Valuation of hospital bed-days released by infection control programs: A comparison of methods

We performed a contingent valuation survey to elicit the opportunity cost of bed-days consumed by healthcare-associated infections in 11 European hospitals. The opportunity cost of a bed-day was significantly lower than the accounting cost; median values were i72 and i929, respectively (P ! .001). Accounting methods overestimate the opportunity cost of bed-days...

The performance advantages for SMEs of product innovation and marketing resource–capability complementarity in emerging economies

This study argues that small and medium-sized enterprises (SMEs) must possess both resources and capabilities at a superior level, and those resources and capabilities must be complementary with one another to achieve superior financial performance. The resources and capabilities of interest are product innovation and marketing. Using data from manufacturing SMEs, the results suggest that product innovation resource–capability complementarity, marketing resource–capability complementarity, and their interaction are positively related to financial performance through product innovation and customer performance. The findings suggest that some SMEs may outperform others not only because they possess a specific individual resource–capability complementarity but also because they create synergy and asset interconnectedness.

MITIE C-Arm - Advanced innovation in education

Aim: In 2013 QUT introduced the Medical Imaging Training Immersive Environment (MITIE) as a virtual reality (VR) platform that allowed students to practice general radiography. The system software has been expanded to now include C-Arm. The aim of this project was to investigate the use of this technology in the pedagogy of undergraduate medical imaging students who have limited to no experience in the use of the C-Arm clinically. Method: The Medical Imaging Training Immersive Environment (MITIE) application provides students with realistic and fully interactive 3D models of C-Arm equipment. As with VR initiatives in other health disciplines (1–2) the software mimics clinical practice as much as possible and uses 3D technology to enhance 3D spatial awareness and realism. The application allows students to set up and expose a virtual patient in a 3D environment as well as creating the resultant “image” for comparison with a gold standard. Automated feedback highlights ways for the student to improve their patient positioning, equipment setup or exposure factors. The students' equipment knowledge was tested using an on line assessment quiz and surveys provided information on the students' pre-clinical confidence scale, with post-clinical data comparisons. Ethical approval for the project was provided by the university ethics panel. Results: This study is currently under way and this paper will present analysis of initial student feedback relating to the perceived value of the application for confidence in a high risk environment (i.e. operating theatre) and related clinical skills development. Further in-depth evaluation is ongoing with full results to be presented. Conclusion: MITIE C-Arm has a development role to play in the pre-clinical skills training for Medical Radiation Science students. It will augment their theoretical understanding prior to their clinical experience. References 1. Bridge P, Appleyard R, Ward J, Phillips R, Beavis A. The development and evaluation of a virtual radiotherapy treatment machine using an immersive visualisation environment. Computers and Education 2007; 49(2): 481–494. 2. Gunn T, Berry C, Bridge P et al. 3D Virtual Radiography: Development and Initial Feedback. Paper presented at the 10th Annual Scientific Meeting of Medical Imaging and Radiation Therapy, March 2013 Hobart, Tasmania.

Examining the new product innovation – performance relationship: Optimizing the role of individual-level creativity and attention-to-detail

New product innovation has been identified as the key to firms' marketplace success, profit and survival. Yet, the failure rate for new products is high. Because of the high costs associated with new product development, there is considerable theoretical and managerial interest in how to minimize the high failure rates of new products and what separates new product winners from losers. This study focuses on individual level ambidexterity – namely head of the R&D departments' capacity to engage in creativity and attention-to-detail simultaneously, a skill involving different centers of attention, and relying on somewhat incompatible behaviors and processes. The ability to engage in these behaviors simultaneously is seen as being ambidextrous. Drawing from the data of 150 advanced manufacturing firms in India (gathered from one CEO and one head of the R&D department for each firm), the results show that when an individual head of R&D engages heavily only in creativity, too many new, risky ideas may come and when he/she engages heavily only in attention-to-detail, he/she may suffer through a lack of novel ideas. Both approaches limit individual's contribution to enhancing product innovation – financial performance relationship. The results also show that an individual head of R&D needs to engage in high levels creativity and attention-to-detail in the pursuit of enhancing product innovation to achieve superior financial performance.

