Integrating mobile devices into nursing curricula: opportunities for implementation using Rogers' Diffusion of Innovation model.

PubMed

Doyle, Glynda J; Garrett, Bernie; Currie, Leanne M

2014-05-01

To identify studies reporting mobile device integration into undergraduate and graduate nursing curricula. To explore the potential use of Rogers' Diffusion of Innovation model as a framework to guide implementation of mobile devices into nursing curricula. Literature review and thematic categorization. Literature published up until June 2013 was searched using EBSCO, PubMed, and Google Scholar. The literature was reviewed for research articles pertaining to mobile device use in nursing education. Research articles were grouped by study design, and articles were classified by: 1) strategies for individual adopters and 2) strategies for organizations. Rogers' Diffusion of Innovation theory was used to categorize reported implementation strategies. Fifty-two research studies were identified. Strategies for implementation were varied, and challenges to integrating mobile devices include lack of administrative support and time/funding to educate faculty as well as students. Overall, the use of mobile devices appears to provide benefits to nursing students; however the research evidence is limited. Anticipating challenges and ensuring a well laid out strategic plan can assist in supporting successful integration of mobile devices. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Economic barriers to implementation of innovations in health care: is the long run-short run efficiency discrepancy a paradox?

PubMed

Adang, Eddy M M; Wensing, Michel

2008-12-01

Favourable cost-effectiveness of innovative technologies is more and more a necessary condition for implementation in clinical practice. But proven cost-effectiveness itself does not guarantee successful implementation. The reason for this is a potential discrepancy between long run efficiency, on which cost-effectiveness is based, and short run efficiency. Long run and short run efficiency is dependent upon economies of scale. This paper addresses the potential discrepancy between long run and short run efficiency of innovative technologies in healthcare, explores diseconomies of scale in Dutch hospitals and suggests what strategies might help to overcome hurdles to implement innovations due to that discrepancy.

Coping with Multiple Innovations in Schools: An Exploratory Study.

ERIC Educational Resources Information Center

Wallace, Mike

1991-01-01

Reviews small-scale, exploratory research into British schools' management of concurrent educational reform innovations generated by government, local education authorities, and the schools themselves. Describes changing innovations patterns, key factors influencing their adoption and implementation, the central management strategies employed, and…

Innovation Process Design: A Change Management and Innovation Dimension Perspective

NASA Astrophysics Data System (ADS)

Peisl, Thomas; Reger, Veronika; Schmied, Juergen

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

Getting Students to Read before Class: Innovation in a University in Chile

ERIC Educational Resources Information Center

McGinn, Noel F.; Schiefelbein, Ernesto

2015-01-01

Reading before class has been demonstrated to improve student learning. This article describes the installation and effectiveness of a strategy to encourage student class preparation. The strategy, called the Class-to-Class Method, has been implemented in a large private university in Chile. The university hopes that this innovation will reduce…

Intensive grazing and maize silage to enhance the sustainability of small-scale dairy systems in the highlands of Mexico.

PubMed

Prospero-Bernal, Fernando; Martínez-García, Carlos Galdino; Olea-Pérez, Rafael; López-González, Felipe; Arriaga-Jordán, Carlos Manuel

2017-10-01

The effects of two innovative feeding strategies-intensive grazing (GR) and maize silage (MS)-on the sustainability of small-scale dairy systems (SSDS) were assessed in the highlands of central Mexico. On a total of 24 farms, four innovations were adopted between 2011 and 2014. Five farms continued their conventional feeding strategy (CC) of cut-and-carry pasture supplemented with commercial concentrate and ground corn grain, as well as straws (maize, oat, and wheat) in the dry season of feed scarcity; six farms implemented MS in the dry season; six farms GR of pastures; and seven farms implemented both GR and MS. Assessment in 2015 showed that farms which implemented both GR and MS had a higher local diversity score (P ≤ 0.001), higher scores for ethics and human development, and a higher score in economic independence (P ≤ 0.05) than farms that implemented only one of the innovations. The overall sustainability score (with range 0-100) was 46 for CC, 47 for MS, 52 for GR, and 55 for GR + MS. The innovations reduced feeding costs and enhanced sustainability, particularly when GR + MS were both implemented.

Implementing complex innovations: factors influencing middle manager support.

PubMed

Chuang, Emmeline; Jason, Kendra; Morgan, Jennifer Craft

2011-01-01

Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their managers to implement these complex innovations.

Implementing an Open Source Learning Management System: A Critical Analysis of Change Strategies

ERIC Educational Resources Information Center

Uys, Philip M.

2010-01-01

This paper analyses the change and innovation strategies that Charles Sturt University (CSU) used from 2007 to 2009 during the implementation and mainstreaming of an open source learning management system (LMS), Sakai, named locally as "CSU Interact". CSU was in January 2008 the first Australian University to implement an open source…

The importance of organizational climate and implementation strategy at the introduction of a new working tool in primary health care.

PubMed

Carlfjord, S; Andersson, A; Nilsen, P; Bendtsen, P; Lindberg, M

2010-12-01

The transmission of research findings into routine care is a slow and unpredictable process. Important factors predicting receptivity for innovations within organizations have been identified, but there is a need for further research in this area. The aim of this study was to describe contextual factors and evaluate if organizational climate and implementation strategy influenced outcome, when a computer-based concept for lifestyle intervention was introduced in primary health care (PHC). The study was conducted using a prospective intervention design. The computer-based concept was implemented at six PHC units. Contextual factors in terms of size, leadership, organizational climate and political environment at the units included in the study were assessed before implementation. Organizational climate was measured using the Creative Climate Questionnaire (CCQ). Two different implementation strategies were used: one explicit strategy, based on Rogers' theories about the innovation-decision process, and one implicit strategy. After 6 months, implementation outcome in terms of the proportion of patients who had been referred to the test, was measured. The CCQ questionnaire response rates among staff ranged from 67% to 91% at the six units. Organizational climate differed substantially between the units. Managers scored higher on CCQ than staff at the same unit. A combination of high CCQ scores and explicit implementation strategy was associated with a positive implementation outcome. Organizational climate varies substantially between different PHC units. High CCQ scores in combination with an explicit implementation strategy predict a positive implementation outcome when a new working tool is introduced in PHC. © 2010 Blackwell Publishing Ltd.

From strategy to action: how top managers' support increases middle managers' commitment to innovation implementation in health care organizations.

PubMed

Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J; Chin, Marshall H; Chiu, Michael; Schaefer, Cynthia T

2015-01-01

Evidence suggests that top managers' support influences middle managers' commitment to innovation implementation. What remains unclear is how top managers' support influences middle managers' commitment. Results may be used to improve dismal rates of innovation implementation. We used a mixed-method sequential design. We surveyed (n = 120) and interviewed (n = 16) middle managers implementing an innovation intended to reduce health disparities in 120 U.S. health centers to assess whether top managers' support directly influences middle managers' commitment; by allocating implementation policies and practices; or by moderating the influence of implementation policies and practices on middle managers' commitment. For quantitative analyses, multivariable regression assessed direct and moderated effects; a mediation model assessed mediating effects. We used template analysis to assess qualitative data. We found support for each hypothesized relationship: Results suggest that top managers increase middle managers' commitment by directly conveying to middle managers that innovation implementation is an organizational priority (β = 0.37, p = .09); allocating implementation policies and practices including performance reviews, human resources, training, and funding (bootstrapped estimate for performance reviews = 0.09; 95% confidence interval [0.03, 0.17]); and encouraging middle managers to leverage performance reviews and human resources to achieve innovation implementation. Top managers can demonstrate their support directly by conveying to middle managers that an initiative is an organizational priority, allocating implementation policies and practices such as human resources and funding to facilitate innovation implementation, and convincing middle managers that innovation implementation is possible using available implementation policies and practices. Middle managers may maximize the influence of top managers' support on their commitment by communicating with top managers about what kind of support would be most effective in increasing their commitment to innovation implementation.

From Strategy to Action: How Top Managers’ Support Increases Middle Managers’ Commitment to Innovation Implementation in Healthcare Organizations

PubMed Central

Lee, Shoou-Yih Daniel; Weiner, Bryan J.; Chin, Marshall H.; Chiu, Michael; Schaefer, Cynthia T.

2014-01-01

Background Evidence suggests that top managers’ support influences middle managers’ commitment to innovation implementation. What remains unclear is how top managers’ support influences middle managers’ commitment. Results may be used to improve dismal rates of innovation implementation. Methods We used a mixed-method sequential design. We surveyed (n = 120) and interviewed (n = 16) middle managers implementing an innovation intended to reduce health disparities in 120 US health centers to assess whether top managers’ support influences middle managers’ commitment directly, by allocating implementation policies and practices, or by moderating the influence of implementation policies and practices on middle managers’ commitment. For quantitative analyses, multivariable regression assessed direct and moderated effects; a mediation model assessed mediating effects. We used template analysis to assess qualitative data. Findings We found support for each hypothesized relationship: Results suggest that top managers increase middle managers’ commitment by directly conveying to middle managers that innovation implementation is an organizational priority (β = 0.37, p = 0.09); allocating implementation policies and practices including performance reviews, human resources, training, and funding (bootstrapped estimate for performance reviews = 0.09; 95 percent CI: 0.03, 0.17); and encouraging middle managers to leverage performance reviews and human resources to achieve innovation implementation. Practice Implications Top managers can demonstrate their support by directly conveying to middle managers that an initiative is an organizational priority, allocating implementation policies and practices such as human resources and funding to facilitate innovation implementation, and convincing middle managers that innovation implementation is possible using available implementation policies and practices. Middle managers may maximize the influence of top managers’ support on their commitment by communicating with top managers about what kind of support would be most effective in increasing their commitment to innovation implementation. PMID:24566252

Learning the Landscape: Implementation Challenges of Primary Care Innovators around Cancer Survivorship Care

PubMed Central

O’Malley, Denalee; Hudson, Shawna V.; Nekhlyudov, Larissa; Howard, Jenna; Rubinstein, Ellen; Lee, Heather S.; Overholser, Linda S.; Shaw, Amy; Givens, Sarah; Burton, Jay S.; Grunfeld, Eva; Parry, Carly; Crabtree, Benjamin F.

2016-01-01

PURPOSE This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models. METHODS Snowball sampling was used to identify innovators. Twelve participants (five cancer survivorship primary care innovators and seven content experts) attended a working conference focused on cancer survivorship population strategies and primary care transformation. Data included meeting discussion transcripts/field notes, transcribed in-depth innovator interviews, and innovators’ summaries of care models. We used a multi-step immersion/crystallization analytic approach, guided by a primary care organizational change model. RESULTS Innovative practice models included: 1) a consultative model in a primary care setting; 2) a primary care physician (PCP)-led, blended consultative/panel-based model in an oncology setting; 3) an oncology nurse navigator in a primary care practice; and 4) two sub-specialty models where PCPs in a general medical practice dedicated part of their patient panel to cancer survivors. Implementation challenges included: (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers. CONCLUSIONS Cancer survivorship delivery models are potentially feasible in primary care; however, significant barriers to widespread implementation exist. Implementation efforts would benefit from increasing the awareness and potential value-add of primary care-focused strategies to address survivors’ needs. PMID:27277895

Design, implementation and evaluation of innovative science teaching strategies for non-formal learning in a natural history museum

NASA Astrophysics Data System (ADS)

Çil, Emine; Maccario, Nihal; Yanmaz, Durmuş

2016-09-01

Background: Museums are useful educational resources in science teaching. Teaching strategies which promote hands-on activities, student-centred learning, and rich social interaction must be designed and implemented throughout the museum visit for effective science learning.

Modeling the leadership attributes of top management in green innovation implementation

NASA Astrophysics Data System (ADS)

Ishak, Noormaizatul Akmar; Ramli, Mohammad Fadzli

2015-05-01

The implementation of green innovation in the companies is the interest of the governments all over the world. This has been the main focus of the Copenhagen Protocol and Kyoto Protocol that require all governments to preserve the nature through green initiatives. This paper proposes a mathematical model on the leadership attributes of the top management in ensuring green innovation implementation in their companies' strategies to reduce operational cost. With green innovation implementation in the Government-Linked Companies (GLCs), we identify the leadership attributes are tied up to the leadership style of the top managers in the companies. Through this model we have proved that green type leadership always contributes better in cost saving, therefore it is a more efficient leadership attribute for the GLCs especially.

An Analysis of Implementation Strategies in a School-Wide Vocabulary Intervention

ERIC Educational Resources Information Center

Roskos, Katheen A.; Moe, Jennifer Randazzo; Rosemary, Catherine

2017-01-01

From an improvement research perspective, this study explores strategies used to implement a school-wide vocabulary intervention into language arts instruction at an urban elementary school. Academic language time, an innovative change in the instructional delivery system, allots time and structure for deliberate teaching of cross-disciplinary…

Supports and Concerns for Teacher Professional Growth During the Implementation of a Science Curriculum Innovation

NASA Astrophysics Data System (ADS)

Peers, Cheryl (Shelley) E.; Diezmann, Carmel M.; Watters, James J.

2003-02-01

Internationally, considerable reform in science education is occurring which promotes constructivist philosophies and advocates constructivist-inspired pedagogical strategies that are new to many teachers. This paper reports on the supporting factors necessary for teacher professional growth and the issues of concern that were evident during one primary teacher''s successful implementation of a unit of work based on a draft of a new state-wide science syllabus which proposes such approaches. One researcher (CEP) provided guidance during the writing and implementation of the unit through professional development workshops complemented by ongoing collegial support. The analysis of the teacher''s practice reveals that professional growth required a willingness of the teacher to engage with change and modify his professional practice. The support factors for teacher growth consisted of an appropriate program of professional development, teacher understanding of the elements of the curriculum innovation, and successful experiences in implementing new approaches. In contrast, the issues of concern were: the adequacy of support for planning including the time required to understand the innovation and make changes to teaching practice; science equipment; teacher knowledge; classroom management strategies; and ways to cope with change. Understanding of these support factors and issues of concern is vital for the successful implementation of science curriculum innovations.

NASA Human Health and Performance Center: Open innovation successes and collaborative projects

NASA Astrophysics Data System (ADS)

Richard, Elizabeth E.; Davis, Jeffrey R.

2014-11-01

In May 2007, what was then the Space Life Sciences Directorate published the 2007 Space Life Sciences Strategy for Human Space Exploration, setting the course for development and implementation of new business models and significant advances in external collaboration over the next five years. The strategy was updated on the basis of these accomplishments and reissued as the NASA Human Health and Performance Strategy in 2012, and continues to drive new approaches to innovation for the directorate. This short paper describes the successful execution of the strategy, driving organizational change through open innovation efforts and collaborative projects, including efforts of the NASA Human Health and Performance Center (NHHPC).

Elaborating on theory with middle managers' experience implementing healthcare innovations in practice.

PubMed

Birken, Sarah A; DiMartino, Lisa D; Kirk, Meredith A; Lee, Shoou-Yih D; McClelland, Mark; Albert, Nancy M

2016-01-04

The theory of middle managers' role in implementing healthcare innovations hypothesized that middle managers influence implementation effectiveness by fulfilling the following four roles: diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. The theory also suggested several activities in which middle managers might engage to fulfill the four roles. The extent to which the theory aligns with middle managers' experience in practice is unclear. We surveyed middle managers (n = 63) who attended a nursing innovation summit to (1) assess alignment between the theory and middle managers' experience in practice and (2) elaborate on the theory with examples from middle managers' experience overseeing innovation implementation in practice. Middle managers rated all of the theory's hypothesized four roles as "extremely important" but ranked diffusing and synthesizing information as the most important and selling innovation implementation as the least important. They reported engaging in several activities that were consistent with the theory's hypothesized roles and activities such as diffusing information via meetings and training. They also reported engaging in activities not described in the theory such as appraising employee performance. Middle managers' experience aligned well with the theory and expanded definitions of the roles and activities that it hypothesized. Future studies should assess the relationship between hypothesized roles and the effectiveness with which innovations are implemented in practice. If evidence supports the theory, the theory should be leveraged to promote the fulfillment of hypothesized roles among middle managers, doing so may promote innovation implementation.

Evaluating the Role and Contribution of Innovation to Health and Wealth in the UK: A Review of Innovation, Health and Wealth: Phase 1 Final Report.

PubMed

Bienkowska-Gibbs, Teresa; Exley, Josephine; Saunders, Catherine L; Marjanovic, Sonja; Chataway, Joanna; MacLure, Calum; McDonald, Ruth; Ling, Tom

2016-06-20

The Department of Health's Innovation, Health and Wealth (IHW) strategy aimed to introduce a more strategic approach to the spread of innovation across the NHS. This study represents the first phase of a three-year evaluation and aims to map progress towards the IHW strategy and its component actions. This evaluation used a combination of quantitative and qualitative methods: document review, key informant interviews and stakeholder survey. This study also forms the basis for selecting case studies for phase two of the evaluation. Our findings from the interviews and survey suggest broad stakeholder support for the overarching ambitions of the IHW strategy. However, we found variable progress towards the overarching objectives of the eight IHW themes and an ambiguous relationship between many of the themes' objectives and their actions. It was difficult to assess progress on IHW's actions as commitment to the actions, implementation guidance and expected outcomes of the actions were not clearly articulated. The Academic Health Science Networks (AHSNs) and the Small Business Research Initiative (SBRI) were reported to be working well, which may be attributed to their clear structures of accountability and earmarked budgets. However, survey respondents and interviewees raised concerns that budgetary pressures may limit the impact of both AHSNs and the SBRI. The main challenges identified for ongoing action were the resources available for their implementation (e.g. Medtech Briefings), lack of awareness of the initiative (e.g. the NICE Implementation Collaborative) and the design of the actions (e.g. the Innovation Scorecard, web portal and High Impact Innovations).

Should Quality School Education Be a Kaizen (Improvement) or an Innovation?

ERIC Educational Resources Information Center

Sun-Keung Pang, Nicholas

1998-01-01

Reviews Hong Kong's School Management Initiative implementation strategies (rational-empirical, power-coercive, and normative-reeducative), compares them with New South Wales, Australia's strategies, and suggests an appropriate strategy for future reforms. In Australia, changes were radical and thorough (using power-coercive strategies), whereas…

Strategies for Success

ERIC Educational Resources Information Center

Tedrick, Lou; Sumsion, Zach; Smith, Mary; Cutshall, Charlie

2012-01-01

"Training" magazine taps 2012 Training Top 125 winners and Top 10 Hall of Famers to provide their learning and development best practices in each issue. This article looks at strategies to foster technology innovation and implementation and onboarding.

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

PubMed

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

2006-01-01

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

Barriers to the implementation of green chemistry in the United States.

PubMed

Matus, Kira J M; Clark, William C; Anastas, Paul T; Zimmerman, Julie B

2012-10-16

This paper investigates the conditions under which firms are able to develop and implement innovations with sustainable development benefits. In particular, we examine "green chemistry" innovations in the United States. Via interviews with green chemistry leaders from industry, academia, nongovernmental institutions (NGOs), and government, we identified six major categories of challenges commonly confronted by innovators: (1) economic and financial, (2) regulatory, (3) technical, (4) organizational, (5) cultural, and (6) definition and metrics. Further analysis of these barriers shows that in the United States, two elements of these that are particular to the implementation of green chemistry innovations are the absence of clear definitions and metrics for use by researchers and decision makers, as well as the interdisciplinary demands of these innovations on researchers and management. Finally, we conclude with some of the strategies that have been successful thus far in overcoming these barriers, and the types of policies which could have positive impacts moving forward.

NASA Human Health and Performance Center: Open Innovation Successes and Collaborative Projects

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.; Richard, Elizabeth E.

2014-01-01

In May 2007, what was then the Space Life Sciences Directorate published the 2007 Space Life Sciences Strategy for Human Space Exploration, which resulted in the development and implementation of new business models and significant advances in external collaboration over the next five years. The strategy was updated on the basis of these accomplishments and reissued as the NASA Human Health and Performance Strategy in 2012, and continues to drive new approaches to innovation for the directorate. This short paper describes the open innovation successes and collaborative projects developed over this timeframe, including the efforts of the NASA Human Health and Performance Center (NHHPC), which was established to advance human health and performance innovations for spaceflight and societal benefit via collaboration in new markets.

What is the impact of innovation on output in healthcare with a special focus on treatment innovations in radiotherapy? A literature review.

PubMed

Jacobs, Maria; Boersma, Liesbeth; Dekker, Andre; Swart, Rachelle; Lambin, Philippe; de Ruysscher, Dirk; Verhaegen, Frank; Stultiens, Joost; Ramaekers, Bram; van Merode, Frits

2017-11-01

To analyse how often innovations in healthcare are evaluated regarding output, especially in radiotherapy. Output was defined as either survival, toxicity, safety, service, efficiency or cost-effectiveness. A systematic literature review was conducted, using three search strategies: (1) innovations in general healthcare; (2) radiotherapy-specific innovations, i.e. organizational innovations and general implementation of innovations; (3) innovations per tumour group/radiotherapy technique. Scientific levels were classified according to the system used in European Society for Medical Oncology guidelines. Finally, we calculated the percentage of implemented innovations in Dutch radiotherapy centres for which we found evidence regarding output in the literature review. Only 94/1072 unique articles matched the inclusion criteria. Significant results on patient outcome, service or safety were reported in 65% of papers, which rose to 76% if confined to radiotherapy reviews. A significant technological improvement was identified in 26%, cost-effectiveness in 10% and costs/efficiency in 36% of the papers. The scientific level of organizational innovations was lower than that of clinical papers. Dutch radiotherapy treatment innovations were adequately evaluated on outcome data before implementation in clinical routine in a minimum of 64-92% of cases. Only few studies report on output when considering innovations in general, but radiotherapy reviews give a reasonably good insight into innovation output effects, with a higher level of evidence. In Dutch radiotherapy centres only small improvements are possible regarding evaluation of treatment innovations before implementation. Advances in knowledge: This study is the first of its kind measuring how innovations are evaluated in scientific literature, before implementation in clinical practice.

E-government strategy of Surabaya city government through e-rt / rw to improve the quality of public service

NASA Astrophysics Data System (ADS)

Oktariyanda, T. A.; Rahaju, T.

2018-01-01

The use of information technology by Surabaya City Government has generated various innovations of public services such as “e-Sapa Warga”, e-Commerce, “e-RT/RW”, e-Budgeting, e-Project, e-Procurement, “e-Pendidikan”. Among the many innovations, e-RT/RW (Rukun Tetangga / Rukun Warga) is an innovation that is quite prominent because there are still many areas that have not implemented. This research can be classified as literature review and critical research. The aims of this research are to describe and analyze e-government strategy in Surabaya City through e-RT / RW to improve public service quality. The result of this research is e-government strategy in Surabaya City through e-RT / RW is already relevant and in accordance with Goldsmith’s theory of e-government. The positive impact of the implementation of e-RT / RW is the increasing quality of public services to bring benefits to all citizens Surabaya City.

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare for a large randomized clinical trial that will test the strategy against other implementation strategies, such as audit/feedback and academic detailing, used to close the gap between knowledge and practice. The systems consultation approach has the potential to shorten the famously long time it takes to implement evidence-based practices and clinical guidelines in healthcare.

Evaluation of Two CEDA Weatherization Pilot Implementations of an Exterior Insulation and Over-Clad Retrofit Strategy for Residential Masonry Buildings in Chicago

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

Neuhauser, K.

This project examines the implementation of an exterior insulation and over-clad strategy for brick masonry buildings in Chicago. The strategy was implemented at a free-standing two story two-family dwelling and a larger free-standing multifamily building. The test homes selected for this research represent predominant housing types for the Chicago area. High heating energy use typical in these buildings threaten housing affordability. Uninsulated mass masonry wall assemblies also have a strongly detrimental impact on comfort. Significant changes to the performance of masonry wall assemblies is generally beyond the reach of typical weatherization (Wx) program resources. The Community and Economic Development Associationmore » of Cook County, Inc. (CEDA) has secured a Sustainable Energy Resources for Consumers (SERC) innovation grant sponsored by the United States Department of Energy (DOE). This grant provides CEDA the opportunity to pursue a pilot implementation of innovative approaches to retrofit in masonry wall enclosures. The exterior insulation and over-clad strategy implemented through this project was designed to allow implementation by contractors active in CEDA weatherization programs and using materials and methods familiar to these contractors. The retrofit measures are evaluated in terms of feasibility, cost and performance. Through observations of the strategies implemented, the research described in this report identifies measures critical to performance as well as conditions for wider adoption. The research also identifies common factors that must be considered in determining whether the exterior insulation and over-clad strategy is appropriate for the building.« less

Implementing active traffic management strategies in the U.S.

DOT National Transportation Integrated Search

2010-10-01

Limited public funding for roadway expansion and improvement projects, coupled with continued growth in travel along congested urban freeway corridors, creates a pressing need for innovative congestion management approaches. Strategies to address con...

Panacea or diagnosis? Imaginaries of innovation and the 'MIT model' in three political cultures.

PubMed

Pfotenhauer, Sebastian; Jasanoff, Sheila

2017-12-01

Innovation studies continue to struggle with an apparent disconnect between innovation's supposedly universal dynamics and a sense that policy frameworks and associated instruments of innovation are often ineffectual or even harmful when transported across regions or countries. Using a cross-country comparative analysis of three implementations of the 'MIT model' of innovation in the UK, Portugal and Singapore, we show how key features in the design, implementation and performance of the model cannot be explained as mere variations on an identical solution to the same underlying problem. We draw on the concept of sociotechnical imaginaries to show how implementations of the 'same' innovation model - and with it the notion of 'innovation' itself - are co-produced with locally specific diagnoses of a societal deficiency and equally specific understandings of acceptable remedies. Our analysis thus flips the conventional notion of 'best-practice transfer' on its head: Instead of asking 'how well' an innovation model has been implemented, we analyze the differences among the three importations to reveal the idiosyncratic ways in which each country imagines the purpose of innovation. We replace the notion of innovation as a 'panacea' - a universal fix for all social woes - with that of innovation-as-diagnosis in which a particular 'cure' is 'prescribed' for a 'diagnosed' societal 'pathology,' which may in turn trigger 'reactions' within the receiving body. This approach offers new possibilities for theorizing how and where culture matters in innovation policy. It suggests that the 'successes' and 'failures' of innovation models are not a matter of how well societies are able to implement a sound, universal model, but more about how effectively they articulate their imaginaries of innovation and tailor their strategies accordingly.

Biopharma business models in Canada.

PubMed

March-Chordà, I; Yagüe-Perales, R M

2011-08-01

This article provides new insights into the different strategy paths or business models currently being implemented by Canadian biopharma companies. Through a case-study methodology, seven biopharma companies pertaining to three business models were analyzed, leading to a broad set of results emerging from the following areas: activity, business model and strategy; management and human resources; and R&D, technology and innovation strategy. The three business models represented were: model 1 (conventional biotech oriented to new drug development, radical innovation and search for discoveries); model 2 (development of a technology platform, usually in proteomics and bioinformatics); and model 3 (incremental innovation, with shorter and less risky development timelines). Copyright © 2011 Elsevier Ltd. All rights reserved.

The GETE approach to facilitating the commercialization and use of DOE-developed environmental technologies

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

Harvey, T.N.

The Global Environmental Technology Enterprise (GETE) was conceived to develop and implement strategies to facilitate the commercialization of innovative, cost-effective Department of Energy (DOE)-developed environmental technologies. These strategies are needed to aid DOE`s clean-up mission; to break down barriers to commercialization; and to build partnerships between the federal government and private industry in order to facilitate the development and use of innovative environmental technologies.

The Impact of Entrepreneurial Leadership on Nurses' Innovation Behavior.

PubMed

Bagheri, Afsaneh; Akbari, Morteza

2018-01-01

The purpose of this study was to examine the influence of entrepreneurial leadership on nurses' innovation work behavior and its dimensions. This cross-sectional study employed the 10-item Innovation Work Behavior Questionnaire and the 8-item Entrepreneurial Leadership Questionnaire to explore the impact of entrepreneurial leadership on the innovation work behavior of 273 nurses from public and private hospitals in Iran. Entrepreneurial leadership had a significant positive impact on nurses' innovation work behavior and most strongly improved idea exploration, followed by idea generation, idea implementation, and idea championing. Entrepreneurial leadership was effective in enhancing nurses' innovation work behavior. More attention needs to be focused on developing entrepreneurial leadership competencies and on developing nurse leaders. Healthcare policies and strategies are needed to facilitate the implementation of entrepreneurial leadership by providing healthcare leaders with the appropriate environment. © 2017 Sigma Theta Tau International.

Hand hygiene promotion and the participation of infection control link nurses: an effective innovation to overcome campaign fatigue.

PubMed

Seto, Wing Hong; Yuen, Shanny W S; Cheung, Christina W Y; Ching, Patricia T Y; Cowling, Benjamin J; Pittet, Didier

2013-12-01

Campaign fatigue was evident in a large hospital in Hong Kong when hand hygiene compliance remained just above 50% after 4 years of aggressive and varied promotional activities. A new innovative strategy was developed that directly involved the infection control link nurses both in formulating the strategy and in implementing the various proposed programs. The new strategy was successful in increasing hand hygiene compliance to 83%. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

[VISPA's group (evaluation of the implementation strategies of the measurements instruments adopted in the Italian nursing practice)].

PubMed

Palese, A; Mecugni, S; Barbieri, M; Bonocore, M; Buscaroli, A; Buscaroli, A; Caparnoni, M; Colognese, S; Costi, D; Di Vaio, S; Lapi, L; Lionte, G; Nasi, A M; Pellicciari, C; Quartieri, M; Ricci, R; Saguatti, K; Saragoni, M; Tarantola, S; Torri, E; Vaccari, S; Volpi, P; Vinceti, M

2010-01-01

An innovative teaching strategy focused on problem based approach rather than theorical aiming to facilitate the learning of the research methodology in advanced nursing student has been introduced. Through out a qualitative evaluation of the diary kept by the student nurses involved, advantages and disadvantages of this innovative approach have been evaluated. This paper reports a synthesis of the teaching strategy and its impact on the competences in the research methodology as it has been perceived by the students participants.

[Development and implementation of the Chronicity Strategy for the Basque Country (Spain): lessons learned].

PubMed

Nuño-Solinís, Roberto

2016-11-01

Public healthcare in the Basque Country (Spain) faces high rates of ageing and chronicity, which stress the sustainability of the system. In response to this situation, the Basque Chronicity Strategy was launched in 2010. This large-scale and far-reaching transformation initiative focused on changing the healthcare provision model towards integrated care of chronicity. Developed in the context of economic and financial crisis, strong political opposition and resistance or passivity of many relevant stakeholders, the design and implementation of the Strategy introduced some noteworthy elements, such as: a narrative of change different to the austerity discourse, which was the dominant narrative at that time; a strategic approach supported by an evidence base and solid theoretical references; and an implementation strategy that favoured local innovation and the "bottom up" approach. In spite of this, it was not possible to overcome the political barriers or bureaucratic immobility, which limited the implementation and scope of the changes, especially those related to the scalability of successful local innovations. However, some changes in the healthcare integration culture at clinical and managerial level have been introduced as a result of the Strategy, as well as organisational progression towards a chronicity-targeted healthcare model. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

75 FR 38850 - NNI Strategic Plan 2010; Request for Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... implements strategies that maximize the economic benefits of its investments in nanotechnology, based on... innovation strategy, NNI member agencies have identified areas ripe for significant advances through closer... human health, resulting in better risk assessment and risk mitigation strategies. Each center works as a...

Thinking Broadly: Financing Strategies for Youth Programs

ERIC Educational Resources Information Center

Deich, Sharon G.; Hayes, Cheryl D.

2007-01-01

This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This strategy brief presents a…

InnovateEDU, Inc.: Brooklyn Laboratory Charter Schools (LAB)

ERIC Educational Resources Information Center

EDUCAUSE, 2015

2015-01-01

Entrepreneurial learning is the backbone of this Brooklyn charter school network which opened in Fall 2014 to serve grades 6-12, including English language learners and students with disabilities. LAB's academic model combines empirically effective learning practices with innovative implementation strategies, including a blended learning model…

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

PubMed

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

2016-08-01

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

Genomic Medicine Without Borders: Which Strategies Should Developing Countries Employ to Invest in Precision Medicine? A New "Fast-Second Winner" Strategy.

PubMed

Mitropoulos, Konstantinos; Cooper, David N; Mitropoulou, Christina; Agathos, Spiros; Reichardt, Jürgen K V; Al-Maskari, Fatima; Chantratita, Wasun; Wonkam, Ambroise; Dandara, Collet; Katsila, Theodora; Lopez-Correa, Catalina; Ali, Bassam R; Patrinos, George P

2017-11-01

Genomic medicine has greatly matured in terms of its technical capabilities, but the diffusion of genomic innovations worldwide faces significant barriers beyond mere access to technology. New global development strategies are sorely needed for biotechnologies such as genomics and their applications toward precision medicine without borders. Moreover, diffusion of genomic medicine globally cannot adhere to a "one-size-fits-all-countries" development strategy, in the same way that drug treatments should be customized. This begs a timely, difficult but crucial question: How should developing countries, and the resource-limited regions of developed countries, invest in genomic medicine? Although a full-scale investment in infrastructure from discovery to the translational implementation of genomic science is ideal, this may not always be feasible in all countries at all times. A simple "transplantation of genomics" from developed to developing countries is unlikely to be feasible. Nor should developing countries be seen as simple recipients and beneficiaries of genomic medicine developed elsewhere because important advances in genomic medicine have materialized in developing countries as well. There are several noteworthy examples of genomic medicine success stories involving resource-limited settings that are contextualized and described in this global genomic medicine innovation analysis. In addition, we outline here a new long-term development strategy for global genomic medicine in a way that recognizes the individual country's pressing public health priorities and disease burdens. We term this approach the "Fast-Second Winner" model of innovation that supports innovation commencing not only "upstream" of discovery science but also "mid-stream," building on emerging highly promising biomarker and diagnostic candidates from the global science discovery pipeline, based on the unique needs of each country. A mid-stream entry into innovation can enhance collective learning from other innovators' mistakes upstream in discovery science and boost the probability of success for translation and implementation when resources are limited. This à la carte model of global innovation and development strategy offers multiple entry points into the global genomics innovation ecosystem for developing countries, whether or not extensive and expensive discovery infrastructures are already in place. Ultimately, broadening our thinking beyond the linear model of innovation will help us to enable the vision and practice of genomics without borders in both developed and resource-limited settings.

Technological Innovation and Developmental Strategies for Sustainable Management of Aquatic Resources in Developing Countries

NASA Astrophysics Data System (ADS)

Agboola, Julius Ibukun

2014-12-01

Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

Technological innovation and developmental strategies for sustainable management of aquatic resources in developing countries.

PubMed

Agboola, Julius Ibukun

2014-12-01

Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

Enabling and Challenging Factors in Institutional Reform: The Case of SCALE-UP

ERIC Educational Resources Information Center

Foote, Kathleen; Knaub, Alexis; Henderson, Charles; Dancy, Melissa; Beichner, Robert J.

2016-01-01

While many innovative teaching strategies exist, integration into undergraduate science teaching has been frustratingly slow. This study aims to understand the low uptake of research-based instructional innovations by studying 21 successful implementations of the Student Centered Active Learning with Upside-down Pedagogies (SCALE-UP) instructional…

Innovative instructional strategy using cinema films in an undergraduate nursing course.

PubMed

Hyde, Norlyn B; Fife, Elizabeth

2005-01-01

Educators can develop innovative instructional strategies to engage students within the philosophical framework of Constructivism. To that end, the authors used films--Hollywood movies--to enhance their curriculum on neurological and psychopathological illnesses. During the fourth quarter of a seven-quarter associate degree nursing program, students developed case studies of the disorders portrayed in selected films. The authors outline the methods used to implement this approach and discuss evaluations from student and faculty perspectives.

Knowledge barriers to PACS adoption and implementation in hospitals.

PubMed

Paré, Guy; Trudel, Marie-Claude

2007-01-01

Drawing on the classical theory of diffusion of innovations advanced by Rogers [E.M. Rogers, Diffusion of Innovations, 4th ed., Free Press, New York, NY, 1995] and on the theory of barriers to innovation [P. Attewell, Technology diffusion and organizational learning: the case of business computing. Organ. Sci. 3 (1992) 1-19; H. Tanriverdi, C.S. Iacono, Knowledge barriers to diffusion of telemedicine. Proceedings of the 20th International Conference on Information Systems, Charlotte, NC, 1999, pp. 39-50; S. Nambisan, Y.-M. Wang, Roadblocks to web technology adoption? Commun. ACM, 42 (1) (1999) 98-101], this study seeks a better understanding of challenges faced in PACS implementations in hospitals and of the strategies required to ensure their success. To attain this objective, we describe and analyze the process used to adopt and implement PACS at two Canadian hospitals. Our findings clearly demonstrate the importance of treating any PACS deployment not simply as a rollout of new technology but as a project that will transform the organization. Proponents of these projects must not lose sight of the fact that, even if technological complexity represents a significant issue, it must not garner all the project team's attention. This situation is even more dangerous, inasmuch as the greatest risk to the implementation often lies elsewhere. It would also appear to be crucial to anticipate and address organizational and behavioral challenges from the very first phase of the innovation process, in order to ensure that all participants will be committed to the project. In order to maximize the likelihood of PACS success, it appears crucial to adopt a proactive implementation strategy, one that takes into consideration all the technical, economic, organizational, and human factors, and does so from the first phase of the innovation process.

Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.

2013-01-01

Objective Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Methods Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader member exchange with innovation climate and attitudes toward adoption and use of EBP. Results Transformational leadership predicted higher innovation climate during implementation while leader member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Conclusions Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. PMID:22449648

Dental education in Wuhan, China: challenges and changes.

PubMed

Huang, Cui; Bian, Zhuan; Tai, Baojun; Fan, Mingwen; Kwan, Chiu-Yin

2007-02-01

The aim of this article is to describe the innovations in the School of Stomatology at Wuhan University (WHUSS) that are likely to shape the future of dental education in the People's Republic of China. There are forty dental schools in China; the five most well known are located in Beijing, Chengdu, Shanghai, Xi'an, and Wuhan. Although patient-centered, comprehensive care has been recommended as the future of dental education, traditional dental education in China still faces many challenges to accomplish this goal. WHUSS, one of the more progressive dental schools in China, has implemented several educational innovations to traditional dental education by restructuring the curriculum through the introduction of problem-based learning (PBL) and other strategies in clinical training. Although implementation of educational innovations is still at an early stage throughout China, it is reasonable to speculate that many schools will develop similar strategies as those developed at Wuhan to improve dental education during the next several years. However, additional research is necessary to evaluate the efficacy of such educational strategies and to determine the appropriate implementation of a contemporary dental curriculum and pedagogic methodology. The curriculum modifications that have been achieved to date as well as the existing challenges are discussed to provide the reader with an understanding of contemporary dental education in China.

Intangible factors leading to success in research: strategy, innovation and leadership.

PubMed

Hecker, Louise; Birla, Ravi K

2008-03-01

At the heart of research is the scientific process, which includes identifying a knowledge gap, execution of experiments, and finally, presentation of scientific data. Identifying a systematic way to undertake research is important; however, equally important are intangible factors, including strategy, innovation and leadership, in determining the outcome of any research project. These intangible factors, although often unspoken, are the essence of success in research. Strategy determines the direction of research and the ability to respond to acute changes in the field to ensure a competitive advantage. Innovation involves generating novel ideas, and at the heart of innovation is the ability to create a positive work environment. Leadership is the ability to exercise influence so as to create change; empowerment and the ability to create leaders at every level are central to effective leadership. Collectively, defining and implementing aspects of these intangible factors will strengthen any research endeavor.

A Review of the Change Literature with Implications for ISSOE Dissemination. Second Printing.

ERIC Educational Resources Information Center

Beuke, Vernon; Farrar, Steven

The state of the art in the implementation of education innovation is assessed in three parts: (1) the identification of promising theories, important issues, and proven implementation strategies with emphasis on practical implications; (2) a review of research directly related to the development and implementation of new occupational education…

Implementation Science Supports Core Clinical Competencies: An Overview and Clinical Example.

PubMed

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.

China's New National Curriculum Reform: Innovation, Challenges and Strategies

ERIC Educational Resources Information Center

Guan, Qun; Meng, Wanjin

2007-01-01

This paper presents systematically China's New National Curriculum Reform (CNNCR). It covers the background, origin, essence, goals, features, evolvement, schedule, implementation, the alignment in primary, secondary and middle schools' curricula and inter-subjects, the outcomes and the challenges and strategies of CNNCR.

Implementing Innovative Elementary Literacy Programs. Program Report.

ERIC Educational Resources Information Center

Schwab, R. G. Jerry; And Others

This four-document collection describes the implementation processes of dramatically improved literacy programs in elementary schools which are leading the move to restructure literacy education in the Northwest (Alaska, Idaho, Montana, Oregon, and Washington). The first document in the collection, "Strategies for Improving School-Wide…

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

PubMed

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

2018-03-01

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

Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation.

PubMed

Aarons, Gregory A; Sommerfeld, David H

2012-04-01

Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader-member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader-member exchange with innovation climate and attitudes toward adoption and use of EBP. Transformational leadership predicted higher innovation climate during implementation, whereas leader-member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Evaluation of Two CEDA Weatherization Pilot Implementations of an Exterior Insulation and Over-Clad Retrofit Strategy for Residential Masonry Buildings in Chicago

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

Neuhauser, Ken

This project examines the implementation of an exterior insulation and over-clad strategy for brick masonry buildings in Chicago—a free-standing two story two-family dwelling and a larger free-standing multifamily building. The test homes selected for this research represent predominant housing types for the Chicago area, in which high heating energy use typical in these buildings threaten housing affordability, and uninsulated mass masonry wall assemblies are uncomfortable for residents. In this project, the Community and Economic Development Association of Cook County, Inc. (CEDA) has secured a Sustainable Energy Resources for Consumers (SERC) innovation grant sponsored by DOE to pursue a pilot implementationmore » of innovative approaches to retrofit in masonry wall enclosures. The retrofit measures are evaluated in terms of feasibility, cost and performance. Through observations of the strategies implemented, the research described in this report identifies measures critical to performance as well as conditions for wider adoption. The research also identifies common factors that must be considered in determining whether the exterior insulation and over-clad strategy is appropriate for the building.« less

Assessing Implementation of a Performance Pay Plan for Teachers: Strategies, Findings and Implications.

ERIC Educational Resources Information Center

Hall, Gene E.; Caffarella, Edward; Bartlett, Ellen

This paper reports how one school district has successfully implemented a major innovation, the Performance Pay Plan (PPP) for Teachers, and how they have collaborated with change process researchers to assess implementation. The paper emphasizes: the community-wide process of involvement and trust building used by the district to launch and…

What roles do middle managers play in implementation of innovative practices?

PubMed Central

Engle, Ryann L.; Lopez, Emily R.; Gormley, Katelyn E.; Chan, Jeffrey A.; Charns, Martin P.; Lukas, Carol VanDeusen

2017-01-01

Background: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. Purpose: The aim of this study was to expand the understanding of middle managers’ influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. Methodology/Approach: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices. We analyzed 98 interviews with staff ranging from senior leaders to frontline staff to identify themes within an a priori framework reflecting middle manager activities. Findings: Analyses yielded 14 emergent themes that allowed us to classify specific expressions of middle manager commitment to implementation of innovative practices (e.g., facilitate improvement innovation, garner staff buy-in). In comparing middle manager behaviors in high and low change potential sites, we found that most emergent themes were present in both groups. However, the activities and interactions described differed between the groups. Practice Implications: Middle managers can use the promising strategies identified by our analyses to guide and improve their effectiveness in implementing new practices. These strategies can also inform senior leaders striving to guide middle managers in those efforts. PMID:26488239

Intent to sustain use of a mental health innovation by school providers: What matters most?

PubMed Central

Livet, Melanie; Yannayon, Mary; Kocher, Kelly; McMillen, Janey

2017-01-01

Despite innovations being routinely introduced in schools to support the mental health of students, few are successfully maintained over time. This study explores the role of innovation characteristics, individual attitudes and skills, and organizational factors in school providers’ decisions to continue use of Centervention, a technology-based tool that supports implementation of evidence-based mental health interventions (EBIs). Data were collected from 44 providers through online surveys following use of Centervention over a one-year period. When considered with individual and organizational factors, experience with Centervention (usability, usefulness, and satisfaction) was found to be the most influential predictor of intent to sustain use. Results reinforce the importance of (1) differentiating between factors that predict initial adoption vs. those that enable sustainability and (2) tailoring sustainability decision models to the nature of the innovation. They also support the need to incorporate strategies to enhance provider experience during implementation of an innovation. PMID:29403540

Implementing the virtual reality learning environment: Second Life.

PubMed

Schmidt, Bonnie; Stewart, Stephanie

2009-01-01

Today, faculty members are challenged to find meaningful learning activities that enhance online nursing education. Second Life is an innovative Internet-based strategy that may be used to engage students in active learning. The authors discuss how this technology was implemented into an accelerated online nursing program.

Lessons from the Social Innovation Fund: Supporting Evaluation to Assess Program Effectiveness and Build a Body of Research Evidence

ERIC Educational Resources Information Center

Zandniapour, Lily; Deterding, Nicole M.

2018-01-01

Tiered evidence initiatives are an important federal strategy to incentivize and accelerate the use of rigorous evidence in planning, implementing, and assessing social service investments. The Social Innovation Fund (SIF), a program of the Corporation for National and Community Service, adopted a public-private partnership approach to tiered…

School Processes That Can Drive Scaling-Up of an Innovation or Contribute to Its Abandonment

ERIC Educational Resources Information Center

Newman, Denis; Zacamy, Jenna; Lazarev, Valeriy; Lin, Li

2017-01-01

This five-year study focused on school processes that promoted the scaling-up of a high school academic literacy framework, Reading Apprenticeship, developed by WestEd's Strategic Literacy Initiative (SLI). Implementing an innovative strategy for scaling-up involving school-based cross-disciplinary teacher teams, SLI brought the framework to 274…

The Effects of an Innovative Activity-Centered Biology Program on Attitude toward Elementary Teachers.

ERIC Educational Resources Information Center

Hall, Donald A.

One of the primary goals in many teacher education programs is to design and to implement specific courses, strategies, and methods that promote positive attitude toward science and science teaching among elementary education majors. This paper describes the effects of a biology content course, patterned after innovative elementary school science…

A diffusion of innovations model of physician order entry.

PubMed

Ash, J S; Lyman, J; Carpenter, J; Fournier, L

2001-01-01

To interpret the results of a cross-site study of physician order entry (POE) in hospitals using a diffusion of innovations theory framework. Qualitative study using observation, focus groups, and interviews. Data were analyzed by an interdisciplinary team of researchers using a grounded approach to identify themes. Themes were then interpreted using classical Diffusion of Innovations (DOI) theory as described by Rogers [1]. Four high level themes were identified: organizational issues; clinical and professional issues; technology implementation issues; and issues related to the organization of information and knowledge. Further analysis using the DOI framework indicated that POE is an especially complex information technology innovation when one considers communication, time, and social system issues in addition to attributes of the innovation itself. Implementation strategies for POE should be designed to account for its complex nature. The ideal would be a system that is both customizable and integrated with other parts of the information system, is implemented with maximum involvement of users and high levels of support, and is surrounded by an atmosphere of trust and collaboration.

Implementing Extreme Programming in Distributed Software Project Teams: Strategies and Challenges

NASA Astrophysics Data System (ADS)

Maruping, Likoebe M.

Agile software development methods and distributed forms of organizing teamwork are two team process innovations that are gaining prominence in today's demanding software development environment. Individually, each of these innovations has yielded gains in the practice of software development. Agile methods have enabled software project teams to meet the challenges of an ever turbulent business environment through enhanced flexibility and responsiveness to emergent customer needs. Distributed software project teams have enabled organizations to access highly specialized expertise across geographic locations. Although much progress has been made in understanding how to more effectively manage agile development teams and how to manage distributed software development teams, managers have little guidance on how to leverage these two potent innovations in combination. In this chapter, I outline some of the strategies and challenges associated with implementing agile methods in distributed software project teams. These are discussed in the context of a study of a large-scale software project in the United States that lasted four months.

Implementing an Online Writing Assessment Strategy for Gerontology

ERIC Educational Resources Information Center

Brown, Pamela S.; Hanks, Roma S.

2008-01-01

Assessment of student learning is a growing concern for programs in gerontology. This report focuses on the conception, design, funding, and implementation of an innovative online workshop to assess and improve writing skills of students enrolled in distance-learning gerontology classes. The approach is multidisciplinary and involves a…

Post-Occupancy Evaluation of a Mental Healthcare Facility Based on Staff Perceptions of Design Innovations.

PubMed

Kalantari, Saleh; Snell, Robin

2017-07-01

This study was a post-occupancy evaluation (POE) to examine the effectiveness of three specific design innovations in a mental healthcare facility. In addition to collecting data about the impact of these specific designs, the study provides a model for the broader implementation of POE approaches in the mental healthcare context. POEs in general healthcare settings have been shown to lead to better work environments and better outcomes for patients. Despite growing evidence of the value provided by POE studies, the industry has been somewhat slow to adopt their regular use, in part due to unfamiliarity with the POE process. This is particularly true in mental healthcare contexts, where POE studies remain virtually nonexistent. In-depth interviews and a widely distributed, anonymous survey were used to collect hospital staff perceptions and feedback regarding the impact of specific design features. The hospital staff were quite enthusiastic about two of the design innovations studied here (a new wayfinding strategy and the use of vibrant colors in specific areas of the facility). The third innovation, open-style communication centers, elicited more mixed evaluations. The results include extensive hypothesis testing about the effects of each innovation as well as narrative discussions of their pros and cons. The study generated new knowledge about three specific mental healthcare design innovations and provides a model for the practical implementation of a POE approach in mental healthcare contexts. The results are particularly relevant for designers who are considering innovative strategies in future mental healthcare facilities.

75 FR 3449 - Office of Innovation and Improvement; Overview Information; Teaching American History Grant...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... Educational Resources (OER). OER are teaching, learning, and research resources that reside in the public... traditional American history content, proven teaching strategies, and lessons learned in implementing TAH... students. The applicant is encouraged to address how its proposed professional development strategy will...

An Exploratory Descriptive Study of Registered Nurse Innovation: Implications for Levels of Adoption.

PubMed

Polster, Debra; Villines, Dana

The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables. There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation. This was a descriptive study at a midwest, urban, teaching, 408-bed Magnet hospital. Surveys were completed by 217 nurses. The participants reported high personal innovativeness ((Equation is included in full-text article.)= 32.1; SD, 6.4), and the institution was perceived as innovative, with 90.3% of scores categorized as positive innovativeness. The statistically significant correlation was in the medical-surgical unit (r = -0.52, P < .01). There is no correlation between personal innovativeness and organizational innovativeness except for medical-surgical nurses (P = .03). They are likely to perceive the organization more innovative than themselves. Determining adopter characteristics can be valuable to the clinical nurse specialist by adapting strategic interventions to advance nursing practice. Exploring levels of adoption can be an innovative strategy to transform nursing at the bedside and throughout the organization.

Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations.

PubMed

Ong, Jason J; Fu, Hongyun; Smith, M Kumi; Tucker, Joseph D

2018-05-01

Syphilis is an important sexually transmitted infection (STI). Despite inexpensive and effective treatment, few key populations receive syphilis testing. Innovative strategies are needed to increase syphilis testing among key populations. Areas covered: This scoping review focused on strategies to increase syphilis testing in key populations (men who have sex with men (MSM), sex workers, people who use drugs, transgender people, and incarcerated individuals). Expert commentary: We identified many promising syphilis testing strategies, particularly among MSM. These innovations are separated into diagnostic, clinic-based, and non-clinic based strategies. In terms of diagnostics, self-testing, dried blood spots, and point-of-care testing can decentralize syphilis testing. Effective syphilis self-testing pilots suggest the need for further attention and research. In terms of clinic-based strategies, modifying default clinical procedures can nudge physicians to more frequently recommend syphilis testing. In terms of non-clinic based strategies, venue-based screening (e.g. in correctional facilities, drug rehabilitation centres) and mobile testing units have been successfully implemented in a variety of settings. Integration of syphilis with HIV testing may facilitate implementation in settings where individuals have increased sexual risk. There is a strong need for further syphilis testing research and programs.

Measures of Potential Flexibility and Practical Flexibility in Equation Solving.

