Data Quality -- A Key to Successfully Implementing ECSS

DTIC Science & Technology

2009-03-01

Inventory inaccuracy and supply chain performance: A simulation study of a retail supply chain. International Journal of Production Economics , 95...Planning (ERP) System Implementations Based on Critical Success Factors (CSFs). International Journal of Production Economics , 98(2), 189- 203. Tersine

Implementing Small-Group Instruction: Insights from Successful Practitioners.

ERIC Educational Resources Information Center

Cooper, James L.; MacGregor, Jean; Smith, Karl A.; Robinson, Pamela

2000-01-01

College faculty who have successfully implemented small-group instruction address common concerns such as: reduced content coverage, reduced amount of learning, need for prerequisite learning, importance of solitary learning, colleagues' concerns, student resistance, logistics, evaluation, use of teaching assistants, and time requirements. (DB)

Implementing a rapid response team: factors influencing success.

PubMed

Murray, Theresa; Kleinpell, Ruth

2006-12-01

Rapid response teams (RRTs), or medical emergency teams, focus on preventing a patient crisis by addressing changes in patient status before a cardiopulmonary arrest occurs. Responding to acute changes, RRTs and medical emergency teams are similar to "code" teams. The exception, however is that they step into action before a patient arrests. Although RRTs are acknowledge as an important initiative, implementation can present many challenges. This article reports on the implementation and ongoing use of a RRT at a community health care setting, highlighting important considerations and strategies for success.

Leadership: The Key to Successful Implementation of Total Quality Management

DTIC Science & Technology

1990-05-01

the implementation of the initiative called Total Quality Management as the philosophy and guiding principles to improve organizational efficiency...where and how to start. This paper presents the critical elements, their interrelationships, and how they can be used to achieve the cultural change necessary for successful implementation of Total Quality Management .

Maternity Nurses' Perceptions of Implementation of the Ten Steps to Successful Breastfeeding.

PubMed

Cunningham, Emilie M; Doyle, Eva I; Bowden, Rodney G

The purpose of this study was to determine maternity nurses' perceptions of implementing the Ten Steps to Successful Breastfeeding. An online survey and a focus group were used to evaluate perceptions of maternity nurses of implementing the Ten Steps to Successful Breastfeeding in an urban Texas hospital at the onset of the project initiation. Responses were transcribed and coded using Nvivo software. Thematic analysis was conducted and consensus was reached among the research team to validate themes. Twenty-eight maternity nurses participated. Nurses perceived a number of barriers to implementing the Ten Steps to Successful Breastfeeding including nurse staffing shortages, variations in practice among nurses, different levels of nurse education and knowledge about breastfeeding, lack of parental awareness and knowledge about breastfeeding, culture, and postpartum issues such as maternal fatigue, visitors, and routine required procedures during recovery care that interfered with skin-to-skin positioning. Maternity nurses desired more education about breastfeeding; specifically, a hands-on approach, rather than formal classroom instruction, to be able to promote successful implementation of the Ten Steps. More education on breastfeeding for new mothers, their families, and healthcare providers was recommended. Nurse staffing should be adequate to support nurses in their efforts to promote breastfeeding. Skin-to-skin positioning should be integrated into the recovery period. Hospital leadership support for full implementation and policy adherence is essential. Challenges in implementing the Ten Steps were identified along with potential solutions.

Implementing and testing theoretical fission fragment yields in a Hauser-Feshbach statistical decay framework

NASA Astrophysics Data System (ADS)

Jaffke, Patrick; Möller, Peter; Stetcu, Ionel; Talou, Patrick; Schmitt, Christelle

2018-03-01

We implement fission fragment yields, calculated using Brownian shape-motion on a macroscopic-microscopic potential energy surface in six dimensions, into the Hauser-Feshbach statistical decay code CGMF. This combination allows us to test the impact of utilizing theoretically-calculated fission fragment yields on the subsequent prompt neutron and γ-ray emission. We draw connections between the fragment yields and the total kinetic energy TKE of the fission fragments and demonstrate that the use of calculated yields can introduce a difference in the 〈TKE〉 and, thus, the prompt neutron multiplicity v, as compared with experimental fragment yields. We deduce the uncertainty on the 〈TKE〉 and v from this procedure and identify possible applications.

Understanding a Successful Implementation of Organizational Social Media: A Multi-Site Case Study

ERIC Educational Resources Information Center

Lahman, Caroline D.

2017-01-01

The purpose of this dissertation was to examine the successful implementation of social media strategies in multiple organizations. Examining the factors an organization used to implement social media can provide the understanding of the benefits and risks associated with this technology. Some businesses are considered successful using social…

Yield model development project implementation plan

NASA Technical Reports Server (NTRS)

Ambroziak, R. A.

1982-01-01

Tasks remaining to be completed are summarized for the following major project elements: (1) evaluation of crop yield models; (2) crop yield model research and development; (3) data acquisition processing, and storage; (4) related yield research: defining spectral and/or remote sensing data requirements; developing input for driving and testing crop growth/yield models; real time testing of wheat plant process models) and (5) project management and support.

A Pharmacy Blueprint for Electronic Medical Record Implementation Success

PubMed Central

Bach, David S.; Risko, Kenneth R.; Farber, Margo S.; Polk, Gregory J.

2015-01-01

Objective: Implementation of an integrated, electronic medical record (EMR) has been promoted as a means of improving patient safety and quality. While there are a few reports of such processes that incorporate computerized prescriber order entry, pharmacy verification, an electronic medication administration record (eMAR), point-of-care barcode scanning, and clinical decision support, there are no published reports on how a pharmacy department can best participate in implementing such a process across a multihospital health care system. Method: This article relates the experience of the design, build, deployment, and maintenance of an integrated EMR solution from the pharmacy perspective. It describes a 9-month planning and build phase and the subsequent rollout at 8 hospitals over the following 13 months. Results: Key components to success are identified, as well as a set of guiding principles that proved invaluable in decision making and dispute resolution. Labor/personnel requirements for the various stages of the process are discussed, as are issues involving medication workflow analysis, drug database considerations, the development of clinical order sets, and incorporation of bar-code scanning of medications. Recommended implementation and maintenance strategies are presented, and the impact of EMR implementation on the pharmacy practice model and revenue analysis are examined. Conclusion: Adherence to the principles and practices outlined in this article can assist pharmacy administrators and clinicians during all medication-related phases of the development, implementation, and maintenance of an EMR solution. Furthermore, review and incorporation of some or all of practices presented may help ease the process and ensure its success. PMID:26405340

The Fundamental Importance of Effective Program Implementation for Successful Character Development

ERIC Educational Resources Information Center

Durlak, Joseph A.

2017-01-01

This article reviews literature that emphasizes how both research findings and practical applications have confirmed the fundamental importance of program implementation in the spread of successful character education interventions. Attention is given to defining implementation, explaining its major elements and why it is so important, discussing…

Critical success factors in implementing an e-rostering system in a healthcare organisation.

PubMed

Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

2017-01-01

Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

Clinical pharmacogenetics implementation: approaches, successes, and challenges.

PubMed

Weitzel, Kristin W; Elsey, Amanda R; Langaee, Taimour Y; Burkley, Benjamin; Nessl, David R; Obeng, Aniwaa Owusu; Staley, Benjamin J; Dong, Hui-Jia; Allan, Robert W; Liu, J Felix; Cooper-Dehoff, Rhonda M; Anderson, R David; Conlon, Michael; Clare-Salzler, Michael J; Nelson, David R; Johnson, Julie A

2014-03-01

Current challenges exist to widespread clinical implementation of genomic medicine and pharmacogenetics. The University of Florida (UF) Health Personalized Medicine Program (PMP) is a pharmacist-led, multidisciplinary initiative created in 2011 within the UF Clinical Translational Science Institute. Initial efforts focused on pharmacogenetics, with long-term goals to include expansion to disease-risk prediction and disease stratification. Herein we describe the processes for development of the program, the challenges that were encountered and the clinical acceptance by clinicians of the genomic medicine implementation. The initial clinical implementation of the UF PMP began in June 2012 and targeted clopidogrel use and the CYP2C19 genotype in patients undergoing left heart catheterization and percutaneous-coronary intervention (PCI). After 1 year, 1,097 patients undergoing left heart catheterization were genotyped preemptively, and 291 of those underwent subsequent PCI. Genotype results were reported to the medical record for 100% of genotyped patients. Eighty patients who underwent PCI had an actionable genotype, with drug therapy changes implemented in 56 individuals. Average turnaround time from blood draw to genotype result entry in the medical record was 3.5 business days. Seven different third party payors, including Medicare, reimbursed for the test during the first month of billing, with an 85% reimbursement rate for outpatient claims that were submitted in the first month. These data highlight multiple levels of success in clinical implementation of genomic medicine. © 2014 Wiley Periodicals, Inc.

Current Barriers to Successful Implementation of FIST Principles

DTIC Science & Technology

2013-07-01

risks will surface during development that could not have been predicted. Managing a thin budget with no schedule slack for these unknown-unknowns is...Fleischer » Keywords: Fast, Inexpensive, Simple, Tiny (FIST); Program Management ; Heuristics; Innovation; Oversight Current Barriers to Successful...Implementation of FIST Principles Capt Brandon Keller, USAF, and Lt Col J. Robert Wirthlin, USAF The Fast, Inexpensive, Simple, and Tiny (FIST

Hope for successful implementation of psychosocial/psychiatric rehabilitation in the forensic mental health setting.

PubMed

Brown, Stephanie A; Lewis, Kent

2015-12-01

To explore staff perceptions of the successes and barriers to implementation of the psychosocial/psychiatric rehabilitation (PSR) model in the forensic mental health setting and identify staff supports needed for greater implementation. A qualitative descriptive design was used and staff focus group data was analyzed using the constant comparative method. All aspects of PSR are being implemented in the forensic setting. Barriers limiting comprehensive implementation include hospital processes and functions, legal components, client clinical presentation, staff attributes and interactions, and lack of resources. To foster greater implementation, employees require support to improve interprofessional interactions and acquire additional resources and education. Strengthening existing successes and addressing barriers identified will foster greater PSR implementation in the forensic setting. Adjusting the physical environment, streamlining documentation, shifting focus from security to rehabilitation goals, and adapting PSR principles to various levels of illness acuity and stages of treatment would enhance PSR implementation. A management focus on improving staff morale, self-care, peer support, team cohesion, and communication would limit burnout and increase successful implementation of PSR. Additional educational opportunities and ongoing training are suggested to support a unified understanding and sustained approach to PSR implementation in the forensic setting. (c) 2015 APA, all rights reserved).

Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

NASA Astrophysics Data System (ADS)

Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

2016-03-01

Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

Effects of people-centred factors on enterprise resource planning implementation project success: empirical evidence from Sri Lanka

NASA Astrophysics Data System (ADS)

Wickramasinghe, Vathsala; Gunawardena, Vathsala

2010-08-01

Extant literature suggests people-centred factors as one of the major areas influencing enterprise resource planning (ERP) implementation project success. Yet, to date, few empirical studies attempted to validate the link between people-centred factors and ERP implementation project success. The purpose of this study is to empirically identify people-centred factors that are critical to ERP implementation projects in Sri Lanka. The study develops and empirically validates a framework for people-centred factors that influence the success of ERP implementation projects. Survey research methodology was used and collected data from 74 ERP implementation projects in Sri Lanka. The people-centred factors of 'project team competence', 'rewards' and 'communication and change' were found to predict significantly the ERP implementation project success.

Steps for successful implementation of proteomic research in the OR.

PubMed

Martin, Chidima Tsion; Henry, Linda; Martin, Lisa; Ad, Niv

2010-02-01

Proteomic studies (ie, the investigation and identification of proteins found in biological samples such as blood and tissue) are at the forefront of the identification of disease biomarkers and the understanding of proteins. These studies promise to enhance diagnostic and prognostic analysis across all disciplines of clinical practice. As the practice of nursing and medicine becomes more preventative in nature and predictive in terms of patient care, successfully integrating and implementing proteomic research will become increasingly important, especially in the OR. It is imperative that perioperative nurses and researchers establish a collaborative process for specimen collection. Steps in establishing and maintaining a successful specimen collection program include implementing and evaluating a protocol, developing good communication, and keeping all participants up to date on the progress of the study. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

What characterizes the work culture at a hospital unit that successfully implements change - a correlation study.

PubMed

André, Beate; Sjøvold, Endre

2017-07-14

To successfully achieve change in healthcare, a balance between technology and "people ware", the human recourses, is necessary. However, the human aspect of the change implementation process has received less attention than the technological issues. The aim was to explore the factors that characterize the work culture in a hospital unit that successfully implemented change compared with the factors that characterize the work culture of a hospital unit with unsuccessful implementation. The Systematizing Person-Group Relations method was used for gathering and analyzing data to explore what dominate the behavior in a particular work environment identifying challenges, limitations and opportunities. This method applied six different dimensions, each representing different behavior in a work culture: Synergy, Withdrawal, Opposition, Dependence, Control and Nurture. We compared two different units at the same hospital, one that successfully implemented change and one that was unsuccessful. There were significant statistical differences between healthcare personnel working at a unit that successfully implemented change contrasted with the unit with unsuccessful implementation. These significant differences were found in both the synergy and control dimensions, which are important positive qualities in a work culture. The results of this study show that healthcare personnel at a unit with a successful implementation of change have a working environment with many positive qualities. This indicates that a work environment with a high focus on goal achievement and task orientation can handle the challenges of implementing changes.

A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

PubMed

MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

2017-04-01

Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

How organizational escalation prevention potential affects success of implementation of innovations: electronic medical records in hospitals.

PubMed

Lambooij, Mattijs S; Koster, Ferry

2016-05-20

Escalation of commitment is the tendency that (innovation) projects continue, even if it is clear that they will not be successful and/or become extremely costly. Escalation prevention potential (EPP), the capability of an organization to stop or steer implementation processes that do not meet their expectations, may prevent an organization of losing time and money on unsuccessful projects. EPP consists of a set of checks and balances incorporated in managerial practices that safeguard management against irrational (but very human) decisions and may limit the escalation of implementation projects. We study whether successful implementation of electronic medical records (EMRs) relates to EPP and investigate the organizational factors accounting for this relationship. Structural equation modelling (SEM), using questionnaire data of 427 doctors and 631 nurses who had experience with implementation and use of EMRs in hospitals, was applied to study whether formal governance and organizational culture mediate the relationship between EPP and the perceived added value of EMRs. Doctors and nurses in hospitals with more EPP report more successful implementation of EMR (in terms of perceived added value of the EMR). Formal governance mediates the relation between EPP and implementation success. We found no evidence that open or innovative culture explains the relationship between EPP and implementation success. There is a positive relationship between the level of EPP and perceived added value of EMRs. This relationship is explained by formal governance mechanisms of organizations. This means that management has a set of tangible tools to positively affect the success of innovation processes. However, it also means that management needs to be able to critically reflect on its (previous) actions and decisions and is willing to change plans if elements of EPP signal that the implementation process is hampered.

Principles of Successful Implementation of Lecture Recordings in Higher Education

ERIC Educational Resources Information Center

Ollermann, Frank; Rolf, Rüdiger; Greweling, Christian; Klaßen, André

2017-01-01

Purpose: This paper aims to describe the principles underlying the successful implementation of a lecture recording service in higher education. Design/methodology/approach: The paper qualitatively reviews the practices and experiences of several years of automated lecture recording at a medium-sized university in Germany. Findings: The paper…

Challenges to the successful implementation of 3-D sound

NASA Astrophysics Data System (ADS)

Begault, Durand R.

1991-11-01

The major challenges for the successful implementation of 3-D audio systems involve minimizing reversals, intracranially heard sound, and localization error for listeners. Designers of 3-D audio systems are faced with additional challenges in data reduction and low-frequency response characteristics. The relationship of the head-related transfer function (HRTF) to these challenges is shown, along with some preliminary psychoacoustic results gathered at NASA-Ames.

The successful implementation of STEM initiatives in lower income schools

NASA Astrophysics Data System (ADS)

Bakshi, Leena

The purpose of this study was to examine the leadership strategies utilized by superintendents, district administrators and school principals and the impact of these identified strategies on implementing STEM initiatives specifically for lower-income students. This study set out to determine (a) What role does district leadership play in the implementation of STEM initiatives in lower income secondary schools; (b) What internal systems of accountability exist in successful lower income secondary schools' STEM programs; (c) What leadership strategies are used to implement STEM curriculum initiatives; (d) How do school and district leadership support staff in order to achieve student engagement in STEM Initiative curriculum. This study used a mixed-methods approach to determine the impact of leadership strategies utilized by superintendents, district administrators and school principals on implementing STEM initiatives. Quantitative data analyzed survey questionnaires to determine the degree of correlation between the school districts that have demonstrated the successful implementation of STEM initiatives at the school and district levels. Qualitative data was collected using highly structured participant interviews and purposeful sampling of four district superintendents, one district-level administrator and five school leaders to capture the key strategies in implementing STEM initiatives in lower income secondary schools. Through the process of triangulation, the results of the study revealed that superintendents and principals should consider the characteristics of effective STEM initiatives that have shown a considerable degree of correlation with positive outcomes for lower income students. These included the leadership strategies of personnel's making decisions about the district's and school's instructional direction and an emphasis on the conceptual development of scientific principles using the Next Generation Science Standards coupled with the Common Core

Reaching Success through Involvement--Implementation Strategy for Creating and Maintaining Effective Schools.

ERIC Educational Resources Information Center

Furtwengler, Willis J.

The educational change strategy termed "reaching success through involvement" (RSI) has yielded promising results in creating school effectiveness. This paper analyzes the theoretical bases and practical applications of RSI strategy among 14 schools over an 8-year period. RSI theory assumes that educational organizations are dynamic social systems…

A regionally-adapted implementation of conservation agriculture delivers rapid improvements to soil properties associated with crop yield stability.

PubMed

Williams, Alwyn; Jordan, Nicholas R; Smith, Richard G; Hunter, Mitchell C; Kammerer, Melanie; Kane, Daniel A; Koide, Roger T; Davis, Adam S

2018-05-31

Climate models predict increasing weather variability, with negative consequences for crop production. Conservation agriculture (CA) may enhance climate resilience by generating certain soil improvements. However, the rate at which these improvements accrue is unclear, and some evidence suggests CA can lower yields relative to conventional systems unless all three CA elements are implemented: reduced tillage, sustained soil cover, and crop rotational diversity. These cost-benefit issues are important considerations for potential adopters of CA. Given that CA can be implemented across a wide variety of regions and cropping systems, more detailed and mechanistic understanding is required on whether and how regionally-adapted CA can improve soil properties while minimizing potential negative crop yield impacts. Across four US states, we assessed short-term impacts of regionally-adapted CA systems on soil properties and explored linkages with maize and soybean yield stability. Structural equation modeling revealed increases in soil organic matter generated by cover cropping increased soil cation exchange capacity, which improved soybean yield stability. Cover cropping also enhanced maize minimum yield potential. Our results demonstrate individual CA elements can deliver rapid improvements in soil properties associated with crop yield stability, suggesting that regionally-adapted CA may play an important role in developing high-yielding, climate-resilient agricultural systems.

Seven Elements Important to Successful Implementation of Early Literacy Intervention

ERIC Educational Resources Information Center

Foorman, Barbara; Dombek, Jennifer; Smith, Kevin

2016-01-01

The objective of this article is to describe seven elements important to successful implementation of early literacy intervention. The seven elements are drawn from research as well as from the authors' recent randomized controlled trial of effective early literacy interventions in kindergarten through second grade in 55 schools across Florida.…

Evaluating the Implementation of Performance Improvement Training: The E[superscript 3] Process for Success

ERIC Educational Resources Information Center

Larbi-Apau, Josephine A.; Moseley, James L.

2008-01-01

This article provides a comprehensive approach to careful review and evaluation of the implementation of performance training intervention. It discusses the E[superscript 3] process for success, a basic framework for evaluating the implementation phase of a training program implemented as a broad-based performance improvement strategy. The intent…

Key Attributes of a Successful Physician Order Entry System Implementation in a Multi-hospital Environment

PubMed Central

Ahmad, Asif; Teater, Phyllis; Bentley, Thomas D.; Kuehn, Lynn; Kumar, Rajee R.; Thomas, Andrew; Mekhjian, Hagop S.

2002-01-01

The benefits of computerized physician order entry have been widely recognized, although few institutions have successfully installed these systems. Obstacles to successful implementation are organizational as well as technical. In the spring of 2000, following a 4-year period of planning and customization, a 9-month pilot project, and a 14-month hiatus for year 2000, the Ohio State University Health System extensively implemented physician order entry across inpatient units. Implementation for specialty and community services is targeted for completion in 2002. On implemented units, all orders are processed through the system, with 80 percent being entered by physicians and the rest by nursing or other licensed care providers. The system is deployable across diverse clinical environments, focused on physicians as the primary users, and accepted by clinicians. These are the three criteria by which the authors measured the success of their implementation. They believe that the availability of specialty-specific order sets, the engagement of physician leadership, and a large-scale system implementation were key strategic factors that enabled physician-users to accept a physician order entry system despite significant changes in workflow. PMID:11751800

Effects of successive subculturing on stability, virulence, conidial yield, germination and shelf-life of entomopathogenic fungi.

PubMed

Ansari, M A; Butt, T M

2011-06-01

To determine the stability and conidial yield of two strains of the entomopathogenic fungus Metarhizium anisopliae and one strain of M. brunneum, being developed for the control of insect pests. The conidial yields and the shelf-life of the conidia of two commercially viable strains of M. anisopliae V275 (=F52) and ARSEF 4556 and one strain of M. brunneum (ARSEF 3297) were determined after harvesting conidia from in vitro subcultures on Sabouraud dextrose agar (SDA) and broken basmati rice. The strains were stable and showed no decline in virulence against Tenebrio molitor, even when subcultured successively 12 times on SDA. Conidia-bound Pr1 protease activity decreased in conidia harvested from SDA and mycosed cadavers after the 1st subculture, but increased in conidia produced on rice. The C:N ratio of conidia from mycosed cadavers was lower than that of conidia from rice or SDA. Irrespective of the number of subcultures, strain ARSEF 4556 produced significantly higher conidial yields than ARSEF 3297 and V275. The 12th subculture of V275 and ARSEF 3297 produced the lowest conidial yield. Shelf-life studies showed that conidia of strain ARSEF 4556 had a higher conidial viability than V275 and ARSEF 3297 after 4 months, stored at 4°C. The current study shows that determining strain stability and conidial yield through successive subculturing is an essential component for selecting the best strain for commercial purposes.   This is the first study to compare quality control parameters in the production of conidia on rice, and it shows that the level of Pr1 is comparatively high for inoculum produced on rice. © 2011 The Authors. Journal of Applied Microbiology © 2011 The Society for Applied Microbiology.

Success factors for implementation of the balanced scorecard in a NHS multi-agency setting.

PubMed

Radnor, Zoe; Lovell, Bill

2003-01-01

Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration. This paper then outlines some factors to be taken into account for "successful" BSC implementation in a NHS multi-agency setting. These findings emerged from a series of focus groups that took place with contributors drawn from all the key organisations within the Bradford Health Action Zone. Finally, this paper argues that if key criteria are met, successful implementation of the BSC may then proceed. However, "blind" BSC implementation without consideration of these factors may result in potential "failure".

Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

PubMed

Giva, Karen R N; Duma, Sinegugu E

2015-08-31

Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

An Exploration of Global Leadership Practices Implemented by Successful Higher Education Faculty Members

ERIC Educational Resources Information Center

Marshall, Vicki Lynn

2015-01-01

This qualitative research study explored global leadership practices implemented by higher education faculty members from eight different states in the U.S. who lead in a global environment. Four research questions guided the exploration of personal and scholarly practices that successful higher education faculty members implement. A purposeful,…

Examining Success Factors Related to ERP Implementations in Higher Education Shared Services Projects

ERIC Educational Resources Information Center

Stoyanoff, Dawn Galadriel Pfeiffer

2012-01-01

This study examined the enterprise resource planning (ERP) implementations that utilized a shared services model in higher education. The purpose of this research was to examine the critical success factors which were perceived to contribute to project success. This research employed a quantitative non-experimental correlational design and the…

Barriers to Successful Implementation of Technology Integration in Educational Settings: A Case Study

ERIC Educational Resources Information Center

Laferrière, T.; Hamel, C.; Searson, M.

2013-01-01

Representing issues discussed at the EduSummIT 2011 relative to essential conditions and barriers to successful technology integration, this article presents a systemic analysis of barriers that needed to be overcome for an information technology initiative (Remote Networked School project) to be successfully implemented. The analysis was…

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

A Method to Evaluate Critical Factors for Successful Implementation of Clinical Pathways.

PubMed

Dong, W; Huang, Z

2015-01-01

Clinical pathways (CPs) have been viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care. Despite widespread enthusiasm for CPs, research has shown that many CP initiatives are unsuccessful. To this end, this study provides a methodology to evaluate critical success factors (CSFs) that can aid healthcare organizations to achieve successful CP implementation. This study presents a new approach to evaluate CP implementation CSFs, with the aims being: (1) to identify CSFs for implementation of CPs through a comprehensive literature review and interviews with collaborative experts; (2) to use a filed study data with a robust fuzzy DEMATEL (the decision making trial and evaluation laboratory) approach to visualize the structure of complicated causal relationships between CSFs and obtain the influence level of these factors. The filed study data is provided by ten clinical experts of a Chinese hospital. 23 identified CSF factors which are initially identified through a review of the literature and interviews with collaborative experts. Then, a number of direct and indirect relationships are derived from the data such that different perceptions can be integrated into a compromised cause and effect model of CP implementation. The results indicate that the proposed approach can systematically evaluate CSFs and realize the importance of each factor such that the most common causes of failure of CP implementation could be eliminated or avoided. Therefore, the tool proposed would help healthcare organizations to manage CP implementation in a more effective and proactive way.

Early access programs: Benefits, challenges, and key considerations for successful implementation

PubMed Central

Patil, Sanjaykumar

2016-01-01

Early access programs, (EAPs) are adopted by an increasing number of pharma companies due to several benefits offered by these programs. EAPs offer ethical, compliant, and controlled mechanisms of access to investigational drugs outside of the clinical trial space and before the commercial launch of the drug, to patients with life-threatening diseases having no treatment options available. In addition to the development of positive relationships with key opinion leaders (KOL), patients, advocacy groups and regulators, the data captured from the implementation of EAPs supports in the formulation of global commercialization strategies. This white paper outlines various circumstances to be considered for the implementation of EAPs named patient programs, the regulatory landscape, the benefits and challenges associated with implementing these programs and the key considerations for their successful implementation. PMID:26955570

Enhancing Professional Self-Efficacy: Factors Contributing to Successful Implementation of Articulated Workplace Intentions

ERIC Educational Resources Information Center

Kile, Kimberly S.

2012-01-01

Competency-based education programs foster participants' abilities to perform or implement a skill taught within the curriculum. A competency-based course enhances a participant's professional self-efficacy by imparting in them the confidence to successfully implement one or more of the skills taught within the course. The Career…

Implementation Fidelity in Community-Based Interventions

PubMed Central

Breitenstein, Susan M.; Gross, Deborah; Garvey, Christine; Hill, Carri; Fogg, Louis; Resnick, Barbara

2012-01-01

Implementation fidelity is the degree to which an intervention is delivered as intended and is critical to successful translation of evidence-based interventions into practice. Diminished fidelity may be why interventions that work well in highly controlled trials may fail to yield the same outcomes when applied in real life contexts. The purpose of this paper is to define implementation fidelity and describe its importance for the larger science of implementation, discuss data collection methods and current efforts in measuring implementation fidelity in community-based prevention interventions, and present future research directions for measuring implementation fidelity that will advance implementation science. PMID:20198637

High School Principals' Rating of Success in Implementation of 21st Century Skills

ERIC Educational Resources Information Center

Sam, Sonn

2011-01-01

The purpose of this quantitative study was to investigate how Rhode Island high school principals rate success in implementing 21st century skills in their schools. Secondly, this study investigated how high school principals rate the influence of implementing of 21st century skills in curriculum and instruction in their schools. The high…

Obstacles and Successes in Implementing the ASCA National Model in Schools

ERIC Educational Resources Information Center

Studer, Jeannine R.; Diambra, Joel F.; Breckner, John A.; Heidel, R. Eric

2011-01-01

Researchers surveyed CACREP school counseling program graduates from a southeastern university to explore successes and barriers in implementing a comprehensive, developmental school counseling program. Findings included significant differences across school levels in programmatic change (p less than 0.001) and responsive services (p = 0.041).…

Obstacles to Successful Implementation of eHealth Applications into Clinical Practice.

PubMed

Voogt, Marianne P; Opmeer, Brent C; Kastelein, Arnoud W; Jaspers, Monique W M; Peute, Linda W

2018-01-01

eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.

User acceptability--a critical success factor for picture archiving and communication system implementation.

PubMed

Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

2000-05-01

The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

Fire fighters as basic life support responders: a study of successful implementation.

PubMed

Høyer, Christian Bjerre; Christensen, Erika Frischknecht

2009-04-02

First responders are recommended as a supplement to the Emergency Medical Services (EMS) in order to achieve early defibrillation. Practical and organisational aspects are essential when trying to implement new parts in the "Chain of Survival"; areas to address include minimizing dispatch time, ensuring efficient and quick communication, and choosing areas with appropriate driving distances. The aim of this study was to implement a system using Basic Life Support (BLS) responders equipped with an automatic external defibrillator in an area with relatively short emergency medical services' response times. Success criteria for implementation was defined as arrival of the BLS responders before the EMS, attachment (and use) of the AED, and successful defibrillation. This was a prospective observational study from September 1, 2005 to December 31, 2007 (28 months) in the city of Aarhus, Denmark. The BLS responder system was implemented in an area up to three kilometres (driving distance) from the central fire station, encompassing approximately 81,500 inhabitants. The team trained on each shift and response times were reduced by choice of area and by sending the alarm directly to the fire brigade dispatcher. The BLS responders had 1076 patient contacts. The median response time was 3.5 minutes (25th percentile 2.75, 75th percentile 4.25). The BLS responders arrived before EMS in 789 of the 1076 patient contacts (73%). Cardiac arrest was diagnosed in 53 cases, the AED was attached in 29 cases, and a shockable rhythm was detected in nine cases. Eight were defibrillated using an AED. Seven of the eight obtained return of spontaneous circulation (ROSC). Six of the seven obtaining ROSC survived more than 30 days. In this study, the implementation of BLS responders may have resulted in successful resuscitations. On basis of the close corporation between all participants in the chain of survival this project contributed to the first link: short response time and trained

Fire fighters as basic life support responders: A study of successful implementation

PubMed Central

Høyer, Christian Bjerre; Christensen, Erika Frischknecht

2009-01-01

Background First responders are recommended as a supplement to the Emergency Medical Services (EMS) in order to achieve early defibrillation. Practical and organisational aspects are essential when trying to implement new parts in the "Chain of Survival"; areas to address include minimizing dispatch time, ensuring efficient and quick communication, and choosing areas with appropriate driving distances. The aim of this study was to implement a system using Basic Life Support (BLS) responders equipped with an automatic external defibrillator in an area with relatively short emergency medical services' response times. Success criteria for implementation was defined as arrival of the BLS responders before the EMS, attachment (and use) of the AED, and successful defibrillation. Methods This was a prospective observational study from September 1, 2005 to December 31, 2007 (28 months) in the city of Aarhus, Denmark. The BLS responder system was implemented in an area up to three kilometres (driving distance) from the central fire station, encompassing approximately 81,500 inhabitants. The team trained on each shift and response times were reduced by choice of area and by sending the alarm directly to the fire brigade dispatcher. Results The BLS responders had 1076 patient contacts. The median response time was 3.5 minutes (25th percentile 2.75, 75th percentile 4.25). The BLS responders arrived before EMS in 789 of the 1076 patient contacts (73%). Cardiac arrest was diagnosed in 53 cases, the AED was attached in 29 cases, and a shockable rhythm was detected in nine cases. Eight were defibrillated using an AED. Seven of the eight obtained return of spontaneous circulation (ROSC). Six of the seven obtaining ROSC survived more than 30 days. Conclusion In this study, the implementation of BLS responders may have resulted in successful resuscitations. On basis of the close corporation between all participants in the chain of survival this project contributed to the first link

Successful implementation of clinical practice guidelines for pressure risk management in a home nursing setting.

PubMed

Kapp, Suzanne

2013-10-01

This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines for the Prediction and Prevention of Pressure Ulcers. In 2007 a pilot study was conducted. Nurse perspectives (n=21) were obtained via survey and a client profile (n=218) was generated. Audit of the uptake and continued use of the pressure risk screening tool, during the pilot study and later once implemented as standard practice organizational wide, was conducted. Nurses at the pilot site successfully implemented the practice guidelines, pressure risk screening was adopted and supporting resources were well received. Most clients were at low risk of pressure ulcer development. The pilot site maintained and extended their pilot study success, ensuring more than 90% of clients were screened for pressure risk over the 18 months which followed. All other sites performed less well initially, however subsequently improved, meeting the pilot sites success after 18 months. Two years later, the organization continues to screen more than 90% of all clients for pressure risk. Implementation of clinical practice guidelines was successful in the pilot project and pressure risk screening became a well-adopted practice. Success continued following organizational wide implementation. Pilot study findings suggest it may be prudent to monitor the pressure ulcer risk status of low risk clients so as to prevent increasing risk and pressure ulcer development among this group. © 2012 John Wiley & Sons Ltd.

Towards a successful clinical implementation of fluorescence-guided surgery.

PubMed

Snoeks, T J A; van Driel, P B A A; Keereweer, S; Aime, S; Brindle, K M; van Dam, G M; Löwik, C W G M; Ntziachristos, V; Vahrmeijer, A L

2014-04-01

During the European Molecular Imaging Meeting (EMIM) 2013, the fluorescence-guided surgery study group held its inaugural session to discuss the clinical implementation of fluorescence-guided surgery. The general aim of this study group is to discuss and identify the steps required to successfully and safely bring intraoperative fluorescence imaging to the clinics. The focus group intends to use synergies between interested groups as a tool to address regulatory and implementation hurdles in Europe and operates within the intraoperative focus group of the World Molecular Imaging Society (WMIS) that promotes the same interests at the WMIS level. The major topics on the critical path of implementation identified within the study group were quality controls and standards for ensuring accurate imaging and the ability to compare results from different studies, regulatory affairs, and strategies to increase awareness among physicians, regulators, insurance companies, and a broader audience. These hurdles, and the possible actions discussed to overcome them, are summarized in this report. Furthermore, a number of recommendations for the future shape of the fluorescence-guided study group are discussed. A main driving conclusion remains that intraoperative imaging has great clinical potential and that many of the solutions required are best addressed with the community working together to optimally promote and accelerate the clinical implementation of fluorescence imaging towards improving surgical procedures.

Health information exchange implementation: lessons learned and critical success factors from a case study.

PubMed

Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

Health Information Exchange Implementation: Lessons Learned and Critical Success Factors From a Case Study

PubMed Central

2014-01-01

Background Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. Objective The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. Methods We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders’ perspectives across technical, organizational, and governance dimensions. Results Several challenges, successes, and lessons learned during the

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

PubMed Central

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

2017-01-01

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

Designing Successful Professional Meetings and Conferences in Education: Planning, Implementation, and Evaluation.

ERIC Educational Resources Information Center

Mundry, Susan; Britton, Edward; Raizen, Senta; Loucks-Horsley, Susan

This book outlines the principles of planning, implementing, and evaluating successful professional meetings and conferences in education. The following are among the topics discussed: (1) the knowledge base of effective meetings and conferences (nine principles held by effective meeting designers; characteristics of effective meetings and…

Task-selective memory effects for successfully implemented encoding strategies.

PubMed

Leshikar, Eric D; Duarte, Audrey; Hertzog, Christopher

2012-01-01

Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies--visual imagery and sentence generation--facilitate memory through the production of different types of mediators (e.g., mental images and sentences). Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator). It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences) for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness) of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study.

Task-Selective Memory Effects for Successfully Implemented Encoding Strategies

PubMed Central

Leshikar, Eric D.; Duarte, Audrey; Hertzog, Christopher

2012-01-01

Previous behavioral evidence suggests that instructed strategy use benefits associative memory formation in paired associate tasks. Two such effective encoding strategies–visual imagery and sentence generation–facilitate memory through the production of different types of mediators (e.g., mental images and sentences). Neuroimaging evidence suggests that regions of the brain support memory reflecting the mental operations engaged at the time of study. That work, however, has not taken into account self-reported encoding task success (i.e., whether participants successfully generated a mediator). It is unknown, therefore, whether task-selective memory effects specific to each strategy might be found when encoding strategies are successfully implemented. In this experiment, participants studied pairs of abstract nouns under either visual imagery or sentence generation encoding instructions. At the time of study, participants reported their success at generating a mediator. Outside of the scanner, participants further reported the quality of the generated mediator (e.g., images, sentences) for each word pair. We observed task-selective memory effects for visual imagery in the left middle occipital gyrus, the left precuneus, and the lingual gyrus. No such task-selective effects were observed for sentence generation. Intriguingly, activity at the time of study in the left precuneus was modulated by the self-reported quality (vividness) of the generated mental images with greater activity for trials given higher ratings of quality. These data suggest that regions of the brain support memory in accord with the encoding operations engaged at the time of study. PMID:22693593

Successful Implementation Factors for Using Computers in Iranian Schools during One Decade (1995-2005)

ERIC Educational Resources Information Center

Zamani, Bibi Eshrat

2010-01-01

The main purpose of this paper is to identify factors and conditions that are important for successful implementation of computers in Iranian schools during one decade from 1995 to 2005. The second focus of this paper is to examine how these factors relate to models of implementation in other countries such as developed countries. This paper is…

Implementation of clinical governance in hospitals: challenges and the keys for success.

PubMed

Mousavi, Seyed Mohammad Hadi; Agharahimi, Zahra; Daryabeigi, Maede; Rezaei, Nima

2014-01-01

There is a number of models and strategies for improving the quality of care such as total quality management, continuous quality improvement and clinical governance. The policy of clinical governance is part of the governments overall strategy for monitoring, assuring and improving in the national health services organization. Clinical governance has been introduced as a bridge between managerial and clinical approaches to quality. For successful implementing of clinical governance, it is necessary to pay attention to firm foundations of the structure, including equipment, staffing arrangement, supporting specialties, and staff training. Therefore, as clinical governance improves safety and quality in health care services, the current situation in hospitals should be evaluated before any intervention while barriers and blocks on structure and process should be determined to select a method for changing them. Considering these points could guarantee success in implementation of clinical governance; otherwise there would be a little chance to achieve the desired results despite consumption of plenty of time and huge paper works.

Safe and successful implementation of CPOE for chemotherapy at a children's cancer center.

PubMed

Hoffman, James M; Baker, Donald K; Howard, Scott C; Laver, Joseph H; Shenep, Jerry L

2011-02-01

Computerized prescriber order entry (CPOE) for medications has been implemented in only approximately 1 in 6 United States hospitals, with CPOE for chemotherapy lagging behind that for nonchemotherapy medications. The high risks associated with chemotherapy combined with other aspects of cancer care present unique challenges for the safe and appropriate use of CPOE. This article describes the process for safe and successful implementation of CPOE for chemotherapy at a children's cancer center. A core principle throughout the development and implementation of this system was that it must be as safe (and eventually safer) as existing paper systems and processes. The history of requiring standardized, regimen-specific, preprinted paper order forms served as the foundation for safe implementation of CPOE for chemotherapy. Extensive use of electronic order sets with advanced functionality; formal process redesign and system analysis; automated clinical decision support; and a phased implementation approach were essential strategies for safe implementation of CPOE. With careful planning and adequate resources, CPOE for chemotherapy can be safely implemented.

Modeling antecedents of electronic medical record system implementation success in low-resource setting hospitals.

PubMed

Tilahun, Binyam; Fritz, Fleur

2015-08-01

With the increasing implementation of Electronic Medical Record Systems (EMR) in developing countries, there is a growing need to identify antecedents of EMR success to measure and predict the level of adoption before costly implementation. However, less evidence is available about EMR success in the context of low-resource setting implementations. Therefore, this study aims to fill this gap by examining the constructs and relationships of the widely used DeLone and MacLean (D&M) information system success model to determine whether it can be applied to measure EMR success in those settings. A quantitative cross sectional study design using self-administered questionnaires was used to collect data from 384 health professionals working in five governmental hospitals in Ethiopia. The hospitals use a comprehensive EMR system since three years. Descriptive and structural equation modeling methods were applied to describe and validate the extent of relationship of constructs and mediating effects. The findings of the structural equation modeling shows that system quality has significant influence on EMR use (β = 0.32, P < 0.05) and user satisfaction (β = 0.53, P < 0.01); information quality has significant influence on EMR use (β = 0.44, P < 0.05) and user satisfaction (β = 0.48, P < 0.01) and service quality has strong significant influence on EMR use (β = 0.36, P < 0.05) and user satisfaction (β = 0.56, P < 0.01). User satisfaction has significant influence on EMR use (β = 0.41, P < 0.05) but the effect of EMR use on user satisfaction was not significant. Both EMR use and user satisfaction have significant influence on perceived net-benefit (β = 0.31, P < 0.01; β = 0.60, P < 0.01), respectively. Additionally, computer literacy was found to be a mediating factor in the relationship between service quality and EMR use (P < 0.05) as well as user satisfaction (P < 0.01). Among all the

School Culture Benchmarks: Bridges and Barriers to Successful Bullying Prevention Program Implementation

ERIC Educational Resources Information Center

Coyle, H. Elizabeth

2008-01-01

A substantial body of research indicates that positive school culture benchmarks are integrally tied to the success of school reform and change in general. Additionally, an emerging body of research suggests a similar role for school culture in effective implementation of school violence prevention and intervention efforts. However, little…

On implementing maximum economic yield in commercial fisheries

PubMed Central

Dichmont, C. M.; Pascoe, S.; Kompas, T.; Punt, A. E.; Deng, R.

2009-01-01

Economists have long argued that a fishery that maximizes its economic potential usually will also satisfy its conservation objectives. Recently, maximum economic yield (MEY) has been identified as a primary management objective for Australian fisheries and is under consideration elsewhere. However, first attempts at estimating MEY as an actual management target for a real fishery (rather than a conceptual or theoretical exercise) have highlighted some substantial complexities generally unconsidered by fisheries economists. Here, we highlight some of the main issues encountered in our experience and their implications for estimating and transitioning to MEY. Using a bioeconomic model of an Australian fishery for which MEY is the management target, we note that unconstrained optimization may result in effort trajectories that would not be acceptable to industry or managers. Different assumptions regarding appropriate constraints result in different outcomes, each of which may be considered a valid MEY. Similarly, alternative treatments of prices and costs may result in differing estimates of MEY and their associated effort trajectories. To develop an implementable management strategy in an adaptive management framework, a set of assumptions must be agreed among scientists, economists, and industry and managers, indicating that operationalizing MEY is not simply a matter of estimating the numbers but requires strong industry commitment and involvement. PMID:20018676

Business process re-engineering in the logistics industry: a study of implementation, success factors, and performance

NASA Astrophysics Data System (ADS)

Shen, Chien-wen; Chou, Ching-Chih

2010-02-01

As business process re-engineering (BPR) is an important foundation to ensure the success of enterprise systems, this study would like to investigate the relationships among BPR implementation, BPR success factors, and business performance for logistics companies. Our empirical findings show that BPR companies outperformed non-BPR companies, not only on information processing, technology applications, organisational structure, and co-ordination, but also on all of the major logistics operations. Comparing the different perceptions of the success factors for BPR, non-BPR companies place greater emphasis on the importance of employee involvement while BPR companies are more concerned about the influence of risk management. Our findings also suggest that management attitude towards BPR success factors could affect performance with regard to technology applications and logistics operations. Logistics companies which have not yet implemented the BPR approach could refer to our findings to evaluate the advantages of such an undertaking and to take care of those BPR success factors affecting performance before conducting BPR projects.

From Project Management Capabilities to ERP Implementation Success: The Mediating Effect of IT Executives' Capabilities

ERIC Educational Resources Information Center

Touir, Maatallah

2016-01-01

Enterprise resource planning project implementation success is necessary for organizations to enhance productivity and achieve operational efficiency; however, the failure rates of ERP projects remain high, ranging between 10% and 90%, and costing organizations $500,000 to $300 million. The problem addressed in this study was the low success rate…

Leadership, Control, Communication and Comprehension: Key Factors in Successful Implementation of SBDM.

ERIC Educational Resources Information Center

Etheridge, Carol Plata; And Others

This study examines the effects of principal leadership styles on the development of the working styles of seven local school councils in Memphis (Tennessee) during their first 15 months of operation. The successful implementation of a school-based decision making (SBDM) management model depends upon the ability of the local school council to…

Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success.

PubMed

Rangachari, Pavani

2018-01-01

In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as "innovation implementation failure" in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the "what"), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the "how"). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and sustainability of health

Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project.

PubMed

Skoien, Wade; Page, Katie; Parsonage, William; Ashover, Sarah; Milburn, Tanya; Cullen, Louise

2016-10-12

The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it

Using the "customer service framework" to successfully implement patient- and family-centered care.

PubMed

Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

2011-01-01

Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.

Ethical budgets: a critical success factor in implementing new public management accountability in health care.

