Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: A qualitative study

This article is made available through the Brunel Open Access Publishing Fund - Copyright @ 2011 Barnett et al.Background: Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods: A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results: Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions: A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly.This research was supported financially by the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH)

Investing in Curation: A Shared Path to Sustainability

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Oversight of non-cash payment schemes: objectives and implementation procedures.

The use of non-cash payment schemes is particularly widespread in France where the number of non-cash transactions is in fact well above the European average. Though they have different features corresponding to users’ varying needs (payments may be face-to-face, remote or recurring, for instance), non-cash payment schemes generally consist of an instrument that generates a payment order combined with the technical and organisational arrangements that enable this order to be processed. Putting these arrangements in place requires close co-operation between all participants of the payment «network», i.e., naturally, credit institutions that hold accounts for debtors and beneficiaries, and also their technical service providers. The Everyday Security Act of 15 November 2001 entrusts the Banque de France with a specific task with regard to overseeing the security of non-cash means of payment. This task falls naturally within the purview of central banks, which guarantee both the value of the currency and the stability of payment systems. To carry out its task, the Banque de France analyses the potential threats associated with payment schemes and defines, in consultation with the parties involved, the minimum security objectives designed to prevent the occurrence of payment-specific risk events. To assess the security of a payment scheme, the Banque de France ensures that the parties involved comply with these objectives.

Pedagogically informed metadata content and structure for learning and teaching

In order to be able to search, compare, gap analyse, recommend, and visualise learning objects, learning resources, or teaching assets, the metadata structure and content must be able to support pedagogically informed reasoning, inference, and machine processing over the knowledge representations. In this paper, we present the difficulties with current metadata standards in education: Dublin Core educational version and IEEELOM, using examples drawn from the areas of e-learning, institutional admissions, and learners seeking courses. The paper suggests expanded metadata components based on an e-learning system engineering model to support pedagogically informed interoperability. We illustrate some examples of the metadata relevant to competency in the nurse training domain

Models for online, open, flexible and technology enhanced higher education across the globe – a comparative analysis

Digital technology has become near ubiquitous in many countries today or is on a path to reach this state in the near future. Across the globe the share of internet users, for instance, has jumped in the last ten years. In Europe most countries have a share of internet users near to or above 90% in 2016 (last year available for international comparisons), in China the current share is 53%, but this has grown from just 16% in 2007, even in Ethiopia the share has grown from 0.4% to 15.4% in the same period (data from ITU). At the same time expectations of widespread adoption of digital solutions in higher education have been rising. In 2017 the New Media Consortium’s Horizon Report predicted that adaptive learning would take less than a year to be widely adopted (Adams Becker et al., 2017). And projects such as ‘Virtually Inspired’ are showcasing creative examples of how new technologies are already being harnessed to improve the quality of teaching and learning. Furthermore, discussion of the United Nations’ Sustainable Development Goals emphasise the key potentials that digital technology holds for achieving the goals for education in 2030 (UNESCO, 2017). These developments lead university and college leadership to the question of how they should position their institution. What type of digitalisation initiatives can be found practice beyond best practices and future potentials? This is the question that this study attempts to answer. It sets out to analyse how higher education providers from across the world are harnessing digitalisation to improve teaching and learning and learner support and to identify emerging types of practice. For this, it focuses on the dimensions of flexibility of provision (in terms of time, place and pace) and openness of provision (in terms of who has access to learning and support and who is involved in the design of learning provision), as both of these dimensions can significantly benefit from integration of digital solutions. The method of information collation used by the study was a global survey of higher education institutions (HEIs) covering all world continents, more than thirty countries and 69 cases. The survey found that nearly three-quarters of all HEIs have at least one strategic focus and typologies were developed based on this analysis to group HEIs with similar strategic focuses. Overall, the findings suggest that most higher education providers are just at the beginning of developing comprehensive strategies for harnessing digitalisation. For this reason, the authors of this study believe that providers can benefit from the outcomes of this study’s research, as it can be used by university and college leadership for benchmarking similarities and differences and for cooperative peer learning between institutions. The database of cases and the guidelines for reviewing current strategies, which accompany this study, aim to facilitate this learning and evaluation process