PubMed

Xu, Le; Liu, Ru-De; Star, Jon R; Wang, Jia; Liu, Ying; Zhen, Rui

2017-01-01

Researchers interested in mathematical proficiency have recently begun to explore the development of strategic flexibility, where flexibility is defined as knowledge of multiple strategies for solving a problem and the ability to implement an innovative strategy for a given problem solving circumstance. However, anecdotal findings from this literature indicate that students do not consistently use an innovative strategy for solving a given problem, even when these same students demonstrate knowledge of innovative strategies. This distinction, sometimes framed in the psychological literature as competence vs. performance-has not been previously studied for flexibility. In order to explore the competence/performance distinction in flexibility, this study developed and validated measures for potential flexibility (e.g., competence, or knowledge of multiple strategies) and practical flexibility (e.g., performance, use of innovative strategies) for solving equations. The measures were administrated to a sample of 158 Chinese middle school students through a Tri-Phase Flexibility Assessment, in which the students were asked to solve each equation, generate additional strategies, and evaluate own multiple strategies. Confirmatory factor analysis supported a two-factor model of potential and practical flexibility. Satisfactory internal consistency was found for the measures. Additional validity evidence included the significant association with flexibility measured with the previous method. Potential flexibility and practical flexibility were found to be distinct but related. The theoretical and practical implications of the concepts and their measures of potential flexibility and practical flexibility are discussed.

Measures of Potential Flexibility and Practical Flexibility in Equation Solving

PubMed Central

Xu, Le; Liu, Ru-De; Star, Jon R.; Wang, Jia; Liu, Ying; Zhen, Rui

2017-01-01

Researchers interested in mathematical proficiency have recently begun to explore the development of strategic flexibility, where flexibility is defined as knowledge of multiple strategies for solving a problem and the ability to implement an innovative strategy for a given problem solving circumstance. However, anecdotal findings from this literature indicate that students do not consistently use an innovative strategy for solving a given problem, even when these same students demonstrate knowledge of innovative strategies. This distinction, sometimes framed in the psychological literature as competence vs. performance—has not been previously studied for flexibility. In order to explore the competence/performance distinction in flexibility, this study developed and validated measures for potential flexibility (e.g., competence, or knowledge of multiple strategies) and practical flexibility (e.g., performance, use of innovative strategies) for solving equations. The measures were administrated to a sample of 158 Chinese middle school students through a Tri-Phase Flexibility Assessment, in which the students were asked to solve each equation, generate additional strategies, and evaluate own multiple strategies. Confirmatory factor analysis supported a two-factor model of potential and practical flexibility. Satisfactory internal consistency was found for the measures. Additional validity evidence included the significant association with flexibility measured with the previous method. Potential flexibility and practical flexibility were found to be distinct but related. The theoretical and practical implications of the concepts and their measures of potential flexibility and practical flexibility are discussed. PMID:28848481

Tracking implementation strategies: a description of a practical approach and early findings.

PubMed

Bunger, Alicia C; Powell, Byron J; Robertson, Hillary A; MacDowell, Hannah; Birken, Sarah A; Shea, Christopher

2017-02-23

Published descriptions of implementation strategies often lack precision and consistency, limiting replicability and slowing accumulation of knowledge. Recent publication guidelines for implementation strategies call for improved description of the activities, dose, rationale and expected outcome(s) of strategies. However, capturing implementation strategies with this level of detail can be challenging, as responsibility for implementation is often diffuse and strategies may be flexibly applied as barriers and challenges emerge. We describe and demonstrate the development and application of a practical approach to identifying implementation strategies used in research and practice that could be used to guide their description and specification. An approach to tracking implementation strategies using activity logs completed by project personnel was developed to facilitate identification of discrete strategies. This approach was piloted in the context of a multi-component project to improve children's access to behavioural health services in a county-based child welfare agency. Key project personnel completed monthly activity logs that gathered data on strategies used over 17 months. Logs collected information about implementation activities, intent, duration and individuals involved. Using a consensus approach, two sets of coders categorised each activity based upon Powell et al.'s (Med Care Res Rev 69:123-57, 2012) taxonomy of implementation strategies. Participants reported on 473 activities, which represent 45 unique strategies. Initial implementation was characterised by planning strategies followed by educational strategies. After project launch, quality management strategies predominated, suggesting a progression of implementation over time. Together, these strategies accounted for 1594 person-hours, many of which were reported by the leadership team that was responsible for project design, implementation and oversight. This approach allows for identifying discrete implementation strategies used over time, estimating dose, describing temporal ordering of implementation strategies, and pinpointing the major implementation actors. This detail could facilitate clear reporting of a full range of implementation strategies, including those that may be less observable. This approach could lead to a more nuanced understanding of what it takes to implement different innovations, the types of strategies that are most useful during specific phases of implementation, and how implementation strategies need to be adaptively applied throughout the course of a given initiative.

Innovation, imitation, and problem-solving in a networked group.

PubMed

Wisdom, Thomas N; Goldstone, Robert L

2011-04-01

We implemented a problem-solving task in which groups of participants simultaneously played a simple innovation game in a complex problem space, with score feedback provided after each of a number of rounds. Each participant in a group was allowed to view and imitate the guesses of others during the game. The results showed the use of social learning strategies previously studied in other species, and demonstrated benefits of social learning and nonlinear effects of group size on strategy and performance. Rather than simply encouraging conformity, groups provided information to each individual about the distribution of useful innovations in the problem space. Imitation facilitated innovation rather than displacing it, because the former allowed good solutions to be propagated and preserved for further cumulative innovations in the group. Participants generally improved their solutions through the use of fairly conservative strategies, such as changing only a small portion of one's solution at a time, and tending to imitate solutions similar to one's own. Changes in these strategies over time had the effect of making solutions increasingly entrenched, both at individual and group levels. These results showed evidence of nonlinear dynamics in the decentralization of innovation, the emergence of group phenomena from complex interactions of individual efforts, stigmergy in the use of social information, and dynamic tradeoffs between exploration and exploitation of solutions. These results also support the idea that innovation and creativity can be recognized at the group level even when group members are generally cautious and imitative.

Integration of Treatment Innovation Planning and Implementation: Strategic Process Models and Organizational Challenges

PubMed Central

Lehman, Wayne E. K.; Simpson, D. Dwayne; Knight, Danica K.; Flynn, Patrick M.

2015-01-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A 2-phase procedural approach is therefore presented based on the integration of TCU models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. PMID:21443294

Innovation through developing consumers’ community. Part I: Innovation in action

NASA Astrophysics Data System (ADS)

Gălăţanu (Avram, E.; Avasilcăi, S.

2015-11-01

Technological changes and need for innovation represents the main concerns for organizational growth and profitability. However the main priority is still about achieving high performance through product development and consumers' engagement activities. As implementation of open innovation applications increased and value co — creation became well known and major process, companies were engaged into value co — innovation activities. From this point of view the need for joint efforts with consumers in product development arose. Thus the primary condition for an organization to be consumer centric is to define clear the vision and mission which reflects the common efforts for co — creation and diffusion of innovation. As Research & Development processes evolved and interest for innovative concepts and products arose, companies started to implement the specific instruments for consumers' attraction and engagement into design and product development. The digitalized innovation became the main source for establishing the direct communication with the consumers. In order to achieve organization growth, profitability and recognition, the companies should be aware of the innovation importance and the need for internal change. From this point of view, there is necessary to assess the organizational structures, to implement new policies and to establish strategic targets. Basically it is justified the need for platform occurrence and development. Based on case study of BMW Group, recognised leader in automotive industry for innovative concepts, there will be analysed main features within organizational context which promotes the innovation implementation. There will be provided the review of the BMW Group experience of innovation activities, main consumers' engagement strategies, the values which promote the consumer — centric product development, new opportunities assessment, major policies and concerns. The foreseen result is to understand how companies are adapting to the technical and innovation changes as the main criteria for future product development and consumers' engagement motivation through the platform — based communication.

Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures

PubMed Central

2013-01-01

Background Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level framework that captures the predominant factors that impact implementation outcomes, conduct a systematic review of available measures assessing constructs subsumed within these primary factors, and determine the criterion validity of these measures in the search articles. Method We conducted a systematic literature review to identify articles reporting the use or development of measures designed to assess constructs that predict the implementation of evidence-based health innovations. Articles published through 12 August 2012 were identified through MEDLINE, CINAHL, PsycINFO and the journal Implementation Science. We then utilized a modified five-factor framework in order to code whether each measure contained items that assess constructs representing structural, organizational, provider, patient, and innovation level factors. Further, we coded the criterion validity of each measure within the search articles obtained. Results Our review identified 62 measures. Results indicate that organization, provider, and innovation-level constructs have the greatest number of measures available for use, whereas structural and patient-level constructs have the least. Additionally, relatively few measures demonstrated criterion validity, or reliable association with an implementation outcome (e.g., fidelity). Discussion In light of these findings, our discussion centers on strategies that researchers can utilize in order to identify, adapt, and improve extant measures for use in their own implementation research. In total, our literature review and resulting measures compendium increases the capacity of researchers to conceptualize and measure implementation-related constructs in their ongoing and future research. PMID:23414420

Implementing Innovative Workplaces: Organizational Implications of Different Strategies. Workscape 21: The Ecology of New Ways of Working.

ERIC Educational Resources Information Center

Becker, Franklin; Quinn, Kristen L.; Rappaport, Andrew J.; Sims, William R.

This document reports a study that examined implementation processes for new workplace practices--nonterritorial offices--in five international organizations in four countries. The organizations are IBM and Ernst & Young in the United Kingdom; Digital Equipment's Natural Office in Sweden; SOL Cleaning Company headquarters in Finland; and…

Progress in the First Five Years: An Evaluation of Achieving the Dream Colleges in Washington State

ERIC Educational Resources Information Center

Jenkins, Davis; Wachen, John; Kerrigan, Monica Reid; Mayer, Alexander K.

2012-01-01

In 2006, six community and technical colleges in Washington State joined the innovative national reform initiative called Achieving the Dream (ATD). This report describes the progress each college made in implementing ATD's "culture of evidence" principles for institutional improvement, examines strategies implemented by the colleges to…

Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

PubMed

von Krogh, Gunn; Nåden, Dagfinn

2008-04-01

To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

An Optimal Mitigation Strategy Against the Asteroid Impact Threat with Short Warning Time

NASA Technical Reports Server (NTRS)

Wie, Bong; Barbee, Brent W.

2015-01-01

This paper presents the results of a NASA Innovative Advanced Concept (NIAC) Phase 2 study entitled "An Innovative Solution to NASA's Near-Earth Object (NEO) Impact Threat Mitigation Grand Challenge and Flight Validation Mission Architecture Development." This NIAC Phase 2 study was conducted at the Asteroid Deflection Research Center (ADRC) of Iowa State University in 2012-2014. The study objective was to develop an innovative yet practically implementable mitigation strategy for the most probable impact threat of an asteroid or comet with short warning time (less than 5 years). The mitigation strategy described in this paper is intended to optimally reduce the severity and catastrophic damage of the NEO impact event, especially when we don't have sufficient warning times for non-disruptive deflection of a hazardous NEO. This paper provides an executive summary of the NIAC Phase 2 study results.

The model and the planning method of volume and variety assessment of innovative products in an industrial enterprise

NASA Astrophysics Data System (ADS)

Anisimov, V. G.; Anisimov, E. G.; Saurenko, T. N.; Sonkin, M. A.

2017-01-01

In the long term, the innovative development strategy efficiency is considered as the most crucial condition for assurance of economic system competitiveness in market conditions. It determines the problem relevance of such justification strategies with regard to specific systems features and conditions of their operation. The problem solution for industrial enterprises can be based on mathematical models of supporting the decision-making on the elements of the innovative manufacturing program. An optimization model and the planning method of innovative products volume and variety are suggested. The feature of the suggested model lies in the nonlinear nature of the objective function. It allows taking into consideration the law of diminishing marginal utility. The suggested method of optimization takes into account the system features and enables the effective implementation of manufacturing capabilities in modern conditions of production organization and sales in terms of market saturation.

Modelling innovation performance of European regions using multi-output neural networks

PubMed Central

Henriques, Roberto

2017-01-01

Regional innovation performance is an important indicator for decision-making regarding the implementation of policies intended to support innovation. However, patterns in regional innovation structures are becoming increasingly diverse, complex and nonlinear. To address these issues, this study aims to develop a model based on a multi-output neural network. Both intra- and inter-regional determinants of innovation performance are empirically investigated using data from the 4th and 5th Community Innovation Surveys of NUTS 2 (Nomenclature of Territorial Units for Statistics) regions. The results suggest that specific innovation strategies must be developed based on the current state of input attributes in the region. Thus, it is possible to develop appropriate strategies and targeted interventions to improve regional innovation performance. We demonstrate that support of entrepreneurship is an effective instrument of innovation policy. We also provide empirical support that both business and government R&D activity have a sigmoidal effect, implying that the most effective R&D support should be directed to regions with below-average and average R&D activity. We further show that the multi-output neural network outperforms traditional statistical and machine learning regression models. In general, therefore, it seems that the proposed model can effectively reflect both the multiple-output nature of innovation performance and the interdependency of the output attributes. PMID:28968449

Modelling innovation performance of European regions using multi-output neural networks.

PubMed

Hajek, Petr; Henriques, Roberto

2017-01-01

Regional innovation performance is an important indicator for decision-making regarding the implementation of policies intended to support innovation. However, patterns in regional innovation structures are becoming increasingly diverse, complex and nonlinear. To address these issues, this study aims to develop a model based on a multi-output neural network. Both intra- and inter-regional determinants of innovation performance are empirically investigated using data from the 4th and 5th Community Innovation Surveys of NUTS 2 (Nomenclature of Territorial Units for Statistics) regions. The results suggest that specific innovation strategies must be developed based on the current state of input attributes in the region. Thus, it is possible to develop appropriate strategies and targeted interventions to improve regional innovation performance. We demonstrate that support of entrepreneurship is an effective instrument of innovation policy. We also provide empirical support that both business and government R&D activity have a sigmoidal effect, implying that the most effective R&D support should be directed to regions with below-average and average R&D activity. We further show that the multi-output neural network outperforms traditional statistical and machine learning regression models. In general, therefore, it seems that the proposed model can effectively reflect both the multiple-output nature of innovation performance and the interdependency of the output attributes.

Nursing contributions to chronic disease management in primary care.

PubMed

Lukewich, Julia; Edge, Dana S; VanDenKerkhof, Elizabeth; Tranmer, Joan

2014-02-01

As the prevalence of chronic diseases continues to increase, emphasis is being placed on the development of primary care strategies that enhance healthcare delivery. Innovations include interprofessional healthcare teams and chronic disease management strategies. To determine the roles of nurses working in primary care settings in Ontario and the extent to which chronic disease management strategies have been implemented. We conducted a cross-sectional survey of a random sample of primary care nurses, including registered practical nurses, registered nurses, and nurse practitioners, in Ontario between May and July 2011. Nurses in primary care reported engaging in chronic disease management activities but to different extents depending on their regulatory designation (licensure category). Chronic disease management strategy implementation was not uniform across primary care practices where the nurses worked. There is the potential to optimize and standardize the nursing role within primary care and improve the implementation of chronic disease management strategies.

An Examination of the Adoption of Preservation Metadata in Cultural Heritage Institutions: An Exploratory Study Using Diffusion of Innovations Theory

ERIC Educational Resources Information Center

Alemneh, Daniel Gelaw

2009-01-01

Digital preservation is a significant challenge for cultural heritage institutions and other repositories of digital information resources. Recognizing the critical role of metadata in any successful digital preservation strategy, the Preservation Metadata Implementation Strategies (PREMIS) has been extremely influential on providing a "core" set…

Implementing an Innovative Educational Program Delivery Strategy to Teach 2014 Farm Bill Changes to Ohio Farmers and Landowners

ERIC Educational Resources Information Center

Bruynis, Chris L.; Shoemaker, Dianne E.; Ward, Barry; Custer, Sam G.

2016-01-01

The timing and complexity of the 2014 Farm Bill required quick dissemination of technical information to allow participants to make decisions affecting risk management strategies for their farms. Using existing organizational structures and incorporating a team approach allowed Ohio State University Extension educators to successfully meet the…

5 strategies for improving performance of academic medical centers.

PubMed

Valletta, Robert M; Harkness, Alicia

2013-06-01

Academic medical centers should consider five strategies for becoming more cost-efficient and profitable as reforms are implemented: Make faculty responsible for cost and quality. Explore opportunities to collaborate with community hospitals. Extend care and education beyond the walls of the organization, employing technology and innovative teaching practices. Maximize healthcare IT investment by sharing data-rich patient records with other medical centers and research institutes. Align research with business strategy.

Expert recommendations for implementing change (ERIC): protocol for a mixed methods study

PubMed Central

2014-01-01

Background Identifying feasible and effective implementation strategies that are contextually appropriate is a challenge for researchers and implementers, exacerbated by the lack of conceptual clarity surrounding terms and definitions for implementation strategies, as well as a literature that provides imperfect guidance regarding how one might select strategies for a given healthcare quality improvement effort. In this study, we will engage an Expert Panel comprising implementation scientists and mental health clinical managers to: establish consensus on a common nomenclature for implementation strategy terms, definitions and categories; and develop recommendations to enhance the match between implementation strategies selected to facilitate the use of evidence-based programs and the context of certain service settings, in this case the U.S. Department of Veterans Affairs (VA) mental health services. Methods/Design This study will use purposive sampling to recruit an Expert Panel comprising implementation science experts and VA mental health clinical managers. A novel, four-stage sequential mixed methods design will be employed. During Stage 1, the Expert Panel will participate in a modified Delphi process in which a published taxonomy of implementation strategies will be used to establish consensus on terms and definitions for implementation strategies. In Stage 2, the panelists will complete a concept mapping task, which will yield conceptually distinct categories of implementation strategies as well as ratings of the feasibility and effectiveness of each strategy. Utilizing the common nomenclature developed in Stages 1 and 2, panelists will complete an innovative menu-based choice task in Stage 3 that involves matching implementation strategies to hypothetical implementation scenarios with varying contexts. This allows for quantitative characterizations of the relative necessity of each implementation strategy for a given scenario. In Stage 4, a live web-based facilitated expert recommendation process will be employed to establish expert recommendations about which implementations strategies are essential for each phase of implementation in each scenario. Discussion Using a novel method of selecting implementation strategies for use within specific contexts, this study contributes to our understanding of implementation science and practice by sharpening conceptual distinctions among a comprehensive collection of implementation strategies. PMID:24669765

The challenge of benchmarking health systems: is ICT innovation capacity more systemic than organizational dependent?

PubMed

Lapão, Luís Velez

2015-01-01

The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison is very enlightening, it is also challenging. Benchmarking exercises present a set of challenges, such as the choice of methodologies and the assessment of the impact on organizational strategy. Precise benchmarking methodology is a valid tool for eliciting information about alternatives for improving health systems. However, many beneficial interventions, which benchmark as effective, fail to translate into meaningful healthcare outcomes across contexts. There is a relationship between results and the innovational and competitive environments. Differences in healthcare governance and financing models are well known; but little is known about their impact on Information and Communication Technology implementation. The article by Catan et al. provides interesting clues about this issue. Public systems (such as those of Portugal, UK, Sweden, Spain, etc.) present specific advantages and disadvantages concerning Information and Communication Technology development and implementation. Meanwhile, private systems based fundamentally on insurance packages, (such as Israel, Germany, Netherlands or USA) present a different set of advantages and disadvantages - especially a more open context for innovation. Challenging issues from both the Portuguese and Israeli cases will be addressed. Clearly, more research is needed on both benchmarking methodologies and on ICT implementation strategies.

Integration of treatment innovation planning and implementation: strategic process models and organizational challenges.

PubMed

Lehman, Wayne E K; Simpson, D Dwayne; Knight, Danica K; Flynn, Patrick M

2011-06-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A two-phase procedural approach is therefore presented based on the integration of Texas Christian University (TCU) models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Implementing Change from within Universities and Colleges: 10 Personal Accounts. Managing Innovation and Change in Universities and Colleges Series.

ERIC Educational Resources Information Center

Slowey, Maria, Ed.

This book presents the personal accounts and reflections of 10 individuals who were given leadership responsibility for the implementation of certain aspects of change in institutions of higher education in Great Britain. The contributions illustrate key dimensions of these changes--the development of strategies aimed at widening access, the…

Using focus groups and social marketing to strengthen promotion of group prenatal care.

PubMed

Vonderheid, Susan C; Carrie, S Klima; Norr, Kathleen F; Grady, Mary Alice; Westdahl, Claire M

2013-01-01

Centering Pregnancy, an innovative group model of prenatal care, shows promise to reduce persistent adverse maternal-infant outcomes and contain costs. Because this innovation requires systemwide change, clinics reported needing support enrolling women into groups and obtaining organizational buy-in. This study used the 3-step social marketing communication strategy to help clinic staff identify key customers and customer-specific barriers to adopting or supporting Centering Pregnancy. They developed targeted information to reduce barriers and built skills in communicating with different customers through role-playing. Findings provide practical information for others to use this communication strategy to improve implementation of Centering Pregnancy.

Looking to the future: Framing the implementation of interprofessional education and practice with scenario planning.

PubMed

Forman, Dawn; Nicol, Pam; Nicol, Paul

2015-01-01

Adapting to interprofessional education and practice requires a change of perspective for many health professionals. We aimed to explore the potential of scenario planning to bridge the understanding gap and framing strategic planning for interprofessional education (IPE) and practice (IPP), as well as to implement innovative techniques and technology for large-group scenario planning. A full-day scenario planning workshop incorporating innovative methodology was designed and offered to participants. The 71 participants included academics from nine universities, as well as service providers, government, students and consumer organisations. The outcomes were evaluated by statistical and thematic analysis of a mixed method survey questionnaire. The scenario planning method resulted in a positive response as a means of collaboratively exploring current knowledge and broadening entrenched attitudes. It was perceived to be an effective instrument for framing strategy for the implementation of IPE/IPP, with 81 percent of respondents to a post-workshop survey indicating they would consider using scenario planning in their own organisations. The scenario planning method can be used by tertiary academic institutions as a strategy in developing, implementing and embedding IPE, and for the enculturation of IPP in practice settings.

Innovative approaches for improving maternal and newborn health--A landscape analysis.

PubMed

Lunze, Karsten; Higgins-Steele, Ariel; Simen-Kapeu, Aline; Vesel, Linda; Kim, Julia; Dickson, Kim

2015-12-17

Essential interventions can improve maternal and newborn health (MNH) outcomes in low- and middle-income countries, but their implementation has been challenging. Innovative MNH approaches have the potential to accelerate progress and to lead to better health outcomes for women and newborns, but their added value to health systems remains incompletely understood. This study's aim was to analyze the landscape of innovative MNH approaches and related published evidence. Systematic literature review and descriptive analysis based on the MNH continuum of care framework and the World Health Organization health system building blocks, analyzing the range and nature of currently published MNH approaches that are considered innovative. We used 11 databases (MedLine, Web of Science, CINAHL, Cochrane, Popline, BLDS, ELDIS, 3ie, CAB direct, WHO Global Health Library and WHOLIS) as data source and extracted data according to our study protocol. Most innovative approaches in MNH are iterations of existing interventions, modified for contexts in which they had not been applied previously. Many aim at the direct organization and delivery of maternal and newborn health services or are primarily health workforce interventions. Innovative approaches also include health technologies, interventions based on community ownership and participation, and novel models of financing and policy making. Rigorous randomized trials to assess innovative MNH approaches are rare; most evaluations are smaller pilot studies. Few studies assessed intervention effects on health outcomes or focused on equity in health care delivery. Future implementation and evaluation efforts need to assess innovations' effects on health outcomes and provide evidence on potential for scale-up, considering cost, feasibility, appropriateness, and acceptability. Measuring equity is an important aspect to identify and target population groups at risk of service inequity. Innovative MNH interventions will need innovative implementation, evaluation and scale-up strategies for their sustainable integration into health systems.

Selling Innovations Like Soap: The Interactive Systems Framework and Social Marketing.

PubMed

McAlindon, Kathryn

2017-09-01

Despite the popularity and noted utility of Wandersman and colleagues' (2008) Interactive Systems Framework, the literature currently provides a primary focus on delivery organizations' and supportive stakeholders' capacities and strategies to implement innovations, presenting a critical gap in understanding. Unfortunately, reflective of a larger void in community dissemination and implementation efforts, there is a more limited focus on the dissemination of innovations. This paper presents the social marketing literature as a supplement to the Prevention Synthesis and Translation System (PSTS), the system responsible for dissemination. The study and practice of innovation synthesis and translation is examined in the literature; and based on the conclusions drawn, social marketing theory is used to provide a systematic approach to improving dissemination within the Interactive Systems Framework. Specifically, three gaps related to the PSTS are identified in the literature that align with and can be filled using social marketing. Social marketing is defined and presented as a supplement by providing theory and practices, within a systems context, for effectively communicating and influencing change. By blending social marketing with the Interactive Systems Framework, the aim is to improve the understanding of strategic communication and its role in the effective dissemination, and subsequent implementation, of innovations. © Society for Community Research and Action 2017.

From Kisiizi to Baltimore: cultivating knowledge brokers to support global innovation for community engagement in healthcare.

PubMed

Ibe, Chidinma A; Basu, Lopa; Gooden, Rachel; Syed, Shamsuzzoha B; Dadwal, Viva; Bone, Lee R; Ephraim, Patti L; Weston, Christine M; Wu, Albert W

2018-02-09

Reverse Innovation has been endorsed as a vehicle for promoting bidirectional learning and information flow between low- and middle-income countries and high-income countries, with the aim of tackling common unmet needs. One such need, which traverses international boundaries, is the development of strategies to initiate and sustain community engagement in health care delivery systems. In this commentary, we discuss the Baltimore "Community-based Organizations Neighborhood Network: Enhancing Capacity Together" Study. This randomized controlled trial evaluated whether or not a community engagement strategy, developed to address patient safety in low- and middle-income countries throughout sub-Saharan Africa, could be successfully applied to create and implement strategies that would link community-based organizations to a local health care system in Baltimore, a city in the United States. Specifically, we explore the trial's activation of community knowledge brokers as the conduit through which community engagement, and innovation production, was achieved. Cultivating community knowledge brokers holds promise as a vehicle for advancing global innovation in the context of health care delivery systems. As such, further efforts to discern the ways in which they may promote the development and dissemination of innovations in health care systems is warranted. Trial Registration Number: NCT02222909 . Trial Register Name: Reverse Innovation and Patient Engagement to Improve Quality of Care and Patient Outcomes (CONNECT). Date of Trial's Registration: August 22, 2014.

Meausures of organizational characteristics associated with adoption and/or implementation of innovations: A systematic review.

PubMed

Allen, Jennifer D; Towne, Samuel D; Maxwell, Annette E; DiMartino, Lisa; Leyva, Bryan; Bowen, Deborah J; Linnan, Laura; Weiner, Bryan J

2017-08-23

This paper identifies and describes measures of constructs relevant to the adoption or implementation of innovations (i.e., new policies, programs or practices) at the organizational-level. This work is intended to advance the field of dissemination and implementation research by aiding scientists in the identification of existing measures and highlighting methodological issues that require additional attention. We searched for published studies (1973-2013) in 11 bibliographic databases for quantitative, empirical studies that presented outcome data related to adoption and/or implementation of an innovation. Included studies had to assess latent constructs related to the "inner setting" of the organization, as defined by the Consolidated Framework for Implementation Research. Of the 76 studies included, most (86%) were cross sectional and nearly half (49%) were conducted in health care settings. Nearly half (46%) involved implementation of evidence-based or "best practice" strategies; roughly a quarter (26%) examined use of new technologies. Primary outcomes most often assessed were innovation implementation (57%) and adoption (34%); while 4% of included studies assessed both outcomes. There was wide variability in conceptual and operational definitions of organizational constructs. The two most frequently assessed constructs included "organizational climate" and "readiness for implementation." More than half (55%) of the studies did not articulate an organizational theory or conceptual framework guiding the inquiry; about a third (34%) referenced Diffusion of Innovations theory. Overall, only 46% of articles reported psychometric properties of measures assessing latent organizational characteristics. Of these, 94% (33/35) described reliability and 71% (25/35) reported on validity. The lack of clarity associated with construct definitions, inconsistent use of theory, absence of standardized reporting criteria for implementation research, and the fact that few measures have demonstrated reliability or validity were among the limitations highlighted in our review. Given these findings, we recommend that increased attention be devoted toward the development or refinement of measures using common psychometric standards. In addition, there is a need for measure development and testing across diverse settings, among diverse population samples, and for a variety of types of innovations.

A Perspective on Implementing a Quantitative Systems Pharmacology Platform for Drug Discovery and the Advancement of Personalized Medicine

PubMed Central

Stern, Andrew M.; Schurdak, Mark E.; Bahar, Ivet; Berg, Jeremy M.; Taylor, D. Lansing

2016-01-01

Drug candidates exhibiting well-defined pharmacokinetic and pharmacodynamic profiles that are otherwise safe often fail to demonstrate proof-of-concept in phase II and III trials. Innovation in drug discovery and development has been identified as a critical need for improving the efficiency of drug discovery, especially through collaborations between academia, government agencies, and industry. To address the innovation challenge, we describe a comprehensive, unbiased, integrated, and iterative quantitative systems pharmacology (QSP)–driven drug discovery and development strategy and platform that we have implemented at the University of Pittsburgh Drug Discovery Institute. Intrinsic to QSP is its integrated use of multiscale experimental and computational methods to identify mechanisms of disease progression and to test predicted therapeutic strategies likely to achieve clinical validation for appropriate subpopulations of patients. The QSP platform can address biological heterogeneity and anticipate the evolution of resistance mechanisms, which are major challenges for drug development. The implementation of this platform is dedicated to gaining an understanding of mechanism(s) of disease progression to enable the identification of novel therapeutic strategies as well as repurposing drugs. The QSP platform will help promote the paradigm shift from reactive population-based medicine to proactive personalized medicine by focusing on the patient as the starting and the end point. PMID:26962875

20 CFR 661.400 - What is the purpose of the General Statutory and Regulatory Waiver Authority provided at section...

Code of Federal Regulations, 2011 CFR

2011-04-01

... strategy, consistent with the key reform principles of WIA. These key reform principles include: (1... the private sector; (6) Providing increased State and local flexibility to implement innovative and...

Helping Teachers Improve Classroom Assessments

ERIC Educational Resources Information Center

Emberger, Marcella

2007-01-01

Understanding and implementing effective classroom assessments are skills that are essential to increasing student achievement. Unfortunately, many teachers have had little training in assessment strategies in either graduate or undergraduate programs. Administrators, therefore, must find innovative ways to help their teachers think like assessors…

Provoking "Eureka" moments for effective infection control strategies.

PubMed

Pittet, Didier

2014-01-01

Safety is now a fundamental principle of patient care and a critical component of quality management. Health care-associated infection prevention strategies need to be constantly revisited and updated to be effective. The "Geneva hand hygiene model" is a typical example of a breakthrough innovatory campaign that caught fire and went viral worldwide, thanks to its adoption by the World Health Organization (WHO) as the First Global Patient Safety Challenge. The campaign remains an inspiration for further innovation. To encourage new and disruptive technologies with the potential to improve patient safety through the successful implementation of the WHO multimodal strategy, the University of Geneva Hospitals/WHO Collaborating Centre on Patient Safety, together with the Aesculap Academy, have created a series of "Hand Hygiene Excellence Awards" and "Hand Hygiene Innovation Awards" worldwide.

Embedding care management in the medical home: a case study.

PubMed

Daaleman, Timothy P; Hay, Sherry; Prentice, Amy; Gwynne, Mark D

2014-04-01

Care managers are playing increasingly significant roles in the redesign of primary care and in the evolution of patient-centered medical homes (PCMHs), yet their adoption within day-to-day practice remains uneven and approaches for implementation have been minimally reported. We introduce a strategy for incorporating care management into the operations of a PCMH and assess the preliminary effectiveness of this approach. A case study of the University of North Carolina at Chapel Hill Family Medicine Center used an organizational model of innovation implementation to guide the parameters of implementation and evaluation. Two sources were used to determine the effectiveness of the implementation strategy: data elements from the care management informatics system in the health record and electronic survey data from the Family Medicine Center providers and care staff. A majority of physicians (75%) and support staff (82%) reported interactions with the care manager, primarily via face-to-face, telephone, or electronic means, primarily for facilitating referrals for behavioral health services and assistance with financial and social and community-based resources. Trend line suggests an absolute decrease of 8 emergency department visits per month for recipients of care management services and an absolute decrease of 7.5 inpatient admissions per month during the initial 2-year implementation period. An organizational model of innovation implementation is a potentially effective approach to guide the process of incorporating care management services into the structure and workflows of PCMHs.

An Innovative Solution to NASA's NEO Impact Threat Mitigation Grand Challenge and Flight Validation Mission Architecture Development

NASA Technical Reports Server (NTRS)

Wie, Bong; Barbee, Brent W.

2015-01-01

This paper presents the results of a NASA Innovative Advanced Concept (NIAC) Phase 2 study entitled "An Innovative Solution to NASA's Near-Earth Object (NEO) Impact Threat Mitigation Grand Challenge and Flight Validation Mission Architecture Development." This NIAC Phase 2 study was conducted at the Asteroid Deflection Research Center (ADRC) of Iowa State University in 2012-2014. The study objective was to develop an innovative yet practically implementable mitigation strategy for the most probable impact threat of an asteroid or comet with short warning time (< 5 years). The mitigation strategy described in this paper is intended to optimally reduce the severity and catastrophic damage of the NEO impact event, especially when we don't have sufficient warning times for non-disruptive deflection of a hazardous NEO. This paper provides an executive summary of the NIAC Phase 2 study results. Detailed technical descriptions of the study results are provided in a separate final technical report, which can be downloaded from the ADRC website (www.adrc.iastate.edu).

The innovation policy of nanotechnology development and convergence for the new Korean government

NASA Astrophysics Data System (ADS)

Bae, Seoung Hun; Lim, Jung Sun; Shin, Kwang Min; Kim, Chang Woo; Kang, Sang Kyu; Shin, Minsoo

2013-11-01

Since 2001, Korea has been establishing and executing policy for the development of nanotechnology in accordance with the National Comprehensive Development Plan of Nanotechnology (NCDPN) periods I, II, and III. NCDPN has been focused on innovation in wide spectrum of technology development, and NT-based convergence technologies are expected to contribute 35 % of the total GDP (about 5.02 billion won) with 1.2 million of job creation in KOREA at 2020. Establishment of new strategies for innovating and commercializing nanotechnology is an emerging global issue in major countries including the United States, Japan, Germany, and Korea, with particular concerns for safety in the implementations of nanotechnology (EHS). Under these circumstances, Korea needs to create a post-catch-up strategy beyond fast-follower approach, to compete effectively with nanotechnology-leading countries. This study analyzes the current status of Korean nanotechnology development and relevant policies, and suggests future policy directions for the new Korean government based on innovative competition theory.

Innovative methods of popularizing technical education

NASA Astrophysics Data System (ADS)

Shkitsa, L. Y.; Panchuk, V. G.; Kornuta, V. A.

2017-05-01

There have been analyzed reasons of the loss of technical education’s popularity. Also, the analysis of known educational and production methods, oriented at the innovative model of development of society, was performed. It is stated that the acquisition of 21st century’s skills as a result of competition of technical education are natural for the DIY ideology, which was realized in the institutions like Fab Lab. The new educational strategy, based on project-based learning, is proposed to be implemented as a special laboratory with equipment, which would be a center of innovative development for students at the Technical University. Moreover, the list of projects planned for implementation, that includes not only projects, specific to a particular university, but also projects, demanded by society as a whole, is specified. It is worth to implement trendy projects in the laboratory, such as toy-like, ecological projects; projects of the energy dependence decrease or the energy efficiency increase, modern digital or innovative projects etc. The student should gain knowledge, skills and, possibly, equipment that are available for immediate usage on the labor market or for the realization of his own projects or the community’s projects in everyday life after the realization of the particular project at the laboratory

Innovation sustainability in challenging health-care contexts: embedding clinically led change in routine practice

PubMed Central

Martin, Graham P; Weaver, Simon; Currie, Graeme; Finn, Rachael; McDonald, Ruth

2012-01-01

The need for organizational innovation as a means of improving health-care quality and containing costs is widely recognized, but while a growing body of research has improved knowledge of implementation, very little has considered the challenges involved in sustaining change – especially organizational change led ‘bottom-up’ by frontline clinicians. This study addresses this lacuna, taking a longitudinal, qualitative case-study approach to understanding the paths to sustainability of four organizational innovations. It highlights the importance of the interaction between organizational context, nature of the innovation and strategies deployed in achieving sustainability. It discusses how positional influence of service leads, complexity of innovation, networks of support, embedding in existing systems, and proactive responses to changing circumstances can interact to sustain change. In the absence of cast-iron evidence of effectiveness, wider notions of value may be successfully invoked to sustain innovation. Sustainability requires continuing effort through time, rather than representing a final state to be achieved. Our study offers new insights into the process of sustainability of organizational change, and elucidates the complement of strategies needed to make bottom-up change last in challenging contexts replete with competing priorities. PMID:23554445

Applying the balanced scorecard in healthcare provider organizations.

PubMed

Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin

2002-01-01

Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system.

NASA Human Health and Performance Strategy

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.

2012-01-01

In May 2007, what was then the Space Life Sciences Directorate, issued the 2007 Space Life Sciences Strategy for Human Space Exploration. In January 2012, leadership and key directorate personnel were once again brought together to assess the current and expected future environment against its 2007 Strategy and the Agency and Johnson Space Center goals and strategies. The result was a refined vision and mission, and revised goals, objectives, and strategies. One of the first changes implemented was to rename the directorate from Space Life Sciences to Human Health and Performance to better reflect our vision and mission. The most significant change in the directorate from 2007 to the present is the integration of the Human Research Program and Crew Health and Safety activities. Subsequently, the Human Health and Performance Directorate underwent a reorganization to achieve enhanced integration of research and development with operations to better support human spaceflight and International Space Station utilization. These changes also enable a more effective and efficient approach to human system risk mitigation. Since 2007, we have also made significant advances in external collaboration and implementation of new business models within the directorate and the Agency, and through two newly established virtual centers, the NASA Human Health and Performance Center and the Center of Excellence for Collaborative Innovation. Our 2012 Strategy builds upon these successes to address the Agency s increased emphasis on societal relevance and being a leader in research and development and innovative business and communications practices. The 2012 Human Health and Performance Vision is to lead the world in human health and performance innovations for life in space and on Earth. Our mission is to enable optimization of human health and performance throughout all phases of spaceflight. All HHPD functions are ultimately aimed at achieving this mission. Our activities enable mission success, optimizing human health and productivity in space before, during, and after the actual spaceflight experience of our crews, and include support for ground-based functions. Many of our spaceflight innovations also provide solutions for terrestrial challenges, thereby enhancing life on Earth. Our strategic goals are aimed at leading human exploration and ISS utilization, leading human health and performance internationally, excelling in management and advancement of innovations in health and human system integration, and expanding relevance to life on Earth and creating enduring support and enthusiasm for space exploration.

NASA Human Health and Performance Strategy

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.

2012-01-01

In May 2007, what was then the Space Life Sciences Directorate, issued the 2007 Space Life Sciences Strategy for Human Space Exploration. In January 2012, leadership and key directorate personnel were once again brought together to assess the current and expected future environment against its 2007 Strategy and the Agency and Johnson Space Center goals and strategies. The result was a refined vision and mission, and revised goals, objectives, and strategies. One of the first changes implemented was to rename the directorate from Space Life Sciences to Human Health and Performance to better reflect our vision and mission. The most significant change in the directorate from 2007 to the present is the integration of the Human Research Program and Crew Health and Safety activities. Subsequently, the Human Health and Performance Directorate underwent a reorganization to achieve enhanced integration of research and development with operations to better support human spaceflight and International Space Station utilization. These changes also enable a more effective and efficient approach to human system risk mitigation. Since 2007, we have also made significant advances in external collaboration and implementation of new business models within the directorate and the Agency, and through two newly established virtual centers, the NASA Human Health and Performance Center and the Center of Excellence for Collaborative Innovation. Our 2012 Strategy builds upon these successes to address the Agency's increased emphasis on societal relevance and being a leader in research and development and innovative business and communications practices. The 2012 Human Health and Performance Vision is to lead the world in human health and performance innovations for life in space and on Earth. Our mission is to enable optimization of human health and performance throughout all phases of spaceflight. All HH&P functions are ultimately aimed at achieving this mission. Our activities enable mission success, optimizing human health and productivity in space before, during, and after the actual spaceflight experience of our crews, and include support for ground-­- based functions. Many of our spaceflight innovations also provide solutions for terrestrial challenges, thereby enhancing life on Earth. Our strategic goals are aimed at leading human exploration and ISS utilization, leading human health and performance internationally, excelling in management and advancement of innovations in health and human system integration, and expanding relevance to life on Earth and creating enduring support and enthusiasm for space exploration.

Online Social Networking Goes to College: Two Case Studies of Higher Education Institutions That Implemented College-Created Social Networking Sites for Recruiting Undergraduate Students

ERIC Educational Resources Information Center

Ferguson, Christopher Paul

2010-01-01

With increased competition among higher education institutions for best- fit students, the profession of college admissions is compelled to implement innovative recruiting strategies (e.g. online social networking sites), that may impact college access and persistence in the United States. This qualitative study examined the reasons why two…

A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia.

PubMed

Psaila, Kim; Fowler, Cathrine; Kruske, Sue; Schmied, Virginia

2014-12-01

The transition of care (ToC) from maternity services, particularly from midwifery care to child and family health (CFH) nursing services, is a critical time in the support of women as they transition into early parenting. However significant issues in service provision exist, particularly meeting the needs of women with social and emotional health risk factors. These include insufficient resources, poor communication and information transfer, limited interface between private and public health systems and tension around role boundaries. In response some services are implementing strategies to improve the transition of care from maternity to CFH services. This paper describes a range of innovations developed to improve transition of care between maternity and child and family health services and identifies the characteristics common to all innovations. Data reported were collected in phase three of a mixed methods study investigating the feasibility of implementing a national approach to child and family health services in Australia (CHoRUS study). Data were collected from 33 professionals including midwives, child and family health nurses, allied health staff and managers, at seven sites across four Australian states. Data were analysed thematically, guided by Braun and Clarke's six-step process of thematic analysis. The range of innovations implemented included those which addressed; information sharing, the efficient use of funding and resources, development of new roles to improve co-ordination of care, the co-location of services and working together. Four of the seven sites implemented innovations that specifically targeted families with additional needs. Successful implementation was dependent on the preliminary work undertaken which required professionals and/or organisations to work collaboratively. Improving the transition of care requires co-ordination and collaboration to ensure families are adequately supported. Collaboration between professionals and services facilitated innovative practice and was core to successful change. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Implementation of an innovative web-based conference table for community-dwelling frail older people, their informal caregivers and professionals: a process evaluation

PubMed Central

2012-01-01

Background Due to fragmentation of care, continuity of care is often limited in the care provided to frail older people. Further, frail older people are not always enabled to become involved in their own care. Therefore, we developed the Health and Welfare Information Portal (ZWIP), a shared Electronic Health Record combined with a communication tool for community-dwelling frail older people and primary care professionals. This article describes the process evaluation of its implementation, and aims to establish (1) the outcomes of the implementation process, (2) which implementation strategies and barriers and facilitators contributed to these outcomes, and (3) how its future implementation could be improved. Methods Mixed methods study, consisting of (1) a survey among professionals (n = 118) and monitoring the use of the ZWIP by frail older people and professionals, followed by (2) semi-structured interviews with purposively selected professionals (n = 12). Results 290 frail older people and 169 professionals participated in the ZWIP. At the end of the implementation period, 55% of frail older people and informal caregivers, and 84% of professionals had logged on to their ZWIP at least once. For professionals, the exposure to the implementation strategies was generally as planned, they considered the interprofessional educational program and the helpdesk very important strategies. However, frail older people’s exposure to the implementation strategies was less than intended. Facilitators for the ZWIP were the perceived need to enhance interprofessional collaboration and the ZWIP application being user-friendly. Barriers included the low computer-literacy of frail older people, a preference for personal communication and limited use of the ZWIP by other professionals and frail older people. Interviewees recommended using the ZWIP for other target populations as well and adding further strategies that may help frail older people to feel more comfortable with computers and the ZWIP. Conclusions This study describes the implementation process of an innovative e-health intervention for community-dwelling frail older people, informal caregivers and primary care professionals. As e-health is an important medium for overcoming fragmentation of healthcare and facilitating patient involvement, but its adoption in everyday practice remains a challenge, the positive results of this implementation are promising. PMID:22894654

A mixed methods multiple case study of implementation as usual in children’s social service organizations: study protocol

PubMed Central

2013-01-01

Background Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies. Methods/design This study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences. Discussion This study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city. PMID:23961701

Maximizing potential: innovative collaborative strategies between one-stops and mental health systems of care.

PubMed

Boeltzig, Heike; Timmons, Jaimie Ciulla; Marrone, Joe

2008-01-01

Barriers to seamless service delivery between workforce development and mental health systems of care have kept both entities from maximizing their potential in regards to employment for job seekers with mental illness who are capable of work and seeking employment. Using a multiple case study design, this study examined the nature of collaboration between workforce development and mental health systems to understand the policies and practices in place to assist individuals with mental illness to find and keep work. The paper presents innovative strategies that involved staff from both workforce development and mental health agencies. Findings from this research identified the following collaborative strategies: (a) the creation of liaison positions and collaborative teams; (b) staff training on mental health and workforce issues; and (c) multi-level involvement of individuals with mental illness. Implications for workforce professionals are offered as a way to stimulate implementation of such strategies.

The implementation of health promotion in primary and community care: a qualitative analysis of the 'Prescribe Vida Saludable' strategy.

PubMed

Martinez, Catalina; Bacigalupe, Gonzalo; Cortada, Josep M; Grandes, Gonzalo; Sanchez, Alvaro; Pombo, Haizea; Bully, Paola

2017-02-17

The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices. Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable) is focused on designing, planning, implementing and evaluating innovative programs to promote multiple healthy habits, feasible to be performed in routine primary health care conditions. After 2 years of piloting, centers were categorized as having high, medium, or low implementation effectiveness. We completed qualitative inductive and deductive analysis of five focus groups with the staff of the centers. Themes generated through consensual grounded qualitative analysis were compared between centers to identify the dimensions that explain the variation in actual implementation of PVS, and retrospectively organized and assessed against the Consolidated Framework for Implementation Research (CFIR). Of the 36 CFIR constructs, 11 were directly related to the level of implementation performance: intervention source, evidence strength and quality, adaptability, design quality and packaging, tension for change, learning climate, self-efficacy, planning, champions, executing, and reflecting and evaluating, with -organizational tracking added as a new sub-construct. Additionally, another seven constructs emerged in the participants' discourse but were not related to center performance: relative advantage, complexity, patients' needs and resources, external policy and incentives, structural characteristics, available resources, and formally appointed internal implementation leaders. Our findings indicate that the success of the implementation seems to be associated with the following components: the context, the implementation process, and the collaborative modelling. Identifying barriers and enablers is useful for designing implementation strategies for health promotion in primary health care centers that are essential for innovation success. An implementation model is proposed to highlight the relationships between the CFIR constructs in the context of health promotion in primary care.

College Students' Attitude towards Computer Technology

ERIC Educational Resources Information Center

Njagi, K. O.; Havice, W. L.

2011-01-01

Recent advances in the contemporary world, especially in the area of computer technology, have heralded the development and implementation of new and innovative teaching strategies and particularly with the Internet revolution. This study assessed students' attitude towards computer technology. Specifically, the study assessed differences in…

An Optimal Mitigation Strategy Against the Asteroid Impact Threat with Short Warning Time

NASA Technical Reports Server (NTRS)

Wie, Bong; Barbee, Brent; Pitz, Alan; Kaplinger, Brian; Hawkins, Matt; Winkler, Tim; Premaratne, Pavithra; Vardaxis, George; Lyzhoft, Joshua; Zimmerman, Ben

2015-01-01

To develop an innovative yet practically implementable mitigation technique for the most probable impact threat of an asteroid or comet with short warning time (i.e., when we don't have sufficient warning times for a deflection mission).

Implementing Entrepreneurial Assignments in a Multidisciplinary, Sophomore-Level Design Course

ERIC Educational Resources Information Center

Dahm, Kevin; Riddell, William; Merrill, Thomas; Harvey, Roberta; Weiss, Leigh

2013-01-01

Many engineering programs stress the importance of technological innovation by offering entrepreneurship electives and programs. Integration of entrepreneurship into the required engineering curriculum has predominantly focused on senior capstone design courses. This paper describes a strategy for integrating entrepreneurship into a…

Brokering the Evidence-Practice Gap: A Strategy for Moving Evidence Into Clinical Practice.

PubMed

Segre, Lisa S; Trusty, Stephanie; Gullickson, Renee; Chuffo Davila, Rebecca; O'Hara, Michael W

2018-05-08

Moving novel, evidence-based interventions into broad community use is challenging. This column describes how a midlevel public health administrator acted in the role of broker to link university-based researchers with maternal health clinical staff to successfully implement an innovative, evidence-based maternal depression treatment. Program evaluation assessed adoption, implementation, reach, and effectiveness. In reflecting on this partnership, the broker provided critical elements of access, credibility, and accountability. A partnership between service providers and research teams provides one strategy to disseminate evidence-based practices among those served by public-health programs.

Statistical synthesis of contextual knowledge to increase the effectiveness of theory-based behaviour change interventions.

PubMed

Hanbury, Andria; Thompson, Carl; Mannion, Russell

2011-07-01

Tailored implementation strategies targeting health professionals' adoption of evidence-based recommendations are currently being developed. Research has focused on how to select an appropriate theoretical base, how to use that theoretical base to explore the local context, and how to translate theoretical constructs associated with the key factors found to influence innovation adoption into feasible and tailored implementation strategies. The reasons why an intervention is thought not to have worked are often cited as being: inappropriate choice of theoretical base; unsystematic development of the implementation strategies; and a poor evidence base to guide the process. One area of implementation research that is commonly overlooked is how to synthesize the data collected in a local context in order to identify what factors to target with the implementation strategies. This is suggested to be a critical process in the development of a theory-based intervention. The potential of multilevel modelling techniques to synthesize data collected at different hierarchical levels, for example, individual attitudes and team level variables, is discussed. Future research is needed to explore further the potential of multilevel modelling for synthesizing contextual data in implementation studies, as well as techniques for synthesizing qualitative and quantitative data.

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

PubMed

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

2015-10-16

Little research has directly compared the effectiveness of implementation strategies in any setting, and we know of no prior trials directly comparing how effectively different combinations of strategies support implementation in community health centers. This paper outlines the protocol of the Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET), a trial designed to compare the effectiveness of several common strategies for supporting implementation of an intervention and explore contextual factors that impact the strategies' effectiveness in the community health center setting. This cluster-randomized trial compares how three increasingly hands-on implementation strategies support adoption of an evidence-based diabetes quality improvement intervention in 29 community health centers, managed by 12 healthcare organizations. The strategies are as follows: (arm 1) a toolkit, presented in paper and electronic form, which includes a training webinar; (arm 2) toolkit plus in-person training with a focus on practice change and change management strategies; and (arm 3) toolkit, in-person training, plus practice facilitation with on-site visits. We use a mixed methods approach to data collection and analysis: (i) baseline surveys on study clinic characteristics, to explore how these characteristics impact the clinics' ability to implement the tools and the effectiveness of each implementation strategy; (ii) quantitative data on change in rates of guideline-concordant prescribing; and (iii) qualitative data on the "how" and "why" underlying the quantitative results. The outcomes of interest are clinic-level results, categorized using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, within an interrupted time-series design with segmented regression models. This pragmatic trial will compare how well each implementation strategy works in "real-world" practices. Having a better understanding of how different strategies support implementation efforts could positively impact the field of implementation science, by comparing practical, generalizable methods for implementing clinical innovations in community health centers. Bridging this gap in the literature is a critical step towards the national long-term goal of effectively disseminating and implementing effective interventions into community health centers. ClinicalTrials.gov, NCT02325531.

Why and How Do Nursing Homes Implement Culture Change Practices? Insights from Qualitative Interviews in a Mixed Methods Study

PubMed Central

Shield, Renée R.; Looze, Jessica; Tyler, Denise; Lepore, Michael; Miller, Susan C.