PubMed

Bosa, Iris M

2010-05-01

New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

Innovation Implementation in the Context of Hospital QI: Lessons Learned and Strategies for Success

PubMed Central

Rangachari, Pavani

2018-01-01

In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care. Circa 2009, nearly a decade after the release of the IOM report, the health care organizational literature began referring to this challenge as “innovation implementation failure” in health care organizations (HCOs), ie, failure to implement an evidence-based practice that is new to a HCO. This stream of literature drew upon management research to explain why innovation implementation failure occurs in HCOs and what could be done to prevent it. This paper conducts an integrative review of the literature on “innovation implementation” in hospitals and health systems over the last decade, since the spotlight was cast on “innovation implementation failure” in HCOs. The review reveals that while some studies have retrospectively sought to identify the key drivers of innovation implementation, through surveys and interviews of practitioners (the “what”), other studies have prospectively sought to understand how innovation implementation occurs in hospitals and health systems (the “how”). Both make distinctive contributions to identifying strategies for success in innovation implementation. While retrospective studies have helped identify the key drivers of innovation implementation, prospective studies have shed light on how these drivers could be attained, thereby helping to develop context-sensitive management strategies for success. The literature has called for more prospective research on the implementation and

Success criteria for electronic medical record implementations in low-resource settings: a systematic review.

PubMed

Fritz, Fleur; Tilahun, Binyam; Dugas, Martin

2015-03-01

Electronic medical record (EMR) systems have the potential of supporting clinical work by providing the right information at the right time to the right people and thus make efficient use of resources. This is especially important in low-resource settings where reliable data are also needed to support public health and local supporting organizations. In this systematic literature review, our objectives are to identify and collect literature about success criteria of EMR implementations in low-resource settings and to summarize them into recommendations. Our search strategy relied on PubMed queries and manual bibliography reviews. Studies were included if EMR implementations in low-resource settings were described. The extracted success criteria and measurements were summarized into 7 categories: ethical, financial, functionality, organizational, political, technical, and training. We collected 381 success criteria with 229 measurements from 47 articles out of 223 articles. Most papers were evaluations or lessons learned from African countries, published from 1999 to 2013. Almost half of the EMR systems served a specific disease area like human immunodeficiency virus (HIV). The majority of criteria that were reported dealt with the functionality, followed by organizational issues, and technical infrastructures. Sufficient training and skilled personnel were mentioned in roughly 10%. Political, ethical, and financial considerations did not play a predominant role. More evaluations based on reliable frameworks are needed. Highly reliable data handling methods, human resources and effective project management, as well as technical architecture and infrastructure are all key factors for successful EMR implementation. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

ERIC Educational Resources Information Center

Patiño, Israel

2015-01-01

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

Content validity of critical success factors for e-Government implementation in Indonesia

NASA Astrophysics Data System (ADS)

Napitupulu, D.; Syafrullah, M.; Rahim, R.; Amar, A.; Sucahyo, YG

2018-05-01

The purpose of this research is to validate the Critical Success Factors (CSFs) of e-Government implementation in Indonesia. The e-Government initiative conducted only to obey the regulation but ignoring the quality. Defining CSFs will help government agencies to avoid failure of e-Government projects. A survey with the questionnaire was used to validate the item of CSF based on expert judgment through two round of Delphi. The result showed from 67 subjects in instrument tested; there are 11 invalid items deleted and remain only 56 items that had good content validity and internal reliability. Therefore, all 56 CSFs should be adopted by government agencies in Indonesia to support e-Government implementation.

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation

PubMed Central

McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-01-01

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. PMID:28882812

Success in health information exchange projects: solving the implementation puzzle.

PubMed

Sicotte, Claude; Paré, Guy

2010-04-01

Interest in health information exchange (HIE), defined as the use of information technology to support the electronic transfer of clinical information across health care organizations, continues to grow among those pursuing greater patient safety and health care accessibility and efficiency. In this paper, we present the results of a longitudinal multiple-case study of two large-scale HIE implementation projects carried out in real time over 3-year and 2-year periods in Québec, Canada. Data were primarily collected through semi-structured interviews (n=52) with key informants, namely implementation team members and targeted users. These were supplemented with non-participants observation of team meetings and by the analysis of organizational documents. The cross-case comparison was particularly relevant given that project circumstances led to contrasting outcomes: while one project failed, the other was a success. A risk management analysis was performed taking a process view in order to capture the complexity of project implementations as evolving phenomena that are affected by interdependent pre-existing and emergent risks that tend to change over time. The longitudinal case analysis clearly demonstrates that the risk factors were closely intertwined. Systematic ripple effects from one risk factor to another were observed. This risk interdependence evolved dynamically over time, with a snowball effect that rendered a change of path progressively more difficult as time passed. The results of the cross-case analysis demonstrate a direct relationship between the quality of an implementation strategy and project outcomes. Copyright 2010 Elsevier Ltd. All rights reserved.

The factors affecting Nigeria's success toward implementation of global public health priorities.

PubMed

Echebiri, Vitalis C

2015-06-01

This paper examines the challenges facing the Nigerian government toward the implementation of global public health priories. The Nigerian government recognizes the need to implement these priorities by putting in place the necessary policy framework, but political instability, poor infrastructural development and inadequate funding have remained barriers toward the achievement of success in implementing these priorities. The rest of the paper elucidates the fact that despite leadership and influence from the World Health Organization and other United Nations agencies, and some responses from the Nigerian government, tackling these public health problems requires much more fundamental reform to primary health services and a reduction in poverty. Although the government has shown enough political will to tackle these problems, it is expected that a better result will be achieved through injecting more funds into the Nigerian health sector, and deploying astute health administrators to manage the sector rather than pure health professionals without managerial acumen. © The Author(s) 2014.

Lessons for Implementation from the World's Most Successful Programme: The Global Eradication of Smallpox.

ERIC Educational Resources Information Center

Pratt, David

1999-01-01

Focuses on lessons educators might learn from the Intensified Campaign for the Global Eradication of Smallpox. Outlines the history of smallpox eradication. Discusses the eradication effort's obstacles, campaign, and costs and benefits. Considers five factors relevant to the successful implementation of educational programs. (CMK)

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

PubMed

Nikula, R E

1999-01-01

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

Developing and validating a model to predict the success of an IHCS implementation: the Readiness for Implementation Model.

PubMed

Wen, Kuang-Yi; Gustafson, David H; Hawkins, Robert P; Brennan, Patricia F; Dinauer, Susan; Johnson, Pauley R; Siegler, Tracy

2010-01-01

To develop and validate the Readiness for Implementation Model (RIM). This model predicts a healthcare organization's potential for success in implementing an interactive health communication system (IHCS). The model consists of seven weighted factors, with each factor containing five to seven elements. Two decision-analytic approaches, self-explicated and conjoint analysis, were used to measure the weights of the RIM with a sample of 410 experts. The RIM model with weights was then validated in a prospective study of 25 IHCS implementation cases. Orthogonal main effects design was used to develop 700 conjoint-analysis profiles, which varied on seven factors. Each of the 410 experts rated the importance and desirability of the factors and their levels, as well as a set of 10 different profiles. For the prospective 25-case validation, three time-repeated measures of the RIM scores were collected for comparison with the implementation outcomes. Two of the seven factors, 'organizational motivation' and 'meeting user needs,' were found to be most important in predicting implementation readiness. No statistically significant difference was found in the predictive validity of the two approaches (self-explicated and conjoint analysis). The RIM was a better predictor for the 1-year implementation outcome than the half-year outcome. The expert sample, the order of the survey tasks, the additive model, and basing the RIM cut-off score on experience are possible limitations of the study. The RIM needs to be empirically evaluated in institutions adopting IHCS and sustaining the system in the long term.

Yield of prolonged wireless pH monitoring in achalasia patients successfully treated with pneumatic dilation

PubMed Central

Franchina, Marianna; Elvevi, Alessandra; Pugliese, Delia; Tenca, Andrea; Conte, Dario; Penagini, Roberto

2016-01-01

Background Gastro-oesophageal reflux disease (GORD) is a long-term complication of achalasia treatments. The aim of our study was to evaluate the yield of prolonged wireless pH monitoring in patients with successfully treated achalasia and its influence on proton pump inhibitor (PPI) use. Methods Twenty-five patients with achalasia who underwent prolonged wireless pH monitoring after a successful treatment with pneumatic dilation were enrolled. pH variables were analysed in the first 24 hours of monitoring to determine if tracings were indicative of GORD; the same variables were analysed in the following 24-hour period in order to obtain a worst-day diagnosis of GORD. PPI therapy before and after the test was recorded. Results Five out of 25 patients had GORD diagnosis during the first day of monitoring and four of them had oesophagitis at endoscopy. During the following days of monitoring four more patients had a diagnosis of GORD. Out of the 25 patients, PPIs were started after the test in six asymptomatic GORD-positive ones, whereas prescription of PPIs was stopped without detrimental effect on symptoms in three GORD-negative patients. Conclusions Prolonged wireless pH monitoring is a useful test to be added to endoscopy in order to evaluate GORD and to optimise antisecretory treatment in successfully treated achalasia patients. PMID:29026592

The VOICES/VOCES success story: effective strategies for training, technical assistance and community-based organization implementation.

PubMed

Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

2006-08-01

The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a comprehensive and user-friendly intervention kit, comprising (a) an implementationmanual and othermaterials necessary for conducting the intervention (b) a Training of Facilitators (TOF) curriculum used to teach agency staff how to implement the EBI in their setting, (c) a network of expert trainers who attend a training institute to become adept at using the TOF curriculum to train facilitators, (d) a comprehensive training coordination center to plan and deliver TOF trainings, (e) proactive technical assistance to trainers, and (f) post-TOF technical assistance for local implementers. This article reports on those strategies and a local CBO's successful participation in DEBI, resulting implementation of VOICES/VOCES, with unique approaches to adaptation and tailoring.

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation.

PubMed

Yen, Po-Yin; McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-09-07

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. ©Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 07.09.2017.

Job sharing in clinical nutrition management: a plan for successful implementation.

PubMed

Visocan, B J; Herold, L S; Mulcahy, M J; Schlosser, M F

1993-10-01

While women continue to enter the American work force in record numbers; many experience difficulty in juggling career and family obligations. Flexible scheduling is one option used to ease work and family pressures. Women's changing work roles have potentially noteworthy implications for clinical nutrition management, a traditionally female-dominated profession where the recruitment and retention of valued, experienced registered dietitians can prove to be a human resources challenge. Job sharing, one type of flexible scheduling, is applicable to the nutrition management arena. This article describes and offers a plan for overcoming obstacles to job sharing, including determining feasibility, gaining support of top management, establishing program design, announcing the job share program, and using implementation, monitoring, and fine-tuning strategies. Benefits that can be derived from a successful job share are reduced absenteeism, decreased turnover, enhanced recruitment, improved morale, increased productivity, improved job coverage, and enhanced skills and knowledge base. A case study illustrates one method for achieving job sharing success in clinical nutrition management.

Implementation of a successful on-call system in clinical chemistry.

PubMed

Hobbs, G A; Jortani, S A; Valdes, R

1997-11-01

Successful practice of clinical pathology depends on a wide variety of laboratory, clinical, and managerial decisions. The skills needed to make these decisions can most effectively be learned by residents and fellows in pathology using a service-oriented on-call approach. We report our experience implementing an on-call system in the clinical chemistry laboratory at the University of Louisville Hospital (Ky). We detail the guidelines used to establish this system and the elements required for its successful implementation. The system emphasizes a laboratory-initiated approach to linking laboratory results to patient care. From inception of the program during late 1990 through 1995, the number of beeper calls (including clinician contacts) steadily increased and is currently 8 to 20 per week. The on-call system is active 24 hours per day, 7 days per week, thus representing activity on all three laboratory shifts. Types of responses were separated into administrative (12%), analytical (42%), clinical (63%), quality control or quality assurance (12%), and consultation (13%) categories. We also present 6 case reports as examples demonstrating multiple elements in these categories. In 23% of the calls, clinician contact was required and achieved by the fellow or resident on call for the laboratory. The on-call reports are documented and presented informally at weekly on-call report sessions. Emphasis is placed on learning and refinement of investigative skills needed to function as an effective laboratory director. Educational emphasis for the medical staff is in establishing awareness of the presence of the laboratory as an important interactive component of patient care. In addition, we found this program to be beneficial to the hospital and to the department of pathology in fulfilling its clinical service and teaching missions. Our experience may be helpful to other institutions establishing such a program.

SU-F-P-04: Implementation of Dose Monitoring Software: Successes and Pitfalls

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

Och, J

2016-06-15

Purpose: to successfully install a dose monitoring software (DMS) application to assist in CT protocol and dose management. Methods: Upon selecting the DMS, we began our implementation of the application. A working group composed of Medical Physics, Radiology Administration, Information Technology, and CT technologists was formed. On-site training in the application was supplied by the vendor. The decision was made to apply the process for all the CT protocols on all platforms at all facilities. Protocols were painstakingly mapped to the correct masters, and the system went ‘live’. Results: We are routinely using DMS as a tool in our Clinicalmore » Performance CT QA program. It is useful in determining the effectiveness of revisions to existing protocols, and establishing performance baselines for new units. However, the implementation was not without difficulty. We identified several pitfalls and obstacles which frustrated progress. Including: Training deficiencies, Nomenclature problems, Communication, DICOM variability. Conclusion: Dose monitoring software can be a potent tool for QA. However, implementation of the program can be problematic and requires planning, organization and commitment.« less

Quantifying potential yield and water-limited yield of summer maize in the North China Plain

NASA Astrophysics Data System (ADS)

Jiang, Mingnuo; Liu, Chaoshun; Chen, Maosi

2017-09-01

The North China Plain is a major food producing region in China, and climate change could pose a threat to food production in the region. Based on China Meteorological Forcing Dataset, simulating the growth of summer maize in North China Plain from 1979 to 2015 with the regional implementation of crop growth model WOFOST. The results showed that the model can reflect the potential yield and water-limited yield of Summer Maize in North China Plain through the calibration and validation of WOFOST model. After the regional implementation of model, combined with the reanalysis data, the model can better reproduce the regional history of summer maize yield in the North China Plain. The yield gap in Southeastern Beijing, southern Tianjin, southern Hebei province, Northwestern Shandong province is significant, these means the water condition is the main factor to summer maize yield in these regions.

Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

PubMed

Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

2017-05-01

Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

Comprehensive Cost Planning Yields Successful Tech Projects

ERIC Educational Resources Information Center

Breeding, Marshall

2006-01-01

In this article, the author calls for librarians to find ways to implement technology projects with very limited budgets and to consider all the cost components of a technology project amidst the economic pressures. The author offers some perspective on what is involved in trying to accomplish important work with limited resources while…

Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses

PubMed Central

2011-01-01

Background Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. This study evaluated the implementation, technical assistance, and perceived impact of a model curriculum ("Learning About Healthy Living") to promote wellness and motivation to quit tobacco use in psychosocial rehabilitation clubhouses. Methods We used semi-structured interviews (n = 9) with clubhouse staff (n = 12) and a survey of participating clubhouse members (n = 271) in nine clubhouses. Results Fifty-eight percent of clubhouse participants completed surveys. Results showed tobacco users open to tobacco-free policies (62%) and perceiving more discussions about quitting tobacco with healthcare providers (69%). Analyses of staff interviews and member surveys revealed four key themes: (1) the curriculum was successfully implemented and appreciated; (2) technical assistance kept implementation on track; (3) adding wellness content and interactive components should enhance the curriculum; and, (4) the curriculum advanced other healthful policies and practices. Conclusions Mental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur. PMID:21917179

Measuring Link-Resolver Success: Comparing 360 Link with a Local Implementation of WebBridge

ERIC Educational Resources Information Center

Herrera, Gail

2011-01-01

This study reviewed link resolver success comparing 360 Link and a local implementation of WebBridge. Two methods were used: (1) comparing article-level access and (2) examining technical issues for 384 randomly sampled OpenURLs. Google Analytics was used to collect user-generated OpenURLs. For both methods, 360 Link out-performed the local…

State experiences implementing youth sports concussion laws: challenges, successes, and lessons for evaluating impact.

PubMed

Lowrey, Kerri McGowan; Morain, Stephanie R

2014-01-01

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws' impacts and the development of future public health laws. We conducted key-informant interviews in 35 states with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws' provisions and to identify successful legal approaches to protecting young athletes. © 2014 American Society of Law, Medicine & Ethics, Inc.

Successful implementation of property cleanup under the Ohio and the Texas voluntary programs

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

Roffman, A.

1999-07-01

Cleanups of two properties, one located in Ohio and the other in Texas were successfully implemented. The facilities were printing plants that manufactured printed material and forms for commercial and industrial use. Primary products and chemicals involved in the manufacturing of the forms included ink, petroleum products and cleaning solvents. The Ohio property underwent a successful cleanup under the Ohio EPA Voluntary Action Program (VAP). It met the Ohio EPA residential land use cleanup standards for soil and shallow groundwater. A No Further Action letter has been submitted to the state and it resulted in the issuance of a Covenantmore » Not to Sue. The Texas facility underwent a successful cleanup under the Texas Natural Resource Conservation Commission (TNRCC) Voluntary Cleanup Program (VCP). It resulted in the issuance of a Certificate of Completion (COC) for residential land use for soil, and a conditional COC for industrial land use for the shallow groundwater.« less

Strategic Planning for Information Systems: The Evidence from a Successful Implementation in an Academic Setting.

ERIC Educational Resources Information Center

Carter, Richard B.; And Others

1991-01-01

Demonstrates how an information systems plan can be successfully developed and implemented within an academic setting. Six guidelines for information systems planning are provided; problems are identified and recommendations to address the problems are suggested; and information systems objectives are discussed, including business communications,…

Method of evaluating the impact of ERP implementation critical success factors - a case study in oil and gas industries

NASA Astrophysics Data System (ADS)

Gajic, Gordana; Stankovski, Stevan; Ostojic, Gordana; Tesic, Zdravko; Miladinovic, Ljubomir

2014-01-01

The so far implemented enterprise resource planning (ERP) systems have in many cases failed to meet the requirements regarding the business process control, decrease of business costs and increase of company profit margin. Therefore, there is a real need for an evaluation of the influence of ERP on the company's performance indicators. Proposed in this article is an advanced model for the evaluation of the success of ERP implementation on organisational and operational performance indicators in oil-gas companies. The recommended method establishes a correlation between a process-based method, a scorecard model and ERP critical success factors. The method was verified and tested on two case studies in oil-gas companies using the following procedure: the model was developed, tested and implemented in a pilot gas-oil company, while the results were implemented and verified in another gas-oil company.

Implementation of oral health initiatives by Australian rural communities: Factors for success.

PubMed

Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

2018-01-01

In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.

Embracing change: practical and theoretical considerations for successful implementation of technology assisting upper limb training in stroke

PubMed Central

2012-01-01

Background Rehabilitation technology for upper limb training of stroke patients may play an important role as therapy tool in future, in order to meet the increasing therapy demand. Currently, implementation of this technology in the clinic remains low. This study aimed at identifying criteria and conditions that people, involved in development of such technology, should take into account to achieve a (more) successful implementation of the technology in the clinic. Methods A literature search was performed in PubMed and IEEE databases, and semi-structured interviews with therapists in stroke rehabilitation were held, to identify criteria and conditions technology should meet to facilitate (implementation of) technology-assisted arm-hand skills training in rehabilitation therapy of stroke patients. In addition, an implementation strategy frequently applied in general health care was used to compose a stepwise guidance to facilitate successful implementation of this technology in therapy of stroke patients. Implementation-related criteria mentioned by therapists during the interviews were integrated in this guidance. Results Results indicate that, related to therapy content, technology should facilitate repetition of task-related movements, tailored to the patient and patient’s goals, in a meaningful context. Variability and increasing levels of difficulty in exercises should be on offer. Regarding hardware and software design of technology, the system should facilitate quick familiarisation and be easily adjustable to individual patients during therapy by therapists (and assistants). The system should facilitate adaptation to individual patients’ needs and their progression over time, should be adjustable as to various task-related variables, should be able to provide instructions and feedback, and should be able to document patient’s progression. The implementation process of technology in the clinic is provided as a stepwise guidance that consists of five

Lean Principles and Defense Information Technology Acquisition: An Investigation of the Determinants of Successful Application

ERIC Educational Resources Information Center

Haley, M.

2013-01-01

The purpose of this study was to investigate whether or not there have been successful applications of lean manufacturing principles in highly variable defense IT environments. Specifically, the study assessed if implementation of the lean philosophies by a defense organization yielded repeatable, predictable results in software release schedules…

How to successfully implement E-learning for both students and teachers.

PubMed

Gotthardt, Martin; Siegert, Maria J; Schlieck, Anja; Schneider, Stefan; Kohnert, Alfred; Gross, Markus W; Schäfer, Christine; Wagner, Richard; Hörmann, Stefan; Behr, Thomas M; Engenhart-Cabillic, Rita; Klose, Klaus J; Jungclas, Hartmut; Glowalla, Ulrich

2006-03-01

Electronic learning (e-learning) may provide a means to enhance learning efficacy. However, introduction of e-learning often fails. We describe a strategy of how an e-learning curriculum was successfully implemented. The curriculum was designed based on published evidence. It consists of self-directed learning, an online discussion forum, and discussion rounds. The e-content in nuclear medicine and radiotherapy was produced by the k-MED team of medical authors, web designers, and psychologists. The online courses were delivered via a dedicated learning management system. The e-content for diagnostic radiology and physics was provided as PDF/HTML script by the respective teachers who objected to participate in the k-MED project. The exam was taken online. Online evaluation of the curriculum by the students was taken at the end of the course. The new curriculum proved very effective. The time for the preparation for the clinical part of the radiology course could be reduced from 4 to 2 weeks. The students particularly enjoyed the self-directed learning. Although the material provided by k-MED received 90%-99% positive scores, the HTML and PDF scripts scored worse (13%-67% positive ratings). The positive results of the evaluation convinced the teachers responsible for physics and diagnostic radiology to participate in k-MED. As our example shows, new e-learning curricula can successfully be introduced. The strategy of implementation should be based on the existing evidence from the literature. The new curriculum helped to increase the efficacy of teaching and save time as the duration of the respective part of the course could be reduced by half.

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

PubMed

Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

2006-08-24

Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

PubMed Central

Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

2006-01-01

Background Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the

Challenges in the Implementation of Success for All in Four High-Need Urban Schools

ERIC Educational Resources Information Center

Klingner, Janette; Cramer, Elizabeth; Harry, Beth

2006-01-01

We examined the challenges faced by 4 high-need urban schools when trying to implement Success for All (SFA). We wanted to understand SFA instruction as well as how SFA fit into the larger school context. Over a span of almost 2 years, we observed 45 SFA lessons (21 complete and 24 partial) across the 4 schools, taught by 30 teachers. We analyzed…

Project planning, training, measurement and sustainment: the successful implementation of voice recognition.

PubMed

Antiles, S; Couris, J; Schweitzer, A; Rosenthal, D; Da Silva, R Q

2000-01-01

Computerized voice recognition systems (VR) can reduce costs and enhance service. The capital outlay required for conversion to a VR system is significant; therefore, it is incumbent on radiology departments to provide cost and service justifications to administrators. Massachusetts General Hospital (MGH) in Boston implemented VR over a two-year period and achieved annual savings of $530,000 and a 50% decrease in report throughput. Those accomplishments required solid planning and implementation strategies, training and sustainment programs. This article walks through the process, step by step, in the hope of providing a tool set for future implementations. Because VR has dramatic implications for workflow, a solid operational plan is needed when assessing vendors and planning for implementation. The goals for implementation should be to minimize operational disruptions and capitalize on efficiencies of the technology. Senior leadership--the department chair or vice-chair--must select the goals to be accomplished and oversee, manage and direct the VR initiative. The importance of this point cannot be overstated, since implementation will require behavior changes from radiologists and others who may not perceive any personal benefits. Training is the pivotal factor affecting the success of voice recognition, and practice is the only way for radiologists to enhance their skills. Through practice, radiologists will discover shortcuts, and their speed and comfort will improve. Measurement and data analysis are critical to changing and improving the voice recognition application and are vital to decision-making. Some of the issues about which valuable date can be collected are technical and educational problems, VR penetration, report turnaround time and annual cost savings. Sustained effort is indispensable to the maintenance of voice recognition. Finally, all efforts made and gains achieved may prove to be futile without ongoing sustainment of the system through

Eight critical factors in creating and implementing a successful simulation program.

PubMed

Lazzara, Elizabeth H; Benishek, Lauren E; Dietz, Aaron S; Salas, Eduardo; Adriansen, David J

2014-01-01

Recognizing the need to minimize human error and adverse events, clinicians, researchers, administrators, and educators have strived to enhance clinicians' knowledge, skills, and attitudes through training. Given the risks inherent in learning new skills or advancing underdeveloped skills on actual patients, simulation-based training (SBT) has become an invaluable tool across the medical education spectrum. The large simulation, training, and learning literature was used to provide a synthesized yet innovative and "memorable" heuristic of the important facets of simulation program creation and implementation, as represented by eight critical "S" factors-science, staff, supplies, space, support, systems, success, and sustainability. These critical factors advance earlier work that primarily focused on the science of SBT success, to also include more practical, perhaps even seemingly obvious but significantly challenging components of SBT, such as resources, space, and supplies. SYSTEMS: One of the eight critical factors-systems-refers to the need to match fidelity requirements to training needs and ensure that technological infrastructure is in place. The type of learning objectives that the training is intended to address should determine these requirements. For example, some simulators emphasize physical fidelity to enable clinicians to practice technical and nontechnical skills in a safe environment that mirrors real-world conditions. Such simulators are most appropriate when trainees are learning how to use specific equipment or conduct specific procedures. The eight factors-science, staff, supplies, space, support, systems, success, and sustainability-represent a synthesis of the most critical elements necessary for successful simulation programs. The order of the factors does not represent a deliberate prioritization or sequence, and the factors' relative importance may change as the program evolves.

KM Critical Success Factors: A Comparison of Perceived Importance Versus Implementation in Malaysian ICT Companies

ERIC Educational Resources Information Center

Chong, Siong Choy

2006-01-01

Purpose: This research examines the level of perception and implementation of 11 identified knowledge management (KM) success factors and their differences among the information and communication technology (ICT) companies operating in Malaysia. Design/methodology/approach: The survey data was obtained from a study of 427 middle managers from 194…

What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders.

PubMed

Peek, Sebastiaan Theodorus Michaël; Wouters, Eveline J M; Luijkx, Katrien G; Vrijhoef, Hubertus J M

2016-05-03

There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard

What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders

PubMed Central

Wouters, Eveline JM; Luijkx, Katrien G; Vrijhoef, Hubertus JM

2016-01-01

Background There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. Objective To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Methods Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Results Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults’ needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying

Implementation of computerized physician order entry in National Guard Hospitals: assessment of critical success factors.

PubMed

Altuwaijri, Majid M; Bahanshal, Abdullah; Almehaid, Mona

2011-09-01

The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia. The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live training", the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to learn from mistakes before expanding the system to other

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

PubMed

Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A

2015-04-01

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration

Critical Success Factors for the Implementation of PeopleSoft Enterprise Resource Planning in a Public Organization

ERIC Educational Resources Information Center

Mukkamala, Hemanth K.

2013-01-01

Organizations of different sizes are changing their information technology (IT) strategies in order to achieve efficiency and effectiveness in today's global economy and to integrate their internal and external information by implementing PeopleSoft Enterprise Resource Planning (ERP) systems. The literature has case studies of successful and…

Supporting the Evaluation and Implementation of Musculoskeletal Models of Care: A Globally Informed Framework for Judging Readiness and Success.

PubMed

Briggs, Andrew M; Jordan, Joanne E; Jennings, Matthew; Speerin, Robyn; Bragge, Peter; Chua, Jason; Woolf, Anthony D; Slater, Helen

2017-04-01

To develop a globally informed framework to evaluate readiness for implementation and success after implementation of musculoskeletal models of care (MOCs). Three phases were undertaken: 1) a qualitative study with 27 Australian subject matter experts (SMEs) to develop a draft framework; 2) an eDelphi study with an international panel of 93 SMEs across 30 nations to evaluate face validity, and refine and establish consensus on the framework components; and 3) translation of the framework into a user-focused resource and evaluation of its acceptability with the eDelphi panel. A comprehensive evaluation framework was developed for judging the readiness and success of musculoskeletal MOCs. The framework consists of 9 domains, with each domain containing a number of themes underpinned by detailed elements. In the first Delphi round, scores of "partly agree" or "completely agree" with the draft framework ranged 96.7%-100%. In the second round, "essential" scores ranged 58.6%-98.9%, resulting in 14 of 34 themes being classified as essential. SMEs strongly agreed or agreed that the final framework was useful (98.8%), usable (95.1%), credible (100%) and appealing (93.9%). Overall, 96.3% strongly supported or supported the final structure of the framework as it was presented, while 100%, 96.3%, and 100% strongly supported or supported the content within the readiness, initiating implementation, and success streams, respectively. An empirically derived framework to evaluate the readiness and success of musculoskeletal MOCs was strongly supported by an international panel of SMEs. The framework provides an important internationally applicable benchmark for the development, implementation, and evaluation of musculoskeletal MOCs. © 2016, American College of Rheumatology.

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective.

PubMed

Sidek, Yusof Haji; Martins, Jorge Tiago

2017-11-01

Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Workflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Landscape simplification reduces classical biological control and crop yield.

PubMed

Grab, Heather; Danforth, Bryan; Poveda, Katja; Loeb, Greg

2018-03-01

Agricultural intensification resulting in the simplification of agricultural landscapes is known to negatively impact the delivery of key ecosystem services such as the biological control of crop pests. Both conservation and classical biological control may be influenced by the landscape context in which they are deployed; yet studies examining the role of landscape structure in the establishment and success of introduced natural enemies and their interactions with native communities are lacking. In this study, we investigated the relationship between landscape simplification, classical and conservation biological control services and importantly, the outcome of these interactions for crop yield. We showed that agricultural simplification at the landscape scale is associated with an overall reduction in parasitism rates of crop pests. Additionally, only introduced parasitoids were identified, and no native parasitoids were found in crop habitat, irrespective of agricultural landscape simplification. Pest densities in the crop were lower in landscapes with greater proportions of semi-natural habitats. Furthermore, farms with less semi-natural cover in the landscape and consequently, higher pest numbers, had lower yields than farms in less agriculturally dominated landscapes. Our study demonstrates the importance of landscape scale agricultural simplification in mediating the success of biological control programs and highlights the potential risks to native natural enemies in classical biological control programs against native insects. Our results represent an important contribution to an understanding of the landscape-mediated impacts on crop yield that will be essential to implementing effective policies that simultaneously conserve biodiversity and ecosystem services. © 2018 by the Ecological Society of America.

An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model.

PubMed

Grant, Bettyanne; Colello, Sandra; Riehle, Martha; Dende, Denise

2010-04-01

To discuss the new Magnet Model as it relates to the successful implementation of a practice change. There is growing international interest in the Magnet Recognition Programme. The latest generation of the Magnet Model has been designed not only as a road map for organizations seeking to achieve Magnet recognition but also as a framework for nursing practice and research in the future. The Magnet Model was used to identify success factors related to a practice change and to evaluate the nursing practice environment. Even when proposed changes to practice are evidence based and thoughtfully considered, the nurses' work environment must be supportive and empowering in order to yield successful and sustainable implementation of new practice. Success factors for implementation of a practice change can be illuminated by aligning environmental characteristics to the components of the new Magnet Model. The Magnet Model provides an exceptional framework for building an agile and dynamic work force. Thoughtful consideration of the components and inter-relationships represented in the new model can help to both predict and ensure organizational vitality.

Group Health's participation in a shared decision-making demonstration yielded lessons, such as role of culture change.

PubMed

King, Jaime; Moulton, Benjamin

2013-02-01

In 2007 Washington State became the first state to enact legislation encouraging the use of shared decision making and decision aids to address deficiencies in the informed-consent process. Group Health volunteered to fulfill a legislated mandate to study the costs and benefits of integrating these shared decision-making processes into clinical practice across a range of conditions for which multiple treatment options are available. The Group Health Demonstration Project, conducted during 2009-11, yielded five key lessons for successful implementation, including the synergy between efforts to reduce practice variation and increase shared decision making; the need to support modifications in practice with changes in physician training and culture; and the value of identifying best implementation methods through constant evaluation and iterative improvement. These lessons, and the legislated provisions that supported successful implementation, can guide other states and health care institutions moving toward informed patient choice as the standard of care for medical decision making.

A successful model to learn and implement ultrasound-guided venous catheterization in apheresis.

PubMed

Gopalasingam, Nigopan; Thomsen, Anna-Marie Eller; Folkersen, Lars; Juhl-Olsen, Peter; Sloth, Erik

2017-12-01

Apheresis treatments can be performed with peripheral venous catheters (PVC), although central venous catheters (CVC) are inserted when PVCs fail or patient with history of difficult vascular access prior to the apheresis. Ultrasound guidance for PVC has shown promising results in other settings. To investigate if ultrasound guidance for PVC could be implemented among apheresis nurses. Second, how implementation of ultrasound guidance affected the number of CVCs used for apheresis per patient. Apheresis nurses completed a systematic training program for ultrasound-guided vascular access. All independent catheterizations were registered during the implementation stage. The number of CVCs in the pre- and postimplementation stages of the ultrasound guidance was compared. Six nurses completed the training program within a median of 48 days (range 38-83 days). In 77 patients, 485 independent ultrasound-guided PVC placements were performed during the implementation stage. All apheresis treatments (485/485) were accomplished using PVCs without requiring CVC as rescue. During the preimplementation stage, 125 of 273 (45.8%) procedures required a CVC for completion of apheresis procedures; during the postimplementation stage only 30 of 227 (13.2%) procedures required a CVC (p < 0.001). In the postimplementation stage, no CVCs were placed as rescue caused by failed PVCs but were only placed for patients where the ultrasound machine was unavailable. It indicates an effective success rate of 100% for ultrasound-guided PVC use. This study showed that ultrasound guidance could be implemented among apheresis nurses as a routine tool eliminating the need of CVC as a rescue. © 2017 Wiley Periodicals, Inc.

Principals' Perceptions and Barriers to Successful Implementation of Special Education in the Wisconsin Evangelical Lutheran Synod

ERIC Educational Resources Information Center

Enser, Tracey L.

2012-01-01

The problem identified in this quantitative descriptive study is that many Wisconsin Evangelical Lutheran Synod Lutheran Elementary Schools (WELS LES) are not adequately prepared to teach all students with special needs. The purpose of the study was to identify principals' perceptions of, and potential barriers to, the successful implementation of…

Strong advocacy led to successful implementation of smokefree Mexico City.

PubMed

Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A

2011-01-01

To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court's ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries.

Strong advocacy led to successful implementation of smokefree Mexico City

PubMed Central

Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A

2011-01-01

Objective To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Methods Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Results Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Conclusions Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court’s ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries. PMID:21059606

Successful implementation of perioperative beta-blockade utilizing a multidisciplinary approach.

PubMed

Armanious, Samuel; Wong, David T; Etchells, Edward; Higgins, Patrick; Chung, Frances

2003-02-01

To describe how we implemented a protocol for perioperative beta-blockade in patients with or at risk of coronary artery disease (CAD) undergoing major non-cardiac surgery and to present our results. After institutional approval, from May 1999 to April 2001, patients with surgical and medical indications (CAD as indicated by previous myocardial infarction, typical angina or atypical angina with a positive stress test or at least two risk factors for CAD: age 65 yr, hypertension, smoking, high cholesterol, diabetes mellitus) for perioperative beta-blockade were identified preoperatively by anesthesiology and referred to the General Internal Medicine Service (MED). MED initiated patients on outpatient beta-blockers. The intraoperative anesthetic management was left to the discretion of the anesthesiologist. In the postanesthesia care unit (PACU), patients received iv metoprolol according to hemodynamic criteria. Postoperatively, patients were followed by MED for adverse cardiac events. Sixty-nine patients received perioperative beta-blockade. Preoperatively, 60% were started on metoprolol, 39% on atenolol and 1% on propranolol. In PACU, 42%, 9% and 38% of patients were given iv metoprolol 0, 5 and 10 mg respectively. One patient was given glycopyrrolate in the PACU for bradycardia and none received vasoactive or inotropic agents. Three patients (4.3%) had postoperative cardiac events. With close collaboration between anesthesiologists, internists, PACU nurses and family physicians, a strategy for perioperative beta-blockade was implemented successfully in patients with cardiac risks. Beta-blockade was associated with few side effects and morbidities.

How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation.

PubMed

Leemans, Kathleen; Van den Block, Lieve; Vander Stichele, Robert; Francke, Anneke L; Deliens, Luc; Cohen, Joachim

2015-12-01

There is an increasing demand for the use of quality indicators in palliative care. With previous research about implementation in this field lacking, we aimed to evaluate the barriers to and facilitators of implementation. Three focus group interviews were organized with 21 caregivers from 18 different specialized palliative care services in Belgium. Four had already worked with the indicators during a pilot study. The focus group discussions were transcribed verbatim and analyzed using the thematic framework approach. The caregivers anticipated that a positive attitude by the team towards quality improvement, the presence of a good leader, and the possible link between quality indicators and reimbursement might facilitate the implementation of quality indicators in specialized palliative care services. Other facilitators concerned the presence of a need to demonstrate quality of care, to perform improvement actions, and to learn from other caregivers and services in the field. A negative attitude by caregivers towards quality measurement and a lack of skills, time, and staff were mentioned as barriers to successful implementation. Palliative caregivers anticipate a number of opportunities and problems when implementing quality indicators. These relate to the attitudes of the team regarding quality measurement; the attitudes, knowledge, and skills of the individual caregivers within the team; and the organizational context and the economic and political context. Training in the advantages of quality indicators and how to use them is indispensable, as are structural changes in the policy concerning palliative care, in order to progress towards systematic quality monitoring.

An Analytic Hierarchy Process-based Method to Rank the Critical Success Factors of Implementing a Pharmacy Barcode System.

PubMed

Alharthi, Hana; Sultana, Nahid; Al-Amoudi, Amjaad; Basudan, Afrah

2015-01-01

Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.

Insights from the design and implementation of a single-entry model of referral for total joint replacement surgery: Critical success factors and unanticipated consequences.

PubMed

Damani, Zaheed; MacKean, Gail; Bohm, Eric; Noseworthy, Tom; Wang, Jenney Meng Han; DeMone, Brie; Wright, Brock; Marshall, Deborah A

2018-02-01

Single-entry models (SEMs) in healthcare allow patients to see the next-available provider and have been shown to improve waiting times, access and patient flow for preference-sensitive, scheduled services. The Winnipeg Central Intake Service (WCIS) for hip and knee replacement surgery was implemented to improve access in the Winnipeg Regional Health Authority. This paper describes the system's design/implementation; successes, challenges, and unanticipated consequences. On two occasions, during and following implementation, we interviewed all members of the WCIS project team, including processing engineers, waiting list coordinators, administrators and policy-makers regarding their experiences. We used semi-structured telephone interviews to collect data and qualitative thematic analysis to analyze and interpret the findings. Respondents indicated that the overarching objectives of the WCIS were being met. Benefits included streamlined processes, greater patient access, improved measurement and monitoring of outcomes. Challenges included low awareness, change readiness, and initial participation among stakeholders. Unanticipated consequences included workload increases, confusion around stakeholder expectations and under-reporting of data by surgeons' offices. Critical success factors for implementation included a requirement for clear communication, robust data collection, physician leadership and patience by all, especially implementation teams. Although successfully implemented, key lessons and critical success factors were learned related to change management, which if considered and applied, can reduce unanticipated consequences, improve uptake and benefit new models of care. Copyright © 2017 Elsevier B.V. All rights reserved.

Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals.

PubMed

Alakaam, Amir; Lemacks, Jennifer; Yadrick, Kathleen; Connell, Carol; Choi, Hwanseok Winston; Newman, Ray G

2018-05-01

Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces. Research aim: This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals. A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% ( N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high. The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments. Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

The Superintendent's Organizational Approach to Defined Autonomy and the Goal Implementation Process as It Impacts Student Success

ERIC Educational Resources Information Center

Kultgen, Merrl Kent

2010-01-01

This single-case study addresses the lack of qualitative research describing the instructional role of the superintendent. Guiding this study are two research questions, "How does the goal implementation process as an element of the superintendent's organizational approach impact student success?" and "How does defined autonomy as…

Implementation of a Standards-Based Grading Model: A Study of Parent and Teacher Perceptions of Success

ERIC Educational Resources Information Center

Wheeler, Amber D.

2017-01-01

The purpose of this study is to explore the perceptions of parents and teachers regarding the success of a standards-based grading initiative in meeting its goals. Furthermore, findings from this study will be used to inform decisions made in future grade level implementations. Standards-based grading meets all criteria for a problem of practice.…

Tripartite Governance: Enabling Successful Implementations with Vulnerable Populations.

PubMed

Kennedy, Margaret Ann

2016-01-01

Vulnerable populations are often at a distinct disadvantage when it comes to the implementation of health information systems in an equitable, appropriate, and timely manner. The disadvantages experienced by vulnerable populations are innumerable and include lack of representation, lack of appropriate levels of funding, lack of resources and capacity, and lack of representation. Increasingly, models of representation for complex implementations involve a tripartite project governance model. This tripartite partnership distributes accountability across all partners, and ensures that vulnerable populations have an equitable contribution to the direction of implementation according to their needs. This article shares lessons learned and best practices from complex tripartite partnerships supporting implementations with vulnerable populations in Canada.

Creep-fatigue modelling in structural steels using empirical and constitutive creep methods implemented in a strip-yield model

NASA Astrophysics Data System (ADS)

Andrews, Benjamin J.

The phenomena of creep and fatigue have each been thoroughly studied. More recently, attempts have been made to predict the damage evolution in engineering materials due to combined creep and fatigue loading, but these formulations have been strictly empirical and have not been used successfully outside of a narrow set of conditions. This work proposes a new creep-fatigue crack growth model based on constitutive creep equations (adjusted to experimental data) and Paris law fatigue crack growth. Predictions from this model are compared to experimental data in two steels: modified 9Cr-1Mo steel and AISI 316L stainless steel. Modified 9Cr-1Mo steel is a high-strength steel used in the construction of pressure vessels and piping for nuclear and conventional power plants, especially for high temperature applications. Creep-fatigue and pure creep experimental data from the literature are compared to model predictions, and they show good agreement. Material constants for the constitutive creep model are obtained for AISI 316L stainless steel, an alloy steel widely used for temperature and corrosion resistance for such components as exhaust manifolds, furnace parts, heat exchangers and jet engine parts. Model predictions are compared to pure creep experimental data, with satisfactory results. Assumptions and constraints inherent in the implementation of the present model are examined. They include: spatial discretization, similitude, plane stress constraint and linear elasticity. It is shown that the implementation of the present model had a non-trivial impact on the model solutions in 316L stainless steel, especially the spatial discretization. Based on these studies, the following conclusions are drawn: 1. The constitutive creep model consistently performs better than the Nikbin, Smith and Webster (NSW) model for predicting creep and creep-fatigue crack extension. 2. Given a database of uniaxial creep test data, a constitutive material model such as the one developed for

Using career ladders to motivate and retain employees: an implementation success story.

PubMed

Garletts, Joseph A

2002-01-01

In October 2000, Phoenix-based Sonora Quest Laboratories, LLC (SQL), commissioned The Gelfond Group to survey SQL employees. Responding to negative survey scores, SQL developed and implemented an entry-level career ladder for line staff of the specimen management/referral testing department. The program was piloted in February 2001, and was implemented fully shortly thereafter. The ladder was designed to provide job enrichment opportunities through company-conducted training and advancement provisions. It contained requirements for productivity and quality of work performed in addition to increasingly rigorous training and competency documentation. Employees were accountable for their own advancement and for ensuring that all documentation was complete. Advancement was automatic once requirements were completed. Pay increases accompanied each advancement on a predetermined scale. At the end of 12 months, employee turnover dropped from 39% to less than 20% annually. Both productivity and morale improved, and results on a second employee survey indicated dramatic improvement in five key areas. The career ladder concept has been replicated successfully in several other departments, including phlebotomy, and a six-tiered ladder is under development for the clinical laboratory. It will encompass CLA, MLT, and MT positions from entry level to technical coordinator.

The Data Warehouse: Keeping It Simple. MIT Shares Valuable Lessons Learned from a Successful Data Warehouse Implementation.

ERIC Educational Resources Information Center

Thorne, Scott

2000-01-01

Explains why the data warehouse is important to the Massachusetts Institute of Technology community, describing its basic functions and technical design points; sharing some non-technical aspects of the school's data warehouse implementation that have proved to be important; examining the importance of proper training in a successful warehouse…

Spectrally-Based Assessment of Crop Seasonal Performance and Yield

NASA Astrophysics Data System (ADS)

Kancheva, Rumiana; Borisova, Denitsa; Georgiev, Georgy

The rapid advances of space technologies concern almost all scientific areas from aeronautics to medicine, and a wide range of application fields from communications to crop yield predictions. Agricultural monitoring is among the priorities of remote sensing observations for getting timely information on crop development. Monitoring agricultural fields during the growing season plays an important role in crop health assessment and stress detection provided that reliable data is obtained. Successfully spreading is the implementation of hyperspectral data to precision farming associated with plant growth and phenology monitoring, physiological state assessment, and yield prediction. In this paper, we investigated various spectral-biophysical relationships derived from in-situ reflectance measurements. The performance of spectral data for the assessment of agricultural crops condition and yield prediction was examined. The approach comprisesd development of regression models between plant spectral and state-indicative variables such as biomass, vegetation cover fraction, leaf area index, etc., and development of yield forecasting models from single-date (growth stage) and multitemporal (seasonal) reflectance data. Verification of spectral predictions was performed through comparison with estimations from biophysical relationships between crop growth variables. The study was carried out for spring barley and winter wheat. Visible and near-infrared reflectance data was acquired through the whole growing season accompanied by detailed datasets on plant phenology and canopy structural and biochemical attributes. Empirical relationships were derived relating crop agronomic variables and yield to various spectral predictors. The study findings were tested using airborne remote sensing inputs. A good correspondence was found between predicted and actual (ground-truth) estimates

An adapted yield criterion for the evolution of subsequent yield surfaces

NASA Astrophysics Data System (ADS)

Küsters, N.; Brosius, A.

