Developing a best practice pathway to support improvements in Indigenous Australians' mental health and well-being: A qualitative study

Objective: There is a need to adapt pathways to care to promote access to mental health services for Indigenous people in Australia. This study explored Indigenous community and service provider perspectives of well-being and ways to promote access to care for Indigenous people at risk of depressive illness. Design: A participatory action research framework was used to inform the development of an agreed early intervention pathway; thematic analysis Setting: 2 remote communities in the Northern Territory. Participants: Using snowball and purposive sampling, 27 service providers and community members with knowledge of the local context and the diverse needs of those at risk of depression were interviewed. 30% of participants were Indigenous. The proposed pathway to care was adapted in response to participant feedback. Results: The study found that Indigenous mental health and well-being is perceived as multifaceted and strongly linked to cultural identity. It also confirms that there is broad support for promotion of a clear pathway to early intervention. Key identified components of this pathway were the health centre, visiting and community-based services, and local community resources including elders, cultural activities and families. Enablers to early intervention were reported. Significant barriers to the detection and treatment of those at risk of depression were identified, including insufficient resources, negative attitudes and stigma, and limited awareness of support options. Conclusions: Successful early intervention for wellbeing concerns requires improved understanding of Indigenous well-being perspectives and a systematic change in service delivery that promotes integration, flexibility and collaboration between services and the community, and recognises the importance of social determinants in health promotion and the healing process. Such changes require policy support, targeted training and education, and ongoing promotion.

Survey of challenges and best practice strategies for participant recruitment to research projects in northern ireland

Participant recruitment is understood to be one of the most difficult aspects of the research process. Researchers are now devoting increasing amounts of time and resources to understand how participants decide to take part in research and what researchers can do to make their work appeal to potential participants. The purpose of the study is to assess the problems experienced by researchers in Northern Ireland when recruiting human participants into trials and studies and to gain insight into how researchers handle and overcome these issues. The main research question being addressed by this research is to develop an understanding of the problems experienced by staff when recruiting human participants to research projects. Methods used to increase study recruitment were also examined. The participants in this research are investigators and other associated staff on research studies based in Northern Ireland. Potential participants were identified through contacts with research active organizations such as the academic researchers in Queen’s University Belfast and research physicians and clinical trialists employed by the Belfast Health and Social Care Trust. Each organization forwarded on the survey request via email or newsletters. Researchers willing to take part accessed the questionnaire through the Survey Monkey website. This study utilised a cross-sectional questionnaire design.

Construction Dispute Resolution in Ireland during Recession: Best Practice for Small-to-Medium Enterprises

The purpose of this paper is to identify best practice construction dispute resolution in small-to-medium enterprises (SMEs) within Ireland during the recent economic recession. A sequential mixed methodology encompassing a detailed literature review, case studies, and questionnaire survey is adopted, with results analyzed using both exploratory (data reduction) and confirmatory (structural equation modelling) factor analysis. The results show that four core aspects should be adopted by SMEs to achieve best practice construction dispute resolution in recession: third-party intervention, adoption of a streamlined process, proactive party characteristics, and the use of legal professionals. Numerous studies of this subject have been conducted; however, no research has been done to date documenting best practice in construction dispute resolution within SMEs, particularly in light of the economic recession in Ireland. It is clear that dispute resolution in Ireland is currently undergoing fundamental changes, and time is necessary to see if the new Construction Contracts Act 2013 will help this practice. Therefore, it is a fundamental requirement for project management and legal professionals to acknowledge the changing environment attributable to the economic downturn and the resultant SME best practices in dispute resolution. This paper fulfills a gap in knowledge with the emergence of the economic recession and the evolution of best practice in dispute resolution within SMEs in the Irish construction sector.

Sustaining Health Care Practice Change: The Experience of Best Practice Spotlight Organizations Implementing and Sustaining RNAO Best Practice Guidelines

Sustainability of change for improvement initiatives has been widely reported as a global challenge both within and outside health care settings. The purpose of this study was to examine the extent to which factors related to staff training and involvement, staff behaviour, and clinical leaders’ and senior leaders’ engagement and support impact the long term sustainability of practice changes for BPSO health care organizations who have implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines. Semi structured interviews with eleven organizational leaders’ from ten health care organizations were conducted to explore the unique experiences, views and perspectives on factors related to staff, clinical leaders and senior leaders and their involvement and impact on the long term sustainability of clinical practice changes within organizations who had implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines (BPGs). The interviews were coded and analyzed using thematic content analysis. Further analysis identified patterns and themes in relation to: 1. The National Health Service (NHS) Sustainability Model which was used as the theoretical framework for this research; and 2. Organizations found to have sustained practice changes longer term verses organizations that did not. Six organizations were found to have sustained practice changes while the remaining four were found to have been unsuccessful in their efforts to sustain the changes. Five major findings in relation to sustainability emerged from this study. First is the importance of early and sustained engagement and frontline staff, managers, and clinical leaders in planning, implementation and ongoing development of BPGs through use of working groups and champions models. Second is the importance of ongoing provision of formal training, tools and resources to all key stakeholders during and after the implementation phase and efforts made to embed changes in current processes whenever possible to ensure sustainability. Third is to ensure staff and management are receptive to the proposed change(s) and/or have been given the necessary background information and rationale so they understand and can support the need for the change. Fourth is the need for early and sustained fiscal and human resources dedicated to supporting BPG implementation and the ongoing use of the BPGs already in place. Fifth is ensuring clinical leaders are trusted, influential, respected and seen as clinical resources by frontline staff. The significance of this study lies in a greater understanding of the influence and impact of factors related to staff on the long term sustainability of implemented practice changes within health care organizations. This study has implications for clinical practice, policy, education and research in relation to sustainability in health care.

