8 resultados para continuous improvement

em University of Queensland eSpace - Australia


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This paper explores the theme of strategic planning in a State Tourism Organization (STO) from a knowledge management perspective. It highlights the value of knowledge in strategy making and the importance of an organisation's knowledge management agenda in facilitating a strategic planning process. In particular, it considers the capability of an STO to implement knowledge management as the key to a successful strategic planning exercise. In order to develop greater insight into the factors that impact on planning competence, the key aim of this paper is to develop a framework on which the capability of a STO to implement a knowledge-based agenda in strategic planning can be assessed. Research on knowledge management in the field of tourism is limited and there is little practical account of the application of knowledge management principles in tourism planning. Further, there is no apparent tool or instrument that allows for the assessment of an STO's capability to implement knowledge management in planning initiatives. Based on a literature review, a three-point framework of assessment is developed. The three elements of the framework are identified as: 1. Integration of knowledge management objectives with strategic imperatives; 2. A planning approach that balances top-down (outcome focused) with bottom-up (process focused) planning processes; and 3. Organisational capacity, including leadership, people and culture, process, technology, content and continuous improvement. The framework is tested through application to a practical case study - a planning initiative undertaken by a leading tourism STO in Australia. The results demonstrate that the framework is a useful means to evaluate organisational capability in knowledge-led strategic planning exercises and would be of practical value as a point of reference for future knowledge- based strategic planning projects. Copyright © by The Haworth Press, Inc. All rights reserved.

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This paper describes and analyses an innovative engineering management course that applies a project management framework in the context of a feasibility study for a prospective research project. The aim is to have students learn aspects of management that will be relevant from the outset of their professional career while simultaneously having immediate value in helping them to manage a research project and capstone design project in their senior year. An integral part of this innovation was the development of a web-based project management tool. While the main objectives of the new course design were achieved, a number of important lessons were learned that would guide the further development and continuous improvement of this course. The most critical of these is the need to achieve the optimum balance in the mind of the students between doing the project and critically analyzing the processes used to accomplish the work.

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Objective: To evaluate the effectiveness of continuous positive airway pressure (CPAP) therapy in the treatment of hypernasality following traumatic brain injury (17111). Design: An A-B-A experimental research design. Assessments were conducted prior to commencement of the program, midway, immediately posttreatment, and 1 month after completion of the CPAP therapy program. Participants: Three adults with dysarthria and moderate to severe hypernasality subsequent to TBI. Outcome Measures: Perceptual evaluation using the Frenchay Dysarthria Assessment, the Assessment of Intelligibility of Dysarthric Speech, and a speech sample analysis, and instrumental evaluation using the Nasometer. Results: Between assessment periods, varying degrees of improvement in hypernasality and sentence intelligibility were noted. At the 1-month post-CPAP assessment, all 3 participants demonstrated reduced nasalance values, and 2 exhibited increased sentence intelligibility. Conclusions: CPAP may be a valuable treatment of impaired velopharyngeal function in the TBI population.

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Continuous infusion (CI) ticarcillin-clavulanate is a potential therapeutic improvement over conventional intermittent dosing because the major pharmacodynamic (PD) predictor of efficacy of beta-lactams is the time that free drug levels exceed the MIC. This study incorporated a 6-year retrospective arm evaluating efficacy and safety of CI ticarcillin-clavulanate in the home treatment of serious infections and a prospective arm additionally evaluating pharmacokinetics (PK) and PD. In the prospective arm, steady-state serum ticarcillin and clavulanate levels and MIC testing of significant pathogens were performed. One hundred and twelve patients (median age, 56 years) were treated with a CI dose of 9.3-12.4 g/day and mean CI duration of 18.0 days. Infections treated included osteomyelitis (50 patients), septic arthritis (6), cellulitis (17), pulmonary infections (12), febrile neutropenia (7), vascular infections (7), intra-abdominal infections (2), and Gram-negative endocarditis (2); 91/112 (81%) of patients were cured, 14 (13%) had partial response and 7 (6%) failed therapy. Nine patients had PICC line complications and five patients had drug adverse events. Eighteen patients had prospective PK/PD assessment although only four patients had sufficient data for a full PK/PD evaluation (both serum steady-state drug levels and ticarcillin and clavulanate MICs from a bacteriological isolate), as this was difficult to obtain in home-based patients, particularly as serum clavulanate levels were found to deteriorate rapidly on storage. Three of four patients with matched PK/PD assessment had free drug levels exceeding the MIC of the pathogen. Home Cl of ticarcillin-clavulanate is a safe, effective, convenient and practical therapy and is a therapeutic advance over traditional intermittent dosing when used in the home setting. (c) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

