Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

The marketing communications industry in flux: Large B2C advertisers’ viewpoint

The recent digitization, fragmentation of the media landscape and consumers’ changing media behavior are all changes that have had drastic effects on creating marketing communications. In order to create effective marketing communications large advertisers are now co-operating with a variety of marketing communications companies. The purpose of the study is to understand how advertisers perceive these different companies and more importantly how do advertisers expect their roles to change in the future as the media landscape continues to evolve. Especially the changing roles of advertising agencies and media agencies are examined as they are at the moment the most relevant partners of the advertisers. However, the research is conducted from a network perspective rather than focusing on single actors of the marketing communications industry network. The research was conducted using a qualitative theme interview method. The empirical data was gathered by interviewing representatives from nine of the 50 largest Finnish advertisers measured by media spending. Thus, the research was conducted solely from large B2C advertisers’ perspective while the views of their other relevant actors of the network were left unexplored. The interviewees were chosen with a focus on variety of points of view. The analytical framework that was used to analyze the gathered data was built the IMP group’s industrial network model that consists of actors, their resources and activities. As technology driven media landscape fragmentation and consumers’ changing media behavior continue to increase the complexity of creating marketing communications, advertisers are going to need to rely on a growing number of partnerships as they see that the current actors of the network will not be able to widen their expertise to answer to these new needs. The advertisers expect to form new partnerships with actors that are more specialized and able to react and produce activities more quickly than at the moment. Thus, new smaller and more agile actors with looser structures are going to appear to fill these new needs. Therefore, the need of co-operation between the actors is going to become more important. These changes pose the biggest threat for traditional advertising agencies as they were seen as being most unable to cope with the ongoing change. Media agencies are in a more favorable position for remaining relevant for the advertisers as they will be able to justify their activities and provided value by leveraging their data handling abilities. In general the advertisers expect to be working with a limited number of close actors and in addition having a network of smaller actors, which are used on a more ad hoc basis.

Improving the performance of a dismounted Future Force Warrior by means of C4I2SR

This thesis comprises seven peer-reviewed articles and examines systems and applications suitable for increasing Future Force Warrior performance, minimizing collateral damage, improving situational awareness and Common Operational Picture. Based on a literature study, missing functionalities of Future Force Warrior were identified and new ideas, concepts and solutions were created as part of early stages of Systems of Systems creation. These introduced ideas have not yet been implemented or tested in combat and for this reason benefit analyses are excluded. The main results of this thesis include the following: A new networking concept, Wireless Polling Sensor Network, which is a swarm of a few Unmanned Aerial Vehicles forming an ad-hoc network and polling a large number of fixed sensor nodes. The system is more robust in a military environment than traditional Wireless Sensor Networks. A Business Process approach to Service Oriented Architecture in a tactical setting is a concept for scheduling and sharing limited resources. New components to military Service Oriented Architecture have been introduced in the thesis. Other results of the thesis include an investigation of the use of Free Space Optics in tactical communications, a proposal for tracking neutral forces, a system for upgrading simple collaboration tools for command, control and collaboration purposes, a three-level hierarchy of Future Force Warrior, and methods for reducing incidents of fratricide.

Reframing the relationship between service design and operations: a service engineering approach

