631 resultados para Care Planning


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In 2009, Australia celebrated the introduction of a national Early Years Learning Framework. This is a critical component in a series of educational reforms designed to support quality pedagogy and practice in early childhood education and care (ECEC) and successful transition to school. As with any policy change, success in real terms relies upon building shared understanding and the capacity of educators to apply new knowledge and support change and improved practice within their service. With these outcomes in mind, a collaborative research project is investigating the efficacy of a new approach to professional learning in ECEC: The professional conversation. This paper provides an overview of the professional conversation approach, including underpinning principles and the design and use of reflective questions to support meaningful conversation and learning.

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In recent years, the value of business planning for new business ventures and small firms has been the subject of debate amongst entrepreneurship researchers (Brinckmann et al 2010: 24). Drawing on institutional theory, a number of writers suggest that business planning is primarily used to confer symbolic legitimacy on businesses seeking investment and engagement from external stakeholders ( Karlsson & Honig 2009; Zimmerman & Zeitz 2002; Delmar & Shane 2004). In this sense, business planning may not have any significant effects on firm learning, but may be used as evidence of good business operations in order to attract external resources. Meta-evaluation of the available empirical literature contests this proposition, finding that both the symbolic and organisational learning effects of business planning influence small firm performance (Brinckmann et al 2010: 36) While social enterprise – which we define as organisations that exist for a public or community benefit and trade to fulfill their mission - the study of social enterprise is a nascent and pre-paradigmatic area of inquiry (Nicholls 2010). As a consequence, there has been relatively little empirical analysis of the nature or effects of business planning amongst social enterprises (for two exceptions, see exploratory studies by Hynes 2009 and Bull & Crompton 2006). In this paper, we examine business planning practices amongst Australian social enterprises. Drawing on a survey of 365 social enterprises conducted in 2010 and in-depth interviews with 11 social entrepreneurs and managers from eight social enterprises, we find that social enterprises report being more actively engaged in business planning activities than their mainstream business counterparts. Our exploratory research suggests that both legitimacy and learning drive business planning amongst social enterprises, although legitimacy is the stronger driver. Our results also suggest that, as multi-stakeholder businesses led by mission, business planning can serve unique communicative and relational functions for this business type.

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Trusted health care outcomes are patient centric. Requirements to ensure both the quality and sharing of patients’ health records are a key for better clinical decision making. In the context of maintaining quality health, the sharing of data and information between professionals and patients is paramount. This information sharing is a challenge and costly if patients’ trust and institutional accountability are not established. Establishment of an Information Accountability Framework (IAF) is one of the approaches in this paper. The concept behind the IAF requirements are: transparent responsibilities, relevance of the information being used, and the establishment and evidence of accountability that all lead to the desired outcome of a Trusted Health Care System. Upon completion of this IAF framework the trust component between the public and professionals will be constructed. Preservation of the confidentiality and integrity of patients’ information will lead to trusted health care outcomes.

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This paper is about planning paths from overhead imagery, the novelty of which is taking explicit account of uncertainty in terrain classification and spatial variation in terrain cost. The image is first classified using a multi-class Gaussian Process Classifier which provides probabilities of class membership at each location in the image. The probability of class membership at a particular grid location is then combined with a terrain cost evaluated at that location using a spatial Gaussian process. The resulting cost function is, in turn, passed to a planner. This allows both the uncertainty in terrain classification and spatial variations in terrain costs to be incorporated into the planned path. Because the cost of traversing a grid cell is now a probability density rather than a single scalar value, we can produce not only the most-likely shortest path between points on the map, but also sample from the cost map to produce a distribution of paths between the points. Results are shown in the form of planned paths over aerial maps, these paths are shown to vary in response to local variations in terrain cost.

