884 resultados para implementation project


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Thomas, R., Spink, S., Durbin, J. & Urquhart, C. (2005). NHS Wales user needs study including knowledgebase tools report. Report for Informing Healthcare Strategy implementation programme. Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: Informing Healthcare, NHS Wales

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BACKGROUND: Despite the impact of hypertension and widely accepted target values for blood pressure (BP), interventions to improve BP control have had limited success. OBJECTIVES: We describe the design of a 'translational' study that examines the implementation, impact, sustainability, and cost of an evidence-based nurse-delivered tailored behavioral self-management intervention to improve BP control as it moves from a research context to healthcare delivery. The study addresses four specific aims: assess the implementation of an evidence-based behavioral self-management intervention to improve BP levels; evaluate the clinical impact of the intervention as it is implemented; assess organizational factors associated with the sustainability of the intervention; and assess the cost of implementing and sustaining the intervention. METHODS: The project involves three geographically diverse VA intervention facilities and nine control sites. We first conduct an evaluation of barriers and facilitators for implementing the intervention at intervention sites. We examine the impact of the intervention by comparing 12-month pre/post changes in BP control between patients in intervention sites versus patients in the matched control sites. Next, we examine the sustainability of the intervention and organizational factors facilitating or hindering the sustained implementation. Finally, we examine the costs of intervention implementation. Key outcomes are acceptability and costs of the program, as well as changes in BP. Outcomes will be assessed using mixed methods (e.g., qualitative analyses--pattern matching; quantitative methods--linear mixed models). DISCUSSION: The study results will provide information about the challenges and costs to implement and sustain the intervention, and what clinical impact can be expected.

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BACKGROUND: Implementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing care in hospitals. Thus, HIT implementation may occur slowly as staff members observe and make sense of unexpected disruptions in care. As a critical organizational function, sensemaking, defined as the social process of searching for answers and meaning which drive action, leads to unified understanding, learning, and effective problem solving -- strategies that studies have linked to successful change. Project teamwork is a change strategy increasingly used by hospitals that facilitates sensemaking by providing a formal mechanism for team members to share ideas, construct the meaning of events, and take next actions. METHODS: In this longitudinal case study, we aim to examine project teams' sensemaking and action as the team prepares to implement new information technology in a tiertiary care hospital. Based on management and healthcare literature on HIT implementation and project teamwork, we chose sensemaking as an alternative to traditional models for understanding organizational change and teamwork. Our methods choices are derived from this conceptual framework. Data on project team interactions will be prospectively collected through direct observation and organizational document review. Through qualitative methods, we will identify sensemaking patterns and explore variation in sensemaking across teams. Participant demographics will be used to explore variation in sensemaking patterns. DISCUSSION: Outcomes of this research will be new knowledge about sensemaking patterns of project teams, such as: the antecedents and consequences of the ongoing, evolutionary, social process of implementing HIT; the internal and external factors that influence the project team, including team composition, team member interaction, and interaction between the project team and the larger organization; the ways in which internal and external factors influence project team processes; and the ways in which project team processes facilitate team task accomplishment. These findings will lead to new methods of implementing HIT in hospitals.

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Objective Describe the methodology and selection of quality indicators (QI) to be implemented in the EFFECT (EFFectiveness of Endometrial Cancer Treatment) project. EFFECT aims to monitor the variability in Quality of Care (QoC) of uterine cancer in Belgium, to compare the effectiveness of different treatment strategies to improve the QoC and to check the internal validity of the QI to validate the impact of process indicators on outcome. Methods A QI list was retrieved from literature, recent guidelines and QI databases. The Belgian Healthcare Knowledge Center methodology was used for the selection process and involved an expert's panel rating the QI on 4 criteria. The resulting scores and further discussion resulted in a final QI list. An online EFFECT module was developed by the Belgian Cancer Registry including the list of variables required for measuring the QI. Three test phases were performed to evaluate the relevance, feasibility and understanding of the variables and to test the compatibility of the dataset. Results 138 QI were considered for further discussion and 82 QI were eligible for rating. Based on the rating scores and consensus among the expert's panel, 41 QI were considered measurable and relevant. Testing of the data collection enabled optimization of the content and the user-friendliness of the dataset and online module. Conclusions This first Belgian initiative for monitoring the QoC of uterine cancer indicates that the previously used QI selection methodology is reproducible for uterine cancer. The QI list could be applied by other research groups for comparison. © 2013 Elsevier Inc.

