Stakeholder challenges in purchasing medical devices for patient safety.

OBJECTIVE: This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. METHODS: Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. RESULTS: The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. CONCLUSIONS: The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.

Stakeholder engagement in early stage product-service system development for healthcare informatics

This paper presents the findings from four case studies on stakeholder engagement in new health information and communication technology (ICT) product-service system (PSS) development. The degree of connectivity between the new health ICT PSS and its intended operating environment has emerged to be an important contextual factor that may impact the decision of stakeholder engagement in the early stage development process. Along with the proposition of a four-level framework to guide stakeholder identification for new PSS development, three stakeholder engagement propositions that are based on the degree of connectivity are developed. Analysis has shown that there can be two types of connectivity: data and process. Moreover, each connectivity type can be characterized by how much the new PSS is connected with its environment: independent if there is no linkage, linked if it interfaces with, or incorporated if it is embedded into. Furthermore, depending upon whether and to what extent the PSS has data and process connectivity with its intended operating environment, the stakeholder engagement needs in early stage development vary. The propositions presented in this paper provide important directions for future work exploring PSS characterization and stakeholder engagement decision in early stage new PSS development in the healthcare industry. © 2013 PICMET.

Building more sustainable solutions in production-consumption systems: the case of food for people with reduced access

In new product development, the ability to integrate different dimensions of sustainability at a value chain level is still a complex, problematic goal. As product-service approaches are increasingly enabling the introduction of more sustainable paths, this paper describes the authors' experience thus far when building insights into conditions for the implementation of integrated solutions in a process of co-development and testing in real life conditions, which are driven by a social need focusing on food for people with reduced access. Throughout this process, which brought together producers, consumers and other stakeholders to design and test industrialised, sustainable solutions, empirical evidence demonstrates feasibility and usefulness of the approach and insight into the conditions for implementing interactive, comprehensive multi-stakeholder processes in real life situations. In addition, results show that the delivery of innovative solutions enabled to offer social added value, economic profits and environmental improvements under specific experimental conditions. © 2006 Elsevier Ltd. All rights reserved.

Community-led resettlement: From a flood affected slum to a new society in Pune, India

This paper describes the resettlement process of a community devastated by annual floods, to newly constructed housing in Pune, India. The relocation from Kamgar Putala slum to a housing society at Hadapsar was organized by a community-led NGO partnership in 2004. The housing development was coordinated by the local NGO Shelter Associates with significant community participation. The housing has been revisited in 2010 to evaluate the sustainability of the resettlement project’s delivery model via stakeholder perception. The process of organizing for resettlement after natural disaster is described along with the implementation and evaluation of the new housing nearly six years after initial occupation. The strong partnership approach overcame a series of political and financial hurdles at various stages of the relocation project. The story of resettling Kamgar Putala is detailed alongside an outline of the current political climate for an alternative slum-upgrading policy in India and Pune. The advantages of an empowered community supported by an influential local NGO demonstrate a commendable team effort which has tackled the threat of floods. The paper highlights the merits of a community-led partnership approach to housing development for achieving sustainable urban development as well as the alleviation of poverty in a developing context.

Community-led resettlement: From a flood-affected slum to a new society in Pune, India

This paper describes the resettlement process of a community devastated by annual floods, to newly constructed housing in Pune, India. The relocation from Kamgar Putala slum to a housing society at Hadapsar was organized by a community-led NGO partnership in 2004. The housing development was coordinated by the local NGO Shelter Associates with significant community participation. The housing has been revisited in 2010 to evaluate the sustainability of the resettlement project's delivery model via stakeholder perception. The process of organizing for resettlement after natural disaster is described along with the implementation and evaluation of the new housing nearly six years after initial occupation. The strong partnership approach overcame a series of political and financial hurdles at various stages of the relocation project. The story of resettling Kamgar Putala is detailed alongside an outline of the current political climate for an alternative slum-upgrading policy in India and Pune. The advantages of an empowered community supported by an influential local NGO demonstrate a commendable team effort which has tackled the threat of floods. The paper highlights the merits of a community-led partnership approach to housing development for achieving sustainable urban development as well as the alleviation of poverty in a developing context. © 2011 Taylor & Francis.

Strategies to reduce the carbon footprint of consumer goods by influencing stakeholders

Consumer goods contribute to anthropogenic climate change across their product life cycles through carbon emissions arising from raw materials extraction, processing, logistics, retail and storage, through to consumer use and disposal. How can consumer goods manufacturers make stepwise reductions in their product life cycle carbon emissions by engaging with, and influencing their main stakeholders? A semi-structured interview approach was used: to identify strategies and actions, stakeholders in the consumer goods industry (suppliers, manufacturers, retailers and NGOs) were interviewed about carbon emissions reduction projects. Based on this, a summarising presentation was made, which was shared during a second round of interviews to validate and refine the results. The results demonstrate several opportunities that have not yet been exploited by companies. These include editing product choice in stores to remove products with higher carbon footprints, using marketing competences for environmental benefits, and bundling competences to create winewinewin business models. Governments and NGOs have important enabling roles to accelerate industry change. Although this work was initially developed to explore how companies can reduce life cycle carbon emissions of their products, these strategies and actions also give insights on how companies can influence and anticipate stakeholder actions in general. © 2012 Elsevier Ltd. All rights reserved.

