Drug doping in sports : an overview and recommendations for the Maltese context

The use of legal and illicit medical substances is widespread in international sport and becoming more complex. Serious concern exists about the use of illicit substances, as listed in the list of the World Anti Doping Agency (WADA) of prohibited substances. This phenomenon is also present among Maltese athletes and positive doping cases have been reported in the media among local sportspersons from varying disciplines. In this paper, a review of the current international conventions with respect to drug doping in sport will be given together with an overview of the prohibited substances. The Maltese situation will also be assessed. Limited local data indicate that this is an underground phenomenon which has existed and persisted over the years. The testing programs, with some exceptions, have to date been very poor and most sporting disciplines are not tested regularly. Recommendations will be made in order to readdress the lacuna in data available, as well as the knowledge and education of this subject among local sportspersons, coaches and sports officials, and various health care professionals. In addition, a call is made for Malta to implement the WADA Code as soon as possible, and sign and ratify the UNESCO and Council of Europe conventions, while ensuring that adequate resources are made available for their enforcement.peer-reviewe

Enterprise Systems Adoption and Firm Performance in Europe: The Role of Innovation

Despite the ubiquitous proliferation and importance of Enterprise Systems (ES), little research exists on their post-implementation impact on firm performance, especially in Europe. This paper provides representative, large-sample evidence on the differential effects of different ES types on performance of European enterprises. It also highlights the mediating role of innovation in the process of value creation from ES investments. Empirical data on the adoption of Enterprise Resource Planning (ERP), Supply Chain Management (SCM), Customer Relationship Management (CRM), Knowledge Management System (KMS), and Document Management System (DMS) is used to investigate the effects on product and process innovation, revenue, productivity and market share growth, and profitability. The data covers 29 sectors in 29 countries over a 5-year period. The results show that all ES categories significantly increase the likelihood of product and process innovation. Most of ES categories affect revenue, productivity and market share growth positively. Particularly, more domainspecific and simpler system types lead to stronger positive effects. ERP systems decrease the profitability likelihood of the firm, whereas other ES categories do not show any significant effect. The findings also imply that innovation acts as a full or partial mediator in the process of value creation of ES implementations. The direct effect of enterprise software on firm performance disappears or significantly diminishes when the indirect effects through product and process innovation are explicitly accounted for. The paper highlights future areas of research.Enterprise Systems; ERP; SCM; CRM; KMS; DMS; IT Adoption; Post-implementation Phase; IT Business Value; Innovation; Firm Performance; Europe

What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context

Background: Given the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualise and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare. Methods: A structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations. Results: Thirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains. Conclusion: If the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences. Comparison of measurement tools across domains suggests that there is scope within EBP for supplementing the current emphasis on human and technical resources to support information uptake and use by individuals. Consideration of measurement tools from the fields of KM and OL shows more content related to social mechanisms to facilitate knowledge recognition, translation, and transfer between individuals and groups

A KM perspective on implementing an electronic patient record within an NHS hospital

The Electronic Patient Record (EPR) is being developed by many hospitals in the UK and across the globe. We class an EPR system as a type of Knowledge Management System (KMS), in that it is a technological tool developed to support the process of knowledge management (KM). Healthcare organisations aim to use these systems to provide a vehicle for more informed and improved clinical decision making thereby delivering reduced errors and risks, enhanced quality and consequently offering enhanced patient safety. Finding an effective way for a healthcare organisation to practically implement these systems is essential. In this study we use the concept of the business process approach to KM as a theoretical lens to analyse and explore how a large NHS teaching hospital developed, executed and practically implemented an EPR system. This theory advocates the importance of taking into account all organizational activities - the business processes - in considering any KM initiatives. Approaching KM through business processes allows for a more holistic view of the requirements across a process: emphasis is placed on how particular activities are performed, how they are structured and what knowledge demanded and not just supplied across each process. This falls in line with the increased emphasis in healthcare on patient-centred approaches to care delivery. We have found in previous research that hospitals are happy with the delivery of patient care being referred to as their 'business'. A qualitative study was conducted over a two and half year period with data collected from semi-structured interviews with eight members of the strategic management team, 12 clinical users and 20 patients in addition to non- participant observation of meetings and documentary data. We believe that the inclusion of patients within the study may well be the first time this has been done in examining the implementation of a KMS. The theoretical propositions strategy was used as the overarching approach for data analysis. Here Initial theoretical research themes and propositions were used to help shape and organise the case study analysis. This paper will present preliminary findings about the hospital's business strategy and its links to the KMS strategy and process