2017-09-01

In numerical analysis of sheet metal forming processes, the anisotropic material behaviour is often modelled with isotropic work hardening and an average Lankford coefficient. In contrast, experimental observations show an evolution of the Lankford coefficients, which can be associated with a yield surface change due to kinematic and distortional hardening. Commonly, extensive efforts are carried out to describe these phenomena. In this paper an isotropic material model based on the Yld2000-2d criterion is adapted with an evolving yield exponent in order to change the yield surface shape. The yield exponent is linked to the accumulative plastic strain. This change has the effect of a rotating yield surface normal. As the normal is directly related to the Lankford coefficient, the change can be used to model the evolution of the Lankford coefficient during yielding. The paper will focus on the numerical implementation of the adapted material model for the FE-code LS-Dyna, mpi-version R7.1.2-d. A recently introduced identification scheme [1] is used to obtain the parameters for the evolving yield surface and will be briefly described for the proposed model. The suitability for numerical analysis will be discussed for deep drawing processes in general. Efforts for material characterization and modelling will be compared to other common yield surface descriptions. Besides experimental efforts and achieved accuracy, the potential of flexibility in material models and the risk of ambiguity during identification are of major interest in this paper.

The Path to Successful ERP Implementation.

ERIC Educational Resources Information Center

Swartz, David G.

2001-01-01

Examines how universities and colleges can economically and efficiently implement an enterprise resource planning project when designing their administrative information system. Administrative steps discussed include conducting a needs assessment, deciding on the right system that matches the assessment, developing the correct contracting…

Change management and clinical engagement: critical elements for a successful clinical information system implementation.

PubMed

Detwiller, Maureen; Petillion, Wendy

2014-06-01

Moving a large healthcare organization from an old, nonstandardized clinical information system to a new user-friendly, standards-based system was much more than an upgrade to technology. This project to standardize terminology, optimize key processes, and implement a new clinical information system was a large change initiative over 4 years that affected clinicians across the organization. Effective change management and engagement of clinical stakeholders were critical to the success of the initiative. The focus of this article was to outline the strategies and methodologies used and the lessons learned.

Paving the Road to Success: A Framework for Implementing the "Success Tutoring" Approach

ERIC Educational Resources Information Center

Spark, Linda; De Klerk, Danie; Maleswena, Tshepiso; Jones, Andrew

2017-01-01

The exponential growth of higher education enrolment in South Africa has resulted in increased diversity of the student body, leading to a proliferation of factors that affect student performance and success. Various initiatives have been adopted by tertiary institutions to mitigate the negative impact these factors may have on student success,…

Successful implementation of an enhanced recovery after surgery programme for elective colorectal surgery: a process evaluation of champions' experiences.

PubMed

Gotlib Conn, Lesley; McKenzie, Marg; Pearsall, Emily A; McLeod, Robin S

2015-07-17

Enhanced recovery after surgery (ERAS) is a multimodal evidence-based approach to patient care that has become the standard in elective colorectal surgery. Implemented globally, ERAS programmes represent a considerable change in practice for many surgical care providers. Our current understanding of specific implementation and sustainability challenges is limited. In January 2013, we began a 2-year ERAS implementation for elective colorectal surgery in 15 academic hospitals in Ontario. The purpose of this study was to understand the process enablers and barriers that influenced the success of ERAS implementation in these centres with a view towards supporting sustainable change. A qualitative process evaluation was conducted from June to September 2014. Semi-structured interviews with implementation champions were completed, and an iterative inductive thematic analysis was conducted. Following a data-driven analysis, the Normalization Process Theory (NPT) was used as an analytic framework to understand the impact of various implementation processes. The NPT constructs were used as sensitizing concepts, reviewed against existing data categories for alignment and fit. Fifty-eight participants were included: 15 surgeons, 14 anaesthesiologists, 15 nurses, and 14 project coordinators. A number of process-related implementation enablers were identified: champions' belief in the value of the programme, the fit and cohesion of champions and their teams locally and provincially, a bottom-up approach to stakeholder engagement targeting organizational relationship-building, receptivity and support of division leaders, and the normalization of ERAS as everyday practice. Technical enablers identified included effective integration with existing clinical systems and using audit and feedback to report to hospital stakeholders. There was an overall optimism that ERAS implementation would be sustained, accompanied by concern about long-term organizational support. Successful ERAS

Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital.

PubMed

Agulnik, Asya; Mora Robles, Lupe Nataly; Forbes, Peter W; Soberanis Vasquez, Doris Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Kleinman, Monica; Rodriguez-Galindo, Carlos

2017-08-01

Hospitalized pediatric oncology patients are at high risk of clinical decline and mortality, particularly in resource-limited settings. Pediatric early warning systems (PEWS) aid in the early identification of clinical deterioration; however, there are limited data regarding their feasibility or impact in low-resource settings. This study describes the successful implementation of PEWS at the Unidad Nacional de Oncología Pediátrica (UNOP), a pediatric oncology hospital in Guatemala, resulting in improved inpatient outcomes. A modified PEWS was implemented at UNOP with systems to track errors, transfers to a higher level of care, and high scores. A retrospective cohort study was used to evaluate clinical deterioration events in the year before and after PEWS implementation. After PEWS implementation at UNOP, there was 100% compliance with PEWS documentation and an error rate of <10%. Implementation resulted in 5 high PEWS per week, with 30% of patients transferring to a higher level of care. Among patients requiring transfer to the pediatric intensive care unit (PICU), 93% had an abnormal PEWS before transfer. The rate of clinical deterioration events decreased after PEWS implementation (9.3 vs 6.5 per 1000-hospitalpatient-days, p = .003). Despite an 18% increase in total hospital patient-days, PICU utilization for inpatient transfers decreased from 1376 to 1088 PICU patient-days per year (21% decrease; P<.001). This study describes the successful implementation of PEWS in a pediatric oncology hospital in Guatemala, resulting in decreased inpatient clinical deterioration events and PICU utilization. This work demonstrates that PEWS is a feasible and effective quality improvement measure to improve hospital care for children with cancer in hospitals with limited resources. Cancer 2017;123:2965-74. © 2017 American Cancer Society. © 2017 American Cancer Society.

National Science Foundation Grant Implementation: Perceptions of Teachers and Graduate Fellows in One School Regarding the Barriers and Successes

NASA Astrophysics Data System (ADS)

Pickering, Sharon Durham

The purpose of this qualitative case study was to examine the perceptions of partner teachers and graduate fellows in 1 school regarding the barriers and successes made during their participation in a National Science Foundation Grant. This study included 9 partner teachers and 7 graduate fellows who participated in the Science First! NSF GK-12 Grant. There were 16 participants in this study. This study was conducted at North Side Elementary and East Tennessee State University. Partner teachers and graduate fellows were interviewed to gain perceptions of the barriers and successes of their participation in the implementation of the Science First! grant at North Side and East Tennessee State University from 2008-2013. A list of possible participants in the study was provided from the grant leadership team. The 16 participants in the study were chosen through purposeful sampling. During data analysis, 4 themes arose as successes and 4 themes arose as barriers. The success themes were (a) relationships, (b) mutual appreciation, (c) increased academic depth, and (d) professional growth. The barriers were (a) communication, (b) time, (c) expectations, and (d) preparation. Based on the research, the following conclusions were presented. The coordination of a major NSF-GK12 grant can provide STEM support and academic rigor for a high poverty school with leadership. Positive relationships between the graduate fellows and partner teachers as well as the 2 participating institutions are critical in fostering successful grant implementation. Professional growth through the grant partnerships was obtained. The participants gained a mutual appreciation for the roles and responsibilities of each other. There are ups and downs in implementing a large grant at 1 elementary school with a university, but the rewards of the potential to influence teacher practices in STEM and student learning are great. Recommendations from the study findings may assist future grant award winners or

Implementing Key Strategies for Successful Network Integration in the Quebec Substance-Use Disorders Programme

PubMed Central

Perreault, Michel; Grenier, Guy; Imboua, Armelle; Brochu, Serge

2016-01-01

Background: Fragmentation and lack of coordination often occur among organisations offering treatment for individuals with substance-use disorders. Better integration from a system perspective within a network of organisations offering substance-use disorder services can be developed using various integration strategies at the administrative and clinical levels. This study aims to identify integration strategies implemented in Quebec substance-use disorder networks and to assess their strengths and limitations. Methods: A total of 105 stakeholders representing two regions and four local substance-use disorder networks participated in focus groups or individual interviews. Thematic qualitative and descriptive quantitative analyses were conducted. Results: Six types of service integration strategies have been implemented to varying degrees in substance-use disorder networks. They are: 1) coordination activities-governance, 2) primary-care consolidation models, 3) information and monitoring management tools, 4) service coordination strategies, 5) clinical evaluation tools and 6) training activities. Conclusion: Important investments have been made in Quebec for the training and assessment of individuals with substance-use disorders, particularly in terms of support for emergency room liaison teams and the introduction of standardised clinical evaluation tools. However, the development of integration strategies was insufficient to ensure the implementation of successful networks. Planning, consolidation of primary care for substance-use disorders and systematic implementation of various clinical and administrative integration strategies are needed in order to ensure a better continuum of care for individuals with substance-use disorders. PMID:27616951

A Guide for Planning and Implementing Successful Mental Health Educational Programs.

PubMed

Blanco-Vieira, Thiago; Ramos, Fernando Augusto da Cunha; Lauridsen-Ribeiro, Edith; Ribeiro, Marcos Vinícius Vieira; Meireles, Elisa Andrade; Nóbrega, Brunno Araújo; Motta Palma, Sonia Maria; Ratto, Maria de Fátima; Caetano, Sheila Cavalcante; Ribeiro, Wagner Silva; Rosário, Maria Conceição do

2018-01-01

Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. These results will be helpful for planning and improving the quality of future educational programs in mental health.

Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia.

PubMed

Djellouli, Nehla; Quevedo-Gómez, María Cristina

2015-05-01

The Caribbean region presents the highest prevalence of HIV/AIDS worldwide after sub-Saharan Africa; leading to serious social, economic and health consequences at the local scale but also at the regional and global levels. In Colombia, a national plan to tackle the epidemic was formulated with little evidence that its implementation in the local context is effective. This study focused on Cartagena - one of Colombia's largest cities and an international touristic hub - that presents one of the highest HIV prevalences in the country, to investigate whether the national plan accounts for local specificities and what are the barriers to local implementation. Based on the Contextual Interaction Theory (CIT), this qualitative research relied upon 27 interviews and 13 life stories of local inhabitants and stakeholders, collected in a first fieldwork in 2006-2007. A follow-up data collection took place in 2013 with 10 participants: key policymakers and implementers, NGO representatives and local inhabitants. Barriers identified by the participants included: local population's understandings and beliefs on condom use; stigma and discrimination; lack of collaboration from the Church, the education sector and local politicians; corruption; high staff turnover; frequent changes in leadership; lack of economic and human resources; and barriers to health care access. The findings suggest that global influences also have an impact on the CIT framework (e.g. international organisations as a major financier in HIV prevention). The participants put forward several feasible solutions to implementation barriers. We discuss how several of the proposed solutions have been applied in other Latin American and Caribbean countries and yielded positive results. However, further research is needed to find possible ways of overcoming certain barriers identified by this study such as corruption, the lack of collaboration of the Church and barriers to health care access. Copyright © 2015

Tips for Ensuring Successful Software Implementation

ERIC Educational Resources Information Center

Weathers, Robert

2013-01-01

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

Strategies for successful trauma registry implementation in low- and middle-income countries-protocol for a systematic review.

PubMed

Paradis, Tiffany; St-Louis, Etienne; Landry, Tara; Poenaru, Dan

2018-02-21

The benefits of trauma registries have been well described. The crucial data they provide may guide injury prevention strategies, inform resource allocation, and support advocacy and policy. This has been shown to reduce trauma-related mortality in various settings. Trauma remains a leading cause of mortality in low- and middle-income countries (LMICs). However, the implementation of trauma registries in LMICs can be challenging due to lack of funding, specialized personnel, and infrastructure. This study explores strategies for successful trauma registry implementation in LMICs. The protocol was registered a priori (CRD42017058586). A peer-reviewed search strategy of multiple databases will be developed with a senior librarian. As per PRISMA guidelines, first screen of references based on abstract and title and subsequent full-text review will be conducted by two independent reviewers. Disagreements that cannot be resolved by discussion between reviewers shall be arbitrated by the principal investigator. Data extraction will be performed using a pre-defined data extraction sheet. Finally, bibliographies of included articles will be hand-searched. Studies of any design will be included if they describe or review development and implementation of a trauma registry in LMICs. No language or period restrictions will be applied. Summary statistics and qualitative meta-narrative analyses will be performed. The significant burden of trauma in LMIC environments presents unique challenges and limitations. Adapted strategies for deployment and maintenance of sustainable trauma registries are needed. Our methodology will systematically identify recommendations and strategies for successful trauma registry implementation in LMICs and describe threats and barriers to this endeavor. The protocol was registered on the PROSPERO international prospective register of systematic reviews ( CRD42017058586 ).

Designing and Implementation of a Course on Successful Dental Practice for Dentists

PubMed Central

Safi, Yaser; Razeghi, Samaneh; Shamloo, Nafiseh; Soroush, Mahdi; Akhgari, Ensieh; Moscowchi, Anahita

2015-01-01

Objectives: We aimed to design, implement and evaluate the efficacy of a comprehensive course on non-clinical competencies that dentists must possess for a successful dental practice. Materials and Methods: In this interventional before-after study an expert panel of five academic staff members and five general practitioners derived the topics for a course on successful dental practice, and aggregated them in the form of a two-day course. It was held for 46 randomly selected dentists in January 2010, at the School of Dentistry, Tehran University of Medical Sciences. The participants completed an anonymous questionnaire asking about their self-perceived need to receive training in each of the proposed topics and their self-assessed knowledge about each topic before and after attending the course. Results: Participants gave a higher priority to the necessity of training on “ergonomics and professional health” and communication skills in post-test compared to pre-test (P<0.05). The self-assessed knowledge of dentists improved significantly after attending the course in seven domains: ergonomics and occupational health, workplace design, documentation principles and IT applications in dentistry, national rules and regulations of dental practice, medical emergencies, dental ethics and communication skills (P<0.05). More than 70% of the participants were completely satisfied or satisfied with practical implication of the course, conformity of the contents with the title and course settings. Conclusion: The designed course seemed to be successful in revealing the need of participants for further education. Considering the high satisfaction rate of the attendants, this course can serve as a model for continuing education purposes. PMID:26884779

Successful hazard analysis critical control point implementation in the United Kingdom: understanding the barriers through the use of a behavioral adherence model.

PubMed

Gilling, S J; Taylor, E A; Kane, K; Taylor, J Z

2001-05-01

Hazard analysis critical control point (HACCP), a system of risk management designed to control food safety, has emerged over the last decade as the primary approach to securing the safety of the food supply. It is thus an important tool in combatting the worldwide escalation of foodborne disease. Yet despite wide dissemination and scientific support of its principles, successful HACCP implementation has been limited. This report takes a psychological approach to this problem by examining processes and factors that could impede adherence to the internationally accepted HACCP Guidelines and subsequent successful implementation of HACCP. Utilizing knowledge of medical clinical guideline adherence models and practical experience of HACCP implementation problems, the potential advantages of applying a behavioral model to food safety management are highlighted. The models' applicability was investigated using telephone interviews from over 200 businesses in the United Kingdom. Eleven key barriers to HACCP guideline adherence were identified. In-depth narrative interviews with food business proprietors then confirmed these findings and demonstrated the subsequent negative effect(s) on HACCP implementation. A resultant HACCP awareness to adherence model is proposed that demonstrates the complex range of potential knowledge, attitude, and behavior-related barriers involved in failures of HACCP guideline adherence. The model's specificity and detail provide a tool whereby problems can be identified and located and in this way facilitate tailored and constructive intervention. It is suggested that further investigation into the barriers involved and how to overcome them would be of substantial benefit to successful HACCP implementation and thereby contribute to an overall improvement in public health.

How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings.

PubMed

Lorenzi, Nancy M; Kouroubali, Angelina; Detmer, Don E; Bloomrosen, Meryl

2009-02-23

Adoption of EHRs by U.S. ambulatory practices has been slow despite the perceived benefits of their use. Most evaluations of EHR implementations in the literature apply to large practice settings. While there are similarities relating to EHR implementation in large and small practice settings, the authors argue that scale is an important differentiator. Focusing on small ambulatory practices, this paper outlines the benefits and barriers to EHR use in this setting, and provides a "field guide" for these practices to facilitate successful EHR implementation. The benefits of EHRs in ambulatory practices include improved patient care and office efficiency, and potential financial benefits. Barriers to EHRs include costs; lack of standardization of EHR products and the design of vendor systems for large practice environments; resistance to change; initial difficulty of system use leading to productivity reduction; and perceived accrual of benefits to society and payers rather than providers. The authors stress the need for developing a flexible change management strategy when introducing EHRs that is relevant to the small practice environment; the strategy should acknowledge the importance of relationship management and the role of individual staff members in helping the entire staff to manage change. Practice staff must create an actionable vision outlining realistic goals for the implementation, and all staff must buy into the project. The authors detail the process of implementing EHRs through several stages: decision, selection, pre-implementation, implementation, and post-implementation. They stress the importance of identifying a champion to serve as an advocate of the value of EHRs and provide direction and encouragement for the project. Other key activities include assessing and redesigning workflow; understanding financial issues; conducting training that is well-timed and meets the needs of practice staff; and evaluating the implementation process. The EHR

Regional media coverage influences the public's negative attitudes to policy implementation success in Sweden.

PubMed

Fredriksson, Mio; Tiainen, Anne; Hanning, Marianne

2015-12-01

One central aspect of health literacy is knowledge of patients' rights. Being an important source of information about health and health care, the media may influence health literacy and act as a policy implementer. To investigate whether regional news media coverage in Sweden is linked to (i) the public's awareness and knowledge of a patient's rights policy, the waiting-time guarantee and (ii) the public's attitudes to how the guarantee's time limits are met, that is, implementation success. Three types of data are used. First, a national telephone survey of the public's awareness, knowledge and attitudes; second, media coverage information from digital media monitoring; and third, official waiting-time statistics. Bivariate and multivariate regression analyses are performed with the 21 Swedish county councils/regions as a base. In the county councils/regions, non-awareness ranged from 1 to 15% and knowledge from 47 to 67%. There are relatively large differences between population groups. The amount of regional media coverage shows no significant correlation to the level of awareness and knowledge. There is, however, a significant correlation to both positive and negative attitudes; the latter remains after controlling for actual waiting times. At the national level, the media function as a policy implementer, being the primary source of information. At the regional level, the media are part of the political communication, reporting more extensively in county councils/regions where the population holds negative views towards the achievement in implementing the guarantee. We conclude that Swedish authorities should develop its communication strategies to bridge health literacy inequalities. © 2014 John Wiley & Sons Ltd.

Challenges to Successful Total Quality Management Implementation in Public Secondary Schools: A Case Study of Kohat District, Pakistan

ERIC Educational Resources Information Center

Suleman, Qaiser; Gul, Rizwana

2015-01-01

The current study explores the challenges faced by public secondary schools in successful implementation of total quality management (TQM) in Kohat District. A sample of 25 heads and 75 secondary school teachers selected from 25 public secondary schools through simple random sampling technique was used. Descriptive research designed was used and a…

Toward the Successful Implementation of the North American Free-Trade Agreement: The Integration of Language and Business Studies.

ERIC Educational Resources Information Center

Raffield, Barney T., III

This paper examines the need for the integration of language and business studies to enhance successful implementation of the North American Free Trade Agreement. For college and university graduates to deal effectively with French-Canadian and Mexican business people and consumers, they must be exposed to their languages and their cultures. This…

A preliminary analysis of the effects of coaching feedback on teacher implementation fidelity of first step to success.

PubMed

Rodriguez, Billie Jo; Loman, Sheldon L; Horner, Robert H

2009-01-01

First Step to Success (FSS) is a "manualized" intervention with documented effectiveness in reducing problem behaviors for young children at risk for school failure. This study is a preliminary analysis focusing on the role of performance feedback from FSS coaches on the fidelity with which teachers implemented FSS. Three typically developing students (2 kindergarten and 1 first grade) and their respective teachers served as participants. Student behavior and teacher implementation fidelity were assessed using a nonconcurrent multiple baseline design across student/teacher dyads, in which a no coaching baseline was followed by a performance feedback condition. The baseline phase showed modest levels of implementation fidelity and initial low levels of problem behavior followed by gradually increasing trends. A relation was demonstrated between coaching feedback and improved implementation fidelity. In addition, improved fidelity was associated with improvements in student problem behavior. Implications are drawn for clinical application of FSS and other "manualized" interventions.

Implementing Financial Assurance for Mitigation Project Success

EPA Pesticide Factsheets

The Institute for Water Resources (IWR) prepared this white paper on financial assurance for mitigation project success to provide a reference resource for Corps district staff involved with establishing and overseeing financial assurances.

Telehealth: seven strategies to successfully implement disruptive technology and transform health care.

PubMed

Schwamm, Lee H

2014-02-01

"Telehealth" refers to the use of electronic services to support a broad range of remote services, such as patient care, education, and monitoring. Telehealth must be integrated into traditional ambulatory and hospital-based practices if it is to achieve its full potential, including addressing the six domains of care quality defined by the Institute of Medicine: safe, effective, patient-centered, timely, efficient, and equitable. Telehealth is a disruptive technology that appears to threaten traditional health care delivery but has the potential to reform and transform the industry by reducing costs and increasing quality and patient satisfaction. This article outlines seven strategies critical to successful telehealth implementation: understanding patients' and providers' expectations, untethering telehealth from traditional revenue expectations, deconstructing the traditional health care encounter, being open to discovery, being mindful of the importance of space, redesigning care to improve value in health care, and being bold and visionary.

Concocting that Magic Elixir: Successful Grant Application Writing in Dissemination and Implementation Research.

PubMed

Brownson, Ross C; Colditz, Graham A; Dobbins, Maureen; Emmons, Karen M; Kerner, Jon F; Padek, Margaret; Proctor, Enola K; Stange, Kurt C

2015-12-01

This paper reports core competencies for dissemination and implementation (D&I) grant application writing and provides tips for writing a successful proposal. Two related phases were used to collect the data: a card sorting process among D&I researchers and an expert review among a smaller set of researchers. Card sorting was completed by 123 respondents. In the second phase, a series of grant application writing tips were developed based on the combined 170 years of grant review experience of the writing team. The card sorting resulted in 12 core competencies for D&I grant application writing that covered the main sections in a grant application to the US National Institutes of Health: (a) specific aims that provide clear rationale, objectives, and an overview of the research plan; (b) significance that frames and justifies the importance of a D&I question; (c) innovation that articulates novel products and new knowledge; and (d) approach that uses a relevant D&I model, addresses measurement and the D&I context, and includes an analysis plan well-tied to the aims and measures. Writing a successful D&I grant application is a skill that can be learned with experience and attention to the core competencies articulated in this paper. © 2015 Wiley Periodicals, Inc.

Concocting that Magic Elixir: Successful Grant Application Writing in Dissemination and Implementation Research

PubMed Central

Colditz, Graham A.; Dobbins, Maureen; Emmons, Karen M.; Kerner, Jon F.; Padek, Margaret; Proctor, Enola K.; Stange, Kurt C.

2015-01-01

Abstract Background This paper reports core competencies for dissemination and implementation (D&I) grant application writing and provides tips for writing a successful proposal. Methods Two related phases were used to collect the data: a card sorting process among D&I researchers and an expert review among a smaller set of researchers. Card sorting was completed by 123 respondents. In the second phase, a series of grant application writing tips were developed based on the combined 170 years of grant review experience of the writing team. Results The card sorting resulted in 12 core competencies for D&I grant application writing that covered the main sections in a grant application to the US National Institutes of Health: (a) specific aims that provide clear rationale, objectives, and an overview of the research plan; (b) significance that frames and justifies the importance of a D&I question; (c) innovation that articulates novel products and new knowledge; and (d) approach that uses a relevant D&I model, addresses measurement and the D&I context, and includes an analysis plan well‐tied to the aims and measures. Conclusions Writing a successful D&I grant application is a skill that can be learned with experience and attention to the core competencies articulated in this paper. PMID:26577630

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.

Analysis of State Laws and Policies Following the Implementation of the Fostering Connections to Success and Increasing Adoptions Act

ERIC Educational Resources Information Center

Perfect, Michelle M.; Stoll, Katherine A.; Thompson, Kristin C.; Scott, Roxanne E.

2013-01-01

The Fostering Connections to Success and Increasing Adoptions Act was implemented in 2008 (P.L. 110-351) in an effort to meet the needs of youth in foster care, including issues related to educational stability, educational services to support stability, and transition into higher education or the workforce. This article examines the written laws,…

Weather-based forecasts of California crop yields

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

Lobell, D B; Cahill, K N; Field, C B

2005-09-26

Crop yield forecasts provide useful information to a range of users. Yields for several crops in California are currently forecast based on field surveys and farmer interviews, while for many crops official forecasts do not exist. As broad-scale crop yields are largely dependent on weather, measurements from existing meteorological stations have the potential to provide a reliable, timely, and cost-effective means to anticipate crop yields. We developed weather-based models of state-wide yields for 12 major California crops (wine grapes, lettuce, almonds, strawberries, table grapes, hay, oranges, cotton, tomatoes, walnuts, avocados, and pistachios), and tested their accuracy using cross-validation over themore » 1980-2003 period. Many crops were forecast with high accuracy, as judged by the percent of yield variation explained by the forecast, the number of yields with correctly predicted direction of yield change, or the number of yields with correctly predicted extreme yields. The most successfully modeled crop was almonds, with 81% of yield variance captured by the forecast. Predictions for most crops relied on weather measurements well before harvest time, allowing for lead times that were longer than existing procedures in many cases.« less

Accelerating Digital Mental Health Research From Early Design and Creation to Successful Implementation and Sustainment

PubMed Central

Lyon, Aaron R; Lattie, Emily G; Reddy, Madhu; Schueller, Stephen M

2017-01-01

Mental health problems are common and pose a tremendous societal burden in terms of cost, morbidity, quality of life, and mortality. The great majority of people experience barriers that prevent access to treatment, aggravated by a lack of mental health specialists. Digital mental health is potentially useful in meeting the treatment needs of large numbers of people. A growing number of efficacy trials have shown strong outcomes for digital mental health treatments. Yet despite their positive findings, there are very few examples of successful implementations and many failures. Although the research-to-practice gap is not unique to digital mental health, the inclusion of technology poses unique challenges. We outline some of the reasons for this gap and propose a collection of methods that can result in sustainable digital mental health interventions. These methods draw from human-computer interaction and implementation science and are integrated into an Accelerated Creation-to-Sustainment (ACTS) model. The ACTS model uses an iterative process that includes 2 basic functions (design and evaluate) across 3 general phases (Create, Trial, and Sustain). The ultimate goal in using the ACTS model is to produce a functioning technology-enabled service (TES) that is sustainable in a real-world treatment setting. We emphasize the importance of the service component because evidence from both research and practice has suggested that human touch is a critical ingredient in the most efficacious and used digital mental health treatments. The Create phase results in at least a minimally viable TES and an implementation blueprint. The Trial phase requires evaluation of both effectiveness and implementation while allowing optimization and continuous quality improvement of the TES and implementation plan. Finally, the Sustainment phase involves the withdrawal of research or donor support, while leaving a functioning, continuously improving TES in place. The ACTS model is a step

Yield Model Development (YMD) implementation plan for fiscal years 1981 and 1982

NASA Technical Reports Server (NTRS)

Ambroziak, R. A. (Principal Investigator)

1981-01-01

A plan is described for supporting USDA crop production forecasting and estimation by (1) testing, evaluating, and selecting crop yield models for application testing; (2) identifying areas of feasible research for improvement of models; and (3) conducting research to modify existing models and to develop new crop yield assessment methods. Tasks to be performed for each of these efforts are described as well as for project management and support. The responsibilities of USDA, USDC, USDI, and NASA are delineated as well as problem areas to be addressed.

Process Evaluation of Two Participatory Approaches: Implementing Total Worker Health® Interventions in a Correctional Workforce

PubMed Central

Dugan, Alicia G.; Farr, Dana A.; Namazi, Sara; Henning, Robert A.; Wallace, Kelly N.; El Ghaziri, Mazen; Punnett, Laura; Dussetschleger, Jeffrey L.; Cherniack, Martin G.

2018-01-01

Background Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. Method HITEC-2 compared two different types of participatory program, a CO-only “Design Team” (DT) and “Kaizen Event Teams” (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. Results Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. Conclusions PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. PMID:27378470

Process evaluation of two participatory approaches: Implementing total worker health® interventions in a correctional workforce.

PubMed

Dugan, Alicia G; Farr, Dana A; Namazi, Sara; Henning, Robert A; Wallace, Kelly N; El Ghaziri, Mazen; Punnett, Laura; Dussetschleger, Jeffrey L; Cherniack, Martin G

2016-10-01

Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. HITEC-2 compared two different types of participatory program, a CO-only "Design Team" (DT) and "Kaizen Event Teams" (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. Am. J. Ind. Med. 59:897-918, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Managers' experience of success criteria and barriers to implementing mobile radiography services in nursing homes in Norway: a qualitative study.

PubMed

Kjelle, Elin; Lysdahl, Kristin Bakke; Olerud, Hilde Merete; Myklebust, Aud Mette

2018-04-25

In order to meet the future challenges posed by ageing populations, new technology, telemedicine and a more personalized healthcare system are needed. Earlier research has shown mobile radiography services to be highly beneficial for nursing home residents in addition to being cost-effective. Despite the benefits, mobile radiography services are uncommon in Europe and Norway. The purpose of this study was to explore success criteria and barriers in the process of implementing mobile radiography services, from the point of view of the hospital and municipal managers. Eleven semi-structured interviews were conducted with managers from five hospitals and six municipalities in Norway where mobile radiography services had been implemented. Core issues in the interview guide were barriers and facilitators in the different phases of implementation. The framework method for thematic analysis was used for analysing the data inductively in a research team. Five main categories were developed through the success criteria and barriers experienced by the participants: national health policy, regional and municipal policy and conditions, inter-organizational implementation projects, experienced outcome, and professional skills and personal characteristics. The categories were allocated into three higher-order classifications: macro, meso and micro levels. The main barriers experienced by the managers were financial, procedural and structural. In particular, the reimbursement system, lack of management across healthcare levels and the lack of compatible information systems acted as barriers. The main facilitators were external funding, enthusiastic individuals in the organizations and good collaboration between hospitals and municipalities. The managers experienced financial, structural and procedural barriers. The main success criteria in the process were external funding, and the support and engagement from the individuals in the organizations. This commitment was mainly

Implementation of a community-based secondhand smoke reduction intervention for caregivers of urban children with asthma: process evaluation, successes and challenges

PubMed Central

Blaakman, Susan; Tremblay, Paul J.; Halterman, Jill S.; Fagnano, Maria; Borrelli, Belinda

2013-01-01

Many children, including those with asthma, remain exposed to secondhand smoke. This manuscript evaluates the process of implementing a secondhand smoke reduction counseling intervention using motivational interviewing (MI) for caregivers of urban children with asthma, including reach, dose delivered, dose received and fidelity. Challenges, strategies and successes in applying MI are highlighted. Data for 140 children (3–10 years) enrolled in the School Based Asthma Therapy trial, randomized to the treatment condition and living with one or more smoker, were analyzed. Summary statistics describe the sample, process measures related to intervention implementation, and primary caregiver (PCG) satisfaction with the intervention. The full intervention was completed by 79% of PCGs, but only 17% of other smoking caregivers. Nearly all (98%) PCGs were satisfied with the care study nurses provided and felt the program might be helpful to others. Despite challenges, this intervention was feasible and well received reaching caregivers who were not actively seeking treatment for smoking cessation or secondhand smoke reduction. Anticipating the strategies required to implement such an intervention may help promote participant engagement and retention to enhance the program’s ultimate success. PMID:22717938

Identifying critical success factors (CSFs) of implementing building information modeling (BIM) in Malaysian construction industry

NASA Astrophysics Data System (ADS)

Yaakob, Mazri; Ali, Wan Nur Athirah Wan; Radzuan, Kamaruddin

2016-08-01

Building Information Modeling (BIM) is defined as existing from the earliest concept to demolition and it involves creating and using an intelligent 3D model to inform and communicate project decisions. This research aims to identify the critical success factors (CSFs) of BIM implementation in Malaysian construction industry. A literature review was done to explore previous BIM studies on definitions and history of BIM, construction issues, application of BIM in construction projects as well as benefits of BIM. A series of interviews with multidisciplinary Malaysian construction experts will be conducted purposely for data collection process guided by the research design and methodology approach of this study. The analysis of qualitative data from the process will be combined with criteria identified in the literature review in order to identify the CSFs. Finally, the CSFs of BIM implementation will be validated by further Malaysian industrialists during a workshop. The validated CSFs can be used as a term of reference for both Malaysian practitioners and academics towards measuring BIM effectiveness level in their organizations.

Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

PubMed

Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

2018-06-01

Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

PubMed

deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

2018-03-01

Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene

A Community-Based Partnership to Successfully Implement and Maintain a Breast Health Navigation Program.

PubMed

Drake, Bettina F; Tannan, Shivon; Anwuri, Victoria V; Jackson, Sherrill; Sanford, Mark; Tappenden, Jennifer; Goodman, Melody S; Colditz, Graham A

2015-12-01

Breast cancer screening combined with follow-up and treatment reduces breast cancer mortality. However, in the study clinic, only 12 % of eligible women ≥40 years received a mammogram in the previous year. The objective of this project was to implement patient navigation, in our partner health clinic to (1) identify women overdue for a mammogram; and (2) increase mammography utilization in this population over a 2-year period. Women overdue for a mammogram were identified. One patient navigator made navigation attempts over a 2-year period (2009-2011). Navigation included working around systems- and individual-level barriers to receive a mammogram as well as the appropriate follow-up post screening. Women were contacted up to three times to initiate navigation. The proportion of women navigated and who received a mammogram during the study period were compared to women who did not receive a mammogram using Chi square tests for categorical variables and t tests for continuous variables with an α = 0.05. Barriers to previous mammography were also assessed. With 94.8 % of eligible women navigated and 94 % of these women completing mammography, the implementation project reached 89 % of the target population. This project was a successful implementation of an evidence-based patient navigation program that continues to provide significant impact in a high-need area. Cost was the most commonly cite barrier to mammography. Increasing awareness of resources in the community for mammography and follow-up care remains a necessary adjunct to removing structural and financial barriers to accessing preventive services.

Comprehensive in vitro Proarrhythmia Assay (CiPA): Pending issues for successful validation and implementation.

PubMed

Cavero, Icilio; Guillon, Jean-Michel; Ballet, Veronique; Clements, Mike; Gerbeau, Jean-Frédéric; Holzgrefe, Henry

2016-01-01

The Comprehensive in vitro Proarrhythmia Assay (CiPA) is a nonclinical Safety Pharmacology paradigm for discovering electrophysiological mechanisms that are likely to confer proarrhythmic liability to drug candidates intended for human use. Key talks delivered at the 'CiPA on my mind' session, held during the 2015 Annual Meeting of the Safety Pharmacology Society (SPS), are summarized. Issues and potential solutions relating to crucial constituents [e.g., biological materials (ion channels and pluripotent stem cell-derived cardiomyocytes), study platforms, drug solutions, and data analysis] of CiPA core assays are critically examined. In order to advance the CiPA paradigm from the current testing and validation stages to a research and regulatory drug development strategy, systematic guidance by CiPA stakeholders is necessary to expedite solutions to pending and newly arising issues. Once a study protocol is proved to yield robust and reproducible results within and across laboratories, it can be implemented as qualified regulatory procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding nurses' views on a pressure ulcer prevention care bundle: a first step towards successful implementation.

PubMed

Chaboyer, Wendy; Gillespie, Brigid M

2014-12-01

To explore nurses' views of the barriers and facilitators to the use of a newly devised patient-centred pressure ulcer prevention care bundle. Given pressure ulcer prevention strategies are not implemented consistently, the use of a pressure ulcer care bundle may improve implementation given bundles generally assist in standardising care. A quality improvement project was undertaken after a pressure ulcer prevention care bundle was developed and pilot-tested. Short, conversational interviews with nurse explored their views of a patient-centred pressure ulcer care bundle. Interviews were audio-taped and transcribed. Inductive content analysis was used to analyse the transcripts. A total of 20 nurses were interviewed. Five categories with corresponding subcategories emerged from the analysis. They were increasing awareness of pressure ulcer prevention, prompting pressure ulcer prevention activities, promoting active patient participation, barriers to using a pressure ulcer prevention care bundle and enabling integration of the pressure ulcer prevention care bundle into routine practice. Benefits of using a patient-centred pressure ulcer prevention care bundle may include prompting patients and staff to implement prevention strategies and promote active patient participation in care. The success of the care bundle relied on both patients' willingness to participate and nurses' willingness to incorporate it into their routine work. A patient-centred pressure ulcer prevention care bundle may facilitate more consistent implementation of pressure ulcer prevention strategies and active patient participation in care. © 2014 John Wiley & Sons Ltd.

Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature.

PubMed

Simons, Sereh M J; Cillessen, Felix H J M; Hazelzet, Jan A

2016-08-02

A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing with the multiplicity of patient problems. The problem list as a precondition is the centerpiece of the problem-oriented medical record (POMR) also called problem-oriented record (POR). Prior to the digital era, paper records presented a flat list of medical problems to the healthcare professional without the features that are possible with current technology. In modern EHRs a POMR based on a structured problem list can be used for clinical decision support, registries, order management, population health, and potentially other innovative functionality in the future, thereby providing a new incentive to the implementation and use of the POMR. On both 12 May 2014 and 1 June 2015 a systematic literature search was conducted. From the retrieved articles statements regarding the POMR and related to successful or non-successful implementation, were categorized. Generic determinants were extracted from these statements. In this research 38 articles were included. The literature analysis led to 12 generic determinants: clinical practice/reasoning, complete and accurate problem list, data structure/content, efficiency, functionality, interoperability, multi-disciplinary, overview of patient information, quality of care, system support, training of staff, and usability. Two main subjects can be distinguished in the determinants: the system that the problem list and POMR is integrated in and the organization using that system. The combination of the two requires a sociotechnical approach and both are equally important for successful implementation of a POMR. All the determinants have to be taken into account, but the weight given to each of the determinants depends on the organizationusing

Accelerating Digital Mental Health Research From Early Design and Creation to Successful Implementation and Sustainment.

PubMed

Mohr, David C; Lyon, Aaron R; Lattie, Emily G; Reddy, Madhu; Schueller, Stephen M

2017-05-10

Mental health problems are common and pose a tremendous societal burden in terms of cost, morbidity, quality of life, and mortality. The great majority of people experience barriers that prevent access to treatment, aggravated by a lack of mental health specialists. Digital mental health is potentially useful in meeting the treatment needs of large numbers of people. A growing number of efficacy trials have shown strong outcomes for digital mental health treatments. Yet despite their positive findings, there are very few examples of successful implementations and many failures. Although the research-to-practice gap is not unique to digital mental health, the inclusion of technology poses unique challenges. We outline some of the reasons for this gap and propose a collection of methods that can result in sustainable digital mental health interventions. These methods draw from human-computer interaction and implementation science and are integrated into an Accelerated Creation-to-Sustainment (ACTS) model. The ACTS model uses an iterative process that includes 2 basic functions (design and evaluate) across 3 general phases (Create, Trial, and Sustain). The ultimate goal in using the ACTS model is to produce a functioning technology-enabled service (TES) that is sustainable in a real-world treatment setting. We emphasize the importance of the service component because evidence from both research and practice has suggested that human touch is a critical ingredient in the most efficacious and used digital mental health treatments. The Create phase results in at least a minimally viable TES and an implementation blueprint. The Trial phase requires evaluation of both effectiveness and implementation while allowing optimization and continuous quality improvement of the TES and implementation plan. Finally, the Sustainment phase involves the withdrawal of research or donor support, while leaving a functioning, continuously improving TES in place. The ACTS model is a step

Yield: it's now an entitlement

NASA Astrophysics Data System (ADS)

George, Bill

1994-09-01

Only a few years ago, the primary method of cost reduction and productivity improvement in the semiconductor industry was increasing manufacturing yields throughout the process. Many of the remarkable reliability improvements realized over the past decade have come about as a result of actions that were originally taken primarily to improve device yields. Obviously, the practice of productivity improvement through yield enhancement is limited to the attainment of 100% yield, at which point some other mechanism must be employed. Traditionally, new products have been introduced to manufacturing at a point of relative immaturity, and semiconductor producers have relied on the traditional `learning curve' method of yield improvement to attain profitable levels of manufacturing yield. Recently, results of a survey of several fabs by a group of University of California at Berkeley researchers in the Competitive Semiconductor Manufacturing Program indicate that most factories learn at about the same rate after startup, in terms of both line yield and defectivity. If this is indeed generally true, then the most competitive factor is the one that starts with the highest yield, and it is difficult to displace a leader once his lead has been established. The two observations made above carry enormous implications for the semiconductor development or manufacturing professional. First, one must achieve very high yields in order to even play the game. Second, the achievement of competitive yields over time in the life of a factory is determined even before the factory is opened, in the planning and development phase. Third, and perhaps most uncomfortable for those of us who have relied on yield improvement as a cost driver, the winners of the nineties will find new levers to drive costs down, having already gotten the benefit of very high yield. This paper looks at the question of how the winners will achieve the critical measures of success, high initial yield and utilization

Lean principles and defense information technology acquisition: An investigation of the determinants of successful application

NASA Astrophysics Data System (ADS)

Haley, M.

The purpose of this study was to investigate whether or not there have been successful applications of lean manufacturing principles in highly variable defense IT environments. Specifically, the study assessed if implementation of the lean philosophies by a defense organization yielded repeatable, predictable results in software release schedules reductions. Additionally, the study set out to determine what potential critical success factors (CSF's) were documented in the secondary data captured for each release, and extracted the variables used in the decision making for acceptability of fielding. In evaluating lean applicability to the high variability environment of USAF IT acquisitions, the research was conducted using non-experimental quantitative methods of archival secondary data. The sample for this case study was compiled from a USAF office that had implemented these techniques in pre-development, development and testing, and fielding phases. Based on the research data, acquisitionists and lean practitioners are inherently interconnected. Therefore, an understanding that critical success factors (CSFs) are integral to successful lean application in DoD IT acquisitions is crucial. Through a combination of synergistic alignments, plyometric CSFs were discovered to maximize the effects of each single CSF to produce rapid results in defense IT acquisitions. These include: (1) Enterprise Incorporation, (2) Team Trust, (3) Transformational Leadership, (4) Recursive Improvement, (5) Integrated Synergy, (6) Customer-Centric Culture and (7) Heuristic Communication.

The First-Year Seminar: Designing, Implementing, and Assessing Courses to Support Student Learning and Success: Volume Two: Instructor Training and Development

ERIC Educational Resources Information Center

Groccia, James; Hunter, Mary Stuart

2012-01-01

"The First-Year Seminar: Designing, Implementing, and Assessing Courses to Support Student Learning and Success," a five-volume series, is designed to assist educators who are interested in launching a firstyear seminar or revamping an existing program. Each volume examines a different aspect of first-year seminar design or…

Development of a framework towards successful implementation of e-governance initiatives in health sector in India.

PubMed

Ray, Subhasis; Mukherjee, Amitava

2007-01-01

The purpose of this paper is to explore the route map for employing efficient e-governance so that at least existing resource and infrastructure are better utilized and deficiencies are tracked for future planning. National health is one of the most important factors in a country's economic growth. India seems to be a victim of the vicious cycle around poor economy and poor health conditions. A detailed study was carried out to find out India's healthcare infrastructure and its standing in e-governance initiatives. After consolidating the fact that effective e-governance can enhance the quality of healthcare service even within limited resources, authors explored success and failure factors of many e-governance initiatives in India and abroad. Finally, an e-governance framework is suggested based on the above factors together with the authors' own experience of implementing e-governance projects in India and abroad. The suggested framework is based on a phased implementation approach. The first phase "Information Dissemination" is more geared towards breaking the "digital divide" across three dimensions: G2Business; G2Citizen; and G2Agent. The most advanced stage is aimed towards joining up healthcare information across the above three dimensions and drawing meaningful analytics out of it. The recommendations also include management of Policies, Scope, Process Reform, Infrastructure, Technology, Finance, Partnership and People for efficient implementation of such e-governance initiatives. The paper provides measures for continuous evaluation of systems as one passes through various stages of implementation. However, the framework can be tested on real or simulated environment to prove its worthiness. This paper can be a potential frame of reference for nation-wide e-healthcare projects not only in India but also in other developing countries. The paper also describes challenges that are most likely to be faced during implementation. Since the paper is practical in

Academic Success Support Groups.

ERIC Educational Resources Information Center

Halstead, Richard

1998-01-01

Describes a five-week group counseling program designed to help students adopt behaviors that can lead to greater academic success. Phases of the program are (1) institution and professor bashing; (2) member confrontation and accepting responsibility; (3) implementation of success strategies; (4) future pacing. Discusses results and implications.…

TMDL Implementation: Lessons Learned

EPA Pesticide Factsheets

Virginia Tech Center for TMDL and Watershed Studies provided state TMDL implementation information and reviewed ongoing TMDL implementation efforts across the country to identify factors that contribute to successful implementation.

Introduction: the realities of antiretroviral therapy rollout: overcoming challenges to successful programmatic implementation.