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A hospital consists of a number of wards, units and departments that provide a variety of medical services and interact on a day-to-day basis. Nearly every department within a hospital schedules patients for the operating theatre (OT) and most wards receive patients from the OT following post-operative recovery. Because of the interrelationships between units, disruptions and cancellations within the OT can have a flow-on effect to the rest of the hospital. This often results in dissatisfied patients, nurses and doctors, escalating waiting lists, inefficient resource usage and undesirable waiting times. The objective of this study is to use Operational Research methodologies to enhance the performance of the operating theatre by improving elective patient planning using robust scheduling and improving the overall responsiveness to emergency patients by solving the disruption management and rescheduling problem. OT scheduling considers two types of patients: elective and emergency. Elective patients are selected from a waiting list and scheduled in advance based on resource availability and a set of objectives. This type of scheduling is referred to as ‘offline scheduling’. Disruptions to this schedule can occur for various reasons including variations in length of treatment, equipment restrictions or breakdown, unforeseen delays and the arrival of emergency patients, which may compete for resources. Emergency patients consist of acute patients requiring surgical intervention or in-patients whose conditions have deteriorated. These may or may not be urgent and are triaged accordingly. Most hospitals reserve theatres for emergency cases, but when these or other resources are unavailable, disruptions to the elective schedule result, such as delays in surgery start time, elective surgery cancellations or transfers to another institution. Scheduling of emergency patients and the handling of schedule disruptions is an ‘online’ process typically handled by OT staff. This means that decisions are made ‘on the spot’ in a ‘real-time’ environment. There are three key stages to this study: (1) Analyse the performance of the operating theatre department using simulation. Simulation is used as a decision support tool and involves changing system parameters and elective scheduling policies and observing the effect on the system’s performance measures; (2) Improve viability of elective schedules making offline schedules more robust to differences between expected treatment times and actual treatment times, using robust scheduling techniques. This will improve the access to care and the responsiveness to emergency patients; (3) Address the disruption management and rescheduling problem (which incorporates emergency arrivals) using innovative robust reactive scheduling techniques. The robust schedule will form the baseline schedule for the online robust reactive scheduling model.

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From its early birth through to the twenty-first century, the planning for social infrastructure has been viewed as a crucial element in promoting the development of healthy communities. The existence of good social infrastructure in every level of human settlement (i.e. neighbourhoods, districts, regions etc.) is vital because it is considered to be an element that impacts positively and meaningfully on the quality of life for members of the targeted community. The increasing importance of the sustainable development agenda in human settlements has prompted concerns over the cost of the government’s failure to provide for adequate social infrastructure for their communities. Part of this failure is attributed to the inconsistent outcome from the use of traditional planning standards that are based on population-to-facility ratios. This paper explores the literature discussion on social infrastructure for sustainable communities. It examines how a participation-oriented, need-sensitive approach in the planning and provision of social infrastructure is used as an alternative to the traditional standards that are based on population-to-facility ratios. It does this by giving an overview of its application in the planning and provision of social infrastructure for Australia’s fastest growing region of South-East Queensland.

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Background: Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods: An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), a numeric/alpha index was developed at two points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alpha) measured access to four basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to their community. Results: The numeric index ranged from 1 (access to principle referral center with cardiac catheterization service ≤ 1 hour) to 8 (no ambulance service, > 3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within 1 hour drive-time) to E (no services available within 1 hour). 13.9 million (71%) Australians resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were over-represented by people aged over 65 years (32%) and Indigenous people (60%). Conclusion: The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and the methodology could be applied to other common disease states within other regions of the world.

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This article reports findings from a survey of Canadian financial planners. The focus of the study is learning more about the depth and breadth of philanthropic planning that is included in their advising services to their high-net worth clients. The findings indicate that a minority of financial planners (1) regularly broach the topic of philanthropy in their counseling, (2) believe their clients are interested in philanthropy, and (3) feel sufficiently knowledgeable to assist their clients with philanthropic planning. The implications of these findings and recommendations for improvement are discussed.