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Ocean biogeochemistry (OBGC) models span a wide variety of complexities, including highly simplified nutrient-restoring schemes, nutrient–phytoplankton–zooplankton–detritus (NPZD) models that crudely represent the marine biota, models that represent a broader trophic structure by grouping organisms as plankton functional types (PFTs) based on their biogeochemical role (dynamic green ocean models) and ecosystem models that group organisms by ecological function and trait. OBGC models are now integral components of Earth system models (ESMs), but they compete for computing resources with higher resolution dynamical setups and with other components such as atmospheric chemistry and terrestrial vegetation schemes. As such, the choice of OBGC in ESMs needs to balance model complexity and realism alongside relative computing cost. Here we present an intercomparison of six OBGC models that were candidates for implementation within the next UK Earth system model (UKESM1). The models cover a large range of biological complexity (from 7 to 57 tracers) but all include representations of at least the nitrogen, carbon, alkalinity and oxygen cycles. Each OBGC model was coupled to the ocean general circulation model Nucleus for European Modelling of the Ocean (NEMO) and results from physically identical hindcast simulations were compared. Model skill was evaluated for biogeochemical metrics of global-scale bulk properties using conventional statistical techniques. The computing cost of each model was also measured in standardised tests run at two resource levels. No model is shown to consistently outperform all other models across all metrics. Nonetheless, the simpler models are broadly closer to observations across a number of fields and thus offer a high-efficiency option for ESMs that prioritise high-resolution climate dynamics. However, simpler models provide limited insight into more complex marine biogeochemical processes and ecosystem pathways, and a parallel approach of low-resolution climate dynamics and high-complexity biogeochemistry is desirable in order to provide additional insights into biogeochemistry–climate interactions.

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This paper, chosen as a best paper from the 2005 SAMOS Workshop on Computer Systems: describes the for the first time the major Abhainn project for automated system level design of embedded signal processing systems. In particular, this describes four key novelties: novel algorithm modelling techniques for DSP systems, automated implementation realisation, algorithm transformation for system optimisation and automated inter-processor communication. This is applied to two complex systems: a radar and sonar system. In both cases technology which allows non-experts to automatically create low-overhead, high performance embedded signal processing systems is exhibited.

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The introduction of new degrees in the Faculty of Education and the relevance of educational guidance comes to them, as a compulsory subject in all four grades started from 2009-2010, gives the opportunity to return and boost the University Guidance Service (UGS) as a means of consistency with the profile of their education and professional development of its students. The aim of the paper focuses on the evaluation of the results after the first year of implementing a peer mentoring project, SOU-estuTUtor Project, developed from UGS with all degree students of the Faculty of Education for Students new entrants. Program has been evaluated through the perception and satisfaction of the mentors on the organization, training, skills developed and adapted to the needs of students. After one academic year of implementation, the results show, on the one hand, the satisfaction and commitment of those involved and the partial response to the needs of the students served, as well as the optimization of the personal resources of the university but also some limitations that make it necessary to review the mentoring program in terms of control and duration of the process.

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This paper outlines how the immediate life support (ILS) course was incorporated into an undergraduate-nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The aim was to develop the student’s ability to recognise the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this the ILS course was only available to qualified nurses and this paper reports on the first time students were provided with an ILS course in an undergraduate setting. The ILS course was delivered to 89 third year nursing students (Adult Branch) and comprised one full teaching day per week over two weeks. Recognised Advanced Life Support (ALS) instructors, in keeping with the United Kingdom Resuscitation Council guidelines, taught the students. Participants completed a 17 item questionnaire which comprised an open-ended section for student comment. Questionnaire data was analysed descriptively using SSPSS version 15.0. Open-ended responses from the questionnaire data was analysed by content and thematic analysis. Results Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge Conclusion. The inclusion of the ILS course provides students with necessary skills to assess and manage the deteriorating patient. In addition the data from this study suggest the ILS course should be delivered in an inter-professional setting – i.e taught jointly with medical students. References: Department of Health & Quality Assurance Agency (2006). Department of Health Phase 2 benchmarking project – final report. Gloucester: Department of Health, London and Quality Assurance Agency for Higher Education

