Managing management innovations: Contextual complexity and the pursuit of improvements in healthcare

In a context characterised by complexity and conflicting demands, healthcare managers at a meso-level struggle to pursue improvements in the quality and efficiency of care operations. An influential approach on how to pursue improvements is quality management (QM). QM adopts the view that systems are centred around a common aim and should be appreciated and managed to reduce undesired variation and improve performance incrementally. Nuancing this view, complexity science propels the idea of healthcare as a complex adaptive system (CAS), which refutes prediction and managerial control of development. As one component of the CAS of healthcare, various management innovations (MIs) provide suggestions on how to achieve improvements. However, achieving any improvement is not often as simple as portrayed and MIs can rarely be fully and exclusively applied in practice. Starting from the practical issue of how to achieve improvements in healthcare, this thesis seeks to explore how healthcare managers at a meso-level can understand and use MIs to handle complexity and achieve improvements. A qualitative and action research-inspired approach is adopted to investigate this issue, concentrating on the context of psychiatric care at the Sahlgrenska University Hospital in Gothenburg, Sweden.Four studies, resulting in five appended papers, are presented. By investigating contemporary MIs, the studies contribute to an improved understanding of how MIs can be used, and complexity handled, in the pursuit of improvements. Study 1 starts by exploring the concept of value at a time when lean was succeeded by value-based healthcare (VBHC) as the MI in fashion in the context and the study follows the implementation of VBHC in an action research-inspired approach. Study 2 tests the utility of the value configurations framework to handle conflicting logics and pursue improvements in psychosis care. In study 3, literature on network configurations in different healthcare contexts is reviewed. Lastly, study 4 is an action research study focusing on contextualisation of learning health systems (LHS) as yet an example of an MI in healthcare. Based on the findings of five appended papers and earlier literature from the fields of QM, complexity science, and MIs, a model is developed that points to the centrality and utility of logics to connect MIs and other system components to improve the understanding of both MIs and CASs. By investigating the logics underlying different MIs, actors in the healthcare system (e.g., politicians, physicians, and managers), and technical features of care (e.g., its predictability and inclination to standardised treatments), a relative appreciation of a CAS can be pursued, which can guide managers in how to use MIs and attract change that can lead to improvements. Furthermore, the thesis supports the view that MIs are often ambiguous concepts that can be translated and adapted to fit a local context in a process of contextualisation. For scholars, the thesis also contributes by integrating the perspectives of QM and complexity science, and of QM and MIs in general, as two parallel approaches to pursue improvements in healthcare

Context based learning: a survey of contextual indicators for personalized and adaptive learning recommendations. A pedagogical and technical perspective

Learning personalization has proven its effectiveness in enhancing learner performance. Therefore, modern digital learning platforms have been increasingly depending on recommendation systems to offer learners personalized suggestions of learning materials. Learners can utilize those recommendations to acquire certain skills for the labor market or for their formal education. Personalization can be based on several factors, such as personal preference, social connections or learning context. In an educational environment, the learning context plays an important role in generating sound recommendations, which not only fulfill the preferences of the learner, but also correspond to the pedagogical goals of the learning process. This is because a learning context describes the actual situation of the learner at the moment of requesting a learning recommendation. It provides information about the learner current state of knowledge, goal orientation, motivation, needs, available time, and other factors that reflect their status and may influence how learning recommendations are perceived and utilized. Context aware recommender systems have the potential to reflect the logic that a learning expert may follow in recommending materials to students with respect to their status and needs. In this paper, we review the state-of-the-art approaches for defining a user learning-context. We provide an overview of the definitions available, as well as the different factors that are considered when defining a context. Moreover, we further investigate the links between those factors and their pedagogical foundations in learning theories. We aim to provide a comprehensive understanding of contextualized learning from both pedagogical and technical points of view. By combining those two viewpoints, we aim to bridge a gap between both domains, in terms of contextualizing learning recommendations

Mini is beautiful:Playing serious mini-games to facilitate collective learning on complex urban processes

Spatial planning projects can be conceived as processes of collective learning. Planners have been looking at games and playful approaches to support these processes. Considering that planning projects are long and complex, we propose to not reason for single, full-fledged and all-encompassing games, but instead work with strings of, so-called, serious mini-games that each addresses a specific learning goal, guided by a collective learning model. This paper conceptualizes a toolbox to support the development and contextualization of such strings of serious mini-games

Designing an E-Mail Prototype to Enhance Effective Communication and Task Management: A Case Study

This paper deals with communicational breakdowns and misunderstandings in computer mediated communication (CMC) and ways to recover from them or to prevent them. The paper describes a case study of CMC conducted in a company named Artigiani. We observed communication and conducted content analysis of e-mail messages, focusing on message exchanges between customer service representatives (CSRs) and their contacts. In addition to task management difficulties, we identified communication breakdowns that result from differences between perspectives, and from the lack of contextual information, mainly technical background and professional jargon at the customers’ side. We examined possible ways to enhance CMC and accordingly designed a prototype for an e-mail user interface that emphasizes a communicational strategy called contextualization as a central component for obtaining effective communication and for supporting effective management and control of organizational activities, especially handling orders, price quoting, and monitoring the supply and installation of products

Hybridizing Technology Management and Knowledge Management to Spur Innovation: A System Dynamics Approach

