Implementing a knowledge management system within an NHS hospital:a case study exploring the roll-out of an Electronic Patient Record (EPR)

This research aims to contribute to understanding the implementation of knowledge management systems (KMS) in the field of health through a case study, leading to theory building and theory extension. We use the concept of the business process approach to knowledge management as a theoretical lens to analyse and explore how a large teaching hospital developed, executed and practically implemented a KMS. A qualitative study was conducted over a 2.5 year period with data collected from semi-structured interviews with eight members of the strategic management team, 12 clinical users and 20 patients in addition to non-participant observation of meetings and documents. The theoretical propositions strategy was used as the overarching approach for data analysis. Our case study provides evidence that true patient centred approaches to supporting care delivery with a KMS benefit from process thinking at both the planning and implementation stages, and an emphasis on the knowledge demands resulting from: the activities along the care pathways; where cross-overs in care occur; and knowledge sharing for the integration of care. The findings also suggest that despite the theoretical awareness of KMS implementation methodologies, the actual execution of such systems requires practice and learning. Flexible, fluid approaches through rehearsal are important and communications strategies should focus heavily on transparency incorporating both structured and unstructured communication methods.

Getting the most out of multidisciplinary teams: a multi-sample study of team innovation in health care

Driven by the assumption that multidisciplinarity contributes positively to team outcomes teams are often deliberately staffed such that they comprise multiple disciplines. However, the diversity literature suggests that multidisciplinarity may not always benefit a team. This study departs from the notion of a linear, positive effect of multidisciplinarity and tests its contingency on the quality of team processes. It was assumed that multidisciplinarity only contributes to team outcomes if the quality of team processes is high. This hypothesis was tested in two independent samples of health care workers (N = 66 and N = 95 teams), using team innovation as the outcome variable. Results support the hypothesis for the quality of innovation, rather than the number of innovations introduced by the teams.

A study of field emission from cadmium sulphide

It was decided to investigate field emission from cadmium sulphide because many workers have found that the agreement between theory and experiment for this material, and other semiconductors, is poor. An electron energy analyser, similar to those used in most of the previously reported experiments, was, therefore, built. The performance of the analyser was thoroughly investigated both theoretically and practically and the results of these investigations were used in conjunction with a tungsten emitter. Excellent agreement was obtained between the usually accepted total energy distribution for tungsten and the corresponding .distribution measured with the present analyser. A method of obtaining reliable cadmium sulphide emitter was developed. These emitters were then used in the analyser and it was found that the agreement between theory and experiment was poor. Previous explanations of the lack of agreement are considered and are found to be doubtful. The theory of field emission from semiconductors is reviewed and possible reasons for the discrepancy between theory and experiment are proposed. Finally, further experiments are described which should prove or disprove the conclusions arrived at in this work.

A study of field emission from semiconductors

In an attempt to clarify the behaviour of semi-conductor field emitters the properties of a narrow band gap material were investigated. A retarding potential analyser was built and tested using a tungsten emitter. The energy distribution of electrons emitted from single crystals of lead telluride (band gap 0.3 eV) and gallium phosphide (band gap 2.26 eV) were measured. The halfwidths of the distributions are discussed with respect to the relevant parameters for the materials. Methods of tip preparation had to be developed. The halfwidth of the energy distribution of electrons field emitted from carbon fibres was measured to be 0.21 ± 0.01 eV. A mechanism explaining the long lifetime of the emitters in poor vacuua is proposed.

The classical theory of field evaporation

The field evaporation literature has been carefully analysed and is shown to contain various confusions. After redefining consistent terminology, this thesis investigates the mechanisms of field evaporation, in particular, the relevance of the theoretical mechanisms by analysing the available experimental data. A new formalism `extended image-hump formalism' is developed and is used to devise several tests of whether the image-hump mechanism is operating. The general conclusion is that in most cases the Mueller mechanism is not operating and escape takes place via Gomer-type mechanisms.

Spectroscopic studies of field-induced electron emission from isolated microstructures

A detailed investigation has been undertaken into the field induced electron emission (FIEE) mechanism that occurs at microscopically localised `sites' on uncoated and dielectric coated metallic electrodes. These processes have been investigated using two dedicated experimental systems that were developed for this study. The first is a novel combined photo/field emission microscope, which employs a UV source to stimulate photo-electrons from the sample surface in order to generate a topographical image. This system utilises an electrostatic lens column to provide identical optical properties under the different operating conditions required for purely topographical and combined photo/field imaging. The system has been demonstrated to have a resolution approaching 1m. Emission images have been obtained from carbon emission sites using this system to reveal that emission may occur from the edge triple junction or from the bulk of the carbon particle. An existing UHV electron spectrometer has been extensively rebuilt to incorporate a computer control and data acquisition system, improved sample handling and manipulation and a specimen heating stage. Details are given of a comprehensive study into the effects of sample heating on the emission process under conditions of both bulk and transient heating. Similar studies were also performed under conditions of both zero and high applied field. These show that the properties of emission sites are strongly temperature and field dependent thus indicating that the emission process is `non-metallic' in nature. The results have been shown to be consistent with an existing hot electron emission model.

Speaking out of turn? Taking the initiative in teacher-fronted classroom interaction.

Teacher-fronted interaction is generally seen to place limitations on the contributions that learners can make to classroom discourse and the conclusion is that learners are unable to experiment with, for example, turn-taking mechanisms. This article looks at teacher-fronted interaction in the language classroom from the perspective of learner talk by examining how learners might take the initiative during this apparently more rigid form of interaction. Detailed microanalysis of classroom episodes, using a conversation analysis institutional discourse approach, shows how learners orient to the institutional context to make sophisticated and effective use of turn-taking mechanisms to take the initiative and direct the interaction, even in the controlled environment of teacher-fronted talk. The article describes some of the functions of such learner initiative, examines how learners and teachers co-construct interaction and how learners can create learning opportunities for themselves. It also briefly looks at teacher reactions to such initiative. The article concludes that learner initiative in teacher-fronted interaction may constitute a significant opportunity for learning and that teachers should find ways of encouraging such interaction patterns.

PMD tolerance of 288 Gbit/s Coherent WDM and transmission over unrepeatered 124 km of field-installed single mode optical fiber

Low-cost, high-capacity optical transmission systems are required for metropolitan area networks. Direct-detected multi-carrier systems are attractive candidates, but polarization mode dispersion (PMD) is one of the major impairments that limits their performance. In this paper, we report the first experimental analysis of the PMD tolerance of a 288Gbit/s NRZ-OOK Coherent Wavelength Division Multiplexing system. The results show that this impairment is determined primarily by the subcarrier baud rate. We confirm the robustness of the system to PMD by demonstrating error-free performance over an unrepeatered 124km field-installed single-mode fiber with a negligible penalty of 0.3dB compared to the back-to-back measurements. (C) 2010 Optical Society of America

Response to out of stock produce and its underlying economic considerations

The goal of this research is to investigate consumer response to out-of-stock product in the produce category. We do this by comparing results from a survey conducted in Greece and the United States to previous research on consumer response to out-of-stock situations for other perishable and non-perishable products. We further examined the underlying economic reasoning as well as the cultural and physical differences between the United States and Greece as explanations of different reactions. Out of Stock produce response proved different in produce than in other perishables and non-perishables. There is some evidence that produce does follow previous the suggested economic reasoning from the previous research, especially within transaction costs. Finally, the respondent’s country proved very significant in dictating response.

The use of an energy analyser for the measurement of the total energy distribution of field-emitted electrons from tungsten

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