PubMed

Ojikutu, Bisola

2007-12-01

In 2006, 2 million human immunodeficiency virus (HIV)-infected people living in low- to middle-income countries were receiving antiretroviral therapy (ART). Although this is an improvement over previous years, significant operational challenges have inhibited progress toward universal access to HIV care and treatment. Despite these challenges, the intense efforts focused on addressing the HIV epidemic present an opportunity for overall health systems improvement in developing nations. In October 2006, Harvard University's Centers for AIDS Research, the Nelson Mandela School of Medicine, the Department of Health of KwaZulu-Natal, and the Medical Research Council of South Africa held a conference entitled "The Realities of Antiretroviral Therapy Rollout: Challenges to Successful Programmatic Implementation" in Durban, South Africa. The goal of the meeting was to bring together international and local leadership, including policy makers, health care workers, and funders, to propose an agenda that would address the challenges to more expeditious provision of HIV care and treatment in resource-limited settings.

Obstacles to TQM success in health care systems.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

Many healthcare organisations have found it difficult to implement total quality management (TQM) successfully. The aim of this paper is to explore the barriers to TQM successful implementation in the healthcare sector. This paper reports a literature review exploring the major reasons for the failure of TQM programmes in healthcare organisations. TQM implementation and its impact depend heavily on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in healthcare organisations can be attributed to the strongly departmentalised, bureaucratic and hierarchical structure, professional autonomy, tensions between managers and professionals and the difficulties involved in evaluating healthcare processes and outcomes. Other obstacles to TQM success include lack of consistent managers' and employees' commitment to and involvement in TQM implementation, poor leadership and management, lack of a quality-oriented culture, insufficient training, and inadequate resources. The review was limited to empirical articles written in the English language during the past 30 years (1980-2010). The findings of this article provide policy makers and managers with a practical understanding of the factors that are likely to obstruct TQM implementation in the healthcare sector. Understanding the factors that obstruct TQM implementation would enable managers to develop more effective strategies for implementing TQM successfully in healthcare organisations.

Easier Said Than Done: Keys to Successful Implementation of the Distress Assessment and Response Tool (DART) Program.

PubMed

Li, Madeline; Macedo, Alyssa; Crawford, Sean; Bagha, Sabira; Leung, Yvonne W; Zimmermann, Camilla; Fitzgerald, Barbara; Wyatt, Martha; Stuart-McEwan, Terri; Rodin, Gary

2016-05-01

Systematic screening for distress in oncology clinics has gained increasing acceptance as a means to improve cancer care, but its implementation poses enormous challenges. We describe the development and implementation of the Distress Assessment and Response Tool (DART) program in a large urban comprehensive cancer center. DART is an electronic screening tool used to detect physical and emotional distress and practical concerns and is linked to triaged interprofessional collaborative care pathways. The implementation of DART depended on clinician education, technological innovation, transparent communication, and an evaluation framework based on principles of change management and quality improvement. There have been 364,378 DART surveys completed since 2010, with a sustained screening rate of > 70% for the past 3 years. High staff satisfaction, increased perception of teamwork, greater clinical attention to the psychosocial needs of patients, patient-clinician communication, and patient satisfaction with care were demonstrated without a resultant increase in referrals to specialized psychosocial services. DART is now a standard of care for all patients attending the cancer center and a quality performance indicator for the organization. Key factors in the success of DART implementation were the adoption of a programmatic approach, strong institutional commitment, and a primary focus on clinic-based response. We have demonstrated that large-scale routine screening for distress in a cancer center is achievable and has the potential to enhance the cancer care experience for both patients and staff. Copyright © 2016 by American Society of Clinical Oncology.

Successful implementation of cooperative handling eliminates the need for restraint in a complex nonhuman primate disease model

PubMed Central

Graham, Melanie L; Rieke, Eric F; Mutch, Lucas A; Zolondek, Elizabeth K; Faig, Aaron W; DuFour, Theresa A; Munson, James W; Kittredge, Jessica A; Schuurman, Henk-Jan

2011-01-01

Introduction Streptozotocin-induced diabetic nonhuman primates are used to study efficacy and safety of innovative immunosuppression after islet transplantation. We implemented a training program for medical management of a chronic disease state. Methods Cooperation with hand feeding and drinking; shifting; and limb presentation were trained utilizing predominately positive but also negative reinforcement in 52 animals compared with 28 macaques subjected to conventional physical and/or chemical restraint. The success of and timing of behavior acquisition was evaluated in a representative subset of 14 animals. Results Over 90% of animals were successful in behavior acquisition. Programmatically this resulted in complete elimination of chair restraint and negligible requirement for sedation. About half of trained animals had no to moderate thymic involution, indicative of a substantial reduction in stress. Conclusion Cooperative handling enhances animal well-being. This contributes to validity of scientific results and eliminates model-induced confounding that can obstruct interpretation of safety and efficacy data. PMID:22150842

How to successfully implement a robotic pediatric surgery program: lessons learned after 96 procedures.

PubMed

de Lambert, Guénolée; Fourcade, Laurent; Centi, Joachim; Fredon, Fabien; Braik, Karim; Szwarc, Caroline; Longis, Bernard; Lardy, Hubert

2013-06-01

Both our teams were the first to implement pediatric robotic surgery in France. The aim of this study was to define the key points we brought to light so other pediatric teams that want to set up a robotic surgery program will benefit. We reviewed the medical records of all children who underwent robotic surgery between Nov 2007 and June 2011 in both departments, including patient data, installation and changes, operative time, hospital stay, intraoperative complications, and postoperative outcome. The department's internal organization, the organization within the hospital complex, and cost were evaluated. A total of 96 procedures were evaluated. There were 38 girls and 56 boys with average age at surgery of 7.6 years (range, 0.7-18 years) and average weight of 26 kg (range, 6-77 kg). Thirty-six patients had general surgery, 57 patients urologic surgery, and 1 thoracic surgery. Overall average operative time was 189 min (range, 70-550 min), and average hospital stay was 6.4 days (range, 2-24 days). The procedures of 3 patients were converted. Median follow-up was 18 months (range, 0.5-43 months). Robotic surgical procedure had an extra cost of 1934 compared to conventional open surgery. Our experience was similar to the findings described in the literature for feasibility, security, and patient outcomes; we had an overall operative success rate of 97 %. Three main actors are concerned in the implementation of a robotic pediatric surgery program: surgeons and anesthetists, nurses, and the administration. The surgeon is at the starting point with motivation for minimally invasive surgery without laparoscopic constraints. We found that it was possible to implement a long-lasting robotic surgery program with comparable quality of care.

Breeding high-yielding drought-tolerant rice: genetic variations and conventional and molecular approaches

PubMed Central

Kumar, Arvind; Dixit, Shalabh; Ram, T.; Yadaw, R. B.; Mishra, K. K.; Mandal, N. P.

2014-01-01

The increased occurrence and severity of drought stress have led to a high yield decline in rice in recent years in drought-affected areas. Drought research at the International Rice Research Institute (IRRI) over the past decade has concentrated on direct selection for grain yield under drought. This approach has led to the successful development and release of 17 high-yielding drought-tolerant rice varieties in South Asia, Southeast Asia, and Africa. In addition to this, 14 quantitative trait loci (QTLs) showing a large effect against high-yielding drought-susceptible popular varieties were identified using grain yield as a selection criterion. Six of these (qDTY 1.1, qDTY 2.2, qDTY 3.1, qDTY 3.2, qDTY 6.1, and qDTY 12.1) showed an effect against two or more high-yielding genetic backgrounds in both the lowland and upland ecosystem, indicating their usefulness in increasing the grain yield of rice under drought. The yield of popular rice varieties IR64 and Vandana has been successfully improved through a well-planned marker-assisted backcross breeding approach, and QTL introgression in several other popular varieties is in progress. The identification of large-effect QTLs for grain yield under drought and the higher yield increase under drought obtained through the use of these QTLs (which has not been reported in other cereals) indicate that rice, because of its continuous cultivation in two diverse ecosystems (upland, drought tolerant, and lowland, drought susceptible), has benefited from the existence of larger genetic variability than in other cereals. This can be successfully exploited using marker-assisted breeding. PMID:25205576

The Z {yields} cc-bar {yields} {gamma}{gamma}*, Z {yields} bb-bar {yields} {gamma}{gamma}* triangle diagrams and the Z {yields} {gamma}{psi}, Z {yields} {gamma}Y decays

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

Achasov, N. N., E-mail: achasov@math.nsc.ru

2011-03-15

The approach to the Z {yields} {gamma}{psi} and Z {yields} {gamma}Y decay study is presented in detail, based on the sum rules for the Z {yields} cc-bar {yields} {gamma}{gamma}* and Z {yields} bb-bar {yields} {gamma}{gamma}* amplitudes and their derivatives. The branching ratios of the Z {yields} {gamma}{psi} and Z {yields} {gamma}Y decays are calculated for different hypotheses on saturation of the sum rules. The lower bounds of {Sigma}{sub {psi}} BR(Z {yields} {gamma}{psi}) = 1.95 Multiplication-Sign 10{sup -7} and {Sigma}{sub {upsilon}} BR(Z {yields} {gamma}Y) = 7.23 Multiplication-Sign 10{sup -7} are found. Deviations from the lower bounds are discussed, including the possibilitymore » of BR(Z {yields} {gamma}J/{psi}(1S)) {approx} BR(Z {yields} {gamma}Y(1S)) {approx} 10{sup -6}, that could be probably measured in LHC. The angular distributions in the Z {yields} {gamma}{psi} and Z {yields} {gamma}Y decays are also calculated.« less

Implementing successful strategic plans: a simple formula.

PubMed

Blondeau, Whitney; Blondeau, Benoit

2015-01-01

Strategic planning is a process. One way to think of strategic planning is to envision its development and design as a framework that will help your hospital navigate through internal and external changing environments over time. Although the process of strategic planning can feel daunting, following a simple formula involving five steps using the mnemonic B.E.G.I.N. (Begin, Evaluate, Goals & Objectives, Integration, and Next steps) will help the planning process feel more manageable, and lead you to greater success.

Evidence-based practice implementation in community mental health settings: the relative importance of key domains of implementation activity.

PubMed

Torrey, William C; Bond, Gary R; McHugo, Gregory J; Swain, Karin

2012-09-01

Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers. This study investigated domains of implementation activities and correlated them to implementation success during a large national evidence-based practice implementation project. Implementation success was correlated with active leadership strategically devoted to redesigning the flow of work and reinforcing implementation through measurement and feedback. Relative attention to workforce development was negatively correlated with implementation. Active leaders should focus on redesigning the flow of work to support the implementation and on reinforcing program improvements.

Student Information Systems: A Guide to Implementation Success

ERIC Educational Resources Information Center

Cramer, Sharon F.

2005-01-01

What will expedite the implementation of a student information system? This document contains constructive examples and practical suggestions, giving readers a step-by-step approach to improving campus buy-in, communication, collaboration and funding; as well as leading project team members and campus administrators through the critically…

Development and validation of an automated ventilator-associated event electronic surveillance system: A report of a successful implementation.

PubMed

Hebert, Courtney; Flaherty, Jennifer; Smyer, Justin; Ding, Jing; Mangino, Julie E

2018-03-01

Surveillance is an important tool for infection control; however, this task can often be time-consuming and take away from infection prevention activities. With the increasing availability of comprehensive electronic health records, there is an opportunity to automate these surveillance activities. The objective of this article is to describe the implementation of an electronic algorithm for ventilator-associated events (VAEs) at a large academic medical center METHODS: This article reports on a 6-month manual validation of a dashboard for VAEs. We developed a computerized algorithm for automatically detecting VAEs and compared the output of this algorithm to the traditional, manual method of VAE surveillance. Manual surveillance by the infection preventionists identified 13 possible and 11 probable ventilator-associated pneumonias (VAPs), and the VAE dashboard identified 16 possible and 13 probable VAPs. The dashboard had 100% sensitivity and 100% accuracy when compared with manual surveillance for possible and probable VAP. We report on the successfully implemented VAE dashboard. Workflow of the infection preventionists was simplified after implementation of the dashboard with subjective time-savings reported. Implementing a computerized dashboard for VAE surveillance at a medical center with a comprehensive electronic health record is feasible; however, this required significant initial and ongoing work on the part of data analysts and infection preventionists. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Implementing quality initiatives in healthcare organizations: drivers and challenges.

PubMed

Abdallah, Abdallah

2014-01-01

Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

The Value of Successful MBSE Adoption

NASA Technical Reports Server (NTRS)

Parrott, Edith

2016-01-01

The value of successful adoption of Model Based System Engineering (MBSE) practices is hard to quantify. Most engineers and project managers look at the success in terms of cost. But there are other ways to quantify the value of MBSE and the steps necessary to achieve adoption. The Glenn Research Center (GRC) has been doing Model-Based Engineering (design, structural, etc.) for years, but the system engineering side has not. Since 2010, GRC has been moving from documents centric to MBSE/SysML. Project adoption of MBSE has been slow, but is steadily increasing in both MBSE usage and complexity of generated products. Sharing of knowledge of lessons learned in the implementation of MBSE/SysML is key for others who want to be successful. Along with GRC's implementation, NASA is working hard to increase the successful implementation of MBSE across all the other centers by developing guidelines, templates and libraries for projects to utilize. This presentation will provide insight into recent GRC and NASA adoption efforts, lessons learned and best practices.

Successful implementation of a perioperative glycemic control protocol in cardiac surgery: barrier analysis and intervention using lean six sigma.

PubMed

Martinez, Elizabeth A; Chavez-Valdez, Raul; Holt, Natalie F; Grogan, Kelly L; Khalifeh, Katherine W; Slater, Tammy; Winner, Laura E; Moyer, Jennifer; Lehmann, Christoph U

2011-01-01

Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period.

Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

PubMed Central

Martinez, Elizabeth A.; Chavez-Valdez, Raul; Holt, Natalie F.; Grogan, Kelly L.; Khalifeh, Katherine W.; Slater, Tammy; Winner, Laura E.; Moyer, Jennifer; Lehmann, Christoph U.

2011-01-01

Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200 mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period. PMID:22091218

Implementation Process of 5S for a Company in Real Life - Problems, Solutions, Successes

NASA Astrophysics Data System (ADS)

Czifra, György

2017-09-01

Developed in Japan, 5S is a system of organizing workplace for efficiency, effectiveness and safety. Is 5s important? The answer is: "YES", because the implementation is about empowering employees to control their work area and create an environment where they want to work every day. It is a program that only works with grass roots level engagement. With commitment to safety, we are equally committed to 5S to ensure a safe place to work. It enabled us to indicate where waste was occurring and thus improve the work area sustainably. We recognized real problems, found solutions and ultimately we were successful in our endeavors. Throughout different companies, various words of similar meaning are used. No matter what specific words are used to identify the steps in 5S, the purpose remains the same: create a clean, organized and efficient work environment.

Active Implementation Frameworks for Program Success: How to Use Implementation Science to Improve Outcomes for Children

ERIC Educational Resources Information Center

Metz, Allison; Bartley, Leah

2012-01-01

Over the past decade the science related to developing and identifying evidence-based programs and practices for children and families has improved significantly. However, the science related to implementing these programs in early childhood settings has lagged far behind. In this article, the authors outline how the science of implementation and…

Multidisciplinary approach to successful implementation of production information system (PRISM)

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

Shariff, M.R.; Gopalakrishnan, S.G.; Francis, N.

1995-12-31

A company wide corporate and regional production database supporting all production areas was envisaged critical to the current expansion within Petronas Carigali Sdn Bhd (PCSB). A multi disciplinary project team was thus formed to analyze the requirements prior to developing, testing, implementing and training users. PCSB has currently evolved into a mature E & P company on par with other E & P companies within the region. This expansion necessitates a common Production Information System for the efficient dissemination of vital Production Information for Production Surveillance, Reservoir Management, Reserve Assessment, Special Studies and Standardized Group-wide Reporting. This paper will discussmore » all the phases involved in the project which includes Systems Requirement Study, Data Migration, System Development, System Implementation and Post-Implementation Plan.« less

Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

PubMed

Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

2017-12-01

Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

Relationship between cotton yield and soil electrical conductivity, topography, and landsat imagery

USDA-ARS?s Scientific Manuscript database

Understanding spatial and temporal variability in crop yield is a prerequisite to implementing site-specific management of crop inputs. Apparent soil electrical conductivity (ECa), soil brightness, and topography are easily obtained data that can explain yield variability. The objectives of this stu...

Process and implementation of participatory ergonomic interventions: a systematic review.

PubMed

van Eerd, Dwayne; Cole, Donald; Irvin, Emma; Mahood, Quenby; Keown, Kiera; Theberge, Nancy; Village, Judy; St Vincent, Marie; Cullen, Kim

2010-10-01

Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount. STATEMENT OF RELEVANCE: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.

The First-Year Seminar: Designing, Implementing, and Assessing Courses to Support Student Learning and Success. Volume One: Designing and Administering the Course

ERIC Educational Resources Information Center

Keup, Jennifer R.; Petschauer, Joni Webb

2011-01-01

"The First-Year Seminar: Designing, Implementing, and Assessing Courses to Support Student Learning and Success," a five-volume series, is designed to assist educators who are interested in launching a first-year seminar or revamping an existing program. Each volume examines a different aspect of first-year seminar design or administration and…

Effect of Anisotropic Yield Function Evolution on Estimation of Forming Limit Diagram

NASA Astrophysics Data System (ADS)

Bandyopadhyay, K.; Basak, S.; Choi, H. J.; Panda, S. K.; Lee, M. G.

2017-09-01

In case of theoretical prediction of the FLD, the variations in yield stress and R-values along different material directions, were long been implemented to enhance the accuracy. Although influences of different yield models and hardening laws on formability were well addressed, anisotropic evolution of yield loci under monotonic loading with different deformation modes is yet to be explored. In the present study, Marciniak-Kuckzinsky (M-K) model was modified to incorporate the change in the shape of the initial yield function with evolution due to anisotropic hardening. Swift’s hardening law along with two different anisotropic yield criteria, namely Hill48 and Yld2000-2d were implemented in the model. The Hill48 yield model was applied with non-associated flow rule to comprehend the effect of variations in both yield stress and R-values. The numerically estimated FLDs were validated after comparing with FLD evaluated through experiments. A low carbon steel was selected, and hemispherical punch stretching test was performed for FLD evaluation. Additionally, the numerically estimated FLDs were incorporated in FE simulations to predict limiting dome heights for validation purpose. Other formability performances like strain distributions over the deformed cup surface were validated with experimental results.

Partitioning potential fish yields from the Great Lakes

USGS Publications Warehouse

Loftus, D.H.; Olver, C.H.; Brown, Edward H.; Colby, P.J.; Hartman, Wilbur L.; Schupp, D.H.

1987-01-01

We proposed and implemented procedures for partitioning future fish yields from the Great Lakes into taxonomic components. These projections are intended as guidelines for Great Lakes resource managers and scientists. Attainment of projected yields depends on restoration of stable fish communities containing some large piscivores that will use prey efficiently, continuation of control of the sea lamprey (Petromyzon marinus), and restoration of high-quality fish habitat. Because Great Lakes fish communities were harmonic before their collapse, we used their historic yield properties as part of the basis for projecting potential yields of rehabilitated communities. This use is qualified, however, because of possible inaccuracies in the wholly commercial yield data, the presence now of greatly expanded sport fisheries that affect yield composition and magnitude, and some possibly irreversible changes since the 1950s in the various fish communities themselves. We predict that total yields from Lakes Superior, Huron, and Ontario will be increased through rehabilitation, while those from Lakes Michigan and Erie will decline. Salmonines and coregonines will dominate future yields from the upper lakes. The Lake Erie fishery will continue to yield mostly rainbow smelt (Osmerus mordax), but the relative importance of percids, especially of walleye (Stizostedion vitreum vitreum) will increase. In Lake Ontario, yields of salmonines will be increased. Managers will have to apply the most rigorous management strictures to major predator species.

Implementing Student Information Systems

ERIC Educational Resources Information Center

Sullivan, Laurie; Porter, Rebecca

2006-01-01

Implementing an enterprise resource planning system is a complex undertaking. Careful planning, management, communication, and staffing can make the difference between a successful and unsuccessful implementation. (Contains 3 tables.)

Critical success factors for physical activity promotion through community partnerships.

PubMed

Lucidarme, Steffie; Marlier, Mathieu; Cardon, Greet; De Bourdeaudhuij, Ilse; Willem, Annick

2014-02-01

To define key factors of effective evidence-based policy implementation for physical activity promotion by use of a partnership approach. Using Parent and Harvey's model for sport and physical activity community-based partnerships, we defined determinants of implementation based on 13 face-to-face interviews with network organisations and 39 telephone interviews with partner organisations. Furthermore, two quantitative data-sets (n = 991 and n = 965) were used to measure implementation. In total, nine variables were found to influence implementation. Personal contact was the most powerful variable since its presence contributed to success while its absence led to a negative outcome. Four contributed directly to success: political motive, absence of a metropolis, high commitment and more qualified staff. Four others resulted in a less successful implementation: absence of positive merger effects, exposure motive and governance, and dispersed leadership. Community networks are a promising instrument for the implementation of evidence-based policies. However, determinants of both formation and management of partnerships influence the implementation success. During partnership formation, special attention should be given to partnership motives while social skills are of utmost importance for the management.

The Fostering Connections to Success and Increasing Adoptions Act: Implementation Issues and a Look Ahead at Additional Child Welfare Reforms. Working Paper

ERIC Educational Resources Information Center

Geen, Rob

2009-01-01

The passage of the Fostering Connections to Success and Increasing Adoptions Act (P.L. 110-351) represents the most significant federal child welfare reform in more than a decade. While the scope and nature of the federal reforms are far reaching, the actual impact of the legislation on children will depend largely upon how it is implemented.…

Government-to-private sector energy programs: Identification of common elements leading to successful implementation

NASA Astrophysics Data System (ADS)

Stockton, Keith M.

This dissertation examines six distinct government energy programs implemented in the United States during the last three decades. A common element within these programs is an attempt by government to drive commercialization of energy technologies leading to changes in energy production or consumptive behavior. We seek to understand the factors that lead to success or failure of these programs with two goals in mind. The first is theoretical in that we test a hypothesis that market-based energy programs have substantially higher success rates than command-and-control programs. The second goal is operational in nature, in which we desire to identify common factors within energy programs that lead either to program success or to failure. We investigate and evaluate three market-based and three command-and-control energy programs. The market-based programs include the federal Corporate Average Fuel Economy and Sulfur Dioxide Emissions Control programs as well as Colorado's Amendment 37. The command-and-control programs include the federal Synthetic Fuels Corporation and Corn Based Ethanol programs as well as Colorado's Solar Electric Power program. We conduct the analysis of each program based on composite methodology derived from leading academics within the Policy Sciences. From our research findings, we conclude that both market-based and command-and-control programs can achieve their legislative goals and objectives, resulting in permanent changes in energy production or consumptive behavior. However, we also find that the economic efficiency is the differentiator between market-based and command-and-control programs. Market-based programs, because of the inherent flexibility, allow participants to react to changing economic and/or technical conditions. In contrast, command-and-control programs lack such flexibility and often result in economic inefficiency when economic conditions change. The financial incentives incorporated in the three command

SU-E-P-05: Electronic Brachytherapy: A Physics Perspective On Field Implementation

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

Pai, S; Ayyalasomayajula, S; Lee, S

2015-06-15

Purpose: We want to summarize our experience implementing a successful program of electronic brachytherapy at several dermatology clinics with the help of a cloud based software to help us define the key program parameters and capture physics QA aspects. Optimally developed software helps the physicist in peer review and qualify the physical parameters. Methods: Using the XOFT™ Axxent™ electronic brachytherapy system in conjunction with a cloud-based software, a process was setup to capture and record treatments. It was implemented initially at about 10 sites in California. For dosimetric purposes, the software facilitated storage of the physics parameters of surface applicatorsmore » used in treatment and other source calibration parameters. In addition, the patient prescription, pathology and other setup considerations were input by radiation oncologist and the therapist. This facilitated physics planning of the treatment parameters and also independent check of the dwell time. From 2013–2014, nearly1500 such calculation were completed by a group of physicists. A total of 800 patients with multiple lesions have been treated successfully during this period. The treatment log files have been uploaded and documented in the software which facilitated physics peer review of treatments per the standards in place by AAPM and ACR. Results: The program model was implemented successfully at multiple sites. The cloud based software allowed for proper peer review and compliance of the program at 10 clinical sites. Dosimtery was done on 800 patients and executed in a timely fashion to suit the clinical needs. Accumulated physics data in the software from the clinics allows for robust analysis and future development. Conclusion: Electronic brachytherapy implementation experience from a quality assurance perspective was greatly enhanced by using a cloud based software. The comprehensive database will pave the way for future developments to yield superior physics

A process to help assure successful commercial space ventures

NASA Astrophysics Data System (ADS)

Mihara, Sam K.

1999-01-01

The purpose of this paper is to describe a process for successful space business ventures-a methodology used by highly successful commercial ventures, but relatively new to space business enterprises. What do highly successful commercial business ventures have in common? How do these companies differ from most commercial space ventures? The answer is the implementation of a state-of-the-art customer satisfaction process. Take the case of the latest winners of the Malcolm Baldrige National Quality Award. What did they do that helped to achieve this performance? The answer is they implemented an effective process that measures and achieves the highest possible level of customer satisfaction. The same process can be implemented by space enterprises to achieve comparable commercial results. This paper describes the six-step process, including examples of each step. It concludes with the strong recommendation that this process be implemented to assure success in the commercial space world.

The First-Year Seminar: Designing, Implementing, and Assessing Courses to Support Student Learning and Success: Volume Three: Teaching in the First-Year Seminar

ERIC Educational Resources Information Center

Garner, Brad

2012-01-01

"The First-Year Seminar: Designing, Implementing, and Assessing Courses to Support Student Learning and Success," a five-volume series, is designed to assist educators who are interested in launching a first-year seminar or revamping an existing program. Each volume examines a different aspect of first-year seminar design or…

Preparing staff for intentional rounding: a process yielding success on a general surgical unit.

PubMed

Patterson, Lisa M

2014-01-01

Intentional rounding is a strategicway to improve patient care through decreasing falls and hospital-acquired pressure ulcers, while increasing patient satisfaction. On the basis of literature reviews and discussions with nurses on units that pilot-tested intentional rounding, useful strategies emerged. This article will provide information about intentional rounding, a means for planning implementation, and the results of evaluating its implementation.

Five Steps to Successfully Implement and Evaluate Propensity Score Matching in Clinical Research Studies.

PubMed

Staffa, Steven J; Zurakowski, David

2018-01-09

In clinical research, the gold standard level of evidence is the randomized controlled trial (RCT). The availability of nonrandomized retrospective data is growing; however, a primary concern of analyzing such data is comparability of the treatment groups with respect to confounding variables. Propensity score matching (PSM) aims to equate treatment groups with respect to measured baseline covariates to achieve a comparison with reduced selection bias. It is a valuable statistical methodology that mimics the RCT, and it may create an "apples to apples" comparison while reducing bias due to confounding. PSM can improve the quality of anesthesia research and broaden the range of research opportunities. PSM is not necessarily a magic bullet for poor-quality data, but rather may allow the researcher to achieve balanced treatment groups similar to a RCT when high-quality observational data are available. PSM may be more appealing than the common approach of including confounders in a regression model because it allows for a more intuitive analysis of a treatment effect between 2 comparable groups.We present 5 steps that anesthesiologists can use to successfully implement PSM in their research with an example from the 2015 Pediatric National Surgical Quality Improvement Program: a validated, annually updated surgery and anesthesia pediatric database. The first step of PSM is to identify its feasibility with regard to the data at hand and ensure availability of data on any potential confounders. The second step is to obtain the set of propensity scores from a logistic regression model with treatment group as the outcome and the balancing factors as predictors. The third step is to match patients in the 2 treatment groups with similar propensity scores, balancing all factors. The fourth step is to assess the success of the matching with balance diagnostics, graphically or analytically. The fifth step is to apply appropriate statistical methodology using the propensity

[How patient safety programmes can be successfully implemented - an example from Switzerland].

PubMed

Kobler, Irene; Mascherek, Anna; Bezzola, Paula

2015-01-01

Internationally, the implementation of patient safety programmes poses a major challenge. In the first part, we will demonstrate that various measures have been found to be effective in the literature but that they often do not reach the patient because their implementation proves difficult. Difficulties arise from both the complexity of the interventions themselves and from different organisational settings in individual hospitals. The second part specifically describes the implementation of patient safety improvement programmes in Switzerland and discusses measures intended to bridge the gap between the theory and practice of implementation in Switzerland. Then, the national pilot programme to improve patient safety in surgery is presented, which was launched by the federal Swiss government and has been implemented by the patient safety foundation. Procedures, challenges and highlights in implementing the programme in Switzerland on a national level are outlined. Finally, first (preliminary) results are presented and critically discussed. Copyright © 2015. Published by Elsevier GmbH.

Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.

PubMed

Ward, Marcia M; Baloh, Jure; Zhu, Xi; Stewart, Greg L

A particularly useful model for examining implementation of quality improvement interventions in health care settings is the PARIHS (Promoting Action on Research Implementation in Health Services) framework developed by Kitson and colleagues. The PARIHS framework proposes three elements (evidence, context, and facilitation) that are related to successful implementation. An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by the Agency for Healthcare Research and Quality, but research is needed to better understand its implementation. We apply the PARIHS framework in studying TeamSTEPPS implementation to identify elements that are most closely related to successful implementation. Quarterly interviews were conducted over a 9-month period in 13 small rural hospitals that implemented TeamSTEPPS. Interview quotes that were related to each of the PARIHS elements were identified using directed content analysis. Transcripts were also scored quantitatively, and bivariate regression analysis was employed to explore relationships between PARIHS elements and successful implementation related to planning activities. The current findings provide support for the PARIHS framework and identified two of the three PARIHS elements (context and facilitation) as important contributors to successful implementation. This study applies the PARIHS framework to TeamSTEPPS, a widely used quality initiative focused on improving health care quality and patient safety. By focusing on small rural hospitals that undertook this quality improvement activity of their own accord, our findings represent effectiveness research in an understudied segment of the health care delivery system. By identifying context and facilitation as the most important contributors to successful implementation, these analyses provide a focus for efficient and effective sustainment of Team

Significantly improving the yield of recombinant proteins in Bacillus subtilis by a novel powerful mutagenesis tool (ARTP): Alkaline α-amylase as a case study.

PubMed

Ma, Yingfang; Yang, Haiquan; Chen, Xianzhong; Sun, Bo; Du, Guocheng; Zhou, Zhemin; Song, Jiangning; Fan, You; Shen, Wei

2015-10-01

In this study, atmospheric and room temperature plasma (ARTP), a promising mutation breeding technique, was successfully applied to generate Bacillus subtilis mutants that yielded large quantities of recombinant protein. The high throughput screening platform was implemented to select those mutants with the highest yield of recombinant alkaline α-amylase (AMY), including the preferred mutant B. subtilis WB600 mut-12#. The yield and productivity of recombinant AMY in B. subtilis WB600 mut-12# increased 35.0% and 8.8%, respectively, the extracellular protein concentration of which increased 37.9%. B. subtilis WB600 mut-12# exhibited good genetic stability. Cells from B. subtilis WB600 mut-12# became shorter and wider than those from the wild-type. This study is the first to report a novel powerful mutagenesis tool (ARTP) that significantly improves the yield of recombinant proteins in B. subtilis and may therefore play an important role in the high expression level of proteins in recombinant microbial hosts. Copyright © 2015 Elsevier Inc. All rights reserved.

Declining nitrate-N yields in the Upper Potomac River Basin: What is really driving progress under the Chesapeake Bay restoration?

NASA Astrophysics Data System (ADS)

Eshleman, Keith N.; Sabo, Robert D.

2016-12-01

Reducing nutrient pollution of surface and coastal waters in the U.S. and elsewhere remains a major environmental and engineering challenge for the 21st century. In the case of the Chesapeake Bay restoration, we still lack scientific proof that watershed-based management actions have been effective at reducing nonpoint-source nutrient loads from the land to this estuary in accordance with restoration goals. While the conventional wisdom is that implementation of best management practices (BMP's) and wastewater treatment have turned the tide against nutrient pollution, we examined long-term (1986-present) nitrate-N trends in streams and major tributaries of the Upper Potomac River Basin (UPRB) and found that: 1) dramatic reductions in annual discharge-weighted mean nitrate-N concentrations and yields across the UPRB can be almost universally attributed to reductions in atmospheric N deposition as opposed to on-the-ground management actions such as implementation of BMP's; 2) observed water quality changes generally comport with a modified kinetic N saturation model (MKNSM); 3) the MKNSM can separate the nitrate-N yield that is responsive to atmospheric deposition from a "non-responsive" yield; and 4) N saturation from atmospheric N deposition appears to be an inherently reversible process across most of the landscape. These unanticipated region-wide water quality benefits can be attributed to NOx emission controls brought about by the 1990 Clean Air Act Amendments (and subsequent U.S. NOX control programs) and reflect a water quality "success story" in the Chesapeake Bay restoration.

Succession planning in state departments of transportation.

DOT National Transportation Integrated Search

2012-07-01

This project examines how state departments of transportation understand and implement : the human resources management practice of succession planning. Past research : examining succession planning in the public sector has identified numerous potent...

IPAS Implementation Handbook

ERIC Educational Resources Information Center

Brooks, D. Christopher

2014-01-01

While the use of analytics to promote student success is gaining in popularity, basic questions about what IPAS is and the issues institutions face during implementation and integration. The "IPAS Implementation Handbook" catalogs the experiences, observations, and practical advice from 19 institutions engaged in IPAS implementation…

Creating a High-Touch Recruitment Event: Utilizing Faculty to Recruit and Yield Students

ERIC Educational Resources Information Center

Freed, Lindsey R.; Howell, Leanne L.

2018-01-01

The following article describes the planning and implementation of a university student recruitment event that produced a high (new) student yield. Detailed descriptions of how staff and faculty worked together to plan and implement this event are described.

Examining Health Information Technology Implementation Success Factors in Critical Access Hospitals

ERIC Educational Resources Information Center

Monkman, Blake D.

2016-01-01

As the role of information technology increases throughout the world, healthcare providers in the United States face industry and governmental pressures to implement health information technology (HIT) as a tool to improve healthcare costs, quality, and safety. The problem addressed in this study was the relatively low HIT implementation success…

Paving the Way to Successful Implementation: Identifying Key Barriers to Use of Technology-Based Therapeutic Tools for Behavioral Health Care.

PubMed

Ramsey, Alex; Lord, Sarah; Torrey, John; Marsch, Lisa; Lardiere, Michael

2016-01-01

This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost and privacy), potential end users (e.g., technology literacy and attitudes about technology), organization structure and climate (e.g., budget and infrastructure), and factors external to organizations (e.g., broadband accessibility and reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools.

Paving the Way to Successful Implementation: Identifying Key Barriers to Use of Technology-Based Therapeutic Tools for Behavioral Health Care

PubMed Central

Ramsey, Alex; Lord, Sarah; Torrey, John; Marsch, Lisa; Lardiere, Michael

2014-01-01

This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision-makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision-makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost, privacy), potential end-users (e.g., technology literacy, attitudes about technology), organization structure and climate (e.g., budget, infrastructure), and factors external to organizations (e.g., broadband accessibility, reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools. PMID:25192755

Improving yield and reliability of FIB modifications using electrical testing

NASA Astrophysics Data System (ADS)

Desplats, Romain; Benbrik, Jamel; Benteo, Bruno; Perdu, Philippe

1998-08-01

Focused Ion Beam technology has two main areas of application for ICs: modification and preparation for technological analysis. The most solicited area is modification. This involves physically modifying a circuit by cutting lines and creating new ones in order to change the electrical function of the circuit. IC planar technologies have an increasing number of metal interconnections making FIB modifications more complex and decreasing their changes of success. The yield of FIB operations on ICs reflects a downward trend that imposes a greater number of circuits to be modified in order to successfully correct a small number of them. This requires extended duration, which is not compatible with production line turn around times. To respond to this problem, two solutions can be defined: either, reducing the duration of each FIB operation or increasing the success rate of FIB modifications. Since reducing the time depends mainly on FIB operator experience, insuring a higher success rate represents a more crucial aspect as both experienced and novice operators could benefit from this improvement. In order to insure successful modifications, it is necessary to control each step of a FIB operation. To do this, we have developed a new method using in situ electrical testing which has a direct impact on the yield of FIB modifications. We will present this innovative development through a real case study of a CMOS ASIC for high-speed communications. Monitoring the electrical behavior at each step in a FIB operation makes it possible to reduce the number of circuits to be modified and consequently reduces system costs thanks to better yield control. Knowing the internal electrical behavior also gives us indications about the impact on reliability of FIB modified circuits. Finally, this approach can be applied to failure analysis and FIB operations on flip chip circuits.

Using Win-Win Strategies to Implement Health in All Policies: A Cross-Case Analysis

PubMed Central

Molnar, Agnes; Renahy, Emilie; O’Campo, Patricia; Muntaner, Carles; Freiler, Alix; Shankardass, Ketan

2016-01-01

Background In spite of increasing research into intersections of public policy and health, little evidence shows how policy processes impact the implementation of Health in All Policies (HiAP) initiatives. Our research sought to understand how and why strategies for engaging partners from diverse policy sectors in the implementation of HiAP succeed or fail in order to uncover the underlying social mechanisms contributing to sustainable implementation of HiAP. Methods In this explanatory multiple case study, we analyzed grey and peer-review literature and key informant interviews to identify mechanisms leading to implementation successes and failures in relation to different strategies for engagement across three case studies (Sweden, Quebec and South Australia), after accounting for the role of different contextual conditions. Findings Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to “win-win” strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors. Conclusion Our findings enrich theoretical understanding in an under-unexplored area of intersectoral action. They also provide policy makers with examples of HiAP across wealthy

Maximized exoEarth candidate yields for starshades

NASA Astrophysics Data System (ADS)

Stark, Christopher C.; Shaklan, Stuart; Lisman, Doug; Cady, Eric; Savransky, Dmitry; Roberge, Aki; Mandell, Avi M.

2016-10-01

The design and scale of a future mission to directly image and characterize potentially Earth-like planets will be impacted, to some degree, by the expected yield of such planets. Recent efforts to increase the estimated yields, by creating observation plans optimized for the detection and characterization of Earth-twins, have focused solely on coronagraphic instruments; starshade-based missions could benefit from a similar analysis. Here we explore how to prioritize observations for a starshade given the limiting resources of both fuel and time, present analytic expressions to estimate fuel use, and provide efficient numerical techniques for maximizing the yield of starshades. We implemented these techniques to create an approximate design reference mission code for starshades and used this code to investigate how exoEarth candidate yield responds to changes in mission, instrument, and astrophysical parameters for missions with a single starshade. We find that a starshade mission operates most efficiently somewhere between the fuel- and exposuretime-limited regimes and, as a result, is less sensitive to photometric noise sources as well as parameters controlling the photon collection rate in comparison to a coronagraph. We produced optimistic yield curves for starshades, assuming our optimized observation plans are schedulable and future starshades are not thrust-limited. Given these yield curves, detecting and characterizing several dozen exoEarth candidates requires either multiple starshades or an η≳0.3.

Multi-site implementation of nutrition screening and diagnosis in medical care units: Success of the More-2-Eat project.

PubMed

Keller, Heather H; Valaitis, Renata; Laur, Celia V; McNicholl, Tara; Xu, Yingying; Dubin, Joel A; Curtis, Lori; Obiorah, Suzanne; Ray, Sumantra; Bernier, Paule; Gramlich, Leah; Stickles-White, Marilee; Laporte, Manon; Bell, Jack

2018-03-22

Improving the detection and treatment of malnourished patients in hospital is needed to promote recovery. To describe the change in rates of detection and triaging of care for malnourished patients in 5 hospitals that were implementing an evidence-based nutrition care algorithm. To demonstrate that following this algorithm leads to increased detection of malnutrition and increased treatment to mitigate this condition. Sites worked towards implementing the Integrated Nutrition Pathway for Acute Care (INPAC), including screening (Canadian Nutrition Screening Tool) and triage (Subjective Global Assessment; SGA) to detect and diagnose malnourished patients. Implementation occurred over a 24-month period, including developmental (Period 1), implementation (Periods 2-5), and sustainability (Period 6) phases. Audits (n = 36) of patient health records (n = 5030) were conducted to identify nutrition care practices implemented with a variety of strategies and behaviour change techniques. All sites increased nutrition screening from Period 1, with three achieving the goal of 75% of admitted patients being screened by Period 3, and the remainder achieving a rate of 70% by end of implementation. No sites were conducting SGA at Period 1, and sites reached the goal of a 75% completion rate or referral for those identified to be at nutrition risk, by Period 3 or 4. By Period 2, 100% of patients identified as SGA C (severely malnourished) were receiving a comprehensive nutritional assessment. In Period 1, the nutrition diagnosis and documentation by the dietitian of 'malnutrition' was a modest 0.37%, increasing to over 5% of all audited health records. The overall use of any Advanced Nutrition Care practices increased from 31% during Period 1 to 63% during Period 6. The success of this multi-site study demonstrated that implementation of nutrition screening and diagnosis is feasible and leads to appropriate care. INPAC promotes efficiency in nutrition care while minimizing

Goals and hurdles for a successful implementation of genomic selection in breeding programme for selected annual and perennial crops.

PubMed

Jonas, Elisabeth; de Koning, Dirk Jan

Genomic Selection is an important topic in quantitative genetics and breeding. Not only does it allow the full use of current molecular genetic technologies, it stimulates also the development of new methods and models. Genomic selection, if fully implemented in commercial farming, should have a major impact on the productivity of various agricultural systems. But suggested approaches need to be applicable in commercial breeding populations. Many of the published research studies focus on methodologies. We conclude from the reviewed publications, that a stronger focus on strategies for the implementation of genomic selection in advanced breeding lines, introduction of new varieties, hybrids or multi-line crosses is needed. Efforts to find solutions for a better prediction and integration of environmental influences need to continue within applied breeding schemes. Goals of the implementation of genomic selection into crop breeding should be carefully defined and crop breeders in the private sector will play a substantial part in the decision-making process. However, the lack of published results from studies within, or in collaboration with, private companies diminishes the knowledge on the status of genomic selection within applied breeding programmes. Studies on the implementation of genomic selection in plant breeding need to evaluate models and methods with an enhanced emphasis on population-specific requirements and production environments. Adaptation of methods to breeding schemes or changes to breeding programmes for a better integration of genomic selection strategies are needed across species. More openness with a continuous exchange will contribute to successes.

Electronic Health Record Implementation: A SWOT Analysis.

PubMed

Shahmoradi, Leila; Darrudi, Alireza; Arji, Goli; Farzaneh Nejad, Ahmadreza

2017-10-01

Electronic Health Record (EHR) is one of the most important achievements of information technology in healthcare domain, and if deployed effectively, it can yield predominant results. The aim of this study was a SWOT (strengths, weaknesses, opportunities, and threats) analysis in electronic health record implementation. This is a descriptive, analytical study conducted with the participation of a 90-member work force from Hospitals affiliated to Tehran University of Medical Sciences (TUMS). The data were collected by using a self-structured questionnaire and analyzed by SPSS software. Based on the results, the highest priority in strength analysis was related to timely and quick access to information. However, lack of hardware and infrastructures was the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics was the significant opportunity of EHR. Finally, the most substantial threats were the lack of strategic planning in the field of electronic health records together with physicians' and other clinical staff's resistance in the use of electronic health records. To facilitate successful adoption of electronic health record, some organizational, technical and resource elements contribute; moreover, the consideration of these factors is essential for HER implementation.

Succession planning: securing the future.

PubMed

Bolton, Julia; Roy, Wendy

2004-12-01

Succession planning is an essential business strategy for healthcare organizations, given the impending retirement of the huge Baby Boomer cohort of experienced nurses. It ensures that there will be qualified candidates when key vacancies occur. The authors describe the critical elements of a succession plan and suggest ways to implement them. The model can be applied to leadership and clinical positions.

Facilitating Ambulatory Electronic Health Record System Implementation: Evidence from a Qualitative Study

PubMed Central

Hefner, Jennifer; Robbins, Julie; Huerta, Timothy R.

2013-01-01

Background. Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR) systems, but little information is available documenting how organizations have successfully implemented these systems. Objective. To characterize elements of successful electronic health record (EHR) system implementation and to synthesize the key informants' perspectives about successful implementation practices. Methods. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods. Results. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during “go-live” and, subsequently, when users had more experience with the system. Conclusion. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success. PMID:24228257

Three Elements of Success: Attendance, Tutoring, and Advising

ERIC Educational Resources Information Center

Fowler, Paul

2007-01-01

Described as "tough love," Louisiana State University at Eunice's "Pathways to Success" program experienced success in its first two years by implementing mandatory placement, attendance, tutoring, and advising policies. Selected student successes and retention data are discussed, along with policies and some practical advice…

Successful implementation of a neonatal pain and sedation protocol at 2 NICUs.

PubMed

Deindl, Philipp; Unterasinger, Lukas; Kappler, Gregor; Werther, Tobias; Czaba, Christine; Giordano, Vito; Frantal, Sophie; Berger, Angelika; Pollak, Arnold; Olischar, Monika

2013-07-01

To evaluate the implementation of a neonatal pain and sedation protocol at 2 ICUs. The intervention started with the evaluation of local practice, problems, and staff satisfaction. We then developed and implemented the Vienna Protocol for Neonatal Pain and Sedation. The protocol included well-defined strategies for both nonpharmacologic and pharmacologic interventions based on regular assessment of a translated version of the Neonatal Pain Agitation and Sedation Scale and titration of analgesic and sedative therapy according to aim scores. Health care staff was trained in the assessment by using a video-based tutorial and bedside teaching. In addition, we performed reevaluation, retraining, and random quality checks. Frequency and quality of assessments, pharmacologic therapy, duration of mechanical ventilation, and outcome were compared between baseline (12 months before implementation) and 12 months after implementation. Cumulative median (interquartile range) opiate dose (baseline dose of 1.4 [0.5-5.9] mg/kg versus intervention group dose of 2.7 [0.4-57] mg/kg morphine equivalents; P = .002), pharmacologic interventions per episode of continuous sedation/analgesia (4 [2-10] vs 6 [2-13]; P = .005), and overall staff satisfaction (physicians: 31% vs 89%; P < .001; nurses: 17% vs 55%; P < .001) increased after implementation. Time on mechanical ventilation, length of stay at the ICU, and adverse outcomes were similar before and after implementation. Implementation of a neonatal pain and sedation protocol at 2 ICUs resulted in an increase in opiate prescription, pharmacologic interventions, and staff satisfaction without affecting time on mechanical ventilation, length of intensive care stay, and adverse outcomes.

