Bayesian hierarchical models in statistical quality control methods to improve healthcare in hospitals

Quality oriented management systems and methods have become the dominant business and governance paradigm. From this perspective, satisfying customers’ expectations by supplying reliable, good quality products and services is the key factor for an organization and even government. During recent decades, Statistical Quality Control (SQC) methods have been developed as the technical core of quality management and continuous improvement philosophy and now are being applied widely to improve the quality of products and services in industrial and business sectors. Recently SQC tools, in particular quality control charts, have been used in healthcare surveillance. In some cases, these tools have been modified and developed to better suit the health sector characteristics and needs. It seems that some of the work in the healthcare area has evolved independently of the development of industrial statistical process control methods. Therefore analysing and comparing paradigms and the characteristics of quality control charts and techniques across the different sectors presents some opportunities for transferring knowledge and future development in each sectors. Meanwhile considering capabilities of Bayesian approach particularly Bayesian hierarchical models and computational techniques in which all uncertainty are expressed as a structure of probability, facilitates decision making and cost-effectiveness analyses. Therefore, this research investigates the use of quality improvement cycle in a health vii setting using clinical data from a hospital. The need of clinical data for monitoring purposes is investigated in two aspects. A framework and appropriate tools from the industrial context are proposed and applied to evaluate and improve data quality in available datasets and data flow; then a data capturing algorithm using Bayesian decision making methods is developed to determine economical sample size for statistical analyses within the quality improvement cycle. Following ensuring clinical data quality, some characteristics of control charts in the health context including the necessity of monitoring attribute data and correlated quality characteristics are considered. To this end, multivariate control charts from an industrial context are adapted to monitor radiation delivered to patients undergoing diagnostic coronary angiogram and various risk-adjusted control charts are constructed and investigated in monitoring binary outcomes of clinical interventions as well as postintervention survival time. Meanwhile, adoption of a Bayesian approach is proposed as a new framework in estimation of change point following control chart’s signal. This estimate aims to facilitate root causes efforts in quality improvement cycle since it cuts the search for the potential causes of detected changes to a tighter time-frame prior to the signal. This approach enables us to obtain highly informative estimates for change point parameters since probability distribution based results are obtained. Using Bayesian hierarchical models and Markov chain Monte Carlo computational methods, Bayesian estimators of the time and the magnitude of various change scenarios including step change, linear trend and multiple change in a Poisson process are developed and investigated. The benefits of change point investigation is revisited and promoted in monitoring hospital outcomes where the developed Bayesian estimator reports the true time of the shifts, compared to priori known causes, detected by control charts in monitoring rate of excess usage of blood products and major adverse events during and after cardiac surgery in a local hospital. The development of the Bayesian change point estimators are then followed in a healthcare surveillances for processes in which pre-intervention characteristics of patients are viii affecting the outcomes. In this setting, at first, the Bayesian estimator is extended to capture the patient mix, covariates, through risk models underlying risk-adjusted control charts. Variations of the estimator are developed to estimate the true time of step changes and linear trends in odds ratio of intensive care unit outcomes in a local hospital. Secondly, the Bayesian estimator is extended to identify the time of a shift in mean survival time after a clinical intervention which is being monitored by riskadjusted survival time control charts. In this context, the survival time after a clinical intervention is also affected by patient mix and the survival function is constructed using survival prediction model. The simulation study undertaken in each research component and obtained results highly recommend the developed Bayesian estimators as a strong alternative in change point estimation within quality improvement cycle in healthcare surveillances as well as industrial and business contexts. The superiority of the proposed Bayesian framework and estimators are enhanced when probability quantification, flexibility and generalizability of the developed model are also considered. The empirical results and simulations indicate that the Bayesian estimators are a strong alternative in change point estimation within quality improvement cycle in healthcare surveillances. The superiority of the proposed Bayesian framework and estimators are enhanced when probability quantification, flexibility and generalizability of the developed model are also considered. The advantages of the Bayesian approach seen in general context of quality control may also be extended in the industrial and business domains where quality monitoring was initially developed.

Visualising mathematical knowledge and understanding

Contemporary mathematics education attempts to instil within learners the conceptualization of mathematics as a highly organized and inter-connected set of ideas. To support this, a means to graphically represent this organization of ideas is presented which reflects the cognitive mechanisms that shape a learner’s understanding. This organisation of information may then be analysed, with the view to informing the design of mathematics instruction in face-to-face and/or computer-mediated learning environments. However, this analysis requires significant work to develop both theory and practice.

