Déclaration et traitement des événements indésirables en médecine interne [Incident-reporting electronic-based system in internal medicine].

How to recognize, announce and analyze incidents in internal medicine units is a daily challenge that is taught to all hospital staff. It allows suggesting useful improvements for patients, as well as for the medical department and the institution. Here is presented the assessment made in the CHUV internal medicine department one year after the beginning of the institutional procedure which promotes an open process regarding communication and risk management. The department of internal medicine underlines the importance of feedback to the reporters, ensures the staff of regular follow-up concerning the measures being taken and offers to external reporters such as general practioners the possibility of using this reporting system too.

Utilization of Incident Reporting in The Finnish Maritime Industry

Marine traffic is expected to increase rapidly in the future, both in the Baltic Sea and in the Gulf of Finland. As the number of vessels in the area increases, so does the risk of serious marine accidents. To help prevent such accidents in the future, the International Maritime Organization (IMO) has put forth the International Safety Management Code (the ISM Code), which aims to improve the safety of the vessels. The second work package of the Development of maritime safety culture (METKU) project investigates the effects of the ISM Code and potential areas of improvement in maritime safety. The first phase in the work package used a literature review to determine how maritime safety culture could be improved. Continuous improvement, management commitment and personnel empowerment and motivation were found to be essential. In the second phase, shipping companies and administrators were interviewed. It was discovered that especially incident reporting based on continuous improvement was felt to be lacking. This third phase aims to take a closer look at incident reporting and suggest improvements based on the findings. Both the IMO and national legislation encourage shipping companies in incident reporting, and on the national level a shared incident reporting system (ForeSea) is being pushed forward. The objective of this research project was to find out the IMO’s attitude towards incident reporting, to establish a theoretical framework of reference in incident reporting, and to observe how reporting is actually being employed on the seas. Existing incident reporting systems were also researched. The study was carried out using a literature review and the results previously gathered in interviews. The results of phase two were elaborated further for themes relating to incident reporting. According to the findings of this research, the theoretical background of incident reporting dates back to the early 20th century. Although some theories are widely accepted, some have also received criticism. The lack of a concise, shared terminology poses major difficulties in maritime incident reporting and in determining its efficiency. A central finding is the fact that existing incident reporting focuses mostly on information flow away from the ship, whereas the backward information flow is much less planned and monitored. In incident reporting, both nationally and internationally, stakeholders are plenty. The information produced by these parties is scattered, however, and thus not very usable. Based on this research, the centralizing of this information should be made a priority. Traditionally, the success of incident reporting has been determined statistically, from the number of reported incidents. Yet existing reporting systems have not been designed with such statistical analysis in mind, so different methodologies might yield a more comprehensive view. The previous findings of seafarers and management (including shipping companies and administration) having differing views on safety work and safety management were backed up by the results of this study. Seafarers find seamanship and storytelling important, while management wants a more systematic and broad approach on safety matters. The research project was carried out by the Centre for Maritime Studies of the University of Turku, in the Kotka unit (Maritime Logistics Research), with coordination by the Kotka Maritime Research Centre. The major financiers of the project were the European Union and the city of Kotka. The financing authority was the Regional Council of Päijät-Häme. Partners in the project were the shipping companies Finnlines Oyj, Kristina Cruises Oy, Meriaura Oy and VG-Shipping Oy, and the ports of Helsinki, Kotka and Hamina. The partners provided both funding for the project and information for the research.

Corporate Social Responsibility in the Oil and Gas Industry: Environmental Management Systems as a Source of Sustainable Development

