Promoting Environments that Measure Outcomes: Partnerships for Change

This paper describes the development of the PrEMO© (Promoting Environments that Measure Outcomes) program. PrEMO© is an innovative model promoting evidence-based practice (EBP) while developing capacity and quality of Level II fieldwork placements. The PrEMO© program is described from initiation to completion, including development of site-specific learning objectives, the twelve week schedule and the role of faculty mentorship. Occupational therapy (OT) students, and university OT program faculty including academic fieldwork coordinators, partner with fieldwork educators at the site to implement EBP using a data-driven decision making (DDDM) process to guide the development of evidence-based practices. PrEMO© appears to be a useful strategy for building Level II fieldwork capacity and enhancing student and fieldwork educators’ knowledge and skills about EBP and outcome measurement in routine OT practice

Selection process of auto-ID technology in warehouse management: A Delphi study

This thesis was submitted for the degree of Doctor of philosophy and awarded by Brunel UniversityIn a supply chain, a warehouse is a crucial component for linking all chain parties. Automatic identification and data capture (auto-ID) technology, e.g. RFID and barcodes are among the essential technologies in the 21st century knowledge-based economy. Selecting an auto-ID technology is a long term investment and it contributes to improving operational efficiency, achieving cost savings and creating opportunities for higher revenues. The interest in auto-ID research for warehouse management is rather stagnant and relatively small in comparison to other research domains such as transport, logistics and supply chain. However, although there are some previous studies that explored factors for the auto-ID selection decision in a warehouse environment, those factors (e.g., operational factors) have been examined separately and researchers have paid no attention to all key factors that may potentially affect this decision. In fact, yet there is no comprehensive framework in the literature that comprehensively investigates the critical factors influencing the auto-ID selection decision and how the factors should be combined to produce a successful auto-ID selection process in warehouse management. Therefore, the main aim of this research is to investigate empirically the auto-ID technology-selection process and to determine the key factors that influence decision makers when selecting auto-ID technology in the warehouse environment. This research is preceded by a comprehensive and systematic review of the relevant literature to identify the set of factors that may affect the technology selection decision. The Technology-Organisation-Environment (TOE) framework has been used as lens to categorise the identified factors (Tornatzky & Fleischer, 1990). Data were collected by conducting first a modified (mixed-method) two-round Delphi study with a worldwide panel of experts (107) including academics, industry practitioners and consultants in auto-ID technologies. The results of the Delphi study were then verified via follow-up interviews, both face-to-face and telephone, carried out with 19 experts across the world. This research in nature is positivist, exploratory/descriptive, deductive/inductive and quantitative/qualitative. The quantitative data were analysed using the statistical package for social sciences, SPSS V.18, while the qualitative data of the Delphi study and the interviews were analysed manually using quantitative content analysis approach and thematic content analysis approach respectively. The findings of this research are reported on the motivations/reasons of warehouses in seeking to use auto-ID technologies, the challenges in making an auto-ID decision, the recommendations to address the challenges, the key steps that should be followed in making auto-ID selection decision, the key factors and their relative importance that influence auto-ID selection decision in a warehouse. The results of the Delphi study show that the six major factors affecting the auto-ID selection decision in warehouse management are: organisational, operational, structural, resources, external environmental and technological factors (in decreasing order of importance). In addition, 54 key sub-factors have been identified from the list of each of the major factors and ranked in decreasing order of the importance mean scores. However, the importance of these factors depends on the objectives and strategic motivations of warehouse; size of warehouse; type of business; nature of business environment; sectors; market types; products and countries. Based on the Delphi study and the interviews findings, a comprehensive multi-stage framework for auto-ID technology selection process has been developed. This research indicates that the selection process is complex and needs support and closer collaboration from all participants involved in the process such as the IT team, top management, warehouse manager, functional managers, experts, stockholders and vendors. Moreover, warehouse managers should have this process for collaboration before adopting the technology in order to reduce the high risks involved and achieve successful implementation. This research makes several contributions for both academic and practitioners with auto-ID selection in a warehouse environment. Academically, it provides a holistic multi-stage framework that explains the critical issues within the decision making process of auto-ID technology in warehouse management. Moreover, it contributes to the body of auto-ID and warehouse management literature by synthesising the literature on key dimensions of auto-ID (RFID/barcode) selection decision in the warehouse field. This research also provides a theoretical basis upon which future research on auto-ID selection and implementation can be built. Practically, the findings provide valuable insights for warehouse managers and executives associated with auto-ID selection and advance their understanding of the issues involved in the technology selection process that need to be considered.Damascus University, Syria and The British Council, Mancheste

