculty facilitate the classroom work. In the first year for students, COPHP, in concert with PHSKC, places students in practicum assignments at PHSKC; in the second year, students undertake a master's project (capstone) in a community or public health agency. The capstone project entails taking on a problem in a community-based agency to improve either the health of a population or the capacity of the agency to improve population health. Both the practicum and the capstone projects emphasize applying classroom learning in actual public health practice work for community-based organizations. This partnership brings PHSKC and COPHP together in every aspect of teaching. In essence, PHSKC acts as the "academic health department" for COPHP. There are detailed agreements and contracts that guide all aspects of the partnership. Both the practicum and capstone projects require written contracts. The arrangements for getting non-University of Washington faculty paid for teaching and advising also include formal contracts.
Handling of hazardous drugs - Effect of an innovative teaching session for nursing students.
Zimmer, Janine; Hartl, Stefanie; Standfuß, Katrin; Möhn, Till; Bertsche, Astrid; Frontini, Roberto; Neininger, Martina P; Bertsche, Thilo
2017-02-01
Imparting knowledge and practical skills in hazardous drug handling in nursing students' education is essential to prevent hazardous exposure and to preserve nurses' health. This study aimed at comparing routine nursing education with an additional innovative teaching session. A prospective controlled study in nursing students was conducted in two study periods: (i) a status-quo period (routine education on handling hazardous drugs) followed by (ii) an intervention period (additional innovative teaching session on handling hazardous drugs). Nursing students at a vocational school were invited to participate voluntarily. In both study periods (i) and (ii), the following factors were analysed: (a) knowledge of hazardous drug handling by questionnaire, (b) practical skills in hazardous drug handling (e.g. cleaning) by a simulated handling scenario, (c) contamination with drug residuals on the work surface by fluorescent imaging. Fifty-three nursing students were enrolled. (a) Median knowledge improved from status-quo (39% right answers) to intervention (65%, p<0.001), (b) practical skills improved from status-quo (53% of all participants cleaned the work surface) to intervention (92%, p<0.001). (c) Median number of particles/m 2 decreased from status-quo to intervention (932/97, p<0.001). Compared with routine education, knowledge and practical skills in hazardous drug handling were significantly improved after an innovative teaching session. Additionally, the amount of residuals on the work surface decreased. This indicates a lower risk for hazardous drug exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.
Professional Demands and Job Satisfaction in Orthopaedic Trauma: An OTA Member Survey.
Cunningham, Brian P; Swanson, David C; Basmajian, Hrayr; McLemore, Ryan; Ortega, Gilbert
2015-12-01
The goal of this study was to examine the factors that affect career satisfaction in orthopaedic traumatologists. We hypothesize that the level of stress and career satisfaction in orthopaedic traumatology would be affected by increased number of call nights and work hours. A 30-question survey was emailed to members of the OTA. The survey evaluated 5 critical areas: training/experience, practice characteristics, demands, stress management strategies, and satisfaction. After approval by the OTA research committee, all active and associate US members of the OTA were contacted. The survey was open to the OTA members from July through November of 2012. Of 1031 members of the OTA, 263 members responded for an overall response rate of 25.5%. Most respondents were fellowship-trained (218, 82.9%) and predominantly young (<5 years in practice, 34.4%) or established surgeons (>15 years in practice, 28.5%). Most surgeons were married (229, 87.1%) and have not been divorced (226, 85.9%). Career satisfaction was statistically improved by belonging to larger practice (P = 0.016), decreased by work for more hours per week (P = 0.001), and improved by taking more call (P = 0.014). Career satisfaction among orthopaedic trauma surgeons was extremely high. Our results indicate that young surgeons may improve their job satisfaction and potentially prolong their career by limiting the numbers of hours worked, taking a consistent number of calls and joining a larger group. Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.
McCreesh, Karen; Larkin, Louise; Lewis, Jeremy
2016-01-01
The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP), patient care, and therapist personal development. PMID:26904293
Whay, Helen R; Dikshit, Amit K; Hockenhull, Jo; Parker, Richard M A; Banerjee, Anindo; Hughes, Sue I; Pritchard, Joy C; Reix, Christine E
2015-01-01
Previous studies have found the prevalence of lameness in working horses to be 90-100%. Risk factors for lameness in this important equine population, together with risk-reduction strategies adopted by their owners, are poorly understood. The objective was to uncover risk factors for lameness and limb abnormalities in working horses, by associating clinical lameness examination findings on three occasions over two years with owner reported changes in equine management and work practices over this period. Twenty-one communities of horse owners in Jaipur, India, took part in a participatory intervention (PI) project aiming to reduce risk factors for poor welfare, particularly lameness and limb problems. Associations between quantitative measures of equine lameness/limb abnormalities and reported changes in management and work practices were compared with 21 control (C) communities of owners where no intervention had taken place. Key findings from 'complete cases', where the same horse stayed with the same owner for the whole study period (PI group = 73 owners of 83 horses, C group = 58 owners of 66 horses), were that more positive statements of change in equine management and work practices were made by PI group owners than C group owners. A mixed picture of potential risk factors emerged: some reported management improvements, for example reducing the weight of the load for cart animals, were associated with improved limbs and lameness, and others, such as making improvements in shoeing and increasing the age at which their animals started work, with negative outcomes. This study illustrates the complexity and interacting nature of risk factors for lameness in working horses, and highlights the importance of longitudinal investigations that recognise and address this. PI group owners found the project useful and requested similar inputs in future. Our findings demonstrate the value of exploratory and participatory research methodology in the field of working horse welfare.
Hoens, Alison M; Reid, W Darlene; Camp, Pat G
2013-01-01
The process of adopting research findings in the clinical setting is challenging, regardless of the area of practice. One strategy to facilitate this process is the use of knowledge brokering. Knowledge brokers (KBs) are individuals who work to bridge the gap between researchers and knowledge users. In the health care setting, KBs work closely with clinicians to facilitate enhanced uptake of research findings into clinical practice. They also work with researchers to ensure research findings are translatable and meaningful to clinical practice. The present article discusses a KB's role in a respiratory care setting. Working closely with both researchers and clinicians, the KB has led teams in the process of conceptualizing, developing, testing, disseminating and evaluating several projects related to respiratory care, including projects related to mobility in critical care settings and acute exacerbations of chronic obstructive pulmonary disease; inspiratory muscle training; and the use of incentive spirometry in postsurgical populations. The KB role has provided an important communication link between researcher and knowledge user that has facilitated evidence-informed practice to improve patient care.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Doyle, C.; Truitt, A.; Inda, D.
The following Photovoltaics Installation Best Practices Guide is one of several work products developed by the Solar Access to Public Capital (SAPC) working group, which works to open capital market investment. SAPC membership includes over 450 leading solar developers, financiers and capital managers, law firms, rating agencies, accounting and engineering firms, and other stakeholders engaged in solar asset deployment. SAPC activities are directed toward foundational elements necessary to pool project cash flows into tradable securities: standardization of power purchase and lease contracts for residential and commercial end customers; development of performance and credit data sets to facilitate investor due diligencemore » activities; comprehension of risk perceived by rating agencies; and the development of best practice guides for PV system installation and operations and maintenance (O&M) in order to encourage high-quality system deployment and operation that may improve lifetime project performance and energy production. This PV Installation Best Practices Guide was developed through the SAPC Installation Best Practices subcommittee, a subgroup of SAPC comprised of a wide array of solar industry leaders in numerous fields of practice. The guide was developed over roughly one year and eight months of direct engagement by the subcommittee and two working group comment periods.« less
An Urban School Leader's Approach to School Improvement: Toward Contextually Responsive Leadership
ERIC Educational Resources Information Center
Reed, Latish C.; Swaminathan, Raji
2016-01-01
This case study examines the leadership practices and actions of an urban high school principal who faced many challenges, but worked diligently to improve student achievement and school climate over a 3-year period. Significant improvements were made by using elements of Distributed Leadership, Professional Learning Communities, and Social…
Linking School Effectiveness and School Improvement: The Background and Outline of the Project
ERIC Educational Resources Information Center
Creemers, Bert P. M.; Reezigt, Gerry J.
2005-01-01
School effectiveness and school improvement have different origins: School effectiveness is more directed to finding out "what works" in education and "why"; school improvement is practice and policy oriented and intended to change education in the desired direction. However, in their orientation to outcomes, input, processes,…
COMPASS-AIM: A University/P-12 Partnership Innovation for Continuous Improvement
ERIC Educational Resources Information Center
Wilcox, Kristen C.; Lawson, Hal A.; Angelis, Janet I.
2017-01-01
COMPASS-AIM is a set of processes and tools used by participants in a research-practice partnership (RPP) to improve organizational capacities and individual and team competencies for organizational learning and improvement. The "COMPASS" team includes teams of teachers and school leaders who work with a university researcher and expert…
Understanding safety climate in small automobile collision repair shops.
Parker, David L; Brosseau, Lisa M; Bejan, Anca; Skan, Maryellen; Xi, Min
2014-01-01
In the United States, approximately 236,000 people work in 37,600 auto collision-repair businesses. Workers in the collision-repair industry may be exposed to a wide range of physical and chemical hazards. This manuscript examines the relationship of safety climate as reported by collision repair shop workers and owners to: (1) an independent business safety assessment, and (2) employee self-reported work practices. The study was conducted in the Twin Cities metropolitan area. A total of 199 workers from 49 collision shops completed a survey of self-reported work practices and safety climate. Surveys were completed by an owner or manager in all but three shops. In general, self-reported work practices were poor. Workers' scores on safety climate were uniformly lower than those of owners. For workers, there was no correlation between how well the business scored on an independent audit of business safety practices and the safety climate measures they reported. For owners, however, there was a positive correlation between safety climate scores and the business safety assessment. For workers, safety rules and procedures were associated with improved work practices for those engaged in both painting-related and body technician-related activities. The enforcement of safety rules and procedures emerged as a strong factor positively affecting self-reported work practices. These findings identify a simple, cost effective path to reducing hazards in small workplaces. © 2013 Wiley Periodicals, Inc.
Critical and Transformative Practices in Professional Learning Communities
ERIC Educational Resources Information Center
Servage, Laura
2008-01-01
Professional learning communities (PLCs) have been held up as powerful structures for teachers' continuing professional development. In this work, the author has applied transformative learning theory to highlight the psychic risks of collaborative teacher learning, as well as the need for practical efforts to improve student learning--the means…
Responsible Student Affairs Practice: Merging Student Development and Quality Management.
ERIC Educational Resources Information Center
Whitner, Phillip A.; And Others
The merging of Total Quality Management (TQM) and Involvement Theory into a managerial philosophy can assist student affairs professionals with an approach for conducting work that improves student affairs practice. When merged or integrated, accountability can easily be obtained because the base philosophies of qualitative research, TQM, and…
Effective Schools Practices That Work.
ERIC Educational Resources Information Center
Lezotte, Lawrence W., Ed.; Jacoby, Barbara C., Ed.
This monograph describes a number of successful solutions that have been used in schools involved in school improvement planning. Problem-solving strategies used by schools across the United States to address various situations are described, in which each school focused on student achievement and teaching learning for all students. The practices,…
Establishing Benchmarks and Measuring Progress at "HSTW" Sites.
ERIC Educational Resources Information Center
Southern Regional Education Board (SREB), 2010
2010-01-01
Schools that join the "High Schools That Work (HSTW)" network are expected to show progress in changing school and classroom practices in ways that improve student achievement and readiness for postsecondary studies and careers. They are expected to focus on practices that have proven most effective in advancing student achievement.…
Health practices of Canadian physicians.
Frank, Erica; Segura, Carolina
2009-08-01
To study the health and health practices of Canadian physicians, which can often influence patient health. Mailed survey. Canada. A random sample of 8100 Canadian physicians; 7934 were found to be eligible and 3213 responded (40.5% response rate). Factors that influence health, such as consumption of fruits and vegetables, amount of exercise and alcohol consumption, smoking status, body mass idex, and participation in preventive health screening measures, as well as work-life balance and emotional stability. Canadian physicians are healthy. More than 90% reported being in good to excellent health, and only 5% reported that poor physical or mental health made it difficult to handle their workload more than half the time in the previous month (although a quarter had reduced work activity because of long-term health conditions). Eight percent were obese, 3% currently smoked cigarettes, and 1% typically consumed 5 drinks or more on days when they drank alcohol. Physicians averaged 4.7 hours of exercise per week and ate fruits and vegetables 4.8 times a day. Their personal screening practices were largely compliant with Canadian Task Force on Preventive Health Care recommendations. They averaged 38 hours per week on patient care and 11 hours on other professional activities. Fifty-seven percent agreed that they had a good work-life balance, and 11% disagreed with the statement "If I can, I work when I am ill." Compared with self-reports from the general Canadian population, Canadian physicians, like American physicians, seem to be healthy and to have generally healthy behaviour. There is, however, room for improvement in physicians' personal and professional well-being, and improving their personal health practices could be an efficient and beneficent way to improve the health of all Canadians.
Applying Lean principles and Kaizen rapid improvement events in public health practice.
Smith, Gene; Poteat-Godwin, Annah; Harrison, Lisa Macon; Randolph, Greg D
2012-01-01
This case study describes a local home health and hospice agency's effort to implement Lean principles and Kaizen methodology as a rapid improvement approach to quality improvement. The agency created a cross-functional team, followed Lean Kaizen methodology, and made significant improvements in scheduling time for home health nurses that resulted in reduced operational costs, improved working conditions, and multiple organizational efficiencies.
Design of a Workstation by a Cognitive Approach
Jaspers, MWM; Steen, T.; Geelen, M.; van den Bos, C.
2001-01-01
To ensure ultimate acceptance of computer systems that are easy to use, provide the desired functionality and fits into users work practices requires the use of improved methods for system design and evaluation. Both designing and evaluating workstations that link up smoothly with daily routine of physicians' work requires a thorough understanding of their working practices. The application of methods from cognitive science may contribute to a thorough understanding of the activities involved in medical information processing. We used cognitive task analysis in designing a physicians' workstation, which seems a promising method to ensure that the system meets the user needs.
Massachusetts Superintendents' Perceptions of Teacher Bargaining Practices
ERIC Educational Resources Information Center
Borstel, Scott L.
2010-01-01
For five decades, collective bargaining has been implemented in American public schools (Loveless, 2000). It has protected the rights of teachers; and teacher work conditions issues and compensation have improved (Hannaway & Rotherham, 2006). However, improvements have created adversarial labor-management relationships, resulted in excessive…
Advancing Social Work Education for Health Impact
Keefe, Robert H.; Ruth, Betty J.; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie
2017-01-01
Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy. PMID:29236540
McMillen, Curtis; Zayas, Luis E.; Books, Samantha; Lee, Madeline
2009-01-01
Accompanying the rise in the number of mental health agency personnel tasked with quality assurance and improvement (QA/I) responsibilities is an increased need to understand the nature of the work these professionals undertake. Four aspects of the work of quality assurance and improvement (QA/I) professionals in mental health were explored in this qualitative study: their perceived roles, their major activities, their QA/I targets, and their contributions. In-person interviews were conducted with QA/I professionals at 16 mental health agencies. Respondents perceived their roles at varying levels of complexity, focused on different targets, and used different methods to conduct their work. Few targets of QA/I work served as indicators of high quality care. Most QA/I professionals provided concrete descriptions of how they had improved agency services, while others could describe none. Accreditation framed much of agency QA/I work, perhaps to its detriment. PMID:18688707
Manthorpe, Jill; Hussein, Shereen; Moriarty, Jo
2005-07-01
Social work education in England underwent significant change in its move to degree status in 2003. It is hoped that the result will be increased professional standing for social workers, an improvement in the current widespread problems with recruitment, and assurance that all newly qualified social workers meet the National Occupational Standards for Social Work (Available from: http://www.topssengland.net/files/cd/). This change has pre-occupied social work educators and debate within the profession has concentrated on the practicalities and expectations of reform. This paper suggests that those working in nurse education may observe a number of similarities with its own earlier reforms and with current debates on whether nursing should move to an all-graduate profession. It then highlights three aspects of the new requirements for social work training: service user involvement, the place of research-minded practice, and the primacy of practice--that may be of interest and relevance to nursing colleagues.
Ramsauer, F
2001-12-01
This prevention concept offers a contribution to the expansion of the set of instruments for occupational safety and health protection within workplace prevention. The concept involves the multilateral analysis of work conditions. The utilized instruments include a strategy group, a survey, a health issue round table, and an analysis of work demands, and lead to synergy effects at the results level. Employees are drawn into the analysis of work conditions and workplace design solutions for the improvement of the work situation. The prevention concept was tested in a large company and its application established in practice. It was accepted by all participants, and the comparison with the previous situation (defined only through the analysis of work demands) demonstrated a significant improvement in health protection.
ERIC Educational Resources Information Center
Pearson, Julie
2011-01-01
In this paper I explore how I have come to theorise my work as a critical emancipatory practice as a lecturer in primary physical education (PE). I give an account of what I understand to be the epistemological foundations and practices of practitioner research and my potential educational influence in my own and other practitioner-researchers'…
Tevaarwerk, Amye J; Lee, Ju-Whei; Terhaar, Abigail; Sesto, Mary E; Smith, Mary Lou; Cleeland, Charles S; Fisch, Michael J
2016-02-01
Improved survival for individuals with metastatic cancer accentuates the importance of employment for cancer survivors. A better understanding of how metastatic cancer affects employment is a necessary step toward the development of tools for assisting survivors in this important realm. The ECOG-ACRIN Symptom Outcomes and Practice Patterns study was analyzed to investigate what factors were associated with the employment of 680 metastatic cancer patients. Univariate and multivariate logistic regression analyses were conducted to compare patients stably working with patients no longer working. There were 668 metastatic working-age participants in the analysis: 236 (35%) worked full- or part-time, whereas 302 (45%) had stopped working because of illness. Overall, 58% reported some change in employment due to illness. A better performance status and non-Hispanic white ethnicity/race were significantly associated with continuing to work despite a metastatic cancer diagnosis in the multivariate analysis. The disease type, time since metastatic diagnosis, number of metastatic sites, location of metastatic disease, and treatment status had no significant impact. Among the potentially modifiable factors, receiving hormonal treatment (if a viable option) and decreasing symptom interference were associated with continuing to work. A significant percentage of the metastatic patients remained employed; increased symptom burden was associated with a change to no longer working. Modifiable factors resulting in work interference should be minimized so that patients with metastatic disease may continue working if this is desired. Improvements in symptom control and strategies developed to help address workplace difficulties have promise for improving this aspect of survivorship. © 2015 American Cancer Society.
ERIC Educational Resources Information Center
Arani, Mohammad Reza Sarkar; Alagamandan, Jafar; Tourani, Heidar
2004-01-01
The work-based learning model of human resource development has captured a great deal of attention and has gained increasing importance in higher education in recent years. Work-based learning is a powerful phenomenon that attempts to help policy-makers, managers and curriculum developers improve the quality of the decision and organizational…
Work Motivation: Theory and Practice.
ERIC Educational Resources Information Center
Katzell, Raymond A.; Thompson, Donna E.
1990-01-01
Presents theories of motivation classified as those dealing either with exogenous causes or with endogenous processes. The following strategies for improving work motivation are discussed: (1) personal motives; (2) incentives and rewards; (3) reinforcement; (4) goal-setting techniques; (5) personal and material resources; (6) social and group…
Research in action: using positive deviance to improve quality of health care
Bradley, Elizabeth H; Curry, Leslie A; Ramanadhan, Shoba; Rowe, Laura; Nembhard, Ingrid M; Krumholz, Harlan M
2009-01-01
Background Despite decades of efforts to improve quality of health care, poor performance persists in many aspects of care. Less than 1% of the enormous national investment in medical research is focused on improving health care delivery. Furthermore, when effective innovations in clinical care are discovered, uptake of these innovations is often delayed and incomplete. In this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care quality. Methods We synthesize existing literature on positive deviance, describe major alternative approaches, propose benefits and limitations of a positive deviance approach for research directed toward improving quality of health care, and describe an application of this approach in improving hospital care for patients with acute myocardial infarction. Results The positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional performance. Steps in this approach: identify 'positive deviants,' i.e., organizations that consistently demonstrate exceptionally high performance in the area of interest (e.g., proper medication use, timeliness of care); study the organizations in-depth using qualitative methods to generate hypotheses about practices that allow organizations to achieve top performance; test hypotheses statistically in larger, representative samples of organizations; and work in partnership with key stakeholders, including potential adopters, to disseminate the evidence about newly characterized best practices. The approach is particularly appropriate in situations where organizations can be ranked reliably based on valid performance measures, where there is substantial natural variation in performance within an industry, when openness about practices to achieve exceptional performance exists, and where there is an engaged constituency to promote uptake of discovered practices. Conclusion The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality. PMID:19426507
Innovative Method of Analysis of Actual Cost of Work in Progress
NASA Astrophysics Data System (ADS)
Fil, O.; Terentev, V.