The environmental aspect of corporate social responsibility (CSR) expressed through the process of the EMS implementation in the oil and gas companies is identified as the main subject of this research. In the theoretical part, the basic attention is paid to justification of a link between CSR and environmental management. The achievement of sustainable competitive advantage as a result of environmental capital growth and inclusion of the socially responsible activities in the corporate strategy is another issue that is of special significance here. Besides, two basic forms of environmental management systems (environmental decision support systems and environmental information management systems) are explored and their role in effective stakeholder interaction is tackled. The most crucial benefits of EMS are also analyzed to underline its importance as a source of sustainable development. Further research is based on the survey of 51 sampled oil and gas companies (both publicly owned and state owned ones) originated from different countries all over the world and providing reports on sustainability issues in the open access. To analyze their approach to sustainable development, a specifically designed evaluation matrix with 37 indicators developed in accordance with the General Reporting Initiative (GRI) guidelines for non-financial reporting was prepared. Additionally, the quality of environmental information disclosure was measured on the basis of a quality – quantity matrix. According to results of research, oil and gas companies prefer implementing reactive measures to the costly and knowledge-intensive proactive techniques for elimination of the negative environmental impacts. Besides, it was identified that the environmental performance disclosure is mostly rather limited, so that the quality of non-financial reporting can be judged as quite insufficient. In spite of the fact that most of the oil and gas companies in the sample claim the EMS to be embedded currently in their structure, they often do not provide any details for the process of their implementation. As a potential for the further development of EMS, author mentions possible integration of their different forms in a single entity, extension of existing structure on the basis of consolidation of the structural and strategic precautions as well as development of a unified certification standard instead of several ones that exist today in order to enhance control on the EMS implementation.

Earnings management in the process of preparing corporate financial reports

Earnings management (EM) literature examines managers’ use of judgment in financial reporting and in structuring transactions to alter financial reports for a specific reason. Mainstream EM literature strongly concentrates on statistical research methodologies and it is driven by positive accounting theory. Although EM occurs in the process of preparing corporate financial reports, that process has so far largely remained a “black box” in prior literature. The purpose of this study is to analyze what EM is, how and why it unfolds and how it is intertwined in the process of preparing corporate financial reports. In order to meet the needs of the study, a qualitative case study method will be used. The contribution of this study is threefold. First, it indicates that the concept of EM is not as unam-biguous as the prior literature has assumed. I find that EM is socially constructed and more open to interpretation than absolutely dichotomous conception given by previous studies. Second, this study contributes to our knowledge of the role and the importance of actors involved in conducting EM, indicating that EM is much more actor-dependent than the prior literature has assumed. Third, this study broadens our knowledge base with regard to the processes and potential for EM in academic research.

Indicent reporting in shipping. Experiences and best practices for the Baltic Sea

Incident and near miss reporting is one of the proactive tools of safety management. By analyzing incidents and near misses and by corrective actions, severe accidents can potentially be avoided. Near miss and incident reporting is widely used in many riskprone industries such as aviation or chemical industry. In shipping incident and near miss reporting is required by the mandatory safety management system International Safety Management Code (ISM Code). However, in several studies the conclusion has been that incidents are reported poorly in the shipping industry. The aim of this report is to highlight the best practices for incident reporting in shipping and to support the shipping industry in the better utilization of incident reporting information. The study consists of three parts: 1) voluntary, shared reporting systems in shipping (international experiences), 2) interview study at four shipping companies in Sweden and in Finland (best practices), 3) expert workshop on incident reporting (problems and solutions). Preconditions for a functional reporting system are an existing no blame culture, commitment of the top management, feedback, good communication, training and an easy-to-use system. Although preconditions are met, problems can still appear, for example due to psychological, interpersonal or nationality-related reasons. In order to keep the reporting system functioning, the shipping company must be committed to maintain and develop the system and to tackle the problems. The whole reporting process from compiling, handling and analyzing a report, creating corrective actions and implementing them has to be handled properly in order to gain benefits from the reporting system. In addition to avoiding accidents, the functional reporting system can also offer other benefits by increasing safety awareness, by improving the overall safety and working conditions onboard, by enhancing team work and communication onboard and between ships and the land-based organization of shipping companies. Voluntary shared reporting systems are supported in the shipping industry in principle, but their development in the Baltic Sea is still in its infancy and the potential benefits of sharing the reports have not been realized. On the basis of this study we recommend that a common reporting system be developed for the Baltic Sea area which all the ships operating in the area could use regardless of their flag. Such a wider system could prevent some of the problems related to the current national systems. There would be more incident cases available in the database and this would support anonymity and thus encourage shipping companies to report to a shared database more frequently. A shared reporting system would contribute to the sharing of experiences and to the wider use of incident information in the shipping industry.

