Nursing and medical students as agents of change in health care: impact of schools core values and culture-a discussion paper

Within the UK the quality of care delivered in some hospitals, nursing homes and caring facilities has been the subject of significant enquiry, challenge and concern in recent years. There was need for a change in the culture of patient and client care. Traditionally a change in culture is seen as moving from an organisational head through to the organisation and in this case through to front-line care. This hasn’t necessarily achieved the desired effect and impact in terms of quality of care within the UK. Historically, certainly nurses have acted more as recipients of change, rather than agents of change
This paper suggests that schools of nursing and medicine with robust core values and a more consistently enacted culture of care, are better able and more likely to transfer this to nursing and medical students within their professional socialisation. In addition, and rather than the newly qualified nurse or doctor being absorbed into existing cultures of care delivery (which are not necessarily always reflecting high qualities of care), schools of nursing and medicine could better facilitate the development of more `agency’ within students and better equipping the students on qualification and stepping into practice, with a role and function as potential agents of change. Effective leadership within schools of nursing and medicine can both translate to quality and consistency, and enactment of organisational core values and working culture. The working culture of schools is intrinsic to developing students as agents of change

Principles and Practice of Fire Modelling: A Collection of Lecture Notes for a Short Course

Once the preserve of university academics and research laboratories with high-powered and expensive computers, the power of sophisticated mathematical fire models has now arrived on the desk top of the fire safety engineer. It is a revolution made possible by parallel advances in PC technology and fire modelling software. But while the tools have proliferated, there has not been a corresponding transfer of knowledge and understanding of the discipline from expert to general user. It is a serious shortfall of which the lack of suitable engineering courses dealing with the subject is symptomatic, if not the cause. The computational vehicles to run the models and an understanding of fire dynamics are not enough to exploit these sophisticated tools. Too often, they become 'black boxes' producing magic answers in exciting three-dimensional colour graphics and client-satisfying 'virtual reality' imagery. As well as a fundamental understanding of the physics and chemistry of fire, the fire safety engineer must have at least a rudimentary understanding of the theoretical basis supporting fire models to appreciate their limitations and capabilities. The five day short course, "Principles and Practice of Fire Modelling" run by the University of Greenwich attempt to bridge the divide between the expert and the general user, providing them with the expertise they need to understand the results of mathematical fire modelling. The course and associated text book, "Mathematical Modelling of Fire Phenomena" are aimed at students and professionals with a wide and varied background, they offer a friendly guide through the unfamiliar terrain of mathematical modelling. These concepts and techniques are introduced and demonstrated in seminars. Those attending also gain experience in using the methods during "hands-on" tutorial and workshop sessions. On completion of this short course, those participating should: - be familiar with the concept of zone and field modelling; - be familiar with zone and field model assumptions; - have an understanding of the capabilities and limitations of modelling software packages for zone and field modelling; - be able to select and use the most appropriate mathematical software and demonstrate their use in compartment fire applications; and - be able to interpret model predictions. The result is that the fire safety engineer is empowered to realise the full value of mathematical models to help in the prediction of fire development, and to determine the consequences of fire under a variety of conditions. This in turn enables him or her to design and implement safety measures which can potentially control, or at the very least reduce the impact of fire.

Final report implementation of relational management

Construction teams and construction organisations have their own distinctive cultures. There also exists an infrastructure, both social and contractual, which ensures that these projects within which the teams operate are completed successfully. It is these issues which this research has addressed. The project was instigated by Queensland Department of Main Roads, Public Works and John Holland Group in order to address how they might better implement relationship management (RM) on their construction projects. The project was devised initially in order to facilitate a change in culture which would allow the project to be run in a relational manner and would lead to effective performance in terms of the KPIs that the organisations set for themselves, described as business better than usual. This report describes the project, its outcomes and deliverable and indicates the changes that were made to the project during the research process. Hence, the initial premise of the project and the problem to investigate was the implementation of relational contracting: • throughout a range of projects; • with a focus on client body staff. The additions that were made to the project, and documented in the variations to the project, included two major additional areas of study: • client management and stakeholder management; • a live case study of an alliancing project. The context within which the research was undertaken is important. The research was driven by main roads with their desire to improve their operations by focusing on the relationship between the major project participants (however, stakeholder and client organisation management became an obvious issue as the research progressed, hence the variations). The context was initially focussed on main roads, public works and John Holland group organisations but it became clear very quickly that this was in fact an industry-wide issue and not an issue specific solely to the project participants. Hence, the context within which this research took place can be described as below: The deliverables from the project are a toolkit for determining RM needs in an organisation, a monograph describing the practical implementation of RM and the outline for a RM CPD and Masters course