2017-11-01
The article focuses on the basic theory and practical aspects of improving the strategic management in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at selecting an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research and the experimental data obtained in the experiment
Kawakami, Tsuyoshi; Van, Vhu Nhu; Theu, Nguyen Van; Khai, Ton That; Kogi, Kazutaka
2008-10-01
The government of Viet Nam places a high priority on upgrading the quality of farmers' lives. Providing adequate occupational safety and health (OSH) protection for all farmers is an important challenge. The Ministry of Labour, Invalids and Social Affairs (MOLISA) of Viet Nam trained WIND (Work Improvement in Neighbourhood Development) farmer volunteers. From 2004-2007, MOLISA in cooperation with ministries of health and agriculture trained 480 WIND farmer volunteers in selected 14 provinces. Trained farmer volunteers trained their neighbouring farmers and expanded their networks. The WIND training programme produced in Cantho, Viet Nam in 1996, was used as the core training methodology. The WIND action-checklist, good example photo-sheets, and other participatory training materials were designed for WIND farmer volunteers as practical training tools. The volunteers trained 7,922 farmers. The trained farmers implemented 28,508 improvements in materials handling, work posture, machine and electrical safety, working environments and control of hazardous chemicals, and welfare facilities. The provincial support committees organized follow-up workshops and strengthen the WIND farmer volunteer networks. The system of WIND farmer volunteers proved effective in extending practical OSH protection measures to farmers at grassroots level. The system of WIND farmer volunteers was adopted in the First National Programme on Labour Protection and OSH of Viet Nam as a practical means in OSH and is now further expanding within the framework of the National Programme.
MacPhee, Maura
2002-12-01
The following article is an example of evidence-based practice applied to an institutional Quality Improvement (QI) project. QI originated in the 1980s and is best associated with the work of W. Deming (1986). It is also known as Continuous Quality Improvement, because a major principle of this approach is constant improvement of services or products. This improvement process contains other critical components: scientific method, employee participation and teamwork, accountable leadership, appropriate training and ongoing education, and client focus (Demming, 1986). QI has been globally successful and has helped transform American industry, including health care services. The following clinically based project illustrates the application of QI concepts and evidence-based practice to enhance outcomes. Copyright 2002, Elsevier Science (USA). All rights reserved.
Conti Cuesta, F; Baena Parejo, M I; Pinzón Pulido, S A
1999-01-01
This study describes the opinion of the veterinarians in Andalusia regarding the organization and management of their professional practice and pinpoints solutions to the problems found for the purpose of providing planning and management aspects in view of the reforms undertaken in the Andalusian Health Service Strategy Plan. Descriptive opinion poll employing a questionnaire filled out by each individual among all of the Primary Care (PC) veterinarians in Andalusia (including those who have been currently employed who possess at least one year's experience, except substitutes). A description was provided of their personal traits, their opinion of the management-related factors involved in their professional practice. A description was also provided of the suggestions for improving the problems found to exist. Over 70% said they were aware of the objectives, although only the coordinators found them to be clearly motivating the practice. Their opinion was that the indicators of activity neither include any quality-related criteria nor afford the possibility of evaluating the activity they are carrying out. They believed that the contributions from other members of the multidisciplinary team improve their work and are in favor of continuing their involvement therein. They were satisfied with doing their work (the coordinators to a greater degree). They found the productivity pay to be too low and not useful as regards providing them with any incentive. They were not satisfied with the training with which they are provided and thought that what they are offered is far less than their other colleagues in the health care field. Most were of the opinion that they should remain under the authority of the Andalusian Health Service. This group prefers to continue working for the same organization, but improving the following management aspects: training offer, practice incentives and activity indicators.
Williams-Whitt, Kelly; Bültmann, Ute; Amick, Benjamin; Munir, Fehmidah; Tveito, Torill H; Anema, Johannes R
2016-12-01
Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.
A New Model of Tracheostomy Care: Closing the Research-Practice Gap
2003-01-01
521 A New Model of Tracheostomy Care: Closing the Research –Practice Gap Joel St. Clair Abstract Performance improvements have brought about...and it continues to close the research - practice gap . The WRAMC Department of Nursing is presently developing similar evidence-based procedures for... Research -Practice Gap 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK
Teachers Use Tools and Strategies to Engage Students in Grade-Level Assignments
ERIC Educational Resources Information Center
Southern Regional Education Board (SREB), 2013
2013-01-01
This newsletter of best practices in implementing the High Schools That Work (HSTW), Making Middle Grades Work (MMGW) and Technology Centers That Work (TCTW) school improvement models is based on presentations at the 27th Annual HSTW Staff Development Conference in Charlotte, North Carolina, in the summer of 2013. The newsletter is divided up into…
ERIC Educational Resources Information Center
Zaid, Abdelkarim; Champy-Remoussenard, Patricia
2015-01-01
This article focuses on professional work placements for teachers of business and management. These one-year work placements seek to develop the teachers' knowledge of the business world, allowing them to improve their teaching practice and produce new pedagogical resources. We examine here, from the teachers' point of view, two questions: What…
The Emergence of Innovative Work in School Development
ERIC Educational Resources Information Center
Vennebo, Kirsten Foshaug; Ottesen, Eli
2015-01-01
In this article, we analyse the school developmental work of a project team in Norwegian upper secondary schools. The team aims to improve teaching and learning by making use of new technologies. The aim of the article is to explore the "black box" of developmental work practices by analysing the interactions between the team members to…
ERIC Educational Resources Information Center
Farquharson, Kelly; Franzluebbers, Chelsea E.
2014-01-01
Clinical Question: Do working memory-based interventions improve language, reading, and/or working memory skills in school-aged children with language impairment? Method: Literature review of evidence-based practice (EBP) intervention comparisons. Sources: Google Scholar, ASHA journals database, Academic OneFile, Academic Search Complete, and…
A study examining the impact of 12-hour shifts on critical care staff.
Richardson, Annette; Turnock, Christopher; Harris, Liz; Finley, Alison; Carson, Sarah
2007-11-01
Twelve-hour shifts contribute to flexible patterns of work, but the effects on delivery of direct care and staff fatigue are important topics for deeper examination. To examine the impact and implications of 12-hour shifts on critical care staff. A staged dual approach using two focus groups (n = 16) and questionnaires (n = 147) with critical care staff from three critical care units. Positive effects were found with planning and prioritizing care, improved relationships with patients/relatives, good-quality time off work and ease of travelling to work. Less favourable effects were with caring for patients in isolation cubicles and the impact on staff motivation and tiredness. Acceptable patterns of work were suggested for 'numbers of consecutive shifts' and 'rest periods between shifts'. Most participants believed 12-hour shifts should continue. The challenge is to ensure existing systems and practices develop to improve on the less positive effects of working 12-hour shifts. This study provides nurse managers with important and relevant staff views on the impact of working 12-hour shifts. In particular to those working within a critical care environment and suggests the challenge is to ensure existing systems and practices develop to improve on the less encouraging effects of working 12-hour shifts. It adds an understanding of the senior nurse's view on the positive and negative effects of managing and organizing staff off duty to safely run a department with 12-hour shifts.
Lennox, Laura; Doyle, Cathal; Reed, Julie E; Bell, Derek
2017-09-24
Although improvement initiatives show benefits to patient care, they often fail to sustain. Models and frameworks exist to address this challenge, but issues with design, clarity and usability have been barriers to use in healthcare settings. This work aimed to collaborate with stakeholders to develop a sustainability tool relevant to people in healthcare settings and practical for use in improvement initiatives. Tool development was conducted in six stages. A scoping literature review, group discussions and a stakeholder engagement event explored literature findings and their resonance with stakeholders in healthcare settings. Interviews, small-scale trialling and piloting explored the design and tested the practicality of the tool in improvement initiatives. National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL). CLAHRC NWL improvement initiative teams and staff. The iterative design process and engagement of stakeholders informed the articulation of the sustainability factors identified from the literature and guided tool design for practical application. Key iterations of factors and tool design are discussed. From the development process, the Long Term Success Tool (LTST) has been designed. The Tool supports those implementing improvements to reflect on 12 sustainability factors to identify risks to increase chances of achieving sustainability over time. The Tool is designed to provide a platform for improvement teams to share their own views on sustainability as well as learn about the different views held within their team to prompt discussion and actions. The development of the LTST has reinforced the importance of working with stakeholders to design strategies which respond to their needs and preferences and can practically be implemented in real-world settings. Further research is required to study the use and effectiveness of the tool in practice and assess engagement with the method over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Occupational safety and health: progress toward the 1990 objectives for the nation.
Millar, J D; Myers, M L
1983-01-01
Occupational safety and health is 1 of 15 areas addressed in the Public Health Service's Objectives for the Nation. This area represents 104 million working men and women and the deaths, diseases, and injuries that result from exposures to hazards in their work environment. Characteristics of public health practice are compared with characteristics of occupational safety and health practice. The National Institute for Occupational Safety and Health (NIOSH), created by the Occupational Safety and Health Act, is discussed. NIOSH has developed a list of 10 leading work-related diseases and injuries. The list is headed by occupational lung diseases. Twenty Objectives for the Nation in the area of occupational safety and health are reviewed, and the status of NIOSH efforts toward their attainment is discussed. Five categories of objectives are covered: (a) improved health status, (b) reduced risk factors, (c) improved public and professional awareness, (d) improved service and protection, and (e) improved surveillance and evaluation. The potential for achieving these objectives is discussed, with special attention given to the lack of a data base for monitoring progress. A major conclusion is that surveillance in occupational safety and health needs to be strengthened. PMID:6310668
How to Sustain Change and Support Continuous Quality Improvement
McQuillan, Rory; Harel, Ziv; Weizman, Adam V.; Thomas, Alison; Nesrallah, Gihad; Bell, Chaim M.; Chan, Christopher T.; Chertow, Glenn M.
2016-01-01
To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. However, most organizational change is not maintained. In this next article in this Moving Points in Nephrology feature on quality improvement, we provide health care professionals with strategies to sustain and support quality improvement. Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are methods to communicate improvement results to staff and leadership. Standard work is a written or visual outline of current best practices for a task and provides a framework to ensure that changes that have improved patient care are consistently and reliably applied to every patient encounter. Improvement huddles are short, regular meetings among staff to anticipate problems, review performance, and support a culture of improvement. Many of these tools rely on principles of visual management, which are systems transparent and simple so that every staff member can rapidly distinguish normal from abnormal working conditions. Even when quality improvement methods are properly applied, the success of a project still depends on contextual factors. Context refers to aspects of the local setting in which the project operates. Context affects resources, leadership support, data infrastructure, team motivation, and team performance. For these reasons, the same project may thrive in a supportive context and fail in a different context. To demonstrate the practical applications of these quality improvement principles, these principles are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). PMID:27016498
["General Practice is a great job anyway" - a qualitative study with vocational trainees].
Steinhäuser, Jost; Paulus, Jan; Roos, Marco; Peters-Klimm, Frank; Ledig, Thomas; Szecsenyi, Joachim; Joos, Stefanie
2011-01-01
Due to the increasing lack of physicians, an ageing and thus multi-morbid society and a misdistribution of physicians in Germany primary care provided by general practitioners is at risk. Therefore, approaches to recruit more physicians for general practice are being sought. The aim of the present study was to explore individual motivations for choosing a career in general practice, vocational trainees' perspectives on the current situation of vocational training and to identify possible approaches to improve the situation with suggestions from vocational trainees in Germany. A qualitative study was conducted by interviewing 13 trainees. The interviews that were based on a predefined interview guideline were recorded and transcribed. The analysis was performed according to Mayring supported by the software Atlas.ti. In general, the reasons given for choosing general practice include the holistic view towards patients, the opportunity to see the direct impact of therapies and self-employment. Furthermore, general practice was perceived as a job with a positive work-life balance. Barriers to vocational training are the lack of structure of individual rotations and the low salaries during the rotation in practice. Furthermore, the basic conditions for working as a self-employed general practitioner in Germany were described as being a disincentive. A general suggestion for improvement was to promote professional recognition of general practice at universities. A qualification of vocational trainers was requested. Specific suggestions were: better payment, better-structured rotations and a specific preparation for the self-employed general practitioner. The results of this study reveal that a single measure is insufficient for recruiting more young doctors for general practice. In fact, a package of measures is necessary to improve aspects of the vocational training but also general conditions for the profession. Copyright © 2010. Published by Elsevier GmbH.
Drug Information Residency Rotation with Pharmaceutical Industry.
ERIC Educational Resources Information Center
Cramer, Richard L.
1986-01-01
Program objectives of a drug information rotation at the Upjohn Company include improving communication between the pharmaceutical industry and hospital pharmacy/academia, exposing the resident to the challenges the industry encounters, improving proficiency in drug information practice, and providing insight into the working relationships of…
Stienen, Martin N; Netuka, David; Demetriades, Andreas K; Ringel, Florian; Gautschi, Oliver P; Gempt, Jens; Kuhlen, Dominique; Schaller, Karl
2016-10-01
Substantial country differences in neurosurgical training throughout Europe have recently been described, ranging from subjective rating of training quality to objective working hours per week. The aim of this study was to analyse whether these differences translate into the results of the written and oral part of the European Board Examination in Neurological Surgery (EBE-NS). Country-specific composite scores for satisfaction with quality of theoretical and practical training, as well as working hours per week, were obtained from an electronic survey distributed among European neurosurgical residents between June 2014 and March 2015. These were related to anonymous country-specific results of the EBE-NS between 2009 and 2016, using uni- and multivariate linear regression analysis. A total of n = 1025 written and n = 63 oral examination results were included. There was a significant linear relationship between the country-specific EBE-NS result in the written part and the country-specific composite score for satisfaction with quality of theoretical training [adjusted regression coefficient (RC) -3.80, 95 % confidence interval (CI) -5.43-7 -2.17, p < 0.001], but not with practical training or working time. For the oral part, there was a linear relationship between the country-specific EBE-NS result and the country-specific composite score for satisfaction with quality of practical training (RC 9.47, 95 % CI 1.47-17.47, p = 0.021), however neither with satisfaction with quality of theoretical training nor with working time. With every one-step improvement on the country-specific satisfaction score for theoretical training, the score in the EBE-NS Part 1 increased by 3.8 %. With every one-step improvement on the country-specific satisfaction score for practical training, the score in the EBE-NS Part 2 increased by 9.47 %. Improving training conditions is likely to have a direct positive influence on the knowledge level of trainees, as measured by the EBE-NS. The effect of the actual working time on the theoretical and practical knowledge of neurosurgical trainees appears to be insignificant.
Teaching Laboratory Renovation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Al-Zuhairi, Ali Jassim; Al-Dahhan, Wedad; Hussein, Falah
Scientists at universities across Iraq are actively working to report actual incidents and accidents occurring in their laboratories, as well as structural improvements made to improve safety and security, to raise awareness and encourage openness, leading to widespread adoption of robust Chemical Safety and Security (CSS) practices. The improvement of students’ understanding of concepts in science and its applications, practical scientific skills and understanding of how science and scientists work in laboratory experiences have been considered key aspects of education in science for over 100 years. Facility requirements for the necessary level of safety and security combined with specific requirementsmore » relevant to the course to be conducted dictate the structural design of a particular laboratory, and the design process must address both. This manuscript is the second in a series of five case studies describing laboratory incidents, accidents, and laboratory improvements. We summarize the process used to guide a major renovation of the chemistry instructional laboratory facilities at Al-Nahrain University and discuss lessons learned from the project.« less
Using human factors engineering to improve patient safety in the cardiovascular operating room.
Gurses, Ayse P; Martinez, Elizabeth A; Bauer, Laura; Kim, George; Lubomski, Lisa H; Marsteller, Jill A; Pennathur, Priyadarshini R; Goeschel, Chris; Pronovost, Peter J; Thompson, David
2012-01-01
Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.
Organisational capacity and chronic disease care: an Australian general practice perspective.
Proudfoot, Judith; Infante, Fernando; Holton, Christine; Powell-Davies, Gawaine; Bubner, Tanya; Beilby, Justin; Harris, Mark
2007-04-01
Although we are rapidly improving our understanding of how to manage patients with chronic illness in Australian general practice, many patients are still receiving suboptimal care. General practices have limited organisational capacity to provide the structured care that is required for managing chronic conditions: regular monitoring, decision support, patient recall, supporting patient self management, team work, and information management. This requires a shift away from episodic, acute models. Overseas research has shown that areas such as team work, clinical information systems, decision support, linkages and leadership are also important in managing chronic illness, but we do not know which of these are most important in Australia.
Gilbert, Nicky
2009-02-01
The importance of nutrition in sport has been recognised since the ancient Olympians, and its role in improving both health and sports performance has widespread acceptance. However, in sporting circles nutritional knowledge, beliefs and practices are extremely varied. Within any sporting organisation the sports dietitian or nutritionist must be able to work with athletes, their family, coaches and other support staff to develop and monitor realistic and practical strategies that work best for each performer, contributing to a positive and sustained outcome on performance. The present review examines the practical application of current key issues in performance nutrition, highlighting the advantages of early intervention in youth development and comprehensive and integrated nutrition services.
Shuggi, Isabelle M; Oh, Hyuk; Shewokis, Patricia A; Gentili, Rodolphe J
2017-09-30
The assessment of mental workload can inform attentional resource allocation during task performance that is essential for understanding the underlying principles of human cognitive-motor behavior. While many studies have focused on mental workload in relation to human performance, a modest body of work has examined it in a motor practice/learning context without considering individual variability. Thus, this work aimed to examine mental workload by employing the NASA TLX as well as the changes in motor performance resulting from the practice of a novel reaching task. Two groups of participants practiced a reaching task at a high and low nominal difficulty during which a group-level analysis assessed the mental workload, motor performance and motor improvement dynamics. A secondary cluster analysis was also conducted to identify specific individual patterns of cognitive-motor responses. Overall, both group- and cluster-level analyses revealed that: (i) all participants improved their performance throughout motor practice, and (ii) an increase in mental workload was associated with a reduction of the quality of motor performance along with a slower rate of motor improvement. The results are discussed in the context of the optimal challenge point framework and in particular it is proposed that under the experimental conditions employed here, functional task difficulty: (i) would possibly depend on an individuals' information processing capabilities, and (ii) could be indexed by the level of mental workload which, when excessively heightened can decrease the quality of performance and more generally result in delayed motor improvements. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.
Eklund, J
1997-10-01
This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.
Improvement in self-reported confidence in nurses’ professional skills in the emergency department
2013-01-01
Background The aim of this study was to assess nurses’ self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Methods Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software. During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses’ skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Results Nurses’ self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). Conclusions During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses’ education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services. PMID:23497683
Improvement in self-reported confidence in nurses' professional skills in the emergency department.
Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari
2013-03-05
The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses' education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services.
Nursing practice environment, quality of care, and morale of hospital nurses in Japan.
Anzai, Eriko; Douglas, Clint; Bonner, Ann
2014-06-01
The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.
Cognitive training with casual video games: points to consider
Baniqued, Pauline L.; Kranz, Michael B.; Voss, Michelle W.; Lee, Hyunkyu; Cosman, Joshua D.; Severson, Joan; Kramer, Arthur F.
2014-01-01
Brain training programs have proliferated in recent years, with claims that video games or computer-based tasks can broadly enhance cognitive function. However, benefits are commonly seen only in trained tasks. Assessing generalized improvement and practicality of laboratory exercises complicates interpretation and application of findings. In this study, we addressed these issues by using active control groups, training tasks that more closely resemble real-world demands and multiple tests to determine transfer of training. We examined whether casual video games can broadly improve cognition, and selected training games from a study of the relationship between game performance and cognitive abilities. A total of 209 young adults were randomized into a working memory–reasoning group, an adaptive working memory–reasoning group, an active control game group, and a no-contact control group. Before and after 15 h of training, participants completed tests of reasoning, working memory, attention, episodic memory, perceptual speed, and self-report measures of executive function, game experience, perceived improvement, knowledge of brain training research, and game play outside the laboratory. Participants improved on the training games, but transfer to untrained tasks was limited. No group showed gains in reasoning, working memory, episodic memory, or perceptual speed, but the working memory–reasoning groups improved in divided attention, with better performance in an attention-demanding game, a decreased attentional blink and smaller trail-making costs. Perceived improvements did not differ across training groups and those with low reasoning ability at baseline showed larger gains. Although there are important caveats, our study sheds light on the mixed effects in the training and transfer literature and offers a novel and potentially practical training approach. Still, more research is needed to determine the real-world benefits of computer programs such as casual games. PMID:24432009
Cognitive training with casual video games: points to consider.
Baniqued, Pauline L; Kranz, Michael B; Voss, Michelle W; Lee, Hyunkyu; Cosman, Joshua D; Severson, Joan; Kramer, Arthur F
2014-01-07
Brain training programs have proliferated in recent years, with claims that video games or computer-based tasks can broadly enhance cognitive function. However, benefits are commonly seen only in trained tasks. Assessing generalized improvement and practicality of laboratory exercises complicates interpretation and application of findings. In this study, we addressed these issues by using active control groups, training tasks that more closely resemble real-world demands and multiple tests to determine transfer of training. We examined whether casual video games can broadly improve cognition, and selected training games from a study of the relationship between game performance and cognitive abilities. A total of 209 young adults were randomized into a working memory-reasoning group, an adaptive working memory-reasoning group, an active control game group, and a no-contact control group. Before and after 15 h of training, participants completed tests of reasoning, working memory, attention, episodic memory, perceptual speed, and self-report measures of executive function, game experience, perceived improvement, knowledge of brain training research, and game play outside the laboratory. Participants improved on the training games, but transfer to untrained tasks was limited. No group showed gains in reasoning, working memory, episodic memory, or perceptual speed, but the working memory-reasoning groups improved in divided attention, with better performance in an attention-demanding game, a decreased attentional blink and smaller trail-making costs. Perceived improvements did not differ across training groups and those with low reasoning ability at baseline showed larger gains. Although there are important caveats, our study sheds light on the mixed effects in the training and transfer literature and offers a novel and potentially practical training approach. Still, more research is needed to determine the real-world benefits of computer programs such as casual games.
Reix, Christine E.; Dikshit, Amit K.; Hockenhull, Jo; Parker, Richard M. A.; Banerjee, Anindo; Burn, Charlotte C.; Pritchard, Joy C.; Whay, Helen R.
