Implementation of a quality care management system for patients with arthritis of the hip and knee

The Orthopaedic Unit of the Repatriation General Hospital (RGH) in Adelaide, South Australia has implemented a quality care management system for patients with arthritis of the hip and knee. The system not only optimises conservative management but ensures that joint replacement surgery is undertaken in an appropriate and timely manner. This new service model addresses identified barriers to service access and provides a comprehensive, coordinated strategy for patient management. Over 4 years the model has reduced waiting times for initial outpatient assessment from 8 to 3 months and surgery from 18 to 8 months, while decreasing length of stay from 6.3 to 5.3 days for hips and 5.8 to 5.3 days for knees. The service reforms have been accompanied by positive feedback from patients and referring general practitioners in relation to the improved coordination of care and enhanced efficiency in service delivery.

What is known about the topic? Several important initiatives both overseas and within Australia have contributed significantly to the development of this model of care. These include the UK National Health Service ‘18 weeks’ Project, the Western Canada Waiting List Project, the New Zealand priority criteria project, the Queensland Health Orthopaedic Physiotherapy Screening Clinic, and most importantly the Melbourne Health–University of Melbourne Orthopaedic Waiting List Project where a wide range of models were explored across Victorian hospitals from 2005 and the Multi-Attribute Prioritisation Tool (MAPT) was developed, validated and tested. This project became the Osteoarthritis Hip and Knee Service (OAHKS) and was operationalised in the Victorian healthcare system from 2012. These initiatives examined and addressed various aspects of management systems for patients with arthritis of the hip and knee in their particular setting.

What does this paper add? The development of this system is an extension of what is already known and is the first to encompass a comprehensive and coordinated strategy across all stages of the care management pathway for this patient group. Their management extends from the initial referral to development and implementation of a management plan, including surgery if assessed as necessary and organisation of long-term post operative follow up as required. By detailing the elements, key processes and measurable outcomes of the service redesign this paper provides a model for other institutions to implement a similar initiative.

What are the implications for practitioners? An important aspect of the design process was practitioner acceptance and engagement and the ability to improve their capacity to deliver services within an efficient and effective model. Intrinsic to the model’s development was assessment of practitioner satisfaction. Data obtained including practitioner surveys indicated an increased level of both satisfaction with the redesigned management service, and confidence in it to deliver its intended improvements.

Deakin University Library : an active partner in the implementation of the new generation e-learning platform Desire2Learn

Deakin University has a long association with e-learning platforms, utilising the functionality of various Learning Management Systems (LMS) over a period of years. Transforming learning and teaching is a key priority of the University and moving to a new generation e-learning platform that supports engaging learning experiences through quality course design is a strategic imperative.

In 2010 Deakin University selected Desire2Learn as its replacement LMS, an innovative platform that offers next generation functionality. The University is investing significant resources in 2011 to implement the new system. The Library is harnessing the opportunity to embed search and discovery and information access throughout the LMS, including presence at the highest level of navigation. A Library widget providing students with clear pathways and immediate access to key library collections, services and features is being developed by the Library in conjunction with the Faculties‟ academic champions and educational developers. Liaison Librarians are negotiating with academic staff to create context-specific pathways, to utilise Desire2Learn Web2.0 capabilities and to imbed more personalised resources and LibGuides aligned with units of study. This is happening at a time when libraries are introducing new approaches to information discovery.

This paper describes Deakin University Library‟s journey in partnering with academic staff and others across the University to implement Desire2Learn as a vital new e-learning platform. It reports on many outcomes including: value created by embedding quality information in learner-centred course delivery; increased awareness of library subscription resources when accessible within students‟ workspace; strong and continuing relationships built with academic staff; enhanced Library staff engagement with flexible learning principles and new technologies. The question of where embedding information access in online courses and units fits with the Library‟s exploration of web scale solutions is also touched upon. And finally, an insight into how recent research undertaken by Deakin University Library has influenced our approach to information discovery solutions suggests an opportunity for many more questions to be explored.