A primer in public policy for the construction industry

The purpose of this document is to introduce non-specialists to the discipline and practice of public policy, particularly in relation to the construction sector in Australia. In order to do this, a brief overview of Australia’s government structure, and some of the main approaches to public policy analysis are outlined. Reference to construction related examples are provided to ensure issues discussed are relevant and understandable to construction professionals. Government is a significant player in the construction industry, and has multiple roles: adjudicator, regulator, constructor, purchaser and client of construction projects. Moreover there are many spheres of government that are typically engaged in construction projects at multiple stages. The machinery of government can be difficult to understand, even for long term public servants. Demystifying the processes within government can help to improve communication and therefore performance in the industry. A better understanding of how policy-making and government policies affect the construction industry will enhance communication and assist construction professionals and academics to understand and work with government. Additionally the document will provide an opportunity to demonstrate the relevance of policy analysis to inquiries of construction policies and regulation.

Social innovation to solve homelessness : wicked solutions for wicked problems

Homelessness is a complex problem that manifests in all societies. This intractable and ‘wicked’ issue resists single-agency solutions and its resolution and requires a large, on-going investment of financial and professional resources that few organisations can sustain. This paper adopts a social innovation framework to examine government and community sector responses to homelessness. While recent evaluations and policy prescriptions have suggested better integrated and more co-ordinated service delivery models for addressing homelessness, there is little understanding of the innovation framework in which alternative service system paradigms emerge. A framework that identifies/distils and explains different innovation levels is put forward. The framework highlights that while government may lead strategic level innovations, community organisations are active in developing innovation at the service and client level. Moreover, community organisations may be unaware of the innovative capacity that resides in their creative responses to resolving social crisis and marginalisation through being without shelter.

Do clients with acquired brain injury use the splints prescribed by occupational therapists? A descriptive study

Clients with acquired brain injury often demonstrate hypertonicity and decreased function in their upper limbs, requiring appropriate intervention. Splinting is one of the intervention methods that is widely used to address these issues. Literature shows that some clients are not using splints following fabrication. However, there is a paucity of research about the factors that influence clients to use or not use splints. This study aims to investigate these influential factors for clients with upper limb hypertonicity. Two survey tools including therapist and client questionnaires were developed and completed by both therapists and clients. Six therapists and 14 clients participated in this study and completed the relevant questionnaires. The results illustrate that most clients (13 out of 14) were continuing to use their splints four weeks following discharge from hospital. The main goals of choosing splints for both therapists and clients were prevention of contracture and deformity. The most indicated client reasons for adhering to the splint wearing program were therapist-related factors including clients’ trust and reliance on their therapists. Further reasons for clients implementing the recommended splint-wearing program and clinical implications are discussed.

Integrated literacies : every online player wins a prize

QUT Library’s model of learning support brings together academic literacy (study skills) and information literacy (research skills). The blended portfolio enables holistic planning and development, seamless services, connected learning resources and more authentic curriculum-embedded education. The model reinforces the Library’s strategic focus on learning service innovation and active engagement in teaching and learning. ----- ----- ----- The online learning strategy is a critical component of the broader literacies framework. This strategy unifies new and existing online resources (e.g.: Pilot, QUT cite|write and IFN001|AIRS Online) to augment learner capability. Across the suite, prudent application of emerging technologies with visual communications and learning design delivers a wide range of adaptive study tools. Separately and together, these resources meet the learning needs and styles of a diverse cohort providing positive and individual learning opportunities. Deliberate articulation with strategic directions regarding First Year Experience, assessment, retention and curriculum alignment assures that the Library’s initiatives move in step with institutional objectives relating to enhancing the student experience and flexible blended learning. ----- ----- ----- The release of Studywell in 2010 emphasises the continuing commitment to blended literacy education. Targeting undergraduate learners (particularly 1st year/transition), this online environment provides 24/7 access to practical study and research tools. Studywell’s design and application of technology creates a “discovery infrastructure” [1] which facilitates greater self-directed learning and interaction with content. ----- ----- ----- This paper presents QUT Library’s online learning strategy within the context of the parent “integrated literacies” framework. Highlighting the key online learning resources, the paper describes the inter-relationships between those resources to develop complementary literacies. The paper details broad aspects of the overarching learning and study support framework as well as the online strategy, including strategic positioning, quality and evaluation processes, maintenance, development, implementation, and client engagement and satisfaction with the learning resources.

External auditors' reliance on internal auditing : further evidence.

Purpose – The purpose of this paper is to explore whether internal audit’s reporting relationship with the audit committee and the client���s business risk environment impact external auditors’ reliance on the work of internal audit. Design/methodology/approach – An experiment is conducted using a 2 £ 2 between-subjects design where we manipulate the above two factors at strong and weak levels. Participants are 66 audit partners, managers and seniors, all experienced with clients having internal audit functions. Findings – The results indicate that both factors affect external auditors’ reliance on work already undertaken by internal audit and their use of internal auditors (IA) as assistants. The results also indicate that external auditors are more likely to use internal audit for control evaluation tasks than for substantive tests of balances. The study does not find any significant interaction effects between the two factors. Originality/value – No prior studies have examined the influence of reporting relationship and client business risk on external auditors’ reliance decisions in the current governance environment. Further, the paper examines the impact of these factors on reliance on work already undertaken by internal audit and on using IA as assistants, with respect to both control evaluation work and substantive testing of balances.

