A non-profit design-led innovation journey

Non-profit organisations in the aged care sector are currently under pressure from more than just a sheer increase of customers. A need to respond to changing legislative requirements, increased expectations from customers and increasing likelihood of shortage in appropriate experienced staff are also contributing to instability within the sector. This paper will present a longitudinal action research study of a non-profit organisation revisiting its core purpose of providing relevant services and attempting to build a customer-centric method for addressing the current and upcoming change drivers in an Australian aged care context. The study found Design- Led Innovation to be an effective methodology for capturing deep customer insights and conceptualising new business models which address the prevalent change drivers. This paper details a design-led approach to innovation, tailored to a non-profit organisation seeking to better understand its stakeholders and redefine its value offering.

The drive towards user-centred engineering in automotive design

Falling sales in Europe and increasing global competition is forcing automotive manufacturers to develop a customer-based approach to differentiate themselves from the similarly technologically-optimised crowd. In spite of this new approach, automotive firms are still firmly entrenched in their reliance upon technology-driven innovation, to design, develop and manufacture their products, placing customer focus on a downstream sales role. However the time-honoured technology-driven approach to vehicle design and manufacture is coming into question, with the increasing importance of accounting for consumer needs pushing automotive engineers to include the user in their designs. The following paper examines the challenges and opportunities for a single global automotive manufacturer that arise in seeking to adopt a user-centred approach to vehicle design amongst technical employees. As part of an embedded case study, engineers from this manufacturer were interviewed in order to gauge the challenges, barriers and opportunities for the adoption of user-centred design tools within the engineering design process. The analysis of these interviews led to the proposal of the need for a new role within automotive manufacturers, the “designeer”, to bridge the divide between designers and engineers and allow the engineering process to transition from a technology-driven to a user- centred approach.

Climbing the design ladder : step by step

This research presents findings of a research project where the first author worked with a small to medium sized enterprise (SME) manufacturing company in order to integrate design at a strategic level within the company. This study aims to identify the changes experienced in the participating company while shifting the perspective of design from a product focus towards a strategic focus. Staff interviews at two points in time and a reflective journal were used as data sources within an action research methodology. A shift in the perspective of design was noted in three cultural changes within the firm over time: a focus on long term as well as short term outcomes, on indirect as well as direct value and on intangible as well as tangible benefits. These three components are proposed as ‘cultural stepping stones’ that describe how a company transitions from an exclusively product- focused utilisation of design, to a process-level application of design. Implications of this research are provided as considerations for businesses that are attempting to facilitate a similar transformation in the future.

Resistances, facilitators and influences on professionals' knowledge sharing behaviour : a case study

The centrality of knowledge sharing to organisations' sustainability has been established. This case study illustrates the influences on individual knowledge sharing decision-making and behaviour among professionals and paraprofessionals - specifically civil engineers and design drafters - in a large public sector organisation that provides transportation infrastructure. The case examines the ways in which overlapping sets of values and behavioural drivers affect knowledge sharing orientation and practices in a collective of experts and novices working in an environment that is largely project-based. The alignment among sector, profession and organisation values provides a supportive environment for knowledge sharing, however individual behaviour is found to be most strongly influenced by the presence and quality of relational capital.

Adenovirus species C is associated with chronic suppurative lung diseases in children

Background The role of human adenoviruses (HAdVs) in chronic respiratory disease pathogenesis is recognized. However, no studies have performed molecular sequencing of HAdVs from the lower airways of children with chronic endobronchial suppuration. We thus examined the major HAdV genotypes/species, and relationships to bacterial coinfection, in children with protracted bacterial bronchitis (PBB) and mild bronchiectasis (BE). Methods Bronchoalveolar lavage (BAL) samples of 245 children with PBB or mild (cylindrical) BE were included in this prospective cohort study. HAdVs were genotyped (when possible) in those whose BAL had HAdV detected (HAdV+). Presence of bacterial infection (defined as ≥104 colony-forming units/mL) was compared between BAL HAdV+ and HAdV negative (HAdV−) groups. Immune function tests were performed including blood lymphocyte subsets in a random subgroup. Results Species C HAdVs were identified in 23 of 24 (96%) HAdV+ children; 13 (57%) were HAdV-1 and 10 (43%) were HAdV-2. An HAdV+ BAL was significantly associated with bacterial coinfection with Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae (odds ratio [OR], 3.27; 95% confidence interval, 1.38–7.75; P = .007) and negatively associated with Staphylococcus aureus infection (P = .03). Young age was related to increased rates of HAdV+. Blood CD16 and CD56 natural killer cells were significantly more likely to be elevated in those with HAdV (80%) compared with those without (56.1%) (P = .027). Conclusions HAdV-C is the major HAdV species detected in the lower airways of children with PBB and BE. Younger age appears to be an important risk factor for HAdV+ of the lower airways and influences the likelihood of bacterial coinfection

Visions and values : the Children’s Book Council of Australia’s prizing of picture books in the twenty-first century

