Early years teachers’ attitudes towards mathematics

Worldwide, there is considerable attention to providing a supportive mathematics learning environment for young children because attitude formation and achievement in these early years of schooling have a lifelong impact. Key influences on young children during these early years are their teachers. Practising early years teachers‟ attitudes towards mathematics influence the teaching methods they employ, which in turn, affects young students‟ attitudes towards mathematics, and ultimately, their achievement. However, little is known about practising early years teachers‟ attitudes to mathematics or how these attitudes form, which is the focus of this study. The research questions were: 1. What attitudes do practising early years teachers hold towards mathematics? 2. How did the teachers‟ mathematics attitudes form? This study adopted an explanatory case study design (Yin, 2003) to investigate practising early years teachers‟ attitudes towards mathematics and the formation of these attitudes. The research took place in a Brisbane southside school situated in a middle socio-economic area. The site was chosen due to its accessibility to the researcher. The participant group consisted of 20 early years teachers. They each completed the Attitude Towards Mathematics Inventory (ATMI) (Schackow, 2005), which is a 40 item instrument that measures attitudes across the four dimensions of attitude, namely value, enjoyment, self-confidence and motivation. The teachers‟ total ATMI scores were classified according to five quintiles: strongly negative, negative, neutral, positive and strongly positive. The results of the survey revealed that these teachers‟ attitudes ranged across only three categories with one teacher classified as strongly positive, twelve teachers classified as positive and seven teachers classified as neutral. No teachers were identified as having negative or strongly negative attitudes. Subsequent to the surveys, six teachers with a breadth of attitudes were selected from the original cohort to participate in open-ended interviews to investigate the formation of their attitudes. The interview data were analysed according to the four dimensions of attitudes (value, enjoyment, self-confidence, motivation) and three stages of education (primary, secondary, tertiary). Highlighted in the findings is the critical impact of schooling experiences on the formation of student attitudes towards mathematics. Findings suggest that primary school experiences are a critical influence on the attitudes of adults who become early years teachers. These findings also indicate the vital role tertiary institutions play in altering the attitudes of preservice teachers who have had negative schooling experiences. Experiences that teachers indicated contributed to the formation of positive attitudes in their own education were games, group work, hands-on activities, positive feedback and perceived relevance. In contrast, negative experiences that teachers stated influenced their attitudes were insufficient help, rushed teaching, negative feedback and a lack of relevance of the content. These findings together with the literature on teachers‟ attitudes and mathematics education were synthesized in a model titled a Cycle of Early Years Teachers’ Attitudes Towards Mathematics. This model explains positive and negative influences on attitudes towards mathematics and how the attitudes of adults are passed on to children, who then as adults themselves, repeat the cycle by passing on attitudes to a new generation. The model can provide guidance for practising teachers and for preservice and inservice education about ways to foster positive influences to attitude formation in mathematics and inhibit negative influences. Two avenues for future research arise from the findings of this study both relating to attitudes and secondary school experiences. The first question relates to the resilience of attitudes, in particular, how an individual can maintain positive attitudes towards mathematics developed in primary school, despite secondary school experiences that typically have a negative influence on attitude. The second question relates to the relationship between attitudes and achievement, specifically, why secondary students achieve good grades in mathematics despite a lack of enjoyment, which is one of the dimensions of attitude.

Cyclists' experiences of harassment from motorists : findings from a survey of cyclists in Queensland, Australia

Objective Harassment from motorists is a major constraint on cycling that has been under-researched. We examined incidence and correlates of harassment of cyclists. Methods Cyclists in Queensland, Australia were surveyed in 2009 about their experiences of harassment while cycling, from motor vehicle occupants. Respondents also indicated the forms of harassment they experienced. Logistic regression modeling was used to examine gender and other correlates of harassment. Results Of 1830 respondents, 76% of men and 72% of women reported harassment in the previous 12 months. The most reported forms of harassment were driving too close (66%), shouting abuse (63%), and making obscene gestures/sexual harassment (45%). Older age, overweight/obesity, less cycling experience (< 2 years) and less frequent cycling (< 3 days/week) were associated with less likelihood of harassment, while living in highly advantaged areas (SEIFA deciles 8 or 9), cycling for recreation, and cycling for competition were associated with increased likelihood of harassment. Gender was not associated with reports of harassment. Conclusions Efforts to decrease harassment should include a closer examination of the circumstances that give rise to harassment, as well as fostering road environments and driver attitudes and behaviors that recognize that cyclists are legitimate road users.