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The new pedagogical framework arisen since the Bologna Declaration,the Prague Communiquéand the introduction of the European Higher Education Area (EHEA), encourages, significantly, the use of new Communication and Information Technology to evolve teaching methodologies. The different ways teachers relate to learners have undergone a staggering change from which educational initiatives have emerged. Many of them are based on contents’ democratization through the use of ICT. The current article is intended to show the results obtained until the 2012/2013 academic course, since the implementation of the teaching innovation project entitled “The use of ICT for the students’ autonomous learning in the university education of the course Photography. Elaboration of a virtual classroom and results’ analysis related to the acquisition of skills and competencies” that has been developed in the course called Draw with light: Photography, belonging to the Fine Arts Degree at the University of Murcia.

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This paper presents the findings from an innovative project funded by the
International Association of Schools of Social Work (IASSW) and undertaken by
an international team of academics investigating the development of a global
curriculum for social work in the context of political conflict. Coupled alongside
the emerging research and literature on the subject, our small-scale survey
findings indicate support for the need for social work educators to address
political conflict more systematically within social work curricula at both
undergraduate and post-qualifying levels of social work education. The paper
illuminates the opportunities for creative pedagogy whilst also examining the
threats and challenges permeating the realisation of such initiatives. In this way,
the implementation of a proposed curriculum for political conflict is given meaning within the context of IASSW’s Global Standards for social work education. Given the exploratory nature of this project, the authors do conclude that further research is warranted in regard to potential curriculum development and suggest using a comparative case study approach with more in-depth qualitative methods as a way to address this.

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Policy-based network management (PBNM) paradigms provide an effective tool for end-to-end resource
management in converged next generation networks by enabling unified, adaptive and scalable solutions
that integrate and co-ordinate diverse resource management mechanisms associated with heterogeneous
access technologies. In our project, a PBNM framework for end-to-end QoS management in converged
networks is being developed. The framework consists of distributed functional entities managed within a
policy-based infrastructure to provide QoS and resource management in converged networks. Within any
QoS control framework, an effective admission control scheme is essential for maintaining the QoS of
flows present in the network. Measurement based admission control (MBAC) and parameter basedadmission control (PBAC) are two commonly used approaches. This paper presents the implementationand analysis of various measurement-based admission control schemes developed within a Java-based
prototype of our policy-based framework. The evaluation is made with real traffic flows on a Linux-based experimental testbed where the current prototype is deployed. Our results show that unlike with classic MBAC or PBAC only schemes, a hybrid approach that combines both methods can simultaneously result in improved admission control and network utilization efficiency

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This paper describes the ParaPhrase project, a new 3-year targeted research project funded under EU Framework 7 Objective 3.4 (Computer Systems), starting in October 2011. ParaPhrase aims to follow a new approach to introducing parallelism using advanced refactoring techniques coupled with high-level parallel design patterns. The refactoring approach will use these design patterns to restructure programs defined as networks of software components into other forms that are more suited to parallel execution. The programmer will be aided by high-level cost information that will be integrated into the refactoring tools. The implementation of these patterns will then use a well-understood algorithmic skeleton approach to achieve good parallelism. A key ParaPhrase design goal is that parallel components are intended to match heterogeneous architectures, defined in terms of CPU/GPU combinations, for example. In order to achieve this, the ParaPhrase approach will map components at link time to the available hardware, and will then re-map them during program execution, taking account of multiple applications, changes in hardware resource availability, the desire to reduce communication costs etc. In this way, we aim to develop a new approach to programming that will be able to produce software that can adapt to dynamic changes in the system environment. Moreover, by using a strong component basis for parallelism, we can achieve potentially significant gains in terms of reducing sharing at a high level of abstraction, and so in reducing or even eliminating the costs that are usually associated with cache management, locking, and synchronisation. © 2013 Springer-Verlag Berlin Heidelberg.