Biochar derived from corn straw affected availability and distribution of soil nutrients and cotton yield.

PubMed

Tian, Xiaofei; Li, Chengliang; Zhang, Min; Wan, Yongshan; Xie, Zhihua; Chen, Baocheng; Li, Wenqing

2018-01-01

Biochar application as a soil amendment has been proposed as a strategy to improve soil fertility and increase crop yields. However, the effects of successive biochar applications on cotton yields and nutrient distribution in soil are not well documented. A three-year field study was conducted to investigate the effects of successive biochar applications at different rates on cotton yield and on the soil nutrient distribution in the 0-100 cm soil profile. Biochar was applied at 0, 5, 10, and 20 t ha-1 (expressed as Control, BC5, BC10, and BC20, respectively) for each cotton season, with identical doses of chemical fertilizers. Biochar enhanced the cotton lint yield by 8.0-15.8%, 9.3-13.9%, and 9.2-21.9% in 2013, 2014, and 2015, respectively, and high levels of biochar application achieved high cotton yields each year. Leaching of soil nitrate was reduced, while the pH values, soil organic carbon, total nitrogen (N), and available K content of the 0-20 cm soil layer were increased in 2014 and 2015. However, the changes in the soil available P content were less substantial. This study suggests that successive biochar amendments have the potential to enhance cotton productivity and soil fertility while reducing nitrate leaching.

A new simple six-step model to promote recruitment to RCTs was developed and successfully implemented.

PubMed

Realpe, Alba; Adams, Ann; Wall, Peter; Griffin, Damian; Donovan, Jenny L

2016-08-01

How a randomized controlled trial (RCT) is explained to patients is a key determinant of recruitment to that trial. This study developed and implemented a simple six-step model to fully inform patients and to support them in deciding whether to take part or not. Ninety-two consultations with 60 new patients were recorded and analyzed during a pilot RCT comparing surgical and nonsurgical interventions for hip impingement. Recordings were analyzed using techniques of thematic analysis and focused conversation analysis. Early findings supported the development of a simple six-step model to provide a framework for good recruitment practice. Model steps are as follows: (1) explain the condition, (2) reassure patients about receiving treatment, (3) establish uncertainty, (4) explain the study purpose, (5) give a balanced view of treatments, and (6) Explain study procedures. There are also two elements throughout the consultation: (1) responding to patients' concerns and (2) showing confidence. The pilot study was successful, with 70% (n = 60) of patients approached across nine centers agreeing to take part in the RCT, so that the full-scale trial was funded. The six-step model provides a promising framework for successful recruitment to RCTs. Further testing of the model is now required. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Water yield following forest-grass-forest transitions

Treesearch

Katherine J. Elliott; Peter V. Caldwell; Steven T. Brantley; Chelcy F. Miniat; James M. Vose; Wayne Swank

2017-01-01

Many currently forested areas in the southern Appalachians were harvested in the early 1900s and cleared for agriculture or pasture, but have since been abandoned and reverted to forest (old-field succession). Land-use and land-cover changes such as these may have altered the timing and quantity of water yield (Q). We examined 80 years of streamflow and vegetation data...

Succesful Lean Manufacturing Implementation: Internal Key Influencing Factors

NASA Astrophysics Data System (ADS)

Virginia, Iuga; Claudiu, Kifor

2015-09-01

Manufacturing sectors and companies all over the world are successfully implementing lean principles within their processes. Nowadays, lean has become an indispensable part of global players. Companies worldwide need to be aware of multiple factors which weigh heavily on the success or failure of lean implementation. This paper focuses on giving a brief and structured overview over the fundamental organizational factors which play a substantial role for the lean manufacturing (LM) implementation process. The study below focuses on internal factors which are indispensable for a successful LM implementation within organizations. It is imperative that these internal factors are known, recognized and taken into consideration during the whole LM implementation process. Ignoring their influence on the process's implementation may lead to endangering the expected results or to making the process more difficult which could result in much higher human resource consumption.

Efficient SRAM yield optimization with mixture surrogate modeling

NASA Astrophysics Data System (ADS)

Zhongjian, Jiang; Zuochang, Ye; Yan, Wang

2016-12-01

Largely repeated cells such as SRAM cells usually require extremely low failure-rate to ensure a moderate chi yield. Though fast Monte Carlo methods such as importance sampling and its variants can be used for yield estimation, they are still very expensive if one needs to perform optimization based on such estimations. Typically the process of yield calculation requires a lot of SPICE simulation. The circuit SPICE simulation analysis accounted for the largest proportion of time in the process yield calculation. In the paper, a new method is proposed to address this issue. The key idea is to establish an efficient mixture surrogate model. The surrogate model is based on the design variables and process variables. This model construction method is based on the SPICE simulation to get a certain amount of sample points, these points are trained for mixture surrogate model by the lasso algorithm. Experimental results show that the proposed model is able to calculate accurate yield successfully and it brings significant speed ups to the calculation of failure rate. Based on the model, we made a further accelerated algorithm to further enhance the speed of the yield calculation. It is suitable for high-dimensional process variables and multi-performance applications.

Presidential Succession: The Role of the President in Succession Planning at Baptist Colleges and Universities

ERIC Educational Resources Information Center

Wright, Adam C.

2012-01-01

The purpose of this qualitative grounded theory study was to examine the role of the president in succession planning at Baptist colleges and universities. Purposeful, criterion sampling yielded twelve presidents to participate in this study. They ranged in years of service from one to 13 years of experience as a president. Data collection…

AMMI adjustment for statistical analysis of an international wheat yield trial.

PubMed

Crossa, J; Fox, P N; Pfeiffer, W H; Rajaram, S; Gauch, H G

1991-01-01

Multilocation trials are important for the CIMMYT Bread Wheat Program in producing high-yielding, adapted lines for a wide range of environments. This study investigated procedures for improving predictive success of a yield trial, grouping environments and genotypes into homogeneous subsets, and determining the yield stability of 18 CIMMYT bread wheats evaluated at 25 locations. Additive Main effects and Multiplicative Interaction (AMMI) analysis gave more precise estimates of genotypic yields within locations than means across replicates. This precision facilitated formation by cluster analysis of more cohesive groups of genotypes and locations for biological interpretation of interactions than occurred with unadjusted means. Locations were clustered into two subsets for which genotypes with positive interactions manifested in high, stable yields were identified. The analyses highlighted superior selections with both broad and specific adaptation.

Designing and Implementing a Successful Gender-Neutral Housing Community

ERIC Educational Resources Information Center

Hobson, Amanda

2014-01-01

Gender-neutral housing (GNH) offers a safe and inclusive environment for students who have need and desire for a space that is gender inclusive and does not limit placement to sex as assigned at birth. In predominant gender-based housing models, students who are gender nonconforming find limited options. The request for, and implementation of, GNH…

Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

PubMed

Itri, Jason N; Jones, Lisa P; Kim, Woojin; Boonn, William W; Kolansky, Ana S; Hilton, Susan; Zafar, Hanna M

2014-04-01

Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department. The open source tools PHP: Hypertext Preprocessor (PHP) and MySQL were used to extract relevant procedural information from the Radiology Information System (RIS), auto-populate the procedure log database, and develop a user interface that generates real-time reports of complication rates and diagnostic yield by site and by operator. Utilizing structured radiology report templates resulted in significantly improved accuracy of information auto-populated from radiology reports, as well as greater compliance with manual data entry. An automated web-based procedure log database is an effective tool to reliably track complication rates and diagnostic yield for US- and CT-guided procedures performed in a radiology department.

Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders.

PubMed

Coronado, Gloria D; Schneider, Jennifer L; Petrik, Amanda; Rivelli, Jennifer; Taplin, Stephen; Green, Beverly B

2017-09-01

Little is known about the challenges faced by community clinics who must address clinical priorities first when participating in pragmatic studies. We report on implementation challenges faced by the eight community health centers that participated in Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), a large comparative effectiveness cluster-randomized trial to evaluate a direct-mail program to increase the rate of colorectal cancer (CRC) screening. We conducted interviews, at the onset of implementation and 1 year later, with center leaders to identify challenges with implementing and sustaining an electronic medical record (EMR)-driven mailed program to increase CRC screening rates. We used the Consolidated Framework for Implementation Research to thematically analyze the content of meeting discussions and identify anticipated and experienced challenges. Common early concerns were patients' access to colonoscopy, patients' low awareness of CRC screening, time burden on clinic staff to carry out the STOP CRC program, inability to accurately identify eligible patients, and incompatibility of the program's approach with the patient population or organizational culture. Once the program was rolled out, time burden remained a primary concern and new organizational capacity and EMR issues were raised (e.g., EMR staffing resources and turnover in key leadership positions). Cited program successes were improved CRC screening processes and rates, more patients reached, reduced costs, and improved patient awareness, engagement, or satisfaction. These findings may inform any clinic considering mailed fecal testing programs and future pragmatic research efforts in community health centers.

Implementation of a hospital-based quality assessment program for rectal cancer.

PubMed

Hendren, Samantha; McKeown, Ellen; Morris, Arden M; Wong, Sandra L; Oerline, Mary; Poe, Lyndia; Campbell, Darrell A; Birkmeyer, Nancy J

2014-05-01

Quality improvement programs in Europe have had a markedly beneficial effect on the processes and outcomes of rectal cancer care. The quality of rectal cancer care in the United States is not as well understood, and scalable quality improvement programs have not been developed. The purpose of this article is to describe the implementation of a hospital-based quality assessment program for rectal cancer, targeting both community and academic hospitals. We recruited 10 hospitals from a surgical quality improvement organization. Nurse reviewers were trained to abstract rectal cancer data from hospital medical records, and abstracts were assessed for accuracy. We conducted two surveys to assess the training program and limitations of the data abstraction. We validated data completeness and accuracy by comparing hospital medical record and tumor registry data. Nine of 10 hospitals successfully performed abstractions with ≥ 90% accuracy. Experienced nurse reviewers were challenged by the technical details in operative and pathology reports. Although most variables had less than 10% missing data, outpatient testing information was lacking from some hospitals' inpatient records. This implementation project yielded a final quality assessment program consisting of 20 medical records variables and 11 tumor registry variables. An innovative program linking tumor registry data to quality-improvement data for rectal cancer quality assessment was successfully implemented in 10 hospitals. This data platform and training program can serve as a template for other organizations that are interested in assessing and improving the quality of rectal cancer care. Copyright © 2014 by American Society of Clinical Oncology.

Implementation of a volunteer university student research assistant program in an emergency department: the nuts and bolts for success.

PubMed

Steadman, Patrick E; Crudden, Johanna; Boutis, Kathy

2015-09-01

Prospective research studies often advance clinical practice in the emergency department (ED), but they can be costly and difficult to perform. In this report, we describe the implementation of a volunteer university student research assistant program that provides students exposure to medicine and clinical research while simultaneously increasing the capacity of an ED's research program. This type of program provides 15 hours per day of research assistant coverage for patient screening and enrolment for minimal risk research studies, and screening for higher risk studies. The latter is true without the added burden or costs of co-administering university course credit or pay for service, which are common features of most of these types of programs currently in operation. We have shown that our volunteer-based program is effective for an ED's research success as well as for its student participants. For other EDs interested in adopting similar programs, we provide the details on how to get such a program started and highlight the structure and non-monetary incentives that facilitate a program's ongoing success.

Biochar derived from corn straw affected availability and distribution of soil nutrients and cotton yield

PubMed Central

Tian, Xiaofei; Zhang, Min; Wan, Yongshan; Xie, Zhihua; Chen, Baocheng; Li, Wenqing

2018-01-01

Biochar application as a soil amendment has been proposed as a strategy to improve soil fertility and increase crop yields. However, the effects of successive biochar applications on cotton yields and nutrient distribution in soil are not well documented. A three-year field study was conducted to investigate the effects of successive biochar applications at different rates on cotton yield and on the soil nutrient distribution in the 0–100 cm soil profile. Biochar was applied at 0, 5, 10, and 20 t ha-1 (expressed as Control, BC5, BC10, and BC20, respectively) for each cotton season, with identical doses of chemical fertilizers. Biochar enhanced the cotton lint yield by 8.0–15.8%, 9.3–13.9%, and 9.2–21.9% in 2013, 2014, and 2015, respectively, and high levels of biochar application achieved high cotton yields each year. Leaching of soil nitrate was reduced, while the pH values, soil organic carbon, total nitrogen (N), and available K content of the 0–20 cm soil layer were increased in 2014 and 2015. However, the changes in the soil available P content were less substantial. This study suggests that successive biochar amendments have the potential to enhance cotton productivity and soil fertility while reducing nitrate leaching. PMID:29324750

Strategy for continuous improvement in IC manufacturability, yield, and reliability

NASA Astrophysics Data System (ADS)

Dreier, Dean J.; Berry, Mark; Schani, Phil; Phillips, Michael; Steinberg, Joe; DePinto, Gary

1993-01-01

Continual improvements in yield, reliability and manufacturability measure a fab and ultimately result in Total Customer Satisfaction. A new organizational and technical methodology for continuous defect reduction has been established in a formal feedback loop, which relies on yield and reliability, failed bit map analysis, analytical tools, inline monitoring, cross functional teams and a defect engineering group. The strategy requires the fastest detection, identification and implementation of possible corrective actions. Feedback cycle time is minimized at all points to improve yield and reliability and reduce costs, essential for competitiveness in the memory business. Payoff was a 9.4X reduction in defectivity and a 6.2X improvement in reliability of 256 K fast SRAMs over 20 months.

Successive DNA extractions improve characterization of soil microbial communities

PubMed Central

de Hollander, Mattias; Smidt, Hauke; van Veen, Johannes A.

2017-01-01

Currently, characterization of soil microbial communities relies heavily on the use of molecular approaches. Independently of the approach used, soil DNA extraction is a crucial step, and success of downstream procedures will depend on how well DNA extraction was performed. Often, studies describing and comparing soil microbial communities are based on a single DNA extraction, which may not lead to a representative recovery of DNA from all organisms present in the soil. The use of successive DNA extractions might improve soil microbial characterization, but the benefit of this approach has only been limitedly studied. To determine whether successive DNA extractions of the same soil sample would lead to different observations in terms of microbial abundance and community composition, we performed three successive extractions, with two widely used commercial kits, on a range of clay and sandy soils. Successive extractions increased DNA yield considerably (1–374%), as well as total bacterial and fungal abundances in most of the soil samples. Analysis of the 16S and 18S ribosomal RNA genes using 454-pyrosequencing, revealed that microbial community composition (taxonomic groups) observed in the successive DNA extractions were similar. However, successive DNA extractions did reveal several additional microbial groups. For some soil samples, shifts in microbial community composition were observed, mainly due to shifts in relative abundance of a number of microbial groups. Our results highlight that performing successive DNA extractions optimize DNA yield, and can lead to a better picture of overall community composition. PMID:28168105

Succession planning in US pharmacy schools.

PubMed

Van Amburgh, Jenny; Surratt, Christopher K; Green, James S; Gallucci, Randle M; Colbert, James; Zatopek, Shara L; Blouin, Robert A

2010-06-15

The deans, associate and assistant deans, and department chairs of a college or school of pharmacy retain historic memories of the institution and share the responsibility for day-to-day operation, sustainability, and future planning. Between the anticipated retirement of baby boomers who are senior administrative faculty members and the steady increase in number of colleges and schools of pharmacy, the academy is facing a shortage of qualified successors. Succession planning involves planning for the effective transition of personnel in leadership positions within an organization. This paper describes the subject of succession planning at a sample population of AACP institutions by obtaining perspectives on the subject from the deans of these institutions via standardized interview instruments. The instruments were utilized with 15 deans; all interview data were blinded and analyzed using analyst triangulation. The majority of deans responded that some level of succession planning was desirable and even necessary; however, none claimed to have a formal succession planning structure in place at his or her home institution. Although widely accepted and well-recognized in the corporate and military sectors, succession planning within pharmacy schools and colleges is neither universally documented nor implemented. Differences exist within the administrative structure of these non-academic and academic institutions that may preclude a uniform succession planning format. While the evidence presented suggests that succession planning is needed within the academy, a concerted effort must be made towards implementing its practice.

Succession Planning in US Pharmacy Schools

PubMed Central

Surratt, Christopher K.; Green, James S.; Gallucci, Randle M.; Colbert, James; Zatopek, Shara L.; Blouin, Robert A.

2010-01-01

The deans, associate and assistant deans, and department chairs of a college or school of pharmacy retain historic memories of the institution and share the responsibility for day-to-day operation, sustainability, and future planning. Between the anticipated retirement of baby boomers who are senior administrative faculty members and the steady increase in number of colleges and schools of pharmacy, the academy is facing a shortage of qualified successors. Succession planning involves planning for the effective transition of personnel in leadership positions within an organization. This paper describes the subject of succession planning at a sample population of AACP institutions by obtaining perspectives on the subject from the deans of these institutions via standardized interview instruments. The instruments were utilized with 15 deans; all interview data were blinded and analyzed using analyst triangulation. The majority of deans responded that some level of succession planning was desirable and even necessary; however, none claimed to have a formal succession planning structure in place at his or her home institution. Although widely accepted and well-recognized in the corporate and military sectors, succession planning within pharmacy schools and colleges is neither universally documented nor implemented. Differences exist within the administrative structure of these non-academic and academic institutions that may preclude a uniform succession planning format. While the evidence presented suggests that succession planning is needed within the academy, a concerted effort must be made towards implementing its practice. PMID:20798799

Nurse manager succession planning: A cost-benefit analysis.

PubMed

Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

2018-03-01

This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

The success of pharmacogenomics in moving genetic association studies from bench to bedside: study design and implementation of precision medicine in the post-GWAS era.

PubMed

Ritchie, Marylyn D

2012-10-01

Pharmacogenomics is emerging as a popular type of study for human genetics in recent years. This is primarily due to the many success stories and high potential for translation to clinical practice. In this review, the strengths and limitations of pharmacogenomics are discussed as well as the primary epidemiologic, clinical trial, and in vitro study designs implemented. A brief discussion of molecular and analytic approaches will be reviewed. Finally, several examples of bench-to-bedside clinical implementations of pharmacogenetic traits will be described. Pharmacogenomics continues to grow in popularity because of the important genetic associations identified that drive the possibility of precision medicine.

Stories of Resiliency: Successful Female Educational Leaders

ERIC Educational Resources Information Center

Pankake, Anita M.; Beaty, Danna M.

2005-01-01

Information about the experiences successful leaders perceive as vital to their development can be helpful to one's understanding of resiliency. Such information can also offer insights into the ways successful leaders use positive and negative situations as learning opportunities and the strategies they implement in addressing adversity. The…

Critical Elements for Successful Implementation and Adoption of Authentic Scientific Research Programs: Lessons Learned from NASA's Mars Student Imaging Project

NASA Astrophysics Data System (ADS)

Klug Boonstra, S.; Swann, J.; Boonstra, D.; Manfredi, L.; Christensen, P. R.

2016-12-01

Recent research identifies the most effective learning as active, engaged learning in which students interact with phenomena, other students, and the teacher/leader to derive meaning and construct understanding of their surroundings. "Similarly, an engaging and effective science education goes well beyond the low-level factual recall that is emphasized in many science classes. It must develop the skills that students need to solve complex problems, work in teams, make and recognize evidence-based arguments, and interpret and communicate complex information" (emphasis added). Authentic science research projects provide active, engaged learning in which students interact with authentic science data in an authentic problem-solving context to derive meaning and construct understanding of the world. In formal (and many informal) settings, the teacher/leader is effectively the gatekeeper who determines the learning experiences in which the students will participate. From our experience of nearly a decade and a half of authentic science programming for 5thgrade through early college students working with NASA Mars data, supporting and enabling the teacher is perhaps the most critical and foundational element for designing a successful authentic research experience. Yet, a major barrier to this type of learning are teacher/leaders who are too often not equipped or who lack confidence to succeed in facilitating authentic research projects. The Mars Student Imaging Project has implemented an iterative process of design, testing, and redesign that has identified and implemented critical teacher/leader-enabling elements that have led to increasingly successful adoptions within formal and informal educational settings - allowing more students to gain the benefits of immersive research experience.

Brazilian Soybean Yields and Yield Gaps Vary with Farm Size

NASA Astrophysics Data System (ADS)

Jeffries, G. R.; Cohn, A.; Griffin, T. S.; Bragança, A.

2017-12-01

Understanding the farm size-specific characteristics of crop yields and yield gaps may help to improve yields by enabling better targeting of technical assistance and agricultural development programs. Linking remote sensing-based yield estimates with property boundaries provides a novel view of the relationship between farm size and yield structure (yield magnitude, gaps, and stability over time). A growing literature documents variations in yield gaps, but largely ignores the role of farm size as a factor shaping yield structure. Research on the inverse farm size-productivity relationship (IR) theory - that small farms are more productive than large ones all else equal - has documented that yield magnitude may vary by farm size, but has not considered other yield structure characteristics. We examined farm size - yield structure relationships for soybeans in Brazil for years 2001-2015. Using out-of-sample soybean yield predictions from a statistical model, we documented 1) gaps between the 95th percentile of attained yields and mean yields within counties and individual fields, and 2) yield stability defined as the standard deviation of time-detrended yields at given locations. We found a direct relationship between soy yields and farm size at the national level, while the strength and the sign of the relationship varied by region. Soybean yield gaps were found to be inversely related to farm size metrics, even when yields were only compared to farms of similar size. The relationship between farm size and yield stability was nonlinear, with mid-sized farms having the most stable yields. The work suggests that farm size is an important factor in understanding yield structure and that opportunities for improving soy yields in Brazil are greatest among smaller farms.

Declining nitrate-N yields in the Upper Potomac River basin: what is really driving progress under the Chesapeake Bay restoration?

NASA Astrophysics Data System (ADS)

Eshleman, K. N.; Sabo, R.

2015-12-01

Reducing nutrient pollution of surface and coastal waters in the U.S. and elsewhere remains a major environmental and engineering challenge for the 21st century. In the case of the Chesapeake Bay restoration, we still lack scientific proof that previous watershed-based management actions have been effective at reducing nonpoint-source nutrient loads from the land to this estuary in accordance with restoration goals. While the conventional wisdom is that implementation of best management practices (BMP's) has turned the against nutrient pollution, we examined long-term (1986-present) nitrate-N trends in streams and major tributaries of the Upper Potomac River Basin (UPRB) and found that: 1) dramatic reductions in annual discharge-weighted nitrate-N concentrations and yields across the UPRB can be almost universally attributed to reductions in atmospheric N deposition as opposed to on-the-ground management actions such as implementation of BMP's; 2) observed water quality changes comport with a modified kinetic N saturation model (MKNSM); 3) the MKNSM can separate the nitrate-N yield that is responsive to atmospheric deposition from a "legacy" yield; and 4) N saturation from atmospheric N deposition appears to be an inherently reversible process across most of the landscape. These unanticipated region-wide water quality benefits can be attributed to NOx emission controls brought about by the 1990 Clean Air Act Amendments (and subsequent U.S. NOX control programs) and reflect one of a very few water quality "success stories" in the Chesapeake Bay restoration; the results have important ramifications for the 2017 "mid-point assessment" that is part of the latest Chesapeake Bay Watershed Agreement.

Critical Success Factors in Online Language Learning

ERIC Educational Resources Information Center

Alberth

2011-01-01

With the proliferation of online courses nowadays, it is necessary to ask what defines the success of teaching and learning in these new learning environments exactly. This paper identifies and critically discusses a number of factors for successful implementation of online delivery, particularly as far as online language learning is concerned.…

Aquifer-yield continuum as a guide and typology for science-based groundwater management

NASA Astrophysics Data System (ADS)

Pierce, Suzanne A.; Sharp, John M.; Guillaume, Joseph H. A.; Mace, Robert E.; Eaton, David J.

2013-03-01

Groundwater availability is at the core of hydrogeology as a discipline and, simultaneously, the concept is the source of ambiguity for management and policy. Aquifer yield has undergone multiple definitions resulting in a range of scientific methods to calculate and model availability reflecting the complexity of combined scientific, management, policy, and stakeholder processes. The concept of an aquifer-yield continuum provides an approach to classify groundwater yields along a spectrum, from non-use through permissive sustained, sustainable, maximum sustained, safe, permissive mining to maximum mining yields, that builds on existing literature. Additionally, the aquifer-yield continuum provides a systems view of groundwater availability to integrate physical and social aspects in assessing management options across aquifer settings. Operational yield describes the candidate solutions for operational or technical implementation of policy, often relating to a consensus yield that incorporates human dimensions through participatory or adaptive governance processes. The concepts of operational and consensus yield address both the social and the technical nature of science-based groundwater management and governance.

Symmetry relations in charmless B{yields}PPP decays

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

Gronau, Michael; Rosner, Jonathan L.; Enrico Fermi Institute and Department of Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637

2005-11-01

Strangeness-changing decays of B mesons to three-body final states of pions and kaons are studied, assuming that they are dominated by a {delta}I=0 penguin amplitude with flavor structure b{yields}s. Numerous isospin relations for B{yields}K{pi}{pi} and for underlying quasi-two-body decays are compared successfully with experiment, in some cases resolving ambiguities in fitting resonance parameters. The only exception is a somewhat small branching ratio noted in B{sup 0}{yields}K*{sup 0}{pi}{sup 0}, interpreted in terms of destructive interference between a penguin amplitude and an enhanced electroweak penguin contribution. Relations for B decays into three kaons are derived in terms of final states involving K{submore » S} or K{sub L}, assuming that {phi}K-subtracted decay amplitudes are symmetric in K and K, as has been observed experimentally. Rates due to nonresonant backgrounds are studied using a simple model, which may reduce discrete ambiguities in Dalitz plot analyses.« less

Hospital IT adoption strategies associated with implementation success: implications for achieving meaningful use.

PubMed

Ford, Eric W; Menachemi, Nir; Huerta, Timothy R; Yu, Feliciano

2010-01-01

Health systems are facing significant pressure to either implement health information technology (HIT) systems that have "certified" electronic health record applications and that fulfill the federal government's definition of "meaningful use" or risk substantial financial penalties in the near future. To this end, hospitals have adopted one of three strategies, described as "best of breed," "best of suite," and "single vendor," to meet organizational and regulatory demands. The single-vendor strategy is used by the simple majority of U.S. hospitals, but is it the most effective mode for achieving full implementation? Moreover, what are the implications of adopting this strategy for achieving meaningful use? The simple answer to the first question is that the hospitals using the hybrid best of suite strategy had fully implemented HIT systems in significantly greater proportions than did hospitals employing either of the other strategies. Nonprofit and system-affiliated hospitals were more likely to have fully implemented their HIT systems. In addition, increased health maintenance organization market penetration rates were positively correlated with complete implementation rates. These results have ongoing implications for achieving meaningful use in the near term. The federal government's rewards and incentives program related to the meaningful use of HIT in hospitals has created an organizational imperative to implement such systems. For hospitals that have not begun systemwide implementation, pursuing a best of suite strategy may provide the greatest chance for achieving all or some of the meaningful use targets in the near term or at least avoiding future penalties scheduled to begin in 2015.

Automatic yield-line analysis of slabs using discontinuity layout optimization

PubMed Central

Gilbert, Matthew; He, Linwei; Smith, Colin C.; Le, Canh V.

2014-01-01

The yield-line method of analysis is a long established and extremely effective means of estimating the maximum load sustainable by a slab or plate. However, although numerous attempts to automate the process of directly identifying the critical pattern of yield-lines have been made over the past few decades, to date none has proved capable of reliably analysing slabs of arbitrary geometry. Here, it is demonstrated that the discontinuity layout optimization (DLO) procedure can successfully be applied to such problems. The procedure involves discretization of the problem using nodes inter-connected by potential yield-line discontinuities, with the critical layout of these then identified using linear programming. The procedure is applied to various benchmark problems, demonstrating that highly accurate solutions can be obtained, and showing that DLO provides a truly systematic means of directly and reliably automatically identifying yield-line patterns. Finally, since the critical yield-line patterns for many problems are found to be quite complex in form, a means of automatically simplifying these is presented. PMID:25104905

Approaches to the Successful Design and Implementation of VR Applications

NASA Technical Reports Server (NTRS)

Bryson, Steve; Cooper, D. M. (Technical Monitor)

1994-01-01

The successful design of virtual reality applications involves both "top-down" and "bottom-up" strategies. This talk will broadly outline these strategies: how bottom-up strategies are driven primarily by performance considerations; and how top-down strategies are driven primarily by the application task, the interaction metaphors, and the integration of the virtual environment. How to ensure these two approaches "meet in the middle" through Iterative design processes will be stressed. The discussion will be motivated by examples of both success and failure. The talk contains information bryson presented at SIGGRAPH '93 and Visualization '93, and is a high-level discussion of design principles for virtual reality. There will be essentially no discussion of virtual wind tunnel specific issues or any other matters relating to aerospace, the tutorial is a repeat of the tutorial Bryson and Steve Feiner presented at Visualization '93 In October 1993 in San Jose, CA, and will cite the virtual windtunnel only as an example.

Science Data Preservation: Implementation and Why It Is Important

NASA Technical Reports Server (NTRS)

Kempler, Steven J.; Moses, John F.; Gerasimov, Irina V.; Johnson, James E.; Vollmer, Bruce E.; Theobald, Michael L.; Ostrenga, Dana M.; Ahmad, Suraiya; Ramapriyan, Hampapuram K.; Khayat, Mohammad G.

2013-01-01

Remote Sensing data generation by NASA to study Earth s geophysical processes was initiated in 1960 with the launch of the first Television Infrared Observation Satellite Program (TIROS), to develop a meteorological satellite information system. What would be deemed as a primitive data set by today s standards, early Earth science missions were the foundation upon which today s remote sensing instruments have built their scientific success, and tomorrow s instruments will yield science not yet imagined. NASA Scientific Data Stewardship requirements have been documented to ensure the long term preservation and usability of remote sensing science data. In recent years, the Federation of Earth Science Information Partners and NASA s Earth Science Data System Working Groups have organized committees that specifically examine standards, processes, and ontologies that can best be employed for the preservation of remote sensing data, supporting documentation, and data provenance information. This presentation describes the activities, issues, and implementations, guided by the NASA Earth Science Data Preservation Content Specification (423-SPEC-001), for preserving instrument characteristics, and data processing and science information generated for 20 Earth science instruments, spanning 40 years of geophysical measurements, at the NASA s Goddard Earth Sciences Data and Information Services Center (GES DISC). In addition, unanticipated preservation/implementation questions and issues in the implementation process are presented.

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success

PubMed Central

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-01-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti’s neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a “directly observed treatment” strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained– 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH—and the significant reduction in burden of infection– 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti’s very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of “best practices” for

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

PubMed

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-10-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but

Pathways to School Success

ERIC Educational Resources Information Center

University of Pittsburgh Office of Child Development, 2012

2012-01-01

In 2006, the University of Pittsburgh Office of Child Development began implementing a multi-year school readiness project in several area schools. Evidence from both research and the field point to several key elements that foster school readiness and create pathways to school success for all children. This paper presents components of a…

Cost reduction with successful implementation of an antibiotic prophylaxis program in a private hospital in Ribeirão Preto, Brazil.

PubMed

Fonseca, S N; Melon Kunzle, S R; Barbosa Silva, S A; Schmidt, J G; Mele, R R

1999-01-01

To describe the implementation and results of a perioperative antibiotic prophylaxis (PAP) program. A protocol for correct use of PAP was implemented in December 1994. For selected months we measured the PAP protocol compliance of a random sample of clean and clean-contaminated procedures and calculated the cost of incorrect use of PAP. SELLING: A 180-bed general hospital in Ribeirão Preto, Brazil. The cost of unnecessary PAP in the obstetric and gynecologic, cardiothoracic, and orthopedic services dropped from $4,224.54 ($23.47/procedure) in November 1994 to $1,147.24 ($6.17/procedure, January 1995), $544.42 ($3.58/procedure, May 1995), $99.06 ($0.50/procedure, August 1995), and $30 ($0.12/procedure, March 1996). In November 1994, only 13.6% of all surgical procedures were done with correct use of PAP, compared to 59% in January 1995, 73% in August 1995, 78% in March 1996, 92% in November 1996, and 98% in May 1997. Incorrect PAP use wastes resources, which is a particular problem in developing countries. Our program is simple and can be implemented without the use of computers and now is being adopted in other hospitals in our region. We credit the success of our program to the commitment of all participants and to the strong support of the hospital directors.

A generic, web-based clinical information system architecture using HL7 CDA: successful implementation in dermatological routine care.

PubMed

Schuler, Thilo; Boeker, Martin; Klar, Rüdiger; Müller, Marcel

2007-01-01

The requirements of highly specialized clinical domains are often underrepresented in hospital information systems (HIS). Common consequences are that documentation remains to be paper-based or external systems with insufficient HIS integration are used. This paper presents a solution to overcome this deficiency in the form of a generic framework based on the HL7 Clinical Document Architecture. The central architectural idea is the definition of customized forms using a schema-controlled XML language. These flexible form definitions drive the user interface, the data storage, and standardized data exchange. A successful proof-of-concept application in a dermatologic outpatient wound care department has been implemented, and is well accepted by the clinicians. Our work with HL7 CDA revealed the need for further practical research in the health information standards realm.

Successful Components of Interdisciplinary Education.

ERIC Educational Resources Information Center

Shepard, Katherine; And Others

1985-01-01

This article presents 10 ideas for developing successful interdisciplinary curricula as suggested in the allied health literature. Implementation of the ideas is illustrated by examples from a clinical geriatric course involving physical therapy, physician assistant, nurse practitioner, and medical students. (Author/CT)

Implementing Adolescent Male Leadership Model to Enhance Behavior, Academic Success

ERIC Educational Resources Information Center

Beliele, Laressa

2012-01-01

Schools are challenged to assist struggling youth. This study used a mixed methods design to evaluate how the school-based program Men of Distinction helps struggling male students develop leadership skills, promoting academic and social success. Quantitative data included attendance, grade point averages, the number of days in in-school…

Successful implementation of a P&T-approved therapeutic interchange program of angiotensin II receptor blockers in a medical center in Taiwan.

PubMed

Lee, Yen-Ying; Hsiao, Paul; Lin, You-Meei; Yen, Yu-Hsuan; Chen, Hsiang-Yin

2012-01-01

Therapeutic interchange is not a common practice in the medical society in Asia. We used clinic blood pressure readings, patients' tolerance, and cost saving as measures to evaluate the impact of a therapeutic interchange program implemented at a medical center in Taiwan. Taipei Medical University-Wan Fang Hospital initiated a therapeutic interchange program involving angiotensin II receptor blockers (ARBs). Data were retrospectively collected for 444 outpatients who were converted from other ARBs to candesartan. Evaluation of therapeutic efficacy, adverse effects associated with therapy, and drug costs was conducted before and after the program implementation. Patients whose treatment was converted to candesartan experienced no statistically significant differences in blood pressure, and the average number of antihypertensive agents used per patient remained unchanged. A direct cost savings of US$62,237 was estimated for the 444 patients studied. Only 3.15% of the patients developed adverse drug reactions potentially related to candesartan, and none required hospitalization. Based on the results of this retrospective chart review, the present ARB therapeutic interchange program was successfully developed and implemented. This is the first study to establish the positive impact of a well-run ARB therapeutic interchange program in Taiwan. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Implementing Technology in the Classroom: Paths to Success and Failure.

ERIC Educational Resources Information Center

Harvey, Glen; And Others

This paper discusses the change process experienced by teachers participating in a study of a computer-based language arts instructional program for the early elementary grades--the Apple Learning Series: Early Language (ALS-EL). The study explored ways in which the teachers were implementing ALS-EL in their classrooms before attempting to…

Factors related to well yield in the fractured-bedrock aquifer of New Hampshire

USGS Publications Warehouse

Moore, Richard Bridge; Schwartz, Gregory E.; Clark, Stewart F.; Walsh, Gregory J.; Degnan, James R.

2002-01-01

The New Hampshire Bedrock Aquifer Assessment was designed to provide information that can be used by communities, industry, professional consultants, and other interests to evaluate the ground-water development potential of the fractured-bedrock aquifer in the State. The assessment was done at statewide, regional, and well field scales to identify relations that potentially could increase the success in locating high-yield water supplies in the fractured-bedrock aquifer. statewide, data were collected for well construction and yield information, bedrock lithology, surficial geology, lineaments, topography, and various derivatives of these basic data sets. Regionally, geologic, fracture, and lineament data were collected for the Pinardville and Windham quadrangles in New Hampshire. The regional scale of the study examined the degree to which predictive well-yield relations, developed as part of the statewide reconnaissance investigation, could be improved by use of quadrangle-scale geologic mapping. Beginning in 1984, water-well contractors in the State were required to report detailed information on newly constructed wells to the New Hampshire Department of Environmental Services (NHDES). The reports contain basic data on well construction, including six characteristics used in this study?well yield, well depth, well use, method of construction, date drilled, and depth to bedrock (or length of casing). The NHDES has determined accurate georeferenced locations for more than 20,000 wells reported since 1984. The availability of this large data set provided an opportunity for a statistical analysis of bedrock-well yields. Well yields in the database ranged from zero to greater than 500 gallons per minute (gal/min). Multivariate regression was used as the primary statistical method of analysis because it is the most efficient tool for predicting a single variable with many potentially independent variables. The dependent variable that was explored in this study was the

Implementation of Risk Management in NASA's CEV Project- Ensuring Mission Success

NASA Astrophysics Data System (ADS)

Perera, Jeevan; Holsomback, Jerry D.

2005-12-01

Most project managers know that Risk Management (RM) is essential to good project management. At NASA, standards and procedures to manage risk through a tiered approach have been developed - from the global agency-wide requirements down to a program or project's implementation. The basic methodology for NASA's risk management strategy includes processes to identify, analyze, plan, track, control, communicate and document risks. The identification, characterization, mitigation plan, and mitigation responsibilities associated with specific risks are documented to help communicate, manage, and effectuate appropriate closure. This approach helps to ensure more consistent documentation and assessment and provides a means of archiving lessons learned for future identification or mitigation activities.A new risk database and management tool was developed by NASA in 2002 and since has been used successfully to communicate, document and manage a number of diverse risks for the International Space Station, Space Shuttle, and several other NASA projects and programs including at the Johnson Space Center. Organizations use this database application to effectively manage and track each risk and gain insight into impacts from other organization's viewpoint to develop integrated solutions. Schedule, cost, technical and safety issues are tracked in detail through this system.Risks are tagged within the system to ensure proper review, coordination and management at the necessary management level. The database is intended as a day-to- day tool for organizations to manage their risks and elevate those issues that need coordination from above. Each risk is assigned to a managing organization and a specific risk owner who generates mitigation plans as appropriate. In essence, the risk owner is responsible for shepherding the risk through closure. The individual that identifies a new risk does not necessarily get assigned as the risk owner. Whoever is in the best position to effectuate

The interplay of contextual elements in implementation: an ethnographic case study.

PubMed

McCullough, Megan B; Chou, Ann F; Solomon, Jeffrey L; Petrakis, Beth Ann; Kim, Bo; Park, Angela M; Benedict, Ashley J; Hamilton, Alison B; Rose, Adam J

2015-02-14

Contextual elements have significant impact on uptake of health care innovations. While existing conceptual frameworks in implementation science suggest contextual elements interact with each other, little research has described how this might look in practice. To bridge this gap, this study identifies the interconnected patterns among contextual elements that influence uptake of an anticoagulation clinic improvement initiative. We completed 51 semi-structured interviews and ethnographic observations across five case study sites involved in an evidence-based practice (EBP) quality improvement initiative. We analyzed data in NVivo 10 using an a priori approach based on the Promoting Action on Research Implementation in Health Services (PARIHS) model and an emergent thematic analysis. Key contextual elements, such as leadership, teamwork, and communication, interacted with each other in contributing to site-level uptake of the EBP, often yielding results that could not be predicted by looking at just one of these elements alone. Sites with context conducive to change in these areas predictably had high uptake, while sites with uniformly weak contextual elements had low uptake. Most sites presented a mixed picture, with contextual elements being strongly supportive of change in some areas and weak or moderate in others. In some cases, we found that sites with strong context in at least one area only needed to have adequate context in other areas to yield high uptake. At other sites, weak context in just one area had the potential to contribute to low uptake, despite countervailing strengths. Even a site with positive views of EBPs could not succeed when context was weak. Interrelationships among different contextual elements can act as barriers to uptake at some sites and as facilitators at others. Accounting for interconnections among elements enables PARIHS to more fully describe the determinants of successful implementation as they operate in real-world settings.

Success rate evaluation of clinical governance implementation in teaching hospitals in Kerman (Iran) based on nine steps of Karsh's model.

PubMed

Vali, Leila; Mastaneh, Zahra; Mouseli, Ali; Kardanmoghadam, Vida; Kamali, Sodabeh

2017-07-01

One of the ways to improve the quality of services in the health system is through clinical governance. This method aims to create a framework for clinical services providers to be accountable in return for continuing improvement of quality and maintaining standards of services. To evaluate the success rate of clinical governance implementation in Kerman teaching hospitals based on 9 steps of Karsh's Model. This cross-sectional study was conducted in 2015 on 94 people including chief executive officers (CEOs), nursing managers, clinical governance managers and experts, head nurses and nurses. The required data were collected through a researcher-made questionnaire containing 38 questions with three-point Likert Scale (good, moderate, and weak). The Karsh's Model consists of nine steps including top management commitment to change, accountability for change, creating a structured approach for change, training, pilot implementation, communication, feedback, simulation, and end-user participation. Data analysis using descriptive statistics and Mann-Whitney-Wilcoxon test was done by SPSS software version 16. About 81.9 % of respondents were female and 74.5 have a Bachelor of Nursing (BN) degree. In general, the status of clinical governance implementation in studied hospitals based on 9 steps of the model was 44 % (moderate). A significant relationship was observed among accountability and organizational position (p=0.0012) and field of study (p=0.000). Also, there were significant relationships between structure-based approach and organizational position (p=0.007), communication and demographic characteristics (p=0.000), and end-user participation with organizational position (p=0.03). Clinical governance should be implemented by correct needs assessment and participation of all stakeholders, to ensure its enforcement in practice, and to enhance the quality of services.

CRM System Implementation in a Multinational Enterprise

NASA Astrophysics Data System (ADS)

Mishra, Alok; Mishra, Deepti

The concept of customer relationship management (CRM) resonates with managers in today's competitive economy. As more and more organizations realize the significance of becoming customer-centric in today's competitive era, they embrace CRM as a core business strategy. CRM an integration of information technology and relationship marketing provides the infrastructure that facilitates long-term relationship building with customers at an enterprise-wide level. Successful CRM implementation is a complex, expensive and rarely technical projects. This paper presents the successful implementation of CRM in a multinational organization. This study will facilitate in understanding transition, constraints and implementation of CRM in multinational enterprises.

"During early implementation you just muddle through": factors that impacted a statewide arthritis program's implementation.

PubMed

Conte, Kathleen P; Marie Harvey, S; Turner Goins, R

2017-12-01

The need to scale-up effective arthritis self-management programs is pressing as the prevalence of arthritis increases. The CDC Arthritis Program funds state health departments to work with local delivery systems to embed arthritis programs into their day-to-day work. To encourage organizational ownership and sustainability of programs, funding is restricted to offset program start-up costs. The purpose of this study was to identify factors that impacted the success of implementing an evidence-based arthritis self-management program, funded by the CDC Arthritis Program, into the Oregon Extension Service. We interviewed staff and partners involved in implementation who had and had not successfully delivered Walk With Ease (N = 12) to identify barriers and facilitators to scaling-up. Document analysis of administrative records was used to triangulate and expand on findings. Delivery goals defined by the funder were not met in Year 1: only 3 of the expected 28 programs were delivered. Barriers to implementation included insufficient planning for implementation driven by pressure to deliver programs and insufficient resources to support staff time. Facilitators included centralized administration of key implementation activities and staffs' previous experience implementing new programs. The importance of planning and preparing for implementation cannot be overlooked. Funders, however, eager to see deliverables, continue to define implementation goals in terms of program reach, exclusive of capacity-building. Lack of capacity-building can jeopardize staff buy-in, implementation quality, and sustainability. Based on our findings coupled with support from implementation literature, we offer recommendations for future large-scale implementation efforts operating under such funding restrictions.

Yield gaps and yield relationships in US soybean production systems

USDA-ARS?s Scientific Manuscript database

The magnitude of yield gaps (YG) (potential yield – farmer yield) provides some indication of the prospects for increasing crop yield to meet the food demands of future populations. Quantile regression analysis was applied to county soybean [Glycine max (L.) Merrill] yields (1971 – 2011) from Kentuc...

Quantitative analysis of relationships between irradiation parameters and the reproducibility of cyclotron-produced (99m)Tc yields.