2015-01-01
Background Participatory methods are increasingly used in international human development, but scientific evaluation of their efficacy versus a control group is rare. Working horses support families in impoverished communities. Lameness and limb abnormalities are highly prevalent in these animals and a cause for welfare concern. We aimed to stimulate and evaluate improvements in lameness and limb abnormalities in horses whose owners took part in a 2-year participatory intervention project to reduce lameness (PI) versus a control group (C) in Jaipur, India. Methodology/Principal Findings In total, 439 owners of 862 horses participated in the study. PI group owners from 21 communities were encouraged to meet regularly to discuss management and work practices influencing lameness and poor welfare and to track their own progress in improving these. Lameness examinations (41 parameters) were conducted at the start of the study (Baseline), and after 1 year and 2 years. Results were compared with control horses from a further 21 communities outside the intervention. Of the 149 horses assessed on all three occasions, PI horses showed significantly (P<0.05) greater improvement than C horses in 20 parameters, most notably overall lameness score, measures of sole pain and range of movement on limb flexion. Control horses showed slight but significantly greater improvements in four parameters, including frog quality in fore and hindlimbs. Conclusions/Significance This participatory intervention succeeded in improving lameness and some limb abnormalities in working horses, by encouraging changes in management and work practices which were feasible within owners’ socioeconomic and environmental constraints. Demonstration of the potentially sustainable improvements achieved here should encourage further development of participatory intervention approaches to benefit humans and animals in other contexts. PMID:25898014
Developing Effective Social Work University-Community Research Collaborations
ERIC Educational Resources Information Center
Begun, Audrey L.; Berger, Lisa K.; Otto-Salaj, Laura L.; Rose, Susan J.
2010-01-01
In many instances, departments of social work in universities and community-based social services agencies have common interests in improving professional practice and advancing knowledge in the profession. Effective university-community research collaborations can help partners achieve these goals jointly, but to be effective these collaborative…
Barriers to Implementation of Optimal Laboratory Biosafety Practices in Pakistan
Shafaq, Humaira; Hasan, Rumina; Qureshi, Shahida M.; Dojki, Maqboola; Hughes, Molly A.; Zaidi, Anita K. M.; Khan, Erum
2016-01-01
The primary goal of biosafety education is to ensure safe practices among workers in biomedical laboratories. Despite several educational workshops by the Pakistan Biological Safety Association (PBSA), compliance with safe practices among laboratory workers remains low. To determine barriers to implementation of recommended biosafety practices among biomedical laboratory workers in Pakistan, we conducted a questionnaire-based survey of participants attending 2 workshops focusing on biosafety practices in Karachi and Lahore in February 2015. Questionnaires were developed by modifying the BARRIERS scale in which respondents are required to rate barriers on a 1-4 scale. Nineteen of the original 29 barriers were included and subcategorized into 4 groups: awareness, material quality, presentation, and workplace barriers. Workshops were attended by 64 participants. Among barriers that were rated as moderate to great barriers by at least 50% of respondents were: lack of time to read biosafety guidelines (workplace subscale), lack of staff authorization to change/improve practice (workplace subscale), no career or self-improvement advantages to the staff for implementing optimal practices (workplace subscale), and unclear practice implications (presentation subscale). A lack of recognition for employees' rights and benefits in the workplace was found to be a predominant reason for a lack of compliance. Based on perceived barriers, substantial improvement in work environment, worker facilitation, and enabling are needed for achieving improved or optimal biosafety practices in Pakistan. PMID:27400192
Working Together to Improve Urban Secondary Schools: A Study of Practice in One City
ERIC Educational Resources Information Center
Ainscow, Mel; Howes, Andy
2007-01-01
Bringing about school improvement in economically poor urban contexts remains a major challenge. In England the emphasis on competition between schools has further complicated this agenda. At the same time, there is evidence of the emergence of a new policy emphasis that involves support and challenge to school-led improvement efforts through…
ERIC Educational Resources Information Center
Spillane, James P.; Coldren, Amy Franz
2011-01-01
This practical resource highlights the critical importance of diagnosis and design in the work of leading and managing for school improvement. The authors maintain that today's school leaders and managers, under intense pressure to improve student learning, cannot simply adopt and implement pre-packaged reforms manufactured outside the school.…
2015-01-01
Background There is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Building public health thinking and leadership capacity in clinicians from primary care teams was seen as an underpinning component to achieving this goal. Clinical teams contributed to service redesign concepts and were contractually supported to embrace a preventive approach. Methods Improvement in quality and preventive focus of dental practice care delivery was explored through determining the impact of several projects, to share how evidence, skill mix and clinical leadership could be utilised in design, implementation and measurement of care outcomes in general dental practice in order to champion and advocate change, during a period of substantial change within the NHS system. The projects were: 1. A needs-led, evidence informed preventive care pathway approach to primary dental care delivery with a focus on quality and outcomes. 2. Building clinical leadership to influence and advocate for improved quality of care; and spread of learning through local professional networks. This comprised two separate projects: improved access for very young children called “Baby Teeth DO Matter” and the production of a clinically led, evidence-based guidance for periodontyal treatment in primary care called “Healthy Gums DO Matter”. Results What worked and what hindered progress, is described. The projects developed understanding of how working with ‘local majorities’ of clinicians influenced, adoption and spread of learning, and the impact in prompting wider policy and contract reform in England. Conclusions The projects identified issues that required change to meet population need. Clinicians were allowed to innovate in an evironment working together with commissioners, patients and public health colleagues. Communication and the development of clinical leadership led to the development of an infrastructure to define care pathways and decision points in the patient's journey. PMID:26392019
Bridgman, Colette; McGrady, Michael G
2015-01-01
There is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Building public health thinking and leadership capacity in clinicians from primary care teams was seen as an underpinning component to achieving this goal. Clinical teams contributed to service redesign concepts and were contractually supported to embrace a preventive approach. Improvement in quality and preventive focus of dental practice care delivery was explored through determining the impact of several projects, to share how evidence, skill mix and clinical leadership could be utilised in design, implementation and measurement of care outcomes in general dental practice in order to champion and advocate change, during a period of substantial change within the NHS system. The projects were: 1. A needs-led, evidence informed preventive care pathway approach to primary dental care delivery with a focus on quality and outcomes. 2. Building clinical leadership to influence and advocate for improved quality of care; and spread of learning through local professional networks. This comprised two separate projects: improved access for very young children called “Baby Teeth DO Matter” and the production of a clinically led, evidence-based guidance for periodontyal treatment in primary care called "Healthy Gums DO Matter". What worked and what hindered progress, is described. The projects developed understanding of how working with 'local majorities' of clinicians influenced, adoption and spread of learning, and the impact in prompting wider policy and contract reform in England. The projects identified issues that required change to meet population need. Clinicians were allowed to innovate in an environment working together with commissioners, patients and public health colleagues. Communication and the development of clinical leadership led to the development of an infrastructure to define care pathways and decision points in the patient's journey.
Sylvain, Chantal; Durand, Marie-José; Maillette, Pascale; Lamothe, Lise
2016-06-07
Depression is a major cause of work absenteeism that general practitioners (GPs) face directly since they are responsible for sickness certification and for supervising the return to work (RTW). These activities give GPs a key role in preventing long-term work disability, yet their practices in this regard remain poorly documented. The objectives of this study were therefore to describe GPs' practices with people experiencing work disability due to depressive disorders and explore how GPs' work context may impact on their practices. We conducted semi-structured individual interviews with 13 GPs and six mental healthcare professionals in two sub-regions of Quebec. The sub-regions differed in terms of availability of specialized resources offering public mental health services. Data were anonymized and transcribed verbatim. Thematic analysis was performed to identify patterns in the GPs' practices and highlight impacting factors in their work context. Our results identified a set of practices common to all the GPs and other practices that differentiated them. Two profiles were defined on the basis of the various practices documented. The first is characterized by the integration of the RTW goal into the treatment goal right from sickness certification and by interventions that include the workplace, albeit indirectly. The second is characterized by a lack of early RTW-oriented action and by interventions that include little workplace involvement. Regardless of the practice profile, actions intended to improve collaboration with key stakeholders remain the exception. However, two characteristics of the work context appear to have an impact: the availability of a dedicated mental health nurse and the regular provision of clinical information by psychotherapists. These conditions are rarely present but tend to make a significant difference for the GPs. Our results highlight the significant role of GPs in the prevention of long-term work disability and their need for support through the organization of mental health services at the primary care level.
Nease, Donald E.; Ruffin, Mack T.; Klinkman, Michael S.; Jimbo, Masahito; Braun, Thomas M.; Underwood, Jennifer M.
2015-01-01
Background Computerized reminder systems (CRS) show promise for increasing preventive services such as colorectal cancer (CRC) screening. However, prior research has not evaluated a generalizable CRS across diverse, community primary care practices. We evaluated whether a generalizable CRS, ClinfoTracker, could improve screening rates for CRC in diverse primary care practices. Methods The study was a prospective trial to evaluate ClinfoTracker using historical control data in 12 Great Lakes Research In Practice Network community-based, primary care practices distributed from Southeast to Upper Peninsula Michigan. Our outcome measures were pre- and post-study practice-level CRC screening rates among patients seen during the 9-month study period. Ability to maintain the CRS was measured by days of reminder printing. Field notes were used to examine each practice’s cohesion and technology capabilities. Results All but one practice increased their CRC screening rates, ranging from 3.3% to 16.8% improvement. t tests adjusted for within practice correlation showed improvement in screening rates across all 12 practices, from 41.7% to 50.9%, P = 0.002. Technology capabilities impacted printing days (74% for high technology vs. 45% for low technology practices, P = 0.01), and cohesion demonstrated an impact trend for screening (15.3% rate change for high cohesion vs. 7.9% for low cohesion practices). Conclusions Implementing a generalizable CRS in diverse primary care practices yielded significant improvements in CRC screening rates. Technology capabilities are important in maintaining the system, but practice cohesion may have a greater influence on screening rates. This work has important implications for practices implementing reminder systems. PMID:18725836
What Makes an Effective Teacher? Quasi-Experimental Evidence. NBER Working Paper No. 16885
ERIC Educational Resources Information Center
Lavy, Victor
2011-01-01
This paper measures empirically the relationship between classroom teaching practices and student achievements. Based on primary- and middle-school data from Israel, I find very strong evidence that two important elements of teaching practices cause student achievements to improve. In particular, classroom teaching that emphasizes the instilment…
ERIC Educational Resources Information Center
Hatch, Thomas; Hill, Kathryn; Roegman, Rachel
2016-01-01
In this article, we explore how organizational routines involving instructional rounds--collective, structured observations and reflections on classroom practice--might contribute to the development of social networks among administrators and support a common, district-wide focus on instruction. Building on work on communities of practice, we…
Open Lessons: A Practice to Develop a Learning Community for Teachers
ERIC Educational Resources Information Center
Shen, Jianping; Zhen, Jinzhou; Poppink, Sue
2007-01-01
Interest in improving the quality of professional development in this age of educational reform has intensified as a growing body of research suggests that teaching practices matter in terms of student achievement. Some have argued for embedding professional development in the context of teachers' work in order to transform both teaching practices…
Working with Teachers to Adapt an Evidence-Based Intervention for Children with Autism
ERIC Educational Resources Information Center
Stahmer, Aubyn C.; Reed, Sarah; Suhrheinrich, Jessica; Schreibman, Laura
2013-01-01
Increasing diagnoses of autism have led to pressure to improve the quality of educational services for children with autism by incorporating evidence-based practices (EBPs) into school programs. However, this process has been difficult, and both autism researchers and educators report frustration concerning the gap between research and practice.…
Children, Child Abuse and Child Protection: Placing Children Centrally.
ERIC Educational Resources Information Center
1999
This book provides an overview of the political, moral, and social context within which British child welfare practitioners and managers attempt to work with children, families, and others. The book reviews the development of improved policy and practices in child protection. Placing children at the center of policy, practice, and discourse, it…
Examining a Program Designed to Improve Supervisory Knowledge and Practices of Cooperating Teachers
ERIC Educational Resources Information Center
Erbilgin, Evrim
2014-01-01
This article reports on how a program based on educative supervision supported the supervisory knowledge and practices of three cooperating teachers. The program was planned as a kind of practicum: the cooperating teachers participated in the program while working with a student teacher. The program included activities where the cooperating…
Improving Teaching and Learning: Three Models to Reshape Educational Practice
ERIC Educational Resources Information Center
Roberson, Sam
2014-01-01
The work of schools is teaching and learning. However, the current educational culture is dominated by three characteristics: (1) the mechanistic view of organization and its practice based on the assembly line model where students progress along a value added conveyor; (2) the predominance of the Essentialist philosophy of education, in which the…
Practice-Based Learning and Improvement: A Dream that Can Become a Reality
ERIC Educational Resources Information Center
Manning, Phil R.
2003-01-01
Systematically enhancing learning from experience (practice-based learning) dominates the teachings of Sir Willian Osler and adult learning theorists such as Eduard Lindeman, Malcolm Knowles, and Cyril Houle. Because of time constraints, most physicians have not implemented methods that systematically facilitate learning from day-to-day work, but…
Valaitis, Ruta K; Akhtar-Danesh, Noori; Brooks, Fiona; Binks, Sally; Semogas, Dyanne
2011-06-01
This study explored community health nurses' viewpoints about a Canadian online community of practice to support their practice with homeless or under-housed populations. Community health nurses who specifically work with homeless and marginally housed populations often report feelings of isolation and stress in managing complex problems in resource constraints. To strengthen intra-professional ties and enhance information access, an online community of practice was designed, implemented and evaluated by and for them. Q-methodology was used. Sixty-six statements about the community of practice were collected from an online survey and focus groups, refined and reduced to 44 statements. In 2009, sixteen participants completed the Q-sort activity, rating each statement relative to the others. Scores for each participant were subjected to by-person factor analysis. Respondents fell into two groups -tacit knowledge warriors and tacit knowledge communicators. Warriors strongly believed that the community of practice could combat stigma associated with homelessness and promote awareness of homelessness issues, and valued its potential to validate and improve practice. Communicators would have used the community of practice more with increased discussion, facilitation and prompt responses. Generally, nurses viewed the community of practice as a place to share stories, validate practice and adapt best practices to their work context. Online communities of practice can be valuable to nurses in specialized fields with limited peer support and access to information resources. Tacit knowledge development is important to nurses working with homeless populations: this needs to be valued in conjunction with scientifically based knowledge. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Tevaarwerk, Amye; Lee, Ju-Whei; Terhaar, Abigail; Sesto, Mary; Smith, Mary Lou; Cleeland, Charles; Fisch, Michael
2015-01-01
Background Improved survival for individuals with metastatic cancer accentuates the importance of employment for cancer survivors. Better understanding of how metastatic cancer affects employment is a necessary step towards the development of tools to assist survivors in this important realm. Methods We analyzed the Eastern Cooperative Oncology Group’s “Symptom Outcomes and Practice Patterns (SOAPP)” study to investigate what factors were associated with employment of 680 metastatic cancer patients. Univariable and multivariable logistic regression analyses were conducted to compare patients stably working (Group A) to patients no longer working (Group B). Results There were 668 metastatic working-age participants in our analysis; 236 (35%) worked full or part-time while 302 (45%) stopped working due to illness. Overall, 58% reported some change in employment due to illness. Better performance status and non-Hispanic White ethnicity/race were significantly associated with continuing to work despite a metastatic cancer diagnosis on multivariable analysis. Disease type, time since metastatic diagnosis, number of metastatic sites, location of metastatic disease, and treatment status had no significant impact. Among the potentially modifiable factors, receiving hormonal treatment (if a viable option) and decreasing symptom interference were associated with continuing to work. Conclusions A significant percentage of metastatic patients remain employed; symptom burden was associated with change to no longer working. Modifiable factors resulting in work interference should be minimized so that patients with metastatic disease may continue working, if desired. Improvements in symptom control and strategies developed to help address work place difficulties have promise to improve this aspect of survivorship. PMID:26687819
Xie, Anping; Woods-Hill, Charlotte Z; King, Anne F; Enos-Graves, Heather; Ascenzi, Judy; Gurses, Ayse P; Klaus, Sybil A; Fackler, James C; Milstone, Aaron M
2017-11-20
Work system assessments can facilitate successful implementation of quality improvement programs. Using a human factors engineering approach, we conducted a work system assessment to facilitate the dissemination of a quality improvement program for optimizing blood culture use in pediatric intensive care units at 2 hospitals. Semistructured face-to-face interviews were conducted with clinicians from Johns Hopkins All Children's Hospital and University of Virginia Medical Center. Interview data were analyzed using qualitative content analysis. Blood culture-ordering practices are influenced by various work system factors, including people, tasks, tools and technologies, the physical environment, organizational conditions, and the external environment. A clinical decision-support tool could facilitate implementation by (1) standardizing blood culture-ordering practices, (2) ensuring that prescribing clinicians review the patient's condition before ordering a blood culture, (3) facilitating critical thinking, and (4) empowering nurses to communicate with physicians and advocate for adherence to blood culture-ordering guidelines. The success of interventions for optimizing blood culture use relies heavily on the local context. A work system analysis using a human factors engineering approach can identify key areas to be addressed for the successful dissemination of quality improvement interventions. © The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
48 CFR 970.5203-2 - Performance improvement and collaboration.
Code of Federal Regulations, 2011 CFR
2011-10-01
... in the communication of the success of improvements to other management and operating contractors in... management and operation of the contract. This may entail the alteration of existing practices or the... approaches consistent with the statement of work and performance measures of this contract. (b) The...
48 CFR 970.5203-2 - Performance improvement and collaboration.
Code of Federal Regulations, 2010 CFR
2010-10-01
... in the communication of the success of improvements to other management and operating contractors in... management and operation of the contract. This may entail the alteration of existing practices or the... approaches consistent with the statement of work and performance measures of this contract. (b) The...
Performance Improvement Processes.
ERIC Educational Resources Information Center
1997
This document contains four papers from a symposium on performance improvement processes. In "Never the Twain Shall Meet?: A Glimpse into High Performance Work Practices and Downsizing" (Laurie J. Bassi, Mark E. Van Buren) evidence from a national cross-industry of more than 200 establishments is used to demonstrate that high-performance…
Japanese Educational System Improving Ongoing Practice in Schools.
ERIC Educational Resources Information Center
Arimoto, Masahiro
1995-01-01
Describes the Japanese education system's unique characteristics. Japanese schools provide a prescribed curriculum, with pupils confined to desks. Teachers identify with their schools and are committed to service. Teachers and students try to improve schools by working harder. Understanding school effectiveness requires frameworks deeply rooted in…
Echevarria, Mercedes
A knowledge translation project involving an academic-practice partnership and guided by action-oriented research was used for exploring barriers that impact management of homebound heart failure patients. The intervention process followed an action research model of interaction, self-reflection, response, and change in direction. External facilitators (academia) and internal facilitators (practice) worked with clinicians to identify a topic for improvement, explore barriers, locate the evidence compare current practice against evidence-based practice recommendations, introduce strategies to "close the gap" between actual practice and the desired practice, develop audit criteria, and reevaluate the impact.
McVay, Allese B; Stamatakis, Katherine A; Jacobs, Julie A; Tabak, Rachel G; Brownson, Ross C
2016-06-10
Evidence-based public health interventions, which research has demonstrated offer the most promise for improving the population's health, are not always utilized in practice settings. The extent to which dissemination from researchers to public health practice settings occurs is not widely understood. This study examines the extent to which public health researchers in the United States are disseminating their research findings to local and state public health departments. In a 2012, nationwide study, an online questionnaire was administered to 266 researchers from the National Institutes of Health, the Centers for Disease Control and Prevention, and universities to determine dissemination practices. Logistic regression analyses were used to examine the association between dissemination to state and/or local health departments and respondent characteristics, facilitators, and barriers to dissemination. Slightly over half of the respondents (58%) disseminated their findings to local and/or state health departments. After adjusting for other respondent characteristics, respondents were more likely to disseminate their findings to health departments if they worked for a university Prevention Research Center or the Centers for Disease Control and Prevention, or received their degree more than 20 years ago. Those who had ever worked in a practice or policy setting, those who thought dissemination was important to their own research and/or to the work of their unit/department, and those who had expectations set by their employers and/or funding agencies were more likely to disseminate after adjusting for work place, graduate degree and/or fellowship in public health, and the year the highest academic degree was received. There is still room for improvement in strengthening dissemination ties between researchers and public health practice settings, and decreasing the barriers researchers face during the dissemination process. Researchers could better utilize national programs or workshops, knowledge brokers, or opportunities provided through academic institutions to become more proficient in dissemination practices.
Nojima, Yoshiaki; Kumakura, Shunichi; Onoda, Keiichi; Hamano, Tsuyoshi; Kimura, Kiyoshi
2015-05-26
The objective of this research is to investigate job and life satisfaction and preference of future practice locations of physicians in rural and remote islands in Japan. A cross-sectional study was conducted for physicians who reside or resided on the Oki islands: isolated islands situated in the Sea of Japan between the Eurasian continent and the mainland of Japan. A questionnaire was sent to physicians on the Oki islands to evaluate physician satisfaction regarding job environment, career development, living conditions, salary, and support by local government. Data was analysed for 49 physicians; 47 were male and 2 were female, and the mean ± SD age was 44.3 ± 10.9 years. Among the variables related to physicians' satisfaction, most of the physicians (>90%) were satisfied with "team work" and "salary". On the other hand, the majority of physicians (approximately 70%) were not satisfied with the "opportunity to continue professional development". Age ≥ 50 years, graduates of medical schools other than Jichi Medical University (established in 1972 with the aim to produce rural physicians), self-selected the Oki islands as a practice location, and satisfaction in "work as a doctor", "opportunity to consult with peers about patients", "relationship with people in the community", and "acceptance by community" were found to be significant factors influencing the choice of the Oki islands as a future practice location. Factors influencing future practice locations on the remote islands were included in a self-reported questionnaire which illustrated the importance of factors that impact both the spouses and children of physicians. Improving work satisfaction, providing outreach support programmes for career development and professional support in rural practice, and building appropriate relationships between physicians and people in the community, which can in turn improve work satisfaction, may contribute to physicians' choices of practising medicine on rural and remote islands in Japan. Addressing family issues is also crucial in encouraging the choice of a rural medical practice location.