The purpose of this research is to identify the drivers of innovativeness in a furniture manufacturing company. The scenario is the business environment where the hybridization of Technology Management (TM) and Knowledge Management (KM) is operative to promote innovation. The elements of the Technology Acceptance Model (TAM) and Socialization-Externalization-Internalization-Externalization (SECI) Model of KM have been modeled and used for simulation for the identification of the role played by the factors influencing the furniture design information conversion rate. The research follows the case study method to research as it draws data from a single company. Data from a multinational furniture manufacturing company that has over 10,000 products and operates in 24 countries have been used for simulation purposes. Results have shown that among the five factors that influence information conversion rate, the company should focus on correction efficiency and calculation efficiency enhancement if the aim is to maximize product and process innovations; and enhance contextualization efficiency if the priority is immediate results of innovativeness improvement. The results have also shown that about 615 innovative products and processes can be produced in six months by improving the correction efficiency to 80%. The theoretical implication of the study is in the form of a model which can be used by innovative companies to identify the critical factors that influence innovativeness, and the practical implications are in the form of suggestions to the managers of the furniture manufacturing company to enhance their innovativeness so as to gain competitive advantage in business

Utilization Focused Developmental Evaluation: Learning Through Practice

Background: Utilization-focused evaluation provides an overall decision-making framework with the intention of ensuring evaluation products and processes are actually used.  Developmental evaluation provides a structure to learn from an experiment or pilot in the making and provide feedback to course-correct and improve the ongoing effort.  In this paper we report on a project where we combined both into a utilization-focused developmental evaluation (UFDE).Purpose: To determine the theoretical complementarities and the practical advantages of combining UFE with DE, by reflecting on a practical experience.  We include a synopsis of the methodology along with a sample of findings, followed by a reflection of the overall process. We emphasize the conditions that enabled this experience to evolve to guide other practitioners interested in this learning approach to evaluation.Setting: The context was the piloting of a social and financial education curriculum for youth called Aflateen that was developed by Aflatoun Child Savings International in Amsterdam and test-driven by over forty partners around the World.  Intervention: The evaluation experience took place during a ten-month period between December 2012 and October 2013. This paper provides a summary of the context and a justification for the approach.Research Design: Not applicable.Data Collection and Analysis: In additional to conventional data collection instruments, we applied participatory inquiry tools from Social Analysis Systems (www.sas2.net) as a means of engaging stakeholders in real-time data collection and analysis.Findings: Examples are provided to demonstrate how some developmental evaluation findings informed organizational strategic and operational decisions during the life of the evaluation

The Impostor: Exploring narrative game design for learning Korean as a foreign language

In recent years, digital language learning games and applications have proliferated. However, most existing apps employ methods and theoretical approaches that are not designed to teach learners practical language competence. Additionally, commercial apps tend to focus on languages with large markets, leaving smaller languages like Korean unsupported. The objective of this thesis is to explore language learning and second language acquisition (SLA) theories and their practical applications to find teaching methods that are best suited for improving practical language competence of Korean. Having identified such methods grounded in socio-cultural and ecological SLA theory, the thesis further integrates the teaching methods into a conceptual design of a digital language learning game for learning Korean as a foreign language. This thesis demonstrates that a grounding the fundamentally messy digital language learning game design process in SLA theory is not only viable but a good starting point. Key findings indicate that the designers need to identify the targeted learning objectives, learning experiences and game experiences as clear design goals early on, to efficiently guide the inherently messy design process. Furthermore, the thesis highlights that digital language learning game designers need to develop and nurture knowledge both in the target language instructional domain and in game design.Viime vuosina digitaalisten kielten oppimista varten luotujen pelien ja applikaatioiden määrä on lisääntynyt voimakkaasti. Valtaosa olemassa olevista applikaatioista soveltaa kuitenkin käytäntöjä ja teoreettisia lähestymistapoja, jotka eivät opeta käytännön kielitaitoja. Lisäksi kaupalliset applikaatiot keskittyvät lähinnä kieliin, joilla on suuret markkinat ja eivätkä tue pienempiä kieliä kuten Koreaa. Tämän opinnäytetyön päämääränä on tutkia kielten oppimisen ja vieraan kielen omaksumisen teoriaa sekä niiden käytännön sovelluksia ja löytää opetusmenetelmiä, jotka soveltuvat parhaiten käytännöllisen Korean kielen taidon opiskeluun. Työn tuloksena löytyi sosiokulttuurilliseen ja ekologiseen kielten omaksumisteoriaan pohjautuvia menetelmiä, jotka integroitiin osaksi opinnäytetyön osana suunniteltua oppimispelikonseptia. Tämä opinnäytetyö havainnollistaa, että pohjimmiltaan sekavan digitaalisten kieltenopiskelupelien suunnitteluprosessin pohjaaminen kieltenoppimisteoriaan on paitsi mahdollista myös erinomainen lähtökohta suunnittelutyölle. Työn päälöydökset osoittavat, että suunnittelijoiden tulee tunnistaa tavoitellut oppimistavoitteet, oppimiskokemukset ja pelikokemukset ajoissa, jotta suunnittelutyö etenisi tehokkaammin. Lisäksi tämä opinnäytetyö korostaa, että digitaalisten kieltenopiskelupelien suunnittelijoiden tulee perehtyä syvällisesti sekä opiskelun kohteena olevaan kieleen että pelisuunnitteluun