Performance evaluation of e-government services using balance scorecard : an empirical study in Jordan

Purpose - the purpose of this paper is to emphasise on a balance between quantitative and qualitative measures, and examine the use of Balanced Scorecard to evaluate and estimate the performance of information and communication technologies (ICT) in delivering valuable e-government services through the internet. Design/methodology/approach - This study tests the hypotheses of e-government effectiveness using Balanced Scorecard technique by incorporating qualitative measures within a quantitative research methodology with data collected by means of a survey questionnaire. The survey sample of 383 stakeholders includes common customers, employees of e-government, and employees from the IT sector. The survey data were analysed to test the hypothesis in measuring e-government effectiveness from Balanced Scorecard's four dimensions: customer perspective, financial perspective, internal business process perspective, and innovation and learning perspective. Findings - The results show that the Balanced Scorecard factors fit very well with monitoring and measuring the performance of e-government in Jordan, and also in evaluating their success in IT project investments. Originality/value - This study attempts to address this gap in the literature and would benefit future studies in applying Balanced Scorecard for performance evaluation of various IT projects that are gaining huge investments from governments and organisations .

Profiling for profit : a report on target marketing and profiling practices in the credit industry

This report examines how many businesses make significant investments to purchase and develop customer relationship management systems. Given such investments, information about these systems is not widely available, but some publicly available information gives indication of the extent, and purpose, of the use. Recognising that lenders use customer information and highly sophisticated systems to target their marketing strategies, is the first step towards ensuring that these practices are taken into account in the development of consumer policy and law reform. This research was funded by the consumer advisory panel of the Australian Securities and Investment Commission (ASIC).

The MOVE study: a study protocol for a randomised controlled trial assessing interventions to maximise attendance at physical activity facilities

BACKGROUND: Physical activity is associated with a host of health benefits, yet many individuals do not perform sufficient physical activity to realise these benefits. One approach to rectifying this situation is through modifying the built environment to make it more conducive to physical activity, such as by building walking tracks or recreational physical activity facilities. Often, however, modifications to the built environment are not connected to efforts aimed at encouraging their use. The purpose of the Monitoring and Observing the Value of Exercise (MOVE) study is to evaluate the effectiveness of two interventions designed to encourage the ongoing use of a new, multi-purpose, community-based physical activity facility. METHODS/DESIGN: A two-year, randomised controlled trial with yearly survey points (baseline, 12 months follow-up, 24 months follow-up) will be conducted among 1,300 physically inactive adult participants aged 18-70 years. Participants will be randomly assigned to one of three groups: control, intervention 1 (attendance incentives), or intervention 2 (attendance incentives and tailored support following a model based on customer relationship management). Primary outcome measures will include facility usage, physical activity participation, mental and physical wellbeing, community connectedness, social capital, friendship, and social support. Secondary outcome measures will include stages of change for facility usage and social cognitive decision-making variables. DISCUSSION: This study will assess whether customer relationship management systems, a tool commonly used in commercial marketing settings, can encourage the ongoing use of a physical activity facility. Findings may also indicate the population segments among which the use of such systems are most effective, as well as their cost-effectiveness. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12615000012572 (registered 9 January 2015).

Os desafios à implantação do modelo de gestão dos recursos hídricos estabelecidos pela lei 9.4333

This article objectified to identify the main challenges to the implementation of the system of management of the water features established by Law 9.433/97, in special the restrictive factors to the installation of Committees of Basin and Hidric Resources Agencies and the challenges to the implementation and management of the basin plans, of the charge and the grant for the hydric resources uses. The analysis is based in the South Paraiba river case, beyond the experience in other countries. The reflections on the gotten information had led to the conclusion of that the magnifying and change of the institucional base of decision, the integration of the entities of water features, the institucional qualification and technique, the social mobilization, the decentralization of the financial features, the integration of the management in frontier basins and the implementation of management systems based in the consensus are the biggest challenges to the execulte of the federal law.