The evidence based practice process

This animation reveals the steps for evidence based practice to ensure better outcomes for patients. This file was edited to remove a legacy hyperlink. The link may be best placed in the efolio text for easy editing by academics.

EnvironalPlanning: an analytical network process model for environmentally conscious construction planning

Although the construction pollution index has been put forward and proved to be an efficient approach to reducing or mitigating pollution level during the construction planning stage, the problem of how to select the best construction plan based on distinguishing the degree of its potential adverse environmental impacts is still a research task. This paper first reviews environmental issues and their characteristics in construction, which are critical factors in evaluating potential adverse impacts of a construction plan. These environmental characteristics are then used to structure two decision models for environmental-conscious construction planning by using an analytic network process (ANP), including a complicated model and a simplified model. The two ANP models are combined and called the EnvironalPlanning system, which is applied to evaluate potential adverse environmental impacts of alternative construction plans.

Best practice in the training, appointment and remuneration of members of dispute boards for large infrastructure projects

This paper reports part of a qualitative study into evolving practice in the implementation of the Dispute Adjudication Board (DAB) construction dispute resolution technique, a variant of the Dispute Review Board (DRB) concept used in the US and Canada. Data was collected through a focus group interview of 20 highly experienced dispute resolution practitioners from engineering and the law. The group was assembled from members of FIDIC-NET with direct experience of project DABs. The part reported here concerns practice and procedure for establishing DABs. The main findings are that: constitution of the DABs is often delayed because of either project owners' ignorance of the DAB process or deterrence by the cost of the DABs; such owners also tend to insist on appointing DAB members from local engineers and lawyers without sufficient understanding of the DAB process; rates of remuneration of DAB members vary widely; the training provision for DAB membership and advocacy skills is inadequate; the process of selecting candidates for DAB membership and negotiating the tripartite agreement between each member and the contractual parties needs to be navigated with great care to avoid raising ethical problems. The research contribution is threefold. First, it highlights the importance of realistic fees for DAB members within a standard framework in achieving timely establishment of a board that works well as a team. Second, it illustrates the use of qualitative focus group interview to study the impact of new contract terms from multiple stakeholder perspectives. Finally, it identifies areas where further research is needed.

Knowledge intensive processes characteristics and improvement: a banking best practice example

This paper identifies characteristics of knowledge intensive processes and a method to improve their performance based on analysis of investment banking front office processes. The inability to improve these processes using standard process improvement techniques confirmed that much of the process was not codified and depended on tacit knowledge and skills. This led to the use of a semi-structured analysis of the characteristics of the processes via a questionnaire to identify knowledge intensive processes characteristics that adds to existing theory. Further work identified innovative process analysis and change techniques that could generate improvements based on an analysis of their properties and the issue drivers. An improvement methodology was developed to harness a number of techniques that were found to effective in resolving the issue drivers and improving these knowledge intensive processes.

Inter-organisational knowledge transfer process model

Knowledge management (KM) is an emerging discipline (Ives, Torrey & Gordon, 1997) and characterised by four processes: generation, codification, transfer, and application (Alavi & Leidner, 2001). Completing the loop, knowledge transfer is regarded as a precursor to knowledge creation (Nonaka & Takeuchi, 1995) and thus forms an essential part of the knowledge management process. The understanding of how knowledge is transferred is very important for explaining the evolution and change in institutions, organisations, technology, and economy. However, knowledge transfer is often found to be laborious, time consuming, complicated, and difficult to understand (Huber, 2001; Szulanski, 2000). It has received negligible systematic attention (Huber, 2001; Szulanski, 2000), thus we know little about it (Huber, 2001). However, some literature, such as Davenport and Prusak (1998) and Shariq (1999), has attempted to address knowledge transfer within an organisation, but studies on inter-organisational knowledge transfer are still much neglected. An emergent view is that it may be beneficial for organisations if more research can be done to help them understand and, thus, to improve their inter-organisational knowledge transfer process. Therefore, this article aims to provide an overview of the inter-organisational knowledge transfer and its related literature and present a proposed inter-organisational knowledge transfer process model based on theoretical and empirical studies.

Challenging 'best practice' subtropical design

Genuine sustainability would require that urban development provide net positive social and ecological gains to compensate for previous lost natural capital and carrying capacity. Thus far, green buildings do not contribute to net sustainability. While they reduce relative resource consumption, they consume vast quantities of materials, energy and water.i Moreover, they replace land and ecosystems with structures that, at best, ‘mimic’ ecosystems. Elsewhere, the author has proposed a‘sustainability standard’, where development would leave the ecology, as well as society, better off after construction than before.ii To meet this standard, a development would need to add natural and social capital beyond what existed prior to development. Positive DesignTM or Positive DevelopmentTM is that which expands both the ecological base (life support system) and the public estate (equitable access to means of survival). How to achieve this is discussed in Positive Development (Birkeland 2008). This paper examines how net positive gains can be achieved in a ubtropical as well as temperate environment.