Safer clinical systems : interim report, August 2010

Safer Clinical Systems is the Health Foundation’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

Barriers to obesity communication - Power, habitus and hidden assumptions

Communication on health issues often founders on the avoidance or denial of key messages by intended recipients. This paper explores the development and application of a research methodology combining elements of Pierre Bourdieu’s work on the unconscious nature of practice with Gerhard Maletzke’s psychological model of communication. This combination was designed to elicit deeper responses than those often found in health communication research. This alternative methodological approach was used to evaluate a year-long, city-wide anti-obesity campaign in Sheffield, UK, which targeted key gatekeepers in the message chain; their responses generate useful insights into resistance to uncomfortable communication. The paper concludes with suggestions for addressing communication about obesity and potentially other uncomfortable health and social topics

Franchising in Frontier Markets: What's Working, What's Not, and Why

Summarizes research on franchising as a way to scale small businesses and, in turn, provide jobs and economic and skills development in Africa and South Asia. Examines successful models, conditions, challenges, barriers, and synergies with microfinance

Technology adoption in the BIM implementation for lean architectural practice

Justification for Research: the construction companies are facing barriers and challenges in BIM adoption as there is no clear guidance or best practice studies from which they can learn and build up their capacity for BIM use in order to increase productivity, efficiency, quality, and to attain competitive advantages in the global market and to achieve the targets in environmental sustainability. Purpose: this paper aims to explain a comprehensive and systemic evaluation and assessment of the relevant BIM technologies as part of the BIM adoption and implementation to demonstrate how efficiency gains have been achieved towards a lean architectural practice. Design/Methodology/Approach: The research is undertaken through a KTP (Knowledge transfer Partnership) project between the University of Salford and the John McCall Architects based in Liverpool, which is an SME (Small Medium Enterprise). The overall aim of KTP is to develop Lean Design Practice through the BIM adoption and implementation. The overall BIM implementation approach uses a socio-technical view in which it does not only consider the implementation of technology but also considers the socio-cultural environment that provides the context for its implementation. The technology adoption methodology within the BIM implementation approach is the action research oriented qualitative and quantitative research for discovery, comparison, and experimentation as the KTP project with JMA provides an environment for “learning by doing” Findings: research has proved that BIM technology adoption should be undertaken with a bottom-up approach rather than top-down approach for successful change management and dealing with the resistance to change. As a result of the BIM technology adoption, efficiency gains are achieved through the piloting projects and the design process is improved through the elimination of wastes and value generation. Originality/Value: successful BIM adoption needs an implementation strategy. However, at operational level, it is imperative that professional guidelines are required as part of the implementation strategy. This paper introduces a systematic approach for BIM technology adoption based on a case study implementation and it demonstrates a guideline at operational level for other SME companies of architectural practices

Family orientation, strategy and organizational learning as predictors of knowledge management in Dutch SMEs

Knowledge management (KM) is becoming a growing concern in management research and practice because of its role in determining firm innovation capability and in enhancing working life quality of knowledge workers. Although research and policy interest in KM is beginning to grow for small and medium-sized suppliers, still relatively limited attention has been paid to understand the specifics of KM issues of SMEs in particular. Previous studies rely on either qualitative case studies or very small samples. In this study, we will investigate KM among SMEs using empirical data from about 2000 SMEs. The aim of this study is to investigate the prevalence of different KM techniques and the determinants of KM. We found that SMEs are most likely to acquire knowledge by staying in touch with professionals and experts outside the company. Also, SMEs are most likely to share knowledge and experience by talking to each other and to store knowledge in formal repositories. Furthermore, we found a significant positive relationship between organizational learning and strategy and knowledge management, as well as a significant negative relationship between family orientation and knowledge management. In conclusion, knowledge management practices are not independent from other resources and processes inside SMEs. Therefore, there is no all-in-one knowledge management practices package for all types of SMEs across industries.

mFish Alpha Pilot: Building a Roadmap for Effective Mobile Technology to Sustain Fisheries and Improve Fisher Livelihoods.

In June 2014 at the Our Ocean Conference in Washington, DC, United States Secretary of State John Kerry announced the ambitious goal of ending overfishing by 2020. To support that goal, the Secretary's Office of Global Partnerships launched mFish, a public-private partnership to harness the power of mobile technology to improve fisher livelihoods and increase the sustainability of fisheries around the world. The US Department of State provided a grant to 50in10 to create a pilot of mFish that would allow for the identification of behaviors and incentives that might drive more fishers to adopt novel technology. In May 2015 50in10 and Future of Fish designed a pilot to evaluate how to improve adoption of a new mobile technology platform aimed at improving fisheries data capture and fisher livelihoods. Full report

Interactive situation modelling in knowledge intensive domains

Interactive Situation Modelling (ISM) method, a semi-methodological approach, is proposed to tackle issues associated with modelling complex knowledge intensive domains, which cannot be easily modelled using traditional approaches. This paper presents the background and implementation of ISM within a complex domain, where synthesizing knowledge from various sources is critical, and is based on the principles of ethnography within a constructivist framework. Although the motivation for the reported work comes from the application presented in the paper, the actual scope of the paper covers a wide range of issues related to modelling complex systems. The author firstly reviews approaches used for modelling knowledge intensive domains, preceded by a brief discussion about two main issues: symmetry of ignorance and system behaviour, which are often confronted when applying modelling approaches to business domains. The ISM process is then characterized and critiqued with lessons from an exemplar presented to illustrate its effectiveness