Recent Trends and Innovations in Modelling City Logistics

AbstractThere are many challenges associated with moving goods within cities as urban areas become larger and elderly residents require more healthcare in their homes. Air quality is also impacted by urban freight vehicles. This paper presents a review of recent trends and innovations in modelling city logistics. New techniques for modelling city logistics developed in the areas of emissions, healthcare and mega-cities are outlined. This paper describes the formulation, solution methodologies and applications of these models

The Assessment of Technology Adoption Interventions and Outcome Achievement Related to the Use of a Clinical Research Data Warehouse

Introduction: While funding for research has declined since 2004, the need for rapid, innovative, and lifesaving clinical and translational research has never been greater due to the rise in chronic health conditions, which have resulted in lower life expectancy and higher rates of mortality and adverse outcomes. Finding effective diagnostic and treatment methods to address the complex challenges in individual and population health will require a team science approach, creating the need for multidisciplinary collaboration among practitioners and researchers. To address this need, the National Institutes of Health (NIH) created the Clinical and Translational Science Awards (CTSA) program. The CTSA program distributes funds to a national network of medical research institutions, known as “hubs,” that work together to improve the translational research process. With this funding, each hub is required to achieve specific goals to support clinical and translational research teams by providing a variety of services, including cutting edge use of informatics technologies. As a result, the majority of CTSA recipients have implemented and maintain data warehouses, which combine disparate data types from a range of clinical and administrative sources, include data from multiple institutions, and support a variety of workflows. These data warehouses provide comprehensive sets of data that extend beyond the contents of a single EHR system and provide more valuable information for translational research. Although significant research has been conducted related to this technology, gaps exist regarding research team adoption of data warehouses. As a result, more information is needed to understand how data warehouses are adopted and what outcomes are achieved when using them. Specifically, this study focuses on three gaps: research team awareness of data warehouses, the outcomes of data warehouse training for research teams, and how to measure objectively outcomes achieved after training. By assessing and measuring data warehouse use, this study aims to provide a greater understanding of data warehouse adoption and the outcomes achieved. With this understanding, the most effective and efficient development, implementation, and maintenance strategies can be used to increase the return on investment for these resource-intensive technologies. In addition, technologies can be better designed to ensure they are meeting the needs of clinical and translational science in the 21st century and beyond. Methods: During the study period, presentations were held to raise awareness of data warehouse technology. In addition, training sessions were provided that focused on the use of data warehouses for research projects. To assess the impact of the presentations and training sessions, pre- and post-assessments gauged knowledge and likelihood to use the technology. As objective measurements, the number of data warehouse access and training requests were obtained, and audit trails were reviewed to assess trainee activities within the data warehouse. Finally, trainees completed a 30-day post-training assessment to provide information about barriers and benefits of the technology. Results: Key study findings suggest that the awareness presentations and training were successful in increasing research team knowledge of data warehouses and likelihood to use this technology, but did not result in a subsequent increase in access or training requests within the study period. In addition, 24% of trainees completed the associated data warehouse activities to achieve their intended outcomes within 30 days of training. The time needed for adopting the technology, the ease of use of data warehouses, the types of support available, and the data available within the data warehouse may all be factors influencing this completion rate. Conclusion: The key finding of this study is that data warehouse awareness presentations and training sessions are insufficient to result in research team adoption of the technology within a three-month study period. Several important implications can be drawn from this finding. First, the timeline for technology adoption requires further investigation, although it is likely longer than 90 days. Future assessments of technology adoption should include an individual’s timeline for pursuing the use of that technology. Second, this study provided a definition for outcome achievement, which was completion o

