90 research outputs found
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Integrating Emerging River Forecast Center Streamflow Products Into the Salt Lake City Parley’s Drinking Water System
Seasonal forecasts of weather provide valuable information for reservoir operations, particularly during unusual events, such as floods or droughts. A challenge confronting reservoir operators today is whether to incorporate new climate products into their operations to help manage such extremes or to use historic data to guide them. This research evaluates the accuracy and value of the Hydrologic Ensemble Forecast System (HEFS) generated from the Climate Forecast System version 2 (CFSv2) using the operations of the Salt Lake City Parley’s System nd compares it to the accuracy and value of using an Ensemble Streamflow Predictions (ESP) approach. Streamflow reforecasts are generated and used to evaluate the predictive skill of the HEFS in reservoir management. Using the HEFS may offer more insight when responding to climate driven extremes than the ESP approach because the HEFS incorporates a fully coupled climate model into its forecasts rather than relying on the historic record
Pengaruh Kecemasan Bertanding Dengan Peranan Psikologi Olahraga Dalam Meningkatkan Prestasi Atlet Judo Padepokan Judo Kesatria Bhayangkara
Penelitian ini bertujuan untuk mengetahui hubungan kecemasan
bertanding dengan peranan psikologi olahraga dalam pencapaian meningkatkan
prestasi atlet judo Padepokan Judo Kesatria Bhayangkara. Penelitian ini dilakukan
pada bulan Juli sampai dengan bulan Agustus yang bertempat di Dojo Sepolwan
yang berlokasikan Komplek Sepolwan Lemdiklat Polri Pondok Pinang Kec.
Kebayoran Lama, Jakarta Selatan, DKI Jakarta. Metode penelitian yang
digunakan dalam penelitian ini yaitu metode deskriptif kualitatif dengan teknik
pengambilan datamenggunakan google form yang disebarkan kepada atlet pelatda
Judo DKI Jakarta. Angket google form diisi oleh 69 orang atlet Padepokan Judo
Kesatria Bhayangkara dan menghasilkan beberapa aspek psikologi yang berperan
dalam pencapaian prestasi. Aspek yang ditemukan dalam penelitian ini yaitu
aspek emosi, aspek agresivitas, aspek motivasi, aspek kecerdasan, aspek
keperayaan diri, aspek kecemasan, dan aspek disiplin. Pada hakikatnya peranan
psikologi olahraga sangatlah penting dalam pembinaan prestasi atlet, untuk
mengetahui faktor-faktor apa saja yang berpengaruh langsung terhadap atlet atau
faktor-faktor dari luar yang dapat mempengaruhi penampilan atlet, ataupun
mental atlet
Nursing Home Referrals within the Veterans Health Administration: Variation by Site and Payment for Care
Background: Veterans may receive Veterans Health Administration (VHA)-paid nursing home (NH) care in VHA Community Living Centers (CLCs), state veterans homes (SVHs), or community NHs; Veterans Affairs Medical Centers (VAMCs) must provide VHA-paid NH care to highly service connected (mandatory) Veterans; VAMCs have discretion to provide VHA-paid care to other Veterans, if resources allow. Study Objective: To examine how Veterans’ eligibility for different types of payment sources—VHA, Medicare, Medicaid, other—informs NH referral within the VHA
Whom Should We Talk to? Investigating the Varying Roles of Internal and External Relationship Quality on Radical and Incremental Innovation Performance
Research suggests that close relationships with internal and external partners are likely to have a significant impact on new product development (NPD). What is unclear is how the effects of internal and external relationships influence development paths for different types of innovations. Prior literature indicates that the pathways for developing incremental innovations differ considerably from those for radical innovations. Thus it is plausible that the effects of external versus internal relationships vary across these two innovation types. This paper uses the 2012 Comparative Performance Assessment Study (CPAS) data set to investigate the roles of internal and external relationship quality on the development of both incremental and radical innovations. The results find that internal and not external relationship quality is beneficial for the development of incremental innovations. When driven by internal relationships, a flexible NPD process is advantageous for the financial performance of incremental innovations. Meanwhile external and not internal relationship quality is valuable for developing radical innovations. External relationship quality results in process flexibility, leading to project execution success and subsequent financial performance for radical innovations. As expected, project execution success consistently leads to increased financial performance. These findings indicate the critical differences in types of relationship quality required when developing new products based on radical versus incremental innovations. © 2016 Product Development & Management Associatio
Evaluating implementation of methicillin-resistant Staphylococcus aureus (MRSA) prevention guidelines in spinal cord injury centers using the PARIHS framework: a mixed methods study
BACKGROUND: To prevent methicillin-resistant Staphylococcus aureus (MRSA) in Spinal Cord Injury and Disorder (SCI/D) Centers, the Guidelines for Implementation of MRSA Prevention Initiative in the Spinal Cord Injury Centers were released in July 2008 in the Veterans Affairs (VA) Health Care System. The purpose of this study was to use the Promoting Action on Research Implementation in Health Systems (PARiHS) framework to evaluate the experiences of implementation of SCI/D MRSA prevention guidelines in VA SCI/D Centers approximately 2-3 years after the guidelines were released.