2013-01-01
Background Job satisfaction and organizational attributes in primary care teams are important issues as they affect clinical outcomes and the quality of health care provided. As practice assistants are an integral part of these teams it is important to gain insight into their views on job satisfaction and organizational attributes. The aim of this study was to evaluate the job satisfaction of practice assistants and the organizational attributes within their general practices in Germany and to explore the existence of possible associations. Methods This observational study was based on a job satisfaction survey and measurement of organizational attributes in general practices in the German federal state of Baden-Wuerttemberg. Job satisfaction was measured with the 10-item ‘Warr-Cook-Wall job satisfaction scale’. Organizational attributes were evaluated with the 21-items ‘survey of organizational attributes for primary care’ (SOAPC). Linear regression analyses were performed in which each of SOAPC scales and the overall score of SOAPC was treated as outcome variables. Results 586 practice assistants out of 794 respondents (73.8%) from 234 general practices completed the questionnaire. Practice assistants were mostly satisfied with their colleagues and least of all satisfied with their income and recognition for their work. The regression analysis showed that ‘freedom of working method’ and ‘recognition of work’, the employment status of practice assistants and the mode of practice were almost always significantly associated with each subscale and overall score of SOAPC. Conclusions Job satisfaction is highly associated with different aspects of organizational attributes for primary care (‘communication’, ‘decision-making’ and ‘stress’). Consequently, improved job satisfaction could lead to a better-organized primary care team. This implication should be investigated directly in further intervention studies with a special focus on improving the recognition for work and income. PMID:23915225
Gazibara, Tatjana; Nurković, Selmina; Marić, Gorica; Kurtagić, Ilma; Kovačević, Nikolina; Kisić-Tepavčević, Darija; Pekmezović, Tatjana
2015-08-01
To assess final year medical students' self-perception of their practical skills. The study was conducted at the Faculty of Medicine in Belgrade during compulsory practical sessions in the period December 2-9, 2013 and 390 students agreed to participate (response rate 77.8%). The questionnaire included questions on demographic characteristics, 21 questions on students' self-perception of their practical skills, and 1 question on students' self-perceived readiness to start working with patients. Cronbach's α for the entire scale was 0.891. Students felt most confident about measuring arterial pulse and blood pressure and taking patients' history (average score 10 for all three skills) and least confident about placing a urinary catheter (average score 1) and suturing a wound (average score 2). They rated their readiness to work with patients with 5.0 out of 10.0 points. The total score did not correlate with students' average mark (Spearman's ρ=0.039; P=0.460) and the average mark did not correlate with the self-perceived readiness to work with patients (Spearman's ρ=-0.048; P=0.365). Our study suggests that medical students lack confidence to perform various clinical procedures, particularly those related to surgical interventions. To improve students' confidence, clinical curriculum should include either more hours of practical work or ensure closer supervision of practical training in wards.
Improving and ensuring best practice continence management in residential aged care.
Heckenberg, Gayle
2008-06-01
Background Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives • Review the literature on best practice management of incontinence • Evaluate current practice in continence management for elderly residents within residential aged care services • Improve adherence to best practice strategies of care for incontinence • Raise awareness within the nursing home of the best practice management of incontinence • Promote appropriate and effective use of resources for continence management • Deliver individualised person-centred care to residents. • Ensure best practice in continence management Methods The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness of what best practice means and the impact their practices have on continence management. The JBI clinical audit and feedback cycle will continue to facilitate the measuring and implementation of best practice for resident outcomes in residential aged care. © 2008 The Author. Journal Compilation © Blackwell Publishing Asia Pty Ltd.
Flexibility First, Then Standardize: A Strategy for Growing Inter-Departmental Systems.
á Torkilsheyggi, Arnvør
2015-01-01
Any attempt to use IT to standardize work practices faces the challenge of finding a balance between standardization and flexibility. In implementing electronic whiteboards with the goal of standardizing inter-departmental practices, a hospital in Denmark chose to follow the strategy of "flexibility first, then standardization." To improve the local grounding of the system, they first focused on flexibility by configuring the whiteboards to support intra-departmental practices. Subsequently, they focused on standardization by using the white-boards to negotiate standardization of inter-departmental practices. This paper investigates the chosen strategy and finds: that super users on many wards managed to configure the whiteboard to support intra-departmental practices; that initiatives to standardize inter-departmental practices improved coordination of certain processes; and that the chosen strategy posed a challenge for finding the right time and manner to shift the balance from flexibility to standardization.
ERIC Educational Resources Information Center
Choi, Jae-Sung; Choi, Soochan; Kim, Yujin
2009-01-01
This article examines current social issues and welfare needs in South Korea and discusses societal efforts to respond to these needs through social welfare systems nationwide. It also reviews how social work scholars, major contributors to the creation of a Korean welfare state, have contributed to the conditions of social work practice by…
ERIC Educational Resources Information Center
Connell, Timothy J.; Mason, Sarah A.
In the 1990s, federal education legislation and policies have encouraged state and local efforts in educational reform and placed a new emphasis on education for and about work. These initiatives have engaged the active participation of a broad range of partners and have spurred a variety of locally customized programs and practices. Nationally,…
ERIC Educational Resources Information Center
Rafferty, Patricia D.
2013-01-01
This article forms part of an exploration into how graduate students experience group work. A single case, embedded study was completed in 2011, which reveals insight and understanding into the manner in which part-time MBA students experience group work assignments and how these experiences contribute to their perception of positive group work…
Working Together Toward a Common Goal: A Grounded Theory of Nurse-Physician Collaboration.
Fewster-Thuente, Lori
2015-01-01
Working together toward a common goal is an empirically derived theory that can guide education and practice to improve patient outcomes while saving money and lives. Grounded theory was used to explore nurses' and physicians' experiences with collaboration in order to understand the process intrinsically.
Student Metacognitive Responses to Feedback: A Multiple Case Study
ERIC Educational Resources Information Center
DeMello, Kate
2017-01-01
This study explored how undergraduate students perceive, self-regulate, and respond to feedback from instructors on written work. The general problem was that students in college are not prepared to practice metacognitive regulation to promote learning, particularly in the context of utilizing instructor feedback on written work to improve their…
Open Hands, Open Hearts: Working with Native Youth in the Schools.
ERIC Educational Resources Information Center
Garrett, Michael Tlanusta; Bellon-Harn, Monica L.; Torres-Rivera, Edil; Garrett, J. T.; Roberts, Lisen C.
2003-01-01
A comprehensive discussion of the potential for cultural discontinuity experienced by native youth in the schools is offered with implications for culturally responsive service delivery. Practical recommendations are provided for special educators and related service professionals working with native youth to improve knowledge, awareness, and…
Educational Neuroscience: What Can We Learn?
ERIC Educational Resources Information Center
Bell, Derek
2014-01-01
There has been a marked increase in interest, research, and publications exploring ways in which educational practices might be influenced by neuroscience. The idea that a greater understanding of how the brain works can improve teaching and learning is very seductive, but what can teachers and other professionals working in education learn from…
Closing Essay: A Journey, Not a Destination
ERIC Educational Resources Information Center
Phelps, James L.
2011-01-01
The author believes that a unified theory might provide ideas helpful for improving research; professional training and practice; and therefore, student achievement. Little attention was paid to how several variables might work together and there is little discussion regarding how they might work together. The author stresses that there are…
Implementing School Reform: "Making Middle Grades Work" for All Students
ERIC Educational Resources Information Center
Cooney, Sondra; Lasater, Beth
2006-01-01
"Making Middle Grades Work" ("MMGW") is a school improvement design developed by the Southern Regional Education Board (SREB) and its member states. "MMGW" is built on research-based instructional practices and policies. The design combines challenging yet attainable goals with accountability that encourages teachers, supports students and results…
The CEIC Review, 2001. A Catalyst for Merging Research, Policy, and Practice.
ERIC Educational Resources Information Center
Hartman, Bonnie, Ed.; Rohland, Mark, Ed.
2001-01-01
These three volumes contain articles related to (1) improving educational productivity (lessons from economics); (2) school-to-work (STW); and (3) reduced class size, offering recommendations from national invitational conferences. Topics include making schools work; tax revolts and school performance; market pressure and the impact on…
Adam, Kerry; Gibson, Elizabeth; Lyle, Alexandra; Strong, Jenny
2010-01-01
This paper will explore the development of occupational therapists' and physiotherapists' roles in work related practice from an early focus on rehabilitation of injured workers, to one including prevention and health promotion. A review of international evidence identified the roles, tasks and employment paths for occupational therapists and physiotherapists in work related practice. The relationship between government regulation and therapists' access to the workplace was also examined. Occupational therapists and physiotherapists hold valued positions in work related professional practice. Whilst initially their roles were based on injury management through occupational rehabilitation, both professions have demonstrated a clear vision of the importance of prevention of work related injury and disease. Social and workplace changes in the late 1970s in a number of western countries, commencing with the Robens' reforms in the United Kingdom, led to improved legislation and regulation for managing occupational health and safety. The approach of both disciplines to practice in this field reflects their individual professional education. However, some role overlaps exists in consultancy activities in the industrial environment. Implementation of modern OHS regulatory programs in other western countries, including Australia, has increased and broadened the opportunities for therapists, as governments, employers and insurers support early intervention to minimise the impact of workplace injuries and diseases.
Ng, Stella L.; Lingard, Lorelei; Hibbert, Kathryn; Regan, Sandra; Phelan, Shanon; Stooke, Rosamund; Meston, Christine; Schryer, Catherine; Manamperi, Madhushani; Friesen, Farah
2015-01-01
Abstract Purpose: School settings are a common practice context for rehabilitation professionals; health advocacy is a common and challenging practice role for professionals in this context. This study explored how pediatric practitioners advocate for children with disabilities at school. Specifically, we examined everyday advocacy in the context of school-based support for children with disabilities. Method: Our theoretical framework and methodological approach were informed by institutional ethnography, which maps and makes visible hidden social coordinators of work processes with a view to improving processes and outcomes. We included families, educators, and health/rehabilitation practitioners from Ontario. Of the 37 consented informants, 27 were interviewed and 15 observed. Documents and texts were collected from the micro-level (e.g. clinician reports) and the macro-level (e.g. policies). Results: Pediatric practitioners' advocacy work included two main work processes: spotlighting invisible disabilities and orienteering the special education terrain. Practitioners advocated indirectly, by proxy, with common proxies being documents and parents. Unintended consequences of advocacy by proxy included conflict and inefficiency, which were often unknown to the practitioner. Conclusions: The findings of this study provide practice-based knowledge about advocacy for children with disabilities, which may be used to inform further development of competency frameworks and continuing education for pediatric practitioners. The findings also show how everyday practices are influenced by policies and social discourses and how rehabilitation professionals may enact change.Implications for RehabilitationRehabilitation professionals frequently perform advocacy work. They may find it beneficial to perform advocacy work that is informed by overarching professional and ethical guidelines, and a nuanced understanding of local processes and structures.Competency frameworks and education for pediatric rehabilitation professionals may be improved by: encouraging professionals to consider how their practices, including their written documents, may affect parental burden, (mis)interpretation by document recipients, and potential unintended consequences.Policies and texts, e.g. privacy legislation and the Diagnostic and Statistical Manual (DSM), influence rehabilitation professionals' actions and interactions when supporting children with disabilities at school.An awareness of the influence of policies and texts may enable practitioners to work more effectively within current systems when supporting individuals with disabilities. PMID:25738906
The evolution and development of an instrument to measure essential professional nursing practices.
Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia
2014-11-01
Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.
Challenges of safe medication practice in paediatric care--a nursing perspective.
Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph
2013-05-01
To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.
Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms.
Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica
2015-01-01
Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee's physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems.
Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms
Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica
2015-01-01
Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee’s physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems. PMID:25961447
Stewart, Rebecca E.; Stirman, Shannon Wiltsey; Chambless, Dianne L.
2012-01-01
This article presents the results of a qualitative analysis of interviews with 25 psychologists in independent practice, investigating everyday treatment decisions and attitudes about treatment outcome research and empirically supported treatments (ESTs). Clinicians noted positive aspects about treatment outcome research, such as being interested in what works. However, they had misgivings about the application of controlled research findings to their practices, were skeptical about using manualized protocols, and expressed concern that nonpsychologists would use EST lists to dictate practice. Clinicians reported practicing in an eclectic framework, and many reported including cognitive-behavioral elements in their practice. To improve their practice, they reported valuing clinical experience, peer networks, practitioner-oriented books, and continuing education when it was not too basic. Time and financial barriers concerned nearly all participants. Clinicians suggested they might be interested in ESTs if they could integrate them into their current frameworks, and if resources for learning ESTs were improved. PMID:22654246
How Work-Family Research Can Finally Have an Impact in Organizations.
Kossek, Ellen Ernst; Baltes, Boris B; Matthews, Russell A
2011-09-01
Although work-family research has mushroomed over the past several decades, an implementation gap persists in putting work-family research into practice. Because of this, work-family researchers have not made a significant impact in improving the lives of employees relative to the amount of research that has been conducted. The goal of this article is to clarify areas where implementation gaps between work-family research and practice are prevalent, discuss the importance of reducing these gaps, and make the case that both better and different research should be conducted. We recommend several alternative but complementary actions for the work-family researcher: (a) work with organizations to study their policy and practice implementation efforts, (b) focus on the impact of rapid technological advances that are blurring work-family boundaries, (c) conduct research to empower the individual to self-manage the work-family interface, and (d) engage in advocacy and collaborative policy research to change institutional contexts and break down silos. Increased partnerships between industrial-organizational (I-O) psychology practitioners and researchers from many industries and disciplines could break down silos that we see as limiting development of the field.
Facilitators of transforming primary care: a look under the hood at practice leadership.
Donahue, Katrina E; Halladay, Jacqueline R; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat
2013-01-01
This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41-4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08-1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement.
Facilitators of Transforming Primary Care: A Look Under the Hood at Practice Leadership
Donahue, Katrina E.; Halladay, Jacqueline R.; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat
2013-01-01
PURPOSE This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. METHODS We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. RESULTS Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41–4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08–1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. CONCLUSIONS In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement. PMID:23690383
Integrated management of depression: improving system quality and creating effective interfaces.
Myette, Thomas L
2008-04-01
Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.
Song, Hummy; Ryan, Molly; Tendulkar, Shalini; Fisher, Josephine; Martin, Julia; Peters, Antoinette S; Frolkis, Joseph P; Rosenthal, Meredith B; Chien, Alyna T; Singer, Sara J
Team-based care is essential for delivering high-quality, comprehensive, and coordinated care. Despite considerable research about the effects of team-based care on patient outcomes, few studies have examined how team dynamics relate to provider outcomes. The aim of this study was to examine relationships among team dynamics, primary care provider (PCP) clinical work satisfaction, and patient care coordination between PCPs in 18 Harvard-affiliated primary care practices participating in Harvard's Academic Innovations Collaborative. First, we administered a cross-sectional survey to all 548 PCPs (267 attending clinicians, 281 resident physicians) working at participating practices; 65% responded. We assessed the relationship of team dynamics with PCPs' clinical work satisfaction and perception of patient care coordination between PCPs, respectively, and the potential mediating effect of patient care coordination on the relationship between team dynamics and work satisfaction. In addition, we embedded a qualitative evaluation within the quantitative evaluation to achieve a convergent mixed methods design to help us better understand our findings and illuminate relationships among key variables. Better team dynamics were positively associated with clinical work satisfaction and quality of patient care coordination between PCPs. Coordination partially mediated the relationship between team dynamics and satisfaction for attending clinicians, suggesting that higher satisfaction depends, in part, on better teamwork, yielding more coordinated patient care. We found no mediating effects for resident physicians. Qualitative results suggest that sources of satisfaction from positive team dynamics for PCPs may be most relevant to attending clinicians. Improving primary care team dynamics could improve clinical work satisfaction among PCPs and patient care coordination between PCPs. In addition to improving outcomes that directly concern health care providers, efforts to improve aspects of team dynamics may also help resolve critical challenges in workforce planning in primary care.
Shift Work: Improving Daytime Sleep
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Ideals, practices, and future prospects of stakeholder involvement in sustainability science
Vermaßen, Hannah; Ellenbeck, Saskia
2017-01-01
This paper evaluates current stakeholder involvement (SI) practices in science through a web-based survey among scholars and researchers engaged in sustainability or transition research. It substantiates previous conceptual work with evidence from practice by building on four ideal types of SI in science. The results give an interesting overview of the varied landscape of SI in sustainability science, ranging from the kinds of topics scientists work on with stakeholders, over scientific trade-offs that arise in the field, to improvements scientists wish for. Furthermore, the authors describe a discrepancy between scientists’ ideals and practices when working with stakeholders. On the conceptual level, the data reflect that the democratic type of SI is the predominant one concerning questions on the understanding of science, the main goal, the stage of involvement in the research process, and the science–policy interface. The fact that respondents expressed agreement to several types shows they are guided by multiple and partly conflicting ideals when working with stakeholders. We thus conclude that more conceptual exchange between practitioners, as well as more qualitative research on the concepts behind practices, is needed to better understand the stakeholder–scientist nexus. PMID:29162698
Ideals, practices, and future prospects of stakeholder involvement in sustainability science.
Mielke, Jahel; Vermaßen, Hannah; Ellenbeck, Saskia
2017-12-12
This paper evaluates current stakeholder involvement (SI) practices in science through a web-based survey among scholars and researchers engaged in sustainability or transition research. It substantiates previous conceptual work with evidence from practice by building on four ideal types of SI in science. The results give an interesting overview of the varied landscape of SI in sustainability science, ranging from the kinds of topics scientists work on with stakeholders, over scientific trade-offs that arise in the field, to improvements scientists wish for. Furthermore, the authors describe a discrepancy between scientists' ideals and practices when working with stakeholders. On the conceptual level, the data reflect that the democratic type of SI is the predominant one concerning questions on the understanding of science, the main goal, the stage of involvement in the research process, and the science-policy interface. The fact that respondents expressed agreement to several types shows they are guided by multiple and partly conflicting ideals when working with stakeholders. We thus conclude that more conceptual exchange between practitioners, as well as more qualitative research on the concepts behind practices, is needed to better understand the stakeholder-scientist nexus. Copyright © 2017 the Author(s). Published by PNAS.
Saito, Yumiko; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Takai, Yukari; Yamamoto-Mitani, Noriko
2018-05-01
To examine burnout and work engagement among nurses in Japanese long-term care hospitals and their relation to nurses' and organisational work values, and nurse-organisation congruence of such values. Nursing managers must help improve nurses' well-being; however, no research has considered strategies to improve staff outcomes in long-term care hospitals. We propose that individual nurse's work values and the congruence of these values with those of their organisations may influence burnout and work engagement. We conducted a cross-sectional survey of nurses in long-term care hospitals. Multiple regression analyses were conducted to examine the effects of nurses' work values and nurse-organisation congruence in these values on burnout and work engagement. Higher individual intrinsic and altruistic work values were associated with improvements in nurses' burnout and work engagement. Nurse-organisation non-congruence in altruistic values was associated with lower work engagement, whereas that of intrinsic work values was not associated with either outcome variable. Promoting intrinsic and altruistic work values among nurses could be effective for improving both burnout and work engagement. Opportunities such as case conferences could foster intrinsic and altruistic work values through the review of good care practices and communication between managers/colleagues about feelings and thoughts. © 2018 John Wiley & Sons Ltd.
Cohen, Elaine V; Hagestuen, Ruth; González-Ramos, Gladys; Cohen, Hillel W; Bassich, Celia; Book, Elaine; Bradley, Kathy P; Carter, Julie H; Di Minno, Mariann; Gardner, Joan; Giroux, Monique; González, Manny J; Holten, Sandra; Joseph, Ricky; Kornegay, Denise D; Simpson, Patricia A; Tomaino, Concetta M; Vandendolder, Richard P; Walde-Douglas, Maria; Wichmann, Rosemary; Morgan, John C
2016-01-01
Examine outcomes for the National Parkinson Foundation (NPF) Allied Team Training for Parkinson (ATTP), an interprofessional education (IPE) program in Parkinson's disease (PD) and team-based care for medicine, nursing, occupational, physical and music therapies, physician assistant, social work and speech-language pathology disciplines. Healthcare professionals need education in evidence-based PD practices and working effectively in teams. Few evidence-based models of IPE in PD exist. Knowledge about PD, team-based care, the role of other disciplines and attitudes towards healthcare teams were measured before and after a protocol-driven training program. Knowledge, attitudes and practice changes were again measured at 6-month post-training. Trainee results were compared to results of controls. Twenty-six NPF-ATTP trainings were held across the U.S. (2003-2013). Compared to control participants (n = 100), trainees (n = 1468) showed statistically significant posttest improvement in all major outcomes, including self-perceived (p < 0.001) and objective knowledge (p < 0.001), Understanding Role of Other Disciplines (p < 0.001), Attitudes Toward Health Care Teams Scale (p < 0.001), and the Attitudes Toward Value of Teams (p < 0.001) subscale. Despite some decline, significant improvements were largely sustained at six-month post-training. Qualitative analyses confirmed post-training practice changes. The NPF-ATTP model IPE program showed sustained positive gains in knowledge of PD, team strategies and role of other disciplines, team attitudes, and important practice improvements. Further research should examine longer-term outcomes, objectively measure practice changes and mediators, and determine impact on patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion
ERIC Educational Resources Information Center
Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara
2014-01-01
In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…
ERIC Educational Resources Information Center
Peel, Henry A.; Wallace, Corinna; Buckner, Kermit G.; Wrenn, Steven L.; Evans, Ralph
1998-01-01
A North Carolina school system worked with NASSP and an area university to develop an improved administrator-preparation plan. Created by NASSP to unite key preparation elements, the "Potential Administrator Development Program" stresses field-based experiences via theory-to-practice classroom activities, mentoring opportunities,…
ERIC Educational Resources Information Center
Abaci, Serdar; Pershing, James A.