Proteomics science & society : the role of knowledge translation in moving towards clinical applications

Background: Outside the mass-spectrometer, proteomics research does not take place in a vacuum. It is affected by policies on funding and research infrastructure. Proteomics research both impacts and is impacted by potential clinical applications. It provides new techniques & clinically relevant findings, but the possibilities for such innovations (and thus the perception of the potential for the field by funders) are also impacted by regulatory practices and the readiness of the health sector to incorporate proteomics-related tools & findings. Key to this process is how knowledge is translated. Methods: We present preliminary results from a multi-year social science project, funded by the Canadian Institutes of Health Research, on the processes and motivations for knowledge translation in the health sciences. The proteomics case within this wider study uses qualitative methods to examine the interplay between proteomics science and regulatory and policy makers regarding clinical applications of proteomics. Results: Adopting an interactive format to encourage conference attendees’ feedback, our poster focuses on deficits in effective knowledge translation strategies from the laboratory to policy, clinical, & regulatory arenas. An analysis of the interviews conducted to date suggests five significant choke points: the changing priorities of funding agencies; the complexity of proteomics research; the organisation of proteomics research; the relationship of proteomics to genomics and other omics sciences; and conflict over the appropriate role of standardisation. Conclusion: We suggest that engagement with aspects of knowledge translation, such as those mentioned above, is crucially important for the eventual clinical application ofproteomics science on any meaningful scale.

Maintaining a cognitive map in darkness : the need to fuse boundary knowledge with path integration

Spatial navigation requires the processing of complex, disparate and often ambiguous sensory data. The neurocomputations underpinning this vital ability remain poorly understood. Controversy remains as to whether multimodal sensory information must be combined into a unified representation, consistent with Tolman's "cognitive map", or whether differential activation of independent navigation modules suffice to explain observed navigation behaviour. Here we demonstrate that key neural correlates of spatial navigation in darkness cannot be explained if the path integration system acted independently of boundary (landmark) information. In vivo recordings demonstrate that the rodent head direction (HD) system becomes unstable within three minutes without vision. In contrast, rodents maintain stable place fields and grid fields for over half an hour without vision. Using a simple HD error model, we show analytically that idiothetic path integration (iPI) alone cannot be used to maintain any stable place representation beyond two to three minutes. We then use a measure of place stability based on information theoretic principles to prove that featureless boundaries alone cannot be used to improve localization above chance level. Having shown that neither iPI nor boundaries alone are sufficient, we then address the question of whether their combination is sufficient and - we conjecture - necessary to maintain place stability for prolonged periods without vision. We addressed this question in simulations and robot experiments using a navigation model comprising of a particle filter and boundary map. The model replicates published experimental results on place field and grid field stability without vision, and makes testable predictions including place field splitting and grid field rescaling if the true arena geometry differs from the acquired boundary map. We discuss our findings in light of current theories of animal navigation and neuronal computation, and elaborate on their implications and significance for the design, analysis and interpretation of experiments.

Communication and organizational social networks : a simulation model

Recent management research has evidenced the significance of organizational social networks, and communication is believed to impact the interpersonal relationships. However, we have little knowledge on how communication affects organizational social networks. This paper studies the dynamics between organizational communication patterns and the growth of organizational social networks. We propose an organizational social network growth model, and then collect empirical data to test model validity. The simulation results agree well with the empirical data. The results of simulation experiments enrich our knowledge on communication with the findings that organizational management practices that discourage employees from communicating within and across group boundaries have disparate and significant negative effect on the social network’s density, scalar assortativity and discrete assortativity, each of which correlates with the organization’s performance. These findings also suggest concrete measures for management to construct and develop the organizational social network.

Potentials of social media for tacit knowledge sharing amongst physicians : preliminary findings

Tacit knowledge sharing amongst physicians, such as the sharing of clinical experiences, skills, or know-how, or know-whom, is known to have a significant impact on the quality of medical diagnosis and decisions. This paper posits that social media can provide new opportunities for tacit knowledge sharing amongst physicians, and demonstrates this by presenting findings from a review of relevant literature and a survey conducted with physicians. Semi-structured interviews were conducted with ten physicians from around the world who were active users of social media. Initial thematic analysis revealed eight themes as potential contributions of social web tools to facilitate tacit knowledge flow amongst physicians. The emergent themes are defined, linked to the literature, and supported by instances of interview transcripts. Findings presented here are preliminary, and final results will be reported after accomplishing all phases of data collection and analysis.