Health management practices and disease prevalence in dairy sheep systems in Argentina

A cross-sectional survey of 19 dairy sheep farms in Argentina was carried out with the purpose to know farm management, health practices, and occurrence and mortality of diseases. The survey comprised 40% of all sheep milking farms in Argentina. A questionnaire was conducted by way of personal interviews with sheep owners during farm visits. The proportions of farms reporting routine vaccination for clostridial diseases, contagious ecthyma, pneumonia and mineral and vitamin parenteral administration were 63%, 47.3%, 16.6% and 42.1% respectively. Regular treatment against lice was used in 37.5% of the farms, and 89.5% o the farmers treated against gastrointestinal nematodes (GIN). The mean number of GIN drenches per farm was 2.26±1.78 annually. In 68.4% of the milking flocks the California Mastitis Test was regularly done and 55.6% of the farmer managers had sampled their flocks once a year for Brucella ovis antibodies. During the pre-mating period respectively 68.4% and 50% of farmers clinically examined their rams and ewe for general health and teeth condition. The udders of ewes were frequently inspected at the start of each milking period. The most important parasite problems noticed were GIN (reported by 57.9% of farmers), lice (57.9%) and scabies (10.5%) and the most frequent infectious diseases were ecthyma (73.7%), pneumonia and other respiratory problems (57.9%), clinical mastitis (55.6%), clostridial diseases (36.9%) and foot lameness (35.2%). Photosensitivity (47.4%) and ruminal acidosis (42.1%) were reported as other frequent toxic or metabolic disorders. Owners mentioned that the mean lifespan or milk productive time per ewe was 4.5±1.4 years. Perinatal lamb mortality was 8.5% and the total flock mortality rates, above the first 24 h of life was 6.9%. The high rates of lamb mortality during the pre-weaning (10.3%) and post-weaning (5.9%) periods indicate that this problem, as well as the most prevalent diseases, should be the subject of further studies.

Harmonization of Environmental Costs and Investments Reporting

The objective of this Master’s Thesis is to examine the current state of environmental costs and investments reporting at Stora Enso in the Business Area of Printing and Reading. Differences and the factors causing the differences in environmental costs and investments reporting are examined in order to further harmonize the reporting between the mills. Research method is a case study, which comprises 11 paper mills. Environmental costs are studied from year 2012 and environmental investments from year 2011 or from 2012 depending on the mill. The results show that there are two types of differences such as actual and harmonisable affecting to environmental costs reporting. Actual differences result from factors such as location and technical features of the mill. Harmonisable differences represent differences, which distort the actual differences. Factors that cause harmonisable differences are identification and traceability of environmental costs as well as interpretation of the instructions. Estimation of the environmental share of indirect environmental investments causes differences between the mills in environmental investments reporting, as it has to be done case-by-case judgments. A further research could consider a detailed examination of the data registering process in order to further improve traceability of environmental costs. Furthermore, identification and reporting of potential savings could be studied from environmental point of view as resource efficiency is an increasing interest.

Financial controlling and management in recovered paper joint ventures

The objective of this Master’s thesis is to examine financial functions, controlling and management in joint ventures of Manufacturing Corporation Oyj Recovered Paper business area. This case study investigated the current situation of financial functions and find out causes that have led the situation. Current situation of financial functions in joint ventures is variable. The most of the companies is outsourced at least some tasks. However, narrow reporting and problems in reliability are the biggest lack of financial controlling and management. The result of study consists of two parts: short-term and long-term improvement. Short-term improvement includes selected solution to outsource all routine financial tasks to new outsourcing partner and improve financial functions. Long-term improvements aim to create better controlling and management system to joint ventures. It is formed corporate governance and performance measurement. In this study it developed new Balanced Scorecard (BSC) for recovered paper joint ventures. Dimensions of BSC are quality, delivery (time), price and financial controlling and management. Earlier researched are showed problems in success of joint venture relationships. Similar results are obtained in this study. In future research, suitable of developed Balanced Scorecard for other industries could be studied

Improving reporting and internal control with process thinking - case study in a multinational corporation

The aim of this Master’s Thesis is to find applicable methods from process management literature for improving reporting and internal control in a multinational corporation. The method of analysis is qualitative and the research is conducted as a case study. Empirical data collection is carried out through interviews and participating observation. The theoretical framework is built around reporting and guidance between parent company and subsidiary, searching for means to improve them from process thinking and applicable frameworks. In the thesis, the process of intercompany reporting in the case company is modelled, and its weak points, risks, and development targets are identified. The framework of critical success factors in process improvement is utilized in assessing the development targets. Also internal control is analyzed with the tools of process thinking. As a result of this thesis, suggestions for actions improving the reporting process and internal control are made to the case company, the most essential of which are ensuring top management’s awareness and commitment to improvement, creating guidelines and tools for internal control and creating and implementing improved intercompany reporting process.