E-grocery logistics: exploring the gap between research and practice

Purpose: This paper investigates the logistics management in the e-grocery sector. It contrasts the key issues faced by practitioners and the topics addressed in the academic literature, to identify potential misalignments between research and practice and propose avenues for future efforts. Design/methodology/approach: This work adopts a twofold methodological approach. From an academic perspective, a systematic literature review (SLR) is performed to define the topics addressed so far by scholars when analysing e-grocery logistics. From a managerial perspective, a Delphi study is accomplished to identify the most significant issues faced by logistics practitioners in the e-grocery context and the associated significance. Findings: The study develops a conceptual framework, identifying and mapping the 9 main logistics challenges for e-grocery along 4 clusters, in the light of a logistics-related revision of the SCOR model: distribution network design (area to be served, infrastructures), order fulfilment process (picking, order storage, consolidation, delivery), logistics-related choices from other domains (product range, stock-out management) and automation. These elements are discussed along three dimensions: criticalities, basic and advanced/automation-based solutions. Finally, the main gaps are identified – in terms of both under-investigated topics (order storage and stock-out management) and investigated topics needing further research (picking and automation) – and research questions and hypotheses are outlined. Originality/value: This paper provides a threefold contribution, revolving around the developed framework. First, it investigates the state of the art about e-grocery logistics, classifying the addressed themes. Second, it explores the main issues e-grocery introduces for logistics practitioners. Third, it contrasts the two outcomes, identifying the misalignment between research and practice, and accordingly, proposing research directions

Strengthening Integrated Primary Health Care in Sofala, Mozambique

Background: Large increases in health sector investment and policies favoring upgrading and expanding the public sector health network have prioritized maternal and child health in Mozambique and, over the past decade, Mozambique has achieved substantial improvements in maternal and child health indicators. Over this same period, the government of Mozambique has continued to decentralize the management of public sector resources to the district level, including in the health sector, with the aim of bringing decision-making and resources closer to service beneficiaries. Weak district level management capacity has hindered the decentralization process, and building this capacity is an important link to ensure that resources translate to improved service delivery and further improvements in population health. A consortium of the Ministry of Health, Health Alliance International, Eduardo Mondlane University, and the University of Washington are implementing a health systems strengthening model in Sofala Province, central Mozambique.Description of implementation: The Mozambique Population Health Implementation and Training (PHIT) Partnership focuses on improving the quality of routine data and its use through appropriate tools to facilitate decision making by health system managers; strengthening management and planning capacity and funding district health plans; and building capacity for operations research to guide system-strengthening efforts. This seven-year effort covers all 13 districts and 146 health facilities in Sofala Province.Evaluation design: A quasi-experimental controlled time-series design will be used to assess the overall impact of the partnership strategy on under-5 mortality by examining changes in mortality pre- and post-implementation in Sofala Province compared with neighboring Manica Province. The evaluation will compare a broad range of input, process, output, and outcome variables to strengthen the plausibility that the partnership strategy led to healthsystem improvements and subsequent population health impact.Discussion: The Mozambique PHIT Partnership expects to provide evidence on the effect of efforts to improvedata quality coupled with the introduction of tools, training, and supervision to improve evidence-based decision making. This contribution to the knowledge base on what works to enhance health systems is highly replicable for rapid scale-up to other provinces in Mozambique, as well as other sub-Saharan African countries with limitedresources and a commitment to comprehensive primary health care

Barriers Against Adoption of Electronic Health Record in Italy

This work aims to expose the barriers which work against the satisfactory adoption and utilization of Electronic Health Records (EHRs) in Italy. Experts from six operating areas were involved where barriers associated with practical daily use of EHRs might arise. Experts disclosed different barriers in their operating areas: the low interoperability of healthcare system infrastructures in diagnostic services; the lack of systems able to represent complex processes characterized by uncertainties in hospital wards; the unsatisfactory information exchange between heterogeneous healthcare providers in territorial healthcare; the lack of models and guidelines for administration process management; the lack of Health Information engineers who are recognized as professionals in Italian hospitals; the lack of domain vocabularies and ontologies for conceptual integration in clinical communication. Our findings suggest how future solutions must be designed considering the environment of specific areas

Development of a Physician Profiling Data Mart

Hospitals and medical centers participate in a physician profiling process. This process is important to ensure that physicians are providing safe care and to comply with regulations. One medical center was struggling with the ongoing generation of physician performance reports that were an important part of the profiling process. A design research project was undertaken to demonstrate that an Access-based data mart could successfully streamline this report generating process. The research also demonstrated the need to eliminate excessive detail and deliver highly summarized reports. In addition, the research provided thorough documentation of the entire data mart development approach. This documentation can serve as a resource for future research and/or for other medical centers that might be struggling to manage the profiling report requirements