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Background Although both strength training (ST) and endurance training (ET) seem to be beneficial in type 2 diabetes mellitus (T2D), little is known about post-exercise glucose profiles. The objective of the study was to report changes in blood glucose (BG) values after a 4-month ET and ST programme now that a device for continuous glucose monitoring has become available. Materials and methods Fifteen participants, comprising four men age 56.5 +/- 0.9 years and 11 women age 57.4 +/- 0.9 years with T2D, were monitored with the MiniMed (Northridge, CA, USA) continuous glucose monitoring system (CGMS) for 48 h before and after 4 months of ET or ST. The ST consisted of three sets at the beginning, increasing to six sets per week at the end of the training period, including all major muscle groups and ET performed with an intensity of maximal oxygen uptake of 60% and a volume beginning at 15 min and advancing to a maximum of 30 min three times a week. Results A total of 17 549 single BG measurements pretraining (619.7 +/- 39.8) and post-training (550.3 +/- 30.1) were recorded, correlating to an average of 585 +/- 25.3 potential measurements per participant at the beginning and at the end of the study. The change in BG-value between the beginning (132 mg dL(-1)) and the end (118 mg dL(-1)) for all participants was significant (P = 0.028). The improvement in BG-value for the ST programme was significant (P = 0.02) but for the ET no significant change was measured (P = 0.48). Glycaemic control improved in the ST group and the mean BG was reduced by 15.6% (Cl 3-25%). Conclusion In conclusion, the CGMS may be a useful tool in monitoring improvements in glycaemic control after different exercise programmes. Additionally, the CGMS may help to identify asymptomatic hypoglycaemia or hyperglycaemia after training programmes.

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Aim: To identify an appropriate dosage strategy for patients receiving enoxaparin by continuous intravenous infusion (CII). Methods: Monte Carlo simulations were performed in NONMEM, (200 replicates of 1000 patients) to predict steady state anti-Xa concentrations (Css) for patients receiving a CII of enoxaparin. The covariate distribution model was simulated based on covariate demographics in the CII study population. The impact of patient weight, renal function (creatinine clearance (CrCL)) and patient location (intensive care unit (ICU)) were evaluated. A population pharmacokinetic model was used as the input-output model (1-compartment first order output model with mixed residual error structure). Success of a dosing regimen was based on the percent of Css that is between the therapeutic range of 0.5 IU/ml to 1.2 IU/ml. Results: The best dose for patients in the ICU was 4.2IU/kg/h (success mean 64.8% and 90% prediction interval (PI): 60.1–69.8%) if CrCL60ml/min, the best dose was 8.3IU/kg/h (success mean 65.4%, 90% PI: 58.5–73.2%). Simulations suggest that there was a 50% improvement in the success of the CII if the dose rate for ICU patients with CrCL

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Although managers consider accurate, timely, and relevant information as critical to the quality of their decisions, evidence of large variations in data quality abounds. Over a period of twelve months, the action research project reported herein attempted to investigate and track data quality initiatives undertaken by the participating organisation. The investigation focused on two types of errors: transaction input errors and processing errors. Whenever the action research initiative identified non-trivial errors, the participating organisation introduced actions to correct the errors and prevent similar errors in the future. Data quality metrics were taken quarterly to measure improvements resulting from the activities undertaken during the action research project. The action research project results indicated that for a mission-critical database to ensure and maintain data quality, commitment to continuous data quality improvement is necessary. Also, communication among all stakeholders is required to ensure common understanding of data quality improvement goals. The action research project found that to further substantially improve data quality, structural changes within the organisation and to the information systems are sometimes necessary. The major goal of the action research study is to increase the level of data quality awareness within all organisations and to motivate them to examine the importance of achieving and maintaining high-quality data.