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Although discussions are underway within the Action Team 14 of the United Nations COPUOS, there is currently no concerted international plan addressing the impact threat from near-Earth objects (NEOs) and how to organize, prepare and implement mitigation measures. We report on a new international project to address impact hazard mitigation issues, being the subject of a proposal submitted to the European Commission in response to the 2011 FP7 Call "Prevention of impacts from near-Earth objects on our planet". Our consortium consists of 13 research institutes, universities, and industrial partners from 6 countries and includes leading US and Russian space organizations. The primary aim of the project, NEOShield, is to investigate in detail the three most promising mitigation techniques: the kinetic impactor, blast deflection,and the gravity tractor, and devise feasible demonstration missions. Furthermore, we will investigate options for an international strategy for implementation when an actual impact threat arises. The NEOShield project was formally accepted by the European Commission on 17 November 2011 and funded with a total of 5.8 million Euros for a period of 3.5 years. The kick-off meeting took place at the DLR Institute of Planetary Research, Berlin, in January 2012. In this paper we present a brief overview of the planned scope of the project.

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The Knowledge Exchange, Spatial Analysis and Healthy Urban Environments (KESUE) project has extended work previously undertaken by a QUB team of inter-disciplinary researchers engaged with the Physical Activity in the Regeneration of Connswater (PARC) project (Tully et al, 2013). The PARC project focussed on parts of East Belfast to assess the health impact of the Connswater Community Greenway. The KESUE project has aimed to extend some of the tools used initially in East Belfast so that they have data coverage of all of Belfast and Derry-Londonderry. The purpose of this has been to enable the development of evidence and policy tools that link features of the built environment with physical activity in these two cities. The project has used this data to help shape policy decisions in areas such as physical activity, park management, public transport and planning.

Working with a range of local partners who part-funded the project (City Councils in Belfast and Derry-Londonderry, Public Health Agency, Belfast Healthy Cities and Department of Regional Development), this project has mapped all the footpaths in the two cities (covering 37% of the NI population) and employed this to develop evidence used in strategies related to healthy urban planning. Using Geographic Information Systems (GIS), the footpath network has been used as a basis for a wide range of policy-relevant analyses including pedestrian accessibility to public facilities, site options for new infrastructure and assessing how vulnerable groups can access services such as pharmacies. Key outputs have been Accessibility Atlases and maps showing how walkability of the built environment varies across the two cities.

In addition to generating this useful data, the project included intense engagement with potential users of the research, which has led to its continued uptake in a number of policies and strategies, creating a virtuous circle of research, implementation and feedback. The project has proved so valuable to Belfast City Council that they have now taken on one of the researchers to continue the work in-house.

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There is a broad consensus surrounding the ability of building information modelling (BIM) to positively impact a project by enabling greater collaboration. This paper aims to examine the development of BIM and how it can contribute to the evermore present and growing cold-formed steel (CFS) industry. This is achieved thorough a comprehensive literature review and four exploratory interviews with industry experts. Work has been carried out, for the first time, alongside one of the UK’s largest CFS Designer/Fabricators in conjunction with Northern Ireland’s leading Architectural and Town Planning Consultants in the identification and dissemination of information. The capabilities of BIM have been investigated through modeling of simple CFS structures n consultation with the project partners. By scrutinising the literature and associated interviews, the primary opportunities, as well as barriers, of BIM implementation have been investigated in the context of these companies. It is essential to develop greater understanding of the flexibility, adaptability and interoperability of BIM software as the UK construction industry faces a daunting challenge; fully collaborative 3D BIM as required by the UK Government under the “Government Construction Strategy” by 2016 in all public sector projects. This paper, and the wider study that it stems from, approaches the problem from a new angle, from sections of the construction industry that have not yet fully embedded BIM.