Achieving service quality through service innovation exploration-exploitation: The critical role of employee empowerment and slack resources

Purpose This study investigates the effects of service innovation exploration-exploitation on financial performance through the delivery of quality services. Additional emphasis is also given to examining the extent to which employee empowerment and slack resources enhance or suppress the performance benefits of service firms engaging in service innovation exploration versus exploitation. Design/methodology/approach Data were drawn from a multi-informant survey of service firms using a drop-and-collect approach. The survey gathered data from managers, customer service employees and customers to test the hypotheses. Findings The results show that excelling at both exploitative and exploratory innovation helps enhance the quality of services, which in turn yield superior financial performance. Further, empowering employees enhances the relationship between exploratory and exploitative service innovation and service quality. We also show that the extent managers’ perceived their market to be competitive influences in the pursuit of high levels of both service innovation exploration and exploitation and that this relationship is impacted by the extent they believe they have available slack resources. Practical implications The findings suggest that service firms need to pursue both exploitation and exploration at high levels simultaneously and empower their employees to stay ahead of competitors in delivering quality services, which ultimately contribute to the achievement of superior financial outcomes. Also, the findings highlight the importance of employee empowerment, market competitiveness and slack resources in the pursuit of high levels of both service innovation exploration and exploitation. Originality/value These findings and our theory indicate that this study is the first to empirically examine organizational ambidexterity in the context of service innovation exploration – exploitation adopting the principles of combined and balanced innovation. The study provides insights into the critical role of customers’ perceptions of service quality in contributing to firms’ financial performance. Our insights are unique in that the study incorporates managers, employees and customers in an integrated service innovation model.

Cube Jam (Engagement Innovation Project)

Cube Jam is a project developed in response to the new and rising marketing in large-scale interactive public screens - the Cube being a premier site. Cube Jam will be a crossbreeding ‘think-ubator’ that rides on the back of the already nationally recognised Game On program and its digital communities. Via a bottom-up, non-directive approach Cube Jam will facilitate a series of design provocations within co-located Jam Studios; studios that are focused on supporting adaptation and new ideation and concept design. These Studios will seek new combinations of skills and knowledges with the intention of discovering provotypes of possibilities in both working and production methodologies and product outcomes.

Evidence-based business process management: Using digital opportunities to drive organizational innovation

Process improvement and innovation are risky endeavors, like swimming in unknown waters. In this chapter, I will discuss how process innovation through BPM can benefit from Research-as-a-Service, that is, from the application of research concepts in the processes of BPM projects. A further subject will be how innovations can be converted from confidence-based to evidence-based models due to affordances of digital infrastructures such as large-scale enterprise soft-ware or social media. I will introduce the relevant concepts, provide illustrations for digital capabilities that allow for innovation, and share a number of key takeaway lessons for how organizations can innovate on the basis of digital opportunities and principles of evidence-based BPM: the foundation of all process decisions in facts rather than fiction.

Theorizing why in digital learning: Opening frontiers for inquiry and innovation with technology

Asking why is an important foundation of inquiry and fundamental to the development of reasoning skills and learning. Despite this, and despite the relentless and often disruptive nature of innovations in information and communications technology (ICT), sophisticated tools that directly support this basic act of learning appear to be undeveloped, not yet recognized, or in the very early stages of development. Why is this so? To this question, there is no single factual answer. In response, however, plausible explanations and further questions arise, and such responses are shown to be typical consequences of why-questioning. A range of contemporary scenarios are presented to highlight the problem. Consideration of the various inputs into the evolution of digital learning is introduced to provide historical context and this serves to situate further discussion regarding innovation that supports inquiry-based learning. This theme is further contextualized by narratives on openness in education, in which openness is also shown to be an evolving construct. Explanatory and descriptive contents are differentiated in order to scope out the kinds of digital tools that might support inquiry instigated by why-questioning and which move beyond the search paradigm. Probing why from a linguistic perspective reveals versatile and ambiguous semantics. The why dimension—asking, learning, knowing, understanding, and explaining why—is introduced as a construct that highlights challenges and opportunities for ICT innovation. By linking reflective practice and dialogue with cognitive engagement, this chapter points to specific frontiers for the design and development of digital learning tools, frontiers in which inquiry may find new openings for support.