METHODS: Mixed methods were used across two phases in this study. The first phase included an anonymous, web-based cross-sectional survey administered to providers at all 24 VA SCI/D Centers. The second phase included semi-structured telephone interviews with providers at 9 SCI/D Centers. The PARiHS framework was used as the foundation of both the survey questions and semi-structured interview guide.
RESULTS: The survey was completed by 295 SCI/D providers (43.8 % response rate) from 22 of the 24 SCI/D Centers (91.7 % participation rate). Respondents included nurses (57.3 %), therapists (24.4 %), physicians (11.1 %), physician assistants (3.4 %), and other health care professionals (3.8 %). Approximately 36 % of the SCI/D providers surveyed had not seen, did not remember seeing, or had never heard of the MRSA SCI/D guidelines, whereas 42.3 % of providers reported that the MRSA SCI/D guidelines were fully implemented in their SCI/D Center. Data revealed numerous barriers and facilitators to guideline implementation. Facilitators included enhanced leadership support and provider education, focused guideline dissemination to reach SCI/D providers, and strong perceived evidence supporting the guidelines. Barriers included lack of awareness of the guidelines among physical therapists and physician assistants and challenges in cohorting/isolating MRSA-positive patients and following contact precautions.
CONCLUSIONS: Successful implementation of MRSA infection prevention guidelines in SCI/D settings requires (1) guideline dissemination that reaches the full range of SCI/D providers working in inpatient, outpatient, and other care settings, (2) provider education that is frequent and systematic, (3) strong leadership support, and (4) that barriers unique to the recommendations are addressed. These findings may be used to inform selection of implementation strategies and optimize infection prevention beyond MRSA as well as in other specialty care populations
Appropriate and inappropriate relationship: David's story
Table of study survey and interview questions mapped to PARiHS elements and sub-elements. Survey and interview questions mapped to the PARiHS framework elements and sub-elements
A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework
<p>Abstract</p> <p>Background</p> <p>The Promoting Action on Research Implementation in Health Services framework, or PARIHS, is a conceptual framework that posits key, interacting elements that influence successful implementation of evidence-based practices. It has been widely cited and used as the basis for empirical work; however, there has not yet been a literature review to examine how the framework has been used in implementation projects and research. The purpose of the present article was to critically review and synthesize the literature on PARIHS to understand how it has been used and operationalized, and to highlight its strengths and limitations.</p> <p>Methods</p> <p>We conducted a qualitative, critical synthesis of peer-reviewed PARIHS literature published through March 2009. We synthesized findings through a three-step process using semi-structured data abstraction tools and group consensus.</p> <p>Results</p> <p>Twenty-four articles met our inclusion criteria: six core concept articles from original PARIHS authors, and eighteen empirical articles ranging from case reports to quantitative studies. Empirical articles generally used PARIHS as an organizing framework for analyses. No studies used PARIHS prospectively to design implementation strategies, and there was generally a lack of detail about how variables were measured or mapped, or how conclusions were derived. Several studies used findings to comment on the framework in ways that could help refine or validate it. The primary issue identified with the framework was a need for greater conceptual clarity regarding the definition of sub-elements and the nature of dynamic relationships. Strengths identified included its flexibility, intuitive appeal, explicit acknowledgement of the outcome of 'successful implementation,' and a more expansive view of what can and should constitute 'evidence.'</p> <p>Conclusions</p> <p>While we found studies reporting empirical support for PARIHS, the single greatest need for this and other implementation models is rigorous, prospective use of the framework to guide implementation projects. There is also need to better explain derived findings and how interventions or measures are mapped to specific PARIHS elements; greater conceptual discrimination among sub-elements may be necessary first. In general, it may be time for the implementation science community to develop consensus guidelines for reporting the use and usefulness of theoretical frameworks within implementation studies.</p