PubMed

Tanguay, J; Hou, X; Buckley, K; Schaffer, P; Bénard, F; Ruth, T J; Celler, A

2015-05-21

Cyclotron production of (99m)Tc through the (100)Mo(p,2n) (99m)Tc reaction channel is actively being investigated as an alternative to reactor-based (99)Mo generation by nuclear fission of (235)U. An exciting aspect of this approach is that it can be implemented using currently-existing cyclotron infrastructure to supplement, or potentially replace, conventional (99m)Tc production methods that are based on aging and increasingly unreliable nuclear reactors. Successful implementation will require consistent production of large quantities of high-radionuclidic-purity (99m)Tc. However, variations in proton beam currents and the thickness and isotopic composition of enriched (100)Mo targets, in addition to other irradiation parameters, may degrade reproducibility of both radionuclidic purity and absolute (99m)Tc yields. The purpose of this article is to present a method for quantifying relationships between random variations in production parameters, including (100)Mo target thicknesses and proton beam currents, and reproducibility of absolute (99m)Tc yields (defined as the end of bombardment (EOB) (99m)Tc activity). Using the concepts of linear error propagation and the theory of stochastic point processes, we derive a mathematical expression that quantifies the influence of variations in various irradiation parameters on yield reproducibility, quantified in terms of the coefficient of variation of the EOB (99m)Tc activity. The utility of the developed formalism is demonstrated with an example. We show that achieving less than 20% variability in (99m)Tc yields will require highly-reproducible target thicknesses and proton currents. These results are related to the service rate which is defined as the percentage of (99m)Tc production runs that meet the minimum daily requirement of one (or many) nuclear medicine departments. For example, we show that achieving service rates of 84.0%, 97.5% and 99.9% with 20% variations in target thicknesses requires producing on average

Quantitative analysis of relationships between irradiation parameters and the reproducibility of cyclotron-produced 99mTc yields

NASA Astrophysics Data System (ADS)

Tanguay, J.; Hou, X.; Buckley, K.; Schaffer, P.; Bénard, F.; Ruth, T. J.; Celler, A.

2015-05-01

Cyclotron production of 99mTc through the 100Mo(p,2n) 99mTc reaction channel is actively being investigated as an alternative to reactor-based 99Mo generation by nuclear fission of 235U. An exciting aspect of this approach is that it can be implemented using currently-existing cyclotron infrastructure to supplement, or potentially replace, conventional 99mTc production methods that are based on aging and increasingly unreliable nuclear reactors. Successful implementation will require consistent production of large quantities of high-radionuclidic-purity 99mTc. However, variations in proton beam currents and the thickness and isotopic composition of enriched 100Mo targets, in addition to other irradiation parameters, may degrade reproducibility of both radionuclidic purity and absolute 99mTc yields. The purpose of this article is to present a method for quantifying relationships between random variations in production parameters, including 100Mo target thicknesses and proton beam currents, and reproducibility of absolute 99mTc yields (defined as the end of bombardment (EOB) 99mTc activity). Using the concepts of linear error propagation and the theory of stochastic point processes, we derive a mathematical expression that quantifies the influence of variations in various irradiation parameters on yield reproducibility, quantified in terms of the coefficient of variation of the EOB 99mTc activity. The utility of the developed formalism is demonstrated with an example. We show that achieving less than 20% variability in 99mTc yields will require highly-reproducible target thicknesses and proton currents. These results are related to the service rate which is defined as the percentage of 99mTc production runs that meet the minimum daily requirement of one (or many) nuclear medicine departments. For example, we show that achieving service rates of 84.0%, 97.5% and 99.9% with 20% variations in target thicknesses requires producing on average 1.2, 1.5 and 1.9 times the

Measuring the success of electronic medical record implementation using electronic and survey data.

PubMed Central

Keshavjee, K.; Troyan, S.; Holbrook, A. M.; VanderMolen, D.

2001-01-01

Computerization of physician practices is increasing. Stakeholders are demanding demonstrated value for their Electronic Medical Record (EMR) implementations. We developed survey tools to measure medical office processes, including administrative and physician tasks pre- and post-EMR implementation. We included variables that were expected to improve with EMR implementation and those that were not expected to improve, as controls. We measured the same processes pre-EMR, at six months and 18 months post-EMR. Time required for most administrative tasks decreased within six months of EMR implementation. Staff time spent on charting increased with time, in keeping with our anecdotal observations that nurses were given more responsibility for charting in many offices. Physician time to chart increased initially by 50%, but went down to original levels by 18 months. However, this may be due to the drop-out of those physicians who had a difficult time charting electronically. PMID:11825201

Food Service Perspectives on National School Lunch Program Implementation.

PubMed

Tabak, Rachel G; Moreland-Russell, Sarah

2015-09-01

Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

Six sigma critical success factors in manufacturing industries

NASA Astrophysics Data System (ADS)

Mustafa, Zainol; Jamaluddin, Z.

2017-04-01

The success of Six Sigma implementation is known to depend on a number of contributing factors. The purpose of this paper is to explore Six Sigma critical success factors (CSFs) in the context of Malaysian manufacturing organizations. Although Six Sigma success factors have been abundantly researched in the global context, in this paper, a maiden attempt is made to identify, through an extensive literature review, the CSFs for Six Sigma implementation followed by their validation using primary data collection from Malaysian manufacturing companies. A total of 33 indicators have thus been compiled through an extensive literature review which then been grouped into 6 contributing factors. These contributing success factors are then validated through an empirical research of selected Malaysian manufacturing companies at various stages of implementation of the Six Sigma process improvement methodology. There has been an overemphasis on the role and commitment of the management in the success of a Six Sigma program. Though it is undoubted, certain other factors also play an equally important role in ensuring that the Six Sigma programs are successful. The factor analysis of CSFs of the Malaysian manufacturing organizations selected in this study demonstrates that the top factor is a composite factor showing combination of the ability of the project teams to use the process management on quality initiative and a training using a proper analysis in problem solving. The CSFs extracted through the factor analysis could provide a basis for manufacturing organizations embarking on the Six Sigma journey to look beyond just management involvement. Thus, one can develop an integrated framework of other factors as outlined and give them appropriate priority and focus.

Atomic Oxygen Erosion Yield Prediction for Spacecraft Polymers in Low Earth Orbit

NASA Technical Reports Server (NTRS)

Banks, Bruce A.; Backus, Jane A.; Manno, Michael V.; Waters, Deborah L.; Cameron, Kevin C.; deGroh, Kim K.

2009-01-01

The ability to predict the atomic oxygen erosion yield of polymers based on their chemistry and physical properties has been only partially successful because of a lack of reliable low Earth orbit (LEO) erosion yield data. Unfortunately, many of the early experiments did not utilize dehydrated mass loss measurements for erosion yield determination, and the resulting mass loss due to atomic oxygen exposure may have been compromised because samples were often not in consistent states of dehydration during the pre-flight and post-flight mass measurements. This is a particular problem for short duration mission exposures or low erosion yield materials. However, as a result of the retrieval of the Polymer Erosion and Contamination Experiment (PEACE) flown as part of the Materials International Space Station Experiment 2 (MISSE 2), the erosion yields of 38 polymers and pyrolytic graphite were accurately measured. The experiment was exposed to the LEO environment for 3.95 years from August 16, 2001 to July 30, 2005 and was successfully retrieved during a space walk on July 30, 2005 during Discovery s STS-114 Return to Flight mission. The 40 different materials tested (including Kapton H fluence witness samples) were selected specifically to represent a variety of polymers used in space as well as a wide variety of polymer chemical structures. The MISSE 2 PEACE Polymers experiment used carefully dehydrated mass measurements, as well as accurate density measurements to obtain accurate erosion yield data for high-fluence (8.43 1021 atoms/sq cm). The resulting data was used to develop an erosion yield predictive tool with a correlation coefficient of 0.895 and uncertainty of +/-6.3 10(exp -25)cu cm/atom. The predictive tool utilizes the chemical structures and physical properties of polymers to predict in-space atomic oxygen erosion yields. A predictive tool concept (September 2009 version) is presented which represents an improvement over an earlier (December 2008) version.

Views of implementation approaches by top managers in health service organizations.

PubMed

Nutt, P C

1996-01-01

This study examined how top managers view the prospects of success and resistance when using four implementation approaches in participative and control cultures that foster climates more or less conducive to change. An accommodation approach was viewed as having the best prospect of success and of lowering resistance in a participative culture. Bargaining and incentive approaches were thought to have successful and low resistance outcomes, which were just below those of accommodation, in a control type of culture. A persuasion approach was thought to be the least effective implementation approach in a control-oriented culture. These preferences differ from prescriptions found in the implementation literature. Assuming that preferences influence behavior, implementation success could be improved if managers selected an implementation approach according to the demands of the situation. More research is needed to appreciate fully the rationale that lies behind the preferences uncovered in this research.

25 CFR 163.11 - Forest management planning and sustained yield management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... implementation of integrated resource management plans which provide coordination for the comprehensive management of all natural resources on Indian land. If the integrated resource management planning process... 25 Indians 1 2010-04-01 2010-04-01 false Forest management planning and sustained yield management...

Experimental study of the solid-liquid interface in a yield-stress fluid flow upstream of a step

NASA Astrophysics Data System (ADS)

Luu, Li-Hua; Pierre, Philippe; Guillaume, Chambon

2014-11-01

We present an experimental study where a yield-stress fluid is implemented to carefully examine the interface between a liquid-like unyielded region and a solid-like yielded region. The studied hydrodynamics consists of a rectangular pipe-flow disturbed by the presence of a step. Upstream of the step, a solid-liquid interface between a dead zone and a flow zone appears. This configuration can both model geophysical erosion phenomenon in debris flows or find applications for industrial extrusion processes. We aim to investigate the dominant physical mechanism underlying the formation of the static domain, by combining the rheological characterization of the yield-stress fluid with local measurements of the related hydrodynamic parameters. In this work, we use a model fluid, namely polymer micro-gel Carbopol, that exhibits a Hershel-Bulkley viscoplastic rheology. Exploiting the fluid transparency, the flow is monitored by Particle Image Velocimetry thanks to internal visualization technique. In particular, we demonstrate that the flow above the dead zone roughly behaves as a plug flow whose velocity profile can successfully be described by a Poiseuille equation including a Hershel-Bulkley rheology (PHB theory), with exception of a thin zone at the close vicinity of the static domain. The border inside the flow zone above which the so-called PHB flow starts, is found to be the same regardless of the flow rate and to move with a constant velocity that increases with the flow rate. We interpret this feature as a slip frontier.

Geriatric hip fracture management: keys to providing a successful program.

PubMed

Basu, N; Natour, M; Mounasamy, V; Kates, S L

2016-10-01

Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program. The Geriatric Fracture Center (GFC) is a treatment model that standardizes the approach to the geriatric fracture patient. It is based on five principles: surgical fracture management; early operative intervention; medical co-management with geriatricians; patient-centered, standard order sets to employ best practices; and early discharge planning with a focus on early functional rehabilitation. Implementing a geriatric fracture program begins with an assessment of the hospital's data on hip fractures and standard care metrics such as length of stay, complications, time to surgery, readmission rates and costs. Business planning is essential along with the medical planning process. To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.

Effect of three pretreatment techniques on the chemical composition and on the methane yields of Opuntia ficus-indica (prickly pear) biomass.

PubMed

Calabrò, P S; Catalán, E; Folino, A; Sánchez, A; Komilis, D

2018-01-01

Opuntia ficus-indica (OFI) is an emerging biomass that has the potential to be used as substrate in anaerobic digestion. The goal of this work was to investigate the effect of three pretreatment techniques (thermal, alkaline, acidic) on the chemical composition and the methane yield of OFI biomass. A composite experimental design with three factors and two to three levels was implemented, and regression modelling was employed using a total of 10 biochemical methane potential (BMP) tests. The measured methane yields ranged from 289 to 604 NmL/gVS added ; according to the results, only the acidic pretreatment (HCl) was found to significantly increase methane generation. However, as the experimental values were quite high with regards to the theoretical methane yield of the substrate, this effect still needs to be confirmed via further research. The alkaline pretreatment (NaOH) did not noticeably affect methane yields (an average reduction of 8% was recorded), despite the fact that it did significantly reduce the lignin content. Thermal pretreatment had no effect on the methane yields or the chemical composition. Scanning electron microscopy images revealed changes in the chemical structure after the addition of NaOH and HCl. Modelling of the cumulated methane production by the Gompertz modified equation was successful and aided in understanding kinetic advantages linked to some of the pretreatments. For example, the alkaline treatment (at the 20% dosage) at room temperature resulted to a μ max (maximum specific methane production rate [NmLCH 4 /(gVS added ·d)]) equal to 36.3 against 18.6 for the control.

Halal Logistics Implementation in Malaysia: A Practical View

NASA Astrophysics Data System (ADS)

Sham, Rohana; Zuraidah Rasi, Raja; Abdamia, Noranita; Mohamed, Suhana; Thahira Bibi, TKM

2017-08-01

Concept of halal is not only acceptable world wide by the Muslim society but also to the non Muslim. However, the implementing of halal logistics in daily operation experience a few difficulties especially on the implementation part. Although there are many academic research paper that highlight the issue of halal logistics and the critical success factor, until today, halal logistics in Malaysia is still experiencing a hiccup. This paper try to highlight a few simple ways of implementation of halal logistics that could enhance the total implementation concept at the very least cost to create benefit to all society. The Paper deals with a few aspect of possible implementation and practice to facilitate the halal logistics approach in daily operation. The main objective is to look at the possible method of implementation and critical success factors towards the implementation of halal logistics operation in daily goods movement in Malaysia.

[Company integration management in small and medium-sized companies. Legal requirements and prerequisites for successful implementation].

PubMed

Ramm, D; Mahnke, C; Tauscher, A; Welti, F; Seider, H; Shafaei, R

2012-01-01

The article is based on the results of the project “Company integration management in small and medium-sized companies. Legal requirements and prerequisites for a successful implementation” (01 January 2009-31 August 2010). Since 2004 all employers have been legally bound to offer company integration management (BEM, Betriebliches Eingliederungsmanagement) for all employees who have been incapacitated for work for more than 6 weeks within a year (Section 84 SGB IX, Book 9 of the German Social Code). Objective of this law is to ensure ongoing employment. The aim of the study was to investigate the requirements companies, rehabilitation centres and services as well as social insurance institutions are faced with according to Section 84 SGB IX. Prerequisites for an effective implementation of BEM in small and medium-sized enterprises were analyzed. Protocol-based interviews with experts were adopted. A total of 38 interviews with experts were carried out. The experts interviewed were either willing to give information by interest (concernment) or were named by law as an initiator or co-operator in the process of integration. A substantial literature research was performed in advance of the interviews. The awareness level of BEM is still very low even 7 years after its introduction. Small and medium-sized enterprises do not have any significant experiential knowledge of long-term incapacity for work and, hence, about BEM. Due to a lack of workers representation in many small and medium companies, management does not receive initiatives or support in implementation of BEM from employees' side. Employers prefer a central contact point providing them with the information and help needed, the common service units, however, being widely unknown in this context. Cost comparisons suggest that a company integration management might be more cost-effective than dismissing employees who are incapacitated for some fields of work. These findings might even hold true for small

Optimizing rice yields while minimizing yield-scaled global warming potential.

PubMed

Pittelkow, Cameron M; Adviento-Borbe, Maria A; van Kessel, Chris; Hill, James E; Linquist, Bruce A

2014-05-01

To meet growing global food demand with limited land and reduced environmental impact, agricultural greenhouse gas (GHG) emissions are increasingly evaluated with respect to crop productivity, i.e., on a yield-scaled as opposed to area basis. Here, we compiled available field data on CH4 and N2 O emissions from rice production systems to test the hypothesis that in response to fertilizer nitrogen (N) addition, yield-scaled global warming potential (GWP) will be minimized at N rates that maximize yields. Within each study, yield N surplus was calculated to estimate deficit or excess N application rates with respect to the optimal N rate (defined as the N rate at which maximum yield was achieved). Relationships between yield N surplus and GHG emissions were assessed using linear and nonlinear mixed-effects models. Results indicate that yields increased in response to increasing N surplus when moving from deficit to optimal N rates. At N rates contributing to a yield N surplus, N2 O and yield-scaled N2 O emissions increased exponentially. In contrast, CH4 emissions were not impacted by N inputs. Accordingly, yield-scaled CH4 emissions decreased with N addition. Overall, yield-scaled GWP was minimized at optimal N rates, decreasing by 21% compared to treatments without N addition. These results are unique compared to aerobic cropping systems in which N2 O emissions are the primary contributor to GWP, meaning yield-scaled GWP may not necessarily decrease for aerobic crops when yields are optimized by N fertilizer addition. Balancing gains in agricultural productivity with climate change concerns, this work supports the concept that high rice yields can be achieved with minimal yield-scaled GWP through optimal N application rates. Moreover, additional improvements in N use efficiency may further reduce yield-scaled GWP, thereby strengthening the economic and environmental sustainability of rice systems. © 2013 John Wiley & Sons Ltd.

Implementing an electronic medication overview in Belgium.

PubMed

Storms, Hannelore; Marquet, Kristel; Nelissen, Katherine; Hulshagen, Leen; Lenie, Jan; Remmen, Roy; Claes, Neree

2014-12-16

An accurate medication overview is essential to reduce medication errors. Therefore, it is essential to keep the medication overview up-to-date and to exchange healthcare information between healthcare professionals and patients. Digitally shared information yields possibilities to improve communication. However, implementing a digitally shared medication overview is challenging. This articles describes the development process of a secured, electronic platform designed for exchanging medication information as executed in a pilot study in Belgium, called "Vitalink". The goal of "Vitalink" is to improve the exchange of medication information between professionals working in healthcare and patients in order to achieve a more efficient cooperation and better quality of care. Healthcare professionals of primary and secondary health care and patients of four Belgian regions participated in the project. In each region project groups coordinated implementation and reported back to the steering committee supervising the pilot study. The electronic medication overview was developed based on consensus in the project groups. The steering committee agreed to establish secured and authorized access through the use of electronic identity documents (eID) and a secured, eHealth-platform conform prior governmental regulations regarding privacy and security of healthcare information. A successful implementation of an electronic medication overview strongly depends on the accessibility and usability of the tool for healthcare professionals. Coordinating teams of the project groups concluded, based on their own observations and on problems reported to them, that secured and quick access to medical data needed to be pursued. According to their observations, the identification process using the eHealth platform, crucial to ensure secured data, was very time consuming. Secondly, software packages should meet the needs of their users, thus be adapted to daily activities of healthcare

Succession Planning: A Necessary Strategy for Rural School Administration.

ERIC Educational Resources Information Center

Wallin, Dawn C.

2001-01-01

Succession planning focuses on anticipated future administrative positions, the expected skill requirements of those positions, and developing potential candidates to fill the positions. Although succession planning is basically a business oriented model, it seems appropriate for rural educational settings. Strategies for implementing succession…

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

Invited review: A commentary on predictive cheese yield formulas.

PubMed

Emmons, D B; Modler, H W

2010-12-01

Predictive cheese yield formulas have evolved from one based only on casein and fat in 1895. Refinements have included moisture and salt in cheese and whey solids as separate factors, paracasein instead of casein, and exclusion of whey solids from moisture associated with cheese protein. The General, Barbano, and Van Slyke formulas were tested critically using yield and composition of milk, whey, and cheese from 22 vats of Cheddar cheese. The General formula is based on the sum of cheese components: fat, protein, moisture, salt, whey solids free of fat and protein, as well as milk salts associated with paracasein. The testing yielded unexpected revelations. It was startling that the sum of components in cheese was <100%; the mean was 99.51% (N × 6.31). The mean predicted yield was only 99.17% as a percentage of actual yields (PY%AY); PY%AY is a useful term for comparisons of yields among vats. The PY%AY correlated positively with the sum of components (SofC) in cheese. The apparent low estimation of SofC led to the idea of adjusting upwards, for each vat, the 5 measured components in the formula by the observed SofC, as a fraction. The mean of the adjusted predicted yields as percentages of actual yields was 99.99%. The adjusted forms of the General, Barbano, and Van Slyke formulas gave predicted yields equal to the actual yields. It was apparent that unadjusted yield formulas did not accurately predict yield; however, unadjusted PY%AY can be useful as a control tool for analyses of cheese and milk. It was unexpected that total milk protein in the adjusted General formula gave the same predicted yields as casein and paracasein, indicating that casein or paracasein may not always be necessary for successful yield prediction. The use of constants for recovery of fat and protein in the adjusted General formula gave adjusted predicted yields equal to actual yields, indicating that analyses of cheese for protein and fat may not always be necessary for yield prediction

Succession Planning for Community Colleges: A Study of Best Practices

ERIC Educational Resources Information Center

McMaster, Susan Marie

2012-01-01

The purpose of this study is to apply best practices for succession planning to community colleges. Succession planning is relevant to management practices in community colleges because there is a surge in retirements in higher education from the "baby boomer" generation. Community colleges need to implement a succession plan to ensure…

EarthSat spring wheat yield system test 1975

NASA Technical Reports Server (NTRS)

1976-01-01

The results of an operational test of the EarthSat System during the period 1 June - 30 August 1975 over the spring wheat regions of North Dakota, South Dakota, and Minnesota are presented. The errors associated with each sub-element of the system during the operational test and the sensitivity of the complete system and each major functional sub-element of the system to the observed errors were evaluated. Evaluations and recommendations for future operational users of the system include: (1) changes in various system sub-elements, (2) changes in the yield model to affect improved accuracy, (3) changes in the number of geobased cells needed to develop an accurate aggregated yield estimate, (4) changes associated with the implementation of future operational satellites and data processing systems, and (5) detailed system documentation.

Closing Yield Gaps: How Sustainable Can We Be?

PubMed

Pradhan, Prajal; Fischer, Günther; van Velthuizen, Harrij; Reusser, Dominik E; Kropp, Juergen P

2015-01-01

management strategies for closing yield gaps are chosen and implemented.

A multi-disciplinary approach to implementation science: the NIH-PEPFAR PMTCT implementation science alliance.

PubMed

Sturke, Rachel; Harmston, Christine; Simonds, R J; Mofenson, Lynne M; Siberry, George K; Watts, D Heather; McIntyre, James; Anand, Nalini; Guay, Laura; Castor, Delivette; Brouwers, Pim; Nagel, Joan D

2014-11-01

In resource-limited countries, interventions to prevent mother-to-child HIV transmission (PMTCT) have not yet realized their full potential health impact, illustrating the common gap between the scientific proof of an intervention's efficacy and effectiveness and its successful implementation at scale into routine health services. For PMTCT, this gap results, in part, from inadequate adaptation of PMTCT interventions to the realities of the implementation environment, including client and health care worker behaviors and preferences, health care policies and systems, and infrastructure and resource constraints. Elimination of mother-to-child HIV transmission can only be achieved through understanding of key implementation barriers and successful adaptation of scientifically proven interventions to the local environment. Central to such efforts is implementation science (IS), which aims to investigate and address major bottlenecks that impede effective implementation and to test new approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions. Advancing IS will require deliberate and strategic efforts to facilitate collaboration, communication, and relationship-building among researchers, implementers, and policy-makers. To speed the translation of effective PMTCT interventions into practice and advance IS more broadly, the US National Institutes of Health, in collaboration with the President's Emergency Plan for AIDS Relief launched the National Institutes of Health/President's Emergency Plan for AIDS Relief PMTCT IS Alliance, comprised of IS researchers, PMTCT program implementers, and policy-makers as an innovative platform for interaction and coordination.

An evaluation of health information technology outsourcing success.

PubMed

Malovec, Shannon N; Borycki, Elizabeth M; Kushniruk, Andre W

2015-01-01

Outsourcing involves contracting out functions performed by an organization to another organization. Many healthcare organizations are exploring outsourcing as a way to address demands for health information technology (HIT). This study researches the success of outsourcing in the health informatics industry in Canada. The study is designed to help understand whether outsourcing four functions of HIT (i.e. development, implementation, operations, and maintenance) can prove successful for an organization. Findings demonstrate that outsourcing these four functions occurs in Canada; however, the research from the semi-structured interviews finds that operations and maintenance may be more commonly outsourced in Canada, over development and implementation functions. Despite this, findings from this research suggest that outsourcing development and implementation may offer more benefits and fewer challenges than outsourcing operations and maintenance. The research also finds that there can be benefits of outsourcing, such as gaining access to expertise and improving service levels. A weakness of outsourcing may be that internal knowledge is lost and having to manage the change required from outsourcing. The study proposes that there are many factors that need to be considered when outsourcing to ensure it is successful.

Food Service Perspectives on National School Lunch Program Implementation

PubMed Central

Tabak, Rachel G.; Moreland-Russell, Sarah

2015-01-01

Objectives Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Methods Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Results Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Conclusions Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation. PMID:26417607

Successful Strategies for Implementation of a High School Standards-Based Integrated Mathematics Curriculum

ERIC Educational Resources Information Center

Brown, Linda

2012-01-01

Math achievement for students in the United States is not as high as in other countries. In response, one state implemented a new standards-based, integrated math curriculum that combines traditional high school math courses and emphasizes student centered instruction. The purpose of this study was to examine the implementation of a standards…

Rational design of high-yield and superior-quality rice.

PubMed

Zeng, Dali; Tian, Zhixi; Rao, Yuchun; Dong, Guojun; Yang, Yaolong; Huang, Lichao; Leng, Yujia; Xu, Jie; Sun, Chuan; Zhang, Guangheng; Hu, Jiang; Zhu, Li; Gao, Zhenyu; Hu, Xingming; Guo, Longbiao; Xiong, Guosheng; Wang, Yonghong; Li, Jiayang; Qian, Qian

2017-03-20

Rice (Oryza sativa L.) is a staple food for more than half of the world's population. To meet the ever-increasing demand for food, because of population growth and improved living standards, world rice production needs to double by 2030 1 . The development of new elite rice varieties with high yield and superior quality is challenging for traditional breeding approaches, and new strategies need to be developed. Here, we report the successful development of new elite varieties by pyramiding major genes that significantly contribute to grain quality and yield from three parents over five years. The new varieties exhibit higher yield potential and better grain quality than their parental varieties and the China's leading super-hybrid rice, Liang-you-pai-jiu (LYP9 or Pei-ai 64S/93-11). Our results demonstrate that rational design is a powerful strategy for meeting the challenges of future crop breeding, particularly in pyramiding multiple complex traits.

NEST: a comprehensive model for scintillation yield in liquid xenon

DOE PAGES

Szydagis, M.; Barry, N.; Kazkaz, K.; ...

2011-10-03

Here, a comprehensive model for explaining scintillation yield in liquid xenon is introduced. We unify various definitions of work function which abound in the literature and incorporate all available data on electron recoil scintillation yield. This results in a better understanding of electron recoil, and facilitates an improved description of nuclear recoil. An incident gamma energy range of O(1 keV) to O(1 MeV) and electric fields between 0 and O(10 kV/cm) are incorporated into this heuristic model. We show results from a Geant4 implementation, but because the model has a few free parameters, implementation in any simulation package should bemore » simple. We use a quasi-empirical approach, with an objective of improving detector calibrations and performance verification. The model will aid in the design and optimization of future detectors. This model is also easy to extend to other noble elements. In this paper we lay the foundation for an exhaustive simulation code which we call NEST (Noble Element Simulation Technique).« less

Assessing relative abundance and reproductive success of shrubsteppe raptors

USGS Publications Warehouse

Lehman, Robert N.; Carpenter, L.B.; Steenhof, Karen; Kochert, Michael N.

1998-01-01

From 1991-1994, we quantified relative abundance and reproductive success of the Ferruginous Hawk (Buteo regalis), Northern Harrier (Circus cyaneus), Burrowing Owl (Speotytoc unicularia), and Short-eared Owl (Asio flammeus) on the shrubsteppe plateaus (benchlands) in and near the Snake River Birds of Prey National Conservation Area in southwestern Idaho. To assess relative abundance, we searched randomly selected plots using four sampling methods: point counts, line transects, and quadrats of two sizes. On a persampling-effort basis, transects were slightly more effective than point counts and quadrats for locating raptor nests (3.4 pairs detected/100 h of effort vs. 2.2-3.1 pairs). Random sampling using quadrats failed to detect a Short-eared Owl population increase from 1993 to 1994. To evaluate nesting success, we tried to determine reproductive outcome for all nesting attempts located during random, historical, and incidental nest searches. We compared nesting success estimates based on all nesting attempts, on attempts found during incubation, and the Mayfield model. Most pairs used to evaluate success were pairs found incidentally. Visits to historical nesting areas yielded the highest number of pairs per sampling effort (14.6/100 h), but reoccupancy rates for most species decreased through time. Estimates based on all attempts had the highest sample sizes but probably overestimated success for all species except the Ferruginous Hawk. Estimates of success based on nesting attempts found during incubation had the lowest sample sizes. All three methods yielded biased nesting snccess estimates for the Northern Harrier and Short-eared Owl. The estimate based on pairs found during incubation probably provided the least biased estimate for the Burrowing Owl. Assessments of nesting success were hindered by difficulties in confirming egg laying and nesting success for all species except the Ferruginous hawk.

Implementation Strategies for Educational Intranet Resources.

ERIC Educational Resources Information Center

Herson, Katie; Sosabowski, Michael; Lloyd, Andrew; Flowers, Stephen; Paine, Cameron; Newton, Becci

2000-01-01

Describes two alternative strategies for intranet implementation based on experiences at the University of Brighton (United Kingdom). Highlights include differing degrees of staff and student utilization; barriers to success; a unified strategy for effective intranet implementation; and how to manage organizational resistance to change.…

Do maize models capture the impacts of heat and drought stresses on yield? Using algorithm ensembles to identify successful approaches.

PubMed

Jin, Zhenong; Zhuang, Qianlai; Tan, Zeli; Dukes, Jeffrey S; Zheng, Bangyou; Melillo, Jerry M

2016-09-01

Stresses from heat and drought are expected to increasingly suppress crop yields, but the degree to which current models can represent these effects is uncertain. Here we evaluate the algorithms that determine impacts of heat and drought stress on maize in 16 major maize models by incorporating these algorithms into a standard model, the Agricultural Production Systems sIMulator (APSIM), and running an ensemble of simulations. Although both daily mean temperature and daylight temperature are common choice of forcing heat stress algorithms, current parameterizations in most models favor the use of daylight temperature even though the algorithm was designed for daily mean temperature. Different drought algorithms (i.e., a function of soil water content, of soil water supply to demand ratio, and of actual to potential transpiration ratio) simulated considerably different patterns of water shortage over the growing season, but nonetheless predicted similar decreases in annual yield. Using the selected combination of algorithms, our simulations show that maize yield reduction was more sensitive to drought stress than to heat stress for the US Midwest since the 1980s, and this pattern will continue under future scenarios; the influence of excessive heat will become increasingly prominent by the late 21st century. Our review of algorithms in 16 crop models suggests that the impacts of heat and drought stress on plant yield can be best described by crop models that: (i) incorporate event-based descriptions of heat and drought stress, (ii) consider the effects of nighttime warming, and (iii) coordinate the interactions among multiple stresses. Our study identifies the proficiency with which different model formulations capture the impacts of heat and drought stress on maize biomass and yield production. The framework presented here can be applied to other modeled processes and used to improve yield predictions of other crops with a wide variety of crop models. © 2016 John

Fission yield calculation using toy model based on Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Jubaidah, Kurniadi, Rizal

2015-09-01

Toy model is a new approximation in predicting fission yield distribution. Toy model assumes nucleus as an elastic toy consist of marbles. The number of marbles represents the number of nucleons, A. This toy nucleus is able to imitate the real nucleus properties. In this research, the toy nucleons are only influenced by central force. A heavy toy nucleus induced by a toy nucleon will be split into two fragments. These two fission fragments are called fission yield. In this research, energy entanglement is neglected. Fission process in toy model is illustrated by two Gaussian curves intersecting each other. There are five Gaussian parameters used in this research. They are scission point of the two curves (Rc), mean of left curve (μL) and mean of right curve (μR), deviation of left curve (σL) and deviation of right curve (σR). The fission yields distribution is analyses based on Monte Carlo simulation. The result shows that variation in σ or µ can significanly move the average frequency of asymmetry fission yields. This also varies the range of fission yields distribution probability. In addition, variation in iteration coefficient only change the frequency of fission yields. Monte Carlo simulation for fission yield calculation using toy model successfully indicates the same tendency with experiment results, where average of light fission yield is in the range of 90yield is in about 135

Implementing priority setting frameworks: Insights from leading researchers.

PubMed

Angell, Blake; Pares, Jennie; Mooney, Gavin

2016-12-01

In spite of a substantial literature developing frameworks for policymakers to use in resource allocation decisions in healthcare, there remains limited published work reporting on the implementation or evaluation of such frameworks in practice. This paper presents findings of a targeted survey of 18 leading researchers around the implementation and evaluation of priority-setting exercises. Approximately one third of respondents knew of situations where recommendations of priority-setting exercises had been implemented, one third knew that recommendations had not been implemented and the final third responded that they did not know whether recommendations had been adopted. The lack of evidence linking the implementation of priority-setting recommendations to equity and efficiency outcomes was highlighted by all respondents. Features identified as facilitating successful implementation of priority-setting recommendations included having a climate ready to accept priority-setting, good leadership or a 'champion' for the priority-setting process and having a health economist to guide the process. Successful disinvestment was very uncommon in the experience of the researchers surveyed. Recommendations emerging from Program Budgeting and Marginal Analysis exercises appeared to be more widely implemented than those coming from alternative processes. Identifying if the process was repeated following the initial process was suggested as a means to measure success. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Achieving College Success: The Impact of the College Success/STEM Program on Students' Matriculation to and Persistence in College. Research Brief

ERIC Educational Resources Information Center

Lane, Brett; Souvanna, Phomdaen

2014-01-01

This College Success Research Brief is one of a series of briefs documenting the implementation and impact of Mass Insight's College Success/STEM program. The research briefs are intended to share key findings, highlight ongoing questions and lines of inquiry, and inform the thinking of practitioners and policymakers on how to scale up efforts to…

[Implementing evidence and implementation research: two different and prime realities].

PubMed

Rumbo Prieto, José María; Martínez Ques, Ángel Alfredo; Sobrido Prieto, María; Raña Lama, Camilo Daniel; Vázquez Campo, Miriam; Braña Marcos, Beatriz

Scientific research can contribute to more efficient health care, enhance care quality and safety of persons. In order for this to happen, the knowledge gained must be put into practice. Implementation is known as the introduction of a change or innovation to daily practice, which requires effective communication and the elimination of barriers that hinder this process. Best practice implementation experiences are being used increasingly in the field of nursing. The difficulty in identifying the factors that indicate the success or failure of implementation has led to increased studies to build a body of differentiated knowledge, recognized as implementation science or implementation research. Implementation research is the scientific study whose objective is the adoption and systematic incorporation of research findings into clinical practice to improve the quality and efficiency of health services. The purpose of implementation research is to improve the health of the population through equitable and effective implementation of rigorously evaluated scientific knowledge, which involves gathering the evidence that has a positive impact on the health of the community. In this text, we set out the characteristics of nursing implementation research, providing a synthesis of different methods, theories, key frameworks and implementation strategies, along with the terminology proposed for greater conceptual clarity. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Specific yield: compilation of specific yields for various materials

USGS Publications Warehouse

Johnson, A.I.

1967-01-01

Specific yield is defined as the ratio of (1) the volume of water that a saturated rock or soil will yield by gravity to (2) the total volume of the rock or soft. Specific yield is usually expressed as a percentage. The value is not definitive, because the quantity of water that will drain by gravity depends on variables such as duration of drainage, temperature, mineral composition of the water, and various physical characteristics of the rock or soil under consideration. Values of specific yields nevertheless offer a convenient means by which hydrologists can estimate the water-yielding capacities of earth materials and, as such, are very useful in hydrologic studies. The present report consists mostly of direct or modified quotations from many selected reports that present and evaluate methods for determining specific yield, limitations of those methods, and results of the determinations made on a wide variety of rock and soil materials. Although no particular values are recommended in this report, a table summarizes values of specific yield, and their averages, determined for 10 rock textures. The following is an abstract of the table. [Table

Barriers to Implementing the Response to Intervention Framework in Secondary Schools: Interviews with Secondary Principals

ERIC Educational Resources Information Center

Bartholomew, Mitch; De Jong, David

2017-01-01

Despite the successful implementation of the Response to Intervention (RtI) framework in many elementary schools, there is little evidence of successful implementation in high school settings. Several themes emerged from the interviews of nine secondary principals, including a lack of knowledge and training for successful implementation, the…

Yield and yield gaps in central U.S. corn production systems

USDA-ARS?s Scientific Manuscript database

The magnitude of yield gaps (YG) (potential yield – farmer yield) provides some indication of the prospects for increasing crop yield. Quantile regression analysis was applied to county maize (Zea mays L.) yields (1972 – 2011) from Kentucky, Iowa and Nebraska (irrigated) (total of 115 counties) to e...

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.

Measuring Success: Evaluating Educational Programs

ERIC Educational Resources Information Center

Fisher, Yael

2010-01-01

This paper reveals a new evaluation model, which enables educational program and project managers to evaluate their programs with a simple and easy to understand approach. The "index of success model" is comprised of five parameters that enable to focus on and evaluate both the implementation and results of an educational program. The…

Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam.

PubMed

Barat, Lawrence M

2006-01-01

While many countries struggle to control malaria, four countries, Brazil, Eritrea, India, and Vietnam, have successfully reduced malaria burden. To determine what led these countries to achieve impact, published and unpublished reports were reviewed and selected program and partner staff were interviewed to identify common factors that contributed to these successes. Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing. All these factors were essential in achieving success. If the goals of Roll Back Malaria are to be achieved, governments and their partners must take the lessons learned from these program successes and apply them in other affected countries.

Building Systems for Successful Implementation of Function-Based Support in Schools

ERIC Educational Resources Information Center

Anderson, Cynthia M.; Horner, Robert H.; Rodriguez, Billie Jo; Stiller, Brianna

2013-01-01

Supporting the full range of students with behavioral challenges requires that schools build the capacity to implement evidence-based behavioral interventions. Fortunately, a substantive body of research documents behavioral interventions are available to both decrease problem behavior and enhance prosocial skills. To date, however, this…

Factors affecting hatch success of hawksbill sea turtles on Long Island, Antigua, West Indies.

PubMed

Ditmer, Mark Allan; Stapleton, Seth Patrick

2012-01-01

Current understanding of the factors influencing hawksbill sea turtle (Eretmochelys imbricata) hatch success is disparate and based on relatively short-term studies or limited sample sizes. Because global populations of hawksbills are heavily depleted, evaluating the parameters that impact hatch success is important to their conservation and recovery. Here, we use data collected by the Jumby Bay Hawksbill Project (JBHP) to investigate hatch success. The JBHP implements saturation tagging protocols to study a hawksbill rookery in Antigua, West Indies. Habitat data, which reflect the varied nesting beaches, are collected at egg deposition, and nest contents are exhumed and categorized post-emergence. We analyzed hatch success using mixed-model analyses with explanatory and predictive datasets. We incorporated a random effect for turtle identity and evaluated environmental, temporal and individual-based reproductive variables. Hatch success averaged 78.6% (SD: 21.2%) during the study period. Highly supported models included multiple covariates, including distance to vegetation, deposition date, individual intra-seasonal nest number, clutch size, organic content, and sand grain size. Nests located in open sand were predicted to produce 10.4 more viable hatchlings per clutch than nests located >1.5 m into vegetation. For an individual first nesting in early July, the fourth nest of the season yielded 13.2 more viable hatchlings than the initial clutch. Generalized beach section and inter-annual variation were also supported in our explanatory dataset, suggesting that gaps remain in our understanding of hatch success. Our findings illustrate that evaluating hatch success is a complex process, involving multiple environmental and individual variables. Although distance to vegetation and hatch success were inversely related, vegetation is an important component of hawksbill nesting habitat, and a more complete assessment of the impacts of specific vegetation types on hatch

Factors Affecting Hatch Success of Hawksbill Sea Turtles on Long Island, Antigua, West Indies

PubMed Central

Ditmer, Mark Allan; Stapleton, Seth Patrick

2012-01-01

Current understanding of the factors influencing hawksbill sea turtle (Eretmochelys imbricata) hatch success is disparate and based on relatively short-term studies or limited sample sizes. Because global populations of hawksbills are heavily depleted, evaluating the parameters that impact hatch success is important to their conservation and recovery. Here, we use data collected by the Jumby Bay Hawksbill Project (JBHP) to investigate hatch success. The JBHP implements saturation tagging protocols to study a hawksbill rookery in Antigua, West Indies. Habitat data, which reflect the varied nesting beaches, are collected at egg deposition, and nest contents are exhumed and categorized post-emergence. We analyzed hatch success using mixed-model analyses with explanatory and predictive datasets. We incorporated a random effect for turtle identity and evaluated environmental, temporal and individual-based reproductive variables. Hatch success averaged 78.6% (SD: 21.2%) during the study period. Highly supported models included multiple covariates, including distance to vegetation, deposition date, individual intra-seasonal nest number, clutch size, organic content, and sand grain size. Nests located in open sand were predicted to produce 10.4 more viable hatchlings per clutch than nests located >1.5 m into vegetation. For an individual first nesting in early July, the fourth nest of the season yielded 13.2 more viable hatchlings than the initial clutch. Generalized beach section and inter-annual variation were also supported in our explanatory dataset, suggesting that gaps remain in our understanding of hatch success. Our findings illustrate that evaluating hatch success is a complex process, involving multiple environmental and individual variables. Although distance to vegetation and hatch success were inversely related, vegetation is an important component of hawksbill nesting habitat, and a more complete assessment of the impacts of specific vegetation types on hatch

Implementing a Standardized Social Networks Testing Strategy in a Low HIV Prevalence Jurisdiction.

PubMed

Schumann, Casey; Kahn, Danielle; Broaddus, Michelle; Dougherty, Jacob; Elderbrook, Megan; Vergeront, James; Westergaard, Ryan

2018-05-15

Alternative HIV testing strategies are needed to engage individuals not reached by traditional clinical or non-clinical testing programs. A social networks recruitment strategy, in which people at risk for or living with HIV are enlisted and trained by community-based agencies to recruit individuals from their social, sexual, or drug-using networks for HIV testing, demonstrates higher positivity rates compared to other non-clinical recruitment strategies in some jurisdictions. During 2013-2015, a social networks testing protocol was implemented in Wisconsin to standardize an existing social networks testing program. Six community-based, non-clinical agencies with multiple sites throughout the state implemented the protocol over the 2-year period. Both quantitative and qualitative data were collected. The new positivity rate (0.49%) through social networks testing did not differ from that of traditional counseling, testing, and referral recruitment methods (0.48%). Although social networks testing did not yield a higher new positivity rate compared to other testing strategies, it proved to be successful at reaching high risk individuals who may not otherwise engage in HIV testing.

Yield and water quality for different residue managements of sugarcane in Louisiana

USDA-ARS?s Scientific Manuscript database

The focus of the study was to provide information on implementation of a modified post-harvest crop residue sweeper on sugarcane yield and water quality. Field experiments were established at three different locations in south Louisiana: Paincourtville, Duson and Baton Rouge. In each location, lar...

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.

Food availability at birth limited reproductive success in historical humans.

PubMed

Rickard, Ian J; Holopainen, Jari; Helama, Samuli; Helle, Samuli; Russell, Andrew F; Lummaa, Virpi

2010-12-01

Environmental conditions in early life can profoundly affect individual development and have consequences for reproductive success. Limited food availability may be one of the reasons for this, but direct evidence linking variation in early-life nutrition to reproductive performance in adulthood in natural populations is sparse. We combined historical agricultural data with detailed demographic church records to investigate the effect of food availability around the time of birth on the reproductive success of 927 men and women born in 18th-century Finland. Our study population exhibits natural mortality and fertility rates typical of many preindustrial societies, and individuals experienced differing access to resources due to social stratification. We found that among both men and women born into landless families (i.e., with low access to resources), marital prospects, probability of reproduction, and offspring viability were all positively related to local crop yield during the birth year. Such effects were generally absent among those born into landowning families. Among landless individuals born when yields of the two main crops, rye and barley, were both below median, only 50% of adult males and 55% of adult females gained any reproductive success in their lifetime, whereas 97% and 95% of those born when both yields were above the median did so. Our results suggest that maternal investment in offspring in prenatal or early postnatal life may have profound implications for the evolutionary fitness of human offspring, particularly among those for which resources are more limiting. Our study adds support to the idea that early nutrition can limit reproductive success in natural animal populations, and provides the most direct evidence to date that this process applies to humans.

Lean Management Systems in Radiology: Elements for Success.

PubMed

Schultz, Stacy R; Ruter, Royce L; Tibor, Laura C

2016-01-01

This article is a review of the literature on Lean and Lean Management Systems and how they have been implemented in healthcare organizations and particularly in radiology departments. The review focuses on the elements required for a successful implementation of Lean by applying the principles of a Lean Management System instead of a Lean tools-only approach. This review shares the successes and failures from healthcare organizations' efforts to improve the quality and safety of the services they provide. There are a limited number of healthcare organizations in the literature who have shared their experiences and additional research is necessary to determine whether a Lean Management System is a viable alternative to the current management structure in healthcare.

ROI on yield data analysis systems through a business process management strategy

NASA Astrophysics Data System (ADS)

Rehani, Manu; Strader, Nathan; Hanson, Jeff

2005-05-01

The overriding motivation for yield engineering is profitability. This is achieved through application of yield management. The first application is to continually reduce waste in the form of yield loss. New products, new technologies and the dynamic state of the process and equipment keep introducing new ways to cause yield loss. In response, the yield management efforts have to continually come up with new solutions to minimize it. The second application of yield engineering is to aid in accurate product pricing. This is achieved through predicting future results of the yield engineering effort. The more accurate the yield prediction, the more accurate the wafer start volume, the more accurate the wafer pricing. Another aspect of yield prediction pertains to gauging the impact of a yield problem and predicting how long that will last. The ability to predict such impacts again feeds into wafer start calculations and wafer pricing. The question then is that if the stakes on yield management are so high why is it that most yield management efforts are run like science and engineering projects and less like manufacturing? In the eighties manufacturing put the theory of constraints1 into practice and put a premium on stability and predictability in manufacturing activities, why can't the same be done for yield management activities? This line of introspection led us to define and implement a business process to manage the yield engineering activities. We analyzed the best known methods (BKM) and deployed a workflow tool to make them the standard operating procedure (SOP) for yield managment. We present a case study in deploying a Business Process Management solution for Semiconductor Yield Engineering in a high-mix ASIC environment. We will present a description of the situation prior to deployment, a window into the development process and a valuation of the benefits.