Using the work system method with freshman information systems students

Recent surveys of information technology management professionals show that understanding business domains in terms of business productivity and cost reduction potential, knowledge of different vertical industry segments and their information requirements, understanding of business processes and client-facing skills are more critical for Information Systems personnel than ever before. In an attempt to restrucuture the information systems curriculum accordingly, our view it that information systems students need to develop an appreciation for organizational work systems in order to understand the operation and significance of information systems within such work systems.

Moving beyond traditional clinics : creating a new legal clinics through community partnerships

To overcome the challenge of finding placements for large student numbers, QUT has partnered with community organisations to enable students to work on community-based projects addressing a community need. Students work in interdisciplinary teams with the community organisation to resolve issues and identify solutions to suit the organisation and client base. This paper will describe the community engaged learning pedagogy that is employed in the subject and will consider the benefits and challenges to law students of working collaboratively and developing community relationships. Critical appraisal of the legal system and the role of lawyers and analysis of the professional and ethical responsibilities legal practitioners is a focus of the subject. Explicit emphasis is placed on developing a sense of social responsibility and inculcating a pro bono ethos. Students attend workshops on topics such as reflective practice, cultural competencies, client solutions, collaborative practice and ethical obligations. This paper will discuss the challenges in creating the new legal clinic subject, benefits to students and community partners, and the results of initial student evaluation of the subject.

Validation of the dietetic confidence scale

Dietitians have reported a lack of confidence in counselling clients with mental health issues. Standardised tools are needed to evaluate programs aiming to improve confidence. The Dietetic Confidence Scale (DCS) was developed to assess dietitians’perception of their capability about working with clients experiencing depression. Exploratory research revealed a 13-item, two-factor model. Dietetic confidence was associated with: 1) Confidence using the Nutrition Care Process; and 2) Confidence in Advocacy for Self-care and Client-care. This study aimed to validate the DCS using this two-factor model.The DCS was administered to 458 dietitians. Confirmatory factor analysis (CFA) assessed the scale’s psychometric validity. Reliability was measured using Cronbach’s alpha (α) co-efficient. CFA results supported the hypothesised two-factor, 13-item model. The Good Fit Index (GFI = 0.95) indicated a strong fit. Item-factor correlations ranged from r = 0.50 to 0.89. The overall scale and subscales showed good reliability (α = 0.93 to 0.76). This is the first study to validate an instrument that measures dietetic confidence about working with clients experiencing depression. The DCS can be used to measure changes in perceived confidence and identify where further training, mentoring or experience is needed. The findings also suggest that initiatives aimed at building dietitians' confidence about working with clients experiencing depression, should focus on improving client-focused nutrition care, foster advocacy, reflective practice, mentoring and encourage professional support networks. Avenues for future research include further validity and reliability testing to expand the generalisability of results; and modifying the scale for other disease or client populations.

Improving the competence of construction management consultants to underpin sustainable construction in China

As a vital component of construction professional services (CPS), construction management consultancy is in nature knowledge-intensive and client-tailored. Although recent studies have acknowledged the increasing role of this subsector of CPS in the attainment of sustainable construction, little attention has been given to the education and training of its main body, namely construction management consultants (CMCs). This study investigated the competence and knowledge structure of CMCs by taking China as an example. Using the methods of interview and questionnaire survey, three key competences of CMCs and the underpinned knowledge structure were identified. The identified competences are personnel quality, onsite practical skills, and continuing professional learning. Underpinned these competences are the knowledge structure composed of a number of disciplines including construction cost planning and control, civil engineering and construction, engineering contract and law, and construction project management. The research findings lay a solid foundation for future studies to probe into the role of construction management consultants in the area of sustainable construction.

