27,767 research outputs found

    Safer clinical systems : interim report, August 2010

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    Safer Clinical Systems is the Health Foundationā€™s new five year programme of work to test and demonstrate ways to improve healthcare systems and processes, to develop safer systems that improve patient safety. It builds on learning from the Safer Patients Initiative (SPI) and models of system improvement from both healthcare and other industries. Learning from the SPI highlighted the need to take a clinical systems approach to improving safety. SPI highlighted that many hospitals struggle to implement improvement in clinical areas due to inherent problems with support mechanisms. Clinical processes and systems, rather than individuals, are often the contributors to breakdown in patient safety. The Safer Clinical Systems programme aimed to measure the reliability of clinical processes, identify defects within those processes, and identify the systems that result in those defects. Methods to improve system reliability were then to be tested and re-developed in order to reduce the risk of harm being caused to patients. Such system-level awareness should lead to improvements in other patient care pathways. The relationship between system reliability and actual harm is challenging to identify and measure. Specific, well-defined, small-scale processes have been used in other programmes, and system reliability has been shown to have a direct causal relationship with harm (e.g. care bundle compliance in an intensive care unit can reduce the incidence of ventilator-associated pneumonia). However, it has become evident that harm can be caused by a variety of factors over time; when working in broader, more complex and dynamic systems, change in outcome can be difficult to attribute to specific improvements and difficulties are also associated with relating evidence to resulting harm. The overall aim of Phase 1 of the Safer Clinical Systems programme was to demonstrate proof-of-concept that using a systems-based approach could contribute to improved patient safety. In Phase 1, experienced NHS teams from four locations worked together with expert advisers to co-design the Safer Clinical Systems programme

    Network Analysis, Creative System Modelling and Decision Support: The NetSyMoD Approach

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    This paper presents the NetSyMoD approach ā€“ where NetSyMod stands for Network Analysis ā€“ Creative System Modelling ā€“ Decision Support. It represents the outcome of several years of research at FEEM in the field of natural resources management, environmental evaluation and decision-making, within the Natural Resources Management Research Programme. NetSyMoD is a flexible and comprehensive methodological framework, which uses a suite of support tools, aimed at facilitating the involvement of stakeholders or experts in decision-making processes. The main phases envisaged for the process are: (i) the identification of relevant actors, (ii) the analysis of social networks, (iii) the creative system modelling and modelling of the reality being considered (i.e. the local socio-economic and environmental system), and (iv) the analysis of alternative options available for the management of the specific case (e.g. alternative projects, plans, strategies). The strategies for participation are necessarily context-dependent, and thus not all the NetSyMod phases may be needed in every application. Furthermore, the practical solutions for their implementation may significantly differ from one case to another, depending not only on the context, but also on the available resources (human and financial). The various applications of NetSyMoD have nonetheless in common the same approach for problem analysis and communication within a group of actors, based upon the use of creative thinking techniques, the formalisation of human-environment relationships through the DPSIR framework, and the use of multi-criteria analysis through the mDSS software.Social Network, Integrated Analysis, Participatory Modelling, Decision Support

    Linking Innovative Potential to SME Performance: An Assessment of Enterprises in Industrial South Wales