Inter-operator and inter-device agreement and reliability of the SEM Scanner
AbstractObjectiveThe SEM Scanner is a medical device designed for use by healthcare providers as part of pressure ulcer prevention programs. The objective of this study was to evaluate the inter-rater and inter-device agreement and reliability of the SEM Scanner.MethodsThirty-one (31) volunteers free of pressure ulcers or broken skin at the sternum, sacrum, and heels were assessed with the SEM Scanner. Each of three operators utilized each of three devices to collect readings from four anatomical sites (sternum, sacrum, left and right heels) on each subject for a total of 108 readings per subject collected over approximately 30 min. For each combination of operator-device-anatomical site, three SEM readings were collected. Inter-operator and inter-device agreement and reliability were estimated.ResultsOver the course of this study, more than 3000 SEM Scanner readings were collected. Agreement between operators was good with mean differences ranging from −0.01 to 0.11. Inter-operator and inter-device reliability exceeded 0.80 at all anatomical sites assessed.ConclusionThe results of this study demonstrate the high reliability and good agreement of the SEM Scanner across different operators and different devices. Given the limitations of current methods to prevent and detect pressure ulcers, the SEM Scanner shows promise as an objective, reliable tool for assessing the presence or absence of pressure-induced tissue damage such as pressure ulcers
Role of "external facilitation" in implementation of research findings: a qualitative evaluation of facilitation experiences in the Veterans Health Administration
BACKGROUND: Facilitation has been identified in the literature as a potentially key component of successful implementation. It has not, however, either been well-defined or well-studied. Significant questions remain about the operational definition of facilitation and about the relationship of facilitation to other interventions, especially to other change agent roles when used in multi-faceted implementation projects. Researchers who are part of the Quality Enhancement Research Initiative (QUERI) are actively exploring various approaches and processes, including facilitation, to enable implementation of best practices in the Veterans Health Administration health care system – the largest integrated healthcare system in the United States. This paper describes a systematic, retrospective evaluation of implementation-related facilitation experiences within QUERI, a quality improvement program developed by the US Department of Veterans Affairs. METHODS: A post-hoc evaluation was conducted through a series of semi-structured interviews to examine the concept of facilitation across several multi-site QUERI implementation studies. The interview process is based on a technique developed in the field of education, which systematically enhances learning through experience by stimulating recall and reflection regarding past complex activities. An iterative content analysis approach relative to a set of conceptually-based interview questions was used for data analysis. FINDINGS: Findings suggest that facilitation, within an implementation study initiated by a central change agency, is a deliberate and valued process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship. Facilitation was described primarily as a distinct role with a number of potentially crucial behaviors and activities. Data further suggest that external facilitators were likely to use or integrate other implementation interventions, while performing this problem-solving and supportive role. PRELIMINARY CONCLUSIONS: This evaluation provides evidence to suggest that facilitation could be considered a distinct implementation intervention, just as audit and feedback, educational outreach, or similar methods are considered to be discrete interventions. As such, facilitation should be well-defined and explicitly evaluated for its perceived usefulness within multi-intervention implementation projects. Additionally, researchers should better define the specific contribution of facilitation to the success of implementation in different types of projects, different types of sites, and with evidence and innovations of varying levels of strength and complexity
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