Improving health and public safety through knowledge management

This paper reports on KM in public healthcare and public safety. It reflects the experiences of the author as a CIO (Chief Information Officer) in both industries in Australia and New Zealand. There are commonalities in goals and challenges in KM in both industries. In the case of public safety a goal of modern policing theory is to move more towards intelligence-driven practice. That means interventions based upon research and analysis of information. In healthcare the goals include investment in capacity based upon knowledge of healthcare needs, evidence-based service planning and care delivery, capture of information and provision of knowledge at the point-of-care and evaluation of outcomes. The issue of knowledge management is explored from the perspectives of the user of information and from the discipline of Information Technology and its application to healthcare and public safety. Case studies are discussed to illustrate knowledge management and limiting or enabling factors. These factors include strategy, architecture, standards, feed-back loops, training, quality processes, and social factors such as expectations, ownership of systems and politics

Cancer Care Coordinators: Realising the Potential for Improving the Patient Journey

A person diagnosed with cancer can receive multiple treatments in a variety of different health care settings over extended periods of time1. During this time, they come into contact with multiple health care providers. For example, one recent UK study reported that cancer patients with a diagnosis of less than one year had met 28 doctors on average since their diagnosis2. Add to this the many other health professionals with whom the patient will come into contact during their illness and the complex maze that can characterise the patient’s cancer journey is obvious. The Optimising Cancer Care in Australia report3 published in 2003 by the peak cancer organisations in Australia concluded that there are many places for the person with cancer to get lost in the system, causing unnecessary morbidity and undue distress. The lack of an integrated care system for people with cancer was identified as a major failing of today’s health system3. A number of states in Australia have moved to appoint cancer care coordinators as a strategy to address such problems. In Queensland, cancer coordination positions have been established in a number of Health Service Districts in the Southern and Central Zone of the State, initially to scope patterns of care, referral pathways and to define a cancer coordination model for their regions that is consistent across the state, but able to meet the local needs of the population. To support its Cancer Clinical Service Framework, the NSW Health Department plans to recruit up to 50 cancer nurse coordinators. Cancer nurse coordinators in NSW will work through Lead Clinicians and Directors of Area Cancer Services to support oncology team meetings, develop care pathways and protocols, and provide a direct source of contact for patients and primary care physicians accessing cancer services4. In Victoria, a number of program coordinators and regional nurse coordinators have been introduced as part of the breast services enhancement program. Individual institutions have also established nurse coordinator roles for specific tumour streams. The cancer care coordinator role is a rapidly emerging one with a mandate to achieve some potentially far-reaching reforms to systems of care. To ensure these developments realise their potential, it is timely to consider the most effective ways to design and implement models of care coordination thatachieve the improvements being sought for the Australian cancer care system

Study of Potential Integrated Management of Water Resources in Las Vegas Valley

Water resource management under short term system perturbations such as storms and longer-term systemic changes caused by climate change such as droughts is a challenge when multiple agencies are involved. To address this challenge this research focuses on water management under changing climate conditions and population growth through understanding the agency water jurisdictions, management strategies, and modes of operation in Las Vegas Valley. A framework for integrated management through sharing data and models is presented that combines drinking water supply, flood control, and waste water treatment. This framework can be adopted to improve coordination among different water management agencies

Achieving Better Chronic Care at Lower Costs Across the Health Care Continuum for Older Americans

Outlines challenges to improving care for seniors, such as fragmentation of financing and care; promising models for infrastructure development, targeted care delivery improvements, and innovative payment methods; and resources in the 2010 reform act

Toward a Process Theory of Making Sustainability Strategies Legitimate in Action

We draw on a three-year qualitative study of the processual dynamics of implementing a sustainability strategy alongside an existing mainstream competitive strategy. We show that despite the legitimacy of the sustainability strategy at the organizational level, actors experience tensions with its implementation at the action level vis-à-vis the mainstream strategy, thus creating the potential for decoupling. Our findings show that working through these tensions on specific tasks, enables actors to legitimate the sustainability strategy in action and to co-enact it with the mainstream strategy within those tasks. Cumulatively, multiple instances of such co-enactment at the action level reinforce the organizational-level legitimacy of the sustainability strategy and its integration with the mainstream strategy. We draw these findings together into a dynamic process model that contributes to the literature on integration of dual strategies at the action and organizational levels as a process of legitimacy making

Performance appraisal systems in private Universities in Nigeria: A Study of Crawford University, Igbesa- Nigeria

The aim of this study was to evaluate the effectiveness of performance appraisal system at private universities in Nigeria. The focus of the study was on the administrative staff of Crawford University. The study evaluated the purpose of performance appraisal in private universities and identifies relevant factors for achieving an effective performance appraisal. A cross- sectional survey was selected for this study because it was easy to undertake compared to longitudinal survey and the results from the same can be inferred to the larger population. The study population was for all the administrative staff of Crawford University. The whole populations of staff were selected as respondents. A structured questionnaire was used to collect the data for analysis. The analysis of collected data was done by the help of SPSS and presented using descriptive statistics, frequency tables and percentages. The findings from the study have established that performance appraisal system is the only tangible metric way by which an organization can know the level of performance of its diverse members of staff. The effectiveness of performance appraisal systems in private universities are only based on training the members of staff involved in the rating/ appraising process and are multi- rating systems. Conclusively because the performance appraisal systems used in private universities are not effective and that they exist just as a matter of formalities, the private universities cannot measure members of staff performance, hence making it difficult to achieve the intended human resource management objective