Organizational influences on innovation to improve quality in health care

With medical evidence constantly advancing, the health care system faces pressure to generate, apply and integrate innovations to improve the quality of patient care. This dissertation examines how organizational characteristics influence these processes. The first study, a systematic review, investigates how organizational features influence the translation of basic research findings to clinical applications. Results showed a dearth of peer-reviewed literature on this topic, despite a proliferation of efforts to accelerate translational research by manipulating organizational structures and processes. Few studies effectively linked structures, processes and outcomes and no organizational feature was associated conclusively with translation of research into clinical practice. The second study draws on in-depth qualitative interviews (82 participants at 10 hospitals) to understand how hospitals that reduced readmission rates had applied innovations in clinical practice and organizational context. High performing and low performing hospitals had both implemented similar clinical practice changes in their efforts to reduce readmissions; however, high performing hospitals reported greater investment in creating an organizational context to facilitate readmissions. This included more extensive efforts to improve collaboration within the hospital, greater coordination between the hospital and outside providers, deeper engagement in learning and problem solving related to readmissions, and greater senior leadership support. The third study draws on an expanded set of interviews from the same data collection (90 participants at 10 hospitals) to investigate mechanisms through which innovations become integrated into hospital routines. Despite a well-developed literature on the initial implementation of new practices, we have limited knowledge about the mechanisms by which integration occurs. Results showed that when an innovation was integrated successfully, a small number of key staff held the innovation in place for as long as a year while more permanent integrating mechanisms began to work. Innovations that proved intrinsically rewarding to staff integrated through shifts in attitudes and norms over time. Innovations that did not provide direct benefits to staff were integrated through changed incentives or automation. Together, these studies illuminate opportunities for hospitals to improve patient care by managing the organizational context in which innovations are deployed. Understanding how organizational context affects translation requires further research.2017-10-02T00:00:00

Facilitating Humanitarian Access to Pharmaceutical and Agricultural Innovation

Calls for intellectual property licensing strategies in the pharmaceutical and agricultural sectors that promote humanitarian access to product innovations for the benefit of the disadvantaged. Includes profiles of successful and promising strategies

Sustainable Community-Based Solutions: Source to Tap and Back Again

This article reflects the thoughts and conclusions of a session sponsored by the Women in Water Programme Steering Committee of the International Water Association (IWA) at the Second IWA Development Congress and Exhibition held in Kuala Lumpur, Malaysia in November 2011. The session, held on 24 November, examined the role women can play in community-based water and sanitation solutions in urbanizing areas. Such solutions range from watershed protection and integrated water resources management (IWRM), to capacity development and stakeholder mobilization. The cases presented reflect the experience and results of projects undertaken by the authors in Asia. The experience of each author brings a broad range of approaches to tackling the challenges faced by water managers in densely populated urban areas. These provide the basis for innovative solutions to expand coverage, strengthen service provision and create new businesses. The article explores ways for communities to work together more effectively to increase knowledge and understanding of the wide variety of interests that exist in a water basin. In particular, community-based solutions can promote protection of the sources of water, and sustainable water and sanitation management. Source to tap and back again speaks to the imperative that all people understand the relationship between upstream and downstream users, and that both women and men be involved in resource management. This article addresses the following issues: Watershed management and urbanization; Community-based approaches for sustainable sanitation in urban areas; The leadership and participation of women in IWRM research and development; and Targeting capacity building programs to empower women water professionals in Asia

Reversible Luminescent Reaction of Amines with Copper(i) Cyanide

Copper(I) cyanide exposed to various liquid or vapor-phase amines (L) at ambient temperature produces a variety of visible photoluminescence colors via reversible formation of amine adducts. The adducts show phase matches to authentic (CuCN)Ln, n = 0.75–2.0, produced by heating CuCN with liquid amine

Active Steps Evaluation: Full Report

Background: Active Steps is a remote behaviour change service supporting inactive adults with a lung condition to become physically active. Aim: To determine the efficacy of Active Steps in improving physical activity and quality life

Volunteer role mastery and commitment: Can HRM make a difference?

Although the literature on human resource management (HRM) has provided compelling evidence that certain HRM practices can help employees attain the competence and confidence to carry out their role, less is known about the potential impact of HRM practices on volunteers in the context of non-profit organisations. This study addresses this gap by presenting a model that situates role mastery – operationalised as role clarity and self-efficacy – as its centrepiece. Our model suggests that role mastery leads to commitment to the volunteer organisation and that role mastery can be achieved through training and supportive relationships with paid staff. A dual-mediation analysis of survey data from a humanitarian non-profit organisation in the United Kingdom (n=647) supported our theoretical model. We contribute to volunteering theory and practice by identifying tools that non-profit organisations can employ to maximise the role mastery and commitment of volunteers