Metodologia de custeio baseado em atividades implementada no Banco Central do Brasil: uma análise de seus desdobramentos

In the last years, there has been a strong tendency of transferring typical business management concepts and practices to the public administration, such as: efficiency, efficacy, effectiveness, economy, operational excellence, results and transparency. The limited offer of resources, as well as the growing demand for accountability, justifies that movement. In order to put the aforementioned concepts into operation, the public administration uses some mechanisms, among them cost management. This dissertation focuses on the use of cost management systems, based on an activity-based costing (ABC) method, by Brazilian public entities. The present analysis is conducted from the ABC system implemented in the Brazilian Central Bank (BACEN) - an indirect public administration autarchy - the main goal of this study is to examine its outcomes since the implementation of the system. The investigation went through three main questions: if the system is being used, if it is fulfilling the objectives sought and, finally, if it is providing the expected benefits. Semi-structured interviews were made with members of the institution; and, according to the assumptions and tools tailored for this study, the collected data were analysed qualitatively. Evidences indicate that information, when not manipulated in a systematic way, hinder not only the incorporation of the cost system to the routine, but also the achievement of the goals and benefits aimed with such implementation.

Cultura de segurança da informação: um processo de mudança organizacional na Petrobrás.

O estudo objetivou verificar até que ponto foi atendido o critério proposto por Kotter para a implantação de uma cultura de segurança da informação na Petrobras. A Petrobras, durante muitos anos, foi uma empresa estatal de petróleo com atuação nacional. Assim como diversas outras empresas, com o advento do processo de internacionalização, mais atores com interesses por informações valiosas começaram a interagir com a empresa. Verificava-se a necessidade de conduzir um processo de gestão da mudança para implantar uma cultura de segurança da informação. O modelo definido por Kotter possui oito etapas que, se seguidas, podem garantir uma mudança bem-sucedida. Para atingir o objetivo do estudo, utilizou-se pesquisa bibliográfica, pesquisa documental em arquivos e documentos da Petrobras e pesquisa de campo. O período analisado foi de 2002 a 2009. A avaliação do processo indicou que algumas falhas foram encontradas nas etapas definidas por Kotter. Pode-se citar: complacência alta; senso de urgência atribuído somente no primeiro momento; visão de longo prazo não foi amplamente declarada; o porquê da mudança, ao longo do tempo, não ficou explícito; estrutura organizacional de segurança da informação nas áreas ainda é deficiente; não houve total alinhamento dos sistemas de gestão da empresa; existência de estruturas e sistemas que dificultam a avaliação das ações e reconhecimento dos envolvidos no processo de mudança cultural e pouca preocupação em comemorar as conquistas de curto prazo.

Impactos da adoção das novas tecnologias BPM (business process management) nos processos governamentais

Este relatório consolida os trabalhos de pesquisa, desenvolvidos entre abril de 2005 e abril de 2006, sobre o estado de adoção e oportunidades para uso de novas tecnologias de informação em processos de governo. A ampliação de fronteiras, para além dos limites tradicionais das organizações, traz uma nova e mais forte demanda por flexibilidade que possibilite o tratamento integrado de organismos de diferentes constituições, arquiteturas e processos operacionais, sem falar nos diferentes sistemas de informações. Isto é ainda mais importante nas organizações públicas. Por outro lado, uma das principais características negativas dos órgãos públicos é a morosidade e a burocracia nos processos administrativos e de atendimento ao cidadão. A falta de uma visão tecnológica moderna, isto é, a falta de um Plano Diretor de Tecnologia da Informação (PDTI) voltada para novas soluções, como é o caso do BPM, alinhada à falta de integração entre os sistemas e processos, faz com que muitos órgãos governamentais estejam caminhando na contramão do desenvolvimento tecnológico. Este projeto de pesquisa reveste-se, portanto, de alto interesse, pois focaliza as possibilidades e impactos da adoção das novas tecnologias orientadas a processos e web services (BPM - Business Process Management e BPMS - Business Process Management Systems) na área governamental, bastante desprovida de soluções integradas de serviços aos cidadãos e empresas. Estas novas tecnologias trazem paradigmas completamente diferentes dos até aqui adotados na implementação de sistemas de informações e automação de processos. Apesar das dificuldades inerentes ao tratamento de um tema complexo e novo, mais ainda em organismos governamentais, acreditamos ter desenvolvido um trabalho bastante aprofundado, atendendo aos objetivos estabelecidos no plano original, com os necessários acertos de rota e foco dos trabalhos. Cremos, também, que este trabalho estabelece uma referência relevante no conhecimento relacionados à melhoria de processos de governo, com base em novas tecnologias. Como sub-produtos planejados e realizados, inseridos no caderno de anexos a este relatório, estão conteúdos já desenvolvidos para a edição um ou dois livros sobre o tema, diversos artigos produzidos, além de diversos eventos realizados na EAESP, envolvendo o tema do projeto, que proporcionaram a oportunidade de excelentes trocas de experiências. Este relatório, apresentado de forma objetiva e sintética, focalizando somente os principais aspectos tratados, é complementado por um extenso conteúdo complementar, entregue em um caderno de Anexos.