The influence of organizational culture on the outcome of an IS implementation

A number of information system (IS) studies have adopted organizational culture (OC) theory to investigate IS implementations. The studies highlight that members will reach consensus or agreement in the use of an IS but also experience inevitable tensions and ambiguities in the use of the IS. However, literature related to IS implementation/OC has rarely examined the influence that the saliency of specific cultural practices may have on the success or failure of IS implementations. Using a case study approach, we adopted the “soft positivism” research philosophy to collect data, underpinned by Martin’s (1992) integration and differentiation perspectives of OC to study organizational implementation of an IS. These perspectives served as interpretive lenses through which to explain how members’ salient behaviors towards an IS evolved during the implementation process. Our study augments the IS implementation/OC literature by demonstrating how salient cultural practices influence the outcome of IS implementatio

Role of Knowledge Management in Providing Quality Care: A Conceptual Model

The purpose of the paper is to signify the effect of factors relating to knowledge management on quality care to patients. A theoretical framework is proposed linking healthcare practitioners’ motivation, knowledge adoption, adaption to web technologies and knowledge friendly culture on quality of care given to patients. The study includes two levels of variables to impart quality care, one is at the level of healthcare practitioner and another is at the organizational level. The factors regarding healthcare practitioner include the motivation to use knowledge management system, knowledge adoption and adaption to web technologies. The factor relating to organization includes the knowledge friendly culture. The conceptual model could be empirically tested using data from healthcare organizations. Propositions are posited for further research. The paper provides value to academicians and practitioners. The outcomes of the empirical study would identify the key factors that pushes healthcare practitioner to contribute to knowledge management system and the policy level modifications could be made to develop, alter and sustain knowledge friendly culture

Implementing a knowledge management system within an NHS hospital:a case study exploring the roll-out of an Electronic Patient Record (EPR)

This research aims to contribute to understanding the implementation of knowledge management systems (KMS) in the field of health through a case study, leading to theory building and theory extension. We use the concept of the business process approach to knowledge management as a theoretical lens to analyse and explore how a large teaching hospital developed, executed and practically implemented a KMS. A qualitative study was conducted over a 2.5 year period with data collected from semi-structured interviews with eight members of the strategic management team, 12 clinical users and 20 patients in addition to non-participant observation of meetings and documents. The theoretical propositions strategy was used as the overarching approach for data analysis. Our case study provides evidence that true patient centred approaches to supporting care delivery with a KMS benefit from process thinking at both the planning and implementation stages, and an emphasis on the knowledge demands resulting from: the activities along the care pathways; where cross-overs in care occur; and knowledge sharing for the integration of care. The findings also suggest that despite the theoretical awareness of KMS implementation methodologies, the actual execution of such systems requires practice and learning. Flexible, fluid approaches through rehearsal are important and communications strategies should focus heavily on transparency incorporating both structured and unstructured communication methods

Assessing the Impact of Electronic Health Record Systems Implementation on Hospital Patient Perceptions of Care

The delivery of health care services has been impacted by advances in Knowledge Management Information Systems (KMIS) and Information Technology (IT). The literature reveals that Electronic Health Records Systems (EHRs) are a comprehensive KMIS. There is a wide recognition in the body of knowledge that demonstrates the potential of EHRs to transform all aspects of health care services and, in consequence, the performance of Health Care Delivery Organizations (HCDO). Authors of published research also agree that there is a need for more empirical contributions that demonstrate the impact of EHRs upon HCDO. It is argued that in most cases, studies have been deployed with very limited data or in a specific health care setting. Small gains in performance and mixed results have made difficult to conclusively demonstrate a significant effect of EHRs on the quality of health care services. This study contributes to the knowledge base by empirically assessing the link between a hospital\u27s level of implementation of EHRs and patients\u27 perceptions of the quality of health care services through the analysis of 2,036 hospitals. Findings reveal that the level of implementation of EHRs has a positive impact, both on the percentage of patients who are willing to recommend the hospital to family and friends, and on the percentage of patients who give high ratings based on their last stay in the hospital