Managing Knowledge in Policymaking and Decision Making

The combined effect of increasing problem complexity and growing demand for participation in decisions has forced policymaking and decision making in organizations to become less an analytic endeavor and more a process of "knowledge management ' This requires an intermediarv to mediate among conflicting perspectives and integrate the different forms and levels of knowledge This article describes one such approach to knowledge management that utilizes a third party to create and facilitate a temporary task organization Following a brief case example, some research resultsfrom an evaluation of six past applications of the approach are presented These results provide insight into the effective structuring and conduct of knowledge management proceduresPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68626/2/10.1177_107554708600800106.pd

Dualities and dilemmas: contending with uncertainty in large-scale safety-critical projects

© 2016, Informa UK Limited, trading as Taylor & Francis Group. Uncertainty is a fact of project life. Most decisions that are made on a safety-critical project involve uncertainty, the consequences of which may be highly significant to the safe and timely delivery of the project. Based on interviews with project management practitioners on nine large-scale civil nuclear and aerospace projects, we explore how uncertainty emerges, and how project management practitioners identify, analyse and act on it. We make three important contributions. First, we present three approaches – structural, behavioural and relational – that individuals and organizations can adopt when contending with project uncertainty. Secondly, we characterize nine dualities at play in the management of project uncertainty and thirdly, we identify key differences between how civil nuclear and aerospace project managers confront project uncertainty, which have important implications for how projects might be organized in both these industry sectors. Drawing attention to the structural, behavioural and relational approaches to project uncertainty and the tensions that manifest themselves in each approach should enable the project management community to make progress in environments of high uncertainty where situations are often complex, rapidly changing and confusing, and yet where, for reasons of safety, failure is not an option

It is time to talk about people: a human-centered healthcare system

Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a) Reason's system approach [1] and b) User-centered design [2,3]. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system

What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature

<p>Abstract</p> <p>Background</p> <p>Despite increasing interest and publication of risk-adjusted hospital mortality rates, the relationship with underlying quality of care remains unclear. We undertook a systematic review to ascertain the extent to which variations in risk-adjusted mortality rates were associated with differences in quality of care.</p> <p>Methods</p> <p>We identified studies in which risk-adjusted mortality and quality of care had been reported in more than one hospital. We adopted an iterative search strategy using three databases – Medline, HealthSTAR and CINAHL from 1966, 1975 and 1982 respectively. We identified potentially relevant studies on the basis of the title or abstract. We obtained these papers and included those which met our inclusion criteria.</p> <p>Results</p> <p>From an initial yield of 6,456 papers, 36 studies met the inclusion criteria. Several of these studies considered more than one process-versus-risk-adjusted mortality relationship. In total we found 51 such relationships in a widen range of clinical conditions using a variety of methods. A positive correlation between better quality of care and risk-adjusted mortality was found in under half the relationships (26/51 51%) but the remainder showed no correlation (16/51 31%) or a paradoxical correlation (9/51 18%).</p> <p>Conclusion</p> <p>The general notion that hospitals with higher risk-adjusted mortality have poorer quality of care is neither consistent nor reliable.</p

Psychological Bias as a Driver of Financial Regulation

I propose here the psychological attraction theory of financial regulation—that regulation is the result of psychological biases on the part of political participants—voters, politicians, bureaucrats, and media commentators; and of regulatory ideologies that exploit these biases. Some key elements of the psychological attraction approach are: salience and vividness, omission bias, scapegoating and xenophobia, fairness and reciprocity norms, overconfidence, and mood effects. This approach further emphasizes emergent effects that arise from the interactions of individuals with psychological biases. For example, availability cascades and ideological replicators have powerful effects on regulatory outcomes

Media and health: A continuing concern for health psychology

Take a moment and consider the last 24 hours, reflecting on your interactions with any form of media. Very few of us would not have interacted with a variety of media within that timeframe. Our daily lives are punctuated with mediated experiences, communications via telephone, email or chat rooms and engagements with television, radio, magazines, newspapers, websites, digital games, billboards, packaging and advertising. Our engagements with media are not simple; we use the media for such things as communicating with others, maintaining social networks, accessing information, staying informed, sustaining a sense of self and place and gaining pleasure and entertainment. Much of the content of these media forms and experiences involve health, broadly defined. An obvious example is provided by public health campaigns, but there are many more general examples including encounters with advertisements promoting healthy food, news reports on the wonders of modern medicine, websites offering information on healthy lifestyles and Internet forums providing dialogue around healthy communities