Do registro ao indicador: gestão da produção da informação assistencial nos hospitais

A valorização da utilização de indicadores assistenciais no monitoramento do desempenho dos sistemas de serviços de saúde cresceu de forma significativa nas últimas décadas. A expansão do Sistema Único de Saúde/SUS e do Sistema de Saúde Suplementar, e as formas de gestão adotadas estimularam o uso de indicadores na avaliação do desempenho, qualidade e segurança nos hospitais, sendo propostos sistemas de indicadores. Não houve uma correspondente preocupação com as condições de produção dos dados e informações para esses indicadores nos serviços de saúde. O artigo discute algumas das condições necessárias para a qualidade nos indicadores para a gestão da assistência nos hospitais: uma cultura de valorização da informação clínica, administrativa e de pesquisa, compartilhada por todos, e a adequada gestão dos registros clínicos, estatísticas hospitalares e sistemas de informações hospitalares. Não existem propostas prontas para a gestão da informação nos hospitais, fazendo-se necessário desenvolver uma capacidade institucional de incorporar e utilizar, na forma mais adequada para cada instituição e contexto, competências e recursos materiais e humanos diversificados, para que a gestão da informação se transforme em um processo dinâmico e parte da gestão do serviço como um todo

SISAL - Um sistema supervisório para elevação artificial de petróleo

MEDEIROS, Adelardo A. D. et al. SISAL - Um Sistema Supervisório para Elevação Artificial de Petróleo. In: Rio Oil and Gas Expo Conference, 2006, Rio de Janeiro, RJ. Anais... Rio de Janeiro, 2006.

Fatores críticos de sucesso como antecedentes da aceitação de um sistema de informação em uma universidade federal

In recent decades the public sector comes under pressure in order to improve its performance. The use of Information Technology (IT) has been a tool increasingly used in reaching that goal. Thus, it has become an important issue in public organizations, particularly in institutions of higher education, determine which factors influence the acceptance and use of technology, impacting on the success of its implementation and the desired organizational results. The Technology Acceptance Model - TAM was used as the basis for this study and is based on the constructs perceived usefulness and perceived ease of use. However, when it comes to integrated management systems due to the complexity of its implementation,organizational factors were added to thus seek further explanation of the acceptance of such systems. Thus, added to the model five TAM constructs related to critical success factors in implementing ERP systems, they are: support of top management, communication, training, cooperation, and technological complexity (BUENO and SALMERON, 2008). Based on the foregoing, launches the following research problem: What factors influence the acceptance and use of SIE / module academic at the Federal University of Para, from the users' perception of teachers and technicians? The purpose of this study was to identify the influence of organizational factors, and behavioral antecedents of behavioral intention to use the SIE / module academic UFPA in the perspective of teachers and technical users. This is applied research, exploratory and descriptive, quantitative with the implementation of a survey, and data collection occurred through a structured questionnaire applied to a sample of 229 teachers and 30 technical and administrative staff. Data analysis was carried out through descriptive statistics and structural equation modeling with the technique of partial least squares (PLS). Effected primarily to assess the measurement model, which were verified reliability, convergent and discriminant validity for all indicators and constructs. Then the structural model was analyzed using the bootstrap resampling technique like. In assessing statistical significance, all hypotheses were supported. The coefficient of determination (R ²) was high or average in five of the six endogenous variables, so the model explains 47.3% of the variation in behavioral intention. It is noteworthy that among the antecedents of behavioral intention (BI) analyzed in this study, perceived usefulness is the variable that has a greater effect on behavioral intention, followed by ease of use (PEU) and attitude (AT). Among the organizational aspects (critical success factors) studied technological complexity (TC) and training (ERT) were those with greatest effect on behavioral intention to use, although these effects were lower than those produced by behavioral factors (originating from TAM). It is pointed out further that the support of senior management (TMS) showed, among all variables, the least effect on the intention to use (BI) and was followed by communications (COM) and cooperation (CO), which exert a low effect on behavioral intention (BI). Therefore, as other studies on the TAM constructs were adequate for the present research. Thus, the study contributed towards proving evidence that the Technology Acceptance Model can be applied to predict the acceptance of integrated management systems, even in public. Keywords: Technology