The Children’s Book Council of Australia (CBCA) administers the oldest national prize for children’s literature in Australia. Each year, the CBCA confers “Book of the Year” awards to literature for young people in five categories. In 2001, the establishment of an “Early Childhood” category opened up the venerable “Picture Book” category (first awarded in 1955) to books with an implied readership up to 18 years of age. As a result, this category has emerged in recent years as a highly visible space within which the CBCA can contest discourses of cultural marginalisation insofar as Australian (“colonial”) literature is constructed as inferior or adjunct to the major Anglophone literary traditions, and the consistent identification of children’s literature (and, indeed, of children) as lesser than its ‘adult’ counterparts. The CBCA is engaged in defining, evaluating, and legitimising a tradition of Australian children’s literature which is underpinned by a canonical impulse, and is a reflexive practice of self-definition, self-evaluation and self-legitimisation for the CBCA itself. While it is obviously problematic to identify award winners as a canon, it is equally obvious that literary prizing is a cultural practice derived from the logic of canonicity. In his discussion of the United States’s Newbery Medal, Kenneth Kidd notes that “Medal books are instant classics, the selection process an ostensible simulation of the test of time” (169) and that “the Medal is part of the canonical architecture of children's literature” (169). Thus, it is instructive to consider the visions and values of the national, of the social, and of the literary-aesthetic, in the picture books chosen by the Children’s Book Council of Australia (CBCA) as the “best” of the early twenty-first century. These books not only constitute a kind of canon for contemporary Australian children’s literature, but may well come to define what contemporary Australian children’s literature means in the wider literary field. The Book of the Year: Picture Book awards given by the CBCA since 2001 demonstrate that it is not only true of the Booker Prize that, “The choices of winning books reflect not only on the books themselves, then, but also back on the Prize, affecting its reputation and creating journalistic capital which is vital for the Prize to achieve its prominence and impact.” (81). Many of the twenty-first century CBCA award-winning picture books complicate traditional or comfortable understanding of Australianness, children’s literature, or “appropriate” modes of form and content, reminding us that “moments when texts resist or complicate recuperation into national discourses offer fruitful points for exploring the relationships between text and celebratory context” (Roberts 6). The CBCA has taken the opportunities offered by the liberation of the Picture Book category from an implied readership to challenge dominant constructions of children’s literature in Australia, and in so doing, are engaged in overt practices of canonicity with potentially long-lasting effects. Works Cited: Kidd, Kenneth. “Prizing Children’s Literature: The Case of Newbery Gold.” Children's Literature 35 (2007): 166-190. Roberts, Gillian. Prizing Literature: The Celebration and Circulation of National Culture. Toronto: U Toronto P, 2011. Squires, Claire. “Book Marketing and the Booker Prize.” Judging a Book by Its Cover: Fans, Publishers, Designers, and the Marketing of Fiction. Eds. Nicole Matthews and Nickianne Moody. Aldershot: Ashgate, 2007. 71-82.

Evaluation of assessment in the context of work-based learning: Qualitative perspectives of new graduates

Aim Evaluation or assessment of competence is an important step to ensure the safety and efficacy of health professionals, including dietitians. Most competency-based assessment studies are focussed on valid and reliable methods of assessment for the preparation of entry-level dietitians, few papers have explored student dietitians’ perceptions of these evaluations. This study aimed to explore the perceptions of recent graduates from accredited nutrition and dietetics training programs in Australia. It also aimed to establish the relevance of competency-based assessment to adequately prepare them for entry-level work roles. Methods A purposive sample of newly-graduated dietitians with a range of assessment experiences and varied employment areas was recruited. A qualitative approach, using in-depth interviews with 13 graduates, with differing assessment experiences was undertaken. Graduates were asked to reflect upon their competency-based assessment experiences whilst a student. Data was thematically analysed by multiple authors. Results Four themes emerged from the data analysis: (i) Transparency and consistency are critical elements of work-based competency assessment. (ii) Students are willing to take greater responsibility in their assessment process. (iii) Work-based competency assessment prepares students for employment. (iv) The relationship between students and their assessors can impact on the student experience and their assessment performance. Conclusions Understanding this unique perspective of students can improve evaluation of future health professionals and assist in designing valid competency-based assessment approaches.

The Ash Burner

Growing up with his father in a small coastal town, all Ted knows about his mother is that she died when he was a boy. His father has brought them halfway across the world to start anew, but her absence defines and haunts their lives. When Ted meets Anthony and Claire, an intense friendship begins, carrying them to Sydney and university. They introduce him to poetry and art, and he feels a sense of belonging at last. But as the trio’s friendship deepens over the years, Ted must learn to negotiate the boundaries of love, and come to terms with a legacy of secrets and silence. Written with extraordinary grace and sensitivity, The Ash Burner explores beauty and desire, grief and loss, and the search for one’s true self.

Palliative care phase : inter-rater reliability and acceptability in a national study

Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase. Setting/participants: Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7% occurred within 2 h. Clinicians rated 54.8% of patients in the stable phase, 15.8% in the unstable phase, 20.8% in the deteriorating phase and 8.7% in the terminal phase. Overall agreement between clinicians’ rating of Palliative Care Phase was substantial (kappa = 0.67; 95% confidence interval = 0.61–0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase. Conclusion: Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.

Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking

PURPOSE Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years. METHODS Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included the Symptom Assessment Scale and the Palliative Care Problem Severity Score. Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models. RESULTS Data were analysed for 19,747 patients (46 % female; 85 % cancer; 27,928 episodes of care; 65,463 phases). There were significant improvements across all domains (symptom control, family care, psychological and spiritual care) except pain. Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved. CONCLUSION These are the first national hospice/palliative care symptom control performance data to demonstrate improvements in clinical outcomes at a service level as a result of routine data collection and systematic feedback.

Stepping outside the circle : a reflective practice framework for creative facilitators

Stepping Outside the Circle was a practice-based research project focussed on creating a professional reflection framework for creative facilitators working within the community, education, corporate and health and wellbeing sectors. Underpinned by theories of critical reflection, transformative learning, reflexivity and agency, this study explored the potential benefits of multimodal inquiry processes, adapting existing reflective practice models for the unique requirements of creative facilitation contexts. Through application of the key findings from this research, synthesised in a practitioner resource, it is hoped that individual practitioners and creative organisations may develop their understanding of evaluation strategies, self- reflexivity, professional sustainability and practitioner self-care.