The medium-term sustainability of organisational innovations in the national health service

Background: There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working-'organisational innovations'-into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place-and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium-and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods: The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods-in-depth interviews, observation of key meetings, and analysis of relevant documents-to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion: Through comparison and contrast across four sites, each involving different organisational innovations, different forms of leadership, and different organisational contexts to contend with, the findings of the study will have wide relevance. The research will produce outputs that are useful for managers and clinicians responsible for organisational innovation, policy makers and senior managers, and academics

Adaptive management of an active services network

The benefits of active services and networks cannot be realised unless the associated increase in system complexity can be efficiently managed. An adaptive management solution is required. Simulation results show that a distributed genetic algorithm, inspired by observations of bacterial communities, can offer many key management functions. The algorithm is fast and efficient, even when the demand for network services is rapidly varying

Learning, Continuity and Change in Adult Life [Wider Benefits of Learning Research Report No. 3]

This report presents results from extensive fieldwork carried out by the Wider Benefits of Learning research team. It presents an original analytical framework developed specifically for this study, combined with empirical results from 140 in-depth biographical interviews in three different areas of England. The interviews explore the way learning affects people’s health and well-being; their family lives; and their engagement in civic activity. The report addresses these effects at both an individual and collective level. It concludes with a set of significant policy implications

HotMobile 2008: Postconference Report

HotMobile 2008 presented a two-day program on mobile computing systems and applications. The authors focuses on the sessions on sensors, modularity, wireless, security, systems, and screens. The mobile device is the most amazing invention in history and that it has had the largest impact on human kind. Because mobile phones combine mobile devices with ongoing developments in software and communication technologies, they have the potential to change the way people think and act

Adaptation of WASH Services Delivery to Climate Change and Other Sources of Risk and Uncertainty

This report urges WASH sector practitioners to take more seriously the threat of climate change and the consequences it could have on their work. By considering climate change within a risk and uncertainty framework, the field can use the multitude of approaches laid out here to adequately protect itself against a range of direct and indirect impacts. Eleven methods and tools for this specific type of risk management are described, including practical advice on how to implement them successfully

The simplification of complex interactions for more inclusive social communication technologies (position paper)

New technologies, especially smart homes and mobile and ubiquitous technologies have the potential to foster improved quality of life in the older population. Some anticipated benefits are linked to specific applications in areas such as home automation, communication, shopping and health. However, some valuable potential benefits lie in building and sustaining relationships with remote extended family, particularly children and grandchildren, as well as with carers, neighbours and friends. Communication with geographically remote family can play an important role in helping to sustain autonomy, inclusion and independence. Reduction in isolation and improved participation have the potential to improve or sustain quality of life, but in addition they can lead to a reduction in vulnerability and sustained physical health. Another benefit can be to reassure adult children about the viability of their parent's independent living. Broadband "always-on" communications are potentially particularly useful tools in sustaining geographically remote relationships with extended family, as they can support many useful kinds of interaction, using modalities such as voice, video, pervasive annotation, selection, and remote concierging. Unfortunately, many possible new interactions are currently complex to manage, ruling them out on grounds of poor acceptability, accessibility and usability. However, our hypothesis is that a new interaction framework that combines social and technical components could be used to simplify many interactions of the kinds noted above sufficiently to the point where they would be rendered acceptable, accessible and usable. This paper outlines plans to test such a framework

Robotic ubiquitous cognitive ecology for smart homes

Robotic ecologies are networks of heterogeneous robotic devices pervasively embedded in everyday environments, where they cooperate to perform complex tasks. While their potential makes them increasingly popular, one fundamental problem is how to make them both autonomous and adaptive, so as to reduce the amount of preparation, pre-programming and human supervision that they require in real world applications. The project RUBICON develops learning solutions which yield cheaper, adaptive and efficient coordination of robotic ecologies. The approach we pursue builds upon a unique combination of methods from cognitive robotics, machine learning, planning and agent- based control, and wireless sensor networks. This paper illustrates the innovations advanced by RUBICON in each of these fronts before describing how the resulting techniques have been integrated and applied to a smart home scenario. The resulting system is able to provide useful services and pro-actively assist the users in their activities. RUBICON learns through an incremental and progressive approach driven by the feed- back received from its own activities and from the user, while also self-organizing the manner in which it uses available sensors, actuators and other functional components in the process. This paper summarises some of the lessons learned by adopting such an approach and outlines promising directions for future work