Etnobiologia do boto cinza (Sotalia guianensis, van Bénéden, 1864) por comunidades pesqueiras do Rio Grande do Norte, Basil

Ethnobiology studies Local Ecological Knowledge (LEK) as well as the use and management of natural resources by local communities in order to understand how the environment is perceived, known and classified by human groups. In fishing communities, LEK adds empirical information about the biology of aquatic species and complements scientific findings, especially when it is difficult to obtain factual information during studies on cetaceans, whose behavior is essentially underwater. Cetaceans (whales and dolphins) are constantly threatened by human activities, especially by accidental capture of small coastal species, as in the case of the estuarine dolphin (Sotalia guianensis), object of this study. Ethnobiological researches in fishing communities are of great importance and can clarify aspects of the biology and conservation of this species. Although extensively studied throughout its distribution range, there are still gaps in the knowledge about S. guianensis. Therefore, fishers local ecological knowledge becomes an additional tool to get and confirm information about S. guianensis. This study evaluated the LEK of artisanal fishers who are daily exposed to local population of S. guianensis, through the use of semistructured interviews (N=116). The interviewed fishers were asked about the biology and popular classification of S. guianensis and about possible interactions between this dolphin and them. The studied communities were located in Tibau do Sul (n=39), Pipa (n=36) and Baía Formosa (n=41), all on the south coast of Rio Grande do Norte, Brazil. The study was based on the assumption that differences in fishers LEK among those communities would be caused by both the variety of fishing environments (lagoon/estuary and ocean) and the intensity of tourism activities. Fishers knowledge is expressive and differed among the studied communities depending on the topic investigated. Fishers correctly reported the habitat, distribution, seasonality and behavioral particularities of S. guianensis. Tourism mainly affected the naming of the species. The study results also suggest that marine fishers have greater knowledge about the species than the estuarine/lagoon ones. Local populations accumulate empirical knowledge according to their environment. Hence, it is important to take into account both empirical knowledge and popular participation in management systems, in order to maintain information sharing among communities

Estudo do potencial do pacu (Piaractus mesopotamicus) como agente de controle biológico de Egeria densa, E. najas e Ceratophyllum demersum

Visando fornecer subsídios para elaboração de sistema de manejo integrado das grandes massas de plantas daninhas aquáticas submersas em lagos e represas, o presente trabalho teve como objetivo verificar a eficiência do pacu (Piaractus mesopotamicus) como agente de controle biológico de Egeria densa, E. najas e Ceratophyllum demersum. As espécies de plantas daninhas foram oferecidas individualmente, duas a duas e as três espécies juntas. Verificou-se que este peixe tem uma eficiência média de controle dessas plantas daninhas variando entre 28 e 100%, podendo eliminar uma massa verde dessas plantas, com a mesma quantidade de seu peso, em sete dias. A eficiência de controle diária aumentou com o tempo de predação. O pacu é mais seletivo para E. densa ou E. najas quando na presença de C. demersum. Não ocorreu alteração na eficiência de controle do pacu sobre E. densa ou E. najas em todos os tratamentos e nos três períodos estudados (três, cinco e sete dias).

Proposta de um modelo de gestão da qualidade para micro e pequenas empresas integrando a estratégia seis sigma à NBR ISO 9001

This work has as its main purpose to set a model of Quality Management for micro and small companies integrating the management models: Six Sigma strategy to NBR ISO 9001:2000. An exploratory research is developed to collect technical and bibliographical information on both methods, emphasizing their integration. Then, a survey is carried out on 65 analysts/consultants of Quality Management Systems and it has detected, besides other factors, that current methodologies must be associated in order to reach better results. At last, it proposes the Sigma 9001 model, which aims to make it possible for micro and small companies to objectively and with low costs, implement a Quality Management System, able to assure competitive advantage through improvement identification in the processes, as well as an improvement in the companies management