2017-01-01
Human Performance Technology (HPT) is the applied study and practice of improving organizational performance through training and non-training interventions. For practitioners working in this area that identify themselves as an HPT practitioner, organizational training and performance (OTP) specialist, or instructional designer--offering the right…
Leveraging Code Comments to Improve Software Reliability
ERIC Educational Resources Information Center
Tan, Lin
2009-01-01
Commenting source code has long been a common practice in software development. This thesis, consisting of three pieces of work, made novel use of the code comments written in natural language to improve software reliability. Our solution combines Natural Language Processing (NLP), Machine Learning, Statistics, and Program Analysis techniques to…
Bitton, Asaf; Ellner, Andrew; Pabo, Erika; Stout, Somava; Sugarman, Jonathan R; Sevin, Cory; Goodell, Kristen; Bassett, Jill S; Phillips, Russell S
2014-09-01
Academic medical centers (AMCs) need new approaches to delivering higher-quality care at lower costs, and engaging trainees in the work of high-functioning primary care practices. In 2012, the Harvard Medical School Center for Primary Care, in partnership with with local AMCs, established an Academic Innovations Collaborative (AIC) with the goal of transforming primary care education and practice. This novel two-year learning collaborative consisted of hospital- and community-based primary care teaching practices, committed to building highly functional teams, managing populations, and engaging patients. The AIC built on models developed by Qualis Health and the Institute for Healthcare Improvement, optimized for the local AMC context. Foundational elements included leadership engagement and development, application of rapid-cycle process improvement, and the creation of teams to care for defined patient populations. Nineteen practices across six AMCs participated, with nearly 260,000 patients and 450 resident learners. The collaborative offered three 1.5-day learning sessions each year featuring shared learning, practice coaches, and improvement measures, along with monthly data reporting, webinars, and site visits. Validated self-reports by transformation teams showed that practices made substantial improvement across all areas of change. Important factors for success included leadership development, practice-level resources, and engaging patients and trainees. The AIC model shows promise as a path for AMCs to catalyze health system transformation through primary care improvement. In addition to further evaluating the impact of practice transformation, expansion will require support from AMCs and payers, and the application of similar approaches on a broader scale.
Hughes, Roger; Margetts, Barrie
2012-11-01
The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. Education and practice settings. This model will have applications for educators and practitioners. Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.
Aiken, Alice
2012-01-01
This article provides an overview of work done in Canada involving the use of physiotherapists in models of collaborative care to enhance orthopedic care and practice. Valuable lessons learned and an important model of collaborative care are summarized. The research around these models of care has also contributed to important scope of practice changes for the profession of physiotherapy.
Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H
2012-01-01
Aims and objectives This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. Background The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. Design This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Methods Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Results Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses’ work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Conclusion Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. Relevance to clinical practice The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. PMID:22380003
Courses offered by the Minas Health Channel: perception of primary care workers.
Pereira, Lizziane D' Ávila; Sena, Roseni Rosângela de
2016-06-01
To analyse how primary healthcare workers perceive the impact of the Health Channel Mines courses in their work process. This is a descriptive exploratory qualitative study conducted with 38 professionals working in primary health care units of three municipalities in the state of Minas Gerais, Brazil. Data were collected in 2014 by means of semi-structured interviews and subjected to thematic content analysis. Data analysis revealed the following three categories: interest in training and its contribution to professional practice; factors that alter professional practices; and proposals for improvement. The study data demonstrated that the Mines Health Channel courses cannot single-handedly change professional practices. Continued and refresher education resources that enable the exchange and articulation of knowledge between the various specialities are needed to transform professional practices.
LaGrone, Lacey N.; Isquith-Dicker, Leah N.; Egoavil, Eduardo Huaman; Herrera-Matta, Juan Jaime; Fuhs, Amy K.; Checa, David Ortega; Revoredo, Fernando; Rodriguez Castro, Manuel J.A.; Mock, Charles N.
2017-01-01
Background Dual practice, simultaneous employment by healthcare workers in the public and private sector, is pervasive worldwide. Although an estimated 30% of the global burden of disease is surgical, the implications of dual practice on surgical care are not well studied. Methods We conducted anonymous in-depth individual interviews on trauma quality improvement practices with healthcare providers who participate in the care of the injured at ten large hospitals in Peru’s capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Results Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians’ time, the quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Conclusions Surgeons in Peru report that dual practice negatively impacts patient care by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. PMID:28251600
A Study of Technical Engineering Peer Reviews at NASA
NASA Technical Reports Server (NTRS)
Chao, Lawrence P.; Tumer, Irem Y.; Bell, David G.
2003-01-01
This report describes the state of practices of design reviews at NASA and research into what can be done to improve peer review practices. There are many types of reviews at NASA: required and not, formalized and informal, programmatic and technical. Standing project formal reviews such as the Preliminary Design Review and Critical Design Review are a required part of every project and mission development. However, the technical, engineering peer reviews that support teams' work on such projects are informal, some times ad hoc, and inconsistent across the organization. The goal of this work is to identify best practices and lessons learned from NASA's experience, supported by academic research and methodologies to ultimately improve the process. This research has determined that the organization, composition, scope, and approach of the reviews impact their success. Failure Modes and Effects Analysis (FMEA) can identify key areas of concern before or in the reviews. Product definition tools like the Project Priority Matrix, engineering-focused Customer Value Chain Analysis (CVCA), and project or system-based Quality Function Deployment (QFD) help prioritize resources in reviews. The use of information technology and structured design methodologies can strengthen the engineering peer review process to help NASA work towards error-proofing the design process.
Payette, Michael; Chatterjee, Abhishek; Weeks, William B
2009-06-01
Efforts to improve patient safety have attempted to incorporate aviation industry safety standards. We sought to evaluate the cost and workforce implications of applying aviation duty-hour restrictions to the entire practicing physician workforce. The work hours and personnel deficit for United States residents and practicing physicians that would be created by the adoption of aviation standards were calculated. Application of aviation standards to the resident workforce creates an estimated annual cost of $6.5 billion, requiring a 174% increase in the number of residents to meet the deficit. Its application to practicing physicians creates an additional annual cost of $80.4 billion, requiring a 71% increase in the physician workforce. Adding in the aviation industry's mandatory retirement age (65 years) increases annual costs by $10.5 billion. The cost per life-year saved would be $1,035,227. Application of aviation duty-hour restrictions to the United States health care system would be prohibitively costly. Alternate approaches for improving patient safety are warranted.
Shaping the Epistemology of Teacher Practice through Reflection and Reflexivity
ERIC Educational Resources Information Center
Hofer, Barbara K.
2017-01-01
Reflection on practice is a core principle for guiding improvement in professional work such as teaching and can be enhanced by reflection on epistemic cognition, the way we think about knowledge and knowing. Viewed as an intellectual virtue, a habit of mind, and a learnable skill, epistemic reflection can help teachers learn to critically…
School Principals at Their Lonely Work: Recording Workday Practices through ESM Logs
ERIC Educational Resources Information Center
Lopez, Veronica; Ahumada, Luis; Galdames, Sergio; Madrid, Romina
2012-01-01
This study used portable technology based on Experience Sampling Methodology (ESM log) to register workday practices of school principals and heads from Chilean schools who were implementing school improvement plans aimed at developing a culture of organizational learning. For a week, Smartphone devices which beeped seven times a day were given to…
ERIC Educational Resources Information Center
Rappolt-Schlichtmann, Gabrielle; Watamura, Sarah E.
2010-01-01
More than ever before, leaders within the field of education are looking to research on basic processes to inform and improve educational practices. Success requires building a reciprocal relationship between the field of education and research on learning and development, similar to what exists between biology and medicine. Key to this effort is…
ERIC Educational Resources Information Center
Hartmann, Elizabeth
2011-01-01
It is essential that children who are deaf-blind have learning experiences that improve their quality of life. Unfortunately, even when educational teams work together to create individualized education programs, these students do not always have full and equal opportunities to learn. This issue of "Practice Perspectives" describes the basics of…
ERIC Educational Resources Information Center
Jäppinen, Aini-Kristiina; Leclerc, Martine; Tubin, Dorit
2016-01-01
Professional learning communities (PLC) have been widely accepted as effective with respect to good atmosphere, adequate leadership practices, and functional working practices. However, the outcomes for school improvement depend on case-specific issues. To identify less culturally and contextually bound issues in 3 PLC settings in Canada, Finland,…
An Authentic Journey: Teachers' Emergent Understandings about Authentic Assessment and Practice.
ERIC Educational Resources Information Center
Einbender, Lynne; Wood, Diane
As a challenge to traditional assessment, this paper describes how the work of a network of teachers to improve schooling through authentic assessment and practice may lead to a general reform of nearly all aspects of the educational enterprise. The paper springs from observation of participant teachers in the Four Seasons Project which is…
ERIC Educational Resources Information Center
Winton, Pamela J., Ed; McCollum, Jeanette A., Ed.; Catlett, Camille, Ed.
2007-01-01
The key to improving the early education of all young children, including those with special needs, is the effective preparation and development of the professionals who work with them. "Practical Approaches to Early Childhood Professional Development" is a comprehensive planning resource for college faculty and consultants engaged in preservice …
ERIC Educational Resources Information Center
Kraft, Matthew A.; Blazar, David
2017-01-01
This article analyzes a coaching model focused on classroom management skills and instructional practices across grade levels and subject areas. We describe the design and implementation of MATCH Teacher Coaching among an initial cohort of 59 teachers working in New Orleans charter schools. We evaluate the effect of the program on teachers'…
Theory into Practice: Best Practices for a School-Wide Approach to Critical Thinking Instruction.
ERIC Educational Resources Information Center
Kassem, Cherrie L.
Educators at one Georgia high school identified improved student proficiency in critical thinking as a major school goal. In order to infuse thinking skills instruction across the curriculum, a nine-member interdisciplinary team of teachers worked with a learning consultant for 1 year. Collaboration resulted in the development of a new model for…
ERIC Educational Resources Information Center
Muller, Eve
2011-01-01
In response to high rates of attrition, increasing numbers of states and localities are developing mentoring programs as a means of retaining qualified special education personnel. Based on examples drawn from around the country, including states and localities with which the Personnel Improvement Center (PIC) has worked, this practice brief…
The Practice of School Reform: Lessons from Two Centuries
ERIC Educational Resources Information Center
Nehring, James
2009-01-01
Former high school teacher, school leader, activist, consultant, and now professor of education James Nehring combines vivid case studies with practical suggestions to describe how the system works to thwart good schools and what educators can do to improve them. In this book he paints the big picture of school reform in the United States, deftly…
Christiansen, Angela; Robson, Linda; Griffith-Evans, Christine
2010-10-01
The present study reports a descriptive survey of nursing students' experience of service improvement learning in the university and practice setting. Opportunities to develop service improvement capabilities were embedded into pre-registration programmes at a university in the Northwest of England to ensure future nurses have key skills for the workplace. A cross-sectional survey designed to capture key aspects of students' experience was completed by nursing students (n = 148) who had undertaken a service improvement project in the practice setting. Work organizations in which a service improvement project was undertaken were receptive to students' efforts. Students reported increased confidence to undertake service improvement and service improvement capabilities were perceived to be important to future career development and employment prospects. Service improvement learning in pre-registration education appears to be acceptable, effective and valued by students. Further research to identify the impact upon future professional practice and patient outcomes would enhance understanding of this developing area. Nurse Managers can play an active role in creating a service culture in which innovation and improvement can flourish to enhance patient outcomes, experience and safety. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Kawakami, Tsuyoshi
2016-08-01
A participatory training program, Work Improvement in Small Construction Sites, was developed to provide practical support measures to the small construction sector. Managers and workers from selected small sites were interviewed about their occupational safety and health risks. The Work Improvement in Small Construction Sites training program comprised a 45-item action checklist, photos, and illustrations showing local examples and group work methods. Pilot training workshops were carried out with workers and employers in Cambodia, Laos, Mongolia, Thailand, and Vietnam. Participants subsequently planned, and using locally available low-cost materials, implemented their own improvements such as hand-made hand trucks to carry heavy materials, removal of projecting nails from timber materials, and fences to protect roof workers from falling. Local Work Improvement in Small Construction Sites trainers consisting of government officials, workers, employers, and nongovernment organization representatives were then trained to implement the Work Improvement in Small Construction Sites training widely. Keys to success were easy-to-apply training tools aiming at immediate, low-cost improvements, and collaboration with various local people's networks. © The Author(s) 2016.
Networking to Improve Nutrition Policy Research.
Kim, Sonia A; Blanck, Heidi M; Cradock, Angie; Gortmaker, Steven
2015-09-10
Effective nutrition and obesity policies that improve the food environments in which Americans live, work, and play can have positive effects on the quality of human diets. The Centers for Disease Control and Prevention's (CDC's) Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) conducts transdisciplinary practice-based policy research and evaluation to foster understanding of the effectiveness of nutrition policies. The articles in this special collection bring to light a set of policies that are being used across the United States. They add to the larger picture of policies that can work together over time to improve diet and health.
Morténius, Helena; Fridlund, Bengt; Marklund, Bertil; Palm, Lars; Baigi, Amir
2012-04-01
To evaluate the long-term utilisation of strategic communication as a factor of importance when changing work practices among primary care staff. In many health care organisations, there is a gap between theory and practice. This gap hinders the provision of optimal evidence-based practice and, in the long term, is unfavourable for patient care. One way of overcoming this barrier is systematically structured communication between the scientific theoretical platform and clinical practice. This longitudinal evaluative study was conducted among a primary care staff cohort. Strategic communication was considered to be the intervention platform and included a network of ambassadors who acted as a component of the implementation. Measurements occurred 7 and 12 years after formation of the cohort. A questionnaire was used to obtain information from participants. In total, 846 employees (70%) agreed to take part in the study. After 12 years, the 352 individuals (60%) who had remained in the organisation were identified and followed up. Descriptive statistics and multivariate analysis were used to analyse the data. Continuous information contributed to significant improvements over time with respect to new ideas and the intention to change work practices. There was a statistically significant synergistic effect on the new way of thinking, that is, willingness to change work practices. During the final two years, the network of ambassadors had created a distinctive image for itself in the sense that primary care staff members were aware of it and its activities. This awareness was associated with a positive change with regard to new ways of thinking. More years of practice was inversely associated with willingness to change work practices. Strategic communication may lead to a scientific platform that promotes high-quality patient care by means of new methods and research findings.
The development of accurate and high quality radiotherapy treatment delivery
NASA Astrophysics Data System (ADS)
Griffiths, Susan E.
Accurate radiotherapy delivery is required for curing cancer. Historical radiotherapy accuracy studies at Leeds (1983-1991) are discussed in context of when radiographers were not involved in practice design. The seminal research was unique in being led by a radiographer practitioner, and in prospectively studying the accuracy of different techniques within one department. The viability of alignment of treatment beams with marks painted on a patient's skin varied daily, and, using film I showed that the alignment of treatment on anatomy varied. I then led 6 sequential studies with collaborating oncologists. Unique outcomes were in identifying the origins of treatment inaccuracies, implementing and evidencing changes in multi-disciplinary practice, thus improving accuracy and reproducibility generally and achieving accuracy for the pelvis to within current norms. Innovations included: discontinuation of painted skin marks and developing whole-body patient positioning using lasers, tattoos, and standardised supports; unification of set-up conditions through planning and treatment; planning normal tissue margins round target tissue to allow for inaccuracies (1985); improved manual shielding methods, changed equipment usage, its quality assurance and design; influenced the development of portal imaging and image analysis. Consequences and current implications. The research, still cited internationally, contributed to clinical management of lymphoma, and critically underpins contemporary practice. It led to my becoming the first radiographer invited into multi-disciplinary collaborative work, to advise in the first multi-centre clinical trials to consider treatment delivery accuracy, contribute to books written from within other disciplines and inform guidelines for good practice so helping to improve practices, with recent publications. I thus led my profession into research activity. Later work included development of a national staffing formula for radiotherapy Centres, and contributing to the evidence-base for improved National radiotherapy resourcing. I recently researched and developed a textbook (second edition) on quality in treatment delivery.
Maximizing your return on people.
Bassi, Laurie; McMurrer, Daniel
2007-03-01
Though most traditional HR performance metrics don't predict organizational performance, alternatives simply have not existed--until now. During the past ten years, researchers Laurie Bassi and Daniel McMurrer have worked to develop a system that allows executives to assess human capital management (HCM) and to use those metrics both to predict organizational performance and to guide organizations' investments in people. The new framework is based on a core set of HCM drivers that fall into five major categories: leadership practices, employee engagement, knowledge accessibility, workforce optimization, and organizational learning capacity. By employing rigorously designed surveys to score a company on the range of HCM practices across the five categories, it's possible to benchmark organizational HCM capabilities, identify HCM strengths and weaknesses, and link improvements or back-sliding in specific HCM practices with improvements or shortcomings in organizational performance. The process requires determining a "maturity" score for each practice, based on a scale of 1 (low) to 5 (high). Over time, evolving maturity scores from multiple surveys can reveal progress in each of the HCM practices and help a company decide where to focus improvement efforts that will have a direct impact on performance. The authors draw from their work with American Standard, South Carolina's Beaufort County School District, and a bevy of financial firms to show how improving HCM scores led to increased sales, safety, academic test scores, and stock returns. Bassi and McMurrer urge HR departments to move beyond the usual metrics and begin using HCM measurement tools to gauge how well people are managed and developed throughout the organization. In this new role, according to the authors, HR can take on strategic responsibility and ensure that superior human capital management becomes central to the organization's culture.
From scientific discovery to health outcomes: A synergistic model of doctoral nursing education.
Michael, Melanie J; Clochesy, John M
2016-05-01
Across the globe, health system leaders and stakeholder are calling for system-level reforms in education, research, and practice to accelerate the uptake and application of new knowledge in practice and to improve health care delivery and health outcomes. An evolving bi-dimensional research-practice focused model of doctoral nursing education in the U.S. is creating unprecedented opportunities for collaborative translational and investigative efforts for nurse researchers and practitioners. The nursing academy must commit to a shared goal of preparing future generations of nurse scientists and practitioners with the capacity and motivation to work together to accelerate the translation of evidence into practice in order to place nursing at the forefront of health system improvement efforts and advance the profession. Copyright © 2016 Elsevier Ltd. All rights reserved.
Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue.
Shaw, William S; Main, Chris J; Pransky, Glenn; Nicholas, Michael K; Anema, Johannes R; Linton, Steven J
2016-12-01
Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.
Pawa, Jasmine; Robson, John; Hull, Sally
2017-11-01
Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.
Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru
2015-01-01
This study aimed at analyzing the effect of 5S practice on staff motivation, patients’ waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement. PMID:28299136
Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru
2015-03-31
This study aimed at analyzing the effect of 5S practice on staff motivation, patients' waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement.
A Deliberate Practice Instructional Approach for Upper Division Physics Courses
NASA Astrophysics Data System (ADS)
Jones, David
2015-05-01
In upper division physics courses, an overarching educational goal is to have students think about and use the material much as a practicing physicist in the field does. Specifically, this would include knowledge (such as concepts, formalism, and instruments), approaches, and metacognitive skills that physicists use in solving ``typical'' (research context) problems to both understand and predict physical observations and accompanying models. Using an interactive instructional approach known as deliberate practice (described earlier in this session) we will discuss our work on how to provide students with the necessary practice and feedback to achieve these skills in a core DAMOP course of modern optics. We present the results of a direct and explicit comparison between this approach and traditional lecture-based instruction revealing evidence that a significant improvement of the students' mastery of these skills occurs when deliberate practice is employed. Our work was supported by the University of British Columbia through the CWSEI.
Improving the workplace for women improves it for everyone
NASA Astrophysics Data System (ADS)
Campbell, Melanie C. W.
2015-12-01
I will discuss various initiatives that make the workplace more equitable for both men and women, including availability of child care, maternity and parental leaves, stopping tenure and grant "clocks" for parental and health leaves, spousal appointments, and best practices in hiring. My theme is that of an equitable workplace that promotes work life balance. I will discuss how these initiatives benefit everyone. I will summarize these issues with examples primarily of policies from my own institution and others in Canada that have made progress towards best practices.
NASA Astrophysics Data System (ADS)
Kluchnikova, O.; Pobegaylov, O.
2017-11-01
The article focuses on the basic theory and practical aspects of the strategic management improving in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at the selection of an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research as well as on the experimental data obtained in the experiment.
