Outsourcing Back Office Services in Small Nonprofits: Pitfalls and Possibilities

Presents findings on small nonprofits' administrative, finance, and other office support needs; reasons and conditions for outsourcing as well as barriers; methods for evaluating options; and guiding principles. Examines three business models

Area and individual differences in personal crime victimization incidence: The role of individual, lifestyle/routine activities and contextual predictors

This article examines how personal crime differences between areas and between individuals are predicted by area and population heterogeneity and their synergies. It draws on lifestyle/routine activities and social disorganization theories to model the number of personal victimization incidents over individuals including routine activities and area characteristics, respectively, as well as their (cross-cluster) interactions. The methodology employs multilevel or hierarchical negative binomial regression with extra binomial variation using data from the British Crime Survey and the UK Census. Personal crime rates differ substantially across areas, reflecting to a large degree the clustering of individuals with measured vulnerability factors in the same areas. Most factors suggested by theory and previous research are conducive to frequent personal victimization except the following new results. Pensioners living alone in densely populated areas face disproportionally high numbers of personal crimes. Frequent club and pub visits are associated with more personal crimes only for males and adults living with young children, respectively. Ethnic minority individuals experience fewer personal crimes than whites. The findings suggest integrating social disorganization and lifestyle theories and prioritizing resources to the most vulnerable, rather than all, residents of poor and densely populated areas to prevent personal crimes

Improving inpatient postnatal services: midwives views and perspectives of engagement in a quality improvement initiative

Background: despite major policy initiatives in the United Kingdom to enhance women's experiences of maternity care, improving in-patient postnatal care remains a low priority, although it is an aspect of care consistently rated as poor by women. As part of a systems and process approach to improving care at one maternity unit in the South of England, the views and perspectives of midwives responsible for implementing change were sought. Methods: a Continuous Quality Improvement (CQI) approach was adopted to support a systems and process change to in-patient care and care on transfer home in a large district general hospital with around 6000 births a year. The CQI approach included an initial assessment to identify where revisions to routine systems and processes were required, developing, implementing and evaluating revisions to the content and documentation of care in hospital and on transfer home, and training workshops for midwives and other maternity staff responsible for implementing changes. To assess midwifery views of the quality improvement process and their engagement with this, questionnaires were sent to those who had participated at the outset. Results: questionnaires were received from 68 (46%) of the estimated 149 midwives eligible to complete the questionnaire. All midwives were aware of the revisions introduced, and two-thirds felt these were more appropriate to meet the women's physical and emotional health, information and support needs. Some midwives considered that the introduction of new maternal postnatal records increased their workload, mainly as a consequence of colleagues not completing documentation as required. Conclusions: this was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their feedback on whether revisions were pragmatic and achieved anticipated improvements in care quality. Their initial involvement ensured priority areas for change were identified and implemented. Their subsequent feedback highlighted further important areas to address as part of CQI to ensure best quality care continues to be implemented. Our findings could support other maternity service organisations to optimise in-patient postnatal services

Performance Measurementof Xyz Government Institution's Contracts Workers Using Personal Balanced Scorecard Method

Implementation of good governance of bureaucracy system of Surabaya City Government, one of them with developed performance-based salary program ( e-performance ) dedicated specially to Civil Servant. But in reality agencies in Surabaya do not have the full use of civil servants as their human resources, thus involving contractors as supporters of government performance processes. The purpose of this study is to determine key performance indicators(KPI) and strategic objectives in XYZ Institution, determine the importance of each KPI criterion, to understand the performance of each contractor at XYZ Government Agency and provide improvement recommendations from the current employee performance. The unit of analysis of this research is carried out at the General Section in the Sub Division of Administration with the administrative position as the administrative contractor. The design of this study used a survey with questionnaire data collection techniques and questionnaires. The method used is personal balanced scorecard by formulating strategic targets and KPI by stakeholders from XYZ Agency. Weighting method using Analytic Network Process method(ANP). From the research results obtained: the formulation of KPI and Strategy Target has been formed with the highest level of KPI weight is KPI Total Late (0.1532). Total performance of the best contractor performance is Mr. C (6.253) while the smallest total performance achievement is obtained Mr. K ie (3.346). Recommendations include: Provide rewards, provide coaching, conduct regular control and evaluation systems, provide socialization and provide slogans in the corner of the room on performance improvement

Operational Plan for HMIS Rollout to be Read in Conjunction with the MoH&SW Document of October 2007