The innovation imperative: The relationships between team climate, innovation, and performance in research and development teams

A team’s climate for innovation has been shown to be important for innovation in management and work teams. This article investigates the relationship of team climate with project team innovation and performance in research and development organizations. It is argued that the relationship between team climate and innovation will be stronger for research teams than development teams as research teams have greater scope for creating novel and innovative ideas. A sample of 193 scientists and technologists in 20 research teams and 18 development teams were measured on their team’s climate for innovation, team performance, and six indicators of innovation. Research and development teams showed similar ratings for team climate and for measures of innovation. However, the relationships between team climate and individual and team innovation were stronger for research teams than development teams. These findings are significant for fostering innovativeness and innovation in knowledge work teams.

A three dimensional virtual medical imaging computed tomography suite: Innovation in education

Aims: The Medical Imaging Training Immersive Environment(MITIE) Computed Tomography(CT) system is an innovative virtual reality (VR) platform that allows students to practice a range of CT techniques. The aim of this pilot study was to harvest user feedback about the educational value of teh application and inform future pedagogical development. This presentation explores the use of this technology for skills training. Background: MITIE CT is a 3D VR environment that allows students to position a patient,and set CT technical parameters including IV contrast dose and dose rate. As with VR initiatives in other health disciplines the software mimics clinical practice as much as possible and uses 3D technology to enhance immersion and realism. The software is new and was developed by the Medical Imaging Course Team at a provider University with funding from a Health Workforce Australia 'Simulated Learning Environments' grant Methods: Current third year medical imaging students were provided with additional 1 hour MITIE laboratory tutorials and studnet feedback was collated with regard to educational value and performance. Ethical approval for the project was provided by the university ethics panel Results: This presentation provides qualitative analysis of student perceptions relating to satisfaction, usability and educational value. Students reported high levels of satisfaction and both feedback and assessment results confirmed the application's significance as a pre-clinical tool. There was a clear emerging theme that MITIE could be a useful learning tool that students could access to consolidate their clinical learning, either on campus or during their clinical placement. Conclusion: Student feedback indicates that MITIE CT has a valuable role to play in the clinial skills training for medical imaging students both in the academic and clinical environment. Future work will establish a framework for an appropriate supprting pedagogy that can cross the boundary between the two environments

Frequency of convergence and accommodative disorders in a clinical population of Mashhad, Iran

Purpose To investigate the frequency of convergence and accommodation anomalies in an optometric clinical setting in Mashhad, Iran, and to determine tests with highest accuracy in diagnosing these anomalies. Methods From 261 patients who came to the optometric clinics of Mashhad University of Medical Sciences during a month, 83 of them were included in the study based on the inclusion criteria. Near point of convergence (NPC), near and distance heterophoria, monocular and binocular accommodative facility (MAF and BAF, respectively), lag of accommodation, positive and negative fusional vergences (PFV and NFV, respectively), AC/A ratio, relative accommodation, and amplitude of accommodation (AA) were measured to diagnose the convergence and accommodation anomalies. The results were also compared between symptomatic and asymptomatic patients. The accuracy of these tests was explored using sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR−). Results Mean age of the patients was 21.3 ± 3.5 years and 14.5% of them had specific binocular and accommodative symptoms. Convergence and accommodative anomalies were found in 19.3% of the patients; accommodative excess (4.8%) and convergence insufficiency (3.6%) were the most common accommodative and convergence disorders, respectively. Symptomatic patients showed lower values for BAF (p = .003), MAF (p = .001), as well as AA (p = .001) compared with asymptomatic patients. Moreover, BAF (S = 75%, Sp = 62%) and MAF (S = 62%, Sp = 89%) were the most accurate tests for detecting accommodative and convergence disorders in terms of both sensitivity and specificity. Conclusions Convergence and accommodative anomalies are the most common binocular disorders in optometric patients. Including tests of monocular and binocular accommodative facility in routine eye examinations as accurate tests to diagnose these anomalies requires further investigation.