Ha, Jong Goon; Man Kim, Ji; Hwang, Won Ju; Lee, Sang Gyu
2014-09-01
The aim of the present study was to analyse the impact of organisational characteristics on the turnover intention of care workers working at nursing homes in Korea. Study participants included 504 care workers working at 14 nursing homes in Korea. The variables measured were: high-performance work practices, consisting of five subfactors (official training, employment stability, autonomy, employee participation and group-based payment); organisational commitment, consisting of three subfactors (affective, normative and continuance commitment); organisational support; and turnover intention. The inter-relationship between high-performance work practices, organisational support, organisational commitment and turnover intention and the fit of the hypothetical model were analysed using structural equation modelling. According to our analysis, high-performance work practices not only had a direct effect on turnover intention, but also an indirect effect by mediating organisational support and commitment. The factor having the largest direct influence on turnover intention was organisational commitment. The results of the present study suggest that to improve health conditions for frail elderly patients at nursing homes, as well as the efficiency of nursing homes through the continuance of nursing service and enhancement of quality of service, long-term care facilities should reduce the turnover intention of care workers by increasing their organisational commitment by actively implementing high-performance work practices.
Innovative Ideas on How Work-Family Research Can Have More Impact.
Kossek, Ellen Ernst; Baltes, Boris B; Matthews, Russell A
2011-09-01
The commentaries on our focal article agreed with its main premise that work-family research should follow new strategies to improve its practical impact, and made suggestions clustering into three main themes. The first theme built on our suggestion to improve the research focus, terminology, and framing of work-family research. These essays offered additional ideas such as decoupling work-family from work-life research, and examining contextual factors more deeply. The second theme focused on how to better apply the findings from work family research. These commentaries provided social change approaches for making work-family issues more central to key stakeholders and to organizations. The third theme focused on broadening our scope to the societal level. These editorials advocated tactics supporting the development of basic rights of work-life balance within and across nations.
Hospital nurses' working conditions in relation to motivation and patient safety.
Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja
2015-03-01
There is a lack of empirical knowledge about nurses' perceptions of their workplace characteristics and conditions, such as level of autonomy and decision authority, work climate, teamwork, skill exploitation and learning opportunities, and their work motivation in relation to practice outputs such as patient safety. Such knowledge is needed particularly in countries, such as Estonia, where hospital systems for preventing errors and improving patient safety are in the early stages of development. This article reports the findings from a cross-sectional survey of hospital nurses in Estonia that was aimed at determining their perceptions of workplace characteristics, working conditions, work motivation and patient safety, and at exploring the relationship between these. Results suggest that perceptions of personal control over their work can affect nurses' motivation, and that perceptions of work satisfaction might be relevant to patient safety improvement work.
Designing Work, Family & Health Organizational Change Initiatives.
Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis
2014-01-01
For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.
Designing Work, Family & Health Organizational Change Initiatives
Hammer, Leslie B.; Kelly, Erin L.; Moen, Phyllis
2014-01-01
Executive Summary For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win–win for productivity and employees’ well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today’s U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor. PMID:24683279
Preparing for the Personal Side of Work.
ERIC Educational Resources Information Center
Burge, Penny L.
1989-01-01
Conflict between work and family roles can be stressful and damaging to the job performance of both sexes. Instruction in combining these roles will improve the quality of life, increase worker productivity, and enable workers to exert a constructive influence on business, industry, and government in stimulating changes in policy and practice. (SK)
ERIC Educational Resources Information Center
Ayres, Paul
2013-01-01
Reducing problem complexity by isolating elements has been shown to be an effective instructional strategy. Novices, in particular, benefit from learning from worked examples that contain partially interacting elements rather than worked examples that provide full interacting elements. This study investigated whether the isolating-elements…
The Conewago Creek initiative: a model for community watershed engagement and restoration
Matt Royer; Kristen Kyler; Jennifer Fetter
2016-01-01
Over the last several years, a partnership of over thirty organizations called the Conewago Creek Initiative has been working cooperatively in a small watershed to increase community engagement and work with farmers and landowners to adopt land management practices to improve water quality.
ERIC Educational Resources Information Center
Smith, Sara D.; Galbraith, Quinn
2012-01-01
Working with younger staff and student employees can be a challenge for library supervisors in a multigenerational workplace. Because members of the Millennial Generation have different work expectations, managers need to adjust to best meet their needs. By surveying its five hundred student employees, Brigham Young University's Harold B. Lee…
Mobile Augmented Communication for Remote Collaboration in a Physical Work Context
ERIC Educational Resources Information Center
Pejoska-Laajola, Jana; Reponen, Sanna; Virnes, Marjo; Leinonen, Teemu
2017-01-01
Informal learning in a physical work context requires communication and collaboration that build on a common ground and an active awareness of a situation. We explored whether mobile video conversations augmented with on-screen drawing features were beneficial for improving communication and remote collaboration practices in the construction and…
In retrospect--a reflection on a 50-year research journey.
Howie, John G R
2014-02-01
This essay is a personal review of a research journey extending over 50 years during which time the understanding of medical practice has changed out of all recognition and the quality and standing of the discipline of general practice has improved substantially. Three main bodies of work are reviewed and set against the reasons why they were undertaken. The first, on the pathology of the appendix and the management of possible appendicitis, was carried out almost entirely in the hospital setting. The second, about the prescribing of antibiotics for respiratory illnesses, and the third, about the determinants of good consulting practice, were carried out in general practice. The essay concludes with a reflection on the relevance of the work to some contemporary academic and health service issues. Although the work was carried out in the UK in the context of its National Health Service (NHS), the conclusions are widely generalizable and have contributed to health service and academic developments in many other countries.
Stuckey, R; Pratt, SG; Murray, W
2015-01-01
Work-related travel and transport by road is fundamental for industry, government and organisations. Traditionally, road safety interventions at societal level have focussed on improving road and vehicle engineering and changing road-user behaviour through transport laws and safety campaigns. Crash data indicate that significant numbers of road-user fatalities occur while driving to or for work. Therefore, workplace initiatives can improve both road and worker safety. This paper reviews regulatory approaches to work-related road safety (WRRS) in Australia, the United Kingdom and United States, identifying significant and consistent gaps in policy, management and research. In all three countries, responsibility for managing and regulating WRRS is spread across government agencies, without a single coordinating body. This paper makes the case that integrating management of WRRS into regulatory and non-regulatory occupational health and safety (OHS) initiatives would foster and support collaboration between research and practice communities, ensuring a comprehensive evidence base for future programs. PMID:26279686
Doran, Diane; Clarke, Sean; Hayes, Laureen; Nincic, Vera
2014-09-01
Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.
Can scribes boost FPs' efficiency and job satisfaction?
Earls, Stephen T; Savageau, Judith A; Begley, Susan; Saver, Barry G; Sullivan, Kate; Chuman, Alan
2017-04-01
Research in other medical specialties has shown that the addition of medical scribes to the clinical team enhances physicians' practice experience and increases productivity. To date, literature on the implementation of scribes in primary care is limited. To determine the feasibility and benefits of implementing scribes in family medicine, we undertook a pilot mixed- method quality improvement (QI) study. In 2014, we incorporated 4 parttime scribes into an academic family medicine practice consisting of 7 physicians. We then measured, via survey and time-tracking data, the impact the scribes had on physician office hours and productivity, time spent on documentation, perceptions of work-life balance, and physician and patient satisfaction. Six of the 7 faculty physicians participated. This study demonstrated that the use of scribes in a busy academic primary care practice substantially reduced the amount of time that family physicians spent on charting, improved work-life balance, and had good patient acceptance. Specifically, the physicians spent an average of 5.1 fewer hours/week (hrs/wk) on documentation, while various measures of productivity revealed increases ranging from 9.2% to 28.8%. Perhaps most important of all, when the results of the pilot study were annualized, they were projected to generate $168,600 per year--more than twice the $79,500 annual cost of 2 full-time equivalent scribes. Surveys assessing work-life balance demonstrated improvement in the physicians' perception of the administrative burden/paperwork related to practice and a decrease in their perception of the extent to which work encroached on their personal lives. In addition, survey data from 313 patients at the time of their ambulatory visit with a scribe present revealed a high level of comfort. Likewise, surveys completed by physicians after 55 clinical sessions (ie, blocks of consecutive, uninterrupted patient appointments; there are usually 2 sessions per day) revealed good to excellent ratings more than 90% of the time. In an outpatient family medicine clinic, the use of scribes substantially improved physicians' efficiency, job satisfaction, and productivity without negatively impacting the patient experience.
Fire and Explosion Hazards Expected in a Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rasool, Shireen R.; Al-Dahhan, Wedad; Al-Zuhairi, Ali Jassim
Scientists at universities across Iraq are actively working to report actual incidents and accidents occurring in their laboratories, as well as structural improvements made to improve safety and security, to raise awareness and encourage openness, leading to widespread adoption of robust Chemical Safety and Security (CSS) practices. This manuscript is the fifth in a series of five case studies describing laboratory incidents, accidents, and laboratory improvements. In this study, we summarize unsafe practices involving the improper installation of a Gas Chromatograph (GC) at an Iraqi university which, if not corrected, could have resulted in a dangerous fire and explosion. Wemore » summarize the identified infractions and highlight lessons learned. By openly sharing the experiences at the university involved, we hope to minimize the possibility of another researcher being injured due to similarly unsafe practices in the future.« less
Iranian pharmacists' knowledge, attitude and practice regarding counterfeit drugs.
Shahverdi, Shieda; Hajimiri, Mirhamed; Pourmalek, Farshad; Torkamandi, Hassan; Gholami, Kheirollah; Hanafi, Somayeh; Ashrafi Shahmirzadi, Nikinaz; Javadi, Mohammadreza
2012-01-01
Background Awareness of pharmacists about counterfeit drugs is necessary for health improvement in community. The purpose of the present study is to assess the knowledge and measure the professional attitude and practice of Iranian pharmacist about counterfeit drugs. In August 2008, a knowledge, attitude and practice (KAP) study was performed in a national sample of 794 pharmacists who participated in an Iranian Pharmacist Association congress. A questionnaire was prepared to collect Demographic and professional characteristics, Knowledge, attitude and practice of pharmacists regarding counterfeit drugs. The mean percent of participants who answer each practice questions correctly is 13.62% and none of questions have more than 14.7% of correct answer, while the participants' attitude towards the subject is at high level. None of demographic factors represented a significant relationship with knowledge and the only related parameters with attitude, were age and gender. Increasing age of pharmacists resulted in attitude improvement (p = 0.013) and women›s attitudes were better than men (p = 0.05).The only related parameters with practice, were the number of working hours per a week and attitude. Increasing the number of working hours per a week, resulted in decreasing the desirable practice (p = 0.041) and attitude also had a direct relationship with practice (p = 0.011). Conclusion The most important finding in the present study was the pharmacists› low knowledge and practice level about counterfeit drugs, while their attitude towards this subject was at a high level. The results point out the need for designing and implementing educational programs.
Choi, Sandy Pin-Pin; Cheung, Kin; Pang, Samantha Mei-Che
2013-04-01
To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice. © 2012 Blackwell Publishing Ltd.
The prevalence of work-related musculoskeletal disorders among sonographers.
Al-Rammah, Tamader Y; Aloufi, Areej S; Algaeed, Saffana K; Alogail, Noura S
2017-01-01
Work-related musculoskeletal disorders (WRMSDs) have a significant effect on the psychological and physical function of the sonographer. This study is concerned about finding the prevalence of WRMSDs among sonographers in the Kingdom of Saudi Arabia and assessing how to improve future practices and develop guidelines for safe, pain-free ultrasound departments. A survey was distributed to sonographers working in major hospitals in Riyadh, Saudi Arabia (n = 100, 83% response rate). The questionnaire focused on workload and ergonomics, pain existence and history, and the level of the sonographers' awareness of prevention measures and best practices. Ethical approval was obtained from a local Institutional Review Board. Eighty-four percent of respondents suffer from pain they associated with their ultrasound practice. The shoulder, back, neck and right hand were the main symptomatic body areas. Low levels of awareness about best practices and safety measures were revealed. There was a strong correlation between the degree of pain suffered and the years of practice, the number of patients scanned per day, and movements during the exam. Implementing standards and guidelines for best ultrasound practices is needed to develop better and safer ultrasound departments in Saudi hospitals for every practitioner.
Zwarenstein, Merrick; Reeves, Scott
2006-01-01
Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in interprofessional relations. Interprofessional education and collaboration interventions aim to improve interprofessional relations, which may in turn facilitate the work of knowledge translation and thus evidence-based practice. We summarize systematic review work on the effects of interventions for interprofessional education and collaboration. The current evidence base contains mainly descriptive studies of these interventions. Knowledge is limited regarding the impact on care and outcomes and the extent to which the interventions increase the practice of evidence-based care. Rigorous multimethod research studies are needed to develop and strengthen the current evidence base in this field. We describe a Health Canada-funded randomized trial in which quantitative and qualitative data will be gathered in 20 general internal medicine units located at 5 Toronto, Ontario, teaching hospitals. The project examines the impact of interprofessional education and collaboration interventions on interprofessional relationships, health care processes (including evidence-based practice), and patient outcomes. Routes are suggested by which interprofessional education and collaboration interventions might affect knowledge translation and evidence-based practice.
Klemenc-Ketis, Zalika; Poplas-Susič, Antonija
2017-12-01
To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients. We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements. © 2017 John Wiley & Sons Ltd.
Hispanic construction workers and assertiveness training.
Shrestha, Pramen P; Menzel, Nancy N
2014-01-01
Hispanic (Latino) construction workers experience disparities in occupational death and injury rates in the United States. The cultural value of respect for those in authority may hinder these workers from requesting safe working conditions from supervisors. To evaluate whether Hispanic construction workers in Las Vegas, Nevada found assertiveness training more useful than non-Hispanic trainees and whether or not they practiced this behavior at work after the training. An assertiveness training simulation was part of fall prevention classes offered to area construction workers. Eight weeks after the training, participants were interviewed by telephone about class topics they found most useful and whether or not they had made any subsequent behavior changes at work. More than half of the 760 fall prevention trainees completed telephone interviews. A smaller proportion of Hispanic trainees found assertiveness training to be useful (11%) than non-Hispanics (28%) (p⩽ 0.001). Only 2% of both groups identified practicing assertiveness at work. A large proportion of Hispanic trainees valued other knowledge more highly. They may weigh job security as more important than speaking up about safety issues, which might threaten their employment. Interventions to improve safety should focus instead on improving work safety climate and engineering controls.
Perceptions of Interdisciplinary Communication Among Correctional Health Care Providers.
Costa, Christine; Lusk, Pamela
2017-01-01
Collaborative practice is a health care standard that improves patient outcomes through maximizing the use of resources and mutual work of all health care providers. Since collaborative practice depends on interdisciplinary communication, effective communication training for health care participants is imperative for success. This article presents the results of research that studied perceptions of interdisciplinary communication and collaborative practice among 24 health care personnel in three correctional facilities in Orange County, California. The research explored different approaches in terms of team structure, mutual support, situation monitoring, leadership, and communication practices. The study used questionnaires to examine the perceptions of teamwork and interdisciplinary communication and how they can be impacted by one educational session. The study results are discussed in terms of modern approaches to health care, including evidence-based practice, along with nationwide initiatives for improving the health of inmates with psychiatric issues.
Action learning: an effective way to improve cancer-related pain management.
Kasasbeh, Mohammed Ali Mohammed; McCabe, Catherine; Payne, Sheila
2017-11-01
To evaluate the efficacy of action learning for improving cancer related pain management in the acute healthcare settings. Despite the prevalent use of action learning in private, public, clinical and non-clinical settings, no studies were found in the literature that either examined cancer pain management or used action learning as an approach to improve patient care in acute healthcare settings. An intervention pre - posttest design was adopted using an action learning programme (ALPs) as the intervention. Healthcare professionals' knowledge, attitudes and practice were assessed and evaluated before and after the implementation of the six-month ALPs. A pre and post audit and survey were conducted for data collection. The data were collected from the entire population of 170 healthcare professionals in one healthcare organisation. The management of cancer related pain improved significantly following the intervention. Significant improvement were also seen in healthcare professionals' knowledge, attitudes with improved cancer related pain management as a consequence of this. Despite many organisational challenges to practice development and collaborative working in healthcare settings there is evidence that action learning can achieve positive outcomes for improving CRP and supporting collaborative working. Action learning needs to be considered as a strategy for achieving high quality standards. © 2016 John Wiley & Sons Ltd.
Five Steps for Improving Evaluation Reports by Using Different Data Analysis Methods.
ERIC Educational Resources Information Center
Thompson, Bruce
Although methodological integrity is not the sole determinant of the value of a program evaluation, decision-makers do have a right, at a minimum, to be able to expect competent work from evaluators. This paper explores five areas where evaluators might improve methodological practices. First, evaluation reports should reflect the limited…
USDA-ARS?s Scientific Manuscript database
Despite millions of dollars invested in soil and water conservation practices and other landscape interventions in the Ethiopian highlands and billions of hours of food-for-work farm labor, sediment concentration in rivers is increasing. Possible ways to reverse the current trend have been investiga...
ERIC Educational Resources Information Center
Johanson, Megan; Arthur, Ann M.
2016-01-01
Background: Improving children's oral language skills is an important focus of educational research and practice; however, relatively few interventions have demonstrated impacts on these skills. This work makes a unique contribution to our understanding of the effects of language-focused interventions in pre-kindergarten settings by examining…
ERIC Educational Resources Information Center
Jones, Christopher M.
2013-01-01
In the 21st century, increased school accountability has sharpened the focus of school and district leaders on improving instructional practice to raise student achievement. The implementation of professional leaning communities (PLCs) is one improvement effort in which schools establish collaborative cultures focused on increasing student…
ERIC Educational Resources Information Center
Travis, Timothy J.
2015-01-01
Instructional rounds are an emerging network structure with processes and protocols designed to develop superintendents' knowledge and skills in leading large-scale improvement, to enable superintendents to build an infrastructure that supports the work of improvement, to assist superintendents in distributing leadership throughout their district,…
(Re)viewing Assessment: Changing Lenses to Refocus on Learning
ERIC Educational Resources Information Center
James, Mary
2017-01-01
In this commentary, Mary James highlights two problems she deemed critical during her work exploring the relationships between assessment and learning in theory and practice. First, efforts to improve assessment for learning were not always successful either in improving performance or in other ways. Second, and this may be a reason for the first…
ERIC Educational Resources Information Center
Murphy, Sean
2013-01-01
The saxophone section of a wind ensemble can easily be one of the most frustrating to work with when it comes to producing a clear, characteristic tone. Sometimes, the road to an improved sound can be a long path of daily diligence and practice; however, there are many quicker solutions that will drastically improve a student's tone. This article…
Mahmoudi, Babak; Erfanian, Abbas
2006-11-01
Mental imagination is the essential part of the most EEG-based communication systems. Thus, the quality of mental rehearsal, the degree of imagined effort, and mind controllability should have a major effect on the performance of electro-encephalogram (EEG) based brain-computer interface (BCI). It is now well established that mental practice using motor imagery improves motor skills. The effects of mental practice on motor skill learning are the result of practice on central motor programming. According to this view, it seems logical that mental practice should modify the neuronal activity in the primary sensorimotor areas and consequently change the performance of EEG-based BCI. For developing a practical BCI system, recognizing the resting state with eyes opened and the imagined voluntary movement is important. For this purpose, the mind should be able to focus on a single goal for a period of time, without deviation to another context. In this work, we are going to examine the role of mental practice and concentration skills on the EEG control during imaginative hand movements. The results show that the mental practice and concentration can generally improve the classification accuracy of the EEG patterns. It is found that mental training has a significant effect on the classification accuracy over the primary motor cortex and frontal area.
Schneider, Carl R; Everett, Alan W; Geelhoed, Elizabeth; Padgett, Cale; Ripley, Scott; Murray, Kevin; Kendall, Peter A; Clifford, Rhonda M
2010-01-01
Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.
Efficacy beliefs predict collaborative practice among intensive care unit nurses.
Le Blanc, Pascale M; Schaufeli, Wilmar B; Salanova, Marisa; Llorens, Susana; Nap, Raoul E
2010-03-01
This paper is a report of an investigation of whether intensive care nurses' efficacy beliefs predict future collaborative practice, and to test the potential mediating role of team commitment in this relationship. Recent empirical studies in the field of work and organizational psychology have demonstrated that (professional) efficacy beliefs are reciprocally related to workers' resources and well-being over time, resulting in a positive gain spiral. Moreover, there is ample evidence that workers' affective commitment to their organization or work-team is related to desirable work behaviours such as citizenship behaviour. A longitudinal design was applied to questionnaire data from the EURICUS-project. Structural Equation Modelling was used to analyse the data. The sample consisted of 372 nurses working in 29 different European intensive care units. Data were collected in 1997 and 1998. However, our research model deals with fundamental psychosocial processes that are not time-dependent. Moreover, recent empirical literature shows that there is still room for improvement in ICU collaborative practice. The hypotheses that (i) the relationship between efficacy beliefs and collaborative practice is mediated by team commitment and (ii) efficacy beliefs, team commitment and collaborative practice are reciprocally related were supported, suggesting a potential positive gain spiral of efficacy beliefs. Healthcare organizations should create working environments that provide intensive care unit nurses with sufficient resources to perform their job well. Further research is needed to design and evaluate interventions for the enhancement of collaborative practice in intensive care units.