Defining Sales and Operations Planning Process in an Environmental Management Company

Sales and operations research publications have increased significantly in the last decades. The concept of sales and operations planning (S&OP) has gained increased recognition and has been put forward as the area within Supply Chain Management (SCM). Development of S&OP is based on the need for determining future actions, both for sales and operations, since off-shoring, outsourcing, complex supply chains and extended lead times make challenges for responding to changes in the marketplace when they occur. Order intake of the case company has grown rapidly during the last years. Along with the growth, new challenges considering data management and information flow have arisen due to increasing customer orders. To manage these challenges, case company has implemented S&OP process, though initial process is in early stage and due to this, the process is not managing the increased customer orders adequately. Thesis objective is to explore extensively the S&OP process content of the case company and give further recommendations. Objectives are categorized into six different groups, to clarify the purpose of this thesis. Qualitative research methods used are active participant observation, qualitative interviews, enquiry, education, and a workshop. It is notable that demand planning was felt as cumbersome, so it is typically the biggest challenge in S&OP process. More proactive the sales forecasting can be, more expanded the time horizon of operational planning will turn out. S&OP process is 60 percent change management, 30 percent process development and 10 percent technology. The change management and continuous improvement can sometimes be arduous and set as secondary. It is important that different people are required to improve the process and the process is constantly evaluated. As well as, process governance is substantially in a central role and it has to be managed consciously. Generally, S&OP process was seen important and all the stakeholders were committed to the process. Particular sections were experienced more important than others, depending on the stakeholders’ point of views. Recommendations to objective groups are evaluated by the achievable benefit and resource requirement. The urgent and easily implemented improvement recommendations should be executed firstly. Next steps are to develop more coherent process structure and refine cost awareness. Afterwards demand planning, supply planning, and reporting should be developed more profoundly. For last, information technology system should be implemented to support the process phases.

The Role of HR Management in the Corporate Matrix System

The successful performance of company in the market relates to the quality management of human capital aiming to improve the company's internal performance and external implementation of the core business strategy. Companies with matrix structure focusing on realization and development of innovation and technologies for the uncertain market need to select thoroughly the approach to HR management system. Human resource management has a significant impact on the organization and use a variety of instruments such as corporate information systems to fulfill their functions and objectives. There are three approaches to strategic control management depending on major impact on the major interference in employee decision-making, development of skills and his integration into the business strategy. The mainstream research has focus only on the framework of strategic planning of HR and general productivity of firm, but not on features of organizational structure and corporate software capabilities for human capital. This study tackles the before mentioned challenges, typical for matrix organization, by using the HR control management tools and corporate information system. The detailed analysis of industry producing and selling electromotor and heating equipment in this master thesis provides the opportunity to improve system for HR control and displays its application in the ERP software. The results emphasize the sustainable role of matrix HR input control for creating of independent project teams for matrix structure who are able to respond to various uncertainties of the market and use their skills for improving performance. Corporate information systems can be integrated into input control system by means of output monitoring to regulate and evaluate the processes of teams, using key performance indicators and reporting systems.