The promotion of sustainability agenda for facilities management through developing knowledge capabilities

The growing awareness of sustainability issues around the world has put extensive pressure on the construction industry to improve its sustainable practice. Sustainability principles need to be applied to not just during design and construction phase but the entire life cycle of a construction project. Compared to sustainability endeavours on earlier development phases, the pace to implement sustainability agenda during the operation and maintenance phase has not been as fast during past practices of facilities management (FM). Literature study suggests that sustainable practices in FM activities can bring substantial benefits such as reducing energy consumptions and waste, while increasing productivity, financial return and standing in the community. It also suggests several barriers which inhibit the implementation of sustainability in FM practices, including the lack of knowledge, discrepancy between capability and skills, and unwillingness of the FM personnel and organizations to adapt to new routines in order to implement sustainability in their business. The capabilities of FM personnel and organizations were regarded as the key enablers in managing sustainability knowledge. In a sustainable development context, capabilities are vital to the fostering of competency in an organization to innovate in a more sustainable way and support the agenda in an organization. Additionally, research which focused on people’s capabilities and skills is still lagging behind the efforts to develop guidelines, technical manuals and knowledge portals. Therefore, it is beneficial to explore the issues of capabilities in dealing with the implementation of sustainable practices in FM. This paper introduces a research project which is aimed at establishing a knowledge capabilities framework for promoting sustainability measures in FM practices. It will explore and highlight challenges to integrate sustainability as well as the personnel and organizational capabilities that are vital in dealing with knowledge issues in implementing sustainability agenda in FM practices. The expected outcome of this research has the potential to further sustainability endeavours in FM practices, while providing a useful source of knowledge to the FM personnel and organizations.

Application of Resilience concept for enhanced management of water supply systems

This paper presents an approach to developing indicators for expressing resilience of a generic water supply system. The system is contextualised as a meta-system consisting of three subsystems to represent the water catchment and reservoir, treatment plant and the distribution system supplying the end-users. The level of final service delivery to end-users is considered as a surrogate measure of systemic resilience. A set of modelled relationships are used to explore relationships between system components when placed under simulated stress. Conceptual system behaviour of specific types of simulated pressure is created for illustration of parameters for indicator development. The approach is based on the hypothesis that an in-depth knowledge of resilience would enable development of decision support system capability which in turn will contribute towards enhanced management of a water supply system. In contrast to conventional water supply system management approaches, a resilience approach facilitates improvement in system efficiency by emphasising awareness of points-of-intervention where system managers can adjust operational control measures across the meta-system (and within subsystems) rather than expansion of the system in entirety in the form of new infrastructure development.

Knowledge economy market development mapping study

The knowledge economy relies on the diffusion and use of knowledge as well as its creation (Houghton and Sheenan, 2000). The future success of economic activity will depend on the capacity of organisations to transform by increasing their flexibility. In particular, this transformation is dependant on a decentralised, networked and multi-skilled workforce. To help organisations transition, new strategies and structures for education are required. Education systems need to concentrate less on specialist skills and more on the development of people with broad-based problem solving skills that are adaptable, with social and inter-personal communication skills necessary for networking and communication. This paper presents the findings of a ‘Knowledge Economy Market Development Mapping Study’ conducted to identify the value of design education programs from primary through to tertiary level in Queensland, Australia. The relationship of these programs to the development of the capacities mentioned above is explored. The study includes the collection of qualitative and quantitative data consisting of a literature review, focus groups and survey. Recommendations for the future development of design education programs in Queensland, Australia are proposed, and future research opportunities are presented and discussed.

The creative citizen : understanding the value of design education programs in the knowledge economy

The knowledge economy relies on the diffusion and use of knowledge as well as its creation (Houghton and Sheenan, 2000). The future success of economic activity will depend on the capacity of organisations to transform by increasing their flexibility. In particular, this transformation is dependant on a decentralised, networked and multi-skilled workforce. To help organisations transition, new strategies and structures for education are required. Education systems need to concentrate less on specialist skills and more on the development of people with broad-based problem solving skills that are adaptable, with social and inter-personal communication skills necessary for networking and communication. This paper presents the findings of a ‘Knowledge Economy Market Development Mapping Study’ conducted to identify the value of design education programs from primary through to tertiary level in Queensland, Australia. The relationship of these programs to the development of the capacities mentioned above is explored. The study includes the collection of qualitative and quantitative data consisting of a literature review, focus groups and survey. Recommendations for the future development of design education programs in Queensland, Australia are proposed, and future research opportunities are presented and discussed.

Transnational higher education programs for facilitating inter-university knowledge transfer : University of Indonesia’s experience