Chang, Anna; Bowen, Judith L; Buranosky, Raquel A; Frankel, Richard M; Ghosh, Nivedita; Rosenblum, Michael J; Thompson, Sara; Green, Michael L
2013-06-01
The U.S. faces a critical gap between residency training and clinical practice that affects the recruitment and preparation of internal medicine residents for primary care careers. The patient-centered medical home (PCMH) represents a new clinical microsystem that is being widely promoted and implemented to improve access, quality, and sustainability in primary care practice. We address two key questions regarding the training of internal medicine residents for practice in PCMHs. First, what are the educational implications of practice transformations to primary care home models? Second, what must we do differently to prepare internal medicine residents for their futures in PCMHs? The 2011 Society of General Internal Medicine (SGIM) PCMH Education Summit established seven work groups to address the following topics: resident workplace competencies, teamwork, continuity of care, assessment, faculty development, 'medical home builder' tools, and policy. The output from the competency work group was foundational for the work of other groups. The work group considered several educational frameworks, including developmental milestones, competencies, and entrustable professional activities (EPAs). The competency work group defined 25 internal medicine resident PCMH EPAs. The 2011 National Committee for Quality Assurance (NCQA) PCMH standards served as an organizing framework for EPAs. The list of PCMH EPAs has the potential to begin to transform the education of internal medicine residents for practice and leadership in the PCMH. It will guide curriculum development, learner assessment, and clinical practice redesign for academic health centers.
Working memory plasticity and aging.
Rhodes, Rebecca E; Katz, Benjamin
2017-02-01
The present research explores how the trajectory of learning on a working memory task changes throughout the life span, and whether gains in working memory performance are exclusively a question of initial working memory capacity (WMC) or whether age exerts an independent effect. In a large, cross-sectional study of younger, middle-aged, and older adults, we examined learning on a widely used working memory task-the dual n-back task-over 20 sessions of practice. We found that, while all age groups improved on the task, older adults demonstrated less improvement on the task, and also reached a lower asymptotic maximum performance than younger adults. After controlling for initial WMC, we found that age exerted independent effects on training gains and asymptotic performance; older adults tended to improve less and reached lower levels of performance than younger adults. The difference between younger and older adults' rates of learning depended in part on initial WMC. These results suggest that age-related effects on working memory include not only effects on capacity, but also plasticity and the ability to improve on a task. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Bloor, D. U.
1981-01-01
The origin and work of the nineteenth century certifying surgeons is described. Their place within the broad spectrum of general practice is emphasized and their efforts to improve the welfare of children is noted. PMID:7021817
Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan
2014-03-20
To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, p<0.001). There was an improvement in the number of clinicians reporting satisfactory practice when diagnosing AKI, 50% vs 68% (χ²=12.1, p<0.001) and investigating patients with AKI, 48% vs 64% (χ²=9.5, p=0.002). Clinical audit makers showed a trend towards better clinical practice. This quality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.
Interprofessional leadership training in MCH social work.
Pecukonis, Edward; Doyle, Otima; Acquavita, Shauna; Aparicio, Elizabeth; Gibbons, Maya; Vanidestine, Todd
2013-01-01
The need to train health social workers to practice interprofessionally is an essential goal of social work education. Although most health social workers have exposure to multidisciplinary practice within their field work, few social work education programs incorporate interprofessional learning as an integrated component of both course work and field experiences (McPherson, Headrick, & Moss, 2001; Reeves, Lewin, Espin, & Zwaranstein, 2010; Weinstein, Whittington, & Leiba, 2003). In addition, little is written about the kinds of curricula that would effectively promote interdisciplinary training for social work students. These findings are particularly puzzling since there is increasing and compelling evidence that interdisciplinary training improves health outcomes (IOM, 2001). This article describes a social work education program that incorporates an Interprofessional education and leadership curriculum for Maternal and Child Health Social Work (MCHSW) at the University of Maryland's School of Social Work. The University of Maryland's Interprofesisonal Training Model is described along with the components needed to formulate an interdisciplinary learning experience. Various outcomes and lessons learned are discussed.
Causal Impact of Employee Work Perceptions on the Bottom Line of Organizations.
Harter, James K; Schmidt, Frank L; Asplund, James W; Killham, Emily A; Agrawal, Sangeeta
2010-07-01
Perceptions of work conditions have proven to be important to the well-being of workers. However, customer loyalty, employee retention, revenue, sales, and profit are essential to the success of any business. It is known that these outcomes are correlated with employee attitudes and perceptions of work conditions, but the research into direction of causality has been inconclusive. Using a massive longitudinal database that included 2,178 business units in 10 large organizations, we found evidence supporting the causal impact of employee perceptions on these bottom-line measures; reverse causality of bottom-line measures on employee perceptions existed but was weaker. Managerial actions and practices can impact employee work conditions and employee perceptions of these conditions, thereby improving key outcomes at the organizational level. Perceptions of specific work conditions that engage employees in their work provide practical guidance in how best to manage people to obtain desired results. © The Author(s) 2010.
Karma yoga: A path towards work in positive psychology
Kumar, Arun; Kumar, Sanjay
2013-01-01
Karma yoga is the path that leads to salvation through action. Salvation is the ultimate state of consciousness. Work is the central and defining characteristic of life. It may have intrinsic value, instrumental value, or both. Instrumental value includes incentive, dignity and power, etc., which is the result expected from the work. The Gita teaches us to do work without thinking of result (work with intrinsic value). Attachment with the result leads to stress, competition and aggression. Stress further gives rise to heart ailments, depression and suicide. Positive psychology studies the factors and conditions leading to pleasurable and satisfying life. Understanding Karma yoga and its practice has a similar role that lead an individual towards work and leading to a satisfied life. This may play a unique role towards practical aspects of positive psychology to improve one's lifestyle and aid in the treatment of stress disorders. PMID:23858246
Pedersen, Line Bjørnskov; Gyrd-Hansen, Dorte
2014-07-01
This study examines the preferences of general practitioners (GPs) in training for organizational characteristics in general practice with focus on aspects that can mitigate problems with GP shortages. A discrete choice experiment was used to investigate preferences for the attributes practice type, number of GPs in general practice, collaboration with other practices, change in weekly working hours (administrative versus patient related), and change in yearly surplus. In May 2011, all doctors actively engaged in the family medicine program in Denmark were invited to participate in a web-based survey. A total of 485 GPs in training responded to the questionnaire, resulting in a response rate of 56%. A mixed logit model showed that GPs in training prefer to work in smaller shared practices (2 GPs). This stands in contrast to the preferences of current GPs. Hence, a generational change in the GP population is likely to introduce more productive practice forms, and problems with GP shortages are likely to be mitigated over the coming years. Results further showed that a majority of the respondents are willing to work in larger shared practices (with 3-4 GPs) if they receive an increase in surplus (approximately 50,000 DKK/6,719 EUR per year) and that they may be willing to take in more patient-related work if the increase in surplus is sufficient (approximately 200,000 DKK/26,875 EUR per year for 5 extra hours per week). Monetary incentives may therefore be an effective tool for further improving productivity.
How behavioural science can contribute to health partnerships: the case of The Change Exchange.
Byrne-Davis, Lucie M T; Bull, Eleanor R; Burton, Amy; Dharni, Nimarta; Gillison, Fiona; Maltinsky, Wendy; Mason, Corina; Sharma, Nisha; Armitage, Christopher J; Johnston, Marie; Byrne, Ged J; Hart, Jo K
2017-06-12
Health partnerships often use health professional training to change practice with the aim of improving quality of care. Interventions to change practice can learn from behavioural science and focus not only on improving the competence and capability of health professionals but also their opportunity and motivation to make changes in practice. We describe a project that used behavioural scientist volunteers to enable health partnerships to understand and use the theories, techniques and assessments of behavioural science. This paper outlines how The Change Exchange, a collective of volunteer behavioural scientists, worked with health partnerships to strengthen their projects by translating behavioural science in situ. We describe three case studies in which behavioural scientists, embedded in health partnerships in Uganda, Sierra Leone and Mozambique, explored the behaviour change techniques used by educators, supported knowledge and skill development in behaviour change, monitored the impact of projects on psychological determinants of behaviour and made recommendations for future project developments. Challenges in the work included having time and space for behavioural science in already very busy health partnership schedules and the difficulties in using certain methods in other cultures. Future work could explore other modes of translation and further develop methods to make them more culturally applicable. Behavioural scientists could translate behavioural science which was understood and used by the health partnerships to strengthen their project work.
Virji, M Abbas; Woskie, Susan R; Pepper, Lewis D
2009-02-01
A 2005 regulatory review of the lead in construction standard by the Occupational Safety and Health Administration (OSHA) noted that alternative pathways of exposure can be as significant as inhalation exposure and that noncompliance with the standard pertaining to hygiene facilities and practices was the second most commonly violated section of the standard. Noncompliance with provisions of the standard and unhealthy work and hygiene practices likely increase the likelihood of take-home lead via contaminated clothing, automobiles, and skin, thus contributing to elevated blood lead levels (BLL) among construction workers and their family members. We performed a cross-sectional study of bridge painters working for small contractors in Massachusetts to investigate causes of persistent elevated BLLs and to assess lead exposures. Thirteen work sites were evaluated for a 2-week period during which surface and skin wipe samples were collected and qualitative information was obtained on personal hygiene practices, decontamination and hand wash facilities, and respiratory protection programs. Results showed lead contamination on workers' skin, respirators, personal automobiles, and the decontamination unit, indicating a significant potential for take-home lead exposure. Overall, the geometric mean (GM) skin lead levels ranged from 373 microg on workers' faces at end of shift to 814 microg on hands at break time. The overall GM lead level inside respirators was 143 microg before work and 286 microg after work. Lead contamination was also present inside workers' personal vehicles as well as on surfaces inside the clean side of the decontamination unit. Review of the respiratory protection programs, work site decontamination and hand wash facilities, and personal hygiene practices indicated that these factors had significant impact on skin and surface contamination levels and identified significant opportunities for improving work site facilities and personal practices. Elevated lead exposure and BLL can be minimized by strict adherence to the OSHA provisions for functioning decontamination and hygiene facilities and healthy personal hygiene practices.
Science and Social Practice: Action Research and Activity Theory as Socio-Critical Approaches
ERIC Educational Resources Information Center
Langemeyer, Ines
2011-01-01
Action research and activity theory are considered by a number of followers as socio-critical approaches, whereas others do not relate them to social-criticism and use them merely as methods to improve practice. This article searches for general insights in Kurt Lewin's and Lev S. Vygotsky's work into how one proceeds and acts critically. In their…
Strength in Numbers: Data-Driven Collaboration May Not Sound Sexy, But it Could Save Your Job
ERIC Educational Resources Information Center
Buzzeo, Toni
2010-01-01
This article describes a practical, sure-fire way for media specialists to boost student achievement. The method is called data-driven collaboration, and it's a practical, easy-to-use technique in which media specialists and teachers work together to pinpoint kids' instructional needs and improve their essential skills. The author discusses the…
Improving Disciplinary Practices in an Urban School: Solving the Problem of Practice
ERIC Educational Resources Information Center
Colcord, Cean R.; Mathur, Sarup R.; Zucker, Stanley H.
2016-01-01
In this article, the authors share a case study of a special educator who worked closely with a leadership team in an urban elementary school to establish universal behavior expectations for all students. The special educator was a behavior coach in the urban elementary school located in a southwestern school of the United States of America.…
ERIC Educational Resources Information Center
Lehman, James D.; Kim, WooRi; Harris, Constance
2014-01-01
The new standards for K-12 science education in the United States call for science teachers to integrate engineering concepts and practices within their science teaching in order to improve student learning. To accomplish this, teachers need appropriate instructional materials as well as the knowledge and skills to effectively use them. This mixed…
ERIC Educational Resources Information Center
Smith, Erica; Comyn, Paul; Kemmis, Roslin Brennan; Smith, Andy
2009-01-01
This study explores the common features of high-quality traineeships using case studies from the cleaning, child care, construction, retail, finance and insurance, and meat processing areas. The research identifies a range of policy measures that could improve both the practice and image of traineeships. A good practice guide has also been…
ERIC Educational Resources Information Center
Larson, Reed W.; Walker, Kathrin C.; Rusk, Natalie; Diaz, Lisa B.
2015-01-01
This article calls for research on the expertise of youth development practitioners. We argue for studies focused on understanding youth practice from practitioners' points of view--as they experience and enact it--with the aim of contributing findings and frameworks that are helpful to their work and learning. To improve youth programs, first, it…
Berry, Anne S; Zanto, Theodore P; Rutman, Aaron M; Clapp, Wesley C; Gazzaley, Adam
2009-09-01
Working memory (WM) performance is impaired by the presence of external interference. Accordingly, more efficient processing of intervening stimuli with practice may lead to enhanced WM performance. To explore the role of practice on the impact that interference has on WM performance, we studied young adults with electroencephalographic (EEG) recordings as they performed three motion-direction, delayed-recognition tasks. One task was presented without interference, whereas two tasks introduced different types of interference during the interval of memory maintenance: distractors and interruptors. Distractors were to be ignored, whereas interruptors demanded attention based on task instructions for a perceptual discrimination. We show that WM performance was disrupted by both types of interference, but interference-induced disruption abated across a single experimental session through rapid learning. WM accuracy and response time improved in a manner that was correlated with changes in early neural measures of interference processing in visual cortex (i.e., P1 suppression and N1 enhancement). These results suggest practice-related changes in processing interference exert a positive influence on WM performance, highlighting the importance of filtering irrelevant information and the dynamic interactions that exist between neural processes of perception, attention, and WM during learning.
Cultural competence in mental health care: a review of model evaluations
Bhui, Kamaldeep; Warfa, Nasir; Edonya, Patricia; McKenzie, Kwame; Bhugra, Dinesh
2007-01-01
Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes. PMID:17266765
Community psychology practice: expanding the impact of psychology's work.
Wolff, Tom
2014-11-01
This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Bolívar Murcia, María Paula; Cruz González, Joan Paola; Rodríguez Bello, Luz Angélica
2018-02-01
Evaluate the change over time of psychosocial risk management for the nursing personnel of an intermediate complexity clinic of Bogota (Colombia). Descriptive and correlational research performed under the approach of risk management (identification, analysis, assessment and treatment). The psychosocial risk of the nursing personnel was studied through 10-year system dynamics models (with and without the implementation of the policy of good practices on the risk treatment) in two scenarios: when the nursing personnel works shifts of 6 hours (morning or afternoon) and when they work over 12 hours (double shift or night shift). When implementing a policy of good practices on the risk treatment, the double shift scenario shows an improvement among 25% to 88% in the variables of: health, labor motivation, burnout, service level and productivity; as well as in the variables of the organization associated to number of patients, nursing personnel and profit. Likewise, the single shift scenario with good practices improves in all the above-mentioned variables and generates stability on the variables of absenteeism and resignations. The best scenario is the single shift scenario with the application of good practices of risk treatment in comparison with the double shift scenario with good practices, which allows concluding that the good practices have a positive effect on the variables of nursing personnel and on those associated to the organization. Copyright© by the Universidad de Antioquia.
Anderson, J E; Ross, A J; Back, J; Duncan, M; Snell, P; Walsh, K; Jaye, P
2016-01-01
Resilience engineering (RE) is an emerging perspective on safety in complex adaptive systems that emphasises how outcomes emerge from the complexity of the clinical environment. Complexity creates the need for flexible adaptation to achieve outcomes. RE focuses on understanding the nature of adaptations, learning from success and increasing adaptive capacity. Although the philosophy is clear, progress in applying the ideas to quality improvement has been slow. The aim of this study is to test the feasibility of translating RE concepts into practical methods to improve quality by designing, implementing and evaluating interventions based on RE theory. The CARE model operationalises the key concepts and their relationships to guide the empirical investigation. The settings are the Emergency Department and the Older Person's Unit in a large London teaching hospital. Phases 1 and 2 of our work, leading to the development of interventions to improve the quality of care, are described in this paper. Ethical approval has been granted for these phases. Phase 1 will use ethnographic methods, including observation of work practices and interviews with staff, to understand adaptations and outcomes. The findings will be used to collaboratively design, with clinical staff in interactive design workshops, interventions to improve the quality of care. The evaluation phase will be designed and submitted for ethical approval when the outcomes of phases 1 and 2 are known. Study outcomes will be knowledge about the feasibility of applying RE to improve quality, the development of RE theory and a validated model of resilience in clinical work which can be used to guide other applications. Tools, methods and practical guidance for practitioners will also be produced, as well as specific knowledge of the potential effectiveness of the implemented interventions in emergency and older people's care. Further studies to test the application of RE at a larger scale will be required, including studies of other healthcare settings, organisational contexts and different interventions.
42 CFR 87.4 - For what purposes may grants be awarded?
Code of Federal Regulations, 2010 CFR
2010-10-01
... Safety and Health Act authorizes grants for research, experiments, and demonstrations relating to... projects designed to: (1) Improve working conditions and practices affecting health in coal or other mines...
42 CFR 87.4 - For what purposes may grants be awarded?
Code of Federal Regulations, 2011 CFR
2011-10-01
... Safety and Health Act authorizes grants for research, experiments, and demonstrations relating to... projects designed to: (1) Improve working conditions and practices affecting health in coal or other mines...
Kolb, Patricia
2013-01-01
This article describes the goals and methods of the international Writing Across the Curriculum (WAC) movement in higher education, and WAC-enriched learning approaches that the author used in teaching a social work gerontology practice course and a sociological theories of aging course. The author's in-class, low-stakes, nongraded writing assignments facilitated students' development of knowledge about gerontological practice and sociological theories, as well as analytical thinking. The assignments are influenced by WAC's perspective that when students write their reactions to information, their understanding and retention of information improves; that writing can facilitate the application of new content to students' own lives and interests; and that increased frequency of writing increases writing comfort and maintenance and can result in the improvement of writing skills. The students' reactions to the assignments have been very positive.
Attracting and retaining GPs: a stakeholder survey of priorities.
Lorant, Vincent; Geerts, Charlotte; Duchesnes, Christiane; Goedhuys, Jo; Ryssaert, Lynn; Remmen, Roy; D'hoore, William
2011-07-01
Despite being a key player in the healthcare system, training and practising general practice has become less attractive in many countries and is in need of reform. To identify political priorities for improving GPs' attraction to the profession and their retention within it. Stakeholder face-to-face survey in Belgium, 2008. A total of 102 key stakeholders were recruited from policymakers, professional groups, academia, GP leaders, and the media. All interviewees were asked to score 23 policies on four criteria: effectiveness in attracting and retaining GPs, cost to society, acceptance by other health professionals, and accessibility of care. An overall performance score was computed (from -3 to +3) for each type of policy - training, financing, work-life balance, practice organisation, and governance - and for innovative versus conservative policies. Practice organisation policies and training policies received the highest scores (mean score ≥ 1.11). Financing policies, governance, and work-life balance policies scored poorly (mean score ≤ 0.65) because they had negative effects, particularly in relation to cost, acceptance, and accessibility of care. Stakeholders were keen on moving GPs towards team work, improving their role as care coordinator, and helping them to offload administrative tasks (score ≥ 1.4). They also favoured moves to increase the early and integrated exposure of all medical students to general practice. Overall, conservative policies were better scored than innovative ones (beta = -0.16, 95% confidence interval = -0.28 to -0.03). The reforming of general practice is made difficult by the small-step approach, as well as the importance of decision criteria related to cost, acceptance, and access.
Scotland's Knowledge Network: translating knowledge into action to improve quality of care.
Wales, A; Graham, S; Rooney, K; Crawford, A
2012-11-01
The Knowledge Network (www.knowledge.scot.nhs.uk) is Scotland's online knowledge service for health and social care. It is designed to support practitioners to apply knowledge in frontline delivery of care, helping to translate knowledge into better health-care outcomes through safe, effective, person-centred care. The Knowledge Network helps to combine the worlds of evidence-based practice and quality improvement by providing access to knowledge about the effectiveness of clinical interventions ('know-what') and knowledge about how to implement this knowledge to support individual patients in working health-care environments ('know-how'). An 'evidence and guidance' search enables clinicians to quickly access quality-assured evidence and best practice, while point of care and mobile solutions provide knowledge in actionable formats to embed in clinical workflow. This research-based knowledge is complemented by social networking services and improvement tools which support the capture and exchange of knowledge from experience, facilitating practice change and systems improvement. In these cases, the Knowledge Network supports key components of the knowledge-to-action cycle--acquiring, creating, sharing and disseminating knowledge to improve performance and innovate. It provides a vehicle for implementing the recommendations of the national Knowledge into Action review, which outlines a new national approach to embedding knowledge in frontline practice and systems improvement.
Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J
2014-09-01
In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs' perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs' perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. © The Author(s) 2013.
Bayer, Angela M.; Garvich, Mijail; Díaz, David A.; Sánchez, Hugo; García, Patricia J.; Coates, Thomas J.
2014-01-01
In Peru, there are few studies on male sex workers (MSWs) and existing studies explore limited sub-groups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives and HIV/STI risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health and well-being. PMID:24368712
LaGrone, L N; Isquith-Dicker, L N; Huaman Egoavil, E; Herrera-Matta, J J; Fuhs, A K; Ortega Checa, D; Revoredo, F; Rodriguez Castro, M J A; Mock, C N
2017-05-01
Dual-practice, simultaneous employment by healthcare workers in the public and private sectors is pervasive worldwide. Although an estimated 30 per cent of the global burden of disease is surgical, the implications of dual practice on surgical care are not well understood. Anonymous in-depth individual interviews on trauma quality improvement practices were conducted with healthcare providers who participate in the care of the injured at ten large hospitals in Peru's capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians' time, quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills, and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Surgeons in Peru report that dual practice influences patient care negatively by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.