A Comparative Picture of Corporate Social Responsibility Approaches by Leading Companies in the United Kingdom and Brazil

Purpose - This paper compares CSR strategy, stakeholder engagement and overseas approaches of six leading companies which have large potential environmental and social impacts, influential stakeholders and notable CSR actions. Design/methodology/approach - It is an exploratory survey based on interviews of senior executives from British and Brazilian companies operating in the steel, petroleum and retail sectors and makes comparisons between and within them. Findings - British companies interviewed are more rule-based, adopt an implicit CSR approach; react to stakeholder’s demands based on moral motives and focus on environmental issues. The Brazilian companies, reviewed in this study, adopt an explicit CSR approach, have relational motives to engage with stakeholders and are more concerned with building a responsible image and narrowing social gaps. Research limitations/implications - The survey is based on perceptions of senior executives interviewed which may or may not correspond to actual practices. The sample size restricts generalization of results and specific firms interviewed may not represent the prevailing CSR business strategy in their respective countries. Practical implications - British companies can learn from the Brazilian experience how to become more innovative in a broader approach to CSR. Brazil should reinforce its legal framework to provide a more systematic and rule-based approach to CSR close to the UK experience. Originality/value - The way CSR is conceived and implemented depends on the ethical, socioeconomic, legal and institutional environment of the country in which the firm operates

A value mapping tool for sustainable business modelling

Purpose: Although business models that deliver sustainability are increasingly popular in the literature, few tools that assist in sustainable business modelling have been identified. This paper investigates how businesses might create balanced social, environmental and economic value through integrating sustainability more fully into the core of their business. A value mapping tool is developed to help firms create value propositions better suited for sustainability. Design/methodology/approach: In addition to a literature review, six sustainable companies were interviewed to understand their approaches to business modelling, using a case study approach. Building on the literature and practice, a tool was developed which was pilot tested through use in a workshop. The resulting improved tool and process was subsequently refined through use in 13 workshops. Findings: A novel value mapping tool was developed to support sustainable business modelling, which introduces three forms of value (value captured, missed/destroyed or wasted, and opportunity) and four major stakeholder groups (environment, society, customer, and network actors). Practical implications: This tool intends to support business modelling for sustainability by assisting firms in better understanding their overall value proposition, both positive and negative, for all relevant stakeholders in the value network. Originality/value: The tool adopts a multiple stakeholder view of value, a network rather than firm centric perspective, and introduces a novel way of conceptualising value that specifically introduces value destroyed or wasted/ missed, in addition to the current value proposition and new opportunities for value creation. © Emerald Group Publishing Limited.

Soil mix technology for integrated remediation and ground improvement: From laboratory work to field trials

Relatively new in the UK, soil mix technology applied to the in-situ remediation of contaminated land involves the use of mixing tools and additives to construct permeable reactive in-ground barriers and low-permeability containment walls and for hot-spot soil treatment by stabilisation/ solidification. It is a cost effective and versatile approach with numerous environmental advantages. Further commercial advantages can be realised by combining this with ground improvement through the development of a single integrated soil mix technology system which is the core objective of Project SMiRT (Soil Mix Remediation Technology). This is a large UK-based R&D project involving academia-industry collaboration with a number of tasks including equipment development, laboratory treatability studies, field trials, stakeholder consultation and dissemination activities. This paper presents aspects of project SMiRT relating to the laboratory treatability study work leading to the design of the field trials. © 2012 American Society of Civil Engineers.

Factor analysis and structural equation modelling of sustainable behaviour in contaminated land remediation

Contaminated land remediation has traditionally been viewed as sustainable practice because it reduces urban sprawl and mitigates risks to human being and the environment. However, in an emerging green and sustainable remediation (GSR) movement, remediation practitioners have increasingly recognized that remediation operations have their own environmental footprint. The GSR calls for sustainable behaviour in the remediation industry, for which a series of white papers and guidance documents have been published by various government agencies and professional organizations. However, the relationship between the adoption of such sustainable behaviour and its underlying driving forces has not been studied. This study aims to contribute to sustainability science by rendering a better understanding of what drives organizational behaviour in adopting sustainable practices. Factor analysis (FA) and structural equation modelling (SEM) were used to investigate the relationship between sustainable practices and key factors driving these behaviour changes in the remediation field. A conceptual model on sustainability in the environmental remediation industry was developed on the basis of stakeholder and institutional theories. The FA classified sustainability considerations, institutional promoting and impeding forces, and stakeholder's influence. Subsequently the SEM showed that institutional promoting forces had significant positive effects on adopting sustainability measures, and institutional impeding forces had significant negative effects. Stakeholder influences were found to have only marginal direct effect on the adoption of sustainability; however, they exert significant influence on institutional promoting forces, thus rendering high total effect (i.e. direct effect plus indirect effect) on the adoption of sustainability. This study suggests that sustainable remediation represents an advanced sustainable practice, which may only be fully endorsed by both internal and external stakeholders after its regulatory, normative and cognitive components are institutionalized. © 2014 Elsevier Ltd. All rights reserved.