The MoH&SW, with a consortium of partners, in October 2007, developed a Proposal to Strengthen the HMIS in Tanzania. This document builds on that proposal to develop a budgeted 6‐month plan to kick‐start implementation of the Revised MTUHA in one region and at national level, to develop a replicable model that can be scaled up to other regions as additional funds become available. The overall HMIS revision process will ensure that, within a period of five years the HMIS will be functional in all 21 regions of the country, in a phased manner Six months intensive systems and database development in Mtwara region Eighteen months implementation in one region in each of the six zones Within 5 years, National rollout to every region The initial six months implementation process, described in depth in this document, will use action research and participatory development methodology that will integrate the six work packages in the HMIS document, in line with the HSSP III proposals for strengthening M&E. A number of dedicated teams will roll out the HMIS, develop a toolkit for implementation in other regions and produce a modern web based data warehouse. The project logframe aims to provide quality routine data for monitoring MDGs and the NHSSPIII by producing five outputs – HMIS revision, HMIS implementation, Capacity development, the DHIS software and action research. Terms of reference are developed for each of the HMIS teams, based on the activities in the logframe – Indicator and dataset revision, HMIS design, Database development and training team. An action‐based budget of US$15 million is provided for three years that envisages The model region will cost$1,25 million for the first year, including the rollout activities, the development of training material, adaptation of software etc. The other six regions will cost 1,05million for first year; all regions will reduce to $500,000 for the second year and$300,000 in the third year. National level costs will reduce from $700,000 to 500,000 a year as local consultants replace international technical assistance and Ministry takes over running expenses. Rollout for the other 14 regions will need a separate budgeting process after the six regions, but should be in the range of 1,8 million a year (or less if costs can be reduced). The activities in the model initiation region will cost$1,2 million for the first year, including the rollout activities, the development of training material, adaptation of software et

Using Smartphone Technology to Enhance Self-Management Support in Adults with Type 2 Diabetes in Primary Care

Background: Self-care is a crucial component in the management of Type 2 Diabetes Mellitus (T2DM). The literature shows that frequent feedback on blood sugar recordings together with reminders can lead to improvements in patient’s glucose control and diabetic self-care. The Chronic Care Model developed by Wagner emphasizes the importance of patient participation in the management of their chronic diseases. Purpose: To explore the possibility of using smartphone technology to help adults with T2DM better manage this chronic disease in a primary care clinic in New England. Methods: A smartphone application (App) OnTrack Diabetes (OnTrack) and text messaging were used to enhance communication between the patient and the provider. After receiving facility and IRB waivers, participants were recruited and trained on the downloaded App. Data was generated through text messages, the App and DNP student journaling, which was evaluated for patient and provider satisfaction with the App. Results: This project lasted about five months with five out of the seven participants recruited actually completing the project. Many (60%) of the participants found the App useful, 80% followed through with the instructions in the text messages and 60% intend to continue to use the App. Three out of five providers liked the App and intend to continue to use it. Most (80%) of the participants noticed a decrease in blood sugar, hemoglobin A1C and weight. Conclusion: This project confirms that an App and text messaging may be a useful tool for primary care providers to enhance self management in patients with T2DM and that frequent communication with the patient in between face to face office visits keeps them engaged and more compliant with diabetes management

Predictors and Outcomes of Postpartum Mothers\u27 Perceptions of Readiness for Discharge after Birth

Objective: To identify predictors and outcomes of postpartum mothers\u27 perceptions of their readiness for hospital discharge. Design: A correlational design with path analyses was used to explore predictive relationships among transition theory-related variables. Setting: Midwestern tertiary perinatal center. Participants: One hundred and forty-one mixed-parity postpartum mothers who had experienced vaginal birth or Cesarean delivery of normal healthy infants. Methods: Before hospital discharge, patients completed questionnaires about sociodemographic characteristics, hospitalization factors, quality of discharge teaching, and readiness for discharge. Three weeks postdischarge, mothers were contacted by telephone to collect coping difficulty and health care utilization data. Main Outcome Measures: Readiness for Hospital Discharge Scale, Post-Discharge Coping Difficulty Scale, Utilization of postdischarge services. Results: Quality of discharge teaching, specifically the relative difference in the amount of informational content needed and received and the skills of nurses in delivering discharge teaching, explained 38% of the variance in postpartum mothers\u27 perceptions of discharge readiness. Readiness for discharge scores explained 22% of the variance in postdischarge coping difficulty scores. Nurses\u27 skills in delivery of discharge teaching, coping difficulty, patient characteristics, and birth hospitalization factors were predictive of utilization of family support and postdischarge health care services. Conclusion: A trajectory of influence was evident in the sequential relationships of quality of discharge teaching, readiness for discharge, postdischarge coping, and utilization of family support and health care services. Transitions theory provided a useful framework for conceptualizing and investigating the transition home after childbirth

The institutional character of computerized information systems

We examine how important social and technical choices become part of the history of a computer-based information system (CB/SJ and embedded in the social structure which supports its development and use. These elements of a CBIS can be organized in specific ways to enhance its usability and performance. Paradoxically, they can also constrain future implementations and post-implementations.We argue that CBIS developed from complex, interdependent social and technical choices should be conceptualized in terms of their institutional characteristics, as well as their information-processing characteristics. The social system which supports the development and operation of a CBIS is one major element whose institutional characteristics can effectively support routine activities while impeding substantial innovation. Characterizing CBIS as institutions is important for several reasons: (1) the usability of CBIS is more critical than the abstract information-processing capabilities of the underlying technology; (2) CBIS that are well-used and have stable social structures are more difficult to replace than those with less developed social structures and fewer participants; (3) CBIS vary from one social setting to another according to the ways in which they are organized and embedded in organized social systems. These ideas are illustrated with the case study of a failed attempt to convert a complex inventory control system in a medium-sized manufacturing firm