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    The attraction of inward investment from the UK and from overseas was the main focus of regional development policy in Wales for much of the 1970s and 1980s. Whilst Wales has been particularly successful in attracting foreign enterprise, the contribution of new investors to improving longer term regional economic prospects has been questioned at several levels. With concerns over inward investor stability, embeddedness, and contribution to local value added, increasing weight has been given to the encouragement, and development of innovative indigenous SMEs in the Welsh economy. General and sectoral initiatives to encourage SME development and innovation in Wales have also taken place against a background of historically low levels of new firm formation in the region, together with the presence of factors expected to hinder SME growth including low levels of capital availability. Ultimately, it is hoped that a strongly performing indigenously controlled and innovative SME sector will go some way to improving regional growth prospects, and hence play a role in reducing the GDP per capita gap between Wales and the UK. During the 1990s a series of research and consultancy studies in Wales have been undertaken seeking to audit SME activities, define needs and identify market failures in provision of information and services. These have formed the basis of revised policy and then for new resource directions emanating at the European, regional and local levels. Encouraging innovative activity has been at the forefront of the network of initiatives currently underway in Wales. New initiatives have often been instituted without a clear appreciation of the nature of innovation, and how innovative activities link to innovative outputs and then feed through to improved business performance. This paper examines the link between innovative activity, outcomes and the performance of SMEs in Wales. A range of European, UK and locally developed initiatives in Wales seek to encourage innovative activity in indigenous SMEs. However, it is the contention of this paper that these initiatives have often been instituted without a clear appreciation of how, if, and which innovative activities feed through to improved business performance. The paper offers a general method of assessing the innovative potential (the configuration of management practices, capabilities, internal and external linkages facilitating the generation of appropriation of ideas) of manufacturing SMEs. This then leads on to an examination of how far innovative potential is connected to operational and general business performance. The paper describes how the model was developed and used to assess the innovative potential of a sample of manufacturing SMEs in Industrial South Wales, and how far the innovative potential can be linked to improved operational and business performance. The introduction to the paper reviews current literature on innovation in SMEs, and demonstrates how far recent studies have succeeded in measuring, and then linking innovative inputs of SMEs to innovative outputs and firm performance. The second section builds upon the review to develop a working model of an innovative SME. Innovation is considered not only in terms of new product or process development but more generally as practice. The model reveals the innovative firm as one that identifies, interprets, and applies knowledge effectively, and as appropriate throughout the organisation. The model described represents a synthesis of previous research. Key factors in the model include strategy and the techniques and practices deployed to facilitate the development and appropriation of ideas for innovation. Broadly this focuses on SME commitment to innovation, and management practices supporting this commitment. The third section describes how the model was operationalised into an auditing tool, and then used to assess the innovative potential of a sample of manufacturing SMEs in Industrial South Wales. The fourth section summarises the results from the initial research programme, and in particular, considers whether the unique operating structures usually associated with SMEs hinder or facilitate the adoption of new structures for organisational learning. Moreover the section examines whether the existence of certain configurations of practices coincide with improved business performance and operational efficiencies. The conclusions consider these results in the context of the directions being adopted by current regional SME policy initiatives in Industrial South Wales.

    Organizational Learning Capability in SMEs: An Empirical Development of Innovation in the Supply Chain

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    Evidence that a companyā€™s innovation performance, Knowledge Management capability, and its corporate and operational performance are inextricably linked has been the focus of numerous academic studies over recent years. Whilst a significant body of research exists focusing on learning at company level, little research exists on how supply chains learn and innovate in collaborative working environments. The aim of this paper is to determine the learning and innovation skills that emerged from a collaborative project with new developed supply chain. Its focus is on identifying how each organisation within the supply chain developed its Organisational Learning Capability (OLC) when the companies were tasked to collaborate and develop a new and innovative product. The companies had not previously worked with each other and so the project monitored the level of collaborative activity as well as innovative output from the collaboration. The results suggest that improved organistional learning capabilities led to increased levels of organisational innovation as well as improved supply chain collaboration. The paper concludes with the development of a Supply Chain Organisational Learning and Innovation Framework (SCOLIF) and the identification of a number of cultural dimensions which are considered useful for managers and engineers to consider when implementing innovation project

    Causal mapping and scenario building with multiple organisations

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    Thinking and planning for the future is critical in a competitive business world. Scenarios are a common technique for investigating the future, but can be time-consuming and challenging to develop, particularly when more than a single organisation is involved. An approach is presented here which shifts the focus of scenario building from the company level to the sector level, whereby a range of organisations engage collectively on a topic of mutual importance. A rapid technique was developed, with simple scenarios being constructed in 2 to 4 hours. This process was implemented in 13 multi-organisational workshops with participants from the construction and building industries, sectors which are traditionally short-term and reactive in their outlook. The resulting feedback, observations and experiences are discussed, together with examples of how the resultant scenarios have been applied. An example of causal map reflection (exposing an individualā€™s causal map to others) is also presented, described and critiqued. It was found that the process was successful in engaging participants in thinking about and discussing the future, appreciating the interconnectivities of the related issues, and understanding the collective implications of their potential decisions, as well as facilitating the socialisation of participant thinking and the construction of collective futures
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