The significance of services as business and human activities has increased dramatically throughout the world in the last three decades. Becoming a more and more competitive and efficient service provider while still being able to provide unique value opportunities for customers requires new knowledge and ideas. Part of this knowledge is created and utilized in daily activities in every service organization, but not all of it, and therefore an emerging phenomenon in the service context is information awareness. Terms like big data and Internet of things are not only modern buzz-words but they are also describing urgent requirements for a new type of competences and solutions. When the amount of information increases and the systems processing information become more efficient and intelligent, it is the human understanding and objectives that may get separated from the automated processes and technological innovations. This is an important challenge and the core driver for this dissertation: What kind of information is created, possessed and utilized in the service context, and even more importantly, what information exists but is not acknowledged or used? In this dissertation the focus is on the relationship between service design and service operations. Reframing this relationship refers to viewing the service system from the architectural perspective. The selected perspective allows analysing the relationship between design activities and operational activities as an information system while maintaining the tight connection to existing service research contributions and approaches. This type of an innovative approach is supported by research methodology that relies on design science theory. The methodological process supports the construction of a new design artifact based on existing theoretical knowledge, creation of new innovations and testing the design artifact components in real service contexts. The relationship between design and operations is analysed in the health care and social care service systems. The existing contributions in service research tend to abstract services and service systems as value creation, working or interactive systems. This dissertation adds an important information processing system perspective to the research. The main contribution focuses on the following argument: Only part of the service information system is automated and computerized, whereas a significant part of information processing is embedded in human activities, communication and ad-hoc reactions. The results indicate that the relationship between service design and service operations is more complex and dynamic than the existing scientific and managerial models tend to view it. Both activities create, utilize, mix and share information, making service information management a necessary but relatively unknown managerial task. On the architectural level, service system -specific elements seem to disappear, but access to more general information elements and processes can be found. While this dissertation focuses on conceptual-level design artifact construction, the results provide also very practical implications for service providers. Personal, visual and hidden activities of service, and more importantly all changes that take place in any service system have also an information dimension. Making this information dimension visual and prioritizing the processed information based on service dimensions is likely to provide new opportunities to increase activities and provide a new type of service potential for customers.

Virtual communities : a virtual treasure trove for end-user developers

End-user development is a very common but often largely overlooked phenomenon in information systems research and practice. End-user development means that regular people, the end-users of software, and not professional developers are doing software development. A large number of people are directly or indirectly impacted by the results of these non-professional development activities. The numbers of users performing end-user development activities are difficult to ascertain precisely. But it is very large, and still growing. Computer adoption is growing towards 100% and many new types of computational devices are continually introduced. In addition, other devices not previously programmable are becoming so. This means that, at this very moment, hundreds of millions of people are likely struggling with development problems. Furthermore, software itself is continually being adapted for more flexibility, enabling users to change the behaviour of their software themselves. New software and services are helping to transform users from consumers to producers. Much of this is now found on-line. The problem for the end-user developer is that little of this development is supported by anyone. Often organisations do not notice end-user development and consequently neither provide support for it, nor are equipped to be able to do so. Many end-user developers do not belong to any organisation at all. Also, the end-user development process may be aggravating the problem. End-users are usually not really committed to the development process, which tends to be more iterative and ad hoc. This means support becomes a distant third behind getting the job done and figuring out the development issues to get the job done. Sometimes the software itself may exacerbate the issue by simplifying the development process, deemphasising the difficulty of the task being undertaken. On-line support could be the lifeline the end-user developer needs. Going online one can find all the knowledge one could ever need. However, that does still not help the end-user apply this information or knowledge in practice. A virtual community, through its ability to adopt the end-user’s specific context, could surmount this final obstacle. This thesis explores the concept of end-user development and how it could be supported through on-line sources, in particular virtual communities, which it is argued here, seem to fit the end-user developer’s needs very well. The experiences of real end-user developers and prior literature were used in this process. Emphasis has been on those end-user developers, e.g. small business owners, who may have literally nowhere to turn to for support. Adopting the viewpoint of the end-user developer, the thesis examines the question of how an end-user could use a virtual community effectively, improving the results of the support process. Assuming the common situation where the demand for support outstrips the supply.

Benchmark of routing protocols regarding green considerations

In Mobile Ad-hoc Networks (MANET) the participating nodes have several roles such as sender, receiver and router. Hence there is a lot of energy consumed by the nodes for the normal working of the network since each node has many different roles. Also in MANET the nodes keep moving constantly and this in turn consumes a lot of energy. Since battery capacity of these nodes is limited it fails to fulfil the high demand of energy. The scarcity of energy makes the energy conservation in mobile ad-hoc networks an important concern. There is several research carried out on the energy consumption of mobile ad-hoc networks these days. Some of this research suggests sleep mode, transmission power control, load balancing etc. In this thesis, we are comparing various proposed energy efficient models for some of the ad-hoc protocols. We compare different energy efficient models for Optimised Linked State Algorithm (OLSR) and Ad-hoc On Demand Distance Vector (AODV). The routing protocols are compared for different parameters such as average remaining energy, number of nodes alive, payload data received and performance with different mobility speed. The simulation results helps in benchmarking the various energy efficient routing models for OLSR and AODV protocols. The benchmarking of the routing protocols can be based on many factors but this thesis concentrates on benchmarking the MANET routing protocols mainly based on the energy efficiency and increased network lifetime.