What the hare can teach the tortoise about make-buy strategies for radical innovations

Purpose of this paper – The purpose of this investigation is to help establish: whether or not strong relationships between suppliers and customers improve performance; and if prescriptive frameworks on outsourcing radical innovations are dependent on industry clockspeed. Design/methodology/approach – A survey of UK-based manufacturers, followed by a statistical analysis. Findings – Long-term supplier links seem not to play a role in the development of radical innovations. Moreover, industry clockspeed has no significant bearing on the success or failure of any outsourcing strategy for radically new technologies. Research limitations/implications – Literature about outsourcing in the face of radical innovation can be more confidently applied to industries of all clockspeeds. Practical implications – Prescriptions for fast clockspeed industries should be applied more broadly: all industries should maintain a high degree of vertical integration in the early days of a radical innovation. Originality/value – Prior papers had explored whether or not a company should outsource radical innovations, but none had determined if this is equally true for slow industries and fast ones. Therein lies the original contribution of this paper.

Implementation of a survey form marking system using image processing techniques on an Imputer

This paper describes the feasibility of the application of an Imputer in a multiple choice answer sheet marking system based on image processing techniques.

Emergency health services : demand and service delivery models. Monograph 1: literature review and activity trends

Emergency Health Services (EHS), encompassing hospital-based Emergency Departments (ED) and pre-hospital ambulance services, are a significant and high profile component of Australia’s health care system and congestion of these, evidenced by physical overcrowding and prolonged waiting times, is causing considerable community and professional concern. This concern relates not only to Australia’s capacity to manage daily health emergencies but also the ability to respond to major incidents and disasters. EHS congestion is a result of the combined effects of increased demand for emergency care, increased complexity of acute health care, and blocked access to ongoing care (e.g. inpatient beds). Despite this conceptual understanding there is a lack of robust evidence to explain the factors driving increased demand, or how demand contributes to congestion, and therefore public policy responses have relied upon limited or unsound information. The Emergency Health Services Queensland (EHSQ) research program proposes to determine the factors influencing the growing demand for emergency health care and to establish options for alternative service provision that may safely meet patient’s needs. The EHSQ study is funded by the Australian Research Council (ARC) through its Linkage Program and is supported financially by the Queensland Ambulance Service (QAS). This monograph is part of a suite of publications based on the research findings that examines the existing literature, and current operational context. Literature was sourced using standard search approaches and a range of databases as well as a selection of articles cited in the reviewed literature. Public sources including the Australian Institute of Health and Welfare (AIHW), the Council of Ambulance Authorities (CAA) Annual Reports, Australian Bureau of Statistics (ABS) and Department of Health and Ageing (DoHA) were examined for trend data across Australia.

Mediators of the relationship between person-organisation fit and individual outcomes

To date, research on P-O fit has focused heavily on the effect of P-O fit on individual and organisational outcomes. Few studies have attempted to explain how or why P-O fit leads to these outcomes. Meglino, Ravlin, and Adkins (1989) and Schein (1985) identified several intervening mechanisms for explaining fit-outcome relationships but only few of these explanations have been tested empirically (Cable & Edwards, 2004; Edwards & Cable, 2009; Kalliath, Bluedorn, & Strube, 1999). This thesis investigates role conflict, cognitive style and organisational justice as three potential mediating mechanisms in the relationship between P-O fit (defined as fit between personal and organisational values – value congruence or value fit) and outcomes including job satisfaction, job performance, service performance, affective commitment and continuance commitment. The study operationalised P-O fit using three measures: subjective fit, perceived fit and objective fit. The mediation model of subjective fit was tested using a Mplus analytical technique, while the mediation models of both perceived and objective fit were tested by modeling the difference between two scores (that is, between personal values and organisational values) using a polynomial regression and response surface analysis (Edwards, 1993). A survey of 558 mid-level managers from seven Brunei public sector organisations provided the data. Our results showed that the relationship between P-O fit and outcomes was partially mediated by organisational justice and cognitive style - for all the three measures of fit, while role conflict had no mediating effects. The findings from this research therefore have both theoretical and practical implications. This research contributes to the literature by combining these theoretical explanations for value congruence effects into one integrated model, and by providing evidence on the partial mediating effects of organisational justice and cognitive style. Future research needs to address and investigate other potential mechanisms by which value congruence affects individual and organisational outcomes. In addition, the study is considered to be the first to test these mediating roles for a value fit-outcomes relationship using three different measures of fit in a non-Western context.