Garman, Andrew N; McAlearney, Ann Scheck; Harrison, Michael I; Song, Paula H; McHugh, Megan
2011-01-01
: Although management practices are recognized as important factors in improving health care quality and efficiency, most research thus far has focused on individual practices, ignoring or underspecifying the contexts within which these practices are operating. Research from other industries, which has increasingly focused on systems rather than individual practices, has yielded results that may benefit health services management. : Our goal was to develop a conceptual model on the basis of prior research from health care as well as other industries that could be used to inform important contextual considerations within health care. : Using theoretical frameworks from A. Donabedian (1966), P. M. Wright, T. M. Gardner, and L. M. Moynihan (2003), and B. Schneider, D. B. Smith, and H. W. Goldstein (2000) and review methods adapted from R. Pawson (2006b), we reviewed relevant research from peer-reviewed and other industry-relevant sources to inform our model. The model we developed was then reviewed with a panel of practitioners, including experts in quality and human resource management, to assess the applicability of the model to health care settings. : The resulting conceptual model identified four practice bundles, comprising 14 management practices as well as nine factors influencing adoption and perceived sustainability of these practices. The mechanisms by which these practices influence care outcomes are illustrated using the example of hospital-acquired infections. In addition, limitations of the current evidence base are discussed, and an agenda for future research in health care settings is outlined. : Results may help practitioners better conceptualize management practices as part of a broader system of work practices. This may, in turn, help practitioners to prioritize management improvement efforts more systematically.
Melby-Lervåg, Monica; Redick, Thomas S.; Hulme, Charles
2016-01-01
It has been claimed that working memory training programs produce diverse beneficial effects. This article presents a meta-analysis of working memory training studies (with a pretest-posttest design and a control group) that have examined transfer to other measures (nonverbal ability, verbal ability, word decoding, reading comprehension, or arithmetic; 87 publications with 145 experimental comparisons). Immediately following training there were reliable improvements on measures of intermediate transfer (verbal and visuospatial working memory). For measures of far transfer (nonverbal ability, verbal ability, word decoding, reading comprehension, arithmetic) there was no convincing evidence of any reliable improvements when working memory training was compared with a treated control condition. Furthermore, mediation analyses indicated that across studies, the degree of improvement on working memory measures was not related to the magnitude of far-transfer effects found. Finally, analysis of publication bias shows that there is no evidential value from the studies of working memory training using treated controls. The authors conclude that working memory training programs appear to produce short-term, specific training effects that do not generalize to measures of “real-world” cognitive skills. These results seriously question the practical and theoretical importance of current computerized working memory programs as methods of training working memory skills. PMID:27474138
An empirical definition of clinical supervision.
Milne, Derek
2007-11-01
The growing recognition of clinical supervision as the basis for high-quality mental health services is apparent in policy, research and clinical practice, but an empirical definition is required to progress research and practice. A logical analysis was used to draft a working definition, and then a systematic review of 24 empirical studies of clinical supervision produced a best evidence synthesis, which was used to test and improve this definition. The logical analysis indicated that the most popular definition (Bernard & Goodyear, 1992) failed all four necessary tests of a good definition: precision, specification, operationalization and corroboration. The systematic review synthesis was then used to test the working definition, which passed these tests (with two amendments). These two complementary review approaches created a firmer basis for advancing research and practice.
Full practice authority--effecting change and improving access to care: the Nevada journey.
VanBeuge, Susan S; Walker, Tomas
2014-06-01
In 2013, Nevada shifted from a collaborative practice model to full practice authority. Given the challenges many states still face, this article provides an outline of the evolution of the "nurse practitioner" (NP) in Nevada. Reviewing the path Nevada took toward full practice authority, we hope to provide insight including lessons learned and opposition encountered to assist other states working toward full practice authority. Literature searches were conducted on PubMed and MEDLINE. Search terms included "autonomous practice," "nurse practitioner," and "full practice authority." Healthcare reform will require nurse practitioners committed to legislative change. Nurse practitioners have the knowledge and ability to affect the legislative process and improve patients' access to care. With careful planning, full engagement, and team building, making a statute change is possible and should be seriously considered in states still struggling with collaborative relationships. Nurse practitioners are well situated to provide primary care in the United States. Removing barriers to practice through statute change will empower NPs to effect positive change in our struggling healthcare system. ©2014 The Author(s) ©2014 American Association of Nurse Practitioners.
A case study: the initiative to improve RN scheduling at Hamilton Health Sciences.
Wallace, Laurel-Anne; Pierson, Sharon
2008-01-01
In 2003, Hamilton Health Sciences embarked on an initiative to improve and standardize nursing schedules and scheduling practices. The scheduling project was one of several initiatives undertaken by a corporate-wide Nursing Resource Group established to enhance the work environment and patient care and to ensure appropriate utilization of nursing resources across the organization's five hospitals. This article focuses on major activities undertaken in the scheduling initiative. The step-by-step approach described, plus examples of the scheduling resources developed and samples of extended-tour schedules, will all provide insight, potential strategies and practical help for nursing administrators, human resources (HR) personnel and others interested in improving nurse scheduling.
Ergonomic design for dental offices.
Ahearn, David J; Sanders, Martha J; Turcotte, Claudia
2010-01-01
The increasing complexity of the dental office environment influences productivity and workflow for dental clinicians. Advances in technology, and with it the range of products needed to provide services, have led to sprawl in operatory setups and the potential for awkward postures for dental clinicians during the delivery of oral health services. Although ergonomics often addresses the prevention of musculoskeletal disorders for specific populations of workers, concepts of workflow and productivity are integral to improved practice in work environments. This article provides suggestions for improving workflow and productivity for dental clinicians. The article applies ergonomic principles to dental practice issues such as equipment and supply management, office design, and workflow management. Implications for improved ergonomic processes and future research are explored.
Cho, Hyeonmi; Han, Kihye
2018-05-14
This study aimed to determine the relationships among the unit-level nursing work environment and individual-level health-promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. This study used a cross-sectional design. Data were collected using self-reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health-promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile-II, respectively. Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse-physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health-promotion interventions for spiritual growth and health responsibility are needed. Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses' responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes. © 2018 Sigma Theta Tau International.
Integration of Simulation into Pre-Laboratory Chemical Course: Computer Cluster versus WebCT
ERIC Educational Resources Information Center
Limniou, Maria; Papadopoulos, Nikos; Whitehead, Christopher
2009-01-01
Pre-laboratory activities have been known to improve students' preparation before their practical work as they assist students to make available more working memory capacity for actual learning during the laboratory. The aim of this investigation was to compare two different teaching approaches which supported a pre-laboratory session by using the…
ERIC Educational Resources Information Center
Floyd, Alan; Morrison, Marlene
2014-01-01
Although the concept of multi-agency working has been pursued and adopted as the most appropriate way to improve childcare provision and health workforces in recent years, both in the UK and more globally, research suggests that participation in such work can be problematic. This article examines current developments in inter-professional…
Interdisciplinary Working Practices: Can Creative Dance Improve Math?
ERIC Educational Resources Information Center
Leandro, Cristina Rebelo; Monteiro, Elisabete; Melo, Filipe
2018-01-01
This study is integrated in the field of Dance in Education, focusing on the instrumentalist aspect of art. We focused on creative dance as a catalyst to learn Mathematics' contents. This interdisciplinary work can enhance the learning, as far as the understanding of Mathematics' concepts is achieved through the body and revealed by expressive and…
The Best Laid Plans: Designing Incentive Programs for School Leaders. WCER Working Paper No. 2014-7
ERIC Educational Resources Information Center
Goff, Peter; Goldring, Ellen; Canney, Melissa
2014-01-01
Notable attention and effort has been directed toward improving educator productivity through the use of performance incentives. Little of this work has focused on incentive systems for school leaders (principals) and less yet examines performance pay systems used in practice. This research uses 34 funded grants from the federal Teacher Incentive…
Commentary: Challenges of Forging Partnerships to Advance Mental Health Science and Practice
ERIC Educational Resources Information Center
Nastasi, Bonnie K.
2003-01-01
The article by Fantuzzo, McWayne, and Bulotsky (2003) describes a model for addressing the former U.S. Surgeon General's (USDHHS, 1999) priorities for improving mental health service delivery to the nation's children. The authors identify several elements that characterize their own work and that can guide the work of school psychologists and…
Growing What Works: Lessons Learned Replicating Promising Practices for Latino Student Success
ERIC Educational Resources Information Center
Santiago, Deborah A.; Lopez, Estela
2013-01-01
How does the country accelerate Latino student success in higher education? The U.S. has to find programs and strategies that improve the success of Latino students, and then replicate or scale up those programs and strategies to serve more students. Those are the basic principles behind "Excelencia" in Education's Growing What Works (GWW)…
Strategic planning applied to quality in asthma management for children.
Goonan, K J; Healy, J M; Jordan, H S; Zazzali, J L; Horowitz, M
1993-01-01
This strategic plan translates the HCHP vision statement into a working plan for one major clinical condition--asthma in children. It is a working plan for clinicians and managers across specialties and levels. The results of the projects will improve in a measurable way significant clinical practice and outcomes, in keeping with the FY 1993 strategic goals.
Learning at Air Navigation Services after Initial Training
ERIC Educational Resources Information Center
Teperi, Anna-Maria; Leppanen, Anneli
2010-01-01
Purpose: This study aims to find out the means used for individual, group and organizational learning at work at one air navigation service provider after the initial training period. The study also aims to find out what practices need to be improved to enhance learning at work. Design/methodology/approach: The data for the study were collected…
ERIC Educational Resources Information Center
Faubert, Brenton
2012-01-01
The purpose of this report is to review the body of literature concerned with reducing school failure by improving equity in schools and classrooms. The literature review will be used to inform the Organisation for Economic Cooperation and Development (OECD) Project "Overcoming School Failure: Policies that Work" and hopefully, future educational…
The HMI Report on Advanced Level Work in Business Education and Economics 1991.
ERIC Educational Resources Information Center
Butler, John
1992-01-01
Evaluates 1991 report of Her Majesty's Inspectorate (HMI) on advanced level work in business education and economics for levels 16-19 in United Kingdom. Discusses areas of improvement and specific examples of good practice identified by HMI. Reports HMI's desire for better, more formalized departmental organization and the need for more in-service…
Tried and True: Tested Ideas for Teaching and Learning from the Regional Educational Laboratories.
ERIC Educational Resources Information Center
Levinson, Luna; Stonehill, Robert
This collection of 16 tested ideas for improving teaching and learning evolved from the work of the 1995 Proven Laboratory Practices Task Force charged with identifying and collecting the best and most useful work from the Regional Educational Laboratories. The Regional Educational Laboratory program is the largest research and development…
Pitcher, Jane
2015-01-01
This article draws on research with adult sex workers in indoor settings in Great Britain to explore diverse forms of self-employment, employment relationships and small business development, set within the context of changes to the wider economy. It considers how external constraints such as the legal context, social stigma and dominant policy discourses can impact on sex workers' autonomy and actively work against their safety and wellbeing. The article argues that broad policy and legal approaches which fail to recognise the complexity of sex work constrain sex workers' opportunities for business development and improvement of their working circumstances. It suggests the need for recognition of sex work as legitimate labour, as a prerequisite for policy changes to support sex workers and pave the way for improved working conditions, not only in managed settings but also facilitating collective arrangements and independent lone working.
Trends in a changing vascular practice environment for members of the Society for Vascular Surgery
Matthews, Mika A. B.; Satiani, Bhagwan; Lohr, Joann M.
2013-01-01
Objective To survey the Society for Vascular Surgery (SVS) membership with regard to practice trends related to work effort, employment status, practice ownership, endovascular cases, and anticipated changes in practice in the near future. Methods A survey questionnaire was developed to gather information about member demographics and practice, hours worked, full-time (FT) or part-time status, employment status, practice ownership, competition for referrals, proportion of endovascular vs open procedures, and anticipated changes in practice in the next 3 years. We used SurveyMonkey and distributed the survey to all active vascular surgeon (VS) members of the SVS. Results The response rate was 207 of 2230 (10.7%). Two thirds were in private practice, and 21% were in solo practice. Twenty-four percent were employed by hospitals/health systems. Those VS under the age of 50 years were more likely to exclusively practice vascular surgery compared with VS over the age of 50 years (P = .0003). Sixty-eight of the physicians (32.7%) were between 50 and 59 years old, 186 (90.3%) were men, 192 (92.8%) worked FT (>36 hours of patient care per week), and almost two thirds worked >60 hours per week. Those in physician-owned practices worked >40 hours of patient care per week more often than did FT employed VS (P = .012). Younger VS (age <50 years) more frequently reported >50% of their workload being endovascular compared with older VS (age ≥50 years; P < .001). Eighty percent of FT VS planned to continue their current practice over the next 3 years. Of the 43.6% indicating loss of referrals, 82% pointed to cardiologists as the competition. Conclusions The current workforce is predominately male and works FT; one-third is between the ages of 50 and 59 years. Younger VS (age <50 years) are more likely to exclusively practice VS and have a higher caseload of endovascular procedures. Those in physician-owned practices are more likely to put in >40 hours of patient care per week than are FT employed VS. Longitudinal surveys of SVS members are imperative to help tailor educational, training, and practice management offerings, guide governmental activities, advocate for issues important to members, improve branding initiatives, and sponsor workforce analyses. PMID:23254185
Supporting clinician educators to achieve "work-work balance".
Maniate, Jerry; Dath, Deepak; Cooke, Lara; Leslie, Karen; Snell, Linda; Busari, Jamiu
2016-10-01
Clinician Educators (CE) have numerous responsibilities in different professional domains, including clinical, education, research, and administration. Many CEs face tensions trying to manage these often competing professional responsibilities and achieve "work-work balance." Rich discussions of techniques for work-work balance amongst CEs at a medical education conference inspired the authors to gather, analyze, and summarize these techniques to share with others. In this paper we present the CE's "Four Ps"; these are practice points that support both the aspiring and established CE to help improve their performance and productivity as CEs, and allow them to approach work-work balance.
Leveraging business intelligence to make better decisions: Part I.
Reimers, Mona
2014-01-01
Data is the new currency. Business intelligence tools will provide better performing practices with a competitive intelligence advantage that will separate the high performers from the rest of the pack. Given the investments of time and money into our data systems, practice leaders must work to take every advantage and look at the datasets as a potential goldmine of business intelligence decision tools. A fresh look at decision tools created from practice data will create efficiencies and improve effectiveness for end-users and managers.
Xu, Gang; Major, Rupert; Shepherd, David; Brunskill, Nigel
2017-01-01
Chronic kidney disease (CKD) is a serious long-term condition, which if left untreated causes significant cardiovascular sequele. It is well recognized management of modifiable risk factors, such as blood pressure (BP), can lead to improved long-term outcomes. A novel information technology (IT) solution presents a possible solution to help clinicians in the community identify and manage at risk patients more efficiently. The IMproving Patient care and Awareness of Kidney disease progression Together (IMPAKT) IT tool was used to identify patients with CKD and uncontrolled hypertension in the community. A CKD nurse utilized the tool at primary care practices to identify patients who warranted potential intervention and disseminated this information to clinical staff. Blood pressure management targets and incidence of coded CKD were used to evaluate the project. Altogether 48 practices participated in an 18 month project from April 2014, and data from 20 practices, with a total adult population of 121,362, was available for analysis. Two full consecutive QI (Quality Improvement) audit cycles were completed. There was an increase in the mean recorded prevalence of coded CKD patients over the course of the project. Similarly, there was an increase in the percentage of patients with BP been recorded and importantly there was an accompanying significant increase in CKD patients achieving BP targets. At the end of the project an additional 345 individuals with CKD achieved better blood pressure control. This could potentially prevent 9 cardiovascular events in the CKD group, translating to a cost saving of £320,000 for the 20 practices involved. The most significant change in clinical markers occurred during cycle 1 of the audit, the improvement was maintained throughout cycle 2 of the audit. Our results show the real-life clinical impact of a relatively simple and easy to implement QI project, to help improve outcomes in patients with CKD. This was achieved through more efficient working by targeting of high-risk groups, and improved communication between primary/secondary care. The project could be adapted for other chronic disease conditions. Despite the recorded improvements in blood pressure management, a large proportion of high-risk patients remained above ideal blood pressure, additional interventions in this area need to be explored. Through collaborative and multi-professional working and utilizing IT resources, we have shown it is possible to deliver measurable and sustainable improvements in blood pressure control for patients with CKD in a real life clinical setting.
Litchfield, Ian; Bentham, Louise; Hill, Ann; McManus, Richard J; Lilford, Richard; Greenfield, Sheila
2015-01-01
Background The testing and result communication process in primary care is complex. Its successful completion relies on the coordinated efforts of a range of staff in primary care and external settings working together with patients. Despite the importance of diagnostic testing in provision of care, this complexity renders the process vulnerable in the face of increasing demand, stretched resources and a lack of supporting guidance. Methods We conducted a series of focus groups with patients and staff across four primary care practices using process-improvement strategies to identify and understand areas where either unnecessary delay is introduced, or the process may fail entirely. We then worked with both patients and staff to arrive at practical strategies to improve the current system. Results A total of six areas across the process were identified where improvements could be introduced. These were: (1) delay in phlebotomy, (2) lack of a fail-safe to ensure blood tests are returned to practices and patients, (3) difficulties in accessing results by telephone, (4) role of non-clinical staff in communicating results, (5) routine communication of normal results and (6) lack of a protocol for result communication. Conclusions A number of potential failures in testing and communicating results to patients were identified, and some specific ideas for improving existing systems emerged. These included same-day phlebotomy sessions, use of modern technology methods to proactively communicate routine results and targeted training for receptionists handling sensitive data. There remains an urgent need for further work to test these and other potential solutions. PMID:26251507
Litchfield, Ian; Bentham, Louise; Hill, Ann; McManus, Richard J; Lilford, Richard; Greenfield, Sheila
2015-11-01
The testing and result communication process in primary care is complex. Its successful completion relies on the coordinated efforts of a range of staff in primary care and external settings working together with patients. Despite the importance of diagnostic testing in provision of care, this complexity renders the process vulnerable in the face of increasing demand, stretched resources and a lack of supporting guidance. We conducted a series of focus groups with patients and staff across four primary care practices using process-improvement strategies to identify and understand areas where either unnecessary delay is introduced, or the process may fail entirely. We then worked with both patients and staff to arrive at practical strategies to improve the current system. A total of six areas across the process were identified where improvements could be introduced. These were: (1) delay in phlebotomy, (2) lack of a fail-safe to ensure blood tests are returned to practices and patients, (3) difficulties in accessing results by telephone, (4) role of non-clinical staff in communicating results, (5) routine communication of normal results and (6) lack of a protocol for result communication. A number of potential failures in testing and communicating results to patients were identified, and some specific ideas for improving existing systems emerged. These included same-day phlebotomy sessions, use of modern technology methods to proactively communicate routine results and targeted training for receptionists handling sensitive data. There remains an urgent need for further work to test these and other potential solutions. 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.
Gollop, R; Whitby, E; Buchanan, D; Ketley, D
2004-01-01
Objective: To explore scepticism and resistance towards changes in working practice designed to achieve service improvement. Two principal questions were studied: (1) why some people are sceptical or resistant towards improvement programmes and (2) what influences them to change their minds. Methods: Semi-structured qualitative interviews were conducted with 19 clinicians and 19 managers who held national and regional roles in two national programmes of service improvement within the NHS involving systematic organisational changes in working practices: the National Booking Programme and the Cancer Services Collaborative (now the Cancer Services Collaborative Improvement Partnership). Results: Scepticism and resistance exist in all staff groups, especially among medical staff. Reasons include personal reluctance to change, misunderstanding of the aims of improvement programmes, and a dislike of the methods by which programmes have been promoted. Sceptical staff can be influenced to become involved in improvement, but this usually takes time. Newly won support may be fragile, requiring ongoing evidence of benefits to be maintained. Conclusions: The support of health service staff, particularly doctors, is crucial to the spread and sustainability of the modernisation agenda. Scepticism and resistance are seen to hamper progress. Leaders of improvement initiatives need to recognise the impact of scepticism and resistance, and to consider ways in which staff can become positively engaged in change. PMID:15069217
Transfer of Mindfulness Training to the Work Setting: A Qualitative Study in a Health Care System.
Lyddy, Christopher J; Schachter, Yotam; Reyer, Amy; Julliard, Kell
2016-01-01
Mindfulness training is now commonly offered as professional development for health care practitioners. Understanding how health care practitioners adopt mindfulness practices is limited, which poses a hurdle to the development of effective mindfulness training programs. To explore how health professionals use and perceive mindfulness practices at work, we conducted an exploratory qualitative study at a large multicomponent inner-city health system. All participants were self-selected health professionals who attended at least one mindfulness training. Training content was derived from the Tergar Meditation Community's nonsectarian Joy of Living program and focused on calming the mind using a flexible and broadly applicable approach. Transcribed interview data were examined using thematic analysis. Individuals receiving mindfulness training varied substantially in their subsequent adoption and utilization of these practices. Interviewees' experiences overall suggest that the workplace presents a relatively challenging but nonetheless viable environment for being mindful. Health care workers relied on more informal practice models than on formal meditation practice routines while at work. Factors reported by some individuals to inhibit effective mindfulness practice supported mindfulness for others, and overall displayed equivocal effects. Adoption and integration of mindfulness practices within the workplace are feasible yet vary significantly by practice type, situation, and the individual. Greater understanding of how individuals adopt workplace mindfulness training could improve future intervention research while clarifying optimal mindfulness training approaches.