Business intelligence – enabling self-service: A case study in a global manufacturing company

Business intelligence (BI) is an information process that includes the activities and applications used to transform business data into valuable business information. Today’s enterprises are collecting detailed data which has increased the available business data drastically. In order to meet changing customer needs and gain competitive advantage businesses try to leverage this information. However, IT departments are struggling to meet the increased amount of reporting needs. Therefore, recent shift in the BI market has been towards empowering business users with self-service BI capabilities. The purpose of this study was to understand how self-service BI could help businesses to meet increased reporting demands. The research problem was approached with an empirical single case study. Qualitative data was gathered with a semi-structured, theme-based interview. The study found out that case company’s BI system was mostly used for group performance reporting. Ad-hoc and business user-driven information needs were mostly fulfilled with self-made tools and manual work. It was felt that necessary business information was not easily available. The concept of self-service BI was perceived to be helpful to meet such reporting needs. However, it was found out that the available data is often too complex for an average user to fully understand. The respondents felt that in order to self-service BI to work, the data has to be simplified and described in a way that it can be understood by the average business user. The results of the study suggest that BI programs struggle in meeting all the information needs of today’s businesses. The concept of self-service BI tries to resolve this problem by allowing users easy self-service access to necessary business information. However, business data is often complex and hard to understand. Self-serviced BI has to overcome this challenge before it can reach its potential benefits.

Business intelligence – enabling self-service: A case study in a global manufacturing company

Business intelligence (BI) is an information process that includes the activities and applications used to transform business data into valuable business information. Today’s enterprises are collecting detailed data which has increased the available business data drastically. In order to meet changing customer needs and gain competitive advantage businesses try to leverage this information. However, IT departments are struggling to meet the increased amount of reporting needs. Therefore, recent shift in the BI market has been towards empowering business users with self-service BI capabilities. The purpose of this study was to understand how self-service BI could help businesses to meet increased reporting demands. The research problem was approached with an empirical single case study. Qualitative data was gathered with a semi-structured, theme-based interview. The study found out that case company’s BI system was mostly used for group performance reporting. Ad-hoc and business user-driven information needs were mostly fulfilled with self-made tools and manual work. It was felt that necessary business information was not easily available. The concept of self-service BI was perceived to be helpful to meet such reporting needs. However, it was found out that the available data is often too complex for an average user to fully understand. The respondents felt that in order to self-service BI to work, the data has to be simplified and described in a way that it can be understood by the average business user. The results of the study suggest that BI programs struggle in meeting all the information needs of today’s businesses. The concept of self-service BI tries to resolve this problem by allowing users easy self-service access to necessary business information. However, business data is often complex and hard to understand. Self-serviced BI has to overcome this challenge before it can reach its potential benefits.

Business Intelligence Competency Centerin perustaminen: Case LähiTapiola

Tässä diplomityössä selvitetään case-tutkimuksena parhaita käytäntöjä Business Intelligence Competency Centerin (BICC) eli liiketoimintatiedonhallinnan osaamiskeskuksen perustamiseen. Työ tehdään LähiTapiolalle, jossa on haasteita BI-alueen hallinnoinnissa kehittämisen hajaantuessa eri yksiköihin ja yhtiöihin. Myös järjestelmäympäristö on moninainen. BICC:llä tavoitellaan parempaa näkyvyyttä liiketoiminnan tarpeisiin ja toisaalta halutaan tehostaa tiedon hyödyntämistä johtamisessa sekä operatiivisen tason työskentelyssä. Tavoitteena on lisäksi saada kustannuksia pienemmäksi yhtenäistämällä järjestelmäympäristöjä ja BI-työkaluja kuten myös toimintamalleja. Työssä tehdään kirjallisuuskatsaus ja haastatellaan asiantuntijoita kolmessa yrityksessä. Tutkimuksen perusteella voidaan todeta, että liiketoiminnan BI-tarpeita kannattaa mahdollistaa eri tasoilla perusraportoinnista Ad-hoc –raportointiin ja edistyneeseen analytiikkaan huomioimalla nämä toimintamalleissa ja järjestelmäarkkitehtuurissa. BICC:n perustamisessa liiketoimintatarpeisiin vastaaminen on etusijalla.