Emergency department models of care in the context of care quality and cost: A systematic review

To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness.

Drug administration guides in dysphagia

Aim: The aim of this evaluation was to evaluate the use of Individualised Medication Administration Guides (IMAGs) for patients with dysphagia on one stroke ward over a 6month period. Background: Patients with dysphagia (PWD) are more likely to suffer an administration error than patients without swallowing difficulties. To both standardise and improve medicines administration to patients with dysphagia I-MAGs were introduced on one stroke ward over a 6 month period. Methods: A software package supported with data on current national guidelines on the administration of medicines to PWD was designed by a specialised pharmacist in dysphagia to enable him to create individualised medication administration guides for patients with dysphagia which stated how each medicine should be optimally prepared and administered. On completion of the pilot service a questionnaire was given to all nurses, pharmacist and speech and language therapists who had experienced the I-MAGs. All the professionals received the same questionnaire but questions relevant only to their practice were added to the nurse’s questionnaire. Results: Of 26 Healthcare professionals (HCPs) approached, 19 returned completed questionnaires. Higher variability was found in the 13 responses from the nurse respondents than in the ones from the 3 pharmacist and the 3 SALTs. 8 (61%) of the nurses felt more confident in their practice when I-MAGs were in place. 10 (76%) of the nurses admitted that the guides could sometimes increase the time of the administration, but saw that it made practice safer. All the pharmacists considered the recommendations in the guides useful and all the respondents with the exception of one nurse (12:13) would like this service to continue. Conclusion: I-MAGs were well received on the ward and they support individualised care for patients with dysphagia. But the guides needed additional pharmacist input and greater nursing time. Research to determine the cost effectiveness of I-MAGs is needed.

Barriers, drivers and enablers for transitioning towards innovation in the Australian water sector

The Australian water sector needs to adapt to effectively deal with the impacts of climate change on its systems. Challenges as a result of climate change include increasingly extreme occurrences of weather events including flooding and droughts (Pittock, 2011). In response to such challenges, the National Water Commission in Australia has identified the need for the water sector to transition towards being readily adaptable and able to respond to complex needs for a variety of supply and demand scenarios (National Water Commission, 2013). To successfully make this transition, the sector will need to move away from business as usual, and proactively pursue and adopt innovative approaches and technologies as a means to successfully address the impacts of climate change on the Australian water sector. In order to effectively respond to specific innovation challenges related to the sector, including climate change, it is first necessary to possess a foundational understanding about the key elements related to innovation in the sector. This paper presents this base level understanding, identifying the key barriers, drivers and enablers, and elements for innovative practise in the water sector. After initially inspecting the literature around the challenges stemming from climate change faced by the sector, the paper then examines the findings from the initial two rounds of a modified Delphi study, conducted with experts from the Australian water sector, including participants from research, government and industry backgrounds. The key barriers, drivers and enablers for innovation in the sector identified during the initial phase of the study formed the basis for the remainder of the investigation. Key elements investigated were: barriers – scepticism, regulation systems, inconsistent policy; drivers – influence of policy, resource scarcity, thought leadership; enablers – framing the problem, effective regulations, community acceptance. There is a convincing argument for the water sector transitioning to a more flexible, adaptive and responsive system in the face of challenges resulting from climate change. However, without first understanding the challenges and opportunities around making this transition, the likelihood of success is limited. For that reason, this paper takes the first step in understanding the elements surrounding innovation in the Australian water sector.