2015-01-01

Objective To understand the process of instituting culture change (CC) practices in nursing homes (NHs). Methods NH Directors of Nursing (DONs) and Administrators (NHAs) at 4,149 United States NHs were surveyed about CC practices. Follow-up interviews with 64 NHAs were conducted and analyzed by a multidisciplinary team which reconciled interpretations recorded in an audit trail. Results The themes include: 1) Reasons for implementing CC practices vary; 2) NH approaches to implementing CC practices are diverse; 3) NHs consider resident mix in deciding to implement practices; 4) NHAs note benefits and few implementation costs of implementing CC practices; 5) Implementation of changes is challenging and strategies for change are tailored to the challenges encountered; 6) Education and communication efforts are vital ways to institute change; and 7) NHA and other staff leadership is key to implementing changes. Discussion Diverse strategies and leadership skills appear to help NHs implement reform practices, including CC innovations. PMID:24652888

Phytoremediation and innovative strategies for specialized remedial actions

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

Alleman, B.C.; Leeson, A.

1999-01-01

Phytoremediation is a site remediation strategy whose time seems to have come in the past few years, with field implementations taking place in a host of applications. From laboratory studies on plant uptake to full-scale phytoremediation treatment strategies, this volume covers the use of plants to treat contaminants such as hydrocarbons, metals, pesticides, perchlorate, and chlorinated solvents. In addition to the phytoremediation studies, this volume also covers specialized remediation approaches such as sequential anaerobic/aerobic in situ treatment, membrane bioreactors, and Fenton's reagent oxidation.

Phytoremediation and innovative strategies for specialized remedial actions

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

Alleman, B.C.; Leeson, A.

1999-11-01

Phytoremediation is a site remediation strategy whose time seems to have come in the past few years, with field implementations taking place in a host of applications. From laboratory studies on plant uptake to full-scale phytoremediation treatment strategies, this volume covers the use of plants to treat contaminants such as hydrocarbons, metals, pesticides, perchlorate, and chlorinated solvents. In addition to the phytoremediation studies, this volume also covers specialized remediation approaches such as sequential anaerobic/aerobic in situ treatment, membrane bioreactors, and Fenton`s reagent oxidation.

Phytoremediation and innovative strategies for specialized remedial applications

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

Alleman, B.C.; Leeson, A.

1999-10-01

Phytoremediation is a site remediation strategy whose time seems to have come in the past few years, with field implementations taking place in a host of applications. From laboratory studies on plant uptake to full-scale phytoremediation treatment strategies, this volume covers the use of plants to treat contaminants such as hydrocarbons, metals, pesticides, perchlorate, and chlorinated solvents. In addition to the phytoremediation studies, this volume also covers specialized remediation approaches such as sequential anaerobic/aerobic in situ treatment, membrane bioreactors, and Fenton`s reagent oxidation.

An Effective Model of In-Service Workshops for Elementary Teachers.

ERIC Educational Resources Information Center

Manning, Patricia C.; Dziuban, Charles

After needs assessments were conducted in six Florida school districts, strategies were developed for implementing creative and relevant workshops emphasizing curricular innovations and individualized instruction. Procedures and techniques evolved from 50 workshops given to 1500 elementary school teachers. Among the activities were: multimedia…

Excellent Beginnings: Evaluation of Phase I (1991-1994).

ERIC Educational Resources Information Center

Brickman, Alan

In 1991 the Plan for Social Excellence, Inc., funded three elementary schools to design and implement a comprehensive early childhood education program. This funding initiative, entitled "Excellent Beginnings," supports programs that include innovative curriculum and classroom-management strategies, extensive parent participation, the use of high…

Reducing Adverse Impact: One City's Efforts.

ERIC Educational Resources Information Center

Prewitt, Jeff

Following a workshop on "Innovations in Employment Testing that Improve Validity and Reduce Adverse Impact," the City of Louisville (Kentucky) implemented a strategy to develop a comprehensive testing and recruiting program for police recruits. To improve candidate expectations and preparation, the following activities were undertaken:…

Technology-Supported Change: A Staff Development Opportunity.

ERIC Educational Resources Information Center

Bradshaw, Lynn K.

1997-01-01

Implementing technology in a classroom is a personal process that varies from teacher to teacher. The Concerns-Based Adoption Model identifies seven stages of concern that teachers may experience, from awareness to refocusing ideas. Innovative staff development strategies include establishing organizational structures to support technological and…

New York State's "Assets Coming Together (ACT) for Youth": a statewide approach effects community change.

PubMed

Riser, Marta H; Mesler, Kristine; Tallon, Thomas C; Birkhead, Guthrie S

2006-11-01

The New York State Department of Health launched an innovative initiative, Assets Coming Together (ACT) for Youth, implemented in 2000, as a public health strategy to promote youth development (YD) as a means to improve health outcomes for youth. ACT for Youth shifted the focus from problems and problem reduction to assets and strength-based means of improving health by enhancing opportunities and supports in communities for all youth and their families. ACT for Youth is innovative in its emphasis on community building and community change at multiple levels. This descriptive report mentions development, implementation, specific objectives, and highlights of accomplishments in mobilizing communities around YD. Lessons learned over the first 5 years of the initiative are reviewed, with emphasis on the elements of successful health department YD programming. From this foundation, New York State hopes to be in the vanguard of utilizing YD as a public health improvement strategy and hopes that others will follow.

Implementing community-based provider participation in research: an empirical study.

PubMed

Teal, Randall; Bergmire, Dawn M; Johnston, Matthew; Weiner, Bryan J

2012-05-08

Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute's (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness.

The Seeds of Policy Change: Leveraging Diffusion to Disseminate Policy Innovations.

PubMed

Boehmke, Frederick J; Rury, Abigail Matthews; Desmarais, Bruce A; Harden, Jeffrey J

2017-04-01

We conduct a series of simulations to compare how various strategies for seeding a policy in the American states affect the rate at which that policy spreads. Using empirically derived parameters of the policy diffusion process, we simulate the diffusion of a hypothetical policy after seeding the policy in just a handful of states. We compare these strategies to seeding the ten states the RWJF monitored during the states' implementation of the Affordable Care Act of 2010. We attempt to mimic the choices that policy advocates make when deciding which states to target with their resources. Our results indicate that focusing on innovative states, that is, those that tend to adopt new policies faster, offers a valuable boost in the speed of diffusion. Even better, though, is a strategy that targets policy leaders. Copyright © 2017 by Duke University Press.

Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

PubMed

Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

2015-11-01

Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

Training innovations in gastroenterology and educational resources: a new vision of gastrointestinal education across Europe.

PubMed

Berberat, Pascal O; de Wit, Niek J; Bockhorn, Maximilian; Lundell, Lars; Drenth, Joost P H

2010-12-01

To define a new educational strategy for the United European Gastroenterology Federation (UEGF) to be followed and implemented in the near future. UEGF organized a consensus-based strategy meeting with stakeholders and key decision makers in European Gastroenterology on Training Innovations in Gastroenterology and Educational Resources. In May 2010, in an 'open-face conference' at Starnberg, Germany, 59 specialists in gastroenterology, hepatology, and related fields from 15 countries and 16 societies participated. Breakout sessions identified the key problem areas, possible solutions, and formulated statements subsequently voted upon in plenum. A majority of the formulated statements (59%) reached a strong agreement. Topics in which UEGF should focus are the future educational activities that include developing ways to advocate multidisciplinarity and integration between levels of care and specialties, ways to improve quality of care, and the development of training tools. The successful outcome of the Training Innovations in Gastroenterology and Educational Resources conference was achieved with the production of a strategy layout for new UEGF educational activities. There was an agreement that improvement in topics related to multidisciplinarity and professionalism, which is crucial for further development. An open-face conference, such as that embodied by the Training Innovations in Gastroenterology and Educational Resources meeting, was shown to be an effective tool in identifying the key problem areas in education and in formulating new strategies.

Productivity-enhancing work innovations: remedies for what ails hospitals?

PubMed

Hames, D S

1991-01-01

Prospective pricing, the proliferation of alternative delivery systems, and the demands of third party payers and corporate employers for the containment of health care costs have engendered the keen interest of hospital executives seeking strategies for improving labor productivity. Despite this interest, the relevant literature suggests that few work innovations designed to enhance labor productivity have been implemented in hospitals. This article describes generic versions of four such work innovations--quality circles, union-management committees, autonomous work groups, and gainsharing--and discusses relevant research indicating the types of benefits gained from each and the reasons why some have failed. Each innovation's potential for success in hospitals is evaluated, and suggestions for increasing the effectiveness of each in hospitals is offered.

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

PubMed

Bousquet, J; Farrell, J; Crooks, G; Hellings, P; Bel, E H; Bewick, M; Chavannes, N H; de Sousa, J Correia; Cruz, A A; Haahtela, T; Joos, G; Khaltaev, N; Malva, J; Muraro, A; Nogues, M; Palkonen, S; Pedersen, S; Robalo-Cordeiro, C; Samolinski, B; Strandberg, T; Valiulis, A; Yorgancioglu, A; Zuberbier, T; Bedbrook, A; Aberer, W; Adachi, M; Agusti, A; Akdis, C A; Akdis, M; Ankri, J; Alonso, A; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Bai, C; Baiardini, I; Bachert, C; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Kheder, A Ben; Bennoor, K S; Benson, M; Bergmann, K C; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Blasi, F; Boner, A L; Bonini, M; Bonini, S; Bosnic-Anticevitch, S; Boulet, L P; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Caimmi, D; Calderon, M A; Calverley, P M; Camargos, P A M; Canonica, G W; Camuzat, T; Carlsen, K H; Carr, W; Carriazo, A; Casale, T; Cepeda Sarabia, A M; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Chung, K F; Ciprandi, G; Cirule, I; Cox, L; Costa, D J; Custovic, A; Dahl, R; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; De Manuel Keenoy, E; Demoly, P; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Djukanovic, R; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fabbri, L M; Fletcher, M; Fiocchi, A; Fink Wagner, A; Fonseca, J; Fokkens, W J; Forastiere, F; Frith, P; Gaga, M; Gamkrelidze, A; Garces, J; Garcia-Aymerich, J; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grisle, I; Grouse, L; Gutter, Z; Guzmán, M A; Heaney, L G; Hellquist-Dahl, B; Henderson, D; Hendry, A; Heinrich, J; Heve, D; Horak, F; Hourihane, J O' B; Howarth, P; Humbert, M; Hyland, M E; Illario, M; Ivancevich, J C; Jardim, J R; Jares, E J; Jeandel, C; Jenkins, C; Johnston, S L; Jonquet, O; Julge, K; Jung, K S; Just, J; Kaidashev, I; Kaitov, M R; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Lodrup Carlsen, K; Louis, R; MacNee, W; Magard, Y; Magnan, A; Mahboub, B; Mair, A; Majer, I; Makela, M J; Manning, P; Mara, S; Marshall, G D; Masjedi, M R; Matignon, P; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Menzies-Gow, A; Merk, H; Michel, J P; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, G M Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Morgan, M; Mösges, R; Mullol, J; Nafti, S; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Ninot, G; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Panzner, P; Papadopoulos, N; Papi, A; Park, H S; Passalacqua, G; Pavord, I; Pawankar, R; Pengelly, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Poethig, D; Pohl, W; Popov, T A; Portejoie, F; Potter, P; Postma, D; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Reitamo, S; Rennard, S; Rodenas, F; Roberts, J; Roca, J; Rodriguez Mañas, L; Rolland, C; Roman Rodriguez, M; Romano, A; Rosado-Pinto, J; Rosario, N; Rosenwasser, L; Rottem, M; Ryan, D; Sanchez-Borges, M; Scadding, G K; Schunemann, H J; Serrano, E; Schmid-Grendelmeier, P; Schulz, H; Sheikh, A; Shields, M; Siafakas, N; Sibille, Y; Similowski, T; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Sterk, P J; Sunyer, J; Thijs, C; To, T; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; Valia, E; Valovirta, E; Van Ganse, E; van Hage, M; Vandenplas, O; Vasankari, T; Vellas, B; Vestbo, J; Vezzani, G; Vichyanond, P; Viegi, G; Vogelmeier, C; Vontetsianos, T; Wagenmann, M; Wallaert, B; Walker, S; Wang, D Y; Wahn, U; Wickman, M; Williams, D M; Williams, S; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zaidi, A; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

2016-01-01

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

Innovative Test Operations to Support Orion and Future Human Rated Missions

NASA Technical Reports Server (NTRS)

Koenig, William J.; Garcia, Rafael; Harris, Richard F.; See, Michael J.; Van Lear, Benjamin S.; Dobson, Jill M.; Norris, Scott Douglas

2017-01-01

This paper describes how the Orion program is implementing new and innovative test approaches and strategies in an evolving development environment. The early flight test spacecraft are evolving in design maturity and complexity requiring significant changes in the ground test operations for each mission. The testing approach for EM-2 is planned to validate innovative Orion production acceptance testing methods to support human exploration missions in the future. Manufacturing and testing at Kennedy Space Center in the Neil Armstrong Operations and Checkout facility will provide a seamless transition directly to the launch site avoiding transportation and checkout of the spacecraft from other locations.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

PubMed

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013 John Wiley & Sons Ltd.

A Perspective on Implementing a Quantitative Systems Pharmacology Platform for Drug Discovery and the Advancement of Personalized Medicine.

PubMed

Stern, Andrew M; Schurdak, Mark E; Bahar, Ivet; Berg, Jeremy M; Taylor, D Lansing

2016-07-01

Drug candidates exhibiting well-defined pharmacokinetic and pharmacodynamic profiles that are otherwise safe often fail to demonstrate proof-of-concept in phase II and III trials. Innovation in drug discovery and development has been identified as a critical need for improving the efficiency of drug discovery, especially through collaborations between academia, government agencies, and industry. To address the innovation challenge, we describe a comprehensive, unbiased, integrated, and iterative quantitative systems pharmacology (QSP)-driven drug discovery and development strategy and platform that we have implemented at the University of Pittsburgh Drug Discovery Institute. Intrinsic to QSP is its integrated use of multiscale experimental and computational methods to identify mechanisms of disease progression and to test predicted therapeutic strategies likely to achieve clinical validation for appropriate subpopulations of patients. The QSP platform can address biological heterogeneity and anticipate the evolution of resistance mechanisms, which are major challenges for drug development. The implementation of this platform is dedicated to gaining an understanding of mechanism(s) of disease progression to enable the identification of novel therapeutic strategies as well as repurposing drugs. The QSP platform will help promote the paradigm shift from reactive population-based medicine to proactive personalized medicine by focusing on the patient as the starting and the end point. © 2016 Society for Laboratory Automation and Screening.

Classifying Adoption of Sustainability Policies and Programs: Quantitative and Qualitative Methods for the Development of a Community Sustainability Typology

EPA Science Inventory

Understanding how and why different communities engage with sustainability policies and actions is of critical importance for furthering implementation of innovative and conventional sustainability strategies. Despite this importance, an understanding of how and why communities a...

Energy minimization strategies and renewable energy utilization for desalination: a review.

PubMed

Subramani, Arun; Badruzzaman, Mohammad; Oppenheimer, Joan; Jacangelo, Joseph G

2011-02-01

Energy is a significant cost in the economics of desalinating waters, but water scarcity is driving the rapid expansion in global installed capacity of desalination facilities. Conventional fossil fuels have been utilized as their main energy source, but recent concerns over greenhouse gas (GHG) emissions have promoted global development and implementation of energy minimization strategies and cleaner energy supplies. In this paper, a comprehensive review of energy minimization strategies for membrane-based desalination processes and utilization of lower GHG emission renewable energy resources is presented. The review covers the utilization of energy efficient design, high efficiency pumping, energy recovery devices, advanced membrane materials (nanocomposite, nanotube, and biomimetic), innovative technologies (forward osmosis, ion concentration polarization, and capacitive deionization), and renewable energy resources (solar, wind, and geothermal). Utilization of energy efficient design combined with high efficiency pumping and energy recovery devices have proven effective in full-scale applications. Integration of advanced membrane materials and innovative technologies for desalination show promise but lack long-term operational data. Implementation of renewable energy resources depends upon geography-specific abundance, a feasible means of handling renewable energy power intermittency, and solving technological and economic scale-up and permitting issues. Copyright © 2011 Elsevier Ltd. All rights reserved.

Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association.

PubMed

Cheng, Adam; Nadkarni, Vinay M; Mancini, Mary Beth; Hunt, Elizabeth A; Sinz, Elizabeth H; Merchant, Raina M; Donoghue, Aaron; Duff, Jonathan P; Eppich, Walter; Auerbach, Marc; Bigham, Blair L; Blewer, Audrey L; Chan, Paul S; Bhanji, Farhan

2018-06-21

The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest. © 2018 American Heart Association, Inc.

Analysis of Propagation Plans in NSF-Funded Education Development Projects

NASA Astrophysics Data System (ADS)

Stanford, Courtney; Cole, Renee; Froyd, Jeff; Henderson, Charles; Friedrichsen, Debra; Khatri, Raina

2017-08-01

Increasing adoption and adaptation of promising instructional strategies and materials has been identified as a critical component needed to improve science, technology, engineering, and mathematics (STEM) education. This paper examines typical propagation practices and resulting outcomes of proposals written by developers of educational innovations. These proposals were analyzed using the Designing for Sustained Adoption Assessment Instrument (DSAAI), an instrument developed to evaluate propagation plans, and the results used to predict the likelihood that a successful project would result in adoption by others. We found that few education developers propose strong propagation plans. Afterwards, a follow-up analysis was conducted to see which propagation strategies developers actually used to help develop, disseminate, and support their innovations. A web search and interviews with principal investigators were used to determine the degree to which propagation plans were actually implemented and to estimate adoption of the innovations. In this study, we analyzed 71 education development proposals funded by the National Science Foundation and predicted that 80% would be unsuccessful in propagating their innovations. Follow-up data collection with a subset of these suggests that the predictions were reasonably accurate.

Alternative Fuels Data Center: Federal Laws and Incentives for Natural Gas

Science.gov Websites

emissions. Grants are available to states, non-profits, and academic institutions to demonstrate innovative from diesel engines through the implementation of varied control strategies and the involvement of are school districts, state and local government programs, federally recognized Indian tribes, and non

Creating Dedicated Local and State Revenue Sources for Youth Programs

ERIC Educational Resources Information Center

Sherman, Rachel H.; Deich, Sharon G.; Langford, Barbara Hanson

2007-01-01

This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to assist policy makers, program developers and community leaders in developing innovative strategies for implementing, financing and sustaining effective programs and policies. This brief highlights six…

A Guide to Successful Public Private Partnerships for Youth Programs

ERIC Educational Resources Information Center

Relave, Nanette; Deich, Sharon

2007-01-01

This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This guide provides practical…

The Career Advancement Portfolio. Advancement for Low-Wage Workers

ERIC Educational Resources Information Center

Jobs for the Future, 2006

2006-01-01

Jobs for the Future created the "Career Advancement Portfolio" as central to its commitment to developing, implementing, and advocating for models, strategies, and policies that enable adults to advance toward economic self-sufficiency for themselves and their families. The "Portfolio" brings together the most innovative workforce development…

Lieko Earle | NREL

Science.gov Websites

evaluations of innovative building envelopes, water heating, and HVAC systems. She also conducts laboratory barriers for emerging and advanced retrofit systems to be implemented on a broad basis, as well as field Monitoring (NILM) techniques, and control strategies to develop cost-effective systems that integrate

10 Budget-Savvy Content Management Strategies

ERIC Educational Resources Information Center

Hillis, David J.

2004-01-01

Facing an overall budget reduction of 10 percent, most colleges or universities would postpone investing in a Web content management system. However, for California State University Monterey Bay (CSUMB), a large budget cut made Web content management even more important. CSUMB found an innovative way to purchase and implement a new Content…

Additive Manufacturing in Finland: Recommendations for a Renewed Innovation Policy

NASA Astrophysics Data System (ADS)

Ituarte, Iñigo Flores; Salmi, Mika; Ballardini, Rosa Maria; Tuomi, Jukka; Partanen, Jouni

The objective of this research is to define an optimal innovation policy and funding strategy to improve Additive Manufacturing (AM) capabilities in Finnish companies. To do so, we present an international review of innovation programs in the area of AM. In addition, the study replied upon a survey prepared to evaluate factors for AM implementation. The ultimate goal is to help in the definition of a national policy strategy in the area of AM based on the characteristics of the Finnish industrial ecosystem. The methodology and data collection method involved defining the taxonomy of Finnish AM industry. The target group of the survey was a population of AM experts, and individuals with knowledge on AM and industrial processes. Overall, the survey revealed that research and innovation activities are well positioned in Finland. In order for future innovation policies to further support developments in the field, we estimated that policy strategies need to generate about 6-8 M€/year in national and EU- funding instruments for AM technology transfer, development, and innovation activities. Efforts should be targeted towards strengthening uses of AM in final production. In fact, only 36% of Finnish respondents declared to use AM for final production, while leading countries in AM use it in average more than 50%. Another area in need of development in Finland is the use of AM high performance materials. Moreover, outsourcing of AM services in Finland is 23 percentage point higher in national and 13 percentage point higher in international outsourcing to service bureaus and suppliers. In this regard, future policies and funding strategies should maintain the created momentum. However, there is a need to acquire high-end research and industrial equipment to stimulate AM integration to the existing production systems. This in the end can trigger the creation of new products, processes and intellectual property, enabling innovation and competitive advantage.

Relationship among science teacher personality characteristics and degree of teacher classroom implementation after in-service workshop

NASA Astrophysics Data System (ADS)

Sechler, Phares Lochiel Coleman

State departments of public instruction require that teachers periodically update their licenses throughout their teaching careers. Various professional development events such as in-service workshops, university offerings, and special innovative programs provide opportunities for novice and experienced teachers to grow professionally. The "Team Science" workshop was designed from models supported by research that described guidelines for successful workshop strategies. In evaluating the workshop, the question was asked "Why did not all teachers implement the ideas from the workshop in their science classrooms?" This study investigates the possible relationship between teacher personality characteristics and implementation of technology innovations. Team Science was an extensive workshop program planned to develop science teachers' expertise in using computer and video technology to teach in physical science, chemistry, and physics classrooms in rural school in North Carolina. Upon evaluating the four-year effort, it was found that the 23 participants implemented the technological strategies at various levels. At the higher end of the range of technology use, some teachers exhibited complete integration of the computers and interfacing devices into both the laboratory work and the classroom inquiry. At the lower end of the range, some teachers used the technology very little. The resulting question emerged from the data collected: Do specific teacher personality characteristics (independent variables) correlate with the degree of implementation (dependent variable) of the innovative ideas and tools used in the teacher's science classroom after the in-service workshop? To determine if there were any significant personality traits, each teacher was given five personality tests. The tests were Hunt's Conceptual Development Test, the Paragraph Completion Test; James Rest's Defining Issues Test; Simmons Personal Survey, an emotional tendency test; the Myers-Briggs Type Indicator; and Riggs and Enochs Self-Efficacy Test. The data were analyzed using descriptive statistics, multiple regression, and factor analysis to see what variables were predictors of implementation. The regression analysis revealed that subtests from Myers-Briggs Type Indicator, Simmons Personal Survey, Hunt's Paragraph Completion Test, and Rest's Defining Issues Test could be used to predict implementation. Factor analysis indicated teachers who implemented the technology were "risk takers" and "flexible planners."

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

PubMed

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

2013-01-01

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

Research odyssey: the evolution of a research partnership between baccalaureate nursing students and practicing nurses.

PubMed

Gray, Mary Tod

2010-05-01

This longitudinal descriptive study evaluates the implementation of an innovative teaching strategy: a research partnership between baccalaureate nursing students and nurses in two acute care hospitals. The impetus for this partnership was to introduce a concrete, clinical dimension to a junior level introductory nursing research course. Formative analysis was used to evaluate the success and weaknesses of this innovative strategy over 3 years. Following each year, an evaluation by students and nursing unit managers led to refinement of the partnership goals and logistics for the following year. The third year culminates in a comparison between student responses to the partnership in the small community hospital and those assigned to a larger magnet status hospital. Conclusions, based on content and descriptive analysis indicate the partnership's educational benefits for students and a few logistical concerns. Future directions for this educational strategy are presented. Copyright 2009 Elsevier Ltd. All rights reserved.

From Innovation to Impact at Scale: Lessons Learned from a Cluster of Research-Community Partnerships

PubMed Central

Schindler, Holly S.; Fisher, Philip A.; Shonkoff, Jack P.

2017-01-01

This paper presents a description of how an interdisciplinary network of academic researchers, community-based programs, parents, and state agencies have joined together to design, test, and scale a suite of innovative intervention strategies rooted in new knowledge about the biology of adversity. Through a process of co-creation, collective pilot-testing, and the support of a measurement and evaluation hub, the Washington State Innovation Cluster is using rapid cycle, iterative learning to elucidate differential impacts of interventions designed to build child and caregiver capacities and address the developmental consequences of socioeconomic disadvantage. Key characteristics of the Innovation Cluster model are described and an example is presented of a video-coaching intervention that has been implemented, adapted, and evaluated through this distinctive, collaborative process. PMID:28777436

The cost-effectiveness of quality improvement projects: a conceptual framework, checklist and online tool for considering the costs and consequences of implementation-based quality improvement.

PubMed

Thompson, Carl; Pulleyblank, Ryan; Parrott, Steve; Essex, Holly

2016-02-01

In resource constrained systems, decision makers should be concerned with the efficiency of implementing improvement techniques and technologies. Accordingly, they should consider both the costs and effectiveness of implementation as well as the cost-effectiveness of the innovation to be implemented. An approach to doing this effectively is encapsulated in the 'policy cost-effectiveness' approach. This paper outlines some of the theoretical and practical challenges to assessing policy cost-effectiveness (the cost-effectiveness of implementation projects). A checklist and associated (freely available) online application are also presented to help services develop more cost-effective implementation strategies. © 2015 John Wiley & Sons, Ltd.

What would it take? Stakeholders' views and preferences for implementing a health care manager program in community mental health clinics under health care reform.

PubMed

Cabassa, Leopoldo J; Gomes, Arminda P; Lewis-Fernández, Roberto

2015-02-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders' recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. © The Author(s) 2014.

What Would It Take? Stakeholders’ Views and Preferences for Implementing a Health Care Manager Program in Community Mental Health Clinics Under Health Care Reform

PubMed Central

Cabassa, Leopoldo J.; Gomes, Arminda P.; Lewis-Fernández, Roberto

2015-01-01

Health care manager interventions can improve the physical health of people with serious mental illness (SMI). In this study, we used concepts from the theory of diffusion of innovations, the consolidated framework for implementation research and a taxonomy of implementation strategies to examine stakeholders’ recommendations for implementing a health care manager intervention in public mental health clinics serving Hispanics with SMI. A purposive sample of 20 stakeholders was recruited from mental health agencies, primary care clinics, and consumer advocacy organizations. We presented participants a vignette describing a health care manager intervention and used semistructured qualitative interviews to examine their views and recommendations for implementing this program. Interviews were recorded, professionally transcribed, and content analyzed. We found that a blend of implementation strategies that demonstrates local relative advantage, addresses cost concerns, and enhances compatibility to organizations and the client population is critical for moving health care manager interventions into practice. PMID:25542194

Sharing risk between payer and provider by leasing health technologies: an affordable and effective reimbursement strategy for innovative technologies?

PubMed

Edlin, Richard; Hall, Peter; Wallner, Klemens; McCabe, Christopher

2014-06-01

The challenge of implementing high-cost innovative technologies in health care systems operating under significant budgetary pressure has led to a radical shift in the health technology reimbursement landscape. New reimbursement strategies attempt to reduce the risk of making the wrong decision, that is, paying for a technology that is not good value for the health care system, while promoting the adoption of innovative technologies into clinical practice. The remaining risk, however, is not shared between the manufacturer and the health care payer at the individual purchase level; it continues to be passed from the manufacturer to the payer at the time of purchase. In this article, we propose a health technology payment strategy-technology leasing reimbursement scheme-that allows the sharing of risk between the manufacturer and the payer: the replacing of up-front payments with a stream of payments spread over the expected duration of benefit from the technology, subject to the technology delivering the claimed health benefit. Using trastuzumab (Herceptin) in early breast cancer as an exemplar technology, we show how a technology leasing reimbursement scheme not only reduces the total budgetary impact of the innovative technology but also truly shares risk between the manufacturer and the health care system, while reducing the value of further research and thus promoting the rapid adoption of innovative technologies into clinical practice. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Ecological control line: A decade of exploration and an innovative path of ecological land management for megacities in China.

PubMed

Hong, Wuyang; Yang, Chengyun; Chen, Liuxin; Zhang, Fangfang; Shen, Shaoqing; Guo, Renzhong

2017-04-15

Ecological control line is a system innovation in the field of ecological environment protection in China and it has become as an important strategy of national ecological protection. Ten years have passed since the first ecological control line in Shenzhen was delimited in 2005. This study examines the connotations of ecological control line and the current study status in China and abroad, and then takes a brief description about the delimitation background and existing problems of the ecological control line in Shenzhen. The problem-solving strategy is gradually transforming from extensive management to refined management. This study proposes a differential ecological space management model that merges the space system, management system, and support system. The implementation paths include the following five aspects: delimiting ecological bottom lines to protect core ecological resources; formulating access systems for new construction projects to strictly control new construction; implementing construction land inventory reclamation assisted by market means; regulating boundary adjusting procedures and processes; and constructing ecological equity products by using multiple means to implement rights relief. Finally, this study illustrates the progress of the implementation and discusses the rigorousness and flexibility problems of ecological control line and calls for the promotion of the legislation. The management model and implementation paths proposed in this study have referential significance for developing countries and megacities to achieve ecological protection and sustainable development. Copyright © 2017 Elsevier Ltd. All rights reserved.

An evaluation of strategies to control noise from air conditioning and refrigeration condensing units

NASA Astrophysics Data System (ADS)

Durden, G. L.; Myers, J. O.; Towers, T. A.; Dickman, D. M.

1981-12-01

Noise from air conditioning and refrigeration condensing units is investigated. The practical aspects of attempting to implement innovative approaches are emphasized. These included: (1) sample selection, (2) noise measurement survey, (3) implementation of aggressive abatement procedures, (4) development and use of a screening graph for determining acceptability of sound rated outdoor unitary equipment, (5) incorporation of noise control considerations, (6) exploration of an operatinal curfew, and (7) development of an incentive/information program.

Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Hurlburt, Michael S

2015-01-16

Leadership is important in the implementation of innovation in business, health, and allied health care settings. Yet there is a need for empirically validated organizational interventions for coordinated leadership and organizational development strategies to facilitate effective evidence-based practice (EBP) implementation. This paper describes the initial feasibility, acceptability, and perceived utility of the Leadership and Organizational Change for Implementation (LOCI) intervention. A transdisciplinary team of investigators and community stakeholders worked together to develop and test a leadership and organizational strategy to promote effective leadership for implementing EBPs. Participants were 12 mental health service team leaders and their staff (n = 100) from three different agencies that provide mental health services to children and families in California, USA. Supervisors were randomly assigned to the 6-month LOCI intervention or to a two-session leadership webinar control condition provided by a well-known leadership training organization. We utilized mixed methods with quantitative surveys and qualitative data collected via surveys and a focus group with LOCI trainees. Quantitative and qualitative analyses support the LOCI training and organizational strategy intervention in regard to feasibility, acceptability, and perceived utility, as well as impact on leader and supervisee-rated outcomes. The LOCI leadership and organizational change for implementation intervention is a feasible and acceptable strategy that has utility to improve staff-rated leadership for EBP implementation. Further studies are needed to conduct rigorous tests of the proximal and distal impacts of LOCI on leader behaviors, implementation leadership, organizational context, and implementation outcomes. The results of this study suggest that LOCI may be a viable strategy to support organizations in preparing for the implementation and sustainment of EBP.

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

PubMed

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

2018-03-21

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

Reinventing R&D in an open innovation ecosystem.

PubMed

Traitler, Helmut; Watzke, Heribert J; Saguy, I Sam

2011-03-01

Today, the idea that random collisions and interactions offer solutions and business opportunities is no longer acceptable. Instead, partnerships and alignments, both downstream and upstream, are paramount for cross-fertilization and synergy. To survive, and thrive, in today's world of global innovation, alliances based on compatible differences must be sought. Innovation Partnerships and the Sharing-is-Winning model represent a paradigm shift toward accelerating co-development of sustainable innovation, with alignment of the entire value chain with consumer-centric innovations being one of its main pillars. It includes 3 levels of typical joint development: universities, research institutes, and centers; start-ups and individual inventors; a select number of key strategic suppliers. Reinventing R&D in an open innovation ecosystem and increasing success rates in an increasingly competitive marketplace require implementing significant steps--both perceived and tangible. Specific recommendations are provided for 10 major identified topics: leadership, strategy, the consumer, the value chain, internal experts and championship, metrics, IP, culture, academia, and passion. The Sharing-is-Winning model extends the scope of open innovation to sustainable and enhanced processes of co-innovation.

Implementing community-based provider participation in research: an empirical study

PubMed Central

2012-01-01

Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Conclusion Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness. PMID:22568935

Bridging the Research-to-Practice Gap in Autism Intervention: An Application of Diffusion of Innovation Theory

PubMed Central

Mandell, David S.

2011-01-01

There is growing evidence that efficacious interventions for autism are rarely adopted or successfully implemented in public mental health and education systems. We propose applying diffusion of innovation theory to further our understanding of why this is the case. We pose a practical set of questions that administrators face as they decide about the use of interventions. Using literature from autism intervention and dissemination science, we describe reasons why efficacious interventions for autism are rarely adopted, implemented, and maintained in community settings, all revolving around the perceived fit between the intervention and the needs and capacities of the setting. Finally, we suggest strategies for intervention development that may increase the probability that these interventions will be used in real-world settings. PMID:20717714

Active Implementation Frameworks for Successful Service Delivery: Catawba County Child Wellbeing Project

ERIC Educational Resources Information Center

Metz, Allison; Bartley, Leah; Ball, Heather; Wilson, Dawn; Naoom, Sandra; Redmond, Phil

2015-01-01

Traditional approaches to disseminating research based programs and innovations for children and families, which rely on practitioners and policy makers to make sense of research on their own, have been found insufficient. There is growing interest in strategies that "make it happen" by actively building the capacity of service providers…

Establishing and Sustaining Networked Improvement Communities: Lessons from Michigan and Minnesota. REL 2017-264

ERIC Educational Resources Information Center

Proger, Amy R.; Bhatt, Monica P.; Cirks, Victoria; Gurke, Deb

2017-01-01

There is growing interest in the ability of improvement science--the systematic study of improvement strategies to identify promising practices for addressing issues in complex systems (Improvement Science Research Network, 2016)--to spur innovation and address complex problems. In education this methodology is often implemented through…

Defragging Computer/Videogame Implementation and Assessment in the Social Studies

ERIC Educational Resources Information Center

McBride, Holly

2014-01-01

Students in this post-industrial technological age require opportunities for the acquisition of new skills, especially in the marketplace of innovation. A pedagogical strategy that is becoming more and more popular within social studies classrooms is the use of computer and video games as enhancements to everyday lesson plans. Computer/video games…

Finding Funding: A Guide to Federal Sources for Youth Programs. Finding Funding Series

ERIC Educational Resources Information Center

Dobbins-Harper, Dionne; Bhat, Soumya

2007-01-01

This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This guide outlines strategies…

Policy Rhetoric and the Renovation of English Schooling: The Case of Creative Partnerships

ERIC Educational Resources Information Center

Jones, Ken; Thomson, Pat

2008-01-01

Facing difficulties in the implementation of its "standards" agenda, the English government has recently introduced a set of policy strategies and initiatives which seek to promote enjoyment, innovation and creativity in education. One such initiative is Creative Partnerships (CP). Funded predominantly from the Arts portfolio, CP brings…

RTI Success: Proven Tools and Strategies for Schools and Classrooms

ERIC Educational Resources Information Center

Whitten, Elizabeth; Esteves, Kelli J.; Woodrow, Alice

2009-01-01

What is Response to Intervention (RTI) and how can it benefit your school? Find out in "RTI Success", an all-in-one resource that provides information on this innovative model as well as step-by-step administrator guidelines and practical teacher tools for implementation. Despite ongoing federal initiatives meant to increase the profile…

Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

ERIC Educational Resources Information Center

Wainer, Allison L.; Ingersoll, Brooke R.

2015-01-01

Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

Innovating from the Inside: Teacher Influence and the "Promisingness" of Digital Learning Environments

ERIC Educational Resources Information Center

Cloonan, Anne; Hutchison, Kirsten; Paatsch, Louise

2014-01-01

In line with global trends, Australian educational policy emphatically recognises the need for contemporary learners to be digitally literate, with provision of "one-to-one" devices to individual learners in schools a major implementation strategy. However, without teacher commitment, the benefits of such investment in one-to-one…

The Effective Teacher's Guide: 50 Ways to Engage Students and Promote Interactive Learning. Second Edition

ERIC Educational Resources Information Center

Frey, Nancy

2010-01-01

This popular guide offers a wealth of innovative, research-based strategies for making K-12 classrooms the best learning environments they can be. Easy-to-implement best practices are presented for establishing a classroom management plan, organizing procedures and materials, building a respectful community, fostering peer collaboration, and…

Technology in the Trenches: Using Standards To Improve the Quality of Instruction.

ERIC Educational Resources Information Center

Soine, Robin

New approaches to teaching and learning are common, but nothing will change unless these ideas are brought to the frontlines of the classroom. Facing the challenge to incorporate varied innovative teaching and learning strategies, set statewide and schoolwide goals, and implement standards, schools need a systematic, consistent framework and high…

Schooling as a Knowledge System: Lessons from Cramim Experimental School

ERIC Educational Resources Information Center

Chen, David

2010-01-01

This article describes an experiment utilizing a research and development strategy to design and implement an innovative school for the future. The development of Cramim Elementary School was a joint effort of researchers from Tel-Aviv University and the staff of the school. The design stage involved constructing a new theoretical framework that…

78 FR 30305 - The President's Management Advisory Board (PMAB); Public Advisory Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... strategies for the implementation of best business practices to improve Federal Government management and... for 2013 which include Management Innovation and Optimizing Federal Real Estate. In addition, the PMAB... offices at GSA, Washington, DC 20006, on official business days between the hours of 10 a.m. and 5 p.m...

The Employment Retention and Advancement Project: Paths to Advancement for Single Parents

ERIC Educational Resources Information Center

Miller, Cynthia; Deitch, Victoria; Hill, Aaron

2010-01-01

Between 2000 and 2003, the Employment Retention and Advancement (ERA) project identified and implemented a diverse set of innovative models designed to promote employment stability and wage or earnings progression among low-income individuals, mostly current or former welfare recipients. The project's goal was to determine which strategies could…

The Employment Retention and Advancement Project: Paths to Advancement for Single Parents. Executive Summary

ERIC Educational Resources Information Center

Miller, Cynthia; Deitch, Victoria; Hill, Aaron

2010-01-01

Between 2000 and 2003, the Employment Retention and Advancement (ERA) project identified and implemented a diverse set of innovative models designed to promote employment stability and wage or earnings progression among low-income individuals, mostly current or former welfare recipients. The project's goal was to determine which strategies could…

Adapting a Technology-Based Implementation Support Tool for Community Mental Health: Challenges and Lessons Learned.

PubMed

Livet, Melanie; Fixsen, Amanda

2018-01-01

With mental health services shifting to community-based settings, community mental health (CMH) organizations are under increasing pressure to deliver effective services. Despite availability of evidence-based interventions, there is a gap between effective mental health practices and the care that is routinely delivered. Bridging this gap requires availability of easily tailorable implementation support tools to assist providers in implementing evidence-based intervention with quality, thereby increasing the likelihood of achieving the desired client outcomes. This study documents the process and lessons learned from exploring the feasibility of adapting such a technology-based tool, Centervention, as the example innovation, for use in CMH settings. Mixed-methods data on core features, innovation-provider fit, and organizational capacity were collected from 44 CMH providers. Lessons learned included the need to augment delivery through technology with more personal interactions, the importance of customizing and integrating the tool with existing technologies, and the need to incorporate a number of strategies to assist with adoption and use of Centervention-like tools in CMH contexts. This study adds to the current body of literature on the adaptation process for technology-based tools and provides information that can guide additional innovations for CMH settings.

German innovation initiative for nanotechnology

NASA Astrophysics Data System (ADS)

Rieke, Volker; Bachmann, Gerd

2004-10-01

In many areas of nanotechnology, Germany can count on a good knowledge basis due to its diverse activities in nanosciences. This knowledge basis, when paired with the production and sales structures needed for implementation and the internationally renowned German talent for system integration, should consequently lead to success in the marketplace. And this is exactly the field of application for the innovation initiative "Nanotechnologie erobert Märkte" (nanotechnology conquers markets) and for the new BMBF strategy in support of nanotechnology. Until now, aspects of nanotechnology have been advanced within the confines of their respective technical subject areas. However, the primary aim of incorporating them into an overall national strategy is to build on Germany's well-developed and internationally competitive research in science and technology to tap the potential of Germany's important industrial sectors for the application of nanotechnology through joint research projects (leading-edge innovations) that strategically target the value-added chain. This development is to be supported by government education policy to remedy a threatening shortage of skilled professionals. To realize that goal, forward-looking political policymaking must become oriented to a uniform concept of innovation, one that takes into consideration all facets of new technological advances that can contribute to a new culture of innovation in Germany. And that includes education and research policy as well as a climate that encourages and supports innovation in science, business and society.

Increasing the practice of questioning among pediatric nurses: "The Growing Culture of Clinical Inquiry" project.

PubMed

Laibhen-Parkes, Natasha

2014-01-01

This paper describes an innovative methodology implemented in an acute care pediatric setting to build nurses' confidence and competence in questioning practice. The Growing Culture of Clinical Inquiry (GCCI) project was composed of several evidence-based strategies to attain and maintain a spirit of clinical inquiry. These strategies included PowerPoint presentations, evidence-based practice (EBP) unit champions, patient-intervention-comparison-outcome (PICO) boxes, Clinical Inquiry Posters, summaries of evidence (SOE), layman's SOE, medical librarian in-services, and journal clubs. After 1 year of implementation, the GCCI project was evaluated and found to be a promising methodology for fostering a culture of inquiry among pediatric nurses. © 2014.

Match your innovation strategy to your innovation ecosystem.

PubMed

Adner, Ron

2006-04-01

High-definition televisions should, by now, be a huge success. Philips, Sony, and Thompson invested billions of dollars to develop TV sets with astonishing picture quality. From a technology perspective, they've succeeded: Console manufacturers have been ready for the mass market since the early 1990s. Yet the category has been an unmitigated failure, not because of deficiencies, but because critical complements such as studio production equipment were not developed or adopted in time. Under-performing complements have left console producers in the position of offering a Ferrari in a world without gasoline or highways--an admirable engineering feat, but not one that creates value for customers. The HDTV story exemplifies the promise and peril of innovation ecosystems--the collaborative arrangements through which firms combine their individual offers into a coherent, customer-facing solution. When they work, innovation ecosystems allow companies to create value that no one firm could have created alone. The benefits of these systems are real. But for many organizations the attempt at ecosystem innovation has been a costly failure. This is because, along with new opportunities, innovation ecosystems also present a new set of risks that can brutally derail a firm's best efforts. Innovation ecosystems are characterized by three fundamental types of risk: initiative risks--the familiar uncertainties of managing a project; interdependence risks--the uncertainties of coordinating with complementary innovators; and integration risks--the uncertainties presented by the adoption process across the value chain. Firms that assess ecosystem risks holistically and systematically will be able to establish more realistic expectations, develop a more refined set of environmental contingencies, and arrive at a more robust innovation strategy. Collectively, these actions will lead to more effective implementation and more profitable innovation.

Voluntary medical male circumcision: translating research into the rapid expansion of services in Kenya, 2008-2011.

PubMed

Mwandi, Zebedee; Murphy, Anne; Reed, Jason; Chesang, Kipruto; Njeuhmeli, Emmanuel; Agot, Kawango; Llewellyn, Emma; Kirui, Charles; Serrem, Kennedy; Abuya, Isaac; Loolpapit, Mores; Mbayaki, Regina; Kiriro, Ndungu; Cherutich, Peter; Muraguri, Nicholas; Motoku, John; Kioko, Jack; Knight, Nancy; Bock, Naomi

2011-11-01

Since the World Health Organization and the Joint United Nations Programme on HIV/AIDS recommended implementation of medical male circumcision (MC) as part of HIV prevention in areas with low MC and high HIV prevalence rates in 2007, the government of Kenya has developed a strategy to circumcise 80% of uncircumcised men within five years. To facilitate the quick translation of research to practice, a national MC task force was formed in 2007, a medical MC policy was implemented in early 2008, and Nyanza Province, the region with the highest HIV burden and low rates of circumcision, was prioritized for services under the direction of a provincial voluntary medical male circumcision (VMMC) task force. The government's early and continuous engagement with community leaders/elders, politicians, youth, and women's groups has led to the rapid endorsement and acceptance of VMMC. In addition, several innovative approaches have helped to optimize VMMC scale-up. Since October 2008, the Kenyan VMMC program has circumcised approximately 290,000 men, mainly in Nyanza Province, an accomplishment made possible through a combination of governmental leadership, a documented implementation strategy, and the adoption of appropriate and innovative approaches. Kenya's success provides a model for others planning VMMC scale-up programs.

Diffusion of palliative care in nursing homes: lessons from the culture change movement.

PubMed

Tyler, Denise A; Shield, Renée R; Miller, Susan C

2015-05-01

Studies have found that nursing homes (NHs) that rely heavily on Medicaid funding are less likely to implement innovative approaches to care, such as palliative care (PC) or resident-centered approaches commonly referred to as "culture change" (CC). However, a nationally representative survey we previously conducted found that some high Medicaid facilities have implemented these innovative approaches. The purpose of this study was to identify the factors that enable some high Medicaid NHs to implement innovative approaches to care. We conducted telephone interviews with 16 NH administrators in four categories of facilities: 1) low PC and low CC, 2) low PC and high CC, 3) high PC and low CC, and 4) high PC and high CC. Interviews explored strategies used to overcome barriers to implementation and the resources needed for implementation. We had expected to find differences between low and high NHs but instead found differences in NHs' experiences with CC and PC. Since the time of our national survey in 2009-2010, most previously low CC NHs had implemented at least some CC practices; however, we did not find similar changes around PC. Administrators reported numerous ways in which they had received information and assistance from outside entities for implementing CC. This was not the case for PC where administrators reported relying exclusively and heavily on hospices for both their residents' PC needs and information related to PC. PC advocates could learn much from the CC model in which advocates have used multipronged efforts to institute reform. Published by Elsevier Inc.

Responsible innovation in port development: the Rotterdam Maasvlakte 2 and the Dalian Dayao Bay extension projects.

PubMed

Ravesteijn, Wim; Liu, Yi; Yan, Ping

2015-01-01

The paper outlines and specifies 'responsible port innovation', introducing the development of a methodological and procedural step-by-step plan for the implementation and evaluation of (responsible) innovations. Subsequently, it uses this as a guideline for the analysis and evaluation of two case-studies. The construction of the Rotterdam Maasvlakte 2 Port meets most of the formulated requirements, though making values more explicit and treating it as a process right from the start could have benefitted the project. The Dalian Dayao Port could improve its decision-making procedures in several respects, including the introduction of new methods to handle value tensions. Both projects show that public support is crucial in responsible port innovation and that it should be not only a multi-faceted but also a multi-level strategy.

Innovative culture in long-term care settings: the influence of organizational characteristics.

PubMed

Nieboer, Anna P; Strating, Mathilde M H

2012-01-01

Innovative cultures have been reported to enhance the creation and implementation of new ideas and working methods in organizations. Although there is considerable research on the impact of organizational context on the innovativeness of organizations, the same is not the case for research on the organizational characteristics responsible for an innovative culture in (long-term) care settings. The aim of this study was to identify organizational characteristics that explain innovative culture in the (long-term) care sector. A large cross-sectional study in Dutch long-term care-nursing homes and/or elderly homes, care organizations for the handicapped, and long-term mental health care organizations-was conducted. A total of 432 managers and care professionals in 37 organizations participated. The Group Innovation Inventory was used to measure innovative culture in long-term care organizations. Structural characteristics of the organization were centralization and formalization, environmental dynamism and competitiveness, internal and external exchange of information, leadership style, commitment to quality improvement, and the organization's innovative strategy. The determinants of an innovative culture were estimated with a two-level random-intercepts and fixed-slopes model. Multilevel regression models were used to account for the organizational clustering of individuals within the 37 care organizations. Environmental dynamism, job codification, formal external exchange of information, transformational leadership, commitment to quality, and an exploratory and exploitative innovation strategy were all significantly correlated with an innovative culture in the multivariate multilevel analysis; the other characteristics were not. The explained organizational- and individual-level variance was 52.5% and 49.2%, respectively. The results point to substantial differences in innovative cultures between and within care organizations that can, in part, be explained by organizational characteristics. Efforts must be made to ensure that organizational characteristics such as environmental dynamism do not hamper the development of innovative cultures in long-term care organizations. Organizations' human resource practices and knowledge management are particularly promising in strengthening innovative cultures.

Using Iterative Plan-Do-Study-Act Cycles to Improve Teaching Pedagogy.

PubMed

Murray, Elizabeth J

2018-01-15

Most students entering nursing programs today are members of Generation Y or the Millennial generation, and they learn differently than previous generations. Nurse educators must consider implementing innovative teaching strategies that appeal to the newest generation of learners. The Plan-Do-Study-Act cycle is a framework that can be helpful when planning, assessing, and continually improving teaching pedagogy. This article describes the use of iterative Plan-Do-Study-Act cycles to implement a change in teaching pedagogy.

Towards personal health care with model-guided medicine: long-term PPPM-related strategies and realisation opportunities within 'Horizon 2020'.

PubMed

Lemke, Heinz U; Golubnitschaja, Olga

2014-01-01

At the international EPMA Summit carried out in the EU Parliament (September 2013), the main challenges in Predictive, Preventive and Personalised Medicine have been discussed and strategies outlined in order to implement scientific and technological innovation in medicine and healthcare utilising new strategic programmes such as 'Horizon 2020'. The joint EPMA (European Association for Predictive, Preventive and Personalised Medicine) / IFCARS (International Foundation for Computer Assisted Radiology and Surgery) paper emphasises the consolidate position of the leading experts who are aware of the great responsibility of being on a forefront of predictive, preventive and personalised medicine. Both societies consider long-term international partnerships and multidisciplinary projects to create PPPM relevant innovation in science, technological tools and practical implementation in healthcare. Personalisation in healthcare urgently needs innovation in design of PPPM-related medical services, new products, research, education, didactic materials, propagation of targeted prevention in the society and treatments tailored to the person. For the paradigm shift from delayed reactive to predictive, preventive and personalised medicine, a new culture should be created in communication between individual professional domains, between doctor and patient, as well as in communication with individual social (sub)groups and patient cohorts. This is a long-term mission in personalised healthcare with the whole spectrum of instruments available and to be created in the field.

Health technopole: innovation applied to clinical engineering & health technology management education.

PubMed

Vilcahuaman, L; Rivas, R

2010-01-01

In the Peruvian Health System, Clinical Engineering does not exist as a topic of intervention. 59% of biomedical equipment is officially classified as operational, however next to apply the correct classification methodology and include security issues, only 10% of the equipment are suitable for use in patients. The serious consequences for patients, is opposite to the increased public investment in the health sector. Reversing this context leads to structural changes at all levels of the organization and they will be achievable only through an appropriate educational program. A strategy focused on joint of capacities called Health Technopole has managed to implement an innovative Model of Education in Healthcare Technology Management HTM and Clinical Engineering CE aimed at solving this problem. The proposal focused on strategies to strengthen the educational goals such as creating HTM & CE Units in hospitals, the implementation of the methodology: Problem Based Learning and Project Management in HTM & CE in classroom and on line courses. The process includes an effective interaction with global organizations through teleconferences, Internships, Workshops and Seminars. A key component was the sustained multidisciplinary approach. Health Technopole CENGETS is an expert adviser for the Ministry of Health and is called for trainings, design training programs for regional governments and also supports global organizations such as PAHO / WHO and ORAS / CONHU. The proposal of innovation applied to HTM & CE Education is effective and is a benchmark for similar countries.