Barriers to information transfer for multi-trauma patients upon discharge from the Emergency Department in a tertiary level hospital

Purpose: Communication is integral to effective trauma care provision. This presentation will report on barriers to meaningful information transfer for multi-trauma patients upon discharge from the Emergency Department (ED) to the care areas of Intensive Care Unit, High Dependency Unit, and Perioperative Services. This is an ongoing study at one tertiary level hospital in Queensland. Method: This is a multi-phase, mixed method study. In Phase 1 data were collected about information transfer. This Phase was initially informed by a comprehensive literature review, then via focus groups, chart audit, staff survey and review of national and international trauma forms. Results: The barriers identified related to nursing handover, documented information, time inefficiency, patient complexity and stability and time of transfer. Specifically this included differences in staff expectations and variation in the nursing handover processes, no agreed minimum dataset of information handed over, missing, illegible or difficult to find information in documentation (both medical and nursing), low compliance with some forms used for documentation. Handover of these patients is complex with information coming from many sources, dealing with issues is more difficult for these patients when transferred out of hours. Conclusions and further directions: This study investigated the current communication processes and standards of information transfer to identify barriers and issues. The barriers identified were the structure used for documentation, processes used (e.g. handover), patient acuity and time. This information is informing the development, implementation and evaluation of strategies to ameliorate the issues identified.

The analysis of social capital in online social communities

Social networks have proven to be an attractive avenue of investigation for researchers since humans are social creatures. Numerous literature have explored the term “social networks” from different perspectives and in diverse research fields. With the popularity of the Internet, social networking has taken on a new dimension. Online social communities therefore have become an emerging social avenue for people to communicate in today’s information age. People use online social communities to share their interests, maintain friendships, and extend their so-called circle of “friends”. Likewise, social capital, also known as human capital, is an important theory in sociology. Researchers usually utilise social capital theory when they investigate the topic relating to social networks. However, there is little literature that can provide an explicit and strong assertion in that research area due to the complexity of social capital. This thesis therefore focuses on the issue related to providing a better understanding about the relationship between social capital and online social communities. To enhance the value within the scope of this analysis, an online survey was conducted to examine the effects of the dimensions of social capital: relational capital, structural capital, and cognitive capital, determining the intensity of using online social communities. The data were derived from a total of 350 self-selected respondents completing an online survey during the research period. The main results indicate that social capital exists in online social communities under normal circumstances. Finally, this thesis also presents three contributions for both theory and practice in Chapter 5. The main results contribute to the understanding of connectivity in the interrelationships between individual social capital exchange within online social networks. Secondly, social trust was found to have a weak effect in influencing the intensity of individuals using online social communities. Third, the perpetual role of information sharing has an indirect influence on individual users participating in online social communities. This study also benefits online marketing consultants as marketers can not only gain consumer information easier from online social communities but also this understanding assists in designing effective communication within online social communities. The cross-sectional study, the reliability of Internet survey data, and sampling issues are the major three limitations in this research. The thesis provides a new research model and recommends that the mediating effects, privacy paradox, and social trust on online social communities should be further explored in future research.