Incident-Reporting-Systeme als Möglichkeit zum organisationalem Lernen (nicht nur) aus Fehlern und kritischen Ereignissen

Die vorliegende Dissertation betrachtet institutionsinterne lokale (Critical-)Incident-Reporting-Systeme ((C)IRS) als eine Möglichkeit zum Lernen aus Fehlern und unerwünschten kritischen Ereignissen (sogenannte Incidents) im Krankenhaus. Die Notwendigkeit aus Incidents zu lernen, wird im Gesundheitswesen bereits seit den 1990er Jahren verstärkt diskutiert. Insbesondere risikoreichen Organisationen, in denen Incidents fatale Konsequenzen haben können, sollten umfassende Strategien erarbeiten, die sie vor Fehlern und unerwünschten Ereignissen schützen und diese als Lernpotenzial nutzen können. Dabei können lokale IRS als ein zentraler Bestandteil des Risikomanagements und freiwillige Dokumentationssysteme im Krankenhaus ein Teil dieser Strategie sein. Sie können eine Ausgangslage für die systematische Erfassung und Auswertung von individuellen Lerngelegenheiten und den Transfer zurück in die Organisation schaffen. Hierfür sind eine lernförderliche Gestaltung, Implementierung und Einbettung lokaler IRS eine wichtige Voraussetzung. Untersuchungen über geeignete lerntheoretisch fundierte und wirkungsvolle IRS-Modelle und empirische Daten fehlen bisher im deutschsprachigen Raum. Einen entsprechenden Beitrag leistet die vorliegende Fallstudie in einem Schweizer Universitätsspital (800 Betten, 6.100 Mitarbeitende). Zu diesem Zweck wurde zuerst ein Anforderungsprofil an lernförderliche IRS aus der Literatur abgeleitet. Dieses berücksichtigt zum einen literaturbasierte Kriterien für die Gestaltung und Nutzung aus der IRS-Literatur, zum anderen die aus der Erziehungswissenschaft und Arbeitspsychologie entlehnten Gestaltungsbedingungen und Erfolgskriterien an organisationales Lernen. Das Anforderungsprofil wurde in drei empirischen Teilstudien validiert und entsprechend adaptiert. In der ersten empirischen Teilstudie erfolgte eine Standortbestimmung der lokalen IRS. Die Erhebung erfolgte in vier Kliniken mittels Dokumentenanalyse, leitfadengestützter Interviews (N=18), sieben strukturierter Gruppendiskussionen und teilnehmender Beobachtungen über einen Zeitraum von 22 Monaten. Erfolgskritische IRS-Merkmale wurden identifiziert mit dem Ziel einer praxisgerechten lernförderlichen Systemgestaltung und Umsetzung von Incident Reporting unter Betrachtung von organisationalen Rahmenbedingungen, Lernpotenzialen und Barrieren. Die zweite Teilstudie untersuchte zwei Fallbeispiele organisationalen Lernens mittels Prozessbegleitung, welche zu einem verwechslungssicheren Design bei einem Medizinalprodukt und einer verbesserten Patientenidentifikation in Zusammenhang mit Blutentnahmen führten. Für das organisationale Lernen im Spital wurden dabei Chancen, Barrieren und Gestaltungsansätze abgeleitet, wie erwünschte Veränderungen und Lernen unter Nutzung von IRS initiiert werden können und dabei ein besseres Gesundheitsresultat erreicht werden kann. Die dritte Teilstudie überprüfte, inwiefern die Nutzung und Implementierung lokaler IRS mittels einer Mitarbeitervollbefragung zur Sicherheitskultur gefördert werden kann. Hierfür wurde eine positive Interaktion, zwischen einer starken Sicherheitskultur und der Bereitschaft ein IRS zu implementieren und Incidents zu berichten, angenommen. Zum Einsatz kam eine deutschsprachige Version des Hospital Survey on Patient Safety Culture (Patientensicherheitsklimainventar) mit einem Rücklauf von 46.8% (2.897 gültige Fragebogen). In 23 von 37 Kliniken führte laut einer Nachbefragung die Sicherheitskulturbefragung zum Implementierungsentscheid. Dies konnte durch Monitoring der IRS-Nutzung bestätigt werden. Erstmals liegen mit diesen Studien empirische Daten für eine wirkungsvolle und lernförderliche Gestaltung und Umsetzung von lokalen IRS am Beispiel einer Schweizer Gesundheitsorganisation vor. Die Ergebnisse der Arbeit zeigen Chancen und Barrieren für IRS als Berichts- und Lernsysteme im Krankenhaus auf. Als Resultat unsachgemäss gestalteter und implementierter IRS konnte dabei vor allem Lernverhinderung infolge IRS aufgezeigt werden. Blinder Aktionismus und eine fehlende Priorisierung von Patientensicherheit, unzureichende Kompetenzen, Qualifikationen und Ressourcen führten dabei zur Schaffung neuer Fehlerquellen mit einer Verstärkung des Lernens erster Ordnung. Eine lernförderliche Gestaltung und Unterhaltung der lokalen IRS, eingebettet in eine klinikumsweite Qualitäts- und Patientensicherheitsstrategie, erwiesen sich hingegen als wirkungsvoll im Sinne eines organisationalen Lernens und eines kontinuierlichen Verbesserungsprozesses. Patientensicherheitskulturbefragungen erwiesen sich zudem bei entsprechender Einbettung als effektives Instrument, um die Implementierung von IRS zu fördern. Zwölf Thesen zeigen in verdichteter Form auf, welche Gestaltungsprinzipien für IRS als Instrument des organisationalen Lernens im Rahmen des klinischen Risikomanagements und zur Förderung einer starken Patientensicherheitskultur zu berücksichtigen sind. Die Erkenntnisse aus den empirischen Studien münden in ein dialogorientiertes Rahmenmodell organisationalen Lernens unter Nutzung lokaler IRS. Die Arbeit zeigt damit zum einen Möglichkeiten für ein Lernen auf den verschiedenen Ebenen der Organisation auf und weist auf die Notwendigkeit einer (Re-)Strukturierung der aktuellen IRS-Diskussion hin.