Towards personal health care with model-guided medicine: long-term PPPM-related strategies and realisation opportunities within ‘Horizon 2020’

PubMed Central

2014-01-01

At the international EPMA Summit carried out in the EU Parliament (September 2013), the main challenges in Predictive, Preventive and Personalised Medicine have been discussed and strategies outlined in order to implement scientific and technological innovation in medicine and healthcare utilising new strategic programmes such as ‘Horizon 2020’. The joint EPMA (European Association for Predictive, Preventive and Personalised Medicine) / IFCARS (International Foundation for Computer Assisted Radiology and Surgery) paper emphasises the consolidate position of the leading experts who are aware of the great responsibility of being on a forefront of predictive, preventive and personalised medicine. Both societies consider long-term international partnerships and multidisciplinary projects to create PPPM relevant innovation in science, technological tools and practical implementation in healthcare. Personalisation in healthcare urgently needs innovation in design of PPPM-related medical services, new products, research, education, didactic materials, propagation of targeted prevention in the society and treatments tailored to the person. For the paradigm shift from delayed reactive to predictive, preventive and personalised medicine, a new culture should be created in communication between individual professional domains, between doctor and patient, as well as in communication with individual social (sub)groups and patient cohorts. This is a long-term mission in personalised healthcare with the whole spectrum of instruments available and to be created in the field. PMID:24883142

[Boundaries of the autonomy of local health administration: innovation, creativity and evidence-based decision-making].

PubMed

Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia

2014-11-01

The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies.

A concept mapping approach to guide and understand dissemination and implementation.

PubMed

Green, Amy E; Fettes, Danielle L; Aarons, Gregory A

2012-10-01

Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping-a mixed method strategy-to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed.

Promoting development and uptake of health innovations: The Nose to Tail Tool

PubMed Central

Gupta, Archna; Thorpe, Cathy; Bhattacharyya, Onil; Zwarenstein, Merrick

2016-01-01

Introduction Health sector management is increasingly complex as new health technologies, treatments, and innovative service delivery strategies are developed. Many of these innovations are implemented prematurely, or fail to be implemented at scale, resulting in substantial wasted resources.   Methods A scoping review was conducted to identify articles that described the scale up process conceptually or that described an instance in which a healthcare innovation was scaled up. We define scale up as the expansion and extension of delivery or access to an innovation for all end users in a jurisdiction who will benefit from it. Results Sixty nine articles were eligible for review. Frequently described stages in the innovation process and contextual issues that influence progress through each stage were mapped. 16 stages were identified: 12 deliberation and 4 action stages. Included papers suggest that innovations progress through stages of maturity and the uptake of innovation depends on the innovation aligning with the interests of 3 critical stakeholder groups (innovators, end users and the decision makers) and is also influenced by 3 broader contexts (social and physical environment, the health system, and the regulatory, political and economic environment). The 16 stages form the rows of the Nose to Tail Tool (NTT) grid and the 6 contingency factors form columns. The resulting stage-by-issue grid consists of 72 cells, each populated with cell-specific questions, prompts and considerations from the reviewed literature. Conclusion We offer a tool that helps stakeholders identify the stage of maturity of their innovation, helps facilitate deliberative discussions on the key considerations for each major stakeholder group and the major contextual barriers that the innovation faces. We believe the NTT will help to identify potential problems that the innovation will face and facilitates early modification, before large investments are made in a potentially flawed solution. PMID:27239275

Implementation Science: Why it matters for the future of social work.

PubMed

Cabassa, Leopoldo J

2016-01-01

Bridging the gap between research and practice is a critical frontier for the future of social work. Integrating implementation science into social work can advance our profession's effort to bring research and practice closer together. Implementation science examines the factors, processes, and strategies that influence the uptake, use, and sustainability of empirically-supported interventions, practice innovations, and social policies in routine practice settings. The aims of this paper are to describe the key characteristics of implementation science, illustrate how implementation science matters to social work by describing several contributions this field can make to reducing racial and ethnic disparities in mental health care, and outline a training agenda to help integrate implementation science in graduate-level social work programs.

Implementation Science: Why it matters for the future of social work

PubMed Central

Cabassa, Leopoldo J.

2016-01-01

Bridging the gap between research and practice is a critical frontier for the future of social work. Integrating implementation science into social work can advance our profession’s effort to bring research and practice closer together. Implementation science examines the factors, processes, and strategies that influence the uptake, use, and sustainability of empirically-supported interventions, practice innovations, and social policies in routine practice settings. The aims of this paper are to describe the key characteristics of implementation science, illustrate how implementation science matters to social work by describing several contributions this field can make to reducing racial and ethnic disparities in mental health care, and outline a training agenda to help integrate implementation science in graduate-level social work programs. PMID:28216992

Disclosure, Apology, and Offer Programs: Stakeholders' Views of Barriers to and Strategies for Broad Implementation

PubMed Central

Bell, Sigall K; Smulowitz, Peter B; Woodward, Alan C; Mello, Michelle M; Duva, Anjali Mitter; Boothman, Richard C; Sands, Kenneth

2012-01-01

Context The Disclosure, Apology, and Offer (DA&O) model, a response to patient injuries caused by medical care, is an innovative approach receiving national attention for its early success as an alternative to the existing inherently adversarial, inefficient, and inequitable medical liability system. Examples of DA&O programs, however, are few. Methods Through key informant interviews, we investigated the potential for more widespread implementation of this model by provider organizations and liability insurers, defining barriers to implementation and strategies for overcoming them. Our study focused on Massachusetts, but we also explored themes that are broadly generalizable to other states. Findings We found strong support for the DA&O model among key stakeholders, who cited its benefits for both the liability system and patient safety. The respondents did not perceive any insurmountable barriers to broad implementation, and they identified strategies that could be pursued relatively quickly. Such solutions would permit a range of organizations to implement the model without legislative hurdles. Conclusions Although more data are needed about the outcomes of DA&O programs, the model holds considerable promise for transforming the current approach to medical liability and patient safety. PMID:23216427

Disclosure, apology, and offer programs: stakeholders' views of barriers to and strategies for broad implementation.

PubMed

Bell, Sigall K; Smulowitz, Peter B; Woodward, Alan C; Mello, Michelle M; Duva, Anjali Mitter; Boothman, Richard C; Sands, Kenneth

2012-12-01

The Disclosure, Apology, and Offer (DA&O) model, a response to patient injuries caused by medical care, is an innovative approach receiving national attention for its early success as an alternative to the existing inherently adversarial, inefficient, and inequitable medical liability system. Examples of DA&O programs, however, are few. Through key informant interviews, we investigated the potential for more widespread implementation of this model by provider organizations and liability insurers, defining barriers to implementation and strategies for overcoming them. Our study focused on Massachusetts, but we also explored themes that are broadly generalizable to other states. We found strong support for the DA&O model among key stakeholders, who cited its benefits for both the liability system and patient safety. The respondents did not perceive any insurmountable barriers to broad implementation, and they identified strategies that could be pursued relatively quickly. Such solutions would permit a range of organizations to implement the model without legislative hurdles. Although more data are needed about the outcomes of DA&O programs, the model holds considerable promise for transforming the current approach to medical liability and patient safety. © 2012 Milbank Memorial Fund.

Achieving Excellence: Investing in People, Knowledge and Opportunity. Canada's Innovation Strategy.

ERIC Educational Resources Information Center

2002

To become one of the world's most innovative countries, Canada requires a national innovation strategy for the 21st century. It is progressing toward a more innovative economy, but lags behind many developed countries in terms of overall innovation performance. A national innovation strategy to meet Canada's innovation challenge proposes goals,…

Disseminating Innovations in Teaching Value-Based Care Through an Online Learning Network.

PubMed

Gupta, Reshma; Shah, Neel T; Moriates, Christopher; Wallingford, September; Arora, Vineet M

2017-08-01

A national imperative to provide value-based care requires new strategies to teach clinicians about high-value care. We developed a virtual online learning network aimed at disseminating emerging strategies in teaching value-based care. The online Teaching Value in Health Care Learning Network includes monthly webinars that feature selected innovators, online discussion forums, and a repository for sharing tools. The learning network comprises clinician-educators and health system leaders across North America. We conducted a cross-sectional online survey of all webinar presenters and the active members of the network, and we assessed program feasibility. Six months after the program launched, there were 277 learning community members in 22 US states. Of the 74 active members, 50 (68%) completed the evaluation. Active members represented independently practicing physicians and trainees in 7 specialties, nurses, educators, and health system leaders. Nearly all speakers reported that the learning network provided them with a unique opportunity to connect with a different audience and achieve greater recognition for their work. Of the members who were active in the learning network, most reported that strategies gleaned from the network were helpful, and some adopted or adapted these innovations at their home institutions. One year after the program launched, the learning network had grown to 364 total members. The learning network helped participants share and implement innovations to promote high-value care. The model can help disseminate innovations in emerging areas of health care transformation, and is sustainable without ongoing support after a period of start-up funding.

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

PubMed

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

2015-01-01

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

Taking Math Students from "Blah" to "Aha": What Can We Do?

ERIC Educational Resources Information Center

Kalajdzievska, Darja

2014-01-01

In many post-secondary, introductory mathematics courses failure and withdrawal rates are reaching as high as 50% and average GPA is steadily decreasing. This is a problem that has been witnessed across the globe. With widespread reforms taking place in K-12 mathematics education, many innovative teaching strategies have been created, implemented,…

The Effects of School Turnaround in Tennessee's Achievement School District and Innovation Zones

ERIC Educational Resources Information Center

Zimmer, Ron; Henry, Gary T.; Kho, Adam

2017-01-01

In recent years, the federal government has invested billions of dollars to reform chronically low-performing schools. To fulfill their federal Race to the Top grant agreement, Tennessee implemented three turnaround strategies that adhered to the federal restart and transformation models: (a) placed schools under the auspices of the Achievement…

Managing Amphibian Disease with Skin Microbiota.

PubMed

Woodhams, Douglas C; Bletz, Molly; Kueneman, Jordan; McKenzie, Valerie

2016-01-16

The contribution of emerging amphibian diseases to the sixth mass extinction is driving innovative wildlife management strategies, including the use of probiotics. Bioaugmentation of the skin mucosome, a dynamic environment including host and microbial components, may not provide a generalized solution. Multi-omics technologies and ecological context underlie effective implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Managing Amphibian Disease with Skin Microbiota.

PubMed

Woodhams, Douglas C; Bletz, Molly; Kueneman, Jordan; McKenzie, Valerie

2016-03-01

The contribution of emerging amphibian diseases to the sixth mass extinction is driving innovative wildlife management strategies, including the use of probiotics. Bioaugmentation of the skin mucosome, a dynamic environment including host and microbial components, may not provide a generalized solution. Multi-omics technologies and ecological context underlie effective implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interactive Whiteboards in Early Childhood Mathematics: Strategies for Effective Implementation in Pre-K-Grade 3

ERIC Educational Resources Information Center

Linder, Sandra M.

2012-01-01

Teachers are using technological innovations--including interactive whiteboards--in pre-K-grade 3 classrooms across the country. An IWB is a wall-mounted, touch-sensitive flat screen. When connected to a computer (or another electronic device) and a projector, it displays enlarged instructional content (such as a math word problem, pictures or…

Engaging Hispanic Students in Agricultural Education and the FFA: A 3-Year Case Study

ERIC Educational Resources Information Center

Roberts, T. Grady; Hall, Johnathan L.; Briers, Gary E.; Gill, Ernie; Shinn, Glen C.; Larke, Alvin, Jr.; Jaure, Paul

2009-01-01

This article describes the outcomes of field-based efforts to increase diversity in agricultural education programs and the FFA. This study focused on three schools in San Antonio, Texas. Guided by Rogers' (2003) theories of diffusion of innovations, a series of six intervention strategies was implemented: (a) provide specific FFA or agricultural…

The Senior Mentor Program at the University of South Carolina School of Medicine: An Innovative Geriatric Longitudinal Curriculum

ERIC Educational Resources Information Center

Roberts, Ellen; Richeson, Nancy A.; Thornhill, Joshua T., IV; Corwin, Sara J.; Eleazer, G. Paul

2006-01-01

This paper describes development, implementation, and evaluation strategies of a longitudinal geriatric curriculum, the Senior Mentor Program (SMP). The rationale for exposing undergraduate medical students to healthy, community-dwelling older adults is to use the relationship and activities as vehicles for improving knowledge of aging and…

Knowledge Utilization Strategies in the Design and Implementation of New Schools--Symbolic Functions.

ERIC Educational Resources Information Center

Sieber, Sam D.

An examination of case studies suggests that rational processes were not entirely at work in the planning and conception of new, innovative schools. The rational model that serves as the foundation of our information systems assumes that a compelling professional need triggers a search for solutions; and, therefore, school personnel are eager to…

Teaching Auction Strategy Using Experiments Administered Via the Internet

ERIC Educational Resources Information Center

Asker, John; Grosskopf, Brit; McKinney, C. Nicholas; Niederle, Muriel; Roth, Alvin E.; Weizsacker, Georg

2004-01-01

The authors present an experimental design used to teach concepts in the economics of auctions and implications for e-Business procurement. The experiment is easily administered and can be adapted to many different treatments. The chief innovation is that it does not require the use of a lab or class time. Instead, the design can be implemented on…

Making strategy: learning by doing.

PubMed

Christensen, C M

1997-01-01

Companies find it difficult to change strategy for many reasons, but one stands out: strategic thinking is not a core managerial competence at most companies. Executives hone their capabilities by tackling problems over and over again. Changing strategy, however, is not usually a task that they face repeatedly. Once companies have found a strategy that works, they want to use it, not change it. Consequently, most managers do not develop a competence in strategic thinking. This Manager's Tool Kit presents a three-stage method executives can use to conceive and implement a creative and coherent strategy themselves. The first stage is to identify and map the driving forces that the company needs to address. The process of mapping provides strategy-making teams with visual representations of team members' assumptions, those pictures, in turn, enable managers to achieve consensus in determining the driving forces. Once a senior management team has formulated a new strategy, it must align the strategy with the company's resource-allocation process to make implementation possible. Senior management teams can translate their strategy into action by using aggregate project planning. And management teams that link strategy and innovation through that planning process will develop a competence in implementing strategic change. The author guides the reader through the three stages of strategy making by examining the case of a manufacturing company that was losing ground to competitors. After mapping the driving forces, the company's senior managers were able to devise a new strategy that allowed the business to maintain a competitive advantage in its industry.

What is the degree of innovation routinely implemented in Dutch radiotherapy centres? A multicentre cross-sectional study.

PubMed

Jacobs, Maria; Boersma, Liesbeth; Dekker, Andre; Bosmans, Geert; van Merode, Frits; Verhaegen, Frank; de Ruysscher, Dirk; Swart, Rachelle; Kengen, Cindy; Lambin, Philippe

2016-11-01

To study the implementation of innovation activities in Dutch radiotherapy (RT) centres in a broad sense (product, technological, market and organizational innovations). A descriptive cross-sectional study was conducted in 15 Dutch RT centres. A list of innovations implemented from 2011 to 2013 was drawn up for each centre using semi-structured interviews. These innovations were classified into innovation categories according to previously defined innovation indicators. Where applicable, each innovation was rated by each centre on the effort required to implement it and on its expected effects, to get an impression of how far reaching and radical the innovations were and to be able to compare the number of innovations between centres. The participating RT centres in the Netherlands implemented 12 innovations per year on average (range 5-25); this number was not significantly different for academic (n = 13) or non-academic centres (n = 10). Several centres were dealing with the same innovations at the same time. The average required effort and expected output did not differ significantly between product, technological and organizational innovation or between academic and non-academic centres. The number of innovations observed per centre varied across a large range, with a large overlap in terms of the type of innovations that were implemented. Registering innovations using the innovation indicators applied in our study would make it possible to improve collaboration between centres, e.g. with common training modules, to avoid duplication of work. Advances in knowledge: This study is the first of its kind investigating innovation implementation in RT in a broad sense.

National Strategies for Technological Innovation

ERIC Educational Resources Information Center

Rossini, Frederick; Bozeman, Barry

1977-01-01

Considers the implications of the technological innovation literature for possible national strategies for innovation. Sketches highly generalized innovation strategies for nations at various levels of technological development. (Author/IRT)

Strategies and Innovative Approaches for the Future of Space Weather Forecasting

NASA Astrophysics Data System (ADS)

Hoeksema, J. T.

2012-12-01

The real and potential impacts of space weather have been well documented, yet neither the required research and operations programs, nor the data, modeling and analysis infrastructure necessary to develop and sustain a reliable space weather forecasting capability for a society are in place. The recently published decadal survey "Solar and Space Physics: A Science for a Technological Society" presents a vision for the coming decade and calls for a renewed national commitment to a comprehensive program in space weather and climatology. New resources are imperative. Particularly in the current fiscal environment, implementing a responsible strategy to address these needs will require broad participation across agencies and innovative approaches to make the most of existing resources, capitalize on current knowledge, span gaps in capabilities and observations, and focus resources on overcoming immediate roadblocks.

Networked Community Change: Understanding Community Systems Change through the Lens of Social Network Analysis.

PubMed

Lawlor, Jennifer A; Neal, Zachary P

2016-06-01

Addressing complex problems in communities has become a key area of focus in recent years (Kania & Kramer, 2013, Stanford Social Innovation Review). Building on existing approaches to understanding and addressing problems, such as action research, several new approaches have emerged that shift the way communities solve problems (e.g., Burns, 2007, Systemic Action Research; Foth, 2006, Action Research, 4, 205; Kania & Kramer, 2011, Stanford Social Innovation Review, 1, 36). Seeking to bring clarity to the emerging literature on community change strategies, this article identifies the common features of the most widespread community change strategies and explores the conditions under which such strategies have the potential to be effective. We identify and describe five common features among the approaches to change. Then, using an agent-based model, we simulate network-building behavior among stakeholders participating in community change efforts using these approaches. We find that the emergent stakeholder networks are efficient when the processes are implemented under ideal conditions. © Society for Community Research and Action 2016.

We have the programme, what next? Planning the implementation of an injury prevention programme

PubMed Central

Donaldson, Alex; Lloyd, David G; Gabbe, Belinda J; Cook, Jill

2017-01-01

Background and aim The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. Methods An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. Results An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. Conclusions A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context. PMID:26787739

Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: a mixed-methods approach.

PubMed

Eaton, Linda H; Meins, Alexa R; Mitchell, Pamela H; Voss, Joachim; Doorenbos, Ardith Z

2015-03-01

To describe evidence-based practice (EBP) beliefs and behaviors of nurses who provide cancer pain management. Descriptive, cross-sectional with a mixed-methods approach. Two inpatient oncology units in the Pacific Northwest. 40 RNs.
 Data collected by interviews and web-based surveys. EBP beliefs, EBP implementation, evidence-based pain management. Nurses agreed with the positive aspects of EBP and their implementation ability, although implementation level was low. They were satisfied with their pain management practices. Oncology nursing certification was associated with innovativeness, and innovativeness was associated with EBP beliefs. Themes identified were (a) limited definition of EBP, (b) varied evidence-based pain management decision making, (c) limited identification of evidence-based pain management practices, and (d) integration of nonpharmacologic interventions into patient care. Nurses' low level of EBP implementation in the context of pain management was explained by their trust that standards of care and medical orders were evidence-based. Nurses' EBP beliefs and behaviors should be considered when developing strategies for sustaining evidence-based pain management practices. Implementation of the EBP process by nurses may not be realistic in the inpatient setting; therefore, hospital pain management policies need to be evidence-based and reinforced with nurses.

A reflective teaching challenge to motivate educational innovation.

PubMed

Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

2014-06-17

To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

Development and implementation of outreach strategies for breast and cervical cancer prevention among African American women. FoCaS Project. Forsyth County Cancer Screening.

PubMed

Tatum, C; Wilson, A; Dignan, M; Paskett, E D; Velez, R

1997-01-01

The purpose of the FoCaS (Forsyth County Cancer Screening) Project was to develop and implement strategies that would improve the beliefs, attitudes, and preventive health habits of populations typically considered hard to reach. Conventional health education methods have not produced substantial results; thus, innovative and unusual strategies are needed. The FoCaS project implemented specific methods to reach the targeted population of African American women aged 40 and older that resides in public housing communities. Five outreach strategies were used: 1) educational classes (group setting and one-on-one sessions) on various topics that relate not to breast and cervical cancer but to women's issues in general; 2) media campaigns strategically scheduled throughout the year; 3) the inclusion of religion in educational classes and community outreach; 4) the use of information centers to distribute materials; and 5) a community-wide cancer-awareness event. These strategies reached women in nonthreatening environments that permitted heavy involvement and easy understanding of the importance of breast and cervical cancer screening. The effects of these strategies on promoting screening will be evaluated using data from the follow-up survey conducted during the spring of 1996.

Innovative Trajectory Designs to meet Exploration Challenges

NASA Technical Reports Server (NTRS)

Folta, David C.

2006-01-01

This document is a viewgraph presentation of the conference paper. Missions incorporated into NASA's Vision for Space Exploration include many different destinations and regions; are challenging to plan; and need new and innovative trajectory design methods to enable them. By combining proven methods with chaos dynamics, exploration goals that require maximum payload mass or minimum duration can be achieved. The implementation of these innovative methods, such as weak stability boundaries, has altered NASA's approach to meet exploration challenges and is described to show how exploration goals may be met in the next decade. With knowledge that various perturbations play a significant role, the mission designer must rely on both traditional design strategies as well as these innovative methods. Over the past decades, improvements have been made that would at first glance seem dramatic. This paper provides a brief narrative on how a fundamental shift has occurred and how chaos dynamics improve the design of exploration missions with complex constraints.

Assessing and changing organizational social contexts for effective mental health services.

PubMed

Glisson, Charles; Williams, Nathaniel J

2015-03-18

Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

Modeling the Innovation-Decision Process: Dissemination and Adoption of a Motivational Interviewing Preparatory Procedure in Addiction Outpatient Clinics

PubMed Central

Walitzer, Kimberly S.; Dermen, Kurt H.; Barrick, Christopher; Shyhalla, Kathleen

2015-01-01

Widespread adoption of empirically-supported treatment innovations has the potential to improve effectiveness of treatment received by individuals with substance use disorders. However, the process of disseminating such innovations has been complex, slow, and difficult. We empirically describe the dissemination and adoption of a treatment innovation – an alcohol-treatment preparatory therapeutic procedure based on motivational interviewing (MI) – in the context of Rogers’ (2003) five stages of innovation-decision process (knowledge, persuasion, decision, implementation and confirmation). To this end, 145 randomly-chosen outpatient addiction treatment clinics in New York State received an onsite visit from a project trainer delivering one of three randomly-assigned dissemination intensities: a 15-minute, a half-day or a full-day presentation. Across these clinics, 141 primary administrators and 837 clinicians completed questionnaires assessing aspects of five innovation-decision stages. At each clinic, questionnaire administration occurred immediately pre- and post-dissemination, as well as one and six months after dissemination. Consistent with Rogers’ theory, earlier stages of the innovation-decision process predicted later stages. As hypothesized, dissemination intensity predicted clinicians’ post-dissemination knowledge. Clinician baseline characteristics (including gender, pre-dissemination knowledge regarding the MI preparatory technique, education, case load, beliefs regarding the nature of alcohol problems, and beliefs and behavior with regard to therapeutic style) predicted knowledge and persuasion stage variables. One baseline clinic characteristic (i.e., clinic mean beliefs and behavior regarding an MI-consistent therapeutic style) predicted implementation stage variables. Findings suggest that dissemination strategies should accommodate clinician and clinic characteristics. PMID:25934460

Implementation of a clinical innovation: the case of advanced clinic access in the Department of Veterans Affairs.

PubMed

Lukas, Carol VanDeusen; Meterko, Mark M; Mohr, David; Seibert, Marjorie Nealon; Parlier, Renee; Levesque, Odette; Petzel, Robert A

2008-01-01

Healthcare organizations seeking to improve clinical practices often have disappointing results because the planned innovations are not successfully implemented. To increase the understanding of implementation, we analyzed the national spread of an ambulatory innovation in the Department of Veterans Affairs. This study provides support for a conceptual model that posits that the extent to which a clinical innovation is implemented will be affected by factors in 3 domains: (1) intentional activities to introduce, spread, and support the innovation; (2) the attitudes and capabilities of clinic staff responsible for implementing the innovation; and (3) the context of the facility in which the innovation is being introduced. Among the strongest predictors of successful implementation, management support for the innovation and clinic team knowledge and skills to make changes successfully were significant across both primary care and specialty clinics.

What is the degree of innovation routinely implemented in Dutch radiotherapy centres? A multicentre cross-sectional study

PubMed Central

Boersma, Liesbeth; Dekker, Andre; Bosmans, Geert; van Merode, Frits; Verhaegen, Frank; de Ruysscher, Dirk; Swart, Rachelle; Kengen, Cindy; Lambin, Philippe

2016-01-01

Objective: To study the implementation of innovation activities in Dutch radiotherapy (RT) centres in a broad sense (product, technological, market and organizational innovations). Methods: A descriptive cross-sectional study was conducted in 15 Dutch RT centres. A list of innovations implemented from 2011 to 2013 was drawn up for each centre using semi-structured interviews. These innovations were classified into innovation categories according to previously defined innovation indicators. Where applicable, each innovation was rated by each centre on the effort required to implement it and on its expected effects, to get an impression of how far reaching and radical the innovations were and to be able to compare the number of innovations between centres. Results: The participating RT centres in the Netherlands implemented 12 innovations per year on average (range 5–25); this number was not significantly different for academic (n = 13) or non-academic centres (n = 10). Several centres were dealing with the same innovations at the same time. The average required effort and expected output did not differ significantly between product, technological and organizational innovation or between academic and non-academic centres. Conclusion: The number of innovations observed per centre varied across a large range, with a large overlap in terms of the type of innovations that were implemented. Registering innovations using the innovation indicators applied in our study would make it possible to improve collaboration between centres, e.g. with common training modules, to avoid duplication of work. Advances in knowledge: This study is the first of its kind investigating innovation implementation in RT in a broad sense. PMID:27660890

Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care.

PubMed

Grandes, Gonzalo; Sanchez, Alvaro; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Balagué, Laura; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

2017-12-06

Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care. Between 10 and 13 discussion and consensus sessions were performed in four highly-motivated primary health care centers involving 80% of the primary care staff and 21 community-based organizations. All four centers chose to address physical activity, diet, and smoking. They selected the 5 A's evidence-based clinical intervention to be adapted to the context of the health centers. The planned implementation strategy worked at multiple levels: bottom-up primary care organizational change, top-down support from managers, community involvement, and the development of innovative e-health information and communication tools. Shared decision making and practice facilitation were perceived as the most positive aspects of the collaborative modeling process, which took more time than expected, especially the development of the new e-health tools integrated into electronic health records. Collaborative modeling of an implementation strategy for the integration of health promotion in primary and community care was feasible in motivated centers. However, it was difficult, being hindered by the heavy workload in primary care and generating uncertainty inherent to a bottom-up decision making processes. Lessons from this experience could be useful in diverse settings and for other clinical interventions. Two companion papers report the evaluation of its feasibility and assess quantitatively and qualitatively the implementation process.

Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

PubMed Central

Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C.; Escoffery, Cam T.; Herrmann, Alison K.; Thatcher, Esther; Hartman, Marieke A.; Fernandez, Maria

2017-01-01

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts. PMID:26500080

Developing Theory to Guide Building Practitioners' Capacity to Implement Evidence-Based Interventions.

PubMed

Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C; Escoffery, Cam T; Herrmann, Alison K; Thatcher, Esther; Hartman, Marieke A; Fernandez, Maria E

2017-02-01

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners' capacity to adopt and implement a variety of EBIs across diverse practice contexts.

Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

PubMed

Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

2017-08-04

The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

A stepped strategy that aims at the nationwide implementation of the Enhanced Recovery After Surgery programme in major gynaecological surgery: study protocol of a cluster randomised controlled trial.

PubMed

de Groot, Jeanny Ja; Maessen, José Mc; Slangen, Brigitte Fm; Winkens, Bjorn; Dirksen, Carmen D; van der Weijden, Trudy

2015-07-30

Enhanced Recovery After Surgery (ERAS) programmes aim at an early recovery after surgical trauma and consequently at a reduced length of hospitalisation. This paper presents the protocol for a study that focuses on large-scale implementation of the ERAS programme in major gynaecological surgery in the Netherlands. The trial will evaluate effectiveness and costs of a stepped implementation approach that is characterised by tailoring the intensity of implementation activities to the needs of organisations and local barriers for change, in comparison with the generic breakthrough strategy that is usually applied in large-scale improvement projects in the Netherlands. All Dutch hospitals authorised to perform major abdominal surgery in gynaecological oncology patients are eligible for inclusion in this cluster randomised controlled trial. The hospitals that already fully implemented the ERAS programme in their local perioperative management or those who predominantly admit gynaecological surgery patients to an external hospital replacement care facility will be excluded. Cluster randomisation will be applied at the hospital level and will be stratified based on tertiary status. Hospitals will be randomly assigned to the stepped implementation strategy or the breakthrough strategy. The control group will receive the traditional breakthrough strategy with three educational sessions and the use of plan-do-study-act cycles for planning and executing local improvement activities. The intervention group will receive an innovative stepped strategy comprising four levels of intensity of support. Implementation starts with generic low-cost activities and may build up to the highest level of tailored and labour-intensive activities. The decision for a stepwise increase in intensive support will be based on the success of implementation so far. Both implementation strategies will be completed within 1 year and evaluated on effect, process, and cost-effectiveness. The primary outcome is length of postoperative hospital stay. Additional outcome measures are length of recovery, guideline adherence, and mean implementation costs per patient. This study takes up the challenge to evaluate an efficient strategy for large-scale implementation. Comparing effectiveness and costs of two different approaches, this study will help to define a preferred strategy for nationwide dissemination of best practices. Dutch Trial Register NTR4058.

Development of a student engagement approach to alcohol prevention: the Pragmatics Project.

PubMed

Buettner, Cynthia K; Andrews, David W; Glassman, Michael

2009-01-01

Significant involvement of students in the development and implementation of college alcohol prevention strategies is largely untested, despite recommendations by the National Institute of Alcohol Abuse and Alcoholism and others. The purpose of the Pragmatics Project was to test a student engagement model for developing and implementing alcohol intervention strategies. The Pragmatics Project involved 89 undergraduate students on a large Midwestern university campus in the design and implementation of projects focused on reducing harm associated with high-risk drinking and off-campus parties. The engagement model used an innovative course piloted in the Human Development and Family Science department. The course successfully involved both students and the community in addressing local alcohol issues. The course design described would fit well into a Master of Public Health, Community Psychology, Health Psychology, or interdisciplinary curricula as well as the service learning model, and it is applicable in addressing other health risk behaviors.

The new rules for bringing innovations to market.

PubMed

Chakravorti, Bhaskar

2004-03-01

It's tough to get consumers to adopt innovations--and it's getting tougher all the time. That's because more and more markets are taking on the characteristics of networks. The interconnections among today's companies are so plentiful that often a new product's adoption by one player depends on its systematic adoption by other players. Consider the disparate companies involved with the popularization of digital photography: software vendors, camera manufacturers, broadband communications companies, printer manufacturers, and so on. By contrast, Kodak was pretty much the sole player involved with popularizing film photography. The traditional levers executives use to launch products--such as targeting unique customer segments or developing compelling value propositions--don't work as well in this new environment. Instead, innovators must orchestrate a change of behaviors across the market, unraveling the status quo so that a large number of players adopt their offerings and believe they are better off for having done so. In this article, Monitor Group's Bhaskar Chakravorti outlines a four-part framework for doing just that. The innovator must reason back from a target endgame, implementing only those strategies that maximize its chances of getting to its goal. It must complement power players, positioning its innovation as an enhancement to their products or services. The innovator must offer coordinated switching incentives to three core groups: the players that add to the innovation's benefits, the players that act as channels to adopters, and the adopters themselves. And it must preserve flexibility in case its initial strategy fails. Chakravorti uses Adobe's introduction of its Acrobat software as an example of an innovator that took into account other players in the network--and succeeded because of it.

Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination.

PubMed

Diel, Roland; Loddenkemper, Robert; Zellweger, Jean-Pierre; Sotgiu, Giovanni; D'Ambrosio, Lia; Centis, Rosella; van der Werf, Marieke J; Dara, Masoud; Detjen, Anne; Gondrie, Peter; Reichman, Lee; Blasi, Francesco; Migliori, Giovanni Battista

2013-09-01

The introduction of new rapid diagnostic tools for tuberculosis (TB) and the promising TB drugs pipeline together with the development of a new World Health Organization Strategy post 2015 allows new discussions on how to direct TB control. The European Respiratory Society's European Forum for TB Innovation was created to stimulate discussion on how to best take advantage of old and new opportunities, and advances, to improve TB control and eventually progress towards the elimination of TB. While TB control is aimed at reducing the incidence of TB by early diagnosis and treatment of infectious cases of TB, TB elimination requires focus on sterilising the pool of latently infected individuals, from which future TB cases would be generated. This manuscript describes the three core components that are necessary to implement the elimination strategy fully. 1) Improve diagnosis of latent TB infected individuals. 2) Improve regimens to treat latent TB infection. 3) ensure public health commitment to make both 1) and 2) possible. Old and new evidence is critically described, focusing on the European commitment to reach elimination and on the innovative experiences and best practices available.

Reciprocal Relations between Coalition Functioning and the Provision of Implementation Support

PubMed Central

Brown, Louis D.; Feinberg, Mark E.; Shapiro, Valerie B.; Greenberg, Mark T.

2014-01-01

Community coalitions have been promoted as a strategy to help overcome challenges to the dissemination and implementation of evidence-based prevention programs. This paper explores the characteristics of coalitions that enable the provision of implementation support for prevention programs in general, and for the implementation of evidence-based prevention programs with fidelity. Longitudinal cross-lagged panel models were used to study 74 Communities That Care (CTC) coalitions in Pennsylvania. These analyses provide evidence of a unidirectional influence of coalition functioning on the provision of implementation support. Coalition member knowledge of the CTC model best predicted the coalition’s provision of support for evidence-based program implementation with fidelity. Implications for developing and testing innovative methods for delivering training and technical assistance to enhance coalition member knowledge are discussed. PMID:24323363

From the abstract to the concrete - Implementation of an innovative tool in home care.

PubMed

Kajamaa, Anu; Schulz, Klaus-Peter

2018-02-01

Background The implementation of innovations in practice is a critical factor for change and development processes in health and home care. We therefore analyze how an innovative tool - a mobility agreement to maintain physical mobility of home care clients - was implemented in Finnish home care. Methods Our study involves ethnographic research of 13 home care visits, two years after the mobility agreement was implemented. We analyze the emergence of contradictions, the motives of the actors and the use of artifacts supporting or inhibiting the implementation. Two in-depth cases illustrate the implementation of the mobility agreement in home care visits. Findings Our findings show that, first, to achieve practice change and development, the innovation implementation requires the overcoming of contradictions in the implementation process. Second, it calls for the emergence of a shared motive between the actors to transform the abstract concept of an innovation into a concrete practice. Third, artifacts, customary to the clients are important in supporting the implementation process. Fourth, the implementation brings about a modification of the innovation and the adopting social system. Conclusions Innovation implementation should be seen as a transformation process of an abstract concept into a concrete practice, enabled by the actors involved. Concept design and implementation should be closely linked. In health/home care innovation management, the implementation of innovations needs to be understood as a complex collective learning process. Results can be far reaching - in our case leading to change of home care workers' professional understanding and elderly clients' mobility habits.

Bridging research and practice: community-researcher partnerships for replicating effective interventions.

PubMed

Rotheram-Borus, M J; Rebchook, G M; Kelly, J A; Adams, J; Neumann, M S

2000-01-01

Long-term collaborations among researchers, staff and volunteers in community-based agencies, staff in institutional settings, and health advocates present challenges. Each group has different missions, procedures, attributes, and rewards. This article reviews areas of potential conflict and suggests strategies for coping with these challenges. During the replication of five effective HIV prevention interventions, strategies for maintaining mutually beneficial collaborations included selecting agencies with infrastructures that could support research-based interventions; obtaining letters of understanding that clarified roles, responsibilities, and time frames; and setting training schedules with opportunities for observing, practicing, becoming invested in, and repeatedly implementing the intervention. The process of implementing interventions highlighted educating funders of research and public health services about (a) the costs of disseminating interventions, (b) the need for innovation to new modalities and theories for delivering effective interventions, and (c) adopting strategies of marketing research and quality engineering when designing interventions.

Combining evidence and diffusion of innovation theory to enhance influenza immunization.

PubMed

Britto, Maria T; Pandzik, Geralyn M; Meeks, Connie S; Kotagal, Uma R

2006-08-01

Children and adolescents with chronic conditions such as asthma, diabetes, and HIV are at high risk of influenza-related morbidity, and there are recommendations to immunize these populations annually. At Cincinnati Children's Hospital Medical Center, the influenza immunization rate increased to 90.4% (5% declined) among 200 patients with cystic fibrosis (CF). Diffusion of innovation theory was used to guide the design and implementation of spread to other clinics. The main intervention strategies were: (1) engagement of interested, nurse-led teams, (2) A collaborative learning session, (3) A tool kit including literature, sample goals, reminder postcards, communication strategies, and team member roles and processes, (4) open-access scheduling and standing orders (5) A simple Web-based registry, (6) facilitated vaccine ordering, (7) recall phone calls, and (8) weekly results posting. Clinic-specific immunization rates ranged from 32.7% to 92.8%, with the highest rate reported in the CF clinic. All teams used multiple strategies; with six of the seven using four or more. Overall, 60.0% (762/1,269) of the population was immunized. Barriers included vaccine shortages, lack of time for reminder calls, and lack of physician support in one clinic. A combination of interventions, guided by evidence and diffusion of innovation theory, led to immunization rates higher than those reported in the literature.

Are We Having Fun Yet? Institutional Resistance and the Introduction of Play and Experimentation into Learning Innovation through Social Media

ERIC Educational Resources Information Center

Bryant, Peter; Coombs, Antony; Pazio, Monika

2014-01-01

Recognising and responding to behaviours and patterns of resistance is critical to the successful implementation of technology-enhanced learning strategies at higher education institutions. At institutional, academic and student levels, resistance manifests itself in a variety of forms, at best supporting a critical culture and at worst creating…

Partners in Innovation: How a High School and College Are Improving Outcomes for Youth in San Diego

ERIC Educational Resources Information Center

Coates, Joy; Webb, Michael

2013-01-01

The early college high school program at San Diego City College is a partnership of the college, San Diego Unified School District, and several state and national organizations. The partnership has successfully implemented a variety of college-readiness and college-connected strategies, including an early college school, to better prepare students…

Embedding Key Transferable Employability Skills for Lifelong Success through Blending an Innovative Portfolio to Complement Traditional Assessment

ERIC Educational Resources Information Center

Hooker, Joanne; Whistance, Jayne

2016-01-01

Southampton Solent University has been running the unit ENG195 Applied and Academic English Advanced for international students since 2008 as part of the Institution-Wide Language Programme. Following the implementation of a new employability strategy in 2013, the unit was revalidated in July 2014, which led to a major redesign of the curriculum…

JPRS Report, East Europe

DTIC Science & Technology

1987-11-05

opinion research. practice in surveys. Poorly prepared surveys also affect They are inclined to attribute refusals more to the low the essential level of...order to achieve the most essential national the one hand, and on the other, on the right to elect the economic priorities, managers. Self-management... essential reproductive contribution to the through innovation. Under the circumstances, innova- implementation of SED economic strategy. This contri

People Getting a Grip on Arthritis II: An Innovative Strategy to Implement Clinical Practice Guidelines for Rheumatoid Arthritis and Osteoarthritis Patients through Facebook

ERIC Educational Resources Information Center

Brosseau, Lucie; Wells, George A.; Brooks, Sydney; De Angelis, G.; Bell, Mary; Egan, Mary; Poitras, Stephane; King, Judy; Casimiro, Lynn; Loew, Laurianne; Novikov, Michael

2014-01-01

Objective: The purpose of the study is to determine if an updated online evidence-based educational programme delivered through Facebook is effective in improving the knowledge, skills, and self-efficacy of patients with arthritis in relation to evidence-based self-management rehabilitation interventions for osteoarthritis (OA) and rheumatoid…

[Social and organizational innovation to tackle the challenge of integrated care of the chronically ill].

PubMed

Nuño-Solinís, Roberto

2014-01-01

The increase in life expectancy, coupled with other factors, has led to an increase in the prevalence of chronic diseases and multiple morbidity. This has led to the need to develop new health and social care models, which will allow managing these efficiently and in a sustainable manner. In particular, there seems to be consensus on the need to move towards integrated, patient-centered, and more proactive care. Thus, in recent years, chronic care models have been developed at international, national and regional level, as well as introducing strategies to tackle the challenge of chronic illness. However, the implementation of actions facilitating the change towards this new model of care does not seem to be an easy task. This paper presents some of the strategic lines and initiatives carried out by the Department of Health of the Basque Government. These actions can be described within a social and organizational innovation framework, as a means for effective implementation of interventions and strategies that shape the model required for the improved care of chronic illnesses within a universal and tax-funded health system. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Comparison among different retrofitting strategies for the vulnerability reduction of masonry bell towers

NASA Astrophysics Data System (ADS)

Milani, Gabriele; Shehu, Rafael; Valente, Marco

2017-11-01

This paper investigates the effectiveness of reducing the seismic vulnerability of masonry towers by means of innovative and traditional strengthening techniques. The followed strategy for providing the optimal retrofitting for masonry towers subjected to seismic risk relies on preventing active failure mechanisms. These vulnerable mechanisms are pre-assigned failure patterns based on the crack patterns experienced during the past seismic events. An upper bound limit analysis strategy is found suitable to be applied for simplified tower models in their present state and the proposed retrofitted ones. Taking into consideration the variability of geometrical features and the uncertainty of the strengthening techniques, Monte Carlo simulations are implemented into the limit analysis. In this framework a wide range of idealized cases are covered by the conducted analyses. The retrofitting strategies aim to increase the shear strength and the overturning load carrying capacity in order to reduce vulnerability. This methodology gives the possibility to use different materials which can fulfill the structural implementability requirements.

From the point-of-purchase perspective: a qualitative study of the feasibility of interventions aimed at portion-size.

PubMed

Vermeer, Willemijn M; Steenhuis, Ingrid H M; Seidell, Jacob C

2009-04-01

Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size. Semi-structured interviews were conducted with 22 representatives of various point-of-purchase settings. Constructs derived from the diffusion of innovations theory were incorporated into the interview guide. Each interview was recorded and transcribed verbatim. Data were coded and analysed with Atlas.ti 5.2 using the framework approach. According to the participants, offering a larger variety of portion-sizes had the most relative advantages, and reducing portions was the most disadvantageous. The participants also considered portion-size reduction and linear pricing of portion-sizes to be risky. Lastly, a larger variety of portion-sizes, pricing strategies and portion-size labelling were seen as the most complex interventions. In general, participants considered offering a larger variety of portion-sizes, portion-size labelling and, to a lesser extent, pricing strategies with respect to portion-sizes as most feasible to implement. Interventions aimed at portion-size were seen as innovative by most participants. Developing adequate communication strategies about portion-size interventions with both decision-makers in point-of-purchase settings and the general public is crucial for successful implementation.

Learning Evaluation: blending quality improvement and implementation research methods to study healthcare innovations.

PubMed

Balasubramanian, Bijal A; Cohen, Deborah J; Davis, Melinda M; Gunn, Rose; Dickinson, L Miriam; Miller, William L; Crabtree, Benjamin F; Stange, Kurt C

2015-03-10

In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. Learning Evaluation is an approach to multi-organization assessment. Qualitative and quantitative data are collected to conduct real-time assessment of implementation processes while also assessing changes in context, facilitating quality improvement using run charts and audit and feedback, and generating transportable lessons. Five principles are the foundation of this approach: (1) gather data to describe changes made by healthcare organizations and how changes are implemented; (2) collect process and outcome data relevant to healthcare organizations and to the research team; (3) assess multi-level contextual factors that affect implementation, process, outcome, and transportability; (4) assist healthcare organizations in using data for continuous quality improvement; and (5) operationalize common measurement strategies to generate transportable results. Learning Evaluation principles are applied across organizations by the following: (1) establishing a detailed understanding of the baseline implementation plan; (2) identifying target populations and tracking relevant process measures; (3) collecting and analyzing real-time quantitative and qualitative data on important contextual factors; (4) synthesizing data and emerging findings and sharing with stakeholders on an ongoing basis; and (5) harmonizing and fostering learning from process and outcome data. Application to a multi-site program focused on primary care and behavioral health integration shows the feasibility and utility of Learning Evaluation for generating real-time insights into evolving implementation processes. Learning Evaluation generates systematic and rigorous cross-organizational findings about implementing healthcare innovations while also enhancing organizational capacity and accelerating translation of findings by facilitating continuous learning within individual sites. Researchers evaluating change initiatives and healthcare organizations implementing improvement initiatives may benefit from a Learning Evaluation approach.

Fish farming as an innovative strategy for promoting food security in drought risk regions of Zimbabwe

PubMed Central

2017-01-01

This article examines the implementation of fish farming as an innovative and economic strategy for promoting food security and dietary diversities among vulnerable households in drought risk areas of Zimbabwe. The declining climatic conditions and lack of economic opportunities in Mwenezi district of Zimbabwe attracted the attention of three non-governmental organisations (NGOs) to implement fish farming as an innovative mechanism to stimulate food security and generate employment in the district. The article used a qualitative research approach that includes semi-structured interviews and secondary data. The purposive sampling technique was adopted to interview participants in Mwenezi district who were involved in fish farming to assess and explore the experiences and benefits they derive from such development projects. Results for the article revealed that fish farming was well embraced by local communities as it led to improvements in food security, household income and employment regeneration. The local government including traditional leadership (Chiefs and Headmen’s) supported the NGO activities as they benefited local communities. The article concludes that although fish farming was instrumental in regenerating employment, some participants still fail to participate because of laziness and desire to maintain dependency syndrome. The article recommends the NGOs to launch awareness campaigns in rural communities and increase networking with the donor community which is fundamental in attracting sustainable funding. The government can also promote fish farming in vulnerable rural communities by providing funding and capacity building programmes. PMID:29955350

The Ottawa Model of Research Use: a guide to clinical innovation in the NICU.

PubMed

Hogan, Debora L; Logan, Jo

2004-01-01

To improve performance of a neonatal transport team by implementing a research-based family assessment instrument. Objectives included providing a structure for evaluating families and fostering the healthcare relationship. Neonatal transports are associated with family crises. Transport teams require a comprehensive framework to accurately assess family responses to adversity and tools to guide their practice toward parental mastery of the event. Currently, there are no assessment tools that merge family nursing expertise with neonatal transport. A family assessment tool grounded in contemporary family nursing theory and research was developed by a clinical nurse specialist. The Ottawa Model of Research Use guided the process of piloting the innovation with members of a transport team. Focus groups, interviews, and surveys were conducted to create profiles of barriers and facilitators to research use by team members. Tailored research transfer strategies were enacted based on the profile results. Formative evaluations demonstrated improvements in team members' perceptions of their knowledge, family centeredness, and ability to assess and intervene with families. The family assessment tool is currently being incorporated into Clinical Practice Guidelines for Transport and thus will be considered standard care. Use of a family assessment tool is an effective way of appraising families and addressing suffering. The Ottawa Model of Research Use provided a framework for implementing the clinical innovation. A key role of the clinical nurse specialist is to influence nursing practice by fostering research use by practitioners. When developing and implementing a clinical innovation, input from end users and consumers is pivotal. Incorporating the innovation into a practice guideline provides a structure to imbed research evidence into practice.

Improving the effectiveness of health care innovation implementation: middle managers as change agents.

PubMed

Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J; Chin, Marshall H; Schaefer, Cynthia T

2013-02-01

The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers' commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers' commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers' influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected.

Improving the Effectiveness of Health Care Innovation Implementation: Middle Managers as Change Agents

PubMed Central

Birken, Sarah A.; Lee, Shoou-Yih Daniel; Weiner, Bryan J.; Chin, Marshall H.; Schaefer, Cynthia T.

2013-01-01

The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers’ commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers’ commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers’ influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected. PMID:22930312

Improving Eleventh Graders' Reading Comprehension through Text Coding and Double Entry Organizer Reading Strategies (Mejoramiento de la comprensión lectora de estudiantes de grado once mediante las estrategias de lectura de codificación de texto y organizador de doble entrada)

ERIC Educational Resources Information Center

Mahecha, Rocío; Urrego, Stella; Lozano, Erika

2011-01-01

In this article we report on an innovation project developed with a group of eleventh graders at a public school in Bogotá. Its aim was to encourage students to improve reading comprehension of texts in English. It was conducted taking into account students' needs, interests and level of English. To do it, we implemented two reading strategies:…

Innovation, systemic appropriation and prevention in the granite mining sector: The case of humidification.

PubMed

Mendes, R W B; Pueyo, V; Béguin, P; Duarte, F J C M

2017-01-01

This research was conducted in the Brazilian granite mining sector. After epidemiological studies, it was established that professional pneumoconiosis is related to the inhalation of dust. Therefore, the Brazilian mining health and safety regulatory standard made it compulsory to provide humidification throughout the extraction and mineral treatment processes. To develop the concept of systemic appropriation of the technological innovations that aim to protect the worker's health. Until now, appropriation has usually been presented in its individual dimensions. In this article, the focus is placed on the collective and organizational aspects of this appropriation. Two methodological approaches were used: interviews with the different individuals involved in order to report the history of the implementation of technical devices which meet the humidification norm; and ergonomic analysis of the work of the operators who used these devices. The appropriation of the technical devices occurred at two distinct levels: 1) Individual, related to the direct contact of the operator with the instrument; 2) Systemic, as the effects of the innovation propagated through the system affecting interdependent tasks, adaptation of the work organization and new production strategies. The implementation of prevention norms require innovations which are necessarily accompanied by transformations in the companies' techniques, work and management.

High-throughput strategies for the discovery and engineering of enzymes for biocatalysis.

PubMed

Jacques, Philippe; Béchet, Max; Bigan, Muriel; Caly, Delphine; Chataigné, Gabrielle; Coutte, François; Flahaut, Christophe; Heuson, Egon; Leclère, Valérie; Lecouturier, Didier; Phalip, Vincent; Ravallec, Rozenn; Dhulster, Pascal; Froidevaux, Rénato

2017-02-01

Innovations in novel enzyme discoveries impact upon a wide range of industries for which biocatalysis and biotransformations represent a great challenge, i.e., food industry, polymers and chemical industry. Key tools and technologies, such as bioinformatics tools to guide mutant library design, molecular biology tools to create mutants library, microfluidics/microplates, parallel miniscale bioreactors and mass spectrometry technologies to create high-throughput screening methods and experimental design tools for screening and optimization, allow to evolve the discovery, development and implementation of enzymes and whole cells in (bio)processes. These technological innovations are also accompanied by the development and implementation of clean and sustainable integrated processes to meet the growing needs of chemical, pharmaceutical, environmental and biorefinery industries. This review gives an overview of the benefits of high-throughput screening approach from the discovery and engineering of biocatalysts to cell culture for optimizing their production in integrated processes and their extraction/purification.

Dedicated education unit: implementing an innovation in replication sites.

PubMed

Moscato, Susan R; Nishioka, Vicki M; Coe, Michael T

2013-05-01

An important measure of an innovation is the ease of replication and achievement of the same positive outcomes. The dedicated education unit (DEU) clinical education model uses a collaborative academic-service partnership to develop an optimal learning environment for students. The University of Portland adapted this model from Flinders University, Australia, to increase the teaching capacity and quality of nursing education. This article identifies DEU implementation essentials and reports on the outcomes of two replication sites that received consultation support from the University of Portland. Program operation information, including education requirements for clinician instructors, types of patient care units, and clinical faculty-to-student ratios is presented. Case studies of the three programs suggest the DEU model is adaptable to a range of different clinical settings and continues to show promise as one strategy for addressing the nurse faculty shortage and strengthening academic-clinical collaborations while maintaining quality clinical education for students. Copyright 2013, SLACK Incorporated.

The North West London Integrated Care Pilot: innovative strategies to improve care coordination for older adults and people with diabetes.