Policy analysis of disaster health management in China

Humankind has been dealing with all kinds of disasters since the dawn of time. The risk and impact of disasters producing mass casualties worldwide is increasing, due partly to global warming as well as to increased population growth, increased density and the aging population. China, as a country with a large population, vast territory, and complex climatic and geographical conditions, has been plagued by all kinds of disasters. Disaster health management has traditionally been a relatively arcane discipline within public health. However, SARS, Avian Influenza, and earthquakes and floods, along with the need to be better prepared for the Olympic Games in China has brought disasters, their management and their potential for large scale health consequences on populations to the attention of the public, the government and the international community alike. As a result significant improvements were made to the disaster management policy framework, as well as changes to systems and structures to incorporate an improved disaster management focus. This involved the upgrade of the Centres for Disease Control and Prevention (CDC) throughout China to monitor and better control the health consequences particularly of infectious disease outbreaks. However, as can be seen in the Southern China Snow Storm and Wenchuan Earthquake in 2008, there remains a lack of integrated disaster management and efficient medical rescue, which has been costly in terms of economics and health for China. In the context of a very large and complex country, there is a need to better understand whether these changes have resulted in effective management of the health impacts of such incidents. To date, the health consequences of disasters, particularly in China, have not been a major focus of study. The main aim of this study is to analyse and evaluate disaster health management policy in China and in particular, its ability to effectively manage the health consequences of disasters. Flood has been selected for this study as it is a common and significant disaster type in China and throughout the world. This information will then be used to guide conceptual understanding of the health consequences of floods. A secondary aim of the study is to compare disaster health management in China and Australia as these countries differ in their length of experience in having a formalised policy response. The final aim of the study is to determine the extent to which Walt and Gilson’s (1994) model of policy explains how disaster management policy in China was developed and implemented after SARS in 2003 to the present day. This study has utilised a case study methodology. A document analysis and literature search of Chinese and English sources was undertaken to analyse and produce a chronology of disaster health management policy in China. Additionally, three detailed case studies of flood health management in China were undertaken along with three case studies in Australia in order to examine the policy response and any health consequences stemming from the floods. A total of 30 key international disaster health management experts were surveyed to identify fundamental elements and principles of a successful policy framework for disaster health management. Key policy ingredients were identified from the literature, the case-studies and the survey of experts. Walt and Gilson (1994)’s policy model that focuses on the actors, content, context and process of policy was found to be a useful model for analysing disaster health management policy development and implementation in China. This thesis is divided into four parts. Part 1 is a brief overview of the issues and context to set the scene. Part 2 examines the conceptual and operational context including the international literature, government documents and the operational environment for disaster health management in China. Part 3 examines primary sources of information to inform the analysis. This involves two key studies: • A comparative analysis of the management of floods in China and Australia • A survey of international experts in the field of disaster management so as to inform the evaluation of the policy framework in existence in China and the criteria upon which the expression of that policy could be evaluated Part 4 describes the key outcomes of this research which include: • A conceptual framework for describing the health consequences of floods • A conceptual framework for disaster health management • An evaluation of the disaster health management policy and its implementation in China. The research outcomes clearly identified that the most significant improvements are to be derived from improvements in the generic management of disasters, rather than the health aspects alone. Thus, the key findings and recommendations tend to focus on generic issues. The key findings of this research include the following: • The health consequences of floods may be described in terms of time as ‘immediate’, ‘medium term’ and ‘long term’ and also in relation to causation as ‘direct’ and ‘indirect’ consequences of the flood. These two aspects form a matrix which in turn guides management responses. • Disaster health management in China requires a more comprehensive response throughout the cycle of prevention, preparedness, response and recovery but it also requires a more concentrated effort on policy implementation to ensure the translation of the policy framework into effective incident management. • The policy framework in China is largely of international standard with a sound legislative base. In addition the development of the Centres for Disease Control and Prevention has provided the basis for a systematic approach to health consequence management. However, the key weaknesses in the current system include: o The lack of a key central structure to provide the infrastructure with vital support for policy development, implementation and evaluation. o The lack of well-prepared local response teams similar to local government based volunteer groups in Australia. • The system lacks structures to coordinate government action at the local level. The result of this is a poorly coordinated local response and lack of clarity regarding the point at which escalation of the response to higher levels of government is advisable. These result in higher levels of risk and negative health impacts. The key recommendations arising from this study are: 1. Disaster health management policy in China should be enhanced by incorporating disaster management considerations into policy development, and by requiring a disaster management risk analysis and disaster management impact statement for development proposals. 2. China should transform existing organizations to establish a central organisation similar to the Federal Emergency Management Agency (FEMA) in the USA or the Emergency Management Australia (EMA) in Australia. This organization would be responsible for leading nationwide preparedness through planning, standards development, education and incident evaluation and to provide operational support to the national and local government bodies in the event of a major incident. 3. China should review national and local plans to reflect consistency in planning, and to emphasize the advantages of the integrated planning process. 4. Enhance community resilience through community education and the development of a local volunteer organization. China should develop a national strategy which sets direction and standards in regard to education and training, and requires system testing through exercises. Other initiatives may include the development of a local volunteer capability with appropriate training to assist professional response agencies such as police and fire services in a major incident. An existing organisation such as the Communist Party may be an appropriate structure to provide this response in a cost effective manner. 5. Continue development of professional emergency services, particularly ambulance, to ensure an effective infrastructure is in place to support the emergency response in disasters. 6. Funding for disaster health management should be enhanced, not only from government, but also from other sources such as donations and insurance. It is necessary to provide a more transparent mechanism to ensure the funding is disseminated according to the needs of the people affected. 7. Emphasis should be placed on prevention and preparedness, especially on effective disaster warnings. 8. China should develop local disaster health management infrastructure utilising existing resources wherever possible. Strategies for enhancing local infrastructure could include the identification of local resources (including military resources) which could be made available to support disaster responses. It should develop operational procedures to access those resources. Implementation of these recommendations should better position China to reduce the significant health consequences experienced each year from major incidents such as floods and to provide an increased level of confidence to the community about the country’s capacity to manage such events.