Tilausompelijan ja asiakkaan näkemyksiä laadusta

The aim of the study was to find out what kind of view on product quality dressmaker and customer have, how the views differ from each other and how the difference affects dressmaker s work as an entrepreneur. The research data consists of eight thematic interviews: four dressmakers and four customers were interviewed for the study. In the core of customised dressmaking is arelationship between a maker and a client. The product of a dressmaker, a unique dress, is created in an immediate interaction between a dressmaker and a client. Also the quality of a unique dress derives from this interaction. In the results of this study, the views on quality are linked with six themes: dress, process, dressmaker, customer, interaction and enterprise. The dressmakers and the customers agree that the quality of a custom-made dress is based on unique fit. Describing the process the dressmakers insist on the quality of manufacturing. The clients' view on process insists on those phases where they themselves take part: designing and fitting. The personality of the dressmaker is part of quality in both the dressmakers' and the customers' points of view. The dressmakers and the customers are also aware of the customers impact on fulfilling the expectations. The immediate interaction between dressmaker and customer is a key to the unique dressmaking. At its best the interaction is followed by a trusting relationship. Entrustment derives also from a good reputation, which is essential in dressmaker-entrepreneurs marketing strategy. The dressmakers views on quality are product- and manufacturing-based. According to the results of the study there can be seen different types of dressmakers, that emphasise different aspects of quality. At the other end is a manufacturing-based, even transcendent view on quality, which rests on the values of the dressmaker. At the other end lies a customer- and value-based approach, which is founded on fulfilling the expectations and needs of the customer. In their views on quality the customers emphasise the immediate interaction between dressmaker and client. Keywords: quality, dressmaker, customer, entrepreneur

Asiakassuunnitelma asiakaslähtöistä auttamista tavoitteellistamassa : Kohteen rakentumisen moniääninen menetelmä

The research focuses on client plan in the field of health care and social work on families with children. The purpose of the plan is to create objectives for helping the client and to assist in coordinating the ever-increasing multi-professional work. In general, the plan is understood in terms of assignments and as a contract specifying what to do in client cases. Taking this into consideration, the plan is outsourced into a written document. Instead of understanding the plan as a tool that stabilizes the objectives of action, documents it and facilitates evaluation, the client plan is conceptualized in this study as a practice. This kind of practice mediates client work as being itself also a process of action that focuses on an object whose gradual emergence and definition is the central question in multi-professional collaboration with a client. The plan is examined empirically in a non-stabilized state which leads to the research methodology being based on the dynamics between stabilization and emerging, non-stabilized entities the co-creation and formulation of practice and context. The theoretical approach of the research is the micro analytic approach of activity theory (Engeström R. 1999b). Grounding on this, the research develops a method of qualitative analysis which follows an emerging object with multiple voices. The research data is composed of the videotaped sessions from client meetings with three families, the interviews with the client and the workers as well as client documents that are used to follow up on client processes for at least one year. The research questions are as follows: 1) How is the client plan constructed between the client and different professional agents? 2) How are meanings constructed in a client-centred plan? 3) What are the elements of client-employee relationships that support the co-configuration necessitated by the changes in the client s everyday life? The study shows that the setting of objectives were limited by the palette of institutional services, which caused that the clients interpretations and acts of giving meaning to the kinds of help that was required were left out of the plan. Conceptually, the distinctions between client-centred and client-specific ways of working as well as an action-based working method are addressed. Central to this action-based approach is construing the everyday life of the client, recognizing different meanings and analyzing them together with the client as well as focusing attention on developing the prerequisites for social agency of the clients. The research portrays the elements for creating an action-based client plan. Key words: client plan, user perspective, multi-voiced meaning, multi-professional social work with children and families, agency

A lei de acesso à informação e a sua influência nos processos de atendimento às demandas da sociedade : estudo do caso do Centro de Documentação e Informação da Câmara dos Deputados

Examina a aplicação da Lei nº 12.527, de 18 de novembro de 2011 – a Lei de Acesso à Informação (LAI) – tendo como locus a Câmara dos Deputados e o seu órgão de gestão da informação, de relacionamento e de atendimento ao público usuário, o Centro de Documentação e Informação (Cedi) e, em particular, a Coordenação de Relacionamento, Pesquisa e Informação (Corpi). Analisa-se, à luz da Ciência da Informação, o impacto causado pela LAI no processo de provimento de informação e na disponibilidade da informação institucional para a sociedade, no contexto do amplo acesso às informações públicas, desejável na Câmara. A pesquisa, de caráter documental, firma-se em documentos e na legislação produzidos na esfera da Câmara dos Deputados. Para o estudo do caso, utilizou-se entrevista com servidores da Corpi, onde se colheram impressões sobre o impacto da LAI na dinâmica do trabalho de atendimento e pesquisa, identificaram-se os principais problemas percebidos e as suas sugestões de melhoria. Discorre-se, também, subsidiariamente, sobre a gestão da informação como parte do ciclo informacional e condição para o acesso à informação, tópico central desta pesquisa. Aborda-se a questão da cidadania e do controle social, bem o direito à informação e transparência governamental que subjazem à proposta de amplo acesso à informação pública preconizada pela LAI, em razão da mudança de paradigma e do regime de informação a que a LAI conduz. O estudo dos efeitos da LAI no âmbito da Câmara teve como marco temporal o período de maio a dezembro de 2012. Estima-se que os indicadores desta pesquisa possam contribuir com estudos futuros relacionados com a governança da informação na Câmara.