PubMed

Harris, Matthew; Greaves, Felix; Patterson, Sue; Jones, Jessica; Pappas, Yannis; Majeed, Azeem; Car, Josip

2012-01-01

The North West London Integrated Care Pilot (ICP) was launched in June 2011 and brings together more than 100 general practices, 2 acute care trusts, 5 primary care trusts, 2 mental health care trusts, 3 community health trusts, 5 local authorities, and 2 voluntary sector organizations (Age UK and Diabetes UK) to improve the coordination of care for a pilot population of 550 000 people. Specifically, the ICP serves people older than 75 years and those with diabetes. Although still in the early stages of implementation, the ICP has already received national awards for its innovations in design and delivery. This article critically describes the ICP objectives, facilitating processes, and planned impact as well as the organizational and financial challenges that policy makers are facing in the implementation of the pilot program.

Innovation Configurations: Analyzing the Adaptations of Innovations.

ERIC Educational Resources Information Center

Hall, Gene E.; Loucks, Susan F.

When implementing an innovation, a multitude of components interact to change not only the users, but the innovation as well. This guide explains the concept of innovation configurations, or adaptations made in innovations during implementation. After presenting and discussing past research on innovation changes, the report outlines a five step…

Variables associated with work performance in multidisciplinary mental health teams

PubMed Central

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Chiocchio, François

2017-01-01

Objectives: This study investigates work performance among 79 mental health teams in Quebec (Canada). We hypothesized that work performance was positively associated with the use of standardized clinical tools and clinical approaches, integration strategies, “clan culture,” and mental health funding per capita. Methods: Work performance was measured using an adapted version of the Work Role Questionnaire. Variables were organized into four key areas: (1) team attributes, (2) organizational culture, (3) inter-organizational interactions, and (4) external environment. Results: Work performance was associated with two types of organizational culture (clan and hierarchy) and with two team attributes (use of standardized clinical tools and approaches). Discussion and conclusion: This study was innovative in identifying associations between work performance and best practices, justifying their implementation. Recommendations are provided to develop organizational cultures promoting a greater focus on the external environment and integration strategies that strengthen external focus, service effectiveness, and innovation. PMID:28839935

Implementing organizational physical activity and healthy eating strategies on paid time: process evaluation of the UCLA WORKING pilot study.

PubMed

Hopkins, Jammie M; Glenn, Beth A; Cole, Brian L; McCarthy, William; Yancey, Antronette

2012-06-01

Integrating organizationally targeted wellness strategies into the routine conduct of business has shown promise in engaging captive audiences at highest risk of obesity and obesity-related health consequences. This paper presents a process evaluation of the implementation of the University of California, Los Angeles, Working Out Regularly Keeps Individuals Nurtured and Going (WORKING) pilot study. WORKING focuses on integrating physical activity and nutrition practices into workplace routine during non-discretionary paid work time. The purpose of the evaluation was to assess the quality of implementation and to understand factors that facilitated or hindered organizations' full uptake of the intervention. Fifteen worksites were randomly assigned to an intervention condition. Qualitative data were gathered through routine site visits and informant interviews conducted throughout each worksite's intervention period. Worksites were classified into one of four implementation success categories based on their level of adoption and maintenance of core intervention strategies. Six key factors emerged that were related to implementation success: site layout and social climate, wellness infrastructure, number and influence of Program Champions, leadership involvement, site innovation and creativity. This pilot study has informed the conduct of WORKING II; a cluster randomized controlled trial aimed at enrolling 60-70 worksites in Los Angeles County.

Implementing organizational physical activity and healthy eating strategies on paid time: process evaluation of the UCLA WORKING pilot study

PubMed Central

Hopkins, Jammie M.; Glenn, Beth A.; Cole, Brian L.; McCarthy, William; Yancey, Antronette

2012-01-01

Integrating organizationally targeted wellness strategies into the routine conduct of business has shown promise in engaging captive audiences at highest risk of obesity and obesity-related health consequences. This paper presents a process evaluation of the implementation of the University of California, Los Angeles, Working Out Regularly Keeps Individuals Nurtured and Going (WORKING) pilot study. WORKING focuses on integrating physical activity and nutrition practices into workplace routine during non-discretionary paid work time. The purpose of the evaluation was to assess the quality of implementation and to understand factors that facilitated or hindered organizations’ full uptake of the intervention. Fifteen worksites were randomly assigned to an intervention condition. Qualitative data were gathered through routine site visits and informant interviews conducted throughout each worksite’s intervention period. Worksites were classified into one of four implementation success categories based on their level of adoption and maintenance of core intervention strategies. Six key factors emerged that were related to implementation success: site layout and social climate, wellness infrastructure, number and influence of Program Champions, leadership involvement, site innovation and creativity. This pilot study has informed the conduct of WORKING II; a cluster randomized controlled trial aimed at enrolling 60–70 worksites in Los Angeles County. PMID:22323279

An organizational perspective on the long-term sustainability of a nursing best practice guidelines program: a case study.

PubMed

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

2015-12-03

Many healthcare innovations are not sustained over the long term, wasting costly implementation efforts and often desperately-needed initial improvements. Although there have been advances in knowledge about innovation implementation, there has been considerably less attention focused on understanding what happens following the early stages of change. Research is needed to determine how to improve the 'staying power' of healthcare innovations. As almost no empirical knowledge exists about innovation sustainability in nursing, the purpose of our study was to understand how a nursing best practice guidelines (BPG) program was sustained over a long-term period in an acute healthcare centre. We conducted a qualitative descriptive case study to examine the program's sustainability at the nursing department level of the organization. The organization was a large, urban, multi-site acute care centre in Canada. The patient safety-oriented BPG program, initiated in 2004, consisted of an organization-wide implementation of three BPGs: falls prevention, pressure ulcer prevention, and pain management. Data were collected eight years following program initiation through 14 key informant interviews, document reviews, and observations. We developed a framework for the sustainability of healthcare innovations to guide data collection and content analysis. Program sustainability entailed a combination of three essential characteristics: benefits, institutionalization, and development. A constellation of 11 factors most influenced the long-term sustainability of the program. These factors were innovation-, context-, leadership-, and process-related. Three key interactions between factors influencing program sustainability and characteristics of program sustainability accounted for how the program had been sustained. These interactions were between: leadership commitment and benefits; complementarity of leadership actions and both institutionalization and development; and a reflection-and-course-correction strategy and development. Study findings indicate that the successful initial implementation of an organizational program does not automatically lead to longer-term program sustainability. The persistent, complementary, and aligned actions of committed leaders, in a variety of roles across a health centre department, seem necessary. Organizational leaders should consider a broad conceptualization of sustainability that extends beyond program institutionalization and/or program benefits. The development of an organizational program may be necessary for its long-term survival.

An Immunization Strategy for Hidden Populations.

PubMed

Chen, Saran; Lu, Xin

2017-06-12

Hidden populations, such as injecting drug users (IDUs), sex workers (SWs) and men who have sex with men (MSM), are considered at high risk of contracting and transmitting infectious diseases such as AIDS, gonorrhea, syphilis etc. However, public health interventions to such groups are prohibited due to strong privacy concerns and lack of global information, which is a necessity for traditional strategies such as targeted immunization and acquaintance immunization. In this study, we introduce an innovative intervention strategy to be used in combination with a sampling approach that is widely used for hidden populations, Respondent-driven Sampling (RDS). The RDS strategy is implemented in two steps: First, RDS is used to estimate the average degree (personal network size) and degree distribution of the target population with sample data. Second, a cut-off threshold is calculated and used to screen the respondents to be immunized. Simulations on model networks and real-world networks reveal that the efficiency of the RDS strategy is close to that of the targeted strategy. As the new strategy can be implemented with the RDS sampling process, it provides a cost-efficient and feasible approach for disease intervention and control for hidden populations.

Eco-innovations in the functioning of companies.

PubMed

Ociepa-Kubicka, A; Pachura, P

2017-07-01

The development of entrepreneurships in the 21st century cannot occur without taking care of the natural environment. The article presents issues related to eco-innovation. Despite the opportunities offered by eco-innovations, implementation of such initiatives remains to lead to various difficulties. They vary across countries and sectors. The insufficient number of enterprises in Poland and other European countries implement adequate level of eco-innovations. The main aim of this paper is to indicate the causes of this status and activities aimed to develop eco-innovativeness. The benefits and risks connected with implementation of innovative products and technologies were also discussed. Furthermore, the advantages of and barriers to their implementation into companies were analysed. The entrepreneurs from the least eco-innovative countries emphasize serious barriers, including uncertain demand from the market, uncertain return on investment or too long a payback period for eco-innovation, lack of funds within the enterprise, insufficient access to existing subsidies and fiscal incentive. They are especially afraid of the financial risks, which raises uncertainty and leads to refraining from innovative initiatives. The possibilities were indicated for the entrepreneurs who face problems with the implementation of innovative solutions. Particular attention was paid to the European Union activities for the development of eco-innovations. Numerous programs supporting their implementation were indicated. The article also presents examples of eco-innovation in water and sewage enterprises. It was emphasized that planning of eco-innovative solutions should be based on comprehensive information about actual benefits and possibility of threats to the environment which can be caused by implementation of eco-innovations. The study presents the example of threats resulting from different methods of sewage sludge management. Copyright © 2017 Elsevier Inc. All rights reserved.

A procedural model for planning and evaluating behavioral interventions.

PubMed

Hyner, G C

2005-01-01

A model for planning, implementing and evaluating health behavior change strategies is proposed. Variables are presented which can be used in the model or serve as examples for how the model is utilized once a theory of health behavior is adopted. Examples of three innovative strategies designed to influence behavior change are presented so that the proposed model can be modified for use following comprehensive screening and baseline measurements. Three measurement priorities: clients, methods and agency are subjected to three phases of assessment: goals, implementation and effects. Lifestyles account for the majority of variability in quality-of-life and premature morbidity and mortality. Interventions designed to influence healthy behavior changes must be driven by theory and carefully planned and evaluated. The proposed model is offered as a useful tool for the behavior change strategist.

From environment to sustainable development: China's strategies for ESD in basic education

NASA Astrophysics Data System (ADS)

Zhang, Tiedao

2010-06-01

This paper intends to provide an overview of the reorientation of education in China in the period 1998-2009 with regard to development issues. During this time, the focus has shifted gradually from the environment and health to education for sustainable development. The article centres on highlighting the main interventions and strategies adopted by China's schools to make this reorientation possible, including: the introduction of new visions of sustainable development and project planning; the establishment of organisational mechanisms and capacity-building measures for their implementation in the field; the integration of ESD into teaching and learning processes; the maintenance of an action-research mechanism for innovations; and the sharing of lessons with both the national and the international community in order to make the implementation of ESD more effective.

Diagnostic, design and implementation of an integrated model of care in France: a bottom-up process with a continuous leadership

PubMed Central

de Stampa, Matthieu; Vedel, Isabelle; Mauriat, Claire; Bagaragaza, Emmanuel; Routelous, Christelle; Bergman, Howard; Lapointe, Liette; Cassou, Bernard; Ankri, Joel; Henrard, Jean-Claude

2010-01-01

Purpose To present an innovative bottom-up and pragmatic strategy used to implement a new integrated care model in France for community-dwelling elderly people with complex needs. Context Sustaining integrated care is difficult, in large part because of problems encountered securing the participation of health care and social service professionals and, in particular, general practitioners (GPs). Case description In the first step, a diagnostic study was conducted with face-to-face interviews to gather data on current practices from a sample of health and social stakeholders working with elderly people. In the second step, an integrated care model called Coordination Personnes Agées (COPA) was designed by the same major stakeholders in order to define its detailed characteristics based on the local context. In the third step, the model was implemented in two phases: adoption and maintenance. This strategy was carried out by a continuous and flexible leadership throughout the process, initially with a mixed leadership (clinician and researcher) followed by a double one (clinician and managers of services) in the implementation phase. Conclusions The implementation of this bottom-up and pragmatic strategy relied on establishing a collaborative dynamic among health and social stakeholders. This enhanced their involvement throughout the implementation phase, particularly among the GPs, and allowed them to support the change practices and services arrangements.

An implementation science perspective on psychological science and cancer: what is known and opportunities for research, policy, and practice.

PubMed

Rabin, Borsika; Glasgow, Russell E

2015-01-01

We discuss the role of implementation science in cancer and summarize the need for this perspective. Following a summary of key implementation science principles and lessons learned, we review the literature on implementation of cancer prevention and control activities across the continuum from prevention to palliative care. We identified 10 unique relevant reviews, four of which were specific to cancer. Multicomponent implementation strategies were found to be superior to single-component interventions, but it was not possible to draw conclusions about specific strategies or the range of conditions across which strategies were effective. Particular gaps identified include the need for more studies of health policies and reports of cost, cost-effectiveness, and resources required. Following this review, we summarize the types of evidence needed to make research findings more actionable and discuss emerging implementation science opportunities for psychological research on cancer prevention and control. These include innovative study designs (i.e., rapid learning designs, simulation modeling, comparative effectiveness, pragmatic studies, mixed-methods research) and measurement science (i.e., development of context-relevant measures; practical, longitudinal measures to gauge improvement; cost-effectiveness data; and harmonized patient report data). We conclude by identifying a few grand challenges for psychologists that if successfully addressed would accelerate integration of evidence into cancer practice and policy more consistently and rapidly. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Effective Risk Management in Innovative Projects: A Case Study of the Construction of Energy-efficient, Sustainable Building of the Laboratory of Intelligent Building in Cracow

NASA Astrophysics Data System (ADS)

Krechowicz, Maria

2017-10-01

Many construction projects fail to meet deadlines or they exceed the assumed budget. This scenario is particularly common in the case of innovative projects, in which too late identification of a high risk of delays and exceeding the assumed costs makes a potentially profitable project untenable. A high risk level, far exceeding the level of risk in standard non-innovative projects, is a characteristic feature of the realization phase of innovative projects. This is associated not only with greater complexity of the design and construction phases, but also with the problems with application of new technologies and prototype solutions, lack of qualified personnel with suitable expertise in specialized areas, and with the ability to properly identify the gaps between available and required knowledge and skills. This paper discusses the process of effective risk management in innovative projects on the example of the realization phase of an innovative, energy-efficient and sustainable building of the Laboratory of Intelligent Building in Cracow - DLJM Lab, from the point of view of DORBUD S.A., its general contractor. In this paper, a new approach to risk management process for innovative construction projects is proposed. Risk management process was divided into five stages: gathering information, identification of the important unwanted events, first risk assessment, development and choice of risk reaction strategies, assessment of the residual risk after introducing risk reactions. 18 unwanted events in an innovative construction project were identified. The first risk assessment was carried out using two-parametric risk matrix, in which the probability of unwanted event occurrence and its consequences were analysed. Three levels of risks were defined: tolerable, controlled and uncontrolled. Risk reactions to each defined unwanted event were developed. The following risk reaction types were considered: risk retention, risk reduction, risk transfer and risk elimination. Three-parametric risk matrix was developed to make it possible to assess risk after implementing risk reactions. The possibility of implementing risk management was inversely proportional to the probability of unwanted event occurrence and its contribution to the project outcome. Introducing this risk management strategy allowed to significantly reduce the risk of the innovative construction project. It proved to be an effective tool to reduce risk to an acceptable level. It had a significant contribution to carrying out the project within the assumed time, budget and quality standards.

The writer's guide to education scholarship in emergency medicine: Education innovations (part 3).

PubMed

Hall, Andrew K; Hagel, Carly; Chan, Teresa M; Thoma, Brent; Murnaghan, Aleisha; Bhanji, Farhan

2018-05-01

The scholarly dissemination of innovative medical education practices helps broaden the reach of this type of work, allowing scholarship to have an impact beyond a single institution. There is little guidance in the literature for those seeking to publish program evaluation studies and innovation papers. This study aims to derive a set of evidence-based features of high-quality reports on innovations in emergency medicine (EM) education. We conducted a scoping review and thematic analysis to determine quality markers for medical education innovation reports, with a focus on EM. A search of MEDLINE, EMBASE, ERIC, and Google Scholar was augmented by a hand search of relevant publication guidelines, guidelines for authors, and website submission portals from medical education and EM journals. Study investigators reviewed the selected articles, and a thematic analysis was conducted. Our search strategy identified 14 relevant articles from which 34 quality markers were extracted. These markers were grouped into seven important themes: goals and need for innovation, preparation, innovation development, innovation implementation, evaluation of innovation, evidence of reflective practice, and reporting and dissemination. In addition, multiple outlets for the publication of EM education innovations were identified and compiled. The publication and dissemination of innovations are critical for the EM education community and the training of health professionals. We anticipate that our list of innovation report quality markers will be used by EM education innovators to support the dissemination of novel educational practices.

Attributes of innovations and approaches to scalability - lessons from a national program to extend the scope of practice of health professionals.

PubMed

Masso, Malcolm; Thompson, Cristina

2016-01-01

The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches - letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers).

Innovation or rebranding, acute care surgery diffusion will continue.

PubMed

Collins, Courtney E; Pringle, Patricia L; Santry, Heena P

2015-08-01

Patterns of adoption of acute care surgery (ACS) as a strategy for emergency general surgery (EGS) care are unknown. We conducted a qualitative study comprising face-to-face interviews with senior surgeons responsible for ACS at 18 teaching hospitals chosen to ensure diversity of opinions and practice environment (three practice types [community, public or charity, and university] in each of six geographic regions [Mid-Atlantic, Midwest, New England, Northeast, South, and West]). Interviews were recorded, transcribed, and analyzed using NVivo (QSR International, Melbourne, Australia). We applied the methods of investigator triangulation using an inductive approach to develop a final taxonomy of codes organized by themes related to respondents' views on the future of ACS as a strategy for EGS. We applied our findings to a conceptual model on diffusion of innovation. We found a paradox between ACS viewed as a health care delivery innovation versus a rebranding of comprehensive general surgery. Optimism for the future of ACS because of increased desirability for trauma and critical care careers as well as improved EGS outcomes was tempered by fear over lack of continuity, poor institutional resources, and uncertainty regarding financial viability. Our analysis suggests that the implementation of ACS, whether a true health care delivery innovation or an innovative rebranding, fits into the Rogers' diffusion of innovation theory. Despite concerns over resource allocation and the definition of the specialty, from the perspective of senior surgeons deeply entrenched in executing this care delivery model, ACS represents the new face of general surgery that will likely continue to diffuse from these early adopters. Published by Elsevier Inc.

Disruptive innovations for designing and diffusing evidence-based interventions.

PubMed

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F

2012-09-01

Evidence-based therapeutic and preventive intervention programs (EBIs) have been growing exponentially. Yet EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically reexamine our scientific conventions and norms. Innovation may be spurred by reexamining the traditional biomedical model for validating, implementing, and diffusing EBI products and science. The model of disruptive innovations suggests that we reengineer EBIs on the basis of their most robust features in order to serve more people in less time and at lower cost. A disruptive innovation provides a simpler and less expensive alternative that meets the essential needs for the majority of consumers and is more accessible, scalable, replicable, and sustainable. Examples of disruptive innovations from other fields include minute clinics embedded in retail chain drug stores, $2 generic eyeglasses, automated teller machines, and telemedicine. Four new research approaches will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing monitoring data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Innovation or rebranding, acute care surgery diffusion will continue

PubMed Central

Collins, Courtney E.; Pringle, Patricia L.; Santry, Heena P.

2015-01-01

Background Patterns of adoption of acute care surgery (ACS) as a strategy for emergency general surgery (EGS) care are unknown. Methods We conducted a qualitative study comprising face-to-face interviews with senior surgeons responsible for ACS at 18 teaching hospitals chosen to ensure diversity of opinions and practice environment (three practice types [community, public/charity, university] in each of six geographic regions [Mid-Atlantic, Midwest, New England, Northeast, South, West]). Interviews were recorded, transcribed, and analyzed using NVivo (QSR International, Melbourne, Australia). We applied the methods of investigator triangulation using an inductive approach to develop a final taxonomy of codes organized by themes related to respondents’ views on the future of ACS as a strategy for EGS. We applied our findings to a conceptual model on diffusion of innovation. Results We found a paradox between ACS viewed as a healthcare delivery innovation versus a rebranding of comprehensive general surgery. Optimism for the future of ACS due to increased desirability for trauma/critical care careers and improved outcomes for EGS was tempered by fear over lack of continuity, poor institutional resources and uncertainty regarding financial viability. Our analysis suggests that the implementation of ACS, whether a true healthcare delivery innovation or an innovative rebranding, fits into the Rogers’ Diffusion of Innovation Theory. Conclusions Despite concerns over resource allocation and the definition of the specialty, from the perspective of senior surgeons deeply entrenched in executing this care-delivery model, ACS represents the new face of general surgery that will likely continue to diffuse from these early adopters. PMID:25891673

ManTech Implementing a Strategy to Deliver Weapon Systems Affordability

DTIC Science & Technology

2010-11-01

Tile 2007 – Translational Friction Stir Welding 2006 – Uncooled Focal Plane Array Producibility 2006 – Engine Rotor Life Extension 2005...compelling ideas will continue to help drive our Department’s innovative engine and ensure our Nation maintains its competitive edge on the...Sheets Composite Vertical Stabilizer Apache AH-64 NAVY The Challenge: Butt welding exterior ship panels produces a weld protrusion that exceeds the

How States Can Promote Local Innovation, Options, and Problem-Solving in Public Education. Linking State and Local School Improvement

ERIC Educational Resources Information Center

Posamentier, Jordan; Lake, Robin; Hill, Paul

2017-01-01

State policy plays a critical role in determining whether and how well local education improvement strategies can be implemented. As states rework their education policies under the Every Student Succeeds Act (ESSA), state and local leaders need a way to assess their current policy environment and identify the changes needed to encourage local…

The Practice of a Quality Assurance System in Open and Distance Learning: A Case Study at Universitas Terbuka Indonesia (The Indonesia Open University)

ERIC Educational Resources Information Center

Belawati, Tian; Zuhairi, Amin

2007-01-01

Quality assurance for distance higher education is one of the main concerns among institutions and stakeholders today. This paper examines the experiences of Universitas Terbuka (UT), which has initiated and implemented an innovative strategy of quality assurance (QA) for continuous improvement. The credo of the UT quality assurance system is…

Community Schooling and State Control: A Dilemma in the Innovation and Reform of Botswana's Basic Education System.

ERIC Educational Resources Information Center

Tshireletso, Lucky

This paper examines the Botswana government's objectives and implementation strategies in the development of community secondary schools. With a population of 1.5 million and an annual growth rate of 3.5 percent, Botswana is one of the fastest growing countries in the world. Recent dramatic economic growth, largely due to diamond revenues, has not…

Student Perceptions of Using the PebblePad E-Portfolio System to Support Self- and Peer-Based Formative Assessment

ERIC Educational Resources Information Center

Welsh, Mary

2012-01-01

The primary objective of the action research project discussed here was to monitor the implementation of an innovative course redesign in which the PebblePad e-portfolio system was used as the medium to support the introduction of self- and peer-based formative assessment strategies to approximately 170 students in the first year of a Bachelor of…

Successful Implementation of New Technology Using an Interdepartmental Collaborative Approach.

PubMed

Tetef, Sue

2017-06-01

The implementation of new technology is vital to the success of health care organizations. New technology provides health care organizations an opportunity to obtain new patients, increase revenue, and stay competitive. In 2014, a union hospital in Southern California successfully implemented a bronchial thermoplasty program. To implement this new technology, the administration created a strategy, identified financial risks and benefits, created an implementation model, established a plan based on Lewin's change model and Roger's diffusion of innovations theory, and recognized adult learning needs through an interdepartmental, open communication, and collaborative approach. In addition, the implementation of the bronchial thermoplasty program allowed the organization to meet the goals, mission, and vision of the organization, which is key to remaining viable and marketable. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2018-01-01

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

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

PubMed Central

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

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation. PMID:29896471

Strategies for integrating personalized medicine into healthcare practice.

PubMed

Pritchard, Daryl E; Moeckel, Franziska; Villa, Mary Susan; Housman, Laura T; McCarty, Catherine A; McLeod, Howard L

2017-03-01

Research and innovation in personalized medicine are surging, however, its adoption into clinical practice is comparatively slow. We identify common challenges to the clinical adoption of personalized medicine and provide strategies for addressing these challenges. Our team developed a list of common challenges through a series of group discussions, surveys and interviews, and convened a national summit to discuss solutions for overcoming these challenges. We used a framework approach for thematic analysis. We categorized challenges into five areas of need: education and awareness; patient empowerment; value recognition; infrastructure and information management; and ensuring access to care. We then developed strategies to address these challenges. In order for healthcare to transition into personalized medicine, it is necessary for stakeholders to build momentum by implementing a progression of strategies.

Thinking Differently: Catalyzing Innovation in Healthcare and Beyond.

PubMed

Samet, Kenneth A; Smith, Mark S

2016-01-01

Convenience, value, access, and choice have become the new expectations of consumers seeking care. Incorporating these imperatives and navigating an expanded competitive landscape are necessary for the success of healthcare organizations-today and in the future-and require thinking differently than in the past.Innovation must be a central strategy for clinical and business operations to be successful. However, the currently popular concept of innovation is at risk of losing its power and meaning unless deliberate and focused action is taken to define it, adopt it, embrace it, and embed it in an organization's culture. This article details MedStar Health's blueprint for establishing the MedStar Institute for Innovation (MI2), which involved recognizing the sharpened need for innovation, creating a single specific entity to catalyze innovation across the healthcare organization and community, discovering the untapped innovation energy already residing in its employee base, and moving nimbly into the white space of possibility.Drawing on MedStar's experience with MI2, we offer suggestions in the following areas for implementing an innovation institute in a large healthcare system:We offer healthcare and business leaders a playbook for identifying and unleashing innovation in their organizations, at a time when innovation is at an increased risk of being misunderstood or misdirected but remains absolutely necessary for healthcare systems and organizations to flourish in the future.

Gaps and strategies in developing health research capacity: experience from the Nigeria Implementation Science Alliance.

PubMed

Ezeanolue, Echezona E; Menson, William Nii Ayitey; Patel, Dina; Aarons, Gregory; Olutola, Ayodotun; Obiefune, Michael; Dakum, Patrick; Okonkwo, Prosper; Gobir, Bola; Akinmurele, Timothy; Nwandu, Anthea; Khamofu, Hadiza; Oyeledun, Bolanle; Aina, Muyiwa; Eyo, Andy; Oleribe, Obinna; Ibanga, Ikoedem; Oko, John; Anyaike, Chukwuma; Idoko, John; Aliyu, Muktar H; Sturke, Rachel

2018-02-12

Despite being disproportionately burdened by preventable diseases than more advanced countries, low- and middle-income countries (LMICs) continue to trail behind other parts of the world in the number, quality and impact of scholarly activities by their health researchers. Our strategy at the Nigerian Implementation Science Alliance (NISA) is to utilise innovative platforms that catalyse collaboration, enhance communication between different stakeholders, and promote the uptake of evidence-based interventions in improving healthcare delivery. This article reports on findings from a structured group exercise conducted at the 2016 NISA Conference to identify (1) gaps in developing research capacity and (2) potential strategies to address these gaps. A 1-hour structured group exercise was conducted with 15 groups of 2-9 individuals (n = 94) to brainstorm gaps for implementation, strategies to address gaps and to rank their top 3 in each category. Qualitative thematic analysis was used. First, duplicate responses were merged and analyses identified emerging themes. Each of the gaps and strategies identified were categorised as falling into the purview of policy-makers, researchers, implementing partners or multiple groups. Participating stakeholders identified 98 gaps and 91 strategies related to increasing research capacity in Nigeria. A total of 45 gaps and an equal number of strategies were ranked; 39 gaps and 43 strategies were then analysed, from which 8 recurring themes emerged for gaps (lack of sufficient funding, poor research focus in education, inadequate mentorship and training, inadequate research infrastructure, lack of collaboration between researchers, research-policy dissonance, lack of motivation for research, lack of leadership buy-in for research) and 7 themes emerged for strategies (increased funding for research, improved research education, improved mentorship and training, improved infrastructure for research, increased collaboration between academic/research institutions, greater engagement between researchers and policy-makers, greater leadership buy-in for research). The gaps and strategies identified in this study represent pathways judged to be important in increasing research and implementation science capacity in Nigeria. The inclusion of perspectives and involvement of stakeholders who play different roles in policy, research and implementation activities makes these findings comprehensive, relevant and actionable, not only in Nigeria but in other similar LMICs.

Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems.

PubMed

Kühne, Franziska; Haagen, Miriam; Baldus, Christiane; Diareme, Stavroula; Grether, Andrea; Schmitt, Florence; Stanescu, Dan; Stöckl, Margit; Thastum, Mikael; Möller, Birgit; Romer, Georg

2013-01-01

Parental physical disease is a family issue, but families' minor children are seldom considered. The current study analyzed experiences with implementation of counseling for families with physically ill parents and minor children during a European multisite pilot project. Implementation protocols of seven European partner centers collaborating in a joint research project were analyzed by Mayring's qualitative content analysis. Both an inductive approach and a deductive approach were chosen. Satisfaction of families and therapists was considered based on information from three partner centers. Satisfaction with counseling was rather high. Mentioned problems referred to aspects related to liaison partners, family-related aspects and physicians' concerns. Recommendations related to contacting families, liaising with other professions, implementing counseling together with a research project, and training. Results are integrated in the current dissemination literature. Successful implementation was mostly determined by aspects of interdisciplinary cooperation and communication, perceived relative advantage and organizational premises. With regard to this kind of innovative child-centered family mental health services, top-down and bottom-up implementation strategies should be combined, and strategies of maintenance and sustainability should be considered from the very beginning. Copyright © 2013 Elsevier Inc. All rights reserved.

Biosurveillance as a Terrain of Innovation in an Era of Monopoly Finance Capital

ERIC Educational Resources Information Center

Magnusson, Jamie

2013-01-01

Situated in a context of higher education policy, this article examines the institutionalization of "innovation" as a national neoliberal economic strategy. As neoliberal capital has become increasingly financialized, this innovation strategy has come to be woven through biotechnological innovation as an economic strategy, and oriented…

Integrated versus fragmented implementation of complex innovations in acute health care.

PubMed

Woiceshyn, Jaana; Blades, Kenneth; Pendharkar, Sachin R

Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations-those that require coordinated use across the adopting organization to have the intended benefits. We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and continual support for and evaluation of implementation, and (d) allowance for local customization within the general principles of standardization.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

PubMed

Vlemmix, Floortje; Rosman, Ageeth N; Fleuren, Margot A H; Rijnders, Marlies E B; Beuckens, Antje; Haak, Monique C; Akerboom, Bettina M C; Bais, Joke M J; Kuppens, Simone M I; Papatsonis, Dimitri N; Opmeer, Brent C; van der Post, Joris A M; Mol, Ben Willem J; Kok, Marjolein

2010-05-10

Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Dutch Trial Register (NTR): 1878.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

PubMed Central

2010-01-01

Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial Registration Dutch Trial Register (NTR): 1878 PMID:20459717

PP167. A process evaluation of an innovative implementation strategy of the Dutch guidelines on hypertensive disorders in pregnancy using a computerized decision support system.

PubMed

Luitjes, S; Mesri, K; Wouters, M; van Tulder, M; Hermens, R

2012-07-01

Hypertensive disorders in pregnancy remain the leading cause of maternal mortality in the Netherlands. The Dutch Society of Obstetrics and Gynecology (NVOG) has developed evidence-based guidelines on the management of hypertension in pregnancy. Previous studies showed a low adherence rate to other NVOG guidelines and a large variation in usual care in different hospitals. In the BIG CHANGE trial an innovative implementation strategy of the NVOG guidelines on hypertension using a web-based application (BOS, by Giant Soft, Leeuwarden, The Netherlands) was compared to a common strategy of professional audit and feedback. In this study a process evaluation of BOS has been done, analyzing its efficiency, barriers and formulate improvement points. Gynecologists, residents and clinical midwives from seven hospitals using BOS were asked to fill in the questionnaire. A questionnaire was developed on the following items: efficiency, barriers and improvement. Thirty four completed questionnaires useful for analysis. 63.6% of the respondent also consulted the NVOG guideline or local protocol, mainly for confirmation of information, background information, medication. Technical problems were found in 44.1%. Positive opinions on user friendliness varied from 73.5% to 100%. No significant difference was found between the user frequency of BOS compared to the NVOG guidelines or local protocol, or between the time needed to consult them. Improvements mentioned by the respondents were mainly regarding the lay-out. Most respondents (85.3%) found it useful to make a computer based support system for other guidelines and 79.4% would also use this. BOS is regarded suitable as an instrument for implementing guidelines and respondents find it useful to develop it for other guidelines as well. Technical problems and poor implementation are important areas of improvement. Copyright © 2012. Published by Elsevier B.V.

It Takes a Village to Prevent Falls: Reconceptualizing Fall Prevention and Management for Older Adults

PubMed Central

Ganz, David A.; Alkema, Gretchen E.; Wu, Shinyi

2013-01-01

Systematic evidence reviews support the efficacy of physical activity programs and multifactorial strategies for fall prevention. However, community settings where fall prevention programs occur often differ substantially from the research settings in which efficacy was first demonstrated. Because of these differences, alternative approaches are needed to judge the adequacy of fall prevention activities occurring as part of standard medical care or community efforts. This paper uses the World Health Organization Innovative Care for Chronic Conditions (ICCC) framework to rethink how fall prevention programs might be implemented routinely in both medical and community settings. We highlight examples of innovative programs and policies that provide fall prevention strategies consistent with the ICCC framework, and provide evidence where available on the effects of these strategies on processes and outcomes of care. We close by proposing a “no wrong door” approach to fall prevention and management, in which older adults who are found to be at risk for falls in either a medical or community setting are linked to a standard fall risk evaluation across three domains (physical activity, medical risks and home safety). PMID:18676787

Interdisciplinary shared governance: a partnership model for high performance in a managed care environment.

PubMed

Anderson, D A; Bankston, K; Stindt, J L; Weybright, D W

2000-09-01

Today's managed care environment is forcing hospitals to seek new and innovative ways to deliver a seamless continuum of high-quality care and services to defined populations at lower costs. Many are striving to achieve this goal through the implementation of shared governance models that support point-of-service decision making, interdisciplinary partnerships, and the integration of work across clinical settings and along the service delivery continuum. The authors describe the key processes and strategies used to facilitate the design and successful implementation of an interdisciplinary shared governance model at The University Hospital, Cincinnati, Ohio. Implementation costs and initial benefits obtained over a 2-year period also are identified.

Understanding Implementation of Complex Interventions in Primary Care Teams.

PubMed

Luig, Thea; Asselin, Jodie; Sharma, Arya M; Campbell-Scherer, Denise L

2018-01-01

The implementation of interventions to support practice change in primary care settings is complex. Pragmatic strategies, grounded in empiric data, are needed to navigate real-world challenges and unanticipated interactions with context that can impact implementation and outcomes. This article uses the example of the "5As Team" randomized control trial to explore implementation strategies to promote knowledge transfer, capacity building, and practice integration, and their interaction within the context of an interdisciplinary primary care team. We performed a qualitative evaluation of the implementation process of the 5As Team intervention study, a randomized control trial of a complex intervention in primary care. We conducted thematic analysis of field notes of intervention sessions, log books of the practice facilitation team members, and semistructured interviews with 29 interdisciplinary clinician participants. We used and further developed the Interactive Systems Framework for dissemination and implementation to interpret and structure findings. Three themes emerged that illuminate interactions between implementation processes, context, and outcomes: (1) facilitating team communication supported collective and individual sense-making and adoption of the innovation, (2) iterative evaluation of the implementation process and real-time feedback-driven adaptions of the intervention proved crucial for sustainable, context-appropriate intervention impact, (3) stakeholder engagement led to both knowledge exchange that contributes to local problem solving and to shaping a clinical context that is supportive to practice change. Our findings contribute pragmatic strategies that can help practitioners and researchers to navigate interactions between context, intervention, and implementation factors to increase implementation success. We further developed an implementation framework that includes sustained engagement with stakeholders, facilitation of team sense-making, and dynamic evaluation and intervention design as integral parts of complex intervention implementation. NCT01967797. 18 October 2013. © Copyright 2018 by the American Board of Family Medicine.

Engaging primary care patients to use a patient-centered personal health record.

PubMed

Krist, Alex H; Woolf, Steven H; Bello, Ghalib A; Sabo, Roy T; Longo, Daniel R; Kashiri, Paulette; Etz, Rebecca S; Loomis, John; Rothemich, Stephen F; Peele, J Eric; Cohn, Jeffrey

2014-01-01

Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. © 2014 Annals of Family Medicine, Inc.

Improving occupational physicians' adherence to a practice guideline: feasibility and impact of a tailored implementation strategy.

PubMed

Joosen, Margot C W; van Beurden, Karlijn M; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P M; van der Klink, Jac J L

2015-04-24

Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived by occupational physicians (OPs). Feasibility and impact on OPs' barriers were evaluated. OPs received 8 training-sessions in small peer-learning groups, aimed at discussing the content of the guideline and their perceived barriers to adhere to guideline recommendations; finding solutions to overcome these barriers; and implementing solutions in practice. The training had a plan-do-check-act (PDCA) structure and was guided by a trainer. Protocol compliance and OPs' experiences were qualitatively and quantitatively assessed. Using a questionnaire, impact on knowledge, attitude, and external barriers to guideline adherence was investigated before and after the training. The training protocol was successfully conducted; guideline recommendations and related barriers were discussed with peers, (innovative) solutions were found and implemented in practice. The participating 32 OPs were divided into 6 groups and all OPs attended 8 sessions. Of the OPs, 90% agreed that the peer-learning groups and the meetings spread over one year were highly effective training components. Significant improvements (p < .05) were found in knowledge, self-efficacy, motivation to use the guideline and its applicability to individual patients. After the training, OPs did not perceive any barriers related to knowledge and self-efficacy. Perceived adherence increased from 48.8% to 96.8% (p < .01). The results imply that an implementation strategy focusing on perceived barriers and tailor-made implementation interventions is a feasible method to enhance guideline adherence. Moreover, the strategy contributed to OPs' knowledge, attitudes, and skills in using the guideline. As a generic approach to overcome barriers perceived in specific situations, this strategy provides a useful method to guideline implementation for other health care professionals too.

The meaning and measurement of implementation climate

PubMed Central

2011-01-01

Background Climate has a long history in organizational studies, but few theoretical models integrate the complex effects of climate during innovation implementation. In 1996, a theoretical model was proposed that organizations could develop a positive climate for implementation by making use of various policies and practices that promote organizational members' means, motives, and opportunities for innovation use. The model proposes that implementation climate--or the extent to which organizational members perceive that innovation use is expected, supported, and rewarded--is positively associated with implementation effectiveness. The implementation climate construct holds significant promise for advancing scientific knowledge about the organizational determinants of innovation implementation. However, the construct has not received sufficient scholarly attention, despite numerous citations in the scientific literature. In this article, we clarify the meaning of implementation climate, discuss several measurement issues, and propose guidelines for empirical study. Discussion Implementation climate differs from constructs such as organizational climate, culture, or context in two important respects: first, it has a strategic focus (implementation), and second, it is innovation-specific. Measuring implementation climate is challenging because the construct operates at the organizational level, but requires the collection of multi-dimensional perceptual data from many expected innovation users within an organization. In order to avoid problems with construct validity, assessments of within-group agreement of implementation climate measures must be carefully considered. Implementation climate implies a high degree of within-group agreement in climate perceptions. However, researchers might find it useful to distinguish implementation climate level (the average of implementation climate perceptions) from implementation climate strength (the variability of implementation climate perceptions). It is important to recognize that the implementation climate construct applies most readily to innovations that require collective, coordinated behavior change by many organizational members both for successful implementation and for realization of anticipated benefits. For innovations that do not possess these attributes, individual-level theories of behavior change could be more useful in explaining implementation effectiveness. Summary This construct has considerable value in implementation science, however, further debate and development is necessary to refine and distinguish the construct for empirical use. PMID:21781328

A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; Zgierska, Aleksandra E; Jacobson, Nora; Robinson, James M; Johnson, Roberta A; Deyo, Brienna M; Madden, Lynn; Tuan, Wen-Jan; Alagoz, Esra

2018-01-25

This paper reports on the feasibility, acceptability, and effectiveness of an innovative implementation strategy named "systems consultation" aimed at improving adherence to clinical guidelines for opioid prescribing in primary care. While clinical guidelines for opioid prescribing have been developed, they have not been widely implemented, even as opioid abuse reaches epidemic levels. We tested a blended implementation strategy consisting of several discrete implementation strategies, including audit and feedback, academic detailing, and external facilitation. The study compares four intervention clinics to four control clinics in a randomized matched-pairs design. Each systems consultant aided clinics on implementing the guidelines during a 6-month intervention consisting of monthly site visits and teleconferences/videoconferences. The mixed-methods evaluation employs the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Quantitative outcomes are compared using time series analysis. Qualitative methods included focus groups, structured interviews, and ethnographic field techniques. Seven clinics were randomly approached to recruit four intervention clinics. Each clinic designated a project team consisting of six to eight staff members, each with at least one prescriber. Attendance at intervention meetings was 83%. More than 80% of staff respondents agreed or strongly agreed with the statements: "I am more familiar with guidelines for safe opioid prescribing" and "My clinic's workflow for opioid prescribing is easier." At 6 months, statistically significant improvements were noted in intervention clinics in the percentage of patients with mental health screens, treatment agreements, urine drug tests, and opioid-benzodiazepine co-prescribing. At 12 months, morphine-equivalent daily dose was significantly reduced in intervention clinics compared to controls. The cost to deliver the strategy was $7345 per clinic. Adaptations were required to make the strategy more acceptable for primary care. Qualitatively, intervention clinics reported that chronic pain was now treated using approaches similar to those employed for other chronic conditions, such as hypertension and diabetes. The systems consultation implementation strategy demonstrated feasibility, acceptability, and effectiveness in a study involving eight primary care clinics. This multi-disciplinary strategy holds potential to mitigate the prevalence of opioid addiction and ultimately may help to improve implementation of clinical guidelines across healthcare. ClinicalTrials.gov (NCT02433496). https://clinicaltrials.gov/ct2/show/NCT02433496 Registered May 5, 2015.

Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence Within State Domestic Violence Coalitions

PubMed Central

Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

2018-01-01

Background Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states. Objective DELTA PREP’s summative evaluation addressed four major questions: (1) Did coalitions improve their prevention capacity during the project period? (2) Did coalitions serve as catalysts for prevention activities within their states during the project period? (3) Was initial prevention capacity associated with the number of prevention activity types initiated by coalitions by the end of the project? (4) Did coalitions sustain their prevention activities 6 months after the end of the project period? Results DELTA PREP achieved its capacity-building goal, with all 19 participant coalitions integrating prevention within their organizations and serving as catalysts for prevention activities in their states. At 6 months follow up, coalitions had sustained almost all prevention activities they initiated during the project. Baseline prevention capacity (Beginner vs. Intermediate) was not associated with the number of prevention activity types coalitions implemented by the end of the project. Conclusion Service and treatment organizations are increasingly asked to integrate a full spectrum of prevention strategies. Selecting organizations that have high levels of general capacity and readiness for an innovation like integrating a public health approach to IPV prevention will likely increase success in building an innovation-specific capacity, and in turn implementing an innovation. PMID:26245932

Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence Within State Domestic Violence Coalitions.

PubMed

Freire, Kimberley E; Zakocs, Ronda; Le, Brenda; Hill, Jessica A; Brown, Pamela; Wheaton, Jocelyn

2015-08-01

Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states. DELTA PREP's summative evaluation addressed four major questions: (1) Did coalitions improve their prevention capacity during the project period? (2) Did coalitions serve as catalysts for prevention activities within their states during the project period? (3) Was initial prevention capacity associated with the number of prevention activity types initiated by coalitions by the end of the project? (4) Did coalitions sustain their prevention activities 6 months after the end of the project period? DELTA PREP achieved its capacity-building goal, with all 19 participant coalitions integrating prevention within their organizations and serving as catalysts for prevention activities in their states. At 6 months follow up, coalitions had sustained almost all prevention activities they initiated during the project. Baseline prevention capacity (Beginner vs. Intermediate) was not associated with the number of prevention activity types coalitions implemented by the end of the project. Service and treatment organizations are increasingly asked to integrate a full spectrum of prevention strategies. Selecting organizations that have high levels of general capacity and readiness for an innovation like integrating a public health approach to IPV prevention will likely increase success in building an innovation-specific capacity, and in turn implementing an innovation. © 2015 Society for Public Health Education.

Disruptive innovation in academic medical centers: balancing accountable and academic care.

PubMed

Stein, Daniel; Chen, Christopher; Ackerly, D Clay

2015-05-01

Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

Facilitating Classroom Innovation in the Geosciences Through the NSF Transforming Undergraduate Education in Science, Technology, Engineering, and Mathematics (TUES) Program

NASA Astrophysics Data System (ADS)

Singer, J.; Ryan, J. G.

2012-12-01

The Transforming Undergraduate Education in Science, Technology, Engineering, and Mathematics (TUES) program seeks to improve the quality of science, technology, engineering, and mathematics (STEM) education for all undergraduate students. Activities supported by the TUES program include the creation, adaptation, and dissemination of learning materials and teaching strategies, development of faculty expertise, implementation of educational innovations, and research on STEM teaching and learning. The TUES program especially encourages projects that have the potential to transform undergraduate STEM education and active dissemination and building a community of users are critical components of TUES projects. To raise awareness about the TUES program and increase both the quality and quantity of proposals submitted by geoscientists to the program, information sessions and proposal writing retreats are being conducted. Digital resources developed especially for the geosciences community are available at www.buffalostate.edu/RTUGeoEd to share information about the TUES program and the many ways this NSF program supports innovation in geoscience education. This presentation also addresses identified impediments to submitting a TUES proposal and strategies for overcoming reasons discouraging geoscientists from preparing a proposal and/or resubmitting a declined proposal.

Tools of the Mind: A Case Study of Implementing the Vygotskian Approach in American Early Childhood and Primary Classrooms. Innodata Monographs 7.

ERIC Educational Resources Information Center

Bodrova, Elena; Leong, Deborah J.

This monograph, one in a series describing innovative educational practice, presents a case study of the Tools of the Mind project. This project, the result of collaboration between Russian and American education researchers, used the Vygotskian approach to create a series of tools or strategies for teachers to use in supporting the development of…

Strategies and Procedures in Developing and Implementing Curriculum. Report of a Sub-Regional Training Workshop on Curriculum Development (Seoul, August 1-30, 1977).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand).

Nine representatives of Thailand, Nepal, Iran, and the Republic of Korea met in Seoul during the month of August, 1977, for a curriculum development training workshop co-sponsored by the Korean National Commission for UNESCO and the Asian Centre of Educational Innovation for Development (ACEID). One aim of the workshop was to improve the…

Teaching undergraduate nursing students critical thinking: An innovative informatics strategy.

PubMed

Warren, Judith J; Connors, Helen R; Weaver, Charlotte; Simpson, Roy

2006-01-01

Simulated e-Health Delivery System (SEEDS) uses a clinical information system (CIS) to teach students how to process data from virtual patient case studies and work with information technology. SEEDS was developed in response to the Institute of Medicine recommendation that students be taught about information systems in order to improve quality patient care and reduce errors. Curriculum implications, implementation of the system, and technology challenges are discussed.

Career Advancement and Work Support Services on the Job: Implementing the Fort Worth Work Advancement and Support Center Program. Executive Summary

ERIC Educational Resources Information Center

Schultz, Caroline; Seith, David

2011-01-01

The Work Advancement and Support Center (WASC) program in Fort Worth was part of a demonstration that is testing innovative strategies to help increase the income of low-wage workers, who make up a large segment of the U.S. workforce. The program offered services to help workers stabilize their employment, improve their skills, and increase their…

Career Advancement and Work Support Services on the Job: Implementing the Fort Worth Work Advancement and Support Center Program

ERIC Educational Resources Information Center

Schultz, Caroline; Seith, David

2011-01-01

The Work Advancement and Support Center (WASC) program in Fort Worth was part of a demonstration that is testing innovative strategies to help increase the income of low-wage workers, who make up a large segment of the U.S. workforce. The program offered services to help workers stabilize their employment, improve their skills, and increase their…

Factors Influencing Rapid Prototyping Innovation Implementation: A Descriptive Model

DTIC Science & Technology

1990-03-01

strategy. NDI can be considered as a balance of risk and technological advancement allowing the services to have a system in the field into the...The U.S. military no longer must go through the long, tedious series of events required by the peacetime research and development and service approval...developed, fielded, and evaluated by the fleet in conjunction with fleet introduction (Interim Service Approval). Rapid prototyping conceptually represents

Strategies for target identification of antimicrobial natural products.

PubMed

Farha, Maya A; Brown, Eric D

2016-05-04

Covering: 2000 to 2015Despite a pervasive decline in natural product research at many pharmaceutical companies over the last two decades, natural products have undeniably been a prolific and unsurpassed source for new lead antibacterial compounds. Due to their inherent complexity, natural extracts face several hurdles in high-throughout discovery programs, including target identification. Target identification and validation is a crucial process for advancing hits through the discovery pipeline, but has remained a major bottleneck. In the case of natural products, extremely low yields and limited compound supply further impede the process. Here, we review the wealth of target identification strategies that have been proposed and implemented for the characterization of novel antibacterials. Traditionally, these have included genomic and biochemical-based approaches, which, in recent years, have been improved with modern-day technology and better honed for natural product discovery. Further, we discuss the more recent innovative approaches for uncovering the target of new antibacterial natural products, which have resulted from modern advances in chemical biology tools. Finally, we present unique screening platforms implemented to streamline the process of target identification. The different innovative methods to respond to the challenge of characterizing the mode of action for antibacterial natural products have cumulatively built useful frameworks that may advocate a renovated interest in natural product drug discovery programs.

Lessons learned in using realist evaluation to assess maternal and newborn health programming in rural Bangladesh.

PubMed

Adams, Alayne; Sedalia, Saroj; McNab, Shanon; Sarker, Malabika

2016-03-01

Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the three MNH programmes under consideration employed different implementation models to deliver similar services and meet similar MNH goals. Programme targets included adoption of recommended antenatal, post-natal and essential newborn care practices; health systems strengthening through improved referral, accountability and administrative systems, and increased community knowledge. Drawing on focused examples from this research, seven steps for operationalizing the realist evaluation approach are offered, while emphasizing the need to iterate and innovate in terms of methods and analysis strategies. The paper concludes by reflecting on lessons learned in applying realist evaluation, and the unique insights it yields regarding implementation strategies for successful MNH programming. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Evolution of electronic waste toxicity: Trends in innovation and regulation.

PubMed

Chen, Mengjun; Ogunseitan, Oladele A; Wang, Jianbo; Chen, Haiyan; Wang, Bin; Chen, Shu

2016-01-01

Rapid innovation in printed circuit board, and the uncertainties surrounding quantification of the human and environmental health impacts of e-waste disposal have made it difficult to confirm the influence of evolving e-waste management strategies and regulatory policies on materials. To assess these influences, we analyzed hazardous chemicals in a market-representative set of Waste printed circuit boards (WPCBs, 1996-2010). We used standard leaching tests to characterize hazard potential and USEtox® to project impacts on human health and ecosystem. The results demonstrate that command-and-control regulations have had minimal impacts on WPCBs composition and toxicity risks; whereas technological innovation may have been influenced more by resource conservation, including a declining trend in the use of precious metals such as gold. WPCBs remain classified as hazardous under U.S. and California laws because of excessive toxic metals. Lead poses the most significant risk for cancers; zinc for non-cancer diseases; copper had the largest potential impact on ecosystem quality. Among organics, acenaphthylene, the largest risk for cancers; naphthalene for non-cancer diseases; pyrene has the highest potential for ecotoxicological impacts. These findings support the need for stronger enforcement of international policies and technology innovation to implement the strategy of design-for-the-environment and to encourage recovery, recycling, and reuse of WPCBs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hot Spot Fishing Community in Rakai, Uganda.