This paper explores the impacts and extent of knowledge transfer (KT) in an undergraduate engineering transnational program with an Australian university partner at the University of Indonesia (UI) using an inter-university KT conceptual framework (Sutrisno, Lisana, & Pillay 2012). For the purpose of this paper, the opportunity for KT in curriculum design is examined. Given the explicit nature of curriculum knowledge, assessing each partner’s curriculum was pivotal in allowing UI to enrich its own curriculum. The KT mechanism of face-to-face contact between Indonesian and Australian academics led to not only transfer of knowledge related to the curriculum of the undergraduate program but also to other cooperation beyond the transnational program in the form of joint research and joint supervision of post-graduate theses. Positive inter-university dynamics, such as trust and willingness to work together between the partners were underpinned by the presence of key actors from both sides at the earlier stages of the partnership. Retrospectively exploring the KT process in the UI’s transnational programs with its Australian partner suggests that there have been both structured and unstructured mechanisms, highlighting the ubiquitous and unbounded nature of KT between universities. While initially successful in facilitating KT, due to rapid succession of persons in charge of the program and the increasing focus on revenue generation, the useful lessons and practices unfortunately are being lost. Although the intention to use the transnational program for KT was always implied, it gradually was overlooked by newer staff members. Based on UI’s experience as the first provider of transnational program in Indonesia and other similar cases in China, seemingly transnational programs driven by short-term immediate financial return are unsuccessful in facilitating KT due to sensitivities to unfavourable economic situation. Those that remain operational and contribute to knowledge exchange between the partners apparently have genuine long-term engagement objective.

The role of knowledge intermediaries in developing firm learning capabilities

Regional innovation systems (RISs) literature has emphasized the critical role of interactive learning and knowledge exchange amongst firms and a variety of spatially connected innovation institutions as the foundation of regional innovation. Knowledge intermediaries have been analysed in terms of the technology-transaction services they provide firms and/or knowledge producers such as universities and therefore the role they play in facilitating interaction within the RIS. However, innovation also depends on the capability of the firm to learn. Some studies have suggested that intermediaries also play a role in that regard as participation in intermediary knowledge transfer programmes can contribute to the development of firm capabilities for problem-solving and learning. Our research is based on two case study intermediary programmes involving interviews with facilitators and participants. Our data show that knowledge intermediaries affect organizational learning capabilities by impacting on firms' network relationships, internal and external communication channels and internal learning processes which in turn affect the ability to interpret and use knowledge within the firm. This suggests that the role of knowledge intermediaries might be greater than facilitating interactions in the innovation system, as knowledge intermediation may affect the ability of firms to learn and absorb knowledge from their environment.

Pre-service teachers' pedagogical relationships and experiences of embedding Indigenous Australian knowledge in teaching practicum

This paper argues from the standpoint that embedding Indigenous knowledge and perspectives in Australian curricula occurs within a space of tension, ‘the cultural interface’ (Nakata, 2002), in negotiation and contestation with other dominant knowledge systems. In this interface, Indigenous knowledge (IK) is in a state of constancy and flux, invisible and simultaneously pronounced depending on the teaching and learning contexts. More often than not, IK competes for validity and is vexed by questions of racial and cultural authenticity, and therefore struggles to be located centrally in educational systems, curricula and pedagogies. Interrogating normative western notions of what constitutes authentic or legitimate knowledge is critical to teaching Indigenous studies and embedding IK. The inclusion (and exclusion) of IK at the interface is central to developing curriculum that allows teachers to test and prod, create new knowledge and teaching approaches. From this perspective, we explore Indigenous Australian pre-service teachers’ experiences of pedagogical relationships within the teaching habitus of Australian classrooms. Our study is engaged with the strategic transgressions of praxis. We contend that tensions that participant Indigenous Australian pre-service teachers experience mirror the broader (and unresolved) political status of Indigenous people and thus where and why IK is strategically deployed as ‘new’ or ‘old knowledge within Australian liberal democratic systems of curriculum and schooling. It is significant to discuss the formation and transformation of the pedagogical cultural identity of the teaching profession within which Indigenous and non-Indigenous pre-service teachers are employed.

Editorial : Learning, teaching and disseminating knowledge in business process management

Process-oriented thinking has become the major paradigm for managing companies and other organizations. The push for better processes has been even more intense due to rapidly evolving client needs, borderless global markets and innovations swiftly penetrating the market. Thus, education is decisive for successfully introducing and implementing Business Process Management (BPM) initiatives. However, BPM education has been an area of challenge. This special issue aims to provide current research on various aspects of BPM education. It is an initial effort for consolidating better practices, experiences and pedagogical outcomes founded with empirical evidence to contribute towards the three pillars of education: learning, teaching, and disseminating knowledge in BPM.

The state-of-the-art in personalized recommender systems for social networking

With the explosion of Web 2.0 application such as blogs, social and professional networks, and various other types of social media, the rich online information and various new sources of knowledge flood users and hence pose a great challenge in terms of information overload. It is critical to use intelligent agent software systems to assist users in finding the right information from an abundance of Web data. Recommender systems can help users deal with information overload problem efficiently by suggesting items (e.g., information and products) that match users’ personal interests. The recommender technology has been successfully employed in many applications such as recommending films, music, books, etc. The purpose of this report is to give an overview of existing technologies for building personalized recommender systems in social networking environment, to propose a research direction for addressing user profiling and cold start problems by exploiting user-generated content newly available in Web 2.0.