Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

Non utile per esam

A pragmatic cluster randomised trial evaluating three implementation interventions

Background Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. Methods A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients' experiences, and stakeholders' experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Results Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. Conclusions This was a large, complex study and one of the first national randomised controlled trials conducted within acute care in implementation research. The evidence base for fasting practice was accepted by those participating in this study and the messages from it simple; however, implementation and practical challenges influenced the interventions' impact. A set of conditions for implementation emerges from the findings of this study, which are presented as theoretically transferable propositions that have international relevance. Trial registration ISRCTN18046709 - Peri-operative Implementation Study Evaluation (POISE

Breakthroughs in Shared Measurement and Social Impact

A surprising new breakthrough is emerging in the social sector: A handful of innovative organizations have developed web-based systems for reporting the performance, measuring the outcomes, and coordinating the efforts of hundreds or even thousands of social enterprises within a field. These nascent efforts carry implications well beyond performance measurement, foreshadowing the possibility of profound changes in the vision and effectiveness of the entire nonprofit sector. This paper, based on six months of interviews and research by FSG Social Impact Advisors, examines twenty efforts to develop shared approaches to performance, outcome, or impact measurement across multiple organizations. The accompanying appendices include a short description of each system and four more in-depth case studies

Building Capacity in Nonprofit Organizations

Offers a capacity building model that is based on a review of civil society, sustainable development, and organizational management literature. Reviews effective capacity building programs sponsored or operated by foundations. Includes recommendations

Four Essentials for Evaluation

GEO created this guide to help grantmakers get to the next level in their evaluation efforts. The target audience is champions and supporters of evaluation who want to embed these practices more deeply in the work of their organizations.The term "evaluation" can refer to a lot of different activities, including data collection, information gathering and research about grantmaker-supported activities. GEO's emphasis, however, is on "evaluation for learning."Evaluation is about more than ensuring that grantees are doing what they promise, or that a specific program area at a foundation is meeting its goals. Rather, it's about advancing knowledge and understanding among grantmakers, their grantees and their partners about what's working, what's not and how to improve their performance over time.Using evaluation in this way requires grantmakers to transform themselves into learning organizations. Beyond getting smarter about specific evaluation methods and approaches, this means adopting a continuous process, a culture and a commitment to support the capacity of people to see patterns and insights that can lead to ever-improving results

A review of GIS-based information sharing systems

GIS-based information sharing systems have been implemented in many of England and Wales' Crime and Disorder Reduction Partnerships (CDRPs). The information sharing role of these systems is seen as being vital to help in the review of crime, disorder and misuse of drugs; to sustain strategic objectives, to monitor interventions and initiatives; and support action plans for service delivery. This evaluation into these systems aimed to identify the lessons learned from existing systems, identify how these systems can be best used to support the business functions of CDRPs, identify common weaknesses across the systems, and produce guidelines on how these systems should be further developed. At present there are in excess of 20 major systems distributed across England and Wales. This evaluation considered a representative sample of ten systems. To date, little documented evidence has been collected by the systems that demonstrate the direct impact they are having in reducing crime and disorder, and the misuse of drugs. All point to how they are contributing to more effective partnership working, but all systems must be encouraged to record how they are contributing to improving community safety. Demonstrating this impact will help them to assure their future role in their CDRPs. By reviewing the systems wholly, several key ingredients were identified that were evident in contributing to the effectiveness of these systems. These included the need for an effective partnership business model within which the system operates, and the generation of good quality multi-agency intelligence products from the system. In helping to determine the future development of GIS-based information sharing systems, four key community safety partnership business service functions have been identified that these systems can most effectively support. These functions support the performance review requirements of CDRPs, operate a problem solving scanning and analysis role, and offer an interface with the public. By following these business service functions as a template will provide for a more effective application of these systems nationally