PubMed

Long, Amanda; Mbabali, Ismail; Hutton, Heidi E; Thomas, Alvin G; Bugos, Eva; Mulamba, Jeremiah; Amico, Kathy Rivet; Nalugoda, Fred; Gray, Ronald H; Wawer, Maria J; Nakigozi, Gertrude; Chang, Larry W

Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The intervention, utilizing a novel, theory-based approach, trained 10 community residents in an HIV hot spot fishing community to use motivational interviewing strategies and a mobile phone-based counseling application. During the first 3 months, 771 residents (median 82/health scout, range 27-160) were counseled. A directly observed Motivational Interviewing Treatment Integrity scale-based evaluation found adequate performance (median score 20/25, range 11-23). The health scout intervention was feasible to implement in a high HIV-prevalence fishing community, and its impact on HIV care outcomes will be evaluated in an ongoing cluster randomized trial. If found to be effective, it may be an important strategy for responding to HIV in high-burden settings.

Evaluating Niger's experience in strengthening supervision, improving availability of child survival drugs through cost recovery, and initiating training for Integrated Management of Childhood Illness (IMCI)

PubMed Central

Tawfik, Youssef M; Legros, Stephane; Geslin, Colette

2001-01-01

Background WHO and UNICEF have recently developed the "Integrated Management of Childhood Illness" (IMCI) as an efficient strategy to assist developing countries reduce childhood mortality. Early experience with IMCI implementation suggests that clinical training is essential but not sufficient for the success of the strategy. Attention needs to be given to strengthening health systems, such as supervision and drug supply. Results This paper presents results of evaluating an innovative approach for implementing IMCI in Niger. It starts with strengthening district level supervision and improving the availability of child survival drugs through cost recovery well before the beginning of IMCI clinical training. The evaluation documented the effectiveness of the initial IMCI clinical training and referral. Conclusions Strengthening supervision and assuring the availability of essential drugs need to precede the initiation of IMCI Clinical training. Longer term follow up is necessary to confirm the impact of the approach on IMCI preparation and implementation. PMID:11504567

Translational Radiomics: Defining the Strategy Pipeline and Considerations for Application-Part 2: From Clinical Implementation to Enterprise.

PubMed

Shaikh, Faiq; Franc, Benjamin; Allen, Erastus; Sala, Evis; Awan, Omer; Hendrata, Kenneth; Halabi, Safwan; Mohiuddin, Sohaib; Malik, Sana; Hadley, Dexter; Shrestha, Rasu

2018-03-01

Enterprise imaging has channeled various technological innovations to the field of clinical radiology, ranging from advanced imaging equipment and postacquisition iterative reconstruction tools to image analysis and computer-aided detection tools. More recently, the advancement in the field of quantitative image analysis coupled with machine learning-based data analytics, classification, and integration has ushered in the era of radiomics, a paradigm shift that holds tremendous potential in clinical decision support as well as drug discovery. However, there are important issues to consider to incorporate radiomics into a clinically applicable system and a commercially viable solution. In this two-part series, we offer insights into the development of the translational pipeline for radiomics from methodology to clinical implementation (Part 1) and from that point to enterprise development (Part 2). In Part 2 of this two-part series, we study the components of the strategy pipeline, from clinical implementation to building enterprise solutions. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

PubMed

Newhouse, Robin P

2007-01-01

Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

YouthAccess to Alcohol: early findings from a community action project to reduce the supply of alcohol to teens.

PubMed

Clark, Sam

2007-01-01

The Youth Access to Alcohol (YATA) project was implemented in 2002 by the Alcohol Advisory Council of New Zealand (ALAC) in thirty communities in New Zealand, with the aim of reducing the harm experienced by young people as a result of alcohol misuse in New Zealand through reducing the supply of alcohol by adults to young people. The communities include a mix of rural and urban from both Islands in New Zealand. The project uses a community action approach, which has included setting up collaborative partnerships of key agencies, the delivery of key strategies, and multimedia awareness raising campaigns. The communities are encouraged to identify unique issues in their community regarding alcohol abuse and young people and to develop action plans incorporating a range of strategies that include tested strategies as well as innovative ideas. Communities are trained to implement several tools to monitor changes in their community over time. The study's limitations are noted and future needed research is suggested.

Patient Blood Management: An International Perspective.

PubMed

Eichbaum, Quentin; Murphy, Michael; Liu, Yu; Kajja, Isaac; Hajjar, Ludhmila Abrahao; Smit Sibinga, Cees Th; Shan, Hua

2016-12-01

This article describes practices in patient blood management (PBM) in 4 countries on different continents that may provide insights for anesthesiologists and other physicians working in global settings. The article has its foundation in the proceedings of a session at the 2014 AABB annual meeting during which international experts from England, Uganda, China, and Brazil presented the programs and implementation strategies in PBM developed in their respective countries. To systematize the review and enhance the comparability between these countries on different continents, authors were requested to respond to the same set of 6 key questions with respect to their country's PBM program(s). Considerable variation exists between these country regions that is driven both by differences in health contexts and by disparities in resources. Comparing PBM strategies from low-, middle-, and high-income countries, as described in this article, allows them to learn bidirectionally from one another and to work toward implementing innovative and preferably evidence-based strategies for improvement. Sharing and distributing knowledge from such programs will ultimately also improve transfusion outcomes and patient safety.

Five Forces of 21st Century Innovation Strategy: Insights for Leaders

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

Arent, Douglas J.; Pless, Jacquelyn; Statwick, Patricia

Understanding these dynamics informs 21st century innovation strategies that government and business leaders rely upon to address modern technological, social, environmental, and demographic realities. This Research Highlight previews JISEA's continuing work on innovation strategy.

The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice.

PubMed

Breimaier, Helga E; Heckemann, Birgit; Halfens, Ruud J G; Lohrmann, Christa

2015-01-01

Implementing clinical practice guidelines (CPGs) in healthcare settings is a complex intervention involving both independent and interdependent components. Although the Consolidated Framework for Implementation Research (CFIR) has never been evaluated in a practical context, it appeared to be a suitable theoretical framework to guide an implementation process. The aim of this study was to evaluate the comprehensiveness, applicability and usefulness of the CFIR in the implementation of a fall-prevention CPG in nursing practice to improve patient care in an Austrian university teaching hospital setting. The evaluation of the CFIR was based on (1) team-meeting minutes, (2) the main investigator's research diary, containing a record of a before-and-after, mixed-methods study design embedded in a participatory action research (PAR) approach for guideline implementation, and (3) an analysis of qualitative and quantitative data collected from graduate and assistant nurses in two Austrian university teaching hospital departments. The CFIR was used to organise data per and across time point(s) and assess their influence on the implementation process, resulting in implementation and service outcomes. Overall, the CFIR could be demonstrated to be a comprehensive framework for the implementation of a guideline into a hospital-based nursing practice. However, the CFIR did not account for some crucial factors during the planning phase of an implementation process, such as consideration of stakeholder aims and wishes/needs when implementing an innovation, pre-established measures related to the intended innovation and pre-established strategies for implementing an innovation. For the CFIR constructs reflecting & evaluating and engaging, a more specific definition is recommended. The framework and its supplements could easily be used by researchers, and their scope was appropriate for the complexity of a prospective CPG-implementation project. The CFIR facilitated qualitative data analysis and provided a structure that allowed project results to be organised and viewed in a broader context to explain the main findings. The CFIR was a valuable and helpful framework for (1) the assessment of the baseline, process and final state of the implementation process and influential factors, (2) the content analysis of qualitative data collected throughout the implementation process, and (3) explaining the main findings.

Activating multi-ethnic youth for smoking prevention: design, baseline findings, and implementation of project SPLASH.

PubMed

Glanz, Karen; Lunde, Kevin B; Leakey, Tricia; Maddock, Jay; Koga, Karin; Yamauchi, Jessica; Maskarinec, Gertraud; Shigaki, Dorothy

2007-01-01

Achieving significant reductions in tobacco use by youth is an important challenge. There is a pressing need to develop and evaluate innovative strategies that stimulate youth involvement and are effective in multi-ethnic populations. This article describes an innovative tobacco prevention trial, and reports baseline characteristics of participants and findings about implementation of the curriculum. The aim of Project SPLASH is to evaluate the impact of a school-based smoking prevention intervention that emphasizes active involvement of middle school students, on rates of smoking initiation and regular smoking in a multi-ethnic cohort of youth in Hawaii. Project SPLASH is a group randomized trial that compares a 2-year innovative intervention with a social influence prevention program, in 20 public schools in Hawaii. The main outcome is mean 30-day smoking prevalence rates. The response rate was 78.4%. Approximately 1 in 4 students had tried smoking and 30-day smoking prevalence at baseline was 8%. Intervention and control groups were comparable in terms of tobacco use, gender, ethnicity, behavioral, environmental, and psychosocial characteristics. Differences in ethnic identification, socio-economic status, acculturation, and involvement in prevention activities may be due to chance. The intervention was well implemented by teachers across both the intervention and control school classes. For this study, 20 schools in Hawaii with close to 4000 participating students were recruited. Student smoking behavior and curriculum implementation were comparable by group status. The intervention study has the potential to elucidate how youth respond to an intervention with student involvement that incorporates cognitive and social action components.

Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study

PubMed Central

2014-01-01

Background Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Methods/Design Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers’s diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods — pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance — with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of implementation costs. Discussion If implementation is successful, the field will have a proven technology that helps Federally Qualified Health Centers and affiliated organizations provide addiction treatment and recovery support, as well as a proven strategy for implementing the technology. Seva also has the potential to improve core elements of addiction treatment, such as referral and treatment processes. A mobile technology for addiction treatment and accompanying implementation model could provide a cost-effective means to improve the lives of patients with drug and alcohol problems. Trial registration ClinicalTrials.gov (NCT01963234). PMID:24884976

Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study.

PubMed

Quanbeck, Andrew R; Gustafson, David H; Marsch, Lisa A; McTavish, Fiona; Brown, Randall T; Mares, Marie-Louise; Johnson, Roberta; Glass, Joseph E; Atwood, Amy K; McDowell, Helene

2014-05-29

Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers's diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods - pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance - with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of implementation costs. If implementation is successful, the field will have a proven technology that helps Federally Qualified Health Centers and affiliated organizations provide addiction treatment and recovery support, as well as a proven strategy for implementing the technology. Seva also has the potential to improve core elements of addiction treatment, such as referral and treatment processes. A mobile technology for addiction treatment and accompanying implementation model could provide a cost-effective means to improve the lives of patients with drug and alcohol problems. ClinicalTrials.gov (NCT01963234).

Contribution au developpement d'une methode de controle des procedes dans une usine de bouletage

NASA Astrophysics Data System (ADS)

Gosselin, Claude

This thesis, a collaborative effort between Ecole de technologie superieure and ArcelorMittal Company, presents the development of a methodology for monitoring and quality control of multivariable industrial production processes. This innovation research mandate was developed at ArcelorMittal Exploitation Miniere (AMEM) pellet plant in Port-Cartier (Quebec, Canada). With this undertaking, ArcelorMittal is striving to maintain its world class level of excellence and continues to pursue initiatives that can augment its competitive advantage worldwide. The plant's gravimetric classification process was retained as a prototype and development laboratory due to its effect on the company's competitiveness and its impact on subsequent steps leading to final production of iron oxide pellets. Concretely, the development of this expertise in process control and in situ monitoring will establish a firm basic knowledge in the fields of complex system physical modeling, data reconciliation, statistical observers, multivariate command and quality control using real-time monitoring of the desirability function. The hydraulic classifier is mathematically modeled. Using planned disturbances on the production line, an identification procedure was established to provide empirical estimations of the model's structural parameters. A new sampling campaign and a previously unpublished data collection and consolidation policy were implemented plant-wide. Access to these invaluable data sources has enabled the establishment of new thresholds that govern the production process and its control. Finally, as a substitute for the traditional quality control process, we have implemented a new strategy based on the use of the desirability function. Our innovation is not in using this Finally, as a substitute for the traditional quality control process, we have implemented a new strategy based on the use of the desirability function. Our innovation is not in using this function as an indicator of overall (economic) satisfaction in the production process, but rather in proposing it as an "observer" of the system's state. The first implementation steps have already demonstrated the method's feasibility as well as other numerous industrial impacts on production processes within the company. Namely, the emergence of the economical aspect as a strategic variable that assures better governance of production processes where quality variables present strategic issues.

Innovation implementation in the public sector: an integration of institutional and collective dynamics.

PubMed

Choi, Jin Nam; Chang, Jae Yoon

2009-01-01

The present study integrates institutional factors and employee-based collective processes as predictors of 2 key implementation outcomes: implementation effectiveness and innovation effectiveness (Klein, Conn, & Sorra, 2001). Specifically, the authors proposed that institutional factors shape employees' collective implementation efficacy and innovation acceptance. The authors further hypothesized that these employee-based collective processes mediate the effects of institutional factors on implementation outcomes. This integrative framework was examined in the context of 47 agencies and ministries of the Korean Government that were implementing a process innovation called E-Government. Three-wave longitudinal data were collected from 60 external experts and 1,732 government employees. The results reveal the importance of management support for collective implementation efficacy, which affected employees' collective acceptance of the innovation. As hypothesized, these collective employee dynamics mediated the effects of institutional enablers on successful implementation as well as the amount of long-term benefit that accrued to the agencies and ministries. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

A look at the ASEAN-NDI: building a regional health R&D innovation network.

PubMed

Montoya, Jaime C; Rebulanan, Carina L; Parungao, Nico Angelo C; Ramirez, Bernadette

2014-01-01

Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally.

Innovative financing for late-stage global health research and development: the Global Health Investment Fund.

PubMed

Fitchett, Joseph Robert; Fan Li, Julia; Atun, Rifat

2016-01-01

Innovative financing strategies for global health are urgently needed to reinvigorate investment and new tools for impact. Bottleneck areas along the research and development (R&D) pipeline require particular attention, such as the transitions from preclinical discovery to clinical study, and product development to implementation and delivery. Successful organizations mobilizing and disbursing resources through innovating financing mechanisms include UNITAID, the Global Fund, and Gavi, the Vaccine Alliance. Although precise numbers are poorly documented, estimated investment in low-income settings falls seriously short of local need. This commentary discusses the newly established Global Health Investment Fund as a case study to support late-stage global health R&D. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A look at the ASEAN-NDI: building a regional health R&D innovation network

PubMed Central

2014-01-01

Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally. PMID:24834349

Attributes of innovations and approaches to scalability – lessons from a national program to extend the scope of practice of health professionals

PubMed Central

Masso, Malcolm; Thompson, Cristina

2016-01-01

The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches – letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers). PMID:27616889

An innovative cross-sectoral method for implementation of trade-off adaptation strategy assessment under climate change

NASA Astrophysics Data System (ADS)

Tsao, Jung-Hsuan; Tung, Ching-Pin; Liu, Tzu-Ming

2014-05-01

Climate change will increase sharp risks to the water and food supply in coming decades. Although impact assessment and adaptation evaluation has been discussed a lot in recent years, the importance of adaptation implement should not be ignored. In Taiwan, and elsewhere, fallow is an option of adaptation strategy under climate change. Fallow would improve the water scarcity of domestic use, but the food security might be threatened. The trade-off effects of adaptation actions are just like the side effects of medicine which cannot be avoided. Thus, managing water resources with an integrated approach will be urgent. This study aims to establish a cross-sectoral framework for implementation the trade-off adaptation strategy. Not only fallow, but also other trade-off strategy like increasing the percentage of national grain self-sufficiency would be analyzed by a rational decision process. The recent percentage of grain self-sufficiency in Taiwan is around 32, which was decreasing from 53 thirty years ago. Yet, the goal of increasing grain self-sufficiency means much more water must be used in agriculture. In that way, domestic users may face the water shortage situation. Considering the conflicts between water supply and food security, the concepts from integrative negotiation are appropriate to apply. The implementation of trade-off adaptation strategies needs to start by quantifying the utility of water supply and food security were be quantified. Next, each side's bottom line can be found by BATNA (Best Alternative to a Negotiated Agreement) and ZOPA (Zone of Possible Agreement). ZOPA provides the entire possible outcomes, and BATNA ensures the efficiency of adaptation actions by moving along with Pareto frontier. Therefore, the optimal percentage of fallow and grain self-sufficiency can be determined. Furthermore, BATNA also provides the pathway step by step which can be a guideline of adaptation strategies. This framework allows analysts and stakeholder to systematically evaluate trade-off adaptation strategies and indicate the priority to implement.

Research on the influence of institutional pressures on green innovation strategy

NASA Astrophysics Data System (ADS)

Zewen, Chen; xin, Li; Hongjun, Cao

2017-11-01

Based on the new Institutional theory and the sample of 116 enterprises, this paper explores the influencing factors of green innovation strategy from the perspective of forced pressure, normative pressure and imitation pressure. The results show that the mandatory regulation, the incentive regulation, the supply chain pressure, and the competitive pressure all have a significant and positive impact on the green innovation strategy. Therefore, the government should take steps to stimulate enterprises to choose the green innovation strategy.

[The implementation of innovations in public health].

PubMed

Systerova, A A; Totskaia, E G

2012-01-01

Nowadays, the innovative activities are considered as the mechanism of implementation of public policy to increase effectiveness of public health system on the basis of achievements of modern medicine and technical sciences. The development, elaboration and implementation of products being in line with corresponding to criteria of innovation, promote the concurrency of medical institutions at the medical services market. The administrators of health departments and medical science professionals are to become aware about the problems of implementation of innovations into medical practice to develop the mechanisms of overcoming these issues.

A practical implementation science heuristic for organizational readiness: R = MC2

PubMed Central

Cook, Brittany S.; Lamont, Andrea; Wandersman, Abraham; Castellow, Jennifer; Katz, Jason; Beidas, Rinad S.

2015-01-01

There are many challenges when an innovation (i.e., a program, process, or policy that is new to an organization) is actively introduced into an organization. One critical component for successful implementation is the organization’s readiness for the innovation. In this article, we propose a practical implementation science heuristic, abbreviated as R= MC2. We propose that organizational readiness involves: 1) the motivation to implement an innovation, 2) the general capacities of an organization, and 3) the innovation-specific capacities needed for a particular innovation. Each of these components can be assessed independently and be used formatively. The heuristic can be used by organizations to assess readiness to implement and by training and technical assistance providers to help build organizational readiness. We present an illustration of the heuristic by showing how behavioral health organizations differ in readiness to implement a peer specialist initiative. Implications for research and practice of organizational readiness are discussed. PMID:26668443

Optimal environmental management strategy and implementation for groundwater contamination prevention and restoration.

PubMed

Wang, Mingyu

2006-04-01

An innovative management strategy is proposed for optimized and integrated environmental management for regional or national groundwater contamination prevention and restoration allied with consideration of sustainable development. This management strategy accounts for availability of limited resources, human health and ecological risks from groundwater contamination, costs for groundwater protection measures, beneficial uses and values from groundwater protection, and sustainable development. Six different categories of costs are identified with regard to groundwater prevention and restoration. In addition, different environmental impacts from groundwater contamination including human health and ecological risks are individually taken into account. System optimization principles are implemented to accomplish decision-makings on the optimal resources allocations of the available resources or budgets to different existing contaminated sites and projected contamination sites for a maximal risk reduction. Established management constraints such as budget limitations under different categories of costs are satisfied at the optimal solution. A stepwise optimization process is proposed in which the first step is to select optimally a limited number of sites where remediation or prevention measures will be taken, from all the existing contaminated and projected contamination sites, based on a total regionally or nationally available budget in a certain time frame such as 10 years. Then, several optimization steps determined year-by-year optimal distributions of the available yearly budgets for those selected sites. A hypothetical case study is presented to demonstrate a practical implementation of the management strategy. Several issues pertaining to groundwater contamination exposure and risk assessments and remediation cost evaluations are briefly discussed for adequately understanding implementations of the management strategy.

Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy.

PubMed

Aradeon, Susan B; Doctor, Henry V

2016-01-01

The Sustainable Development Goal (SDG) maternal mortality target risks being underachieved like its Millennium Development Goal (MDG) predecessor. The MDG skilled birth attendant (SBA) strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER) strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and postimplementation Knowledge, Attitude, and Practice Survey results and qualitative assessments support the CCER theory of change. This theory of change rests on a set of implementation steps that rely on three innovative components: Community Communication, Rapid Imitation Practice, and CCER support structures. Innovative communication body tools and the rote learning Rapid Imitation Practice training methodology enabled low-literate volunteers to saturate their communities with informed group discussions transferring communication capacity and ownership to the discussion participants. CCER is especially efficient because virtually every timely, community referral for emergency maternal care results in a saved life, whereas on average, only one in every eight births delivered by an SBA (12%) is expected to be a delivery-associated complication requiring lifesaving care.

What Does Innovation Mean for Moral Educators?

ERIC Educational Resources Information Center

Reiman, Alan J.; Dotger, Benjamin H.

2008-01-01

This article examines the links between prosocial moral education, educational innovations and concerns of school system personnel during an innovation's implementation process. The role of social innovations in promoting prosocial moral education is discussed with attention given to the challenges and processes associated with implementing such…

Enhanced use of phylogenetic data to inform public health approaches to HIV among MSM

PubMed Central

German, Danielle; Grabowski, Mary Kate; Beyrer, Chris

2017-01-01

The multi-dimensional nature and continued evolution of HIV epidemics among men who have sex with men (MSM) requires innovative intervention approaches. Strategies are needed that recognize the individual, social, and structural factors driving HIV transmission; that can pinpoint networks with heightened transmission risk; and that can help target intervention in real-time. HIV phylogenetics is a rapidly evolving field with strong promise for informing innovative responses to the HIV epidemic among MSM. Currently, HIV phylogenetic insights are providing new understandings of characteristics of HIV epidemics involving MSM, social networks influencing transmission, characteristics of HIV transmission clusters involving MSM, targets for antiretroviral and other prevention strategies, and dynamics of emergent epidemics. Maximizing the potential of HIV phylogenetics for HIV responses among MSM will require attention to key methodological challenges and ethical considerations, as well as resolving key implementation and scientific questions. Enhanced and integrated use of HIV surveillance, socio-behavioral, and phylogenetic data resources are becoming increasingly critical for informing public health approaches to HIV among MSM. PMID:27584826

Meeting the challenge of the 80's cost reduction measures at the Iron Ore Company of Canada's Carol Project 1980-85

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

Tinto, I.A.

1985-01-01

The mining facilities, crushing plant, and concentrator of the Iron Ore Company of Canada were in operation by 1962. Today, the Carol Project has the capacity to produce 20 million tonnes of concentrate from which 10.5 million tonnes of pellets can be produced. The period 1980-85 spans a period of energy crisis, world-wide recession, and a consequent re-structuring of the North American steel industry as it struggles to survive in an arena of excess world stell making capacity, government subsidized industries, and the increasing competition from overseas and from developing countries. This paper reviews cost reduction programs implemented by themore » Iron Ore Company of Canada at its 'Carol Project' and emphasizes improvements made in labour productivity, energy conservation, mining strategy, quality control, and reduced cost through technical innovations over this difficult period. The cost reduction program is reviewed under the headings of labor productivity, energy conservation, mining strategy, technical innovations and quality control.« less

A Novel Implementation Strategy in Residential Care Settings to Promote EBP: Direct Care Provider Perceptions and Development of a Conceptual Framework.

PubMed

Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Jones, C Allyson; Estabrooks, Carole A

2017-06-01

Innovative approaches are required to facilitate the adoption and sustainability of evidence-based care practices. We propose a novel implementation strategy, a peer reminder role, which involves offering a brief formal reminder to peers during structured unit meetings. This study aims to (a) identify healthcare aide (HCA) perceptions of a peer reminder role for HCAs, and (b) develop a conceptual framework for the role based on these perceptions. In 2013, a qualitative focus group study was conducted in five purposively sampled residential care facilities in western Canada. A convenience sample of 24 HCAs agreed to participate in five focus groups. Concurrent with data collection, two researchers coded the transcripts and identified themes by consensus. They jointly determined when saturation was achieved and took steps to optimize the trustworthiness of the findings. Five HCAs from the original focus groups commented on the resulting conceptual framework. HCAs were cautious about accepting a role that might alienate them from their co-workers. They emphasized feeling comfortable with the peer reminder role and identified circumstances that would optimize their comfort including: effective implementation strategies, perceptions of the role, role credibility and a supportive context. These intersecting themes formed a peer reminder conceptual framework. We identified HCAs' perspectives of a new peer reminder role designed specifically for them. Based on their perceptions, a conceptual framework was developed to guide the implementation of a peer reminder role for HCAs. This role may be a strategic implementation strategy to optimize the sustainability of new practices in residential care settings, and the related framework could offer guidance on how to implement this role. © 2017 Sigma Theta Tau International.

How Can Innovative Learning Environments Promote the Diffusion of Innovation?

ERIC Educational Resources Information Center

Osborne, Mark

2016-01-01

Schools implementing innovative learning environments (ILEs) face many challenges, including the need to discard previously cherished practices and behaviours, adjust mindsets, and invent successful new ways of operating. Leaders can support these processes by implementing structures that: i) support ongoing, distributed, participatory innovation;…

The Use of Research-Based Instructional Strategies in Introductory Physics: Where do Faculty Leave the Innovation-Decision Process?

NASA Astrophysics Data System (ADS)

Henderson, Charles; Dancy, Melissa; Niewiadomska-Bugaj, Magdalena

2013-03-01

During the Fall of 2008 a web survey was completed by a representative sample of 722 United States physics faculty. In this talk we will briefly present summary statistics to describe faculty knowledge about and use of 24 specific research-based instructional strategies (RBIS). We will then analyze the results based on a four stage model of the innovation-decision process: knowledge, trial, continuation, and high use. The largest losses occur at the continuation stage, with approximately 1/3 of faculty discontinuing use of all RBIS after trying one or more of these strategies. These results suggest that common dissemination strategies are good at creating knowledge about RBIS and motivation to try a RBIS, but more work is needed to support faculty during implementation and continued use of RBIS. Based on a logistic regression analysis, only nine of the 20 potential predictor variables measured were statistically significant when controlling for other variables. Faculty age, institutional type, and percentage of job related to teaching were not found to be correlated with knowledge or use at any stage. High research productivity and large class sizes were not found to be barriers to use of at least some RBIS. Supported by NSF #0715698.

Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States

PubMed Central

Manangan, Lilia Ponce; Tryon, Cheryl; Magee, Elvin; Miramontes, Roque

2012-01-01

Introduction. The Centers for Disease Control and Prevention (CDC)'s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009. Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit. Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions' QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012. Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality. PMID:22685648

A Plan for Action: Key Perspectives from the Racial/Ethnic Disparities Strategy Forum

PubMed Central

King, Roderick K; Green, Alexander R; Tan-Mcgrory, Aswita; Donahue, Elizabeth J; Kimbrough-Sugick, Jessie; Betancourt, Joseph R

2008-01-01

Context Racial and ethnic disparities in health care in the United States have been well documented, with research largely focusing on describing the problem rather than identifying the best practices or proven strategies to address it. Methods In 2006, the Disparities Solutions Center convened a one-and-a-half-day Strategy Forum composed of twenty experts from the fields of racial/ethnic disparities in health care, quality improvement, implementation research, and organizational excellence, with the goal of deciding on innovative action items and adoption strategies to address disparities. The forum used the Results Based Facilitation model, and several key recommendations emerged. Findings The forum's participants concluded that to identify and effectively address racial/ethnic disparities in health care, health care organizations should: (1) collect race and ethnicity data on patients or enrollees in a routine and standardized fashion; (2) implement tools to measure and monitor for disparities in care; (3) develop quality improvement strategies to address disparities; (4) secure the support of leadership; (5) use incentives to address disparities; and (6) create a messaging and communication strategy for these efforts. This article also discusses these recommendations in the context of both current efforts to address racial and ethnic disparities in health care and barriers to progress. Conclusions The Strategy Forum's participants concluded that health care organizations needed a multifaceted plan of action to address racial and ethnic disparities in health care. Although the ideas offered are not necessarily new, the discussion of their practical development and implementation should make them more useful. PMID:18522613

Implementation through Innovation: A Literature-Based Analysis of the Tuning Project

ERIC Educational Resources Information Center

Pálvölgyi, Krisztián

2017-01-01

Tuning Educational Structures in Europe is perhaps the most important higher education innovation platform nowadays. The main objective of the Tuning Project is to develop a tangible approach to implement the action lines of the Bologna Process; thus, implementation and innovation are closely linked in Tuning. However, during its development,…

Teaching Strategies to Increase Nursing Student Acceptance and Management of Unconscious Bias.

PubMed

Schultz, Paula L; Baker, Janet

2017-11-01

Medical providers' unconscious biases may contribute to health disparities. Awareness and self-reflection strategies commonly used to teach cultural competence in academic settings are generally ineffective in reducing unconscious bias or motivating change. This article describes the innovative teaching strategies implemented in a graduate setting (N = 75) to increase nursing learners' acceptance and management of unconscious bias. Strategies used guided the debriefing and feedback that incorporated implicit association testing, interactive audience polling, categorized management strategies, and perspective taking. Strategies resulted in positive learner feedback, including a high likelihood to learn more about unconscious bias, acceptance of unconscious bias influence on health disparities, and importance of using management strategies to address personal bias. Increasingly diverse patient populations require nurses who have the skills to understand, assess, and correct unconscious biases. To accomplish this goal, consistent exposure to unconscious bias curricula that includes focused debriefing, feedback, and management strategies is needed at all levels of nursing education. [J Nurs Educ. 2017;56(11):692-696.]. Copyright 2017, SLACK Incorporated.

"RAPID" team triage: one hospital's approach to patient-centered team triage.

PubMed

Shea, Sheila Sanning; Hoyt, K Sue

2012-01-01

Patients who present to the emergency department want definitive care by a health care provider who can perform an initial assessment, initiate treatment, and implement a disposition plan. The traditional "nurse triage" model often creates barriers to the process of rapidly evaluating patients. Therefore, innovative strategies must be explored to improve the time of patient arrival to the time seen by a qualified provider in order to complete a thorough medical screening examination. One such approach is a rapid team triage system that provides a patient-centered process. This article describes the implementation of a rapid team triage model in an urban community hospital.

Implementing a writing course in an online RN-BSN program.

PubMed

Stevens, Carol J; D'Angelo, Barbara; Rennell, Nathalie; Muzyka, Diann; Pannabecker, Virginia; Maid, Barry

2014-01-01

Scholarly writing is an essential skill for nurses to communicate new research and evidence. Written communication directly relates to patient safety and quality of care. However, few online RN-BSN programs integrate writing instruction into their curricula. Nurses traditionally learn how to write from instructor feedback and often not until midway into their baccalaureate education. Innovative strategies are needed to help nurses apply critical thinking skills to writing. The authors discuss a collaborative project between nursing faculty and technical communication faculty to develop and implement a writing course that is 1 of the 1st courses the students take in the online RN-BSN program.

An expert system environment for the Generic VHSIC Spaceborne Computer (GVSC)

NASA Astrophysics Data System (ADS)

Cockerham, Ann; Labhart, Jay; Rowe, Michael; Skinner, James

The authors describe a Phase II Phillips Laboratory Small Business Innovative Research (SBIR) program being performed to implement a flexible and general-purpose inference environment for embedded space and avionics applications. This inference environment is being developed in Ada and takes special advantage of the target architecture, the GVSC. The GVSC implements the MIL-STD-1750A ISA and contains enhancements to allow access of up to 8 MBytes of memory. The inference environment makes use of the Merit Enhanced Traversal Engine (METE) algorithm, which employs the latest inference and knowledge representation strategies to optimize both run-time speed and memory utilization.

An Overview of Innovative Strategies for Fracture Mechanics at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Ransom, Jonathan B.; Glaessgen, Edward H.; Ratcliffe, James G.

2010-01-01

Engineering fracture mechanics has played a vital role in the development and certification of virtually every aerospace vehicle that has been developed since the mid-20th century. NASA Langley Research Center s Durability, Damage Tolerance and Reliability Branch has contributed to the development and implementation of many fracture mechanics methods aimed at predicting and characterizing damage in both metallic and composite materials. This paper presents a selection of computational, analytical and experimental strategies that have been developed by the branch for assessing damage growth under monotonic and cyclic loading and for characterizing the damage tolerance of aerospace structures

Democratizing Implementation and Innovation in Mental Health Care.

PubMed

Saxe, Glenn; Acri, Mary

2017-03-01

Improvements in the quality of mental health care in the United States depend on the successful implementation of evidence-based treatments (EBT's) in typical settings of care. Unfortunately, there is little evidence that EBT's are used in ways that would approximate their established fidelity standards in such settings. This article describes an approach to more successful implementation of EBT's via a collaborative process between intervention developers and intervention users (e.g. providers, administrators, consumers) called Lead-user Innovation. Lead-user Innovation democratizes the implementation process by integrating the expertise of lead-users in the delivery, adaptation, innovation and evaluation of EBT's.

Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

PubMed

Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

2006-11-01

All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance service innovations; investment in human resource development - was critical to the reform success.

Mapping new theoretical and methodological terrain for knowledge translation: contributions from critical realism and the arts

PubMed Central

Kontos, Pia C; Poland, Blake D

2009-01-01

Background Clinical practice guidelines have been a popular tool for the improvement of health care through the implementation of evidence from systematic research. Yet, it is increasingly clear that knowledge alone is insufficient to change practice. The social, cultural, and material contexts within which practice occurs may invite or reject innovation, complement or inhibit the activities required for success, and sustain or alter adherence to entrenched practices. However, knowledge translation (KT) models are limited in providing insight about how and why contextual contingencies interact, the causal mechanisms linking structural aspects of context and individual agency, and how these mechanisms influence KT. Another limitation of KT models is the neglect of methods to engage potential adopters of the innovation in critical reflection about aspects of context that influence practice, the relevance and meaning of innovation in the context of practice, and the identification of strategies for bringing about meaningful change. Discussion This paper presents a KT model, the Critical Realism and the Arts Research Utilization Model (CRARUM), that combines critical realism and arts-based methodologies. Critical realism facilitates understanding of clinical settings by providing insight into the interrelationship between its structures and potentials, and individual action. The arts nurture empathy, and can foster reflection on the ways in which contextual factors influence and shape clinical practice, and how they may facilitate or impede change. The combination of critical realism and the arts within the CRARUM model promotes the successful embedding of interventions, and greater impact and sustainability. Conclusion CRARUM has the potential to strengthen the science of implementation research by addressing the complexities of practice settings, and engaging potential adopters to critically reflect on existing and proposed practices and strategies for sustaining change. PMID:19123945

Innovation for the future of Irish MedTech industry: retrospective qualitative review of impact of BioInnovate Ireland's clinical fellows.

PubMed

McGloughlin, Elizabeth Kate; Anglim, Paul; Keogh, Ivan; Sharif, Faisal

2018-01-01

Clinicians have historically been integral in innovating and developing technology in medicine and surgery. In recent years, however, in an increasingly complex healthcare system, a doctor with innovative ideas is often left behind. Transition from idea to bedside now entails significant hurdles, which often go unrecognised at the outset, particularly for first-time innovators. The BioInnnovate Ireland process, based on the Stanford Biodesign Programme (Identify, Invent and Implement), aims to streamline the process of innovation within the MedTech sector. These programmes focus on needs-based innovation and enable multidisciplinary teams to innovate and collaborate more succinctly. In this preliminary study, the authors aimed to examine the impact of BioInnovate Ireland has had on the clinicians involved and validate the collaborative process. To date, 13 fellows with backgrounds in clinical medicine have participated in the BioInnovate programme. Ten of these clinicians remain involved in clinical innovation projects with four of these working on Enterprise Ireland funded commercialisation grants and one working as chief executive officer of a service-led start-up, Strive. Of these, five also remain engaged in clinical practice on a full or part-time basis. The clinicians who have returned to full-time clinical practice have used the process and learning of the programme to influence their individual clinical areas and actively seek innovative solutions to meet clinical challenges. Clinicians, in particular, describe gaining value from the BioInnovate programme in areas of 'Understanding Entrepreneurship' and 'Business Strategy'. Further study is needed into the quantitative impact on the ecosystem and impact to other stakeholders.

Re-thinking wastewater landscapes: combining innovative strategies to address tomorrow's urban wastewater treatment challenges.

PubMed

Smith, B R

2009-01-01

Most major cities worldwide face urban water management challenges relating to drinking supply, stormwater and wastewater treatment, and ecological preservation. In light of climate change and finite natural resources, addressing these challenges in sustainable ways will require innovative solutions arising from interdisciplinary collaboration. This article summarizes five major urban water management strategies that bridge the fields of engineering, ecology, landscape architecture, and urban planning. A conceptual implementation of these strategies is demonstrated through a design for a small constructed wetland treatment system in San Francisco, California. The proposed decentralized system described in this article consists of a detention basin, vegetated and open free water surface wetlands, and ultraviolet disinfection. In wet weather, the system would detain and treat combined sewer discharges (CSD), and in dry weather it would treat residential greywater for toilet flushing and irrigation in a nearby neighborhood. It is designed to adapt over time to changing climatic conditions and treatment demands. Importantly, this proposal demonstrates how constructed wetland engineers can incorporate multiple benefits into their systems, offering a vision of how wastewater infrastructure can be an attractive community, educational, recreational, and habitat amenity through the integration of engineering, ecology, and landscape design.

An innovative nurse education program in the Torres Strait Islands.

PubMed

Usher, Kim; Lindsay, David; Mackay, Wendy

2005-08-01

As the most numerous and geographically dispersed professional group, registered nurses in Australia work with Aboriginal and Torres Strait Islander health workers and other members of the multidisciplinary team in a variety of practice contexts to provide health care to Indigenous and non-Indigenous people. Despite the introduction of a variety of recruitment and proactive support strategies by employers, universities and State and Commonwealth governments, few Indigenous people in Australia enrol in, and graduate from, entry level higher education courses in the health professions. The reasons for this are complex and, as yet, not well understood or described; however, it is clear that the well-documented execrable health status of Indigenous Australians demands a response from universities, which are largely responsible for the education of health professionals. An innovative model of registered nurse education in the Torres Strait region of Australia is reported in this paper. A satellite campus established by James Cook University (JCU) on Thursday Island delivers the undergraduate nursing course by mixed mode, supplemented by specific strategies designed to improve Indigenous student recruitment and retention and thus increase the likelihood of graduation. The course and the strategies implemented are discussed in this paper.

Determining the predictors of innovation implementation in healthcare: a quantitative analysis of implementation effectiveness.

PubMed

Jacobs, Sara R; Weiner, Bryan J; Reeve, Bryce B; Hofmann, David A; Christian, Michael; Weinberger, Morris

2015-01-22

The failure rates for implementing complex innovations in healthcare organizations are high. Estimates range from 30% to 90% depending on the scope of the organizational change involved, the definition of failure, and the criteria to judge it. The innovation implementation framework offers a promising approach to examine the organizational factors that determine effective implementation. To date, the utility of this framework in a healthcare setting has been limited to qualitative studies and/or group level analyses. Therefore, the goal of this study was to quantitatively examine this framework among individual participants in the National Cancer Institute's Community Clinical Oncology Program using structural equation modeling. We examined the innovation implementation framework using structural equation modeling (SEM) among 481 physician participants in the National Cancer Institute's Community Clinical Oncology Program (CCOP). The data sources included the CCOP Annual Progress Reports, surveys of CCOP physician participants and administrators, and the American Medical Association Physician Masterfile. Overall the final model fit well. Our results demonstrated that not only did perceptions of implementation climate have a statistically significant direct effect on implementation effectiveness, but physicians' perceptions of implementation climate also mediated the relationship between organizational implementation policies and practices (IPP) and enrollment (p <0.05). In addition, physician factors such as CCOP PI status, age, radiological oncologists, and non-oncologist specialists significantly influenced enrollment as well as CCOP organizational size and structure, which had indirect effects on implementation effectiveness through IPP and implementation climate. Overall, our results quantitatively confirmed the main relationship postulated in the innovation implementation framework between IPP, implementation climate, and implementation effectiveness among individual physicians. This finding is important, as although the model has been discussed within healthcare organizations before, the studies have been predominately qualitative in nature and/or at the organizational level. In addition, our findings have practical applications. Managers looking to increase implementation effectiveness of an innovation should focus on creating an environment that physicians perceive as encouraging implementation. In addition, managers should consider instituting specific organizational IPP aimed at increasing positive perceptions of implementation climate. For example, IPP should include specific expectations, support, and rewards for innovation use.

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

PubMed Central

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

2016-01-01

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

[Aedes aegypti control strategies: a review].

PubMed

Zara, Ana Laura de Sene Amâncio; Santos, Sandra Maria Dos; Fernandes-Oliveira, Ellen Synthia; Carvalho, Roberta Gomes; Coelho, Giovanini Evelim

2016-01-01

to describe the main strategies to control Aedes aegypti, with emphasis on promising technological innovations for use in Brazil. this study is a non-systematic review of the literature. several technologies have been developed as alternatives in the control of Ae. aegypti, using different mechanisms of action, such as selective monitoring of the infestation, social interventions, dispersing insecticides, new biological control agents and molecular techniques for population control of mosquitoes, also considering the combination between them. Evolving technologies require evaluation of the effectiveness, feasibility and costs of implementation strategies as complementary to the actions already recommended by the National Program for Dengue Control. the integration of different compatible and effective vector control strategies, considering the available technologies and regional characteristics, appears to be a viable method to try to reduce the infestation of mosquitoes and the incidence of arbovirus transmitted by them.

Exploring the Usefulness of Two Conceptual Frameworks for Understanding How Organizational Factors Influence Innovation Implementation in Cancer Care

ERIC Educational Resources Information Center

Urquhart, Robin; Sargeant, Joan; Grunfeld, Eva

2013-01-01

Moving knowledge into practice and the implementation of innovations in health care remain significant challenges. Few researchers adequately address the influence of organizations on the implementation of innovations in health care. The aims of this article are to (1) present 2 conceptual frameworks for understanding the organizational factors…

Implementation of a Technological Innovation: Factors Influencing the Adoption of a New Student Information System

ERIC Educational Resources Information Center

Johnston, Katrina M.

2013-01-01

School information systems (SIS) have the potential to cause a change in a school's technical, structural, psycho-social, and managerial systems. Implementation of a technological innovation such as an SIS is not a one-step occurrence; it is a process that occurs over time. Implementing any technological innovation involves active learning…

Proposing evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings: a summative analysis

PubMed Central

Manyazewal, Tsegahun; Oosthuizen, Martha J; Matlakala, Mokgadi C

2016-01-01

Objectives Many resource-limited countries have adopted and implemented healthcare reform to improve the quality of healthcare, but few have had much impact and strategies in support of these efforts remain limited. We aimed to explore and propose evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings. Design Descriptive and exploratory designs in two phases. Phase I involved assessing the effectiveness of the healthcare reform implemented in Ethiopia in the form of business process reengineering, with evidence compiled from healthcare professionals through a self-administered questionnaire; and phase II involved proposing strategies and seeking consensus from experts using Delphi method. Setting Public hospitals in central Ethiopia. Participants 406 healthcare professionals and 10 senior health policy experts. Findings The healthcare reform that we evaluated was able to restructure hospital departments into case teams, with the goal of adopting a ‘one-stop shopping’ approach. However, shortages of critical infrastructure, furniture and supplies and job dissatisfaction continued to hamper the system. The most important predictors that influenced implementation of the reform were financial resources, top management commitment and support, collaborative working environment and information technology (IT). Five strategies with 14 operational objectives and 67 potential interventions that could strengthen the reform are proposed based on their strategic priority, which are as follows: reinforce patient-centred quality of care services; foster a healthy and respectful workforce environment; efficient and accountable leadership and governance; efficient use of hospital financing and maximise innovations and the use of health technologies. Conclusions Effective implementation of healthcare reform remained a challenge for governments in resource-limited settings. Resilient operational, clinical and governance functions of health systems, as well as a motivated and committed health workforce, are important to move healthcare reform processes forward. Political commitments at this juncture might be critical though there need to be a clear demarcation between political and technical engagements. PMID:27650769

Integrated versus fragmented implementation of complex innovations in acute health care

PubMed Central

Woiceshyn, Jaana; Blades, Kenneth; Pendharkar, Sachin R.

2017-01-01

Background: Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations—those that require coordinated use across the adopting organization to have the intended benefits. Purpose: We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. Methodology: We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. Findings: In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Practice Implications: Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and continual support for and evaluation of implementation, and (d) allowance for local customization within the general principles of standardization. PMID:26469705

Instructional Strategies to Support Creativity and Innovation in Education

ERIC Educational Resources Information Center

Seechaliao, Thapanee

2017-01-01

The purpose of the study focused on the instructional strategies that support creation of creative and innovative education. The sample for this study consisted of 11 experts in the field of instructional strategies that support innovation of education. Among them, five were specialists in design and development of teaching and learning, three…

Innovation, Corporate Strategy, and Cultural Context: What Is the Mission for International Business Communication?

ERIC Educational Resources Information Center

Ulijn, Jan; O'Hair, Dan; Weggeman, Mathieu; Ledlow, Gerald; Hall, H. Thomas

2000-01-01

Reviews relevant literature in the areas of communication and innovation and explores how efforts toward innovative practices are directly related to globalism and business strategy. Focuses on issues associated with national culture, corporate culture, and professional culture that are relevant to strategies for researching business communication…

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

GOLDSTON, WELFORD T.; SMITH, WINCHESTER IV

DOE issued Order 435.1, ''Radioactive Waste Management,'' on July 9, 1999 for immediate implementation. The requirements for Low Level Mixed, Transuranic, and High Level Waste have been completely rewritten. The entire DOE complex has been struggling with how to implement these new requirements within the one year required timeframe. This paper will chronicle the implementation strategy and actual results of the work to carry out that strategy at the Savannah River Site. DOE-SR and the site contractors worked closely together to implement each of the new requirements across the SRS, crossing many barriers and providing innovative solutions to the manymore » problems that surfaced throughout the year. The results are that SRS declared compliance with all of the requirements of the Order within the prescribed timeframe. The challenge included all waste types in SRS facilities and programs that handle LLW, MLLW, TRU, and HLW. This paper will describe the implementation details for development of Radioactive Waste Management Basis for each facility, Identification of Wastes with No Path to Disposal, Waste Incidental to Reprocessing Determinations, Low Level Waste 90-Day Staging and One Year Limits for Storage Programs, to name a few of the requirements that were addressed by the SRS 435.1 Implementation Team. This paper will trace the implementation, problems (both technical and administrative), and the current pushback efforts associated with the DOE ''Top-to-Bottom'' review.« less

Macquarie Surgical Innovation Identification Tool (MSIIT): a study protocol for a usability and pilot test

PubMed Central

Blakely, Brette; Rogers, Wendy A; Clay-Williams, Robyn

2016-01-01

Introduction Medicine relies on innovation to continually improve. However, innovation is potentially risky, and not all innovations are successful. Therefore, it is important to identify innovations prospectively and provide support, to make innovation as safe and effective as possible. The Macquarie Surgical Innovation Identification Tool (MSIIT) is a simple checklist designed as a practical tool for hospitals to identify planned surgical innovations. This project aims to test the usability and pilot the use of the MSIIT in a surgical setting. Methods and analysis The project will run in two phases at two Australian hospitals, one public and one private. Phase I will involve interviews, focus groups and a survey of hospital administrators and surgical teams to assess the usability and system requirements for the use of the MSIIT. Current practice regarding surgical innovation within participating hospitals will be mapped, and the best implementation strategy for MSIIT completion will be established. Phase II will involve trialling the MSIIT for each surgery within the trial period by various surgical personnel. Follow-up interviews, focus groups and a survey will be conducted with trial participants to collect feedback on their experience of using the MSIIT during the trial period. Comparative data on rates of surgical innovation during the trial period will also be gathered from existing hospital systems and compared to the rates identified by the MSIIT. Ethics and dissemination Ethical approval has been obtained. The results of this study will be presented to interested health services and other stakeholders, presented at conferences and published in a peer-reviewed MEDLINE-indexed journal. PMID:27864253

Strategies for patient empowerment through the promotion of medicines in Israel: regulatory framework for the pharmaceutical industry.

PubMed

Schwartzberg, Eyal; Barnett-Itzhaki, Zohar; Grotto, Itamar; Marom, Eli

2017-09-29

The correct and rational use of medications can have a positive direct impact on disease outcomes, as well on the utilization of the health system resources. Unfortunately, 50% of the patients do not take their medications as prescribed, largely due to lack of patients' understanding of their medical condition, as well as the lack of reliable medicine information.There are multiple strategies implemented in many countries to tackle this challenge including: disease awareness campaigns (DAC) to raise the public awareness to specific diseases, direct-to-consumer advertisement (DTCA) to raise the public awareness to prescription medicines, specific treatments and over-the-counter (OTC) products to improve the accessibility of patients to specific medicines.Prior to 2013, the Israeli policy prohibited prescribing medication advertising and prevented the flow of information from pharmaceutical companies to the patient. In the last five years, the Pharmaceutical division in the Israeli Ministry of Health, as part of the "empowering the patient" agenda, has taken new innovative approaches to raise public awareness to diseases, medications and appropriate usage, as well as promotion of information to improve patient adherence to the prescribed medication.This paper elaborates on the aforementioned strategies implemented in developed countries, and specifically focuses on newly implemented strategies and regulations in Israel regarding pre- and post-prescription information, to improve patient appropriate utilization and adherence to medication.

The impact of innovation intermediary on knowledge transfer

NASA Astrophysics Data System (ADS)

Lin, Min; Wei, Jun

2018-07-01

Many firms have opened up their innovation process and actively transfer knowledge with external partners in the market of technology. To reduce some of the market inefficiencies, more and more firms collaborate with innovation intermediaries. In light of the increasing importance of intermediary in the context of open innovation, we in this paper systematically investigate the effect of innovation intermediary on knowledge transfer and innovation process in networked systems. We find that the existence of innovation intermediary is conducive to the knowledge diffusion and facilitate the knowledge growth at system level. Interestingly, the scale of the innovation intermediary has little effect on the growth of knowledge. We further investigate the selection of intermediary members by comparing four selection strategies: random selection, initial knowledge level based selection, absorptive capability based selection, and innovative ability based selection. It is found that the selection strategy based on innovative ability outperforms all the other strategies in promoting the system knowledge growth. Our study provides a theoretical understanding of the impact of innovation intermediary on knowledge transfer and sheds light on the design and selection of innovation intermediary in open innovation.

Employing Content-Based Curricula in Nursing at Illinois Central College to Improve Equity and Outcomes for Students. Pathways to Results: Implementation Partnerships Strategy Brief

ERIC Educational Resources Information Center

Graham, Edmund

2016-01-01

Since the creation of Pathways to Results (PTR) in 2009, Illinois Central College (ICC) has participated in all but one year, working to improve outcomes across a number of different pathways. ICC has been innovative in its use of PTR over the years, and the 2014/2015 PTR project was no different. The ICC team worked to identify parallels between…

Writing Using Blogs: A Way to Engage Colombian Adolescents in Meaningful Communication (La escritura a través de bitácoras o "blogs": una forma de involucrar a adolescentes colombianos en comunicación significativa)

ERIC Educational Resources Information Center

Rojas Álvarez, Gloria

2011-01-01

We report an action research project developed with ninth grade students of a public school in Bogotá, Colombia, and which focused on innovating English communication through writing blogs. The project took into account the implementation of a specific blog that proposes activities, suggestions, strategies and links, among other things, to…

Building organizational capacity for evidence use: the experience of two Canadian healthcare organizations.

PubMed

Humphries, Serena; Hampe, Tanis; Larsen, Derrick; Bowen, Sarah

2013-01-01

The use of evidence to inform decisions at the program level within healthcare organizations is a priority. The purpose of this article is to provide an overview of an innovative collaboration between two Canadian healthcare organizations to build organizational capacity for evidence use in program planning, implementation, and evaluation. The lessons learned from the initiative suggest that other healthcare organizations would find the capacity-building strategies identified and developed through the initiative useful.

Providing a healthy work environment for nurses: the influence on retention.

PubMed

Cohen, Jayne; Stuenkel, Diane; Nguyen, Quyen

2009-01-01

Differences in registered nurses' (RNs) perceptions of their work environment were measured with the Insel and Moos' Work Environment Scale to identify factors in the work environment that may influence retention. Statistically significant differences for perceptions of supervisor support and innovation were found between those RNs who left their unit or hospital during a 24-month period and those who stayed. Implementing strategies to promote retention of RNs to ensure safe, quality patient care is essential.