Disability Policy Implementation from a Cross-Cultural Perspective

ERIC Educational Resources Information Center

Verdugo, Miguel A.; Jenaro, Cristina; Calvo, Isabel; Navas, Patricia

2017-01-01

Implementation of disability policy is influenced by social, political, and cultural factors. Based on published work, this article discusses four guidelines considered critical for successful policy implementation from a cross-cultural perspective. These guidelines are to: (a) base policy implementation on a contextual analysis, (b) employ a…

Total Quality Management (TQM). Implementers Workshop

DTIC Science & Technology

1990-05-15

SHEE’T :s t’ii ,rrl DEPARTMENT OF DEFENSE May 15, 1990 Lfl CN I TOTAL QUALITY MANAGEMENT (TQM) Implementers Workshop © Copyright 1990 Booz.Allen...must be continually performed in order to achieve successful TQM implementation. 1-5 = TOTAL QUALITY MANAGEMENT Implementers Workshop Course Content...information, please refer to the student manual, Total Quality Management (TOM) Awareness Seminar, that was provided for the Awareness Course. You may

Determinants of hospital tax-exempt debt yields: corrections for selection and simultaneous equation bias.

PubMed Central

Carpenter, C E

1992-01-01

The cost of capital for hospitals is a topic of continuing interest as Medicare's new capital payment policy is implemented. This study examines the determinants of tax-exempt revenue bond yields, the primary source of long-term capital for hospitals. Two important methodological issues are addressed. A probit analysis estimates the probability that a hospital or system will be observed in the tax-exempt market. A selection-corrected two-stage least squares analysis allows for the simultaneous determination of bond yield and bond size. The study is based on a sample of hospitals that issued tax-exempt revenue bonds in 1982-1984, the years immediately surrounding implementation of Medicare's new payment system based on diagnosis-related groups, and an equal number of hospitals not in the market during the study period. Results suggest that hospital systems and hospitals with high occupancy rates are most likely to enter the tax-exempt revenue bond market. The yield equation suggests that hospital-specific variables may not be good predictors of the cost of capital once estimates are corrected for selection. PMID:1464540

Determinants of hospital tax-exempt debt yields: corrections for selection and simultaneous equation bias.

PubMed

Carpenter, C E

1992-12-01

The cost of capital for hospitals is a topic of continuing interest as Medicare's new capital payment policy is implemented. This study examines the determinants of tax-exempt revenue bond yields, the primary source of long-term capital for hospitals. Two important methodological issues are addressed. A probit analysis estimates the probability that a hospital or system will be observed in the tax-exempt market. A selection-corrected two-stage least squares analysis allows for the simultaneous determination of bond yield and bond size. The study is based on a sample of hospitals that issued tax-exempt revenue bonds in 1982-1984, the years immediately surrounding implementation of Medicare's new payment system based on diagnosis-related groups, and an equal number of hospitals not in the market during the study period. Results suggest that hospital systems and hospitals with high occupancy rates are most likely to enter the tax-exempt revenue bond market. The yield equation suggests that hospital-specific variables may not be good predictors of the cost of capital once estimates are corrected for selection.

Simultaneous achievement of high ethanol yield and titer in Clostridium thermocellum.

PubMed

Tian, Liang; Papanek, Beth; Olson, Daniel G; Rydzak, Thomas; Holwerda, Evert K; Zheng, Tianyong; Zhou, Jilai; Maloney, Marybeth; Jiang, Nannan; Giannone, Richard J; Hettich, Robert L; Guss, Adam M; Lynd, Lee R

2016-01-01

Biofuel production from plant cell walls offers the potential for sustainable and economically attractive alternatives to petroleum-based products. Fuels from cellulosic biomass are particularly promising, but would benefit from lower processing costs. Clostridium thermocellum can rapidly solubilize and ferment cellulosic biomass, making it a promising candidate microorganism for consolidated bioprocessing for biofuel production, but increases in product yield and titer are still needed. Here, we started with an engineered C. thermocellum strain where the central metabolic pathways to products other than ethanol had been deleted. After two stages of adaptive evolution, an evolved strain was selected with improved yield and titer. On chemically defined medium with crystalline cellulose as substrate, the evolved strain produced 22.4 ± 1.4 g/L ethanol from 60 g/L cellulose. The resulting yield was about 0.39 gETOH/gGluc eq, which is 75 % of the maximum theoretical yield. Genome resequencing, proteomics, and biochemical analysis were used to examine differences between the original and evolved strains. A two step selection method successfully improved the ethanol yield and the titer. This evolved strain has the highest ethanol yield and titer reported to date for C. thermocellum, and is an important step in the development of this microbe for industrial applications.

Fission yield calculation using toy model based on Monte Carlo simulation

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

Jubaidah, E-mail: jubaidah@student.itb.ac.id; Physics Department, Faculty of Mathematics and Natural Science – State University of Medan. Jl. Willem Iskandar Pasar V Medan Estate – North Sumatera, Indonesia 20221; Kurniadi, Rizal, E-mail: rijalk@fi.itb.ac.id

2015-09-30

Toy model is a new approximation in predicting fission yield distribution. Toy model assumes nucleus as an elastic toy consist of marbles. The number of marbles represents the number of nucleons, A. This toy nucleus is able to imitate the real nucleus properties. In this research, the toy nucleons are only influenced by central force. A heavy toy nucleus induced by a toy nucleon will be split into two fragments. These two fission fragments are called fission yield. In this research, energy entanglement is neglected. Fission process in toy model is illustrated by two Gaussian curves intersecting each other. Theremore » are five Gaussian parameters used in this research. They are scission point of the two curves (R{sub c}), mean of left curve (μ{sub L}) and mean of right curve (μ{sub R}), deviation of left curve (σ{sub L}) and deviation of right curve (σ{sub R}). The fission yields distribution is analyses based on Monte Carlo simulation. The result shows that variation in σ or µ can significanly move the average frequency of asymmetry fission yields. This also varies the range of fission yields distribution probability. In addition, variation in iteration coefficient only change the frequency of fission yields. Monte Carlo simulation for fission yield calculation using toy model successfully indicates the same tendency with experiment results, where average of light fission yield is in the range of 90« less

Success with ACCESS: Use of Community-Based Participatory Research for Implementation

ERIC Educational Resources Information Center

Eilola, Carolyn; Fishman, Kathryn; Greenburg, Arielle; Moore, Crystal Dea; Schrijver, Andrew; Totino, Jamin

2011-01-01

The Assessment of Campus Climate to Enhance Student Success survey (ACCESS) is a set of four questionnaires designed to elicit feedback from five campus constituencies including faculty, administration, staff, students with disabilities, and students without disabilities "to use in planning and garnering support for meaningful activities and…

De-implementation: A concept analysis.

PubMed

Upvall, Michele J; Bourgault, Annette M

2018-04-25

The purpose of this concept analysis is to explore the meaning of de-implementation and provide a definition that can be used by researchers and clinicians to facilitate evidence-based practice. De-implementation is a relatively unknown process overshadowed by the novelty of introducing new ideas and techniques into practice. Few studies have addressed the challenge of de-implementation and the cognitive processes involved when terminating harmful or unnecessary practices. Also, confusion exists regarding the myriad of terms used to describe de-implementation processes. Walker and Avant's method (2011) for describing concepts was used to clarify de-implementation. A database search limited to academic journals yielded 281 publications representing basic research, study protocols, and editorials/commentaries from implementation science experts. After applying exclusion criterion of English language only and eliminating overlap between databases, 41 articles were selected for review. Literature review and synthesis provided a concept analysis and a distinct definition of de-implementation. De-implementation was defined as the process of identifying and removing harmful, non-cost-effective, or ineffective practices based on tradition and without adequate scientific support. The analysis provided further refinement of de-implementation as a significant concept for ongoing theory development in implementation science and clinical practice. © 2018 Wiley Periodicals, Inc.

Using qualitative psychology to investigate HACCP implementation barriers.

PubMed

Taylor, Eunice; Taylor, Joanne Zaida

2004-02-01

Hazard Analysis Critical Control Point (HACCP) is a system of food safety management that in the last few decades has become an increasing part of national government and international strategy to reduce the prevalence of food borne disease. Yet despite wide dissemination and scientific support of its principles, successful HACCP implementation has been limited. There has been very little in-depth consideration of the reasons behind this, and qualitative psychological research examining the interplay of factors involved is almost non-existent. For this study therefore, four in-depth narrative interviews were carried out with small business owners attempting to implement HACCP. Non-prescriptive analysis of their interviews was carried out, and this revealed five key themes acting as 'barriers' to successful implementation. These were of HACCP as difficult, burdensome and unnecessary, and hindered by staff and external problems. The analysis showed furthermore the complexity of issues underpinning problems with HACCP implementation and the way in which they operate at knowledge, attitude and behavioural levels. From this, essential issues to be addressed in order for successful HACCP to be achieved are put forward.

Simulating long-term landcover change and water yield dynamics in a forested, snow-dominated Rocky Mountain watershed

Treesearch

R. S. Ahl; S. W. Woods

2006-01-01

Changes in the extent, composition, and configuration of forest cover over time due to succession or disturbance processes can result in measurable changes in streamflow and water yield. Removal of forest cover generally increases streamflow due to reduced canopy interception and evapotranspiration. In watersheds where snow is the dominant source of water, yield...

Using Satellite Data to Unpack Causes of Yield Gaps in India's Wheat Belt

NASA Astrophysics Data System (ADS)

Jain, M.; Singh, B.; Srivastava, A.; Malik, R. K.; McDonald, A.; Lobell, D. B.

2016-12-01

India will face significant food security challenges in the coming decades due to climate change, natural resource degradation, and population growth. Yields of wheat, one of India's staple crops, are already stagnating and will be significantly impacted by warming temperatures. Despite these challenges, wheat yields can be enhanced by implementing improved management in regions with existing yield gaps. To identify the magnitude and causes of current yield gaps, we produced 30 m resolution yield maps across India's main wheat belt, the Indo-Gangetic Plains (IGP), from 2000 to 2015. Yield maps were derived using a new method that translates satellite vegetation indices to yield estimates using crop model simulations, bypassing the need for ground calibration data that rarely exist in smallholder systems. We find that yields can be increased by 5% on average and up to 16% in the eastern IGP by improving management to current best practices within a given district. However, if policies and technologies are put in place to improve management to current best practices in Punjab, the highest yielding state, yields can be increased by 29% in the eastern IGP. Considering which factors most influence wheat yields, we find that later sow dates and warmer temperatures are most associated with low yields across the IGP. This suggests that strategies that reduce the negative effects of heat stress, like earlier sowing and planting heat-tolerant wheat varieties, are critical to India's current and future food security.

Key factors for the implementation of successful, stand-alone village electrification schemes in Peru

NASA Astrophysics Data System (ADS)

Sanchez-Campos, Teodoro

The hypothesis of this work is that there are social, financial, technical, managerial institutional and political key factors that may either support or prevent the success of small stand alone energy systems in rural areas. This research work aims at contributing to the identification of such factors and study their relevance to the performance and sustainability of stand alone energy systems in rural areas; to meet its purpose, a wide range of literature was reviewed including rural electrification programmes and projects, research and development projects on access to electricity in rural areas, impact studies and others, and a field research survey was done the Andes and Upper Jungle regions in Peru. Nineteen possible critical factors were identified, thirteen with relevance at the local context (the community or village), and six with relevance at the national (or wider) context. From literature review it was found that the possible local critical factors were relevant only to four categories of factors instead of the six considered initially (i.e. social, financial, technological and managerial): the other two categories, political and institutional were found to be more relevant to the national context, therefore those were included in the group of possible critical factors of wider context. A series of questionnaires were designed to collect field data information, which was later used to analyse and establish the relation of each identified factor with the success of the systems studied. The survey research was implemented in 14 villages, 7 with small diesel sets and 7 with small hydropower schemes, all spread in the Andes and Upper Jungle of Peru, which were carefully selected to be representative of regions with isolated stand alone systems and with different socioeconomic background. Out of the 13 possible critical factors of local context, it was found that only 3 are really critical, the others are important but not critical; one of them (technical

Success factors for strategic change initiatives: a qualitative study of healthcare administrators' perspectives.

PubMed

Kash, Bita Arbab; Spaulding, Aaron; Johnson, Christopher E; Gamm, Larry

2014-01-01

Success factors related to the implementation of change initiatives are well documented and discussed in the management literature, but they are seldom studied in healthcare organizations engaged in multiple strategic change initiatives. The purpose of this study was to identify key success factors related to implementation of change initiatives based on rich qualitative data gathered from health leader interviews at two large health systems implementing multiple change initiatives. In-depth personal interviews with 61 healthcare leaders in the two large systems were conducted and inductive qualitative analysis was employed to identify success factors associated with 13 change initiatives. Results from this analysis were compared to success factors identified in the literature, and generalizations were drawn that add significantly to the management literature, especially to that in the healthcare sector. Ten specific success factors were identified for the implementation of change initiatives. The top three success factors were (1) culture and values, (2) business processes, and (3) people and engagement. Two of the identified success factors are unique to the healthcare sector and not found in the literature on change models: service quality and client satisfaction (ranked fourth of 10) and access to information (ranked ninth). Results demonstrate the importance of human resource functions, alignment of culture and values with change, and business processes that facilitate effective communication and access to information to achieve many change initiatives. The responses also suggest opportunities for leaders of healthcare organizations to more formally recognize the degree to which various change initiatives are dependent on one another.

A Blueprint for Success. Operation Rescue.

ERIC Educational Resources Information Center

National Foundation for the Improvement of Education, Washington, DC.

A set of principles that focus on issues concerning implementation of a successful dropout prevention program is presented by a consortium of national educational organizations. The key elements of this "blueprint" consider local adaptations and effective results among various programs. The booklet discusses seven principles for dropout…

The Successful Implementation of Electronic Health Records at Small Rural Hospitals

ERIC Educational Resources Information Center

Richardson, Daniel

2016-01-01

Electronic health records (EHRs) have been in use since the 1960s. U.S. rural hospital leaders and administrators face significant pressure to implement health information technology because of the American Recovery and Reinvestment Act of 2009. However, some leaders and managers of small rural hospital lack strategies to develop and implement…

Measurement of fission yields and isomeric yield ratios at IGISOL

NASA Astrophysics Data System (ADS)

Pomp, Stephan; Mattera, Andrea; Rakopoulos, Vasileios; Al-Adili, Ali; Lantz, Mattias; Solders, Andreas; Jansson, Kaj; Prokofiev, Alexander V.; Eronen, Tommi; Gorelov, Dimitri; Jokinen, Ari; Kankainen, Anu; Moore, Iain D.; Penttilä, Heikki; Rinta-Antila, Sami

2018-03-01

Data on fission yields and isomeric yield ratios (IYR) are tools to study the fission process, in particular the generation of angular momentum. We use the IGISOL facility with the Penning trap JYFLTRAP in Jyväskylä, Finland, for such measurements on 232Th and natU targets. Previously published fission yield data from IGISOL concern the 232Th(p,f) and 238U(p,f) reactions at 25 and 50 MeV. Recently, a neutron source, using the Be(p,n) reaction, has been developed, installed and tested. We summarize the results for (p,f) focusing on the first measurement of IYR by direct ion counting. We also present first results for IYR and relative yields for Sn and Sb isotopes in the 128-133 mass range from natU(n,f) based on γ-spectrometry. We find a staggering behaviour in the cumulative yields for Sn and a shift in the independent fission yields for Sb as compared to current evaluations. Plans for the future experimental program on fission yields and IYR measurements are discussed.

Closing Yield Gaps: How Sustainable Can We Be?

PubMed Central

Pradhan, Prajal; Fischer, Günther; van Velthuizen, Harrij; Reusser, Dominik E.; Kropp, Juergen P.

2015-01-01

management strategies for closing yield gaps are chosen and implemented. PMID:26083456

SUCCESSFUL IMPLEMENTATION OF LEAN AS A MANAGERIAL PRINCIPLE IN HEALTH CARE: A CONCEPTUAL ANALYSIS FROM SYSTEMATIC LITERATURE REVIEW.

PubMed

Maijala, Riikka; Eloranta, Sini; Reunanen, Tero; Ikonen, Tuija S

2018-01-01

The aim of this study was to identify and analyze the characteristics of leadership and management associated with a successful Lean thinking adaptation in healthcare. A systematic literature review was undertaken using electronic databases: PubMed, PubMed Systematic Review, ABI/INFORM, Business Source Complete, Emerald, JBI, and Cinahl. Inclusion criteria were: (i) a description of Lean management or leadership in health care, (ii) a reference to Lean thinking, (iii) a peer-reviewed original research article or a literature review, and (iv) a full text article available in English. Among the 1,754 peer-reviewed articles identified, nine original articles and three systematic reviews met the inclusion criteria. Data on informants, methods, and settings were extracted and collated. Content analysis was used to conduct a review of the nine original studies describing and analyzing the success factors of Lean adaptation. The characteristics of leadership and management were analyzed by using the concept of a managerial windshield that divides leadership and management into four ontological dimensions: activities, style, focus, and purpose, each with typical developmental stages of skills and capabilities. The current study has some limitations: some papers from the journals not indexed in the searched databases may have been overlooked and the literature searches were carried out only for a 5-year period. Considering the results using the windshield concept emphasizes the philosophy, principles, and tools of Lean thinking. Lean leadership and management factors in health care were mainly conceptualized as skills and capabilities such as problem solving, making changes occur, empowering, communicating, coaching, supporting, facilitating, being democratic, organizational learning, and organizational success, all of which represented middle-stage or advanced managerial skills and capabilities. A conceptual analysis of systematically reviewed studies of Lean leadership

An improved extraction method to increase DNA yield from molted feathers

Treesearch

Shelley Bayard De Volo; Richard T. Reynolds; Marlis R. Douglas; Michael F. Antolin

2008-01-01

To assess the value of molted feathers as a noninvasive source of DNA for genetic studies of Northern Goshawks (Accipiter gentilis), we isolated and quantified DNA from molted feathers and compared yields across five feather types. We also compared PCR success across the same five feather types using five microsatellite genetic markers of varying...

Testing some major determinants for hospital innovation success.

PubMed

Caccia-Bava, Maria do Carmo; Guimaraes, Valerie C K; Guimaraes, Tor

2009-01-01

Hospitals have adopted new policies, methods and technologies to change their processes, improve services, and support other organizational changes necessary for better performance. The literature regarding the four major areas of strategic leadership, competitive intelligence, management of technology, and specific characteristics of the organization's change process propose their importance in successfully implementing organization innovation. While these factors may indeed be important to enhance hospital performance, the existing literature contains limited empirical evidence supporting their relationship to successfully implementing innovation in hospitals. This study aims to empirically test these relationships proposed in the literature by researchers in separate knowledge areas. A survey of 223 hospitals has been used to test an integrated model of these relationships. The response rate and the representativeness of the sample in terms of hospital size and geographical location were found satisfactory. The quality assurance/compliance managers for each hospital were the target respondents to questions, which require a corporate perspective while reducing the chance of bias for questions regarding top management leadership abilities. The results provide clear evidence about the importance of strategic leadership, competitive intelligence, management of technology, and specific characteristics of the hospital's change process to the hospitals success in implementing innovation. Given the importance of hospitals to change their processes, improve services, and support other organizational changes necessary for better performance, a great benefit is that the main factors for successful innovation have been brought together from scattered literature and tested among hospitals. Further, the items used for measuring the main constructs provide further insights into how hospital administrators should go about developing these areas within their organizations. This

Marker assisted pyramiding of drought yield QTLs into a popular Malaysian rice cultivar, MR219.

PubMed

Shamsudin, Noraziyah Abd Aziz; Swamy, B P Mallikarjuna; Ratnam, Wickneswari; Sta Cruz, Ma Teressa; Raman, Anitha; Kumar, Arvind

2016-01-27

Three drought yield QTLs, qDTY 2.2, qDTY 3.1, and qDTY 12.1 with consistent effect on grain yield under reproductive stage drought stress were pyramided through marker assisted breeding with the objective of improving the grain yield of the elite Malaysian rice cultivar MR219 under reproductive stage drought stress. Foreground selection using QTL specific markers, recombinant selection using flanking markers, and background selection were performed. BC1F3-derived lines with different combinations of qDTY 2.2 , qDTY 3.1, and qDTY 12.1 were evaluated under both reproductive stage drought stress and non-stress during the dry seasons of 2013 and 2014 at IRRI. The grain yield reductions in the stress trials compared to non-stress trials ranged from 79 to 93%. In the stress trials, delay in days to flowering and reduction in plant height were observed. In both seasons, MR219 did not produce any yield under stress, however it produced a yield of 5917 kg ha(-1) during the 2013 dry season and 8319 kg ha(-1) during the 2014 dry season under non-stress. Selected introgressed lines gave a yield advantage of 903 to 2500 kg ha(-1) over MR219 under reproductive stage drought stress and a yield of more than 6900 kg ha(-1) under non-stress during the 2014 dry season. Among lines with single qDTY, lines carrying qDTY 2.2 provided a higher yield advantage under reproductive stage drought stress in the MR219 background. Two-qDTY combinations (qDTY 3.1+ qDTY 2.2 and qDTY 3.1+ qDTY 12.1) performed better than lines with three qDTY combinations, indicating the absence of positive interactions between the three qDTYs. We successfully developed drought-tolerant MR219 pyramided lines with a yield advantage of more than 1500 kg ha(-1). Differential yield advantages of different combinations of the qDTYs indicate a differential synergistic relationship among qDTYs. This is the first report on the successful effect of qDTYs in increasing the yield under drought in genetic backgrounds other

Estimating sugarcane yield potential using an in-season determination of normalized difference vegetative index.

PubMed

Lofton, Josh; Tubana, Brenda S; Kanke, Yumiko; Teboh, Jasper; Viator, Howard; Dalen, Marilyn

2012-01-01

Estimating crop yield using remote sensing techniques has proven to be successful. However, sugarcane possesses unique characteristics; such as, a multi-year cropping cycle and plant height-limiting for midseason fertilizer application timing. Our study objective was to determine if sugarcane yield potential could be estimated using an in-season estimation of normalized difference vegetative index (NDVI). Sensor readings were taken using the GreenSeeker® handheld sensor from 2008 to 2011 in St. Gabriel and Jeanerette, LA, USA. In-season estimates of yield (INSEY) values were calculated by dividing NDVI by thermal variables. Optimum timing for estimating sugarcane yield was between 601-750 GDD. In-season estimated yield values improved the yield potential (YP) model compared to using NDVI. Generally, INSEY value showed a positive exponential relationship with yield (r(2) values 0.48 and 0.42 for cane tonnage and sugar yield, respectively). When models were separated based on canopy structure there was an increase the strength of the relationship for the erectophile varieties (r(2) 0.53 and 0.47 for cane tonnage and sugar yield, respectively); however, the model for planophile varieties weakened slightly. Results of this study indicate using an INSEY value for predicting sugarcane yield shows potential of being a valuable management tool for sugarcane producers in Louisiana.

Compensatory stream and wetland mitigation in North Carolina: an evaluation of regulatory success.

PubMed

Hill, Tammy; Kulz, Eric; Munoz, Breda; Dorney, John R

2013-05-01

Data from a probability sample were used to estimate wetland and stream mitigation success from 2007 to 2009 across North Carolina (NC). "Success" was defined as whether the mitigation site met regulatory requirements in place at the time of construction. Analytical results were weighted by both component counts and mitigation size. Overall mitigation success (including preservation) was estimated at 74 % (SE = 3 %) for wetlands and 75 % (SE = 4 %) for streams in NC. Compared to the results of previous studies, wetland mitigation success rates had increased since the mid-1990s. Differences between mitigation providers (mitigation banks, NC Ecosystem Enhancement Program's design-bid-build and full-delivery programs, NC Department of Transportation and private permittee-responsible mitigation) were generally not significant although permittee-responsible mitigation yielded higher success rates in certain circumstances. Both wetland and stream preservation showed high rates of success and the stream enhancement success rate was significantly higher than that of stream restoration. Additional statistically significant differences when mitigation size was considered included: (1) the Piedmont yielded a lower stream mitigation success rate than other areas of the state, and (2) recently constructed wetland mitigation projects demonstrated a lower success rate than those built prior to 2002. Opportunities for improvement exist in the areas of regulatory record-keeping, understanding the relationship between post-construction establishment and long-term ecological trajectories of stream and wetland restoration projects, incorporation of numeric ecological metrics into mitigation monitoring and success criteria, and adaptation of stream mitigation designs to achieve greater success in the Piedmont.

Initial, successful implementation of sepsis guidelines in an emergency department.

PubMed

Plambech, Morten Z; Lurie, Andrew I; Ipsen, Helle L

2012-12-01

Early screening and treatment of sepsis can reduce mortality. Region Zealand established guidelines for the diagnosis and treatment of sepsis. We assess an interdisciplinary intervention for implementation of these guidelines at the Department of Emergency Medicine at Nykøbing Falster Hospital from July 2009 to August 2010. Structured training was imparted to personnel during the first 18 weeks. Electronically accessible guidelines, posters with diagnostic and treatment algorithms, pocket references and checklists were made available to encourage adherence to the guidelines. Key nurses and doctors encouraged compliance. Journal audits (at baseline, 18 weeks and one year) were undertaken to measure adherence to six elements of the sepsis guidelines: lactate measurement, oxygen and fluid treatment, timely antibiotic treatment, blood culture and planning of treatment monitoring. A total of 27 (baseline), 29 (18 weeks) and 48 (one year) patients were included for analysis. Adherence to 3-5 of the elements of the sepsis guidelines' six elements increased from 37% to 65% from baseline to the first follow-up at 18 weeks (p = 0.03). Adherence to 3-5 of the elements decreased from the first to the second follow-up at one year. Lactate measurement, blood culture and antibiotic administration increased from baseline to the one-year follow-up. The intervention had a positive effect on the implementation of guidelines. This effect was reduced one year after the baseline audit, possibly due to a decline in the focus on the intervention and/or personnel turnover in the department.

Slope Controls Grain Yield and Climatic Yield in Mountainous Yunnan province, China

NASA Astrophysics Data System (ADS)

Duan, X.; Rong, L.; Gu, Z.; Feng, D.

2017-12-01

Mountainous regions are increasingly vulnerable to food insecurity because of limited arable land, growing population pressure, and climate change. Development of sustainable mountain agriculture will require an increased understanding of the effects of environmental factors on grain and climatic yields. The objective of this study was to explore the relationships between actual grain yield, climatic yield, and environmental factors in a mountainous region in China. We collected data on the average grain yield per unit area in 119 counties in Yunnan province from 1985 to 2012, and chose 17 environmental factors for the same period. Our results showed that actual grain yield ranged from 1.43 to 6.92 t·ha-1, and the climatic yield ranged from -0.15 to -0.01 t·ha-1. Lower climatic yield but higher grain yield was generally found in central areas and at lower slopes and elevations in the western and southwestern counties of Yunnan province. Higher climatic yield but lower grain yield were found in northwestern parts of Yunnan province on steep slopes. Annual precipation and temperature had a weak influence on the climatic yield. Slope explained 44.62 and 26.29% of the variation in grain yield and climatic yield. The effects of topography on grain and climatic yields were greater than climatic factors. Slope was the most important environmental variable for the variability in climatic and grain yields in the mountainous Yunnan province due to the highly heterogeneous topographic conditions. Conversion of slopes to terraces in areas with higher climatic yields is an effective way to maintain grain production in response to climate variability. Additionally, soil amendments and soil and water conservation measures should be considered to maintain soil fertility and aid in sustainable development in central areas, and in counties at lower slopes and elevations in western and southwestern Yunnan province.

Towards local implementation of Dutch health policy guidelines: a concept-mapping approach.

PubMed

Kuunders, Theo J M; van Bon-Martens, Marja J H; van de Goor, Ien A M; Paulussen, Theo G W M; van Oers, Hans A M

2017-02-22

To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful implementation of the guideline were identified. Differences and similarities in perceptions of these characteristics between RHSs and developers were explored. Separate concept mapping procedures were executed in two RHSs, one with representatives from partner local health organizations and municipalities, the second with RHS members only. A third map was conducted with the developers of the guideline. All mapping procedures followed the same design of generating statements up to interpretation of results with participants. Concept mapping, as a practical implementation tool, will be discussed in the context of international research literature on guideline implementation in public health. Guideline developers consider implementation successful when substantive components (health issues) of the guidelines, content are visible in local policy practice. RHSs, local organizations and municipalities view the implementation process itself within and between organizations as more relevant, and state that usability of the guideline for municipal policy and commitment by officials and municipal managers are critical targets for successful implementation. Between the RHSs, differences in implementation targets were smaller than between RHSs and guideline developers. For successful implementation, RHSs tend to focus on process targets while developers focus more on the thematic contents of the guideline. Implications of these different orientations for implementation strategies are dealt with in the discussion. © The Author 2017. Published by Oxford University Press.

The influence of ideological entrepreneurship to social enterprise’s success

NASA Astrophysics Data System (ADS)

Permana, A.; Mursitama, T. N.

2018-03-01

Corporate Social Responsibility (CSR) activities are often a product of the tension between a company’s function as a profit-optimizing institution and its social obligations, which are grounded in particular locus of sociality, which bring about change in the local society. There is also a global push to consider environmental factors and the sustainable development. The successful implementation of CSR activities of PT. Riau Andalan Pulp and Paper (RAPP) in Riau, Indonesia, is an example of a program based on business and ethical values. This case produced successful models for the CSR-based social enterprise. The hypothesis here is that the success of a social enterprise is due in part to underlying moral philosophy, such as how ideological entrepreneurship is implemented based on ideological, personal and local values. Without neglecting the search for the essence of business operations, which give space for community development and empowerment, this research also proves the influence of ideological entrepreneurship on the success of a social enterprise.

From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control

PubMed Central

Gneiting, Uwe

2016-01-01

Global policy attention to tobacco control has increased significantly since the 1990s and culminated in the first international treaty negotiated under the auspices of the World Health Organization—the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC’s progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990s, in translating countries’ commitment to the FCTC into domestic policy change. By comparing the network’s influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network’s effectiveness around the FCTC’s implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network’s success than the evidence base for the effectiveness of tobacco control interventions. The network’s variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment. PMID:26253698

Yield Potential of Sugar Beet – Have We Hit the Ceiling?

PubMed Central

Hoffmann, Christa M.; Kenter, Christine

2018-01-01

The yield of sugar beet has continuously increased in the past decades. The question arises, whether this progress will continue in the future. A key factor for increasing yield potential of the crop is breeding progress. It was related to a shift in assimilate partitioning in the plant toward more storage carbohydrates (sucrose), whereas structural carbohydrates (leaves, cell wall compounds) unintendedly declined. The yield potential of sugar beet was estimated at 24 t sugar ha-1. For maximum yield, sufficient growth factors have to be available and the crop has to be able to fully utilize them. In sugar beet, limitations result from the lacking coincidence of maximum irradiation rates and full canopy cover, sink strength for carbon assimilation and high water demand, which cannot be met by rainfall alone. After harvest, sugar losses during storage occur. The paper discusses options for a further increase in yield potential, like autumn sowing of sugar beet, increasing sink strength and related constraints. It is prospected that yield increase by further widening the ratio of storage and structural carbohydrates will come to its natural limit as a certain cell wall stability is necessary. New challenges caused by climate change and by prolonged processing campaigns will occur. Thus breeding for improved pathogen resistance and storage properties will be even more important for successful sugar beet production than a further increase in yield potential itself. PMID:29599787

Successful demonstration of a comprehensive lithography defect monitoring strategy

NASA Astrophysics Data System (ADS)

Peterson, Ingrid B.; Breaux, Louis H.; Cross, Andrew; von den Hoff, Michael

2003-07-01

This paper describes the validation of the methodology, the model and the impact of an optimized Lithography Defect Monitoring Strategy at two different semiconductor manufacturing factories. The lithography defect inspection optimization was implemented for the Gate Module at both factories running 0.13-0.15μm technologies on 200mm wafers, one running microprocessor and the other memory devices. As minimum dimensions and process windows decrease in the lithography area, new technologies and technological advances with resists and resist systems are being implemented to meet the demands. Along with these new technological advances in the lithography area comes potentially unforeseen defect issues. The latest lithography processes involve new resists in extremely thin, uniform films, exposing the films under conditions of highly optimized focus and illumination, and finally removing the resist completely and cleanly. The lithography cell is defined as the cluster of process equipment that accomplishes the coating process (surface prep, resist spin, edge-bead removal and soft bake), the alignment and exposure, and the developing process (post-exposure bake, develop, rinse) of the resist. Often the resist spinning process involves multiple materials such as BARC (bottom ARC) and / or TARC (top ARC) materials in addition to the resist itself. The introduction of these new materials with the multiple materials interfaces and the tightness of the process windows leads to an increased variety of defect mechanisms in the lithography area. Defect management in the lithography area has become critical to successful product introduction and yield ramp. The semiconductor process itself contributes the largest number and variety of defects, and a significant portion of the total defects originate within the lithography cell. From a defect management perspective, the lithography cell has some unique characteristics. First, defects in the lithography process module have the

Implementation of proteomic biomarkers: making it work

PubMed Central

Mischak, Harald; Ioannidis, John PA; Argiles, Angel; Attwood, Teresa K; Bongcam-Rudloff, Erik; Broenstrup, Mark; Charonis, Aristidis; Chrousos, George P; Delles, Christian; Dominiczak, Anna; Dylag, Tomasz; Ehrich, Jochen; Egido, Jesus; Findeisen, Peter; Jankowski, Joachim; Johnson, Robert W; Julien, Bruce A; Lankisch, Tim; Leung, Hing Y; Maahs, David; Magni, Fulvio; Manns, Michael P; Manolis, Efthymios; Mayer, Gert; Navis, Gerjan; Novak, Jan; Ortiz, Alberto; Persson, Frederik; Peter, Karlheinz; Riese, Hans H; Rossing, Peter; Sattar, Naveed; Spasovski, Goce; Thongboonkerd, Visith; Vanholder, Raymond; Schanstra, Joost P; Vlahou, Antonia

2012-01-01

While large numbers of proteomic biomarkers have been described, they are generally not implemented in medical practice. We have investigated the reasons for this shortcoming, focusing on hurdles downstream of biomarker verification, and describe major obstacles and possible solutions to ease valid biomarker implementation. Some of the problems lie in suboptimal biomarker discovery and validation, especially lack of validated platforms with well-described performance characteristics to support biomarker qualification. These issues have been acknowledged and are being addressed, raising the hope that valid biomarkers may start accumulating in the foreseeable future. However, successful biomarker discovery and qualification alone does not suffice for successful implementation. Additional challenges include, among others, limited access to appropriate specimens and insufficient funding, the need to validate new biomarker utility in interventional trials, and large communication gaps between the parties involved in implementation. To address this problem, we propose an implementation roadmap. The implementation effort needs to involve a wide variety of stakeholders (clinicians, statisticians, health economists, and representatives of patient groups, health insurance, pharmaceutical companies, biobanks, and regulatory agencies). Knowledgeable panels with adequate representation of all these stakeholders may facilitate biomarker evaluation and guide implementation for the specific context of use. This approach may avoid unwarranted delays or failure to implement potentially useful biomarkers, and may expedite meaningful contributions of the biomarker community to healthcare. PMID:22519700

Implementing healthier foodservice guidelines in hospital and federal worksite cafeterias: barriers, facilitators and keys to success.

PubMed

Jilcott Pitts, S B; Graham, J; Mojica, A; Stewart, L; Walter, M; Schille, C; McGinty, J; Pearsall, M; Whitt, O; Mihas, P; Bradley, A; Simon, C

2016-12-01

Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings. © 2016 The British Dietetic Association Ltd.

Effective Implementation of Collaborative Care for Depression: What is Needed?

PubMed Central

Whitebird, Robin R.; Solberg, Leif I.; Jaeckels, Nancy A.; Pietruszewski, Pamela B.; Hadzic, Senka; Unützer, Jürgen; Ohnsorg, Kris A.; Rossom, Rebecca C.; Beck, Arne; Joslyn, Ken; Rubenstein, Lisa V.

2014-01-01

Objective To identify the care model factors that were key for successful implementation of collaborative depression care in a statewide Minnesota primary care initiative. Study Design We used a mixed-methods design incorporating both qualitative data from clinic site visits and quantitative measures of patient activation and 6-month remission rates. Methods Care model factors identified from the site visits were tested for association with rates of activation into the program and remission rates. Results Nine factors were identified as important for successful implementation of collaborative care by the consultants who had trained and interviewed participating clinic teams. Factors correlated with higher patient activation rates were: strong leadership support (0.63), well-defined and implemented care manager roles (0.62), a strong primary care physician champion (0.60), and an on-site and accessible care manager (0.59). However, remission rates at six months were correlated with: an engaged psychiatrist (0.62), not seeing operating costs as a barrier to participation (0.56), and face-to-face communication (warm handoffs) between the care-manager and primary care physician for new patients (0.54). Conclusions Care model factors most important for successful program implementation differ for patient activation into the program versus remission at six months. Knowing which implementation factors are most important for successful implementation will be useful for those interested in adopting this evidence-based approach to improve primary care for patients with depression. PMID:25365745

Understanding Policy Implementation: District-Level Leaders' Perceptions of Reading Policy Implementation Efforts

ERIC Educational Resources Information Center

Hall, Charles Dana

2013-01-01

Research investigating the complex, multi-directional relationships inherent to public education has become a focal point of reform research. This study investigated the perceptions held by district-level leaders regarding the Colorado Department of Education's efforts to facilitate the successful implementation of reading policy. In addition, it…

The Key Pieces of the Career Survival and Success Puzzle.

ERIC Educational Resources Information Center

Simonetti, Jack L.

1999-01-01

Analysis of career-success factors identified by 5,000 managers yielded 10 key pieces: excellent performance record, communication skills, interpersonal skills, personality, skill currency, significant work experiences, power, ability to withstand pressure, ability to make difficult decisions, and having a mentor. (SK)

A complex adaptive systems perspective of health information technology implementation.

PubMed

Keshavjee, Karim; Kuziemsky, Craig; Vassanji, Karim; Ghany, Ahmad

2013-01-01

Implementing health information technology (HIT) is a challenge because of the complexity and multiple interactions that define HIT implementation. Much of the research on HIT implementation is descriptive in nature and has focused on distinct processes such as order entry or decision support. These studies fail to take into account the underlying complexity of the processes, people and settings that are typical of HIT implementations. Complex adaptive systems (CAS) is a promising field that could elucidate the complexity and non-linear interacting issues that are typical in HIT implementation. Initially we sought new models that would enable us to better understand the complex nature of HIT implementation, to proactively identify problem issues that could be a precursor to unintended consequences and to develop new models and new approaches to successful HIT implementations. Our investigation demonstrates that CAS does not provide prediction, but forces us to rethink our HIT implementation paradigms and question what we think we know. CAS provides new ways to conceptualize HIT implementation and suggests new approaches to increasing HIT implementation successes.

Using the Consolidated Framework for Implementation Research to Identify Barriers and Facilitators for the Implementation of an Internet-Based Patient-Provider Communication Service in Five Settings: A Qualitative Study

PubMed Central

Varsi, Cecilie; Ekstedt, Mirjam; Gammon, Deede

2015-01-01

Background Although there is growing evidence of the positive effects of Internet-based patient-provider communication (IPPC) services for both patients and health care providers, their implementation into clinical practice continues to be a challenge. Objective The 3 aims of this study were to (1) identify and compare barriers and facilitators influencing the implementation of an IPPC service in 5 hospital units using the Consolidated Framework for Implementation Research (CFIR), (2) assess the ability of the different constructs of CFIR to distinguish between high and low implementation success, and (3) compare our findings with those from other studies that used the CFIR to discriminate between high and low implementation success. Methods This study was based on individual interviews with 10 nurses, 6 physicians, and 1 nutritionist who had used the IPPC to answer messages from patients. Results Of the 36 CFIR constructs, 28 were addressed in the interviews, of which 12 distinguished between high and low implementation units. Most of the distinguishing constructs were related to the inner setting domain of CFIR, indicating that institutional factors were particularly important for successful implementation. Health care providers’ beliefs in the intervention as useful for themselves and their patients as well as the implementation process itself were also important. A comparison of constructs across ours and 2 other studies that also used the CFIR to discriminate between high and low implementation success showed that 24 CFIR constructs distinguished between high and low implementation units in at least 1 study; 11 constructs distinguished in 2 studies. However, only 2 constructs (patient need and resources and available resources) distinguished consistently between high and low implementation units in all 3 studies. Conclusions The CFIR is a helpful framework for illuminating barriers and facilitators influencing IPPC implementation. However, CFIR’s strength

Competency champions in the clinical competency committee: a successful strategy to implement milestone evaluations and competency coaching.

PubMed

Ketteler, Erika R; Auyang, Edward D; Beard, Kathy E; McBride, Erica L; McKee, Rohini; Russell, John C; Szoka, Nova L; Nelson, M Timothy

2014-01-01

To create a clinical competency committee (CCC) that (1) centers on the competency-based milestones, (2) is simple to implement, (3) creates competency expertise, and (4) guides remediation and coaching of residents who are not progressing in milestone performance evaluations. We created a CCC that meets monthly and at each meeting reviews a resident class for milestone performance, a competency (by a faculty competency champion), a resident rotation service, and any other resident or issue of concern. University surgical residency program. The CCC members include the program director, associate program directors, director of surgical curriculum, competency champions, departmental chair, 2 at-large faculty members, and the administrative chief residents. Seven residents were placed on remediation (later renamed as coaching) during the academic year after falling behind on milestone progression in one or more competencies. An additional 4 residents voluntarily placed themselves on remediation for medical knowledge after receiving in-training examination scores that the residents (not the CCC membership) considered substandard. All but 2 of the remediated/coached residents successfully completed all area milestone performance but some chose to stay on the medical knowledge competency strategy. Monthly meetings of the CCC make milestone evaluation less burdensome. In addition, the expectations of the residents are clearer and more tangible. "Competency champions" who are familiar with the milestones allow effective coaching strategies and documentation of clear performance improvements in competencies for successful completion of residency training. Residents who do not reach appropriate milestone performance can then be placed in remediation for more formal performance evaluation. The function of our CCC has also allowed us opportunity to evaluate the required rotations to ensure that they offer experiences that help residents achieve competency performance necessary

Successes and Lessons Learned From Implementing Community Health Worker Programs in Community-Based and Clinical Settings: Insights From the Gulf Coast.

PubMed

Sherman, Mya; Covert, Hannah; Fox, Laila; Lichtveld, Maureen

Community health workers (CHWs) are an increasingly viable component of the American health system. While organizations may be interested in incorporating CHWs into the health care workforce, there are challenges to doing so. This study characterizes the successes and lessons learned from implementing new CHW programs in clinical and community-based settings in 4 US Gulf states. Semistructured interviews were conducted with CHWs and their supervisors. Interviews were conducted with participants in 16 community-based organizations and federally qualified health centers located in coastal counties and parishes of Louisiana, Florida, Alabama, and Mississippi. Study participants consisted of 22 CHWs and 17 CHW supervisors. Although most challenges and strategies were reported by participants working in both clinical and community-based settings, some were workplace-specific. Participants from predominantly clinical settings described the importance of strengthening organizational cohesion and coordination, whereas participants from community-based participants discussed the need for specialized training for CHWs. In both work environments, participants indicated that CHW functioning was constrained by limited organizational resources, difficulty accessing the client population, and limited knowledge regarding the CHW's scope of practice. Strategies to improve CHW functioning in both settings included investing in local partnerships, streamlining resources, prioritizing strong communication and outreach, and establishing explicit operating procedures. The majority of participants noted that challenges lessened over time. Evaluating successes and lessons learned in CHW work is critical to maximize CHWs' abilities to address clients' health needs and promote health in underserved communities. This study provides important insights into how to successfully integrate CHWs into the public health workforce.

Factors Supporting Implementation among CDSMP Organizations.

PubMed

Paone, Deborah

2014-01-01

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP - citing the alignment between the program and their organizations' mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption - particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program.

Factors Supporting Implementation among CDSMP Organizations

PubMed Central

Paone, Deborah

2015-01-01

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP – citing the alignment between the program and their organizations’ mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption – particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program. PMID:25964928

Achieving Solution Success: An Investigation of User Participation Approaches

ERIC Educational Resources Information Center

Mattia, Angela Marie

2009-01-01

User participation and its relationship to system success have been discussed in the information systems (IS) literature from many theoretical and practical perspectives. In reality, most of this discussion is grounded in empirical research that has yielded mixed results on the importance of user participation and its relationship to system…

Predictors of Reading and Math Academic Success in Pennsylvania Charter Schools

ERIC Educational Resources Information Center

Yetsko, April Christine

2010-01-01

The charter school movement, established to implement innovative educational methods that improve student outcomes (Nathan, 1996), necessitates further research on successful charter schools. Using a multivariate prediction design, this quantitative study sought to address the relationship between charter school success and demographic and…

Evaluating the implementation of a national disclosure policy for large-scale adverse events in an integrated health care system: identification of gaps and successes.