Assessment of preterm infants' readiness to commence breastfeeding

Preterm infants commence breastfeeding when health-care professionals deem them to be ready. However, the optimal timing for commencement of breastfeeding is unclear. Currently, there is little guidance for neonatal care providers to decide when to initiate breastfeeding among preterm infants. A mixed-methods study was conducted to develop and test the Preterm Sucking Readiness (PTSR) scale in four phases. The first phase involved a chart audit to explore the use of age as a criterion by investigating when preterm infants meet feeding milestones as well as other factors that may affect an infant’s readiness to engage in nutritive sucking behaviour. The second phase utilised focus groups to explore and define how neonatal care providers decide when to commence breastfeeding. To gain consensus on the criteria mentioned by the focus groups, a Delphi survey was conducted in phase 3, involving neonatal providers across Australia and New Zealand. Phase 4 of the study involved an observational study that was used to test the six-item PTSR. The age at which specific feeding milestones were reached was consistent with what has been previously described in the literature. The chart audit showed that the time taken to the first feeding attempt in the preterm infant population was affected by gestational age at birth, birth weight, and specific interventions. Staff also considered age along with other criteria when deciding when to initiate feeding. Consensus on nine criteria for inclusion into the six-item PTSR was achieved using the Delphi technique. Three items of PTSR showed significant differences between the preterm and fullterm infant groups. Only two items, feeding-readiness behaviour and low pulse oximetry during handling, explained the variance in breastfeeding behaviour. The inter-rater variability ranged between moderate and very good for the PTSR items. The results of this study indicate the importance of assessing behavioural cues as an indication of breastfeeding readiness in the preterm infant population, once an infant is deemed physiologically stable. Age continues to be a factor in some clinicians' decisions to commence breastfeeding. However, age alone cannot be used to decide if an infant is ready to engage in breastfeeding. Further research is needed to confirm these findings.

A conceptual model for manufacturing performance improvement

Purpose: Important performance objectives manufacturers sought can be achieved through adopting the appropriate manufacturing practices. This paper presents a conceptual model proposing relationship between advanced quality practices, perceived manufacturing difficulties and manufacturing performances. Design/methodology/approach: A survey-based approach was adopted to test the hypotheses proposed in this study. The selection of research instruments for inclusion in this survey was based on literature review, the pilot case studies and relevant industrial experience of the author. A sample of 1000 manufacturers across Australia was randomly selected. Quality managers were requested to complete the questionnaire, as the task of dealing with the quality and reliability issues is a quality manager’s major responsibility. Findings: Evidence indicates that product quality and reliability is the main competitive factor for manufacturers. Design and manufacturing capability and on time delivery came second. Price is considered as the least important factor for the Australian manufacturers. Results show that collectively the advanced quality practices proposed in this study neutralize the difficulties manufacturers face and contribute to the most performance objectives of the manufacturers. The companies who have put more emphasize on the advanced quality practices have less problem in manufacturing and better performance in most manufacturing performance indices. The results validate the proposed conceptual model and lend credence to hypothesis that proposed relationship between quality practices, manufacturing difficulties and manufacturing performances. Practical implications: The model shown in this paper provides a simple yet highly effective approach to achieving significant improvements in product quality and manufacturing performance. This study introduces a relationship based ‘proactive’ quality management approach and provides great potential for managers and engineers to adopt the model in a wide range of manufacturing organisations. Originality/value: Traditional ways of checking product quality are different types of testing, inspection and screening out bad products after manufacturing them. In today’s manufacturing where product life cycle is very short, it is necessary to focus on not to manufacturing them first rather than screening out the bad ones. This study introduces, for the first time, the idea of relationship based advanced quality practices (AQP) and suggests AQPs will enable manufacturers to develop reliable products and minimize the manufacturing anomalies. This paper explores some of the attributes of AQP capable of reducing manufacturing difficulties and improving manufacturing performances. The proposed conceptual model contributes to the existing knowledge base of quality practices and subsequently provides impetus and guidance towards increasing manufacturing performance.