Control strategy of an electrically actuated morphing flap for the next generation green regional aircraft

NASA Astrophysics Data System (ADS)

Arena, Maurizio; Noviello, Maria Chiara; Rea, Francesco; Amoroso, Francesco; Pecora, Rosario

2018-03-01

The design and application of adaptive devices are currently ambitious targets in the field of aviation research addressed at new generation aircraft. The development of intelligent structures involves aspects of multidisciplinary nature: the combination of compact architectures, embedded electrical systems and smart materials, allows for developing a highly innovative device. The paper aims to present the control system design of an innovative morphing flap tailored for the next generation regional aircraft, within Clean Sky 2 - Airgreen 2 European Research Scenario. A distributed system of electromechanical actuators (EMAs) has been sized to enable up to three operating modes of a structure arranged in four blocks along the chord-wise direction: •overall camber-morphing; •upwards/downwards deflection and twisting of the final tip segment. A state-of-art feedback logic based on a decentralized control strategy for shape control is outlined, including the results of dynamic stability analysis based on the blocks rational schematization within Matlab/Simulink® environment. Such study has been performed implementing a state-space model, considering also design parameters as the torsional stiffness and damping of the actuation chain. The design process is flowing towards an increasingly "robotized" system, which can be externally controlled to perform certain operations. Future developments will be the control laws implementation as well as the functionality test on a real flap prototype.

Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program.

PubMed

Fox, Annie B; Hamilton, Alison B; Frayne, Susan M; Wiltsey-Stirman, Shannon; Bean-Mayberry, Bevanne; Carney, Diane; Di Leone, Brooke A L; Gierisch, Jennifer M; Goldstein, Karen M; Romodan, Yasmin; Sadler, Anne G; Yano, Elizabeth M; Yee, Ellen F; Vogt, Dawne

2016-01-01

Although providing culturally sensitive health care is vitally important, there is little consensus regarding the most effective strategy for implementing cultural competence trainings in the health care setting. Evidence-based quality improvement (EBQI), which involves adapting evidence-based practices to meet local needs, may improve uptake and effectiveness of a variety of health care innovations. Yet, to our knowledge, EBQI has not yet been applied to cultural competence training. To evaluate whether EBQI could enhance the impact of an evidence-based training intended to improve veterans affairs health care staff gender sensitivity and knowledge (Caring for Women Veterans; CWV), we compared the reach and effectiveness of EBQI delivery versus standard web-based implementation strategies of CWV and assessed barriers and facilitators to EBQI implementation. Workgroups at four diverse veterans affairs health care sites were randomized to either an EBQI or standard web-based implementation condition (SI). All EBQI sites selected a group-based implementation strategy. Employees (N = 84) completed pretraining and posttraining assessments of gender sensitivity and knowledge, and focus groups/interviews were conducted with leadership and staff before and after implementation. Reach of CWV was greater in the EBQI condition versus the SI condition. Whereas both gender sensitivity and knowledge improved in the EBQI condition, only gender sensitivity improved in the SI condition. Qualitative analyses revealed that the EBQI approach was well received, although a number of barriers were identified. Findings suggest that EBQI can enhance the uptake and effectiveness of employee trainings. However, the decision to pursue EBQI must be informed by a consideration of available resources.

TU-E-BRD-01: President’s Symposium: The Necessity of Innovation in Medical Physics

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

Bayouth, J; Siewerdsen, J; Wahl, E

This abstract will not blow you away, but speed-painting presenter Erik Wahl will certainly make a truly unique AAPM symposium that you will not want to miss. Along with clinical director John Bayouth and scientific leader Jeff Siewerdsen, this session will highlight innovation. To avoid being button pushers and irrelevant investigators of yesterday’s science, we must innovate. This is particularly challenging in the changing landscape of declining research funding and healthcare reimbursement. But all hope is not lost, Medical Physics is a field born out of innovation. As scientists we quickly translated the man-made and natural phenomena of radiation intomore » a tool that could diagnose broken bones, locate foreign objects imbedded within the body, and treat a spectrum of diseases. As hyperbolae surrounding the curative powers of radiation overcame society, physicists continued their systematic pursuit of a fundamental understanding of radiation and applied their knowledge to enable the diagnostic and therapeutic power of this new tool. Health economics and the decline in research funding have put the Medical Physicist in a precarious position: how do we optimally participate in medical research and advanced patient care in the face of many competing needs? Today's diagnostic imaging and therapeutic approaches are tremendously sophisticated. Researchers and commercial vendors are producing technologies at a remarkable rate; to enable their safe and effective implementation Medical Physicists must work from a fundamental understanding of these technologies. This requires all of us, clinically practicing Medical Physicists, Researchers and Educators alike, to combine our training in scientific methods with innovation. Innovation is the key to our past, a necessity for our contemporary challenges, and critical for the future of Medical Physics. The keynote speakers for the 2014 AAPM Presidential Symposium session will address the way we approach these vitally important technologies for diagnosis and therapy into opportunities to innovate. The speed-painting artist and lecturer Erik Wahl will finish the symposium with a fast-paced and entertaining presentation on embracing the future by creating disruptive innovation strategies. Learning Objectives: Identify connection between Medical Physics and Innovation. Understand how Innovation enables Clinical Medical Physicists to implement novel technologies. Learn how innovative Medical Physics solutions can address significant and relevant challenges in science. Become inspired to pursue a new scientific understanding, positive change in clinical practice, and benefit to patients.« less

Implementing Response to Intervention: Use of Innovation Configuration Maps within a Multiple-Case Study Analysis

ERIC Educational Resources Information Center

Fernando, Sheara

2010-01-01

The success of an implementation effort depends on the ability for a system to utilize the innovation effectively; the effective usage of an innovation can be determined by monitoring for program integrity and fidelity, and assessing the degree to which the program implementation matches the intended plan (Fixsen, Blase, Horner, & Sugai 2007). The…

Performance of Lempel-Ziv compressors with deferred innovation

NASA Technical Reports Server (NTRS)

Cohn, Martin

1989-01-01

The noiseless data-compression algorithms introduced by Lempel and Ziv (LZ) parse an input data string into successive substrings each consisting of two parts: The citation, which is the longest prefix that has appeared earlier in the input, and the innovation, which is the symbol immediately following the citation. In extremal versions of the LZ algorithm the citation may have begun anywhere in the input; in incremental versions it must have begun at a previous parse position. Originally the citation and the innovation were encoded, either individually or jointly, into an output word to be transmitted or stored. Subsequently, it was speculated that the cost of this encoding may be excessively high because the innovation contributes roughly 1g(A) bits, where A is the size of the input alphabet, regardless of the compressibility of the source. To remedy this excess, it was suggested to store the parsed substring as usual, but encoding for output only the citation, leaving the innovation to be encoded as the first symbol of the next substring. Being thus included in the next substring, the innovation can participate in whatever compression that substring enjoys. This strategy is called deferred innovation. It is exemplified in the algorithm described by Welch and implemented in the C program compress that has widely displaced adaptive Huffman coding (compact) as a UNIX system utility. The excessive expansion is explained, an implicit warning is given against using the deferred innovation compressors on nearly incompressible data.

Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

PubMed

Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

2015-12-01

Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. © The Author(s) 2015.

A Strategy for Assessing Costs of Implementing New Practices in the Child Welfare System: Adapting the English Cost Calculator in the United States

PubMed Central

Snowden, Lonnie R.; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

2015-01-01

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided. PMID:20976620

The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments.

PubMed

Glisson, Charles; Schoenwald, Sonja K

2005-12-01

This paper reviews the implications of organizational and community intervention research for the implementation of effective mental health treatments in usual community practice settings. The paper describes an organizational and community intervention model named ARC for Availability, Responsiveness and Continuity, that was designed to support the improvement of social and mental health services for children. The ARC model incorporates intervention components from organizational development, interorganizational domain development, the diffusion of innovation, and technology transfer that target social, strategic, and technological factors in effective children's services. This paper also describes a current NIMH-funded study that is using the ARC intervention model to support the implementation of an evidence-based treatment, Multisystemic Therapy (MST), for delinquent youth in extremely rural, impoverished communities in the Appalachian Mountains of East Tennessee.

A strategy for assessing costs of implementing new practices in the child welfare system: adapting the English cost calculator in the United States.

PubMed

Chamberlain, Patricia; Snowden, Lonnie R; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

2011-01-01

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided.

What does an innovative teaching assignment strategy mean to nursing students?

PubMed

Neuman, Lois H; Pardue, Karen T; Grady, Janet L; Gray, Mary Tod; Hobbins, Bonnie; Edelstein, Jan; Herrman, Judith W

2009-01-01

The concept of innovation in nursing education has been addressed in published literature on faculty-defined and faculty-created teaching strategies and instructional methods. In this project, innovation is defined as "using knowledge to create ways and services that are new (or perceived as new) in order to transform systems" (Pardue, Tagliareni, Valiga, Davison-Price, & Orchowsky, 2005). Studies on nursing student perceptions of innovation are limited, and it is unclear how undergraduate and graduate students conceptualize innovative learning experiences. This project explored students' perceptions of their experiences with instructor-defined, innovative teaching/learning strategies in four types of nursing education programs. Issues nurse educators should consider as they apply new techniques to their teaching are discussed.

Exploring the usefulness of two conceptual frameworks for understanding how organizational factors influence innovation implementation in cancer care.

PubMed

Urquhart, Robin; Sargeant, Joan; Grunfeld, Eva

2013-01-01

Moving knowledge into practice and the implementation of innovations in health care remain significant challenges. Few researchers adequately address the influence of organizations on the implementation of innovations in health care. The aims of this article are to (1) present 2 conceptual frameworks for understanding the organizational factors important to the successful implementation of innovations in health care settings; (2) discuss each in relation to the literature; and (3) briefly demonstrate how each may be applied to 3 initiatives involving the implementation of a specific innovation-synoptic reporting tools-in cancer care. Synoptic reporting tools capture information from diagnostic tests, surgeries, and pathology examinations in a standardized, structured manner and contain only the information necessary for patient care. The frameworks selected were the Promoting Action on Research Implementation in Health Services framework and an organizational framework of innovation implementation; these frameworks arise from different disciplines (nursing and management, respectively). The constructs from each framework are examined in relation to the literature, with each construct applied to synoptic reporting tool implementation to demonstrate how each may be used to inform both practice and research in this area. By improving our understanding of existing frameworks, we enhance our ability to more effectively study and target implementation processes. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Peer Assessment and Compliance Review (PACR) Innovative Strategies Report. California Court Appointed Special Advocates (CASA) Programs

ERIC Educational Resources Information Center

Macro, Bronwen; Huang, Lee Ann

2005-01-01

This report focuses on the innovative strategies study component of the Peer Assessment and Compliance Review (PACR) project. California (Court Appointed Special Advocates) CASA programs have developed many innovative strategies to serve children in their communities. At each of the programs visited during the PACR project, the team identified at…

Maternal Health Situation in India: A Case Study

PubMed Central

Mavalankar, Dileep V.; Ramani, K.V.; Upadhyaya, Mudita; Sharma, Bharati; Iyengar, Sharad; Gupta, Vikram; Iyengar, Kirti

2009-01-01

Since the beginning of the Safe Motherhood Initiative, India has accounted for at least a quarter of maternal deaths reported globally. India's goal is to lower maternal mortality to less than 100 per 100,000 livebirths but that is still far away despite its programmatic efforts and rapid economic progress over the past two decades. Geographical vastness and sociocultural diversity mean that maternal mortality varies across the states, and uniform implementation of health-sector reforms is not possible. The case study analyzes the trends in maternal mortality nationally, the maternal healthcare-delivery system at different levels, and the implementation of national maternal health programmes, including recent innovative strategies. It identifies the causes for limited success in improving maternal health and suggests measures to rectify them. It recommends better reporting of maternal deaths and implementation of evidence-based, focused strategies along with effective monitoring for rapid progress. It also stresses the need for regulation of the private sector and encourages further public-private partnerships and policies, along with a strong political will and improved management capacity for improving maternal health. PMID:19489415

Scaling up Evidence-Based Practices: Strategies from Investing in Innovation (i3)

ERIC Educational Resources Information Center

DeWire, Tom; McKithen, Clarissa; Carey, Rebecca

2017-01-01

What can the Investing in Innovation (i3) grantees tell us about scaling innovative educational practices? The newly released white paper "Scaling Up Evidence-Based Practices: Strategies from Investing in Innovation (i3)" captures the experiences of nine grantees whose projects collectively have reached over 1.2 million students across…

Personalized Herbal Medicine? A Roadmap for Convergence of Herbal and Precision Medicine Biomarker Innovations.

PubMed

Thomford, Nicholas Ekow; Dzobo, Kevin; Chimusa, Emile; Andrae-Marobela, Kerstin; Chirikure, Shadreck; Wonkam, Ambroise; Dandara, Collet

2018-06-01

While drugs remain the cornerstone of medicine, herbal medicine is an important comedication worldwide. Thus, precision medicine ought to face this clinical reality and develop "companion diagnostics" for drugs as well as herbal medicines. Yet, many are in denial with respect to the extent of use of traditional/herbal medicines, overlooking that a considerable number of contemporary therapeutic drugs trace their discovery from herbal medicines. This expert review underscores that absent such appropriate attention on both classical drug therapy and herbal medicines, precision medicine biomarkers will likely not stand the full test of clinical practice while patients continue to use both drugs and herbal medicines and, yet the biomarker research and applications focus only (or mostly) on drug therapy. This asymmetry in biomarker innovation strategy needs urgent attention from a wide range of innovation actors worldwide, including governments, research funders, scientists, community leaders, civil society organizations, herbal, pharmaceutical, and insurance industries, policymakers, and social/political scientists. We discuss the various dimensions of a future convergence map between herbal and conventional medicine, and conclude with a set of concrete strategies on how best to integrate biomarker research in a realm of both herbal and drug treatment. Africa, by virtue of its vast experience and exposure in herbal medicine and a "pregnant" life sciences innovation ecosystem, could play a game-changing role for the "birth" of biomarker-informed personalized herbal medicine in the near future. At this critical juncture when precision medicine initiatives are being rolled out worldwide, precision/personalized herbal medicine is both timely and essential for modern therapeutics, not to mention biomarker innovations that stand the test of real-life practices and implementation in the clinic and society.

Teaching statics of fluids in bioengineering: a multidisciplinary proposal based on competences

NASA Astrophysics Data System (ADS)

Alborch, A.; Puzzella, A.; Lopez, N.; Cabrera, L.; Zabala, A.; Demartini, H.

2007-11-01

The aim of this work is to share the findings of an educational experience undertaken by first-year university students of bioengineering, oriented towards the model of Competence-based Education. Different aspects on integrative education pursued in the subject goals are explicitly focused here by designing a strategy within a contextualized and multidisciplinary approach that combines knowledge from Physics, Chemistry and Biology. The topic chosen for the work is Static of Fluids, because it allows relating pressure to its biological effects on human beings. After evaluating a pre-test, new interrelated strategies are implemented. Due to the motivation audiovisuals generate in adolescents, we start showing an argumentative film entitled 'The Big Blue', and continue with different individual and/or group activities, finishing with a post-test to assess the development of the competences proposed. Results are encouraging as regards the level of specific competences acquired and, complementarily, basic and professional competences in general. Besides, the experience met expectations as regards student motivation, interest and commitment to learning, which ensured the path taken by the academicians by means of implementing innovative strategies.

Implementing climate change mitigation in health services: the importance of context.

PubMed

Desmond, Sharon

2016-10-01

Academic interest in strategies to reduce the impact of health services on climate change is quickening. Research has largely focused on local innovations with little consideration of the contextual and systemic elements that influence sustainable development across health systems. A realistic framework specifically to guide decision-making by health care providers is still needed. To address this deficit, the literature is explored in relation to health services and climate change mitigation strategies, and the contextual factors that influence efforts to mitigate climate effects in health service delivery environments are highlighted. A conceptual framework is proposed that offers a model for the pursuit of sustainable development practice in health services. A set of propositions is advanced to provide a systems approach to assist decision-making by decoding the challenges faced in implementing sustainable health services. This has important implications for health care providers, funders and legislators since the financial, policy and regulatory environment of health care, along with its leadership and models of care generally conflict with carbon literacy and climate change mitigation strategies. © The Author(s) 2016.

Suicide burden and prevention in Nepal: The need for a national strategy.

PubMed

Marahatta, Kedar; Samuel, Reuben; Sharma, Pawan; Dixit, Lonim; Shrestha, Bhola Ram

2017-04-01

Suicide is a major cause of deaths worldwide and is a key public health concern in Nepal. Although routine national data are not collected in Nepal, the available evidence suggests that suicide rates are relatively high, notably for women. In addition, civil conflict and the 2015 earthquake have had significant contributory effects. A range of factors both facilitate suicide attempts and hinder those affected from seeking help, such as the ready availability of toxic pesticides and the widespread, although erroneous, belief that suicide is illegal. Various interventions have been undertaken at different levels in prevention and rehabilitation but a specific long-term national strategy for suicide prevention is lacking. Hence, to address this significant public health problem, a multisectoral platform of stakeholders needs to be established under government leadership, to design and implement innovative and country-contextualized policies and programmes. A bottom-up approach, with active and participatory community engagement from the start of the policy- and strategy-formulation stage, through to the design and implementation of interventions, could potentially build grass-roots public ownership, reduce stigma and ensure a scaleable and sustainable response.

Using Hybrid Change Strategies to Improve the Patient Experience in Outpatient Specialty Care.

PubMed

Miranda, Rafael; Glenn, Sean W; Leighton, Jonathan A; Pasha, Shabana E; Gurudu, Suryakanth R; Teaford, Harry G; Mertz, Lester E; Lee, Howard R; Mamby, Sylvia A; Johnson, Margaret F; Raghu, T S

2015-01-01

The emerging changes in healthcare impose significant burdens on integrated outpatient specialty services with respect to setting patient expectations, handling outside medical records; and coordinating specialty appointments scheduling. Moreover, because of the evolution of the electronic health record and its widespread use, it is critical that patient and physician interaction is maintained and clerical tasks are minimized. In the context of increased government regulation, declining reimbursement, and the rise of new payment models, outpatient practices need to be reimagined so that they are more efficient for the patient and the provider. The redesign of integrated outpatient specialty services can be accomplished only through teamwork, innovation, and efficient use of technology. To address these challenges, the Department of Medicine at Mayo Clinic in Scottsdale, Arizona, implemented an ideal practice design initiative that leveraged a hybrid set of change strategies. The change strategy, which was initiated after examination of current practices and design options, engaged key stakeholders and patients. A number of enablers and barriers to adoption were identified as a result of the implementation experience.

[Building bridges between research and policy to extend social protection in health in Latin America and the Caribbean: a strategy for cooperation].

PubMed

Bazzani, Roberto; Levcovitz, Eduardo; Urrutia, Soledad; Zarowsky, Christina

2006-01-01

The Pan American Health Organization (PAHO) and International Development Research Centre (IDRC) have promoted a joint initiative to design, implement, and evaluate innovative strategies for the Extension of Social Protection in Health (SPH) in Latin America and the Caribbean (LAC), involving active partnership between researchers and research users. This initiative was based on a previous review of research on health sector reforms and the recommendations of the workshop on "Health Sector Reforms in the Americas: Strengthening the Links between Research and Policy" (Montreal, Canada, 2001). In its first phase, the initiative supported the development of proposals aiming to extend SPH, elaborated jointly by researchers and decision-makers. In the second phase, the implementation of five of these proposals was supported in order to promote the development of new SPH strategies and new stakeholder interaction models. In this edition of the journal, the process of linking researchers and decision-makers will be analyzed in the context of the five projects supported by this initiative.

Implementation of Technology-based Patient Engagement Strategies within Practice-based Research Networks.

PubMed

Careyva, Beth; Shaak, Kyle; Mills, Geoffrey; Johnson, Melanie; Goodrich, Samantha; Stello, Brian; Wallace, Lorraine S

2016-01-01

Technology-based patient engagement strategies (such as patient portals) are increasingly available, yet little is known about current use and barriers within practice-based research networks (PBRNs). PBRN directors have unique opportunities to inform the implementation of patient-facing technology and to translate these findings into practice. PBRN directors were queried regarding technology-based patient engagement strategies as part of the 2015 CAFM Educational Research Alliance (CERA) survey of PBRN directors. A total of 102 PBRN directors were identified via the Agency for Healthcare Research and Quality's registry; 54 of 96 eligible PBRN directors completed the survey, for a response rate of 56%. Use of technology-based patient engagement strategies within PBRNs was limited, with less than half of respondents reporting experience with the most frequently named tools (risk assessments/decision aids). Information technology (IT) support was the top barrier, followed by low rates of portal enrollment. For engaging participant practices, workload and practice leadership were cited as most important, with fewer respondents noting concerns about patient privacy. Given limited use of patient-facing technologies, PBRNs have an opportunity to clarify the optimal use of these strategies. Providing IT support and addressing clinician concerns regarding workload may facilitate the inclusion of innovative technologies in PBRNs. © Copyright 2016 by the American Board of Family Medicine.

Heterogeneous update mechanisms in evolutionary games: Mixing innovative and imitative dynamics

NASA Astrophysics Data System (ADS)

Amaral, Marco Antonio; Javarone, Marco Alberto

2018-04-01

Innovation and evolution are two processes of paramount relevance for social and biological systems. In general, the former allows the introduction of elements of novelty, while the latter is responsible for the motion of a system in its phase space. Often, these processes are strongly related, since an innovation can trigger the evolution, and the latter can provide the optimal conditions for the emergence of innovations. Both processes can be studied by using the framework of evolutionary game theory, where evolution constitutes an intrinsic mechanism. At the same time, the concept of innovation requires an opportune mathematical representation. Notably, innovation can be modeled as a strategy, or it can constitute the underlying mechanism that allows agents to change strategy. Here, we analyze the second case, investigating the behavior of a heterogeneous population, composed of imitative and innovative agents. Imitative agents change strategy only by imitating that of their neighbors, whereas innovative ones change strategy without the need for a copying source. The proposed model is analyzed by means of analytical calculations and numerical simulations in different topologies. Remarkably, results indicate that the mixing of mechanisms can be detrimental to cooperation near phase transitions. In those regions, the spatial reciprocity from imitative mechanisms is destroyed by innovative agents, leading to the downfall of cooperation. Our investigation sheds some light on the complex dynamics emerging from the heterogeneity of strategy revision methods, highlighting the role of innovation in evolutionary games.

Heterogeneous update mechanisms in evolutionary games: Mixing innovative and imitative dynamics.

PubMed

Amaral, Marco Antonio; Javarone, Marco Alberto

2018-04-01

Innovation and evolution are two processes of paramount relevance for social and biological systems. In general, the former allows the introduction of elements of novelty, while the latter is responsible for the motion of a system in its phase space. Often, these processes are strongly related, since an innovation can trigger the evolution, and the latter can provide the optimal conditions for the emergence of innovations. Both processes can be studied by using the framework of evolutionary game theory, where evolution constitutes an intrinsic mechanism. At the same time, the concept of innovation requires an opportune mathematical representation. Notably, innovation can be modeled as a strategy, or it can constitute the underlying mechanism that allows agents to change strategy. Here, we analyze the second case, investigating the behavior of a heterogeneous population, composed of imitative and innovative agents. Imitative agents change strategy only by imitating that of their neighbors, whereas innovative ones change strategy without the need for a copying source. The proposed model is analyzed by means of analytical calculations and numerical simulations in different topologies. Remarkably, results indicate that the mixing of mechanisms can be detrimental to cooperation near phase transitions. In those regions, the spatial reciprocity from imitative mechanisms is destroyed by innovative agents, leading to the downfall of cooperation. Our investigation sheds some light on the complex dynamics emerging from the heterogeneity of strategy revision methods, highlighting the role of innovation in evolutionary games.

The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

PubMed

Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

2018-12-01

The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. To identify these challenges within these clinics, as well as potential strategies to address them. The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents' patient; 2) managing and balancing residents' appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents' patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models.

The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

PubMed Central

Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

2018-01-01

ABSTRACT Background: The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. Objective: To identify these challenges within these clinics, as well as potential strategies to address them. Design: The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents’ patient; 2) managing and balancing residents’ appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents’ patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. Conclusions: To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models. PMID:29464984

Development and implementation of a psychotherapy tracking database in primary care.

PubMed

Craner, Julia R; Sawchuk, Craig N; Mack, John D; LeRoy, Michelle A

2017-06-01

Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article. A continuously populating database for psychotherapy services was implemented across 5 primary care clinics in a large health system to assess several levels of patient care, including service utilization, symptomatic outcomes, and session-by-session use of psychotherapy principles by providers. Each phase of implementation revealed challenges, including clinician time, dissemination to clinics with different resources, and fidelity of data collection strategy across providers, as well as benefits, including the generation of useful data to inform clinical care, program development, and empirical research. The feasible and sustainable implementation of data collection for routine clinical practice in primary care has the potential to fuel the evidence base around integrated care. The current project describes the development of an innovative approach that, with further empirical study and refinement, could enable health care professionals and systems to understand their population and clinical process in a way that addresses essential gaps in the integrated care literature. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

War-gaming application for future space systems acquisition: MATLAB implementation of war-gaming acquisition models and simulation results

NASA Astrophysics Data System (ADS)

Vienhage, Paul; Barcomb, Heather; Marshall, Karel; Black, William A.; Coons, Amanda; Tran, Hien T.; Nguyen, Tien M.; Guillen, Andy T.; Yoh, James; Kizer, Justin; Rogers, Blake A.

2017-05-01

The paper describes the MATLAB (MathWorks) programs that were developed during the REU workshop1 to implement The Aerospace Corporation developed Unified Game-based Acquisition Framework and Advanced Game - based Mathematical Framework (UGAF-AGMF) and its associated War-Gaming Engine (WGE) models. Each game can be played from the perspectives of the Department of Defense Acquisition Authority (DAA) or of an individual contractor (KTR). The programs also implement Aerospace's optimum "Program and Technical Baseline (PTB) and associated acquisition" strategy that combines low Total Ownership Cost (TOC) with innovative designs while still meeting warfighter needs. The paper also describes the Bayesian Acquisition War-Gaming approach using Monte Carlo simulations, a numerical analysis technique to account for uncertainty in decision making, which simulate the PTB development and acquisition processes and will detail the procedure of the implementation and the interactions between the games.

Barriers and facilitators related to the uptake of four strategies to prevent neonatal early-onset group B haemolytic streptococcus disease: a qualitative study.

PubMed

Kolkman, Diny G E; Fleuren, Margot A H; Wouters, Maurice G A J; de Groot, Christianne J M; Rijnders, Marlies E B

2017-05-09

Actions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal GBS colonisation (screening strategy), 2) identified risk factors (risk-based strategy) or 3) a combination of these two conditions (maternal GBS colonisation and identified risk factors: combination strategy and the Dutch guideline). Low adherence to guidelines preventing EOGBS has been reported. Each strategy has drawbacks and clinical outcomes are affected by care providers' and women's adherence. The actual impact of any preventive strategy is the product of efficacy of the strategy and the level of implementation. In order to reduce neonatal death due to EOGBS by developing the optimal guideline, we analysed barriers and facilitators of current used strategies. Focus group and personal interviews with care providers and women were performed. Impeding and enhancing factors in adherence to the preventive strategies were discussed and scored using the Measurement Instrument for Determinants of Innovations (MIDI) and analysed by two independent researchers. Overall, care providers identified 3.6 times more factors that would impede (n = 116) rather than facilitate (n = 32) adherence to the preventive strategies. 28% facilitative factors were reported in relation to the combination strategy and 86% impeding factors in relation to the Dutch guideline. The most preferred strategy was the combination strategy by 74% of the care providers and by 86% of the women. We obtained a detailed understanding of factors that influence adherence to preventive strategies. This insight can be used to develop implementation activities to improve the uptake of new strategies. The trial is registered in the Dutch Trial Register NTR3965 .

SU-E-E-07: An Adaptable Approach for Education On Medical Physics at Undergraduate and Postgraduate Levels

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

Miller-Clemente, R; Universidad de Oriente, Santiago De Cuba, Santiago de Cuba; Mendez-Perez, L

Purpose: To contribute to the professional profile of future medical physicists, technologists and physicians, and implement an adaptable educational strategy at both undergraduate and postgraduate levels. Methods: The Medical Physics Block of Electives (MPBE) designed was adapted to the Program of B.S. in Physics. The conferences and practical activities were developed with participatory methods, with interdisciplinary collaboration from research institutions and hospitals engaged on projects of Research, Development and Innovation (RDI). The scientific education was implemented by means of critical analysis of scientific papers and seminars where students debated on solutions for real research problems faced by medical physicists. Thismore » approach included courses for graduates not associated to educational programs of Medical Physics (MP). Results: The implementation of the MPBE began in September 2014, with the electives of Radiation MP and Introduction to Nuclear Magnetic Resonance. The students of second year received an Introduction to MP. This initiative was validated by the departmental Methodological Workshop, which promoted the full implementation of the MPBE. Both postgraduated and undergraduate trainees participated in practices with our DICOM viewer system, a local prototype for photoplethysmography and a home-made interface for ROC analysis, built with MATLAB. All these tools were designed and constructed in previous RDI projects. The collaborative supervision of University’s researchers with clinical medical physicists will allow to overcome the limitations of residency in hospitals, to reduce the workload for clinical supervisors and develop appropriate educational activities. Conclusion: We demonstrated the feasibility of adaptable educational strategies, considering available resources. This provides an innovative way for prospective medical physicists, technologists and radiation oncologists. This strategy can be implemented in several regions without formal programs of MP, like most of developing countries. Starting with undergraduate students would allow to reach appropriate certification faster than most of traditional or alternative approaches for education on MP. The authors acknowledge Radiation Consulting Group, LLC, an Arizona Corporation which promotes the use of ionizing radiation in the healing arts, for the “Oscar Luis Caballero” travel grant. The authors thanks to professors Meisbel Daudinot, David Adame and Alexander Pascau for the practices through imagis, imageROC and ANGIODIN PD3000 respectively.« less

Logistics in smallpox: the legacy.

PubMed

Wickett, John; Carrasco, Peter

2011-12-30

Logistics, defined as "the time-related positioning of resources" was critical to the implementation of the smallpox eradication strategy of surveillance and containment. Logistical challenges in the smallpox programme included vaccine delivery, supplies, staffing, vehicle maintenance, and financing. Ensuring mobility was essential as health workers had to travel to outbreaks to contain them. Three examples illustrate a range of logistic challenges which required imagination and innovation. Standard price lists were developed to expedite vehicle maintenance and repair in Bihar, India. Innovative staffing ensured an adequate infrastructure for vehicle maintenance in Bangladesh. The use of disaster relief mechanisms in Somalia provided airlifts, vehicles and funding within 27 days of their initiation. In contrast the Expanded Programme on Immunization (EPI) faces more complex logistical challenges. Copyright © 2011 Elsevier Ltd. All rights reserved.

Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

PubMed Central

Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2014-01-01

Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, p<0.01) and SF-12 physical scores (ES 0.25, p=0.03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. ATSM is a strategy for improving patient-reported self-management and may also improve some outcomes. PMID:24594561

A social marketing approach to changing mental health practices directed at youth and adolescents.

PubMed

Andreason, Alan R

2004-01-01

The mental health problems of children are of increasing social concern. Many best practices have been developed but often not implemented. Social marketing has been suggested as an innovative, useful approach to this challenge-along with others in the health care field. However, much confusion exists over what the approach entails, where it has been applied and how it can be adapted to significant social challenges such as changing mental health practices directed at youth and adolescents. This article defines key terms, offers historical perspective and provides a specific approach and set of models to implement an effective social marketing strategy in a range of contexts.

A Strategy for American Innovation: Driving towards Sustainable Growth and Quality Jobs

ERIC Educational Resources Information Center

Executive Office of the President, 2009

2009-01-01

Since taking office, President Obama has taken historic steps to lay the foundation for the innovation economy of the future. The Obama Innovation Strategy builds on well over $100 billion of Recovery Act funds that support innovation, additional support for education, infrastructure and others in the Recovery Act and the President's Budget, and…

Innovation Vouchers and LEP Structural Funds Strategies. Innovation and Growth Factsheet Series. No. 1

ERIC Educational Resources Information Center

Universities UK, 2014

2014-01-01

This factsheet, the first in a series on innovation and growth, provides an overview of the benefits of innovation vouchers, and gives some examples of how universities and Local Enterprise Partnerships (LEPs) are including them in their European Structural and Investment Funds (ESIF) strategies. [For the second factsheet in the series,…

Reinvention of Classroom Practice Innovations

ERIC Educational Resources Information Center

Sansom, David W.

2017-01-01

Experienced teachers are introduced to classroom practice innovations during in-service education and training (INSET) programmes. Teachers return to particular teaching contexts in schools and other institutions after INSET and it is here teachers implement innovations and change classroom practice. However, this implementation is not certain;…

Space Technology Industry Forum

NASA Image and Video Library

2010-07-12

Program Executive for the NASA Innovative Advanced Concepts (NIAC) Program Jay Falker speaks during the NASA New Space Technology Industry Forum being held at the University of Maryland in College Park on Tuesday, July 13, 2010. During the two-day event, speakers are focusing on the president's fiscal year 2011 budget request for NASA's new Space Technology Program. Representatives from industry, academia and the federal government are in attendance to discuss strategy, development and implementation of NASA's proposed new technology-enabled exploration. Photo Credit: (NASA/Bill Ingalls)

Safe Schools, Safe Students. Proceedings of the National Education Goals Panel/National Alliance of Pupil Services Organizations Conference on "Safe Schools, Safe Students: A Collaborative Approach to Achieving Safe, Disciplined, and Drug-free Schools Conducive to Learning" (Washington, D.C., October 28-29, 1994).

ERIC Educational Resources Information Center

Talley, Ronda C., Ed.; Walz, Garry R., Ed.

The "Safe Schools, Safe Students" conference brought together leading researchers and practitioners in order to share knowledge about innovative safety strategies being used in America's schools. The papers here represent the thinking of scientific experts and school-based pupil service providers who are implementing programs to prevent…

Strategies for revitalizing organizations; Proceedings of the Second NASA Symposium on Quality and Productivity, Washington, DC, Dec. 2, 3, 1986

NASA Technical Reports Server (NTRS)

Gerard, Mireille (Editor); Edwards, Pamela W. (Editor)

1987-01-01

Attention is given to topics concerning managerial improvement of the American economy's goods and services through enhanced workforce productivity. The broad topic of entrepreneurialism in management organizations was addressed with a view to its effect on innovation in large corporations, and methods for measuring and sharing productivity increases were treated with respect to white collar productivity. Also discussed are participative management techniques and their implementation, and worker involvement in the enhancement of product quality.

Enabling and challenging factors in institutional reform: The case of SCALE-UP

NASA Astrophysics Data System (ADS)

Foote, Kathleen; Knaub, Alexis; Henderson, Charles; Dancy, Melissa; Beichner, Robert J.

2016-06-01

While many innovative teaching strategies exist, integration into undergraduate science teaching has been frustratingly slow. This study aims to understand the low uptake of research-based instructional innovations by studying 21 successful implementations of the Student Centered Active Learning with Upside-down Pedagogies (SCALE-UP) instructional reform. SCALE-UP significantly restructures the classroom environment and pedagogy to promote highly active and interactive instruction. Although originally designed for university introductory physics courses, SCALE-UP has spread to many other disciplines at hundreds of departments around the world. This study reports findings from in-depth, open-ended interviews with 21 key contact people involved with successful secondary implementations of SCALE-UP throughout the United States. We defined successful implementations as those who restructured their pedagogy and classroom and sustained and/or spread the change. Interviews were coded to identify the most common enabling and challenging factors during reform implementation and compared to the theoretical framework of Kotter's 8-step Change Model. The most common enabling influences that emerged are documenting and leveraging evidence of local success, administrative support, interaction with outside SCALE-UP user(s), and funding. Many challenges are linked to the lack of these enabling factors including difficulty finding funding, space, and administrative and/or faculty support for reform. Our focus on successful secondary implementations meant that most interviewees were able to overcome challenges. Presentation of results is illuminated with case studies, quotes, and examples that can help secondary implementers with SCALE-UP reform efforts specifically. We also discuss the implications for policy makers, researchers, and the higher education community concerned with initiating structural change.

[Controlling systems for operating room managers].

PubMed

Schüpfer, G; Bauer, M; Scherzinger, B; Schleppers, A

2005-08-01

Management means developing, shaping and controlling of complex, productive and social systems. Therefore, operating room managers also need to develop basic skills in financial and managerial accounting as a basis for operative and strategic controlling which is an essential part of their work. A good measurement system should include financial and strategic concepts for market position, innovation performance, productivity, attractiveness, liquidity/cash flow and profitability. Since hospitals need to implement a strategy to reach their business objectives, the performance measurement system has to be individually adapted to the strategy of the hospital. In this respect the navigation system developed by Gälweiler is compared to the "balanced score card" system of Kaplan and Norton.

Effective learner-centered strategies for teaching adults: using visual media to engage the adult learner.

PubMed

Myers, Dennis R; Sykes, Catherine; Myers, Scott

2008-01-01

This article offers practical guidance for educators as they prepare specialists to enhance the lives and communities of older persons through the strategic use of visual media in age-related courses. Advantages and disadvantages of this learning innovation are provided as well as seven approaches for enriching instruction. Resources are included for locating effective visual media, matching course content with video resources, determining fair use of copyrighted media, and inserting video clips into PowerPoint presentations. Strategies for accessing assistive services for implementing visual media in the classroom are also addressed. This article promotes the use of visual media for the purpose of enriching gerontological and geriatrics instruction for the adult learner.

Hospital preparedness in community measles outbreaks—challenges and recommendations for low-resource settings

PubMed Central

Shakoor, Sadia; Mir, Fatima; Zaidi, Anita K. M.; Zafar, Afia

2015-01-01

We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities. PMID:25882388

Innovation in teaching deaf students physics and astronomy in Bulgaria

NASA Astrophysics Data System (ADS)

Zamfirov, Milen; Saeva, Svetoslava; Popov, Tsviatko

2007-01-01

This paper presents a new strategy to be implemented in Bulgarian schools in teaching physics and astronomy to students with impaired hearing at grades 7 (13-year-old students) and 8 (14-year-old students). The strategy provides effective education for students with hearing disabilities in mainstream schools as well as for those attending specialized schools. A multimedia CD has been developed, which offers a large number of basic terms from the corresponding fields of physics and astronomy, accompanied by textual explanation and various illustrations. The terms are explained in Bulgarian, Bulgarian Sign Language and English. This multimedia product can be used by children with hearing disabilities, as well as by children without disorders.

Determinants of practice nurses' intention to implement a new smoking cessation intervention: the importance of attitude and innovation characteristics.

PubMed

Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2013-12-01

To identify determinants of practice nurses' intention to implement a new smoking cessation intervention and to investigate the independent value of attitude and Rogers' innovation characteristics. While effective smoking cessation interventions exist, implementation is often suboptimal. No previous studies have disentangled the independent value of beliefs towards implementation and innovation characteristics in explaining implementation. A cross-sectional descriptive study. In 2010, 56 of 91 general practice nurses who participated in an intervention effectiveness trial completed an online questionnaire concerning demographics, patient population characteristics, attitude, innovation characteristics, self-efficacy, perceived social influence and intention to implement the intervention in the future. Recruitment success during the trial was defined as the number of patients participating. To detect differences between intending and non-intending practice nurses, independent sample t-tests and Chi-squared tests were conducted. Correlation coefficients were calculated to identify associations between potential determinants of intention. To identify significant determinants logistic hierarchical regression analyses were conducted. Innovation characteristics and attitude were both significantly associated with practice nurses' intention to implement. While recruitment success showed a significant positive association with intention, perceived patient support was only a significant determinant when including innovation characteristics or attitude. To increase new interventions' implementation rates, it is most important to convince health professionals of its beneficial characteristics, to generate a positive attitude towards the intervention, to aid practice nurses in recruiting smoking patients and to increase perceived patient support. © 2013 John Wiley & Sons Ltd.

Integrated e-Health approach based on vascular ultrasound and pulse wave analysis for asymptomatic atherosclerosis detection and cardiovascular risk stratification in the community.

PubMed

Santana, Daniel Bia; Zócalo, Yanina A; Armentano, Ricardo L

2012-03-01

New strategies are urgently needed to identify subjects at increased risk of atherosclerotic cardiovascular disease (ACVD) development or complications. A National Public University Center (CUiiDARTE) was created in Uruguay, based on six main pillars: 1) integration of experts in different disciplines and creation of multidisciplinary teams, 2) incidence in public and professional education programs to give training in the use of new technologies and to shift the focus from ACVD treatment to disease prevention, 3) implementation of free vascular studies in the community (distributed rather than centralized healthcare), 4) innovation and application of e-Health and noninvasive technology and approaches, 5) design and development of a biomedical approach to determine the target population and patient workflow, and 6) improvement in individual risk estimation and differentiation between aging and ACVD-related arterial changes using population-based epidemiological and statistical patient-specific models. This work describes main features of CUiiDARTE project implementation, the scientific and technological steps and innovations done for individual risk stratification, and sub-clinical ACVD diagnosis. © 2012 IEEE

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

PubMed

Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

When the user is not the chooser: learning from stakeholder involvement in technology adoption decisions in infection control.

PubMed

Ahmad, R; Kyratsis, Y; Holmes, A

2012-07-01

Health systems need efficient and effective innovation decisions to provide maximum benefit to patients, particularly in a climate of financial constraints. Although evidence-based innovations exist for helping to address healthcare-associated infections, the uptake and implementation of these is highly variable and in some cases very slow. To investigate innovation adoption decisions and implementation processes from an organizational perspective, focusing on the implications of stakeholder involvement during the innovation process. Thirty-eight technology adoption decisions and implementation processes were examined through 121 qualitative interviews in 12 National Health Service healthcare organizations across England. Stakeholder involvement varied across organizations with decisions highly exclusive to the infection prevention and control (IPC) team, to highly inclusive of wider organizational members. The context, including organizational culture, previous experience, and logistical factors influenced the level of stakeholder engagement. The timing of stakeholder involvement in the process impacted on: (i) the range of innovations considered; (ii) the technologies selected, and (iii) the success of technology implementation. Cases of non-adoption, discontinued adoption, and of successful implementation are presented to share learning. The potential benefits of stakeholder involvement for 'successful' innovation adoption are presented including a goal-oriented framework for involvement. Key stakeholder involvement can lead to innovation adoption and implementation compatible with structural and cultural contexts, particularly when involvement crosses the phases of initiation, decision-making and implementation. Involving members of the wider healthcare organization can raise the profile of IPC and reinforce efforts to make IPC everybody's business. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy

PubMed Central

Aradeon, Susan B; Doctor, Henry V

2016-01-01

The Sustainable Development Goal (SDG) maternal mortality target risks being underachieved like its Millennium Development Goal (MDG) predecessor. The MDG skilled birth attendant (SBA) strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER) strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and postimplementation Knowledge, Attitude, and Practice Survey results and qualitative assessments support the CCER theory of change. This theory of change rests on a set of implementation steps that rely on three innovative components: Community Communication, Rapid Imitation Practice, and CCER support structures. Innovative communication body tools and the rote learning Rapid Imitation Practice training methodology enabled low-literate volunteers to saturate their communities with informed group discussions transferring communication capacity and ownership to the discussion participants. CCER is especially efficient because virtually every timely, community referral for emergency maternal care results in a saved life, whereas on average, only one in every eight births delivered by an SBA (12%) is expected to be a delivery-associated complication requiring lifesaving care. PMID:27088844

Enhanced use of phylogenetic data to inform public health approaches to HIV among men who have sex with men.

PubMed

German, Danielle; Grabowski, Mary Kate; Beyrer, Chris

2017-02-01

The multidimensional nature and continued evolution of HIV epidemics among men who have sex with men (MSM) requires innovative intervention approaches. Strategies are needed that recognise the individual, social and structural factors driving HIV transmission; that can pinpoint networks with heightened transmission risk; and that can help target intervention in real time. HIV phylogenetics is a rapidly evolving field with strong promise for informing innovative responses to the HIV epidemic among MSM. Currently, HIV phylogenetic insights are providing new understandings of characteristics of HIV epidemics involving MSM, social networks influencing transmission, characteristics of HIV transmission clusters involving MSM, targets for antiretroviral and other prevention strategies and dynamics of emergent epidemics. Maximising the potential of HIV phylogenetics for HIV responses among MSM will require attention to key methodological challenges and ethical considerations, as well as resolving key implementation and scientific questions. Enhanced and integrated use of HIV surveillance, sociobehavioural and phylogenetic data resources are becoming increasingly critical for informing public health approaches to HIV among MSM.

Supply-side options for an endgame for the tobacco industry.

PubMed

Callard, Cynthia D; Collishaw, Neil E

2013-05-01

Although governments have imposed controls on tobacco company behaviour, they have not yet aligned tobacco industry goals to public health objectives. As a result, tobacco companies have delayed or diminished the impact of imposed public health measures and have not contributed to curbing the epidemic of tobacco use. Over the past decade, several regulatory innovations have been proposed as ways to better align industry actions with public health needs, but none have been put in place. These policy suggestions share the goal of providing a supply-side complement to conventional demand reduction strategies, but they differ in the assumptions they make and in the regulatory and governance approaches they take. Similarly, differing views on ideology and political context within the tobacco control community and between governments may hinder the establishment of a global consensus on the ideal supply-side intervention. A government willing to implement innovative supply-side strategies as part of a tobacco control endgame may not require such consensus if factors specific to their national public health systems or political contexts are supportive.

Supply-side options for an endgame for the tobacco industry

PubMed Central

Callard, Cynthia D; Collishaw, Neil E

2013-01-01

Although governments have imposed controls on tobacco company behaviour, they have not yet aligned tobacco industry goals to public health objectives. As a result, tobacco companies have delayed or diminished the impact of imposed public health measures and have not contributed to curbing the epidemic of tobacco use. Over the past decade, several regulatory innovations have been proposed as ways to better align industry actions with public health needs, but none have been put in place. These policy suggestions share the goal of providing a supply-side complement to conventional demand reduction strategies, but they differ in the assumptions they make and in the regulatory and governance approaches they take. Similarly, differing views on ideology and political context within the tobacco control community and between governments may hinder the establishment of a global consensus on the ideal supply-side intervention. A government willing to implement innovative supply-side strategies as part of a tobacco control endgame may not require such consensus if factors specific to their national public health systems or political contexts are supportive. PMID:23591497

Fostering Integrated Learning and Faculty Collaboration through Curriculum Design: A Case Study

ERIC Educational Resources Information Center

Routhieaux, Robert L.

2015-01-01

Designing and implementing innovative curricula can enhance student learning while simultaneously fostering faculty collaboration. However, innovative curricula can also surface numerous challenges for faculty, staff, students, and administration. This case study documents the design and implementation of an innovative Master of Business…

Inventory of Educational Innovations in Asia and the Pacific.

ERIC Educational Resources Information Center

Asian Centre of Educational Innovation for Development, Bangkok (Thailand).

Fourteen innovative educational programs implemented by countries in Asia and the Pacific region are described to aid other educators engaged in planning and implementing innovative programs. The programs are: faculty-oriented breakfast programme (Australia); farm school on the air (India); multimedia, inservice teacher training for primary…

Research for better health: the Panamanian priority-setting experience and the need for a new process

PubMed Central

2014-01-01

Background Panama is, economically, the fastest growing country in Central America and is making efforts to improve management mechanisms for research and innovation. However, due to contextual factors, the Panamanian Health Research System is not well developed and is poorly coordinated with the Health System. Likewise, despite recent efforts to define a National Health Research Agenda, implementing this agenda and aligning it with Panamanians’ health needs remains difficult. This articles aims to review Panama’s experience in health research priority setting by analyzing the fairness of previous prioritization processes in order to promote an agreed-upon national agenda aligned with public health needs. Methods The three health research prioritization processes performed in Panama between 2006 and 2011 were analyzed based on the guidelines established by the four “Accountability for Reasonableness” principles, namely “relevance”, “publicity”, “revision”, and “enforcement”, which provide a framework for evaluating priority-setting fairness. Results The three health research priority-setting events performed in Panama during the reference period demonstrated a heterogeneous pattern of decision-making strategies, stakeholder group composition, and prioritization outcomes. None of the three analyzed events featured an open discussion process with the scientific community, health care providers, or civil society in order to reach consensus. Conclusions This investigation makes evident the lack of a strategy to encourage open discussion by the multiple stakeholders and interest groups that should be involved during the priority-setting process. The analysis reveals the need for a new priority-setting exercise that validates the National Agenda, promotes its implementation by the National Secretariat for Science, Technology and Innovation in conjunction with the Ministry of Health, and empowers multiple stakeholders; such an exercise would, in turn, favor the implementation of the agenda. PMID:25117661

Innovative approaches to educating medical students for practice in a changing health care environment: the National UME-21 Project.

PubMed

Rabinowitz, H K; Babbott, D; Bastacky, S; Pascoe, J M; Patel, K K; Pye, K L; Rodak, J; Veit, K J; Wood, D L

2001-06-01

In today's continually changing health care environment, there is serious concern that medical students are not being adequately prepared to provide optimal health care in the system where they will eventually practice. To address this problem, the Health Resources and Services Administration (HRSA) developed a $7.6 million national demonstration project, Undergraduate Medical Education for the 21st Century (UME-21). This project funded 18 U.S. medical schools, both public and private, for a three-year period (1998-2001) to implement innovative educational strategies. To accomplish their goals, the 18 UME-21 schools worked with more than 50 organizations external to the medical school (e.g., managed care organizations, integrated health systems, Area Health Education Centers, community health centers). The authors describe the major curricular changes that have been implemented through the UME-21 project, discuss the challenges that occurred in carrying out those changes, and outline the strategies for evaluating the project. The participating schools have developed curricular changes that focus on the core primary care clinical clerkships, take place in ambulatory settings, include learning objectives and competencies identified as important to providing care in the future health care system, and have faculty development and internal evaluation components. Curricular changes implemented at the 18 schools include having students work directly with managed care organizations, as well as special demonstration projects to teach students the knowledge, skills, and attitudes necessary for successfully managing care. It is already clear that the UME-21 project has catalyzed important curricular changes within 12.5% of U.S. medical schools. The ongoing national evaluation of this project, which will be completed in 2002, will provide further information about the project's impact and effectiveness.

Macquarie Surgical Innovation Identification Tool (MSIIT): a study protocol for a usability and pilot test.

PubMed

Blakely, Brette; Selwood, Amanda; Rogers, Wendy A; Clay-Williams, Robyn

2016-11-18

Medicine relies on innovation to continually improve. However, innovation is potentially risky, and not all innovations are successful. Therefore, it is important to identify innovations prospectively and provide support, to make innovation as safe and effective as possible. The Macquarie Surgical Innovation Identification Tool (MSIIT) is a simple checklist designed as a practical tool for hospitals to identify planned surgical innovations. This project aims to test the usability and pilot the use of the MSIIT in a surgical setting. The project will run in two phases at two Australian hospitals, one public and one private. Phase I will involve interviews, focus groups and a survey of hospital administrators and surgical teams to assess the usability and system requirements for the use of the MSIIT. Current practice regarding surgical innovation within participating hospitals will be mapped, and the best implementation strategy for MSIIT completion will be established. Phase II will involve trialling the MSIIT for each surgery within the trial period by various surgical personnel. Follow-up interviews, focus groups and a survey will be conducted with trial participants to collect feedback on their experience of using the MSIIT during the trial period. Comparative data on rates of surgical innovation during the trial period will also be gathered from existing hospital systems and compared to the rates identified by the MSIIT. Ethical approval has been obtained. The results of this study will be presented to interested health services and other stakeholders, presented at conferences and published in a peer-reviewed MEDLINE-indexed journal. 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/.

Development of innovative tools for understanding marine biodiversity and assessing good environmental status, within the European Marine Strategy Framework Directive

NASA Astrophysics Data System (ADS)

Borja, Angel; Uyarra, María C.