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In this paper, a hardware-based path planning architecture for unmanned aerial vehicle (UAV) adaptation is proposed. The architecture aims to provide UAVs with higher autonomy using an application specific evolutionary algorithm (EA) implemented entirely on a field programmable gate array (FPGA) chip. The physical attributes of an FPGA chip, being compact in size and low in power consumption, compliments it to be an ideal platform for UAV applications. The design, which is implemented entirely in hardware, consists of EA modules, population storage resources, and three-dimensional terrain information necessary to the path planning process, subject to constraints accounted for separately via UAV, environment and mission profiles. The architecture has been successfully synthesised for a target Xilinx Virtex-4 FPGA platform with 32% logic slices utilisation. Results obtained from case studies for a small UAV helicopter with environment derived from LIDAR (Light Detection and Ranging) data verify the effectiveness of the proposed FPGA-based path planner, and demonstrate convergence at rates above the typical 10 Hz update frequency of an autopilot system.

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Background Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Methods/Design The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. “live”). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures. Discussion If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance. Trial registration Trial registration number: ACTRN12611000936921

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Background: Timely access to appropriate cardiac care is critical for optimising outcomes. Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services for Australia's 20,387 population locations. Methods: An expert panel defined a single patient care pathway. Using geographic information systems (GIS) the numeric/alpha index was modelled in two phases. The acute phase index (numeric) ranged from 1 (access to tertiary centre with PCI ≤1 h) to 8 (no ambulance service, >3 h to medical facility, air transport required). The aftercare index was modelled into 5 alphabetic categories; A (Access to general practitioner, pharmacy, cardiac rehabilitation, pathology ≤1 h) to E (no services available within 1 h). Results: Approximately 70% or 13.9 million people lived within a CardiacARIAindex category 1A location. Disparity continues in access to category 1A cardiac services for 5.8 million (30%) of all Australians, 60% of Aboriginal and Torres Strait Islander people and 32% of people over 65 years of age. In a cardiac emergency only 40% of the Indigenous population reside within one hour of category 1 hospital. Approximately 30% (81,491 Indigenous persons) are more than one to three hours from basic cardiac services. Conclusion: Geographically, the majority of Australian's have timely access for survival of a cardiac event. The CardiacARIAindex objectively demonstrates that the healthcare system may not be providing for the needs of 60% of Indigenous people residing outside the 1A geographic radius. Innovative clinical practice maybe required to address these disparities.

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Background: There are inequalities in geographical access and delivery of health care services in Australia, particularly for cardiovascular disease (CVD), Australia's major cause of death. Analyses and models that can inform and positively influence strategies to augment services and preventative measures are needed. The Cardiac-ARIA project is using geographical spatial technology (GIS) to develop a national index for each of Australia's 13,000 population centres. The index will describe the spatial distribution of CVD health care services available to support populations at risk, in a timely manner, after a major cardiac event. Methods: In the initial phase of the project, an expert panel of cardiologists and an emergency physician have identified key elements of national and international guidelines for management of acute coronary syndromes, cardiac arrest, life-threatening arrhythmias and acute heart failure, from the time of onset (potentially dial 000) to return from the hospital to the community (cardiac rehabilitation). Results: A systematic search has been undertaken to identify the geographical location of, and type of, cardiac services currently available. This has enabled derivation of a master dataset of necessary services, e.g. telephone networks, ambulance, RFDS, helicopter retrieval services, road networks, hospitals, general practitioners, medical community centres, pathology services, CCUs, catheterisation laboratories, cardio-thoracic surgery units and cardiac rehabilitation services. Conclusion: This unique and innovative project has the potential to deliver a powerful tool to both highlight and combat the burden of disease of CVD in urban and regional Australia.

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At one level the urban landscapes of South Florida and South East Queensland look quite similar. However at another level the context of planning and planning control and regulation is quite different. To understand the contextual differences between South Florida and South East Queensland, four themes will be used, some of which were based on Cullingworth and Booth. The four themes include: demography, governance, the law and regulatory philosophy. After having evaluated South Florida and South East Queensland across these four themes, we propose a framework for examining whether these differences have shaped planning outcomes and in particular, the built form.