PubMed

Maguire, Elizabeth M; Bokhour, Barbara G; Wagner, Todd H; Asch, Steven M; Gifford, Allen L; Gallagher, Thomas H; Durfee, Janet M; Martinello, Richard A; Elwy, A Rani

2016-11-11

Many healthcare organizations have developed disclosure policies for large-scale adverse events, including the Veterans Health Administration (VA). This study evaluated VA's national large-scale disclosure policy and identifies gaps and successes in its implementation. Semi-structured qualitative interviews were conducted with leaders, hospital employees, and patients at nine sites to elicit their perceptions of recent large-scale adverse events notifications and the national disclosure policy. Data were coded using the constructs of the Consolidated Framework for Implementation Research (CFIR). We conducted 97 interviews. Insights included how to handle the communication of large-scale disclosures through multiple levels of a large healthcare organization and manage ongoing communications about the event with employees. Of the 5 CFIR constructs and 26 sub-constructs assessed, seven were prominent in interviews. Leaders and employees specifically mentioned key problem areas involving 1) networks and communications during disclosure, 2) organizational culture, 3) engagement of external change agents during disclosure, and 4) a need for reflecting on and evaluating the policy implementation and disclosure itself. Patients shared 5) preferences for personal outreach by phone in place of the current use of certified letters. All interviewees discussed 6) issues with execution and 7) costs of the disclosure. CFIR analysis reveals key problem areas that need to be addresses during disclosure, including: timely communication patterns throughout the organization, establishing a supportive culture prior to implementation, using patient-approved, effective communications strategies during disclosures; providing follow-up support for employees and patients, and sharing lessons learned.

Modelling Bambara Groundnut Yield in Southern Africa: Towards a Climate-Resilient Future

NASA Technical Reports Server (NTRS)

Karunaratne, A. S.; Walker, S.; Ruane, A. C.

2015-01-01

Current agriculture depends on a few major species grown as monocultures that are supported by global research underpinning current productivity. However, many hundreds of alternative crops have the potential to meet real world challenges by sustaining humanity, diversifying agricultural systems for food and nutritional security, and especially responding to climate change through their resilience to certain climate conditions. Bambara groundnut (Vigna subterranea (L.) Verdc.), an underutilised African legume, is an exemplar crop for climate resilience. Predicted yield performances of Bambara groundnut by AquaCrop (a crop-water productivity model) were evaluated for baseline (1980-2009) and mid-century climates (2040-2069) under 20 downscaled Global Climate Models (CMIP5-RCP8.5), as well as for climate sensitivities (AgMIPC3MP) across 3 locations in Southern Africa (Botswana, South Africa, Namibia). Different land - races of Bambara groundnut originating from various semi-arid African locations showed diverse yield performances with diverse sensitivities to climate. S19 originating from hot-dry conditions in Namibia has greater future yield potential compared to the Swaziland landrace Uniswa Red-UN across study sites. South Africa has the lowest yield under the current climate, indicating positive future yield trends. Namibia reported the highest baseline yield at optimum current temperatures, indicating less yield potential in future climates. Bambara groundnut shows positive yield potential at temperatures of up to 31degC, with further warming pushing yields down. Thus, many regions in Southern Africa can utilize Bambara groundnut successfully in the coming decades. This modelling exercise supports decisions on genotypic suitability for present and future climates at specific locations.

A recipe for success: ingredients for a successful family planning program.

PubMed

Merrill, J

1992-09-01

The basic elements of a successful family planning (FP) program are variable between countries. Providing better access to modern contraceptives, access to general and reproductive health care, and increasing economic and educational opportunities contribute to reducing fertility rates. Effective distribution is constrained by rural, isolated populations and cultural attitudes. Indonesia has used floating clinics located on boats to reach inaccessible areas; Norplant and hormonal injection availability also contribute to the 53% contraceptive prevalence rate. The Japanese Organization for International Cooperation in Family Planning has shipped bicycles to developing countries. The result has been improved status among peers and greater program success. Contraceptive social marketing programs (CSM) have been successful in some countries to distribute contraceptives through local channels such as shops and stalls; people seem willing to pay also. CSM has been successful in Egypt in increasing condom sales. IUD use increased from 11% to 42% between 1975-88 with CSM. Multimedia promotion that is carefully researched and targeted is another way to increase contraceptive prevalence (CP) rates. A Brazilian multimedia vasectomy campaign led to an 80% monthly increase in Pro-Pater male health clinics. 240,000 women in Turkey were encouraged through multimedia efforts to switch to modern methods. In Zimbabwe, men have been the target of efforts to educate them about the advantages of small families. Women are recruited to implement FP services in INdia and in poor neighborhoods; an increase from 12% to 61% was achieved. Highly motivated workers with a respect for the community's values is essential to any successful FP program as is government support. China's policy has drawn criticism; China has welcomed a UN program which provides financial motivation. Thailand has been successful due to the commitment between public and private sectors; in 17 years CP rose from 10% to

Reporting on the Strategies Needed to Implement Proven Interventions: An Example From a "Real-World" Cross-Setting Implementation Study.

PubMed

Gold, Rachel; Bunce, Arwen E; Cohen, Deborah J; Hollombe, Celine; Nelson, Christine A; Proctor, Enola K; Pope, Jill A; DeVoe, Jennifer E

2016-08-01

The objective of this study was to empirically demonstrate the use of a new framework for describing the strategies used to implement quality improvement interventions and provide an example that others may follow. Implementation strategies are the specific approaches, methods, structures, and resources used to introduce and encourage uptake of a given intervention's components. Such strategies have not been regularly reported in descriptions of interventions' effectiveness, or in assessments of how proven interventions are implemented in new settings. This lack of reporting may hinder efforts to successfully translate effective interventions into "real-world" practice. A recently published framework was designed to standardize reporting on implementation strategies in the implementation science literature. We applied this framework to describe the strategies used to implement a single intervention in its original commercial care setting, and when implemented in community health centers from September 2010 through May 2015. Per this framework, the target (clinic staff) and outcome (prescribing rates) remained the same across settings; the actor, action, temporality, and dose were adapted to fit local context. The framework proved helpful in articulating which of the implementation strategies were kept constant and which were tailored to fit diverse settings, and simplified our reporting of their effects. Researchers should consider consistently reporting this information, which could be crucial to the success or failure of implementing proven interventions effectively across diverse care settings. clinicaltrials.gov Identifier: NCT02299791. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Training employees as a management attribute of successful companies.

PubMed

Khumalo, R

2001-12-01

This paper discusses training as an important attribute of successful companies and identified as characteristic of excellent Zimbabwean companies. Although confident this attribute contributes to successful performance by companies in which it is applied, it is possible that contributions could be more effective were all characteristics implemented collectively. However, the research suggests that training alone can offer significant improvement in employees' performance.

Model Identification and FE Simulations: Effect of Different Yield Loci and Hardening Laws in Sheet Forming

NASA Astrophysics Data System (ADS)

Flores, P.; Duchêne, L.; Lelotte, T.; Bouffioux, C.; El Houdaigui, F.; Van Bael, A.; He, S.; Duflou, J.; Habraken, A. M.

2005-08-01

The bi-axial experimental equipment developed by Flores enables to perform Baushinger shear tests and successive or simultaneous simple shear tests and plane-strain tests. Such experiments and classical tensile tests investigate the material behavior in order to identify the yield locus and the hardening models. With tests performed on two steel grades, the methods applied to identify classical yield surfaces such as Hill or Hosford ones as well as isotropic Swift type hardening or kinematic Armstrong-Frederick hardening models are explained. Comparison with the Taylor-Bishop-Hill yield locus is also provided. The effect of both yield locus and hardening model choice will be presented for two applications: Single Point Incremental Forming (SPIF) and a cup deep drawing.

[Guideline implementation study on asthma: Results of a pragmatic implementation approach].

PubMed

Redaèlli, Marcus; Vollmar, Horst Christian; Simic, Dusan; Maly-Schürer, Cornelia; Löscher, Susanne; Koneczny, Nikolaus

2015-01-01

Knowledge transfer from theory to practice in healthcare systems poses a challenge worldwide. Typical examples include national disease management guidelines. The present study contributes towards improving implementation strategies for an asthma guideline. A guideline implementation strategy was examined in a four-armed, non-randomised, controlled intervention study with an additional control group. The study participants were general practitioners and paediatricians recruited from primary care quality circles. All study participants attended an interactive seminar on the evidence-based recommendations for patients with asthma. In addition, the participants were asked to choose among the following options: no further intervention, additional e-learning, training of their practice nurses, or e-learning and training of their practice nurses. The success of the intervention was measured by questionnaire (and the success rate expressed as a percentage). About one third of all participants (n=313) opted for the combination of an interactive seminar and a training of practice nurses; two third preferred the classic way of continuing medical education with an interactive seminar without a further intervention. Just 10 % of the physicians participated in e-learning. Independently of their choice for continuing medical education, all participants demonstrated an increase in knowledge about asthma and an improvement in the management of asthma. The physicians exhibited an average increase in both categories of about 10 % of the percentage values, compared to an increase of about 28 % among the practice nurses without continuing medical education. The physicians' free choice of the educative modules might be an integral part of successful implementation strategies. However, this will require a change of focus from general continuing medical education packages to a more individualised culture of continuing professional development in Germany. Copyright © 2015. Published by

Thermic conversion of benzene into 6-phenylfulvene with high yield mediated by GaP nanocrystals.

PubMed

Gao, Shanmin; Lu, Jun; Zhao, Yan; Chen, Nan; Xie, Yi

2002-12-07

With GaP nanocrystals being used in a close reaction system, 6-phenylfulvene is successfully obtained via a high yield thermic conversion from benzene, which provides the possibility of applying nanocrystals to mediate organic reactions.

Enterprise Implementation of Digital Pathology: Feasibility, Challenges, and Opportunities.

PubMed

Hartman, D J; Pantanowitz, L; McHugh, J S; Piccoli, A L; OLeary, M J; Lauro, G R

2017-10-01

Digital pathology is becoming technically possible to implement for routine pathology work. At our institution, we have been using digital pathology for second opinion intraoperative consultations for over 10 years. Herein, we describe our experience in converting to a digital pathology platform for primary pathology diagnosis. We implemented an incremental rollout for digital pathology on subspecialty benches, beginning with cases that contained small amounts of tissue (biopsy specimens). We successfully scanned over 40,000 slides through our digital pathology system. Several lessons (both challenges and opportunities) were learned through this implementation. A successful conversion to digital pathology requires pre-imaging adjustments, integrated software and post-imaging evaluations.

Groundwater subsidies and penalties to corn yield

NASA Astrophysics Data System (ADS)

Zipper, S. C.; Booth, E.; Loheide, S. P.

2013-12-01

Proper water management is critical to closing yield gaps (observed yield below potential yield) as global populations continue to expand. However, the impacts of shallow groundwater on crop production and surface processes are poorly understood. The presence of groundwater within or just below the root zone has the potential to cause (via oxygen stress in poorly drained soils) or eliminate (via water supply in dry regions) yield gaps. The additional water use by a plant in the presence of shallow groundwater, compared to free drainage conditions, is called the groundwater subsidy; the depth at which the groundwater subsidy is greatest is the optimal depth to groundwater (DTGW). In wet years or under very shallow water table conditions, the groundwater subsidy is likely to be negative due to increased oxygen stress, and can be thought of as a groundwater penalty. Understanding the spatial dynamics of groundwater subsidies/penalties and how they interact with weather is critical to making sustainable agricultural and land-use decisions under a range of potential climates. Here, we examine patterns of groundwater subsidies and penalties in two commercial cornfields in the Yahara River Watershed, an urbanizing agricultural watershed in south-central Wisconsin. Water table levels are generally rising in the region due to a long-term trend of increasing precipitation over the last several decades. Biophysical indicators tracked throughout both the 2012 and 2013 growing seasons show a strong response to variable groundwater levels on a field scale. Sections of the field with optimal DTGW exhibit consistently higher stomatal conductance rates, taller canopies and higher leaf area index, higher ET rates, and higher pollination success rates. Patterns in these biophysical lines of evidence allow us to pinpoint specific periods within the growing season that plants were experiencing either oxygen or water stress. Most importantly, groundwater subsidies and penalties are

A Continuous Quality Improvement Airway Program Results in Sustained Increases in Intubation Success.

PubMed

Olvera, David J; Stuhlmiller, David F E; Wolfe, Allen; Swearingen, Charles F; Pennington, Troy; Davis, Daniel P

2018-02-21

Airway management is a critical skill for air medical providers, including the use of rapid sequence intubation (RSI) medications. Mediocre success rates and a high incidence of complications has challenged air medical providers to improve training and performance improvement efforts to improve clinical performance. The aim of this research was to describe the experience with a novel, integrated advanced airway management program across a large air medical company and explore the impact of the program on improvement in RSI success. The Helicopter Advanced Resuscitation Training (HeART) program was implemented across 160 bases in 2015. The HeART program includes a novel conceptual framework based on thorough understanding of physiology, critical thinking using a novel algorithm, difficult airway predictive tools, training in the optimal use of specific airway techniques and devices, and integrated performance improvement efforts to address opportunities for improvement. The C-MAC video/direct laryngoscope and high-fidelity human patient simulation laboratories were implemented during the study period. Chi-square test for trend was used to evaluate for improvements in airway management and RSI success (overall intubation success, first-attempt success, first-attempt success without desaturation) over the 25-month study period following HeART implementation. A total of 5,132 patients underwent RSI during the study period. Improvements in first-attempt intubation success (85% to 95%, p < 0.01) and first-attempt success without desaturation (84% to 94%, p < 0.01) were observed. Overall intubation success increased from 95% to 99% over the study period, but the trend was not statistically significant (p = 0.311). An integrated advanced airway management program was successful in improving RSI intubation performance in a large air medical company.

Adapting the Consolidated Framework for Implementation Research to Create Organizational Readiness and Implementation Tools for Project ECHO.

PubMed

Serhal, Eva; Arena, Amanda; Sockalingam, Sanjeev; Mohri, Linda; Crawford, Allison

2018-03-01

The Project Extension for Community Healthcare Outcomes (ECHO) model expands primary care provider (PCP) capacity to manage complex diseases by sharing knowledge, disseminating best practices, and building a community of practice. The model has expanded rapidly, with over 140 ECHO projects currently established globally. We have used validated implementation frameworks, such as Damschroder's (2009) Consolidated Framework for Implementation Research (CFIR) and Proctor's (2011) taxonomy of implementation outcomes, combined with implementation experience to (1) create a set of questions to assess organizational readiness and suitability of the ECHO model and (2) provide those who have determined ECHO is the correct model with a checklist to support successful implementation. A set of considerations was created, which adapted and consolidated CFIR constructs to create ECHO-specific organizational readiness questions, as well as a process guide for implementation. Each consideration was mapped onto Proctor's (2011) implementation outcomes, and questions relating to the constructs were developed and reviewed for clarity. The Preimplementation list included 20 questions; most questions fall within Proctor's (2001) implementation outcome domains of "Appropriateness" and "Acceptability." The Process Checklist is a 26-item checklist to help launch an ECHO project; items map onto the constructs of Planning, Engaging, Executing, Reflecting, and Evaluating. Given that fidelity to the ECHO model is associated with robust outcomes, effective implementation is critical. These tools will enable programs to work through key considerations to implement a successful Project ECHO. Next steps will include validation with a diverse sample of ECHO projects.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited

Biosphere reserves: Attributes for success.

PubMed

Van Cuong, Chu; Dart, Peter; Hockings, Marc

2017-03-01

Biosphere reserves established under the UNESCO Man and the Biosphere Program aim to harmonise biodiversity conservation and sustainable development. Concerns over the extent to which the reserve network was living up to this ideal led to the development of a new strategy in 1995 (the Seville Strategy) to enhance the operation of the network of reserves. An evaluation of effectiveness of management of the biosphere reserve network was called for as part of this strategy. Expert opinion was assembled through a Delphi Process to identify successful and less successful reserves and investigate common factors influencing success or failure. Ninety biosphere reserves including sixty successful and thirty less successful reserves in 42 countries across all five Man and the Biosphere Program regions were identified. Most successful sites are the post-Seville generation while the majority of unsuccessful sites are pre-Seville that are managed as national parks and have not been amended to conform to the characteristics that are meant to define a biosphere reserve. Stakeholder participation and collaboration, governance, finance and resources, management, and awareness and communication are the most influential factors in the success or failure of the biosphere reserves. For success, the biosphere reserve concept needs to be clearly understood and applied through landscape zoning. Designated reserves then need a management system with inclusive good governance, strong participation and collaboration, adequate finance and human resource allocation and stable and responsible management and implementation. All rather obvious but it is difficult to achieve without commitment to the biosphere reserve concept by the governance authorities. Copyright © 2016 Elsevier Ltd. All rights reserved.

The UIS Model for Online Success

ERIC Educational Resources Information Center

Bloemer, Bill

2009-01-01

This case study describes the philosophy underlying the delivery of online programs and courses at the University of Illinois-Springfield. The strategies used to implement the UIS model and the measures used to validate its success are outlined. These factors are reviewed in the context of the Sloan-C Five Pillars for quality learning environments.

Food security: increasing yield and improving resource use efficiency.

PubMed

Parry, Martin A J; Hawkesford, Malcolm J

2010-11-01

Food production and security will be a major issue for supplying an increasing world population. The problem will almost certainly be exacerbated by climate change. There is a projected need to double food production by 2050. In recent times, the trend has been for incremental modest yield increases for most crops. There is an urgent need to develop integrated and sustainable approaches that will significantly increase both production per unit land area and the resource use efficiency of crops. This review considers some key processes involved in plant growth and development with some examples of ways in which molecular technology, plant breeding and genetics may increase the yield and resource use efficiency of wheat. The successful application of biotechnology to breeding is essential to provide the major increases in production required. However, each crop and each specific agricultural situation presents specific requirements and targets for optimisation. Some increases in production will come about as new varieties are developed which are able to produce satisfactory crops on marginal land presently not considered appropriate for arable crops. Other new varieties will be developed to increase both yield and resource use efficiency on the best land.

A New Age of Implementation: Guiding Principles for Implementing Performance Assessment Systems

ERIC Educational Resources Information Center

Chapin, Gary; Gagnon, Laurie; Hammonds, Virgel

2017-01-01

In an examination of the conditions required for the successful implementation of performance assessment, the authors draw on a range of personal experience and other insights to guide practitioners and policymakers. Building on the authentic assessment work of the Boston Pilot Schools (CCE 2004), in 2008 the Center for Collaborative Education…

From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control.

PubMed

Gneiting, Uwe

2016-04-01

Global policy attention to tobacco control has increased significantly since the 1990 s and culminated in the first international treaty negotiated under the auspices of the World Health Organization--the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC's progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990 s, in translating countries' commitment to the FCTC into domestic policy change. By comparing the network's influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network's effectiveness around the FCTC's implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network's success than the evidence base for the effectiveness of tobacco control interventions. The network's variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Chronicling a successful secondary implementation of Studio Physics

NASA Astrophysics Data System (ADS)

Kohl, Patrick B.; Vincent Kuo, H.

2012-09-01

The Colorado School of Mines (CSM) has taught its first-semester calculus-based introductory physics course (Physics I) using a hybrid lecture/Studio Physics format since the spring of 1997. Starting in the fall of 2007, we have been converting the second semester of our calculus-based introductory physics course (Physics II) to a hybrid lecture/Studio Physics format, beginning from a traditional lecture/lab/recitation course. In this paper, we document the stages of this transformation, highlighting what has worked and what has not, and the challenges and benefits associated with the switch to Studio Physics. A major goal in this study is to develop a method for secondary implementations of Studio physics that keeps the time and resource investments manageable. We describe the history of Studio at CSM and characterize our progress via several metrics, including pre/post Conceptual Survey of Electricity and Magnetism (CSEM) scores, Colorado Learning About Science Survey scores (CLASS), exam scores, failure rates, and a variety of qualitative observations. Results suggest that Studio has increased student performance and satisfaction despite an aggressive expansion of class sizes in the past few years. Gains have been concentrated mostly in problem-solving skills and exam performance (as opposed to conceptual survey gains), in contrast to what has sometimes been seen in other studies.

Yield enhancement with DFM

NASA Astrophysics Data System (ADS)

Paek, Seung Weon; Kang, Jae Hyun; Ha, Naya; Kim, Byung-Moo; Jang, Dae-Hyun; Jeon, Junsu; Kim, DaeWook; Chung, Kun Young; Yu, Sung-eun; Park, Joo Hyun; Bae, SangMin; Song, DongSup; Noh, WooYoung; Kim, YoungDuck; Song, HyunSeok; Choi, HungBok; Kim, Kee Sup; Choi, Kyu-Myung; Choi, Woonhyuk; Jeon, JoongWon; Lee, JinWoo; Kim, Ki-Su; Park, SeongHo; Chung, No-Young; Lee, KangDuck; Hong, YoungKi; Kim, BongSeok

2012-03-01

A set of design for manufacturing (DFM) techniques have been developed and applied to 45nm, 32nm and 28nm logic process technologies. A noble technology combined a number of potential confliction of DFM techniques into a comprehensive solution. These techniques work in three phases for design optimization and one phase for silicon diagnostics. In the DFM prevention phase, foundation IP such as standard cells, IO, and memory and P&R tech file are optimized. In the DFM solution phase, which happens during ECO step, auto fixing of process weak patterns and advanced RC extraction are performed. In the DFM polishing phase, post-layout tuning is done to improve manufacturability. DFM analysis enables prioritization of random and systematic failures. The DFM technique presented in this paper has been silicon-proven with three successful tape-outs in Samsung 32nm processes; about 5% improvement in yield was achieved without any notable side effects. Visual inspection of silicon also confirmed the positive effect of the DFM techniques.

Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. IERC 2015-3

ERIC Educational Resources Information Center

Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

2015-01-01

The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

The implementation research institute: training mental health implementation researchers in the United States

PubMed Central

2013-01-01

Background The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trainings at Washington University in St. Louis. Training is provided through a rigorous curriculum, local and national mentoring, a ‘learning site visit’ to a federally funded implementation research project, pilot research, and grant writing. Methods This paper describes the rationale, components, outcomes to date, and participant experiences with IRI. Results IRI outcomes include 31 newly trained implementation researchers, their new grant proposals, contributions to other national dissemination and implementation research training, and publications in implementation science authored by the Core Faculty and fellows. Former fellows have obtained independent research funding in implementation science and are beginning to serve as mentors for more junior investigators. Conclusions Based on the number of implementation research grant proposals and papers produced by fellows to date, the IRI is proving successful in preparing new researchers who can inform the process of making evidence-based mental healthcare more available through real-world settings of care and who are advancing the field of implementation science. PMID:24007290

Implementing team huddles in small rural hospitals: How does the Kotter model of change apply?

PubMed

Baloh, Jure; Zhu, Xi; Ward, Marcia M

2017-12-17

To examine how the process of change prescribed in Kotter's change model applies in implementing team huddles, and to assess the impact of the execution of early change phases on change success in later phases. Kotter's model can help to guide hospital leaders to implement change and potentially to improve success rates. However, the model is under studied, particularly in health care. We followed eight hospitals implementing team huddles for 2 years, interviewing the change teams quarterly to inquire about implementation progress. We assessed how the hospitals performed in the three overarching phases of the Kotter model, and examined whether performance in the initial phase influenced subsequent performance. In half of the hospitals, change processes were congruent with Kotter's model, where performance in the initial phase influenced their success in subsequent phases. In other hospitals, change processes were incongruent with the model, and their success depended on implementation scope and the strategies employed. We found mixed support for the Kotter model. It better fits implementation that aims to spread to multiple hospital units. When the scope is limited, changes can be successful even when steps are skipped. Kotter's model can be a useful guide for nurse managers implementing changes. © 2017 John Wiley & Sons Ltd.

Diagnostic Yield of Chromosomal Microarray Analysis in an Autism Primary Care Practice: Which Guidelines to Implement?

ERIC Educational Resources Information Center

McGrew, Susan G.; Peters, Brittany R.; Crittendon, Julie A.; Veenstra-VanderWeele, Jeremy

2012-01-01

Genetic testing is recommended for patients with ASD; however specific recommendations vary by specialty. American Academy of Pediatrics and American Academy of Neurology guidelines recommend G-banded karyotype and Fragile X DNA. The American College of Medical Genetics recommends Chromosomal Microarray Analysis (CMA). We determined the yield of…

Understanding effective care management implementation in primary care: a macrocognition perspective analysis.

PubMed

Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

2015-08-21

Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care routines. It involves changes to who is working with patients, and consequently such things as who is making decisions, who is sharing patient information, and how. Studying the range of such changes in "knowledge work" during implementation requires a perspective and tools designed to do so. We used the macrocognition perspective, which is designed to understand how individuals think in dynamic, messy real-world environments such as care management implementation. To do so, we used cognitive task analysis to understand implementation in terms of such thinking as decision making, knowledge, and communication. Data collection involved semi-structured interviews and observations at baseline and at approximately 9 months into implementation at five practices in one physician-owned administratively connected group of practices in the state of Michigan, USA. Practices were intervention participants in a larger trial of chronic care model implementation. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with macrocognition as a guiding framework. Seventy-four interviews and five observations were completed. There were differences in implementation success across the practices, and these differences in implementation success were well explained by macrocognition. Practices that used more macrocognition functions and used them more often were also more successful in care management implementation. Although care management can introduce many new changes into the delivery of primary care clinical practice, implementing it successfully as a new complex intervention is possible. Macrocognition is a

The Implementer Disposition of Teacher Certification Policy in Indonesia

ERIC Educational Resources Information Center

Malkab, Marnih; Nawawi, Juanda; Mahmud, Alimuddin; Sujiono, Eko Hadi

2015-01-01

This research aims to examine and analyze the implementers disposition in the implementation of teacher certification policy in Makassar City and to know how is the disposition affects in successful implementation policy. This research is descriptive by using a qualitative approach. Sources of data in this study are primary data from the…

Contractor Incentives for Success in Implementing Performance-Based Logistics: A Progress Report

DTIC Science & Technology

2010-04-30

amount of risk; this, however, gives the contractor more latitude in determining and applying its methods ( KMC /OPI, 2010). The general consensus...Klevan, P. (2008, October 27). Navy success with PBL. Presentation at the DoD Maintenance Symposium. KMC /OPI. (2010, January 19). Acquisition

Foreskin-isolated keratinocytes provide successful extemporaneous autologous paediatric skin grafts.

PubMed

Mcheik, Jiad N; Barrault, Christine; Pedretti, Nathalie; Garnier, Julien; Juchaux, Franck; Levard, Guillaume; Morel, Franck; Lecron, Jean-Claude; Bernard, François-Xavier

2016-03-01

Severe burns in children are conventionally treated with split-thickness skin autografts or epidermal sheets. However, neither early complete healing nor quality of epithelialization is satisfactory. An alternative approach is to graft isolated keratinocytes. We evaluated paediatric foreskin and auricular skin as donor sources, autologous keratinocyte transplantation, and compared the graft efficiency to the in vitro capacities of isolated keratinocytes to divide and reconstitute epidermal tissue. Keratinocytes were isolated from surgical samples by enzymatic digestion. Living cell recovery, in vitro proliferation and epidermal reconstruction capacities were evaluated. Differentiation status was analysed, using qRT-PCR and immunolabelling. Eleven children were grafted with foreskin-derived (boys) or auricular (girls) keratinocyte suspensions dripped onto deep severe burns. The aesthetic and functional quality of epithelialization was monitored in a standardized way. Foreskin keratinocyte graft in male children provides for the re-epithelialization of partial deep severe burns and accelerates wound healing, thus allowing successful wound closure, and improves the quality of scars. In accordance, in vitro studies have revealed a high yield of living keratinocyte recovery from foreskin and their potential in terms of regeneration and differentiation. We report a successful method for grafting paediatric males presenting large severe burns through direct spreading of autologous foreskin keratinocytes. This alternative method is easy to implement, improves the quality of skin and minimizes associated donor site morbidity. In vitro studies have highlighted the potential of foreskin tissue for graft applications and could help in tissue selection with the prospect of grafting burns for girls. Copyright © 2013 John Wiley & Sons, Ltd.

Successful implementation of biochar carbon sequestration in European soils requires additional benefits and close collaboration with the bioenergy sector

NASA Astrophysics Data System (ADS)

Hauggaard-Nielsen, Henrik; Müller-Stöver, Dorette; Bruun, Esben W.; Petersen, Carsten T.

2014-05-01

Biochar soil application has been proposed as a measure to mitigate climate change and on the same time improve soil fertility by increased soil carbon sequestration. However, while on tropical soils the beneficial effects of biochar application on crop growth often become immediately apparent, it has been shown to be more difficult to demonstrate these effects on the more fertile soils in temperate regions. Therefore and because of the lack of carbon credits for farmers, it is necessary to link biochar application to additional benefits, both related to agricultural as well as to bioenergy production. Thermal gasification of biomass is an efficient (95% energy efficiency) and flexible way (able to cope with many different and otherwise difficult-to-handle biomass fuels) to generate bioenergy, while producing a valuable by-product - gasification biochar, containing recalcitrant carbon and essential crop nutrients. The use of the residual char product in agricultural soils will add value to the technology as well as result in additional soil benefits such as providing plant nutrients and improving soil water-holding capacity while reducing leaching risks. From a soil column (30 x 130 cm) experiment with gasification straw biochar amendment to coarse sandy subsoil increased root density of barley at critical depths in the soil profile reducing the mechanical resistance was shown, increasing yields, and the soil's capacity to store plant available water. Incorporation of residuals from a bioenergy technology like gasification show great potentials to reduce subsoil constraints increasing yield potentials on poor soils. Another advantage currently not appropriately utilized is recovery of phosphorus (P). In a recent pot experiments char products originating from low-temperature gasification of various biofuels were evaluated for their suitability as P fertilizers. Wheat straw gasification biochar generally had a low P content but a high P plant availability. To improve

Yield-stress fluids foams: flow patterns and controlled production in T-junction and flow-focusing devices.

PubMed

Laborie, Benoit; Rouyer, Florence; Angelescu, Dan E; Lorenceau, Elise

2016-11-23

We study the formation of yield-stress fluid foams in millifluidic flow-focusing and T-junction devices. First, we provide a phase diagram for the unsteady operating regimes of bubble production when the gas pressure and the yield-stress fluid flow rate are imposed. Three regimes are identified: a co-flow of gas and yield-stress fluid, a transient production of bubble and a flow of yield-stress fluid only. Taking wall slip into account, we provide a model for the pressure at the onset of bubble formation. Then, we detail and compare two simple methods to ensure steady bubble production: regulation of the gas pressure or flow-rate. These techniques, which are easy to implement, thus open pathways for controlled production of dry yield-stress fluid foams as shown at the end of this article.

Kinetically accessible yield (KAY) for redirection of metabolism to produce exo-metabolites

DOE PAGES

Lafontaine Rivera, Jimmy G.; Theisen, Matthew K.; Chen, Po-Wei; ...

2017-04-05

The product formation yield (product formed per unit substrate consumed) is often the most important performance indicator in metabolic engineering. Until now, the actual yield cannot be predicted, but it can be bounded by its maximum theoretical value. The maximum theoretical yield is calculated by considering the stoichiometry of the pathways and cofactor regeneration involved. Here in this paper we found that in many cases, dynamic stability becomes an issue when excessive pathway flux is drawn to a product. This constraint reduces the yield and renders the maximal theoretical yield too loose to be predictive. We propose a more realisticmore » quantity, defined as the kinetically accessible yield (KAY) to predict the maximum accessible yield for a given flux alteration. KAY is either determined by the point of instability, beyond which steady states become unstable and disappear, or a local maximum before becoming unstable. Thus, KAY is the maximum flux that can be redirected for a given metabolic engineering strategy without losing stability. Strictly speaking, calculation of KAY requires complete kinetic information. With limited or no kinetic information, an Ensemble Modeling strategy can be used to determine a range of likely values for KAY, including an average prediction. We first apply the KAY concept with a toy model to demonstrate the principle of kinetic limitations on yield. We then used a full-scale E. coli model (193 reactions, 153 metabolites) and this approach was successful in E. coli for predicting production of isobutanol: the calculated KAY values are consistent with experimental data for three genotypes previously published.« less

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

Implementation of emergency department transfer communication measures in Minnesota critical access hospitals.

PubMed

Klingner, Jill; Moscovice, Ira; Casey, Michelle; McEllistrem Evenson, Alex

2015-01-01

Previously published findings based on field tests indicated that emergency department patient transfer communication measures are feasible and worthwhile to implement in rural hospitals. This study aims to expand those findings by focusing on the wide-scale implementation of these measures in the 79 Critical Access Hospitals (CAHs) in Minnesota from 2011 to 2013. Information was obtained from interviews with key informants involved in implementing the emergency department patient transfer communication measures in Minnesota as part of required statewide quality reporting. The first set of interviews targeted state-level organizations regarding their experiences working with providers. A second set of interviews targeted quality and administrative staff from CAHs regarding their experiences implementing measures. Implementing the measures in Minnesota CAHs proved to be successful in a number of respects, but informants also faced new challenges. Our recommendations, addressed to those seeking to successfully implement these measures in other states, take these challenges into account. Field-testing new quality measure implementations with volunteers may not be indicative of a full-scale implementation that requires facilities to participate. The implementation team's composition, communication efforts, prior relationships with facilities and providers, and experience with data collection and abstraction tools are critical factors in successfully implementing required reporting of quality measures on a wide scale. © 2014 National Rural Health Association.

The yield and post-yield behavior of high-density polyethylene

NASA Technical Reports Server (NTRS)

Semeliss, M. A.; Wong, R.; Tuttle, M. E.

1990-01-01

An experimental and analytical evaluation was made of the yield and post-yield behavior of high-density polyethylene, a semi-crystalline thermoplastic. Polyethylene was selected for study because it is very inexpensive and readily available in the form of thin-walled tubes. Thin-walled tubular specimens were subjected to axial loads and internal pressures, such that the specimens were subjected to a known biaxial loading. A constant octahederal shear stress rate was imposed during all tests. The measured yield and post-yield behavior was compared with predictions based on both isotropic and anisotropic models. Of particular interest was whether inelastic behavior was sensitive to the hydrostatic stress level. The major achievements and conclusions reached are discussed.

Spectral reflectance indices as a selection criterion for yield improvement in wheat

NASA Astrophysics Data System (ADS)

Babar, Md. Ali

2005-11-01

Scope and methods of study. Yield in wheat ( Triticum aestivum L.) is a complex trait and influenced by many environmental factors, and yield improvement is a daunting task for wheat breeders. Spectral reflectance indices (SRIs) have been used to study different physiological traits in wheat. SRIs have the potential to differentiate genotypes for grain yield. SRIs strongly associated with grain yield can be used to achieve effective genetic gain in wheat under different environments. Three experiments (15 adapted genotypes, 25 and 36 random sister lines derived from two different crosses) under irrigated conditions, and three experiments (each with 30 advanced genotypes) under water-limited conditions were conducted in three successive years in Northwest Mexico at the CIMMYT (International Maize and wheat Improvement Center) experimental station. SRIs and different agronomic data were collected for three years, and biomass was harvested for two years. Phenotypic and genetic correlations between SRIs and grain yield, between SRIs and biomass, realized and broad sense heritability, direct and correlated selection responses for grain yield, and SRIs were calculated. Findings and conclusion. Seven SRIs were calculated, and three near infrared based indices (WI, NWI-1 and NWI-2) showed higher level of genetic and phenotypic correlations with grain yield, yield components and biomass than other SRIs (PRI, RNDVI, GNDVI, and SR) under both irrigated and water limiting environments. Moderate to high realized and broad sense heritability, and selection response were demonstrated by the three NIR based indices. High efficiency of correlated response for yield estimation was demonstrated by the three NIR based indices. The ratio between the correlated response to grain yield based on the three NIR based indices and direct selection response for grain yield was very close to one. The NIR based indices showed very high accuracy in selecting superior genotypes for grain yield

Nitrogen rate strategies for reducing yield-scaled nitrous oxide emissions in maize

NASA Astrophysics Data System (ADS)

Zhao, Xu; Nafziger, Emerson D.; Pittelkow, Cameron M.

2017-12-01

Mitigating nitrogen (N) losses from agriculture without negatively impacting crop productivity is a pressing environmental and economic challenge. Reductions in N fertilizer rate are often highlighted as a solution, yet the degree to which crop yields and economic returns may be impacted at the field-level remains unclear, in part due to limited data availability. Farmers are risk averse and potential yield losses may limit the success of voluntary N loss mitigation protocols, thus understanding field-level yield tradeoffs is critical to inform policy development. Using a case study of soil N2O mitigation in the US Midwest, we conducted an ex-post assessment of two economic and two environmental N rate reduction strategies to identify promising practices for maintaining maize yields and economic returns while reducing N2O emissions per unit yield (i.e. yield-scaled emissions) compared to an assumed baseline N input level. Maize yield response data from 201 on-farm N rate experiments were combined with an empirical equation predicting N2O emissions as a function of N rate. Results indicate that the economic strategy aimed at maximizing returns to N (MRTN) led to moderate but consistent reductions in yield-scaled N2O emissions with small negative impacts on yield and slight increases in median returns. The economic optimum N rate strategy reduced yield-scaled N2O emissions in 75% of cases but increased them otherwise, challenging the assumption that this strategy will automatically reduce environmental impacts per unit production. Both environmental strategies, one designed to increase N recovery efficiency and one to balance N inputs with grain N removal, further reduced yield-scaled N2O emissions but were also associated with negative yield penalties and decreased returns. These results highlight the inherent tension between achieving agronomic and economic goals while reducing environmental impacts which is often overlooked in policy discussions. To enable the

Effects of diurnal temperature range and drought on wheat yield in Spain

NASA Astrophysics Data System (ADS)

Hernandez-Barrera, S.; Rodriguez-Puebla, C.; Challinor, A. J.

2017-07-01

This study aims to provide new insight on the wheat yield historical response to climate processes throughout Spain by using statistical methods. Our data includes observed wheat yield, pseudo-observations E-OBS for the period 1979 to 2014, and outputs of general circulation models in phase 5 of the Coupled Models Inter-comparison Project (CMIP5) for the period 1901 to 2099. In investigating the relationship between climate and wheat variability, we have applied the approach known as the partial least-square regression, which captures the relevant climate drivers accounting for variations in wheat yield. We found that drought occurring in autumn and spring and the diurnal range of temperature experienced during the winter are major processes to characterize the wheat yield variability in Spain. These observable climate processes are used for an empirical model that is utilized in assessing the wheat yield trends in Spain under different climate conditions. To isolate the trend within the wheat time series, we implemented the adaptive approach known as Ensemble Empirical Mode Decomposition. Wheat yields in the twenty-first century are experiencing a downward trend that we claim is a consequence of widespread drought over the Iberian Peninsula and an increase in the diurnal range of temperature. These results are important to inform about the wheat vulnerability in this region to coming changes and to develop adaptation strategies.

Organic Farming Improves Pollination Success in Strawberries

PubMed Central

Andersson, Georg K. S.; Rundlöf, Maj; Smith, Henrik G.

2012-01-01

Pollination of insect pollinated crops has been found to be correlated to pollinator abundance and diversity. Since organic farming has the potential to mitigate negative effects of agricultural intensification on biodiversity, it may also benefit crop pollination, but direct evidence of this is scant. We evaluated the effect of organic farming on pollination of strawberry plants focusing on (1) if pollination success was higher on organic farms compared to conventional farms, and (2) if there was a time lag from conversion to organic farming until an effect was manifested. We found that pollination success and the proportion of fully pollinated berries were higher on organic compared to conventional farms and this difference was already evident 2–4 years after conversion to organic farming. Our results suggest that conversion to organic farming may rapidly increase pollination success and hence benefit the ecosystem service of crop pollination regarding both yield quantity and quality. PMID:22355380

Yield gap mapping as a support tool for risk management in agriculture

NASA Astrophysics Data System (ADS)

Lahlou, Ouiam; Imani, Yasmina; Slimani, Imane; Van Wart, Justin; Yang, Haishun

2016-04-01

The increasing frequency and magnitude of droughts in Morocco and the mounting losses from extended droughts in the agricultural sector emphasized the need to develop reliable and timely tools to manage drought and to mitigate resulting catastrophic damage. In 2011, Morocco launched a cereals multi-risk insurance with drought as the most threatening and the most frequent hazard in the country. However, and in order to assess the gap and to implement the more suitable compensation, it is essential to quantify the potential yield in each area. In collaboration with the University of Nebraska-Lincoln, a study is carried out in Morocco and aims to determine the yield potentials and the yield gaps in the different agro-climatic zones of the country. It fits into the large project: Global Yield Gap and Water Productivity Atlas: http://www.yieldgap.org/. The yield gap (Yg) is the magnitude and difference between crop yield potential (Yp) or water limited yield potential (Yw) and actual yields, reached by farmers. World Food Studies (WOFOST), which is a Crop simulation mechanistic model, has been used for this purpose. Prior to simulations, reliable information about actual yields, weather data, crop management data and soil data have been collected in 7 Moroccan buffer zones considered, each, within a circle of 100 km around a weather station point, homogenously spread across the country and where cereals are widely grown. The model calibration was also carried out using WOFOST default varieties data. The map-based results represent a robust tool, not only for drought insurance organization, but for agricultural and agricultural risk management. Moreover, accurate and geospatially granular estimates of Yg and Yw will allow to focus on regions with largest unexploited yield gaps and greatest potential to close them, and consequently to improve food security in the country.

Implementing Effective Educational Practices at Scales of Social Importance.

PubMed

Horner, Robert H; Sugai, George; Fixsen, Dean L

2017-03-01

Implementing evidence-based practices is becoming both a goal and standard across medicine, psychology, and education. Initial successes, however, are now leading to questions about how successful demonstrations may be expanded to scales of social importance. In this paper, we review lessons learned about scaling up evidence-based practices gleaned from our experience implementing school-wide positive behavioral interventions and supports (PBIS) across more than 23,000 schools in the USA. We draw heavily from the work of Flay et al. (Prev Sci 6:151-175, 2005. doi: 10.1007/s11121-005-5553-y ) related to defining evidence-based practices, the significant contributions from the emerging "implementation science" movement (Fixsen et al. in Implementation research: a synthesis of the literature, University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231), Tampa 2005), and guidance we have received from teachers, family members, students, and administrators who have adopted PBIS.

Field-based high throughput phenotyping rapidly identifies genomic regions controlling yield components in rice

PubMed Central

Tanger, Paul; Klassen, Stephen; Mojica, Julius P.; Lovell, John T.; Moyers, Brook T.; Baraoidan, Marietta; Naredo, Maria Elizabeth B.; McNally, Kenneth L.; Poland, Jesse; Bush, Daniel R.; Leung, Hei; Leach, Jan E.; McKay, John K.

2017-01-01

To ensure food security in the face of population growth, decreasing water and land for agriculture, and increasing climate variability, crop yields must increase faster than the current rates. Increased yields will require implementing novel approaches in genetic discovery and breeding. Here we demonstrate the potential of field-based high throughput phenotyping (HTP) on a large recombinant population of rice to identify genetic variation underlying important traits. We find that detecting quantitative trait loci (QTL) with HTP phenotyping is as accurate and effective as traditional labor-intensive measures of flowering time, height, biomass, grain yield, and harvest index. Genetic mapping in this population, derived from a cross of an modern cultivar (IR64) with a landrace (Aswina), identified four alleles with negative effect on grain yield that are fixed in IR64, demonstrating the potential for HTP of large populations as a strategy for the second green revolution. PMID:28220807

Simultaneous achievement of high ethanol yield and titer in Clostridium thermocellum

DOE PAGES

Tian, Liang; Papanek, Beth; Olson, Daniel G.; ...

2016-06-02

Background Biofuel production from plant cell walls offers the potential for sustainable and economically attractive alternatives to petroleum-based products. Fuels from cellulosic biomass are particularly promising, but would benefit from lower processing costs. Clostridium thermocellum can rapidly solubilize and ferment cellulosic biomass, making it a promising candidate microorganism for consolidated bioprocessing for biofuel production, but increases in product yield and titer are still needed. Results We started with an engineered C. thermocellum strain where the central metabolic pathways to products other than ethanol had been deleted. After two stages of adaptive evolution, an evolved strain was selected with improved yieldmore » and titer. On chemically defined medium with crystalline cellulose as substrate, the evolved strain produced 22.4 ± 1.4 g/L ethanol from 60 g/L cellulose. Moreover, the resulting yield was about 0.39 gETOH/gGluc eq, which is 75 % of the maximum theoretical yield. Genome resequencing, proteomics, and biochemical analysis were used to examine differences between the original and evolved strains. Conclusions A two step selection method successfully improved the ethanol yield and the titer. Finaly, this evolved strain has the highest ethanol yield and titer reported to date for C. thermocellum, and is an important step in the development of this microbe for industrial applications.« less

Beliefs and Responsibilities of Educational Stakeholders Concerning Student Success and Effective Principal Leadership

ERIC Educational Resources Information Center

Lapointe, Pierre; Poirel, Emmanuel; Brassard, Andre

2013-01-01

As elsewhere in Canada, the provincial educational system has adopted an accountability framework to improve student success by putting the emphasis on the rendering of accounts and production of a success plan. However, the implementation of school success plans is not always self-evident for socioeconomically disadvantaged communities. This case…

[Success factors in hospital management].

PubMed

Heberer, M

1998-12-01

The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management.

Investigating the Implementation of Robotics.

DTIC Science & Technology

1984-02-01

decisions are going to be made participatively and also what participation means to all involved parties. Successful implementations of new technologies...Reporting Communication Communication that They Received Increased Workers’ eCommunication Understanding* Written communication 13% 4.3 Workplace meetings

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

PubMed

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

2017-01-01

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

The Challenges and Success of Implementing Climate Studies Lessons for Pre-Professional Teachers at a Small Historically Black College to Engage Student Teaching of Science Pedagogy and Content Skill Based Learning.

NASA Astrophysics Data System (ADS)

Arnold, J.; Wider-Lewis, F.; Miller-Jenkins, A.

2017-12-01

This poster is a description of the challenges and success of implementing climate studies lessons for pre-service teachers to engage student teaching pedagogy and content skill based learning. Edward Waters College is a historical black college with an elementary education teacher program focused on urban elementary school teaching and learning. Pre-Service Elementary Educator Students often have difficulty with science and mathematics content and pedagogy. This poster will highlight the barriers and successes of using climate studies lessons to develop and enhance pre-service teachers' knowledge of elementary science principles particularly related to climate studies, physical and earth space science.

A metric for success