2014-05-01

Marine natural resources and ecosystem services constitute the natural capital that supports economies, societies and individual well-being. Good governance requires a quantification of the interactions and trade-offs among ecosystem services and understanding of how biodiversity underpins ecosystem functions and services across time, scales and sectors. Marine biodiversity is a key descriptor for the assessment within the Marine Strategy Framework Directive (MSFD), approved in 2008, which comprises a total of 11 descriptors. However, the relationships between pressures from human activities and climatic influences and their effects on marine biological diversity are still only partially understood. Hence, these relationships need to be better understood in order to fully achieve a good environmental status (GEnS), as required by the MSFD. This contribution is based upon the FP7 EU project DEVOTES (DEVelopment Of innovative Tools for understanding marine biodiversity and assessing good Environmental Status), which focus on developing innovative conceptual frameworks, methods and coherent, shared protocols to provide consistent datasets and knowledge at different scales, within four regional seas (Black Sea, Mediterranean, Atlantic and Baltic Sea). This project is developing innovative approaches to valuate biodiversity and ecosystem services and to develop public goods and sustainable economic activities from them. The research will benefit sea users and stakeholders, and will contribute to assess and monitor the environmental status of marine waters. The main objectives are: (i) to improve our understanding of the impact of human activities and variations associated to climate on marine biodiversity, (ii) to test indicators (referred in the Commission Decision on GEnS) and develop new ones for assessment at several ecological levels (species, habitat, ecosystems) and for the characterization and status classification of the marine waters, (iii) to develop, test and validate, on the basis of observations, innovative integrative modelling tools in order to further strengthen our understanding of ecosystem and biodiversity changes in space and time. The resultant models are being developed for implementation as operational tools for managers, decision takers and policy makers. The project is contributing (i) to enable the adaptive development of management (ecosystem-based management approach) strategies and management measures as a result of their implementation taking into account the role of industry and relevant stakeholders, (ii) to provide economic assessment of the consequences of management practices, (iii) to identify the barriers (socio-economic and legislative) that prevent the GES to be achieved (e.g. eutrophication), (iv) to provide a set of policy options for the relevant authorities. In addition the project should propose and demonstrate the utility of innovative monitoring systems capable of providing data on a range of parameters, efficiently and effectively, that may be used as indicators of good environmental status. This contribution presents a summary of most of these aspects.

Advanced excimer laser technologies enable green semiconductor manufacturing

NASA Astrophysics Data System (ADS)

Fukuda, Hitomi; Yoo, Youngsun; Minegishi, Yuji; Hisanaga, Naoto; Enami, Tatsuo

2014-03-01

"Green" has fast become an important and pervasive topic throughout many industries worldwide. Many companies, especially in the manufacturing industries, have taken steps to integrate green initiatives into their high-level corporate strategies. Governments have also been active in implementing various initiatives designed to increase corporate responsibility and accountability towards environmental issues. In the semiconductor manufacturing industry, there are growing concerns over future environmental impact as enormous fabs expand and new generation of equipments become larger and more powerful. To address these concerns, Gigaphoton has implemented various green initiatives for many years under the EcoPhoton™ program. The objective of this program is to drive innovations in technology and services that enable manufacturers to significantly reduce both the financial and environmental "green cost" of laser operations in high-volume manufacturing environment (HVM) - primarily focusing on electricity, gas and heat management costs. One example of such innovation is Gigaphoton's Injection-Lock system, which reduces electricity and gas utilization costs of the laser by up to 50%. Furthermore, to support the industry's transition from 300mm to the next generation 450mm wafers, technologies are being developed to create lasers that offer double the output power from 60W to 120W, but reducing electricity and gas consumption by another 50%. This means that the efficiency of lasers can be improve by up to 4 times in 450mm wafer production environments. Other future innovations include the introduction of totally Heliumfree Excimer lasers that utilize Nitrogen gas as its replacement for optical module purging. This paper discusses these and other innovations by Gigaphoton to enable green manufacturing.

[Motivations and barriers of chilean children; threats or opportunities for the implementation of 2013 food based dietary guidelines].

PubMed

Olivares, Sonia; Zacarías, Isabel; González, Carmen Gloria

2014-08-01

Implementation of the updated Food Based Dietary Guidelines (FBDG) for the Chilean population requires the design of innovative strategies and effective. To determine motivations and barriers for children and mothers of preschool-age children to follow new FBDG messages, aiming to identify challenges and opportunities for designing effective communication and implementation strategies. A qualitative study based on 12 focus groups of 9 to 13 age children and 6 focus groups of mothers of preschool-age children, living in the north, central and south regions of the country, to analyze their reaction to each one of the 2013 FBDG messages. Answers of children and mothers did not show differences by gender (in the case of the children) or region of the country. Results show the most frequent and representative comments regarding each message. Challenges to reducing the consumption of foods high in energy, fat, sugar and salt include advertisements and plentiful supply and low prices for these types of foods, both in the school environment and on the street. Opportunities identified included the advertisement of fruits, vegetables and dairy products to promote their consumption, as well as the coming implementation of Law 20.606, which is expected to be an effective way to support this initiative. The results of this study show that the design of strategies based on values, desires and needs of different groups will contribute to optimizing the implementation of the 2013 Chilean FBDG. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service.

PubMed

Simmons, Magenta B; Coates, Dominiek; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deborah

2017-12-12

Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health. © 2017 John Wiley & Sons Australia, Ltd.

Identification of Good Practices in the Implementation of Innovative Learning Methodologies

ERIC Educational Resources Information Center

Lincaru, Cristina; Ciuca, Vasilica; Grecu, Liliana; Atanasiu, Draga; Dragoiu, Codruta

2011-01-01

We intend to present the partial issues resulted from the development of the European Project DeInTRA "cooperation for innovative training methodologies deployment in the European Labour Market"--Stage 4: Identification of good practices in the implementation of innovative learning methodologies. This project is included into the…

Rejection of an innovation: health information management training materials in east Africa.

PubMed

Gladwin, J; Dixon, R A; Wilson, T D

2002-12-01

A shift towards decentralization in many low-income countries has meant more skills are demanded of primary health care managers, including data and information handling at all levels of the health care system. Ministries of Health are changing their central reporting health information systems to health management information systems with emphasis on managers utilizing information at the point of collection. This paper reports on a research study to investigate the introduction of new information management strategies intended to promote an informational approach to management at the operational health service level in low-income countries. It aims to understand the process taking place when externally developed training materials (PHC MAP), which are intended to strengthen health management information systems, are introduced to potential users in an east African country. A case study has been undertaken and this research has demonstrated that the dynamic equilibrium approach to organizational change is applicable to the introduction of new information management strategies and management approaches in low-income countries. Although PHC MAP developers envisaged a technical innovation needing implementation, potential users saw the situation as one of organizational change. Contributions to theory have been made and many implications for introducing new information systems or the informational approach to management are identified. This theoretical framework could also facilitate the introduction of future information management innovations and would allow practitioners to perceive the introduction of information management innovations as one of organizational change that needs to be managed. Consequently, issues that may facilitate or inhibit adoption could be identified in advance.

CMS Innovation Center Health Care Innovation Awards

PubMed Central

Berry, Sandra H.; Concannon, Thomas W.; Morganti, Kristy Gonzalez; Auerbach, David I.; Beckett, Megan K.; Chen, Peggy G.; Farley, Donna O.; Han, Bing; Harris, Katherine M.; Jones, Spencer S.; Liu, Hangsheng; Lovejoy, Susan L.; Marsh, Terry; Martsolf, Grant R.; Nelson, Christopher; Okeke, Edward N.; Pearson, Marjorie L.; Pillemer, Francesca; Sorbero, Melony E.; Towe, Vivian; Weinick, Robin M.

2013-01-01

Abstract The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This article describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care. PMID:28083297

Implementation of a two-part unit-based multiple intervention: moving evidence-based practice into action.

PubMed

Rashotte, Judy; Thomas, Margot; Grégoire, Diane; Ledoux, Sheila

2008-06-01

This study examined the impact of a 2-part unit-based multiple intervention on the use by pediatric critical care nurses of best practice guidelines for pressure-ulcer prevention. A total of 23 nurses participated in a repeated-measures design pre- and post-intervention to address 2 questions: Is there a difference in nurses' evidence-based practices following implementation of an educational intervention only versus implementation of both an educational and an innovative intervention? Are the changes sustained 6 months after completion of the intervention? A significant change occurred in the implementation of 2 of 11 recommended practices following both interventions: assessment of risk of pressure ulcers using an age-appropriate tool (p < or = 0.001), and the documentation of same (p < or = 0.001). These changes may have been sustained. The findings bring to light the real challenges encountered when attempting to implement and evaluate multiple knowledge translation strategies associated with complex best practice guidelines in clinical practice.

Experiences of nursing students of Evidence-Based Practice Education according to Rogers' Diffusion of Innovation Model: A Directed Content Analysis.

PubMed

Pashaeypoor, Shahzad; Ashktorab, Tahereh; Rassouli, Maryam; Alavi Majd, Hamid

2017-10-01

Evidence based practice (EBP) education is essential in promoting of clinical care, but an effective educational strategy for teaching EBP in nursing faculties is not available. The aim of this study was to explore the experiences of nursing students of EBP Education according to Rogers' Diffusion of Innovation Model. This qualitative study was carried out using a directed content analysis method and purposeful sampling. Data were collected until saturation by fourteen semi-structured face-to-face individual interviews and two focus group discussions with nursing students from two nursing faculties in Tehran, Iran. Rogers' Model was used in this study. Data were classified into five themes and 11 categories according to the Rogers's Model. Themes and main categories were knowledge (educational enrichment, new strategy for education), persuasion (internalization of education, improvement of motivation), decision (acceptance, use in the future), implementation (objectivity, consolidation of learning) and confirmation (learning and teaching, achieving a goal, self-confidence). EBP Education, based on the teaching strategy of Rogers's Model, leads to an improved EBP learning. All the necessary steps for a better education of it are included in this educational approach which can be used to teach any new subject like EBP.

Proteomic and metallomic strategies for understanding the mode of action of anticancer metallodrugs.

PubMed

Gabbiani, Chiara; Magherini, Francesca; Modesti, Alessandra; Messori, Luigi

2010-05-01

Since the discovery of cisplatin and its introduction in the clinics, metal compounds have been intensely investigated in view of their possible application in cancer therapy. In this frame, a deeper understanding of their mode of action, still rather obscure, might turn crucial for the design and the obtainment of new and better anticancer agents. Due to the extreme complexity of the biological systems, it is now widely accepted that innovative and information-rich methods are absolutely needed to afford such a goal. Recently, both proteomic and metallomic strategies were successfully implemented for the elucidation of specific mechanistic features of anticancer metallodrugs within an innovative "Systems Biology" perspective. Particular attention was paid to the following issues: i) proteomic studies of the molecular basis of platinum resistance; ii) proteomic analysis of cellular responses to cytotoxic metallodrugs; iii) metallomic studies of the transformation and fate of metallodrugs in cellular systems. Notably, those pioneering studies, that are reviewed here, allowed a significant progress in the understanding of the molecular mechanisms of metal based drugs at the cellular level. A further extension of those studies and a closer integration of proteomic and metallomic strategies and technologies might realistically lead to rapid and significant advancements in the mechanistic knowledge of anticancer metallodrugs.

Neoclassic drug discovery: the case for lead generation using phenotypic and functional approaches.

PubMed

Lee, Jonathan A; Berg, Ellen L

2013-12-01

Innovation and new molecular entity production by the pharmaceutical industry has been below expectations. Surprisingly, more first-in-class small-molecule drugs approved by the U.S. Food and Drug Administration (FDA) between 1999 and 2008 were identified by functional phenotypic lead generation strategies reminiscent of pre-genomics pharmacology than contemporary molecular targeted strategies that encompass the vast majority of lead generation efforts. This observation, in conjunction with the difficulty in validating molecular targets for drug discovery, has diminished the impact of the "genomics revolution" and has led to a growing grassroots movement and now broader trend in pharma to reconsider the use of modern physiology-based or phenotypic drug discovery (PDD) strategies. This "From the Guest Editors" column provides an introduction and overview of the two-part special issues of Journal of Biomolecular Screening on PDD. Terminology and the business case for use of PDD are defined. Key issues such as assay performance, chemical optimization, target identification, and challenges to the organization and implementation of PDD are discussed. Possible solutions for these challenges and a new neoclassic vision for PDD that combines phenotypic and functional approaches with technology innovations resulting from the genomics-driven era of target-based drug discovery (TDD) are also described. Finally, an overview of the manuscripts in this special edition is provided.

Considerations for a business model for the effective integration of novel biomarkers into drug development.

PubMed

Frueh, Felix W

2008-11-01

It is 10 years since the introduction of trastuzumab into the US market, and we are still waiting for a validation of the business case for biomarker-driven drug development. While many reasons for the lack of duplication of this model may exist, the need for accelerated innovation in drug development paired with the opportunity of integrating biomarker-driven research into drug development programs may lead to new and creative ways of fostering the cooperation between drug developers and test manufacturers. The rapid increase in knowledge about biomarkers and our understanding of disease and disease mechanisms open unprecedented prospects to make not only better, more informed decisions regarding patient care, but also strategic decisions during drug development. This requires that a biomarker strategy becomes an integral part of (early) drug development and that new, innovative paths are tried towards a model that combines the scientific approach with an economically feasible implementation strategy. Collaborative research, the use of new communication tools, the exploration of alternative ways to position a product in the market, and other considerations are part of such a strategy. This perspective article illustrates the current landscape and takes a look at some of these new ways for more effectively integrating biomarkers into drug development.

A strategy for the implementation of a quality indicator system in German primary care.

PubMed

van den Heuvel, Henricus

2011-01-01

The Quality and Outcomes Framework (QOF) has had a major impact on the quality of care in British general practice. It is seen as a major innovation amongst quality indicator systems and as a result various countries are looking at whether such initiatives could be used in their primary care. In Germany also the development of similar schemes has started. To propose a strategy indicating key issues for the implementation of a quality indicator scheme in German primary care. Literature review with a focus on the QOF and German quality indicator literature. There are major differences between the German and British healthcare and primary care systems. The development of quality indicator systems for German general practice is in progress and there is a net force for the implementation of such systems. The following ten key factors are suggested for the successful implementation of such a system in German primary care: involvement of general practitioners (GPs) at all levels of the development, a clear implementation process, investment in practice information technology (IT) systems, an accepted quality indicator set, a quality indicator setting institution and data collection organisation, clear financial and non-financial incentives, a 'practice registration' structure, an exception reporting mechanism, delegation of routine clinical data collection tasks to practice assistants, a stepped implementation approach and adequate evaluation processes. For the successful implementation of a quality indicator system in German primary care a number of key issues, as presented in this article, need to be taken into account.

Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

PubMed

Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A

2015-06-01

New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.

Faculty professional development in emergent pedagogies for instructional innovation in dental education.

PubMed

Zheng, M; Bender, D; Nadershahi, N

2017-05-01

Innovative pedagogies have significantly impacted health professions' education, dental education included. In this context, faculty, defined in this study as instructor in higher education, has been increasingly required to hone their instructional skills. The purpose of this exploratory study was to share the design, implementation and preliminary outcomes of two programmes to enhance dental faculty's instructional skills, the Teaching and Learning Seminar Series and the Course Director Orientation. Data sources included faculty and student surveys developed and administered by the researchers; data extracted from the learning management system; reports from the learning analytics tool; and classroom observations. Participants' satisfaction, self-reported learning, instructional behavioural change, and impact on student learning behaviours and institutional practice were assessed borrowing from Kirkpatrick's 4-level model of evaluation of professional development effectiveness. Initial findings showed that faculty in both programmes reported positive learning experiences. Participants reported that the programmes motivated them to improve instructional practice and improved their knowledge of instructional innovation. Some faculty reported implementation of new instructional strategies and tools, which helped create an active and interactive learning environment that was welcomed by their students. The study contributes to literature and best practice in health sciences faculty development in pedagogy and may guide other dental schools in designing professional development programmes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Resource and Technology: A beacon for change in the reform of Jamaica's secondary education system - or a "pipedream"?

NASA Astrophysics Data System (ADS)

Jennings, Zellynne

2012-04-01

Different strategies are being employed worldwide to prepare school-leavers for the world of work. Central to the Reform of Secondary Education (ROSE) in Jamaica in the 1990s was the achievement of goals of access, equity and quality through the implementation of a common curriculum in all schools. Within this reform, Resource and Technology (R&T) was an innovation designed to develop the creative potential in technology and to transform pedagogical practices from being teacher-centred to being student-centred. This paper examines how teachers and principals involved in the implementation of R&T perceive its attributes, such as need and relevance and observability. The findings reveal how the achievement of goals was frustrated and which challenges the users faced, including a lack of clarity of the means for implementing R&T.

The Challenge of City-Level Data-Gathering for Implementing SDG 11 in Africa

NASA Astrophysics Data System (ADS)

Elias, P. O.

2017-12-01

Implementing sustainable development goal 11 in Africa which includes measuring and monitoring social and economic welfare indicators at the city-level requires data of the best quality. In recent years, there have been progress in national statistics and censuses survey yet data gathering in many African countries are not accurate, timely, disaggregated and widely usable. This often diminish the capability of governments to tackle urban development challenges, which are particularly exacerbated by inequality, poverty and uncontrolled development especially in cities. To support knowledge driven decisions and policies there is need to improve data-gathering systems about health, education, and safety, economy and poverty, land, housing and environment, trade and commerce, population and demography. Also, the underlying dynamics, processes, distributions, patterns, trends or disparities inherent in African cities require the breaking down of aggregated data into their component parts or smaller units, which underscores urban data revolution towards achieving SDG 11. In Africa, the process of bringing together diverse data communities to embrace a diverse range of data sources, tools, and innovative technologies, to provide disaggregated data for decision-making, service delivery and citizen engagement is still emerging. Several factors are inhibiting urban data revolution and need to be overturned before we can provide more evidence, more data and more certainty for decision makers towards achieving urban development targets and sustainable cities for Africa. The paper examines the challenge of city-level data-gathering for implementing SDG 11 in Africa. Specifically, it examines the role of cities in implementing SDG 11 in Africa and the need to disaggregate data at city-level; it assesses existing data sources, compilation and dissemination channels as well as the challenges of deploying innovative techniques and strategies including digital and social media platforms and concludes with suggesting sustainable options for evolving cutting-edge strategies for integrating diverse data communities for responsible city-level data-gathering that is reliable, timely, disaggregated and widely usable.

Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study

PubMed Central

2011-01-01

Background Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly. PMID:22176739

Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study.

PubMed

Barnett, Julie; Vasileiou, Konstantina; Djemil, Fayika; Brooks, Laurence; Young, Terry

2011-12-16

Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly.

Dissemination of sustainable irrigation strategies for almond and olive orchards via a participatory approach. Project LIFE+IRRIMAN

NASA Astrophysics Data System (ADS)

Garcia-Vila, Margarita; Gamero-Ojeda, Pablo; Ascension Carmona, Maria; Berlanga, Jose; Fereres, Elias

2017-04-01

Dissemination of sustainable irrigation strategies for almond and olive orchards via a participatory approach. Project LIFE+IRRIMAN Spain is the world's first and third largest producer of olive oil and almond, respectively. Despite huge efforts in the last years by the production sector towards intensification, cultural issues relative to the traditional rain-fed crop management know how, prevent farmers from adoption of sustainable irrigation management practices. Consequently, even though there has been progress in irrigation management research for these two crops, adoption of modern irrigation techniques by farmers has been slow. Sustainable irrigation strategies for olive and almond orchards are being designed, implemented, validated and disseminated under the framework of the LIFE+ IRRIMAN project, through a participatory approach. The implementation of the LIFE+ IRRIMAN innovative and demonstrative actions has been carried out in an irrigation district of Southern Spain (Genil-Cabra Irrigation Scheme, Andalusia). The approach designed has four phases: i) design and implementation of sustainable irrigation strategies in demonstration farms; ii) dissemination of best irrigation practices which were tested in the initial year throughout the irrigation scheme by the irrigation advisory service; iii) assessment of degree of adoption and re-design of the dissemination strategies; and, iv) based on the results obtained, elaboration of sustainable irrigation guidelines for knowledge transfer in the district at regional and national levels to promote changes in irrigation practices. Participatory approaches have proven to be effective tools for successful irrigation strategies design and diffusion, especially in traditional rain fed crops such as olive and almond trees in the Mediterranean countries. Acknowledgements This work has been funded by the European Union LIFE+ project IRRIMAN (LIFE13 ENV/ES/000539).

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

PubMed

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

2016-11-01

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

Service innovation management practices in the telecommunications industry: what does cross country analysis reveal?

PubMed

Rahman, Syed Abidur; Taghizadeh, Seyedeh Khadijeh; Ramayah, T; Ahmad, Noor Hazlina

2015-01-01

Service innovation management practice is currently being widely scrutinized mainly in the developed countries, where it has been initiated. The current study attempts to propose a framework and empirically validate and explain the service innovation practices for successful performance in the telecommunications industry of two developing countries, Malaysia and Bangladesh. The research framework proposes relationships among organisational culture, operating core (innovation process, cross-functional organisation, and implementation of tools/technology), competition-informed pricing, and performance. A total of 176 usable data from both countries are analysed for the purpose of the research. The findings show that organisational culture tends to be more influential on innovation process and cross-functional organisation in Malaysian telecommunication industry. In contrast, implementation of tools/technology plays a more instrumental role in competition-informed pricing practices in Bangladesh. This study revealed few differences in the innovation management practices between two developing countries. The findings have strategic implications for the service sectors in both the developing countries regarding implementation of innovative enterprises, especially in Bangladesh where innovation is the basis for survival. Testing the innovation management practices in the developing countries perhaps contains uniqueness in the field of innovation management.

The FIDELIS initiative: innovative strategies for increased case finding.

PubMed

Hinderaker, S G; Rusen, I D; Chiang, C-Y; Yan, L; Heldal, E; Enarson, D A

2011-01-01

Low-income, high tuberculosis (TB) burden countries. To compare case finding of new smear-positive pulmonary TB patients in projects funded to apply innovative approaches. Prospective application of innovative approaches to case finding within routine services to determine the numbers of additional cases detected and the cost per additional case detected, according to the type of approach applied. Between 2003 and 2007, 51 FIDELIS projects were implemented in 18 countries; 273,239 cases were reported, of which 85,267 were additional to the number reported in the previous year. The median cost per additional case was US$103. The interventions employed were: 1) social mobilisation and information, education and communication; 2) engagement of the private sector; 3) innovative approaches for microscopy services; 4) enhanced or semi-active case finding; 5) health systems strengthening; and 6) use of incentives. None of these was significantly more likely to detect additional cases or to have a lower cost per additional case than any of the others. While there was a substantial increase in cases detected, at a moderate cost per additional case, we were unable to show that any single intervention had an advantage over the others.

What kind of innovation policy does the bioeconomy need?

PubMed

Schütte, Georg

2018-01-25

In recent years, the bioeconomy has established itself worldwide as a mainstay for achieving a sustainable economy. The targeted use of biological resources for industrial purposes can help to successfully reconcile ecology and economy in the long term. Like digitalization, biologization as the guiding principle of the bioeconomy has the potential to effect a fundamental change in industry. This change must be driven and supported by a committed research and innovation policy. The German Federal Government was one of the first governments worldwide to put the bioeconomy on its research policy agenda when it adopted the "National Research Strategy BioEconomy 2030" in 2010. The respective national policy strategy was published two years later. Since then we have been successfully implementing measures to establish the bioeconomy. Our research programme is currently being developed further. Our aim is to strengthen the biobased transformation process towards a sustainable economy and to attach special importance to innovative technologies. Furthermore, bioeconomy research policy will have to be aimed more strongly towards achieving international goals such as the Sustainable Development Goals (SDGs) and to showing what contribution the bioeconomy can make in this context. The success of the bioeconomy requires a societal discourse on how our society can reconcile economic growth and sustainability in future. This requires the adaptation and continued development of national agendas and initiatives as well as efficient international cooperation. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevention of Pressure Ulcers in the Acute Care Setting: New Innovations and Technologies.

PubMed

Tran, Jacquelynn P; McLaughlin, Jillian M; Li, Ramon T; Phillips, Linda G

2016-09-01

Pressure ulcers (PUs) challenge many in the healthcare field requiring costly and complex care. PUs result from prolonged ischemia and subsequent soft-tissue injury caused by unrelieved pressure over a bony prominence. Proper risk assessment and implementation of prevention strategies for PUs are crucial to providing comprehensive care while reducing healthcare costs. The emphasis has led to the expansion of research in PU prevention technologies in the recent years. The aim of this review is to present an evidence-based summary of some of the new innovations in PU prevention. A literature search was performed. Articles were included if the article discussed the cost, prevalence, assessment, diagnosis, and/or prevention of PUs. The literature search was limited to 2013 to 2016. A total of 1393 potential studies were identified using the search criteria. Three hundred fifty-three articles were reviewed and when possible, preference for inclusion was given to those studies with a higher level of evidence or those discussing novel ideas/innovations. The summary of topics explored includes the following: the use of risk assessment scales as an adjunct in risk identification, the benefit of alternative support surfaces to aid in prevention as compared with standard hospital mattresses, effective repositioning strategies, silicone prophylactic dressing for shear reduction, microclimate control, nutritional considerations, use of electrical stimulation for spinal cord injury patients, and the importance of patient participation.

Patent cliff mitigation strategies: giving new life to blockbusters.

PubMed

Kakkar, Ashish Kumar

2015-01-01

With several blockbuster drugs on the brink of another significant patent expiry cliff, innovator pharmaceutical firms are at risk of losing billions of dollars in sales to generic competition. With issues such as staggering R&D costs, reduced productivity and increasing governmental emphasis on pharmacoeconomics, timely planning and implementation of product lifecycle management strategies is becoming indispensable. A variety of strategies designed to mitigate the post-patent expiry revenue loss exist. These approaches range from fairly straightforward measures, such as strategic price cuts and launching own or authorized generics, to complex and lengthy ones, such as new formulations and indications that require companies to reinvent their pharmaceuticals. As patent expiries loom and product pipelines continue to remain thin, proactive planning for generic entry will be critical for pharma companies to drive growth and earnings in a sustainable manner.

The Rural Outreach Project

NASA Technical Reports Server (NTRS)

Coleman, Clarence D.

2000-01-01

The Rural Outreach Project was designed to increase the diversity of NASA's workforce by: 1) Conducting educational research designed to investigate the most effective strategies for expanding innovative, NASA-sponsored pre-college programs into rural areas; 2) Field-testing identified rural intervention strategies; 3) Implementing expanded NASA educational programs to include 300 rural students who are disabled, female and/or minority; and 4) Disseminating project strategies. The Project was a partnership that included NASA Langley Research Center's Office of Education, Norfolk State University, Cooperative Hampton Roads Organizations for Minorities in Engineering (CHROME) and Paul D. Camp Community College. There were four goals and activities identified for this project; 1) Ascertain effective strategies for expanding successful NASA-sponsored urban-based, pre-college programs into rural settings; 2) Field test identified rural intervention strategies; 3) Publish or disseminate two reports, concerning project research and activities at a national conference; 4) Provide educational outreach to 300, previously underserved, rural students who are disabled, female and /or minority.

Innovation in dental education: The "On-the-Fly" approach to simultaneous development, implementation and evidence collection.

PubMed

de Boer, I R; Bakker, D R; Serrano, C M; Koopman, P; Wesselink, P R; Vervoorn, J M

2018-03-01

This study outlines an approach for education innovation and addresses the ambivalence between evidence-based and non-evidence-based conditions. The "on-the-fly" approach was described as involving implementation during the development of an innovation for dental education. The process of designing and implementing cutting-edge technology of the MOOG Simodont Dental Trainer (DT) whilst systematically collecting evidence illustrates the "on-the-fly" approach. Using the "on-the-fly" approach for developing, implementing and collecting evidence simultaneously in an academic environment appears feasible in serving both the professionals, users and developers and system designers. During the implementation of the new technology, growing evidence stepwise strengthened its position; therefore, showing stakeholders that evidence was used to improve the technology seemed to support and increase acceptance of the new technology. When pioneering an innovative technology in a specialty field, the development stage often precedes evidence for its effectiveness. Consciously choosing the "on-the-fly" approach clarifies to stakeholders in advance about the lack of evidence in an innovation and the need of their support to collect such evidence for improvement and in order to facilitate implementation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

David Bowie and the Art of Slow Innovation: A Fast-Second Winner Strategy for Biotechnology and Precision Medicine Global Development.

PubMed

Özdemir, Vural; Patrinos, George P

2017-11-01

Original ideas and innovation cannot always be ordered like a courier service and delivered fresh to our desk at 9 am. Yet, most creativity-based organizations, careers, and professions, science and biotechnology innovation included, emphasize the speed as the prevailing ideology. But a narrow focus on speed has several and overlooked shortcomings. For example, it does not offer the opportunity to draw from, and stitch together disparate concepts and practices for truly disruptive innovation. Preventing false starts, learning from others' or our own mistakes, and customizing innovations for local community needs are difficult in a speed-hungry innovation ecosystem. We introduce a new strategy, the Fast-Second Winner, specifically in relation to global development of biotechnologies and precision medicine. This à la carte global development strategy envisions a midstream entry into the innovation ecosystem. Moreover, we draw from the works of the late David Bowie who defied rigid classifications as an artist and prolific innovator, and introduce the concept and practice of slow innovation that bodes well with the Fast-Second Winner strategy. A type of slow innovation, the Fast-Second Winner is actually fast and sustainable in the long term, and efficient by reducing false starts in new precision medicine application contexts and geographies, learning from other innovators' failures, and shaping innovations for the local community needs. The establishment of Centers for Fast-Second Innovation (CFSIs), and their funding, for example, by crowdfunding and other innovative mechanisms, could be timely for omics and precision medicine global development. If precision medicine is about tailoring drug treatments and various health interventions to individuals, we suggest to start from tailoring new ideas, and focus not only on how much we innovate but also what and how we innovate. In principle, the Fast-Second Winner can be applied to omics and other biotechnology responsible development in medical practice or any field of applied innovation.

The Roles of Teacher Efficacy in Instructional Innovation: Its Predictive Relations to Constructivist and Didactic Instruction

ERIC Educational Resources Information Center

Nie, Youyan; Tan, Gim Hoon; Liau, Albert Kienfie; Lau, Shun; Chua, Bee Leng

2013-01-01

Constructivist instruction has been implemented in the current instructional innovation in Singapore. Large scale survey study was conducted to examine the roles of teacher efficacy in implementing the innovative constructivist instruction. The results showed that the positive correlation between teacher efficacy and constructivist instruction was…

Conceptualising Educational Changes: A Social Innovation Approach

ERIC Educational Resources Information Center

Loogma, Krista; Tafel-Viia, Külliki; Ümarik, Meril

2013-01-01

The intention of the authors in this article is to contribute to the discussion concerning educational change by implementing the concept of social innovation. We argue that the application of the concept of social innovation makes it possible to better understand the process of implementation as well as sustainability and the social impact of…

Occupying the Principal Position: Examining Relationships between Transformational Leadership, Social Network Position, and Schools' Innovative Climate

ERIC Educational Resources Information Center

Moolenaar, Nienke M.; Daly, Alan J.; Sleegers, Peter J. C.

2010-01-01

Throughout the world, educational policy makers, practitioners, and scholars have acknowledged the importance of principal leadership in the generation and implementation of innovations. In many studies, transformational leadership has emerged as a promising approach in response to increasing demands to develop and implement innovations in…

The demonstration of a theory-based approach to the design of localized patient safety interventions

PubMed Central

2013-01-01

Background There is evidence of unsafe care in healthcare systems globally. Interventions to implement recommended practice often have modest and variable effects. Ideally, selecting and adapting interventions according to local contexts should enhance effects. However, the means by which this can happen is seldom systematic, based on theory, or made transparent. This work aimed to demonstrate the applicability, feasibility, and acceptability of a theoretical domains framework implementation (TDFI) approach for co-designing patient safety interventions. Methods We worked with three hospitals to support the implementation of evidence-based guidance to reduce the risk of feeding into misplaced nasogastric feeding tubes. Our stepped process, informed by the TDF and key principles from implementation literature, entailed: involving stakeholders; identifying target behaviors; identifying local factors (barriers and levers) affecting behavior change using a TDF-based questionnaire; working with stakeholders to generate specific local strategies to address key barriers; and supporting stakeholders to implement strategies. Exit interviews and audit data collection were undertaken to assess the feasibility and acceptability of this approach. Results Following audit and discussion, implementation teams for each Trust identified the process of checking the positioning of nasogastric tubes prior to feeding as the key behavior to target. Questionnaire results indicated differences in key barriers between organizations. Focus groups generated innovative, generalizable, and adaptable strategies for overcoming barriers, such as awareness events, screensavers, equipment modifications, and interactive learning resources. Exit interviews identified themes relating to the benefits, challenges, and sustainability of this approach. Time trend audit data were collected for 301 patients over an 18-month period for one Trust, suggesting clinically significant improved use of pH and documentation of practice following the intervention. Conclusions The TDF is a feasible and acceptable framework to guide the implementation of patient safety interventions. The stepped TDFI approach engages healthcare professionals and facilitates contextualization in identifying the target behavior, eliciting local barriers, and selecting strategies to address those barriers. This approach may be of use to implementation teams and policy makers, although our promising findings confirm the need for a more rigorous evaluation; a balanced block evaluation is currently underway. PMID:24131864

From innovation to implementation: the long and winding road.

PubMed

Galavotti, Christine; Kuhlmann, Anne K Sebert; Kraft, Joan Marie; Harford, Nicola; Petraglia, Joseph

2008-06-01

Building on theory and past research, in early 2000 scientists in the Division of Reproductive Health developed a prevention innovation for CDC's Global AIDS Program for use in countries severely affected by the HIV/AIDS epidemic. This innovative program model is called MARCH: Modeling and Reinforcement to Combat HIV/AIDS (Galavotti et al. Am J Public Health 91:1602-1607, 2001). MARCH promotes behavioral changes that reduce the risk of HIV infection and creates normative environments that sustain these changes through two key program components: entertainment-education using mass media, particularly long-running radio serial dramas, and reinforcement activities at the community level. Using the framework developed by Wandersman et al. (Am J Commun Psychol, 41(3-4), 2008), we describe the key elements of the MARCH prevention innovation and outline how we support its adaptation and implementation. We focus on the following questions: How do we get from an innovative model to effective program implementation in the field? How do we support implementation with fidelity when adaptation is required? And, once implemented, can we demonstrate fidelity of the adaptation to the original program model? Because our program model requires local adaptation for every instance of implementation, we suggest a potential enhancement to the Interactive Systems Framework-support for adaptation of the innovation-as part of the Prevention Support System. In this paper we describe how we supported adaptation of the radio serial drama component for unique contexts in several African countries. We focus attention on the tools and trainings we developed to build innovation specific capacity for implementation, including capacities for adaptation. We then present results of a qualitative analysis of scripts from the MARCH radio serial drama in Zimbabwe to assess the adapted program's fidelity to the original design of the innovation. Finally, we discuss lessons learned and explore implications for the field.

Exploring the feasibility of Conjoint Analysis as a tool for prioritizing innovations for implementation

PubMed Central

2013-01-01

Background In an era of scarce and competing priorities for implementation, choosing what to implement is a key decision point for many behavioural change projects. The values and attitudes of the professionals and managers involved inevitably impact the priority attached to decision options. Reliably capturing such values is challenging. Methods This paper presents an approach for capturing and incorporating professional values into the prioritization of healthcare innovations being considered for adoption. Conjoint Analysis (CA) was used in a single UK Primary Care Trust to measure the priorities of healthcare professionals working with women with postnatal depression. Rating-based CA data was gathered using a questionnaire and then mapped onto 12 interventions being considered as a means of improving the management of postnatal depression. Results The ‘impact on patient care’ and the ‘quality of supporting evidence’ associated with the potential innovations were the most influential in shaping priorities. Professionals were least influenced by whether an innovation was an existing national or local priority, or whether current practice in the Trust was meeting minimum standards. Ranking the 12 innovations by the preferences of potential adopters revealed ‘guided self help’ was the top priority for implementation and ‘screening questions for post natal depression’ the least. When other factors were considered (such as the presence of routine data or planned implementation activity elsewhere in the Trust), the project team chose to combine the eight related treatments and implement these as a single innovation referred to as ‘psychological therapies’. Conclusions Using Conjoint Analysis to prioritise potential innovation implementation options is a feasible means of capturing the utility of stakeholders and thus increasing the chances of an innovation being adopted. There are some practical barriers to overcome such as increasing response rates to conjoint surveys before routine and unevaluated use of this technique should be considered. PMID:23714429

Seven behaviors to advance teamwork: findings from a study of innovation leadership in a simulation center.

PubMed

Weberg, Dan; Weberg, Kim

2014-01-01

Traditional notions of individual-based leadership behaviors are no longer adequate to achieve innovation in health care organizations. A major contributing factor for limited innovation is that outdated leadership practices, such as leader centricity, linear thinking, and poor readiness for innovation, are being used in health care organizations. Through a qualitative case study analysis of innovation implementation, 7 characteristics of innovation leadership, founded in team behaviors, were uncovered. The characteristics that were uncovered included boundary spanning, risk taking, visioning, leveraging opportunity, adaptation, coordination of information flow, and facilitation. These characteristics describe how leaders throughout the system were able to influence and implement innovation successfully.

Whittle Communications and Channel One: Rhetorical Strategies of Innovation.

ERIC Educational Resources Information Center

Adams, Scott

A study examined the message features that influence an innovation's acceptance by a mass audience. The study looked at three strategies of innovational rhetoric (denial of controversy, subtle criticism of existing institutions, and projection of a rhetorical vision) used by a commercial broadcasting company, called Whittle Communications in 1989,…

Implementing Innovation: The Creation of an iUnit and the Role of Nursing.

PubMed

Tiase, Victoria L; Ventura, Rosemary; Sorbello, Daniel; Robinson, Kenya

2016-01-01

NewYork-Presbyterian Hospital took on the challenge of thinking about innovation differently with the implementation of an innovation unit or iUnit to create the patient care unit of the future. Goals were to understand more about the innovation process and to test new service models, technology platforms, devices, and deployment models. Key findings from the focus groups included the need for additional training and technical support. In general, the initiative was felt to improve overall communication and represents a starting point for further innovation programs.

Comparative Effectiveness and Implementation Research: Directions for Neurology

PubMed Central

Vickrey, Barbara G.; Hirtz, Deborah; Waddy, Salina; Cheng, Eric M.; Johnston, S. Claiborne

2013-01-01

There is an enormous unmet need for knowledge about how new insights from discovery and translational research can yield measurable, population-level improvements in health and reduction in mortality among those having or at risk for neurological disease. Once several, well-conducted randomized controlled trials establish the efficacy of a given therapy, implementation research can generate new knowledge about barriers to uptake of the therapy into widespread clinical care, and what strategies are effective in overcoming those barriers and in addressing health disparities. Comparative effectiveness research aims to elucidate the relative value (including clinical benefit, clinical harms, and/or costs) of alternative efficacious management approaches to a neurological disorder, generally through direct comparisons, and may include comparisons of methodologies for implementation. Congress has recently appropriated resources and established an institute to prioritize funding for such research. Neurologists and neuroscientists should understand the scope and objectives of comparative effectiveness and implementation research, their range of methodological approaches (formal literature syntheses, randomized trials, observational studies, modeling), and existing research resources (centers for literature synthesis, registries, practice networks) relevant to research for neurological conditions, in order to close the well-documented “evidence-to-practice gap.” Future directions include building this research resource capacity, producing scientists trained to conduct rigorous comparative effectiveness and implementation research, and embracing innovative strategies to set research priorities in these areas. PMID:22718542

Proposing evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings: a summative analysis.

PubMed

Manyazewal, Tsegahun; Oosthuizen, Martha J; Matlakala, Mokgadi C

2016-09-20

Many resource-limited countries have adopted and implemented healthcare reform to improve the quality of healthcare, but few have had much impact and strategies in support of these efforts remain limited. We aimed to explore and propose evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings. Descriptive and exploratory designs in two phases. Phase I involved assessing the effectiveness of the healthcare reform implemented in Ethiopia in the form of business process reengineering, with evidence compiled from healthcare professionals through a self-administered questionnaire; and phase II involved proposing strategies and seeking consensus from experts using Delphi method. Public hospitals in central Ethiopia. 406 healthcare professionals and 10 senior health policy experts. The healthcare reform that we evaluated was able to restructure hospital departments into case teams, with the goal of adopting a 'one-stop shopping' approach. However, shortages of critical infrastructure, furniture and supplies and job dissatisfaction continued to hamper the system. The most important predictors that influenced implementation of the reform were financial resources, top management commitment and support, collaborative working environment and information technology (IT). Five strategies with 14 operational objectives and 67 potential interventions that could strengthen the reform are proposed based on their strategic priority, which are as follows: reinforce patient-centred quality of care services; foster a healthy and respectful workforce environment; efficient and accountable leadership and governance; efficient use of hospital financing and maximise innovations and the use of health technologies. Effective implementation of healthcare reform remained a challenge for governments in resource-limited settings. Resilient operational, clinical and governance functions of health systems, as well as a motivated and committed health workforce, are important to move healthcare reform processes forward. Political commitments at this juncture might be critical though there need to be a clear demarcation between political and technical engagements. 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/

Safe Surgery for All: Early Lessons from Implementing a National Government-Driven Surgical Plan in Ethiopia.

PubMed

Burssa, Daniel; Teshome, Atlibachew; Iverson, Katherine; Ahearn, Olivia; Ashengo, Tigistu; Barash, David; Barringer, Erin; Citron, Isabelle; Garringer, Kaya; McKitrick, Victoria; Meara, John; Mengistu, Abraham; Mukhopadhyay, Swagoto; Reynolds, Cheri; Shrime, Mark; Varghese, Asha; Esseye, Samson; Bekele, Abebe

2017-12-01

Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity. As Ethiopia progresses with its commitment to prioritize surgery within its Health Sector Transformation Plan, disseminating the process and outcomes of the SaLTS initiative will inform other countries on successful national implementation strategies. The following article describes the process by which the Ethiopian FMOH established surgical system reform and the preliminary results of implementation across these eight pillars.

Using online program development to foster curricular change and innovation.

PubMed

Gwozdek, Anne E; Springfield, Emily C; Peet, Melissa R; Kerschbaum, Wendy E

2011-03-01

Distance education offers an opportunity to catalyze sweeping curricular change. Faculty members of the University of Michigan Dental Hygiene Program spent eighteen months researching best practices, planning outcomes and courses, and implementing an e-learning (online) dental hygiene degree completion program. The result is a collaborative and portfolio-integrated program that focuses on the development of reflective practitioners and leaders in the profession. A team-based, systems-oriented model for production, implementation, and evaluation has been critical to the program's success. The models and best practices on which this program was founded are described. Also provided is a framework of strategies for development, including the utilization of backward course design, which can be used in many areas of professional education.

Research on Green Construction Technology Applied at Guangzhou Hongding Building Project

NASA Astrophysics Data System (ADS)

Lou, Yong Zhong

2018-06-01

The green construction technology is the embodiment of sustainable development strategy in the construction industry, and it is a new construction mode which requires a higher environmental protection. Based on the Hongding building project, this paper describes the application and innovation of technical in the process of implementing green construction in the project, as well as the difficulties and characteristics in the specific practice; .The economic and social benefits of green construction are compared to the traditional construction model; .The achievements and experience of the green construction technology are summarized in the project; The ideas and methods in the process of implementing green construction are abstracted; some suggestions are put forward for the development of green construction.

[Innovative culture and diagnosis related groups in a high complexity hospital, Colombia].

PubMed

Gorbanev, Iouri; Agudelo-Londoño, Sandra; Cortes, Ariel; Yepes, Francisco J

2016-04-01

Objectives To characterize the perception of Diagnosis-Related Groups (DRGs) as an innovation among physicians, nurses and administrative staff in a hospital in Colombia. Methods A case study of innovative culture in a hospital. Surveys and focus groups were carried out with the medical, nursing and administrative staff. Descriptive statistics were calculated for the perceptions of innovative culture. Comparative analysis was done between professional groups. The results of the focus groups were transcribed and analyzed to deepen the findings of the surveys. Results Significant differences were found in perceptions of the innovative culture. The nursing staff were more enthusiastic than doctors when evaluating the innovative culture and leadership. Physicians felt more autonomy when discussing professional issues. Administrative staff assessed the Hospital's disposition to acquire new medical technologies as higher than that of physicians. The three groups know little about DRG's. Conclusions When implementing a health innovation it is advisable to analyze its effect on the professionals who participate in the implementation. Physicians perceive DRGs as a threat to their professional autonomy, while nurses see it as a pro-innovation force. It is important to involve nursing and administrative staff when implementing this kind of innovation.

A qualitative study of the determinants of HIV guidelines implementation in two south-eastern districts of Tanzania

PubMed Central

Geubbels, Eveline; Wringe, Alison; Todd, Jim; Klatser, Paul; Dieleman, Marjolein

2017-01-01

Abstract Current HIV policies in Tanzania have adopted the three long-term impact results of zero new infections, zero HIV deaths and zero stigma and discrimination. Strategies to reach these results include scaling-up HIV Testing and Counselling (HTC); Preventing Mother-To-Child Transmission (PMTCT); and strengthening Care and Treatment Clinic (CTC) services. Previous studies showed that HIV policy and guideline recommendations were not always implemented in rural South Tanzania. This study aims to identify the determinants of HIV guideline implementation. A qualitative study of 23 semi-structured interviews with facility in-charges; healthcare workers; district, regional and national HIV coordinators was conducted. Five health facilities were purposively selected by level, ownership and proximity to district headquarters. Interviews were analysed according to Fleuren’s five determinants of innovation uptake related to: strategies used in guideline development and dissemination; guideline characteristics; the guideline implementing organization; guideline users; and the socio-cultural and regulatory context. None of the facilities had the HTC national guideline document. Non-involvement of providers in revisions and weak planning for guideline dissemination impeded their implementation. Lengthy guidelines and those written in English were under-used, and activities perceived to be complicated, like WHO-staging, were avoided. Availability of staff and lack of supplies like test kits and medication impeded implementation. Collaboration between facilities enhanced implementation, as did peer-support among providers. Provider characteristics including education level, knowledge of, and commitment to the guideline influenced implementation. According to providers, determinants of clients’ service use included gender norms, stigma, trust and perceived benefits. The regulatory context prohibited private hospitals from buying HIV supplies. Being tools for bringing policies to practice, national guidelines are crucial in the efforts towards the three zeros. Strategies to improve providers’ adherence to guidelines should include development of clearer guideline dissemination plans, strengthening of the health system, and possibly addressing of provider-perceived patient-level barriers to utilizing HIV services. PMID:28369374

Applying the concepts of innovation strategies to plastic surgery.

PubMed

Wang, Yirong; Kotsis, Sandra V; Chung, Kevin C

2013-08-01

Plastic surgery has a well-known history of innovative procedures and products. However, with the rise in competition, such as aesthetic procedures being performed by other medical specialties, there is a need for continued innovation in plastic surgery to create novel treatments to advance this specialty. Although many articles introduce innovative technologies and procedures, there is a paucity of publications to highlight the application of principles of innovation in plastic surgery. The authors review the literature regarding business strategies for innovation. The authors evaluate concepts of innovation, process of innovation (i.e., idea generation, idea evaluation, idea conversion, idea diffusion, and adoption), ethical issues, and application to plastic surgery. Adopting a business model of innovation is helpful for promoting a new paradigm of progress to propel plastic surgery to new avenues of creativity.

Strategies used to guide the design and implementation of a national river monitoring programme in South Africa.

PubMed

Roux, D J

2001-06-01

This article explores the strategies that were, and are being, used to facilitate the transition from scientific development to operational application of the South African River Health Programme (RHP). Theoretical models from the field of the management of technology are used to provide insight into the dynamics that influence the relationship between the creation and application of environmental programmes, and the RHP in particular. Four key components of the RHP design are analysed, namely the (a) guiding team, (b) concepts, tools and methods, (c) infra-structural innovations and (d) communication. These key components evolved over three broad life stages of the programme, which are called the design, growth and anchoring stages.

Organizational Strategies for Building Capacity in Evidence-Based Oncology Nursing Practice: A Case Report of an Australian Tertiary Cancer Center.

PubMed

Chan, Raymond Javan; Bowers, Alison; Barton-Burke, Margaret

2017-03-01

The ever-increasing cancer care demand has posed a challenge for oncology nurses to deliver evidence-based, innovative care. Despite efforts to promote evidence-based practice, barriers remain and executives find it difficult to implement evidence-based practice efficiently. Using the successful experience of an Australian tertiary cancer center, this paper depicts 4 effective strategies for facilitating evidence-based practice at the organizational level-the Embedded Scholar: Enabler, Enactor, and Engagement (4 Es) Model-includes a 12-week evidence-based practice program that prioritizes relevant research proposed by clinical staff and endorses high-quality, evidence-based point-of-care resources. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Community partnerships in preventing childhood lead poisoning

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

Dugbatey, K.; Evans, R.G.; Lienhop, M.T.

1995-11-01

Childhood lead poisoning is an environmental health problem that has no socio-economic, racial/ethnic, or regional boundaries. Because the key element in the exposure pathway is lead-based paint, it is more likely to impact inner city urban populations than those living in suburban areas. Suburban development primarily occurred after lead was removed from lead-based paint. It is maximally effective to adopt strategies that promote grassroots community development in designing preventive interventions. This paper reviews such a strategy for building community partnerships that have been instrumental in the development and implementation of an innovative lead education program. Saint Louis University School ofmore » Public Health reaches out to private and public nonprofit community organizations in this community-based lead education program.« less

Soil and solid poultry waste nutrient management and water quality.

PubMed

Chapman, S L

1996-07-01

Concerns about the impacts of nitrogen, phosphorus, and pathogens on surface and ground water quality has forced the poultry industry to implement voluntary waste management guidelines for use by growers. In some states, animal waste guidelines are being enforced by regulatory agencies. Strategies that growers may use to properly dispose of poultry waste include: 1) local land application as a fertilizer; 2) offsite marketing for use as a fertilizer or soil amendment, feed additive, or energy source; and 3) chemical additives that will immobilize nitrogen and phosphorus in the manure or litter. If properly followed, these and other innovative strategies should be adequate to protect surface and ground water quality without adversely affecting the economics of poultry production.

State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems.

PubMed

Stewart, Rebecca E; Marcus, Steven C; Hadley, Trevor R; Hepburn, Brian M; Mandell, David S

2018-06-01

Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States. The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness. Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives. Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.

The Quest for Quality Education: The Case of Curriculum Innovations in Kenya

ERIC Educational Resources Information Center

Bunyi, Grace W.

2013-01-01

Purpose: The paper sets out to analyse the quality education curriculum innovations that have been implemented in Kenya since independence in 1963. The purpose of the analysis is to assess the success and or failure of the innovations and determine the lessons learned that can inform future design and implementation of curriculum innovations…

Relative Ranking of Conditions that Facilitate Innovation Implementation in the USA

ERIC Educational Resources Information Center

Ensminger, David C.; Surry, Daniel W,

2008-01-01

This study compared how people working in three different types of organisations in the United States (K-12 schools, higher education, and business) rank the importance of eight conditions that have been shown to facilitate the implementation of innovations. The study also sought to determine if the nature of the innovation (i.e., technology or…

Multiple models guide strategies for agricultural nutrient reductions

USGS Publications Warehouse

Scavia, Donald; Kalcic, Margaret; Muenich, Rebecca Logsdon; Read, Jennifer; Aloysius, Noel; Bertani, Isabella; Boles, Chelsie; Confesor, Remegio; DePinto, Joseph; Gildow, Marie; Martin, Jay; Redder, Todd; Robertson, Dale M.; Sowa, Scott P.; Wang, Yu-Chen; Yen, Haw

2017-01-01

In response to degraded water quality, federal policy makers in the US and Canada called for a 40% reduction in phosphorus (P) loads to Lake Erie, and state and provincial policy makers in the Great Lakes region set a load-reduction target for the year 2025. Here, we configured five separate SWAT (US Department of Agriculture's Soil and Water Assessment Tool) models to assess load reduction strategies for the agriculturally dominated Maumee River watershed, the largest P source contributing to toxic algal blooms in Lake Erie. Although several potential pathways may achieve the target loads, our results show that any successful pathway will require large-scale implementation of multiple practices. For example, one successful pathway involved targeting 50% of row cropland that has the highest P loss in the watershed with a combination of three practices: subsurface application of P fertilizers, planting cereal rye as a winter cover crop, and installing buffer strips. Achieving these levels of implementation will require local, state/provincial, and federal agencies to collaborate with the private sector to set shared implementation goals and to demand innovation and honest assessments of water quality-related programs, policies, and partnerships.

Innovation in Your Community

EPA Pesticide Factsheets

EPA has many innovation programs that can help the public bring innovative solutions to their local areas by reducing waste, engaging students to contribute innovative ideas, and helping businesses implement sustainable practices.