An investigation of unique challenges in National Historic relics and scenic sites (NHRSSs) in Chinese research literature 1982-2008 using co-word analysis

National Housing Relics and Scenic Sites (NHRSSs) in China are the equivalent of National Parks in the West but have contrasting features and broader roles when compared to their Western counterparts. By reviewing and analysing more than 370 academic sources, this paper identifies 6 major issue clusters and future challenges that will influence the management of NHRSSs over time. It also provides a number of cases to illustrate the particular features of NHRSSs. Identifying the hot issues and important challenges in Chinese NHRSSs will provide valuable insights into priorities now being discussed in highly populated areas of the World.

Impact of a data warehouse model for improved decision-making process in healthcare

The health system is one sector dealing with a deluge of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Also, there are many healthcare organisations, which still have stand-alone systems, not integrated for management of information and decision-making. This shows, there is a need for an effective system to capture, collate and distribute this health data. Therefore, implementing the data warehouse concept in healthcare is potentially one of the solutions to integrate health data. Data warehousing has been used to support business intelligence and decision-making in many other sectors such as the engineering, defence and retail sectors. The research problem that is going to be addressed is, "how can data warehousing assist the decision-making process in healthcare". To address this problem the researcher has narrowed an investigation focusing on a cardiac surgery unit. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. The cardiac surgery unit at TPCH uses a stand-alone database of patient clinical data, which supports clinical audit, service management and research functions. However, much of the time, the interaction between the cardiac surgery unit information system with other units is minimal. There is a limited and basic two-way interaction with other clinical and administrative databases at TPCH which support decision-making processes. The aims of this research are to investigate what decision-making issues are faced by the healthcare professionals with the current information systems and how decision-making might be improved within this healthcare setting by implementing an aligned data warehouse model or models. As a part of the research the researcher will propose and develop a suitable data warehouse prototype based on the cardiac surgery unit needs and integrating the Intensive Care Unit database, Clinical Costing unit database (Transition II) and Quality and Safety unit database [electronic discharge summary (e-DS)]. The goal is to improve the current decision-making processes. The main objectives of this research are to improve access to integrated clinical and financial data, providing potentially better information for decision-making for both improved from the questionnaire and by referring to the literature, the results indicate a centralised data warehouse model for the cardiac surgery unit at this stage. A centralised data warehouse model addresses current needs and can also be upgraded to an enterprise wide warehouse model or federated data warehouse model as discussed in the many consulted publications. The data warehouse prototype was able to be developed using SAS enterprise data integration studio 4.2 and the data was analysed using SAS enterprise edition 4.3. In the final stage, the data warehouse prototype was evaluated by collecting feedback from the end users. This was achieved by using output created from the data warehouse prototype as examples of the data desired and possible in a data warehouse environment. According to the feedback collected from the end users, implementation of a data warehouse was seen to be a useful tool to inform management options, provide a more complete representation of factors related to a decision scenario and potentially reduce information product development time. However, there are many constraints exist in this research. For example the technical issues such as data incompatibilities, integration of the cardiac surgery database and e-DS database servers and also, Queensland Health information restrictions (Queensland Health information related policies, patient data confidentiality and ethics requirements), limited availability of support from IT technical staff and time restrictions. These factors have influenced the process for the warehouse model development, necessitating an incremental approach. This highlights the presence of many practical barriers to data warehousing and integration at the clinical service level. Limitations included the use of a small convenience sample of survey respondents, and a single site case report study design. As mentioned previously, the proposed data warehouse is a prototype and was developed using only four database repositories. Despite this constraint, the research demonstrates that by implementing a data warehouse at the service level, decision-making is supported and data quality issues related to access and availability can be reduced, providing many benefits. Output reports produced from the data warehouse prototype demonstrated usefulness for the improvement of decision-making in the management of clinical services, and quality and safety monitoring for better clinical care. However, in the future, the centralised model selected can be upgraded to an enterprise wide architecture by integrating with additional hospital units’ databases.