IT support for administrative planning of clinical practice.

The administration of clinical practice placements for nursing students is a highly complex and information driven task. This demonstration is intended to give insight into the web based system KliPP (a Swedish acronym for Clinical Practice Planning) and to discuss the possibilities for further development and use.

On administrative borders and accessibility to public services: : The case of hospitals in Sweden.

An administrative border might hinder the optimal allocation of a given set of resources by restricting the flow of goods, services, and people. In this paper we address the question: Do administrative borders lead to poor accessibility to public service such as hospitals? In answering the question, we have examined the case of Sweden and its regional borders. We have used detailed data on the Swedish road network, its hospitals, and its geo-coded population. We have assessed the population’s spatial accessibility to Swedish hospitals by computing the inhabitants’ distance to the nearest hospital. We have also elaborated several scenarios ranging from strongly confining regional borders to no confinements of borders and recomputed the accessibility. Our findings imply that administrative borders are only marginally worsening the accessibility.

Automating condition monitoring of vegetation on railway trackbeds and embankments

Vegetation growing on railway trackbeds and embankments present potential problems. The presence of vegetation threatens the safety of personnel inspecting the railway infrastructure. In addition vegetation growth clogs the ballast and results in inadequate track drainage which in turn could lead to the collapse of the railway embankment. Assessing vegetation within the realm of railway maintenance is mainly carried out manually by making visual inspections along the track. This is done either on-site or by watching videos recorded by maintenance vehicles mainly operated by the national railway administrative body. A need for the automated detection and characterisation of vegetation on railways (a subset of vegetation control/management) has been identified in collaboration with local railway maintenance subcontractors and Trafikverket, the Swedish Transport Administration (STA). The latter is responsible for long-term planning of the transport system for all types of traffic, as well as for the building, operation and maintenance of public roads and railways. The purpose of this research project was to investigate how vegetation can be measured and quantified by human raters and how machine vision can automate the same process. Data were acquired at railway trackbeds and embankments during field measurement experiments. All field data (such as images) in this thesis work was acquired on operational, lightly trafficked railway tracks, mostly trafficked by goods trains. Data were also generated by letting (human) raters conduct visual estimates of plant cover and/or count the number of plants, either on-site or in-house by making visual estimates of the images acquired from the field experiments. Later, the degree of reliability of(human) raters’ visual estimates were investigated and compared against machine vision algorithms. The overall results of the investigations involving human raters showed inconsistency in their estimates, and are therefore unreliable. As a result of the exploration of machine vision, computational methods and algorithms enabling automatic detection and characterisation of vegetation along railways were developed. The results achieved in the current work have shown that the use of image data for detecting vegetation is indeed possible and that such results could form the base for decisions regarding vegetation control. The performance of the machine vision algorithm which quantifies the vegetation cover was able to process 98% of the im-age data. Investigations of classifying plants from images were conducted in in order to recognise the specie. The classification rate accuracy was 95%.Objective measurements such as the ones proposed in thesis offers easy access to the measurements to all the involved parties and makes the subcontracting process easier i.e., both the subcontractors and the national railway administration are given the same reference framework concerning vegetation before signing a contract, which can then be crosschecked post maintenance.A very important issue which comes with an increasing ability to recognise species is the maintenance of biological diversity. Biological diversity along the trackbeds and embankments can be mapped, and maintained, through better and robust monitoring procedures. Continuously monitoring the state of vegetation along railways is highly recommended in order to identify a need for maintenance actions, and in addition to keep track of biodiversity. The computational methods or algorithms developed form the foundation of an automatic inspection system capable of objectively supporting manual inspections, or replacing manual inspections.

Local politico-administrative perspectives on quality improvement based on national registry data in Sweden : a qualitative study using the Consolidated Framework for Implementation Research.

Background. Through a national policy agreement, over 167 million Euros will be invested in the Swedish National Quality Registries (NQRs) between 2012 and 2016. One of the policy agreement¿s intentions is to increase the use of NQR data for quality improvement (QI). However, the evidence is fragmented as to how the use of medical registries and the like lead to quality improvement, and little is known about non-clinical use. The aim was therefore to investigate the perspectives of Swedish politicians and administrators on quality improvement based on national registry data. Methods. Politicians and administrators from four county councils were interviewed. A qualitative content analysis guided by the Consolidated Framework for Implementation Research (CFIR) was performed. Results. The politicians and administrators perspectives on the use of NQR data for quality improvement were mainly assigned to three of the five CFIR domains. In the domain of intervention characteristics, data reliability and access in reasonable time were not considered entirely satisfactory, making it difficult for the politico-administrative leaderships to initiate, monitor, and support timely QI efforts. Still, politicians and administrators trusted the idea of using the NQRs as a base for quality improvement. In the domain of inner setting, the organizational structures were not sufficiently developed to utilize the advantages of the NQRs, and readiness for implementation appeared to be inadequate for two reasons. Firstly, the resources for data analysis and quality improvement were not considered sufficient at politico-administrative or clinical level. Secondly, deficiencies in leadership engagement at multiple levels were described and there was a lack of consensus on the politicians¿ role and level of involvement. Regarding the domain of outer setting, there was a lack of communication and cooperation between the county councils and the national NQR organizations. Conclusions. The Swedish experiences show that a government-supported national system of well-funded, well-managed, and reputable national quality registries needs favorable local politico-administrative conditions to be used for quality improvement; such conditions are not yet in place according to local politicians and administrators.