Construction management research: a field of application

Research in construction management is diverse in content and in quality. There is much to be learned from more fundamental disciplines. Construction is a sub-set of human experience rather than a completely separate phenomenon. Therefore, it is likely that there are few problems in construction requiring the invention of a completely new theory. If construction researchers base their work only on that of other construction researchers, our academic community will become less relevant to the world at large. The theories that we develop or test must be of wider applicability to be of any real interest. In undertaking research, researchers learn a lot about themselves. Perhaps the only difference between research and education is that if we are learning about something which no-one else knows, then it is research, otherwise it is education. Self-awareness of this will help to reduce the chances of publishing work which only reveals a researcher’s own learning curve. Scientific method is not as simplistic as non-scientists claim and is the only real way of overcoming methodological weaknesses in our work. The reporting of research may convey the false impression that it is undertaken in the sequence in which it is written. Construction is not so unique and special as to require a completely different set of methods from other fields of enquiry. Until our research is reported in mainstream journals and conferences, there is little chance that we will influence the wider academic community and a concomitant danger that it will become irrelevant. The most useful insights will come from research which challenges the current orthodoxy rather than research which merely reports it.

The practice of sustainable facilities management: Design sentiments and the knowledge chasm

The construction industry with its nature of project delivery is very fragmented in terms of the various processes that encompass design, construction, facilities and assets management. Facilities managers are in the forefront of delivering sustainable assets management and hence further the venture for mitigation and adaptation to climate change. A questionnaire survey was conducted to establish perceptions, level of commitment and knowledge chasm in practising sustainable facilities management (FM). This has significant implications for sustainable design management, especially in a fragmented industry. The majority of questionnaire respondents indicated the importance of sustainability for their organization. Many of them stated that they reported on sustainability as part of their organization annual reporting with energy efficiency, recycling and waste reduction as the main concern for them. The overwhelming barrier for implementing sound, sustainable FM is the lack of consensual understanding and focus of individuals and organizations about sustainability. There is a knowledge chasm regarding practical information on delivering sustainable FM. Sustainability information asymmetry in design, construction and FM processes render any sustainable design as a sentiment and mere design aspiration. Skills and training provision, traditionally offered separately to designers and facilities managers, needs to be re-evaluated. Sustainability education and training should be developed to provide effective structures and processes to apply sustainability throughout the construction and FM industries coherently and as common practice.

Facilities management in South East Asia

The purpose of this paper is to provide an insight into the growth stage of facilities management (FM) in the South East Asia region. A questionnaire study of local and international firms operating in South East Asia was used. South East Asia needs to open up to change, particularly with respect to parity in issues of global competition in FM standards. This study is based on a limited sample size using a self-reporting methodology. Further research is needed to further investigate the findings. This paper addresses a unique insight into the contrasting approach to FM in the South East Asia region.