Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

Transforming the psychological contract through a continuous innovation methodology

This paper introduces the Corporate Culture Change Cycle: a continuous innovation methodology for transforming the psychological contract in an organisational context. The eight step process is based on the action learning model. The purpose of this methodology is to benchmark the psychological contract against eight changing values of the employment relationship as a basis for facilitating a process of aligning the changing needs of employer and employee. Both the Corporate Culture Change Cycle and the New Employment Relationship Model have been validated in several organisational settings and subsequently refined. This continuous innovation methodology addresses gaps in the psychological contract, change management and continuous innovation research literatures. The approach therefore should be of interest to researchers in these fields of study and from a practical perspective for managers wishing to transform their workplace cultures.

Effective communication in innovation processes

Innovation processes are rarely smooth and disruptions often occur at transition points were one knowledge domain passes the technology on to another domain. At these transition points communication is a key component in assisting the smooth hand over of technologies. However for smooth transitions to occur we argue that appropriate structures have to be in place and boundary spanning activities need to be facilitated. This paper presents three case studies of innovation processes and the findings support the view that structures and boundary spanning are essential for smooth transitions.

Human resource management and innovation: what are knowledge-intensive firms doing?

An undeniable shift in focus from traditional production companies to Knowledge-Intensive Firms (KIFs) poses challenges for academics and practioners alike. In particular, effective management of an organization's human resources has become a critical issue for ensuring sustained innovation capacity. The relationship between Human Resource Management (HRM) in KIFs is however still a largely unexplored arena. The objective of this paper is to explore this relationship in an effort to identify HRM practices that support innovation. To this end, the paper includes reviews of the literature relevant to HRM and innovation in KIFs and four case studies from companies in Denmark and Australia that have been recognized for excellence in innovation. On the basis of content analyses conducted on the case data, some preliminary conclusions are posited regarding the role of HRM in KIFs. More specifically, the findings from this study suggest that while there are commonalities between HRM practices in traditional manufacturing companies and KIFs, there are also important differences, especially in terms of staffing practices. The paper contributes by offering recommendations for management of HRM in innovative KIFs and potential avenues for research to further develop our understanding of how HRM can support innovation in KIFs.

Enhancing research and development: designing collaborative environments for innovation

Work environments have previously been studied to identify the strategies, structures and processes which increase the likelihood of creativity, innovation and collaboration for productive workplaces. A number of perspectives have emerged which identify social and cognitive factors known to contribute to or to restrict innovation and collaboration. Recently more attention has been given to designing physical environments to encourage processes relevant to innovation such as creativity (McCoy & Evans, 2002) knowledge sharing (Hemlin, Allwood & Martin, 2008) and collaboration (Bozeman & Corley, 2004). Some attention has been given specifically to research and development environments (Boutellier et al, 2008) but little integration of this research has occurred. In the context of the construction of new purpose-built premises which will bring together under one roof separate public sector agencies engaged in research and development in agriculture, natural resource systems and the environment, this paper examines the extant literature and develops initial propositions for research relevant to the transition, collaboration and performance of research and development in new organizational environments where traditional boundaries have been redrawn.

Dynamic capabilities and innovation in supply chains

Supply chain relationships between firms are increasingly important in terms of both competitiveness and developing dynamic capability to respond to rapid changes in the market. Innovation capacity both in firms and in supply chains is also integral to responding to dynamic markets and customer needs. This explorative research examines a sample of firms active in supply chain relationships in Australia, as a pilot study, to examine any linkages between firm dynamic capabilities and supply chains developing innovative capacity to meet competitive and market changes. Initial findings indicate that although firms focus on developing capabilities, particularly dynamic capabilities to innovate individually, these preliminary findings indicate little reliance on developing their supply chain innovation capacity. This study is the initial stage of more extensive research on this topic.

The economic rationale for infection control in Australian hospitals

The objective of the present study was to predict the economic consequences of healthcare-acquired infections arising among admissions to Australian acute care hospitals. A quantitative algorithm informed by epidemiological and economic data was developed. All acute care hospitals in Australia were included in the study and the participants included all admissions to general medical and general surgical specialties. The main outcome measures were the numbers of cases of healthcare-acquired infection and bed days lost annually. It was estimated that there are 175 153 (95% credible interval 155 911 : 195 168) cases of healthcare-acquired infection among admissions to Australian hospitals annually, and the extra stay in hospital to treat symptoms accounts for 854 289 bed days (95% credible interval 645 091 : 1 096 244). If rates were reduced by 1%, then 150 158 bed days would be released for alternative uses. This would allow ~38 500 new admissions. Healthcare-acquired infections in patients cause bed blocks in Australian hospitals. The cost-effectiveness of hospital services might be improved by allocating more resources to infection control, releasing beds and allowing new admissions. There exists an opportunity to improve the efficiency of the Australian health care system.

Defining reference service life : an open innovation approach

The endeavour to obtain estimates of durability of components for use in lifecycle assessment or costing and infrastructure and maintenance planning systems is large. The factor method and the reference service life concept provide a very valuable structure, but do not resolve the central dilemma of the need to derive an extensive database of service life. Traditional methods of estimating service life, such as dose functions or degradation models, can play a role in developing this database, however the scale of the problem clearly indicates that individual dose functions cannot be derived for each component in each different local and geographic setting. Thus, a wider range of techniques is required in order to devise reference service life. This paper outlines the approaches being taken in the Cooperative Research Centre for Construction Innovation project to predict reference service life. Approaches include the development of fundamental degradation and microclimate models, the development of a situation-based reasoning ‘engine’ to vary the ‘estimator’ of service life, and the development of a database on expert performance (Delphi study). These methods should be viewed as complementary rather than as discrete alternatives. As discussed in the paper, the situation-based reasoning approach in fact has the possibility of encompassing all other methods.

Developing within-company information and communication technologies (ICT) innovation diffusion networks : a study of three Australian major contractors

The innovation diffusion and knowledge management literature strongly supports the importance of communities of practice (COP) for enabling knowledge about how to use and adopt innovation initiatives. One of the most powerful tools for innovation diffusion is word-of-mouth wisdom from committed individuals who mentor and support each other. Close proximity for face-to-face interaction is highly effective, however, many organisations are geographically dispersed with projects being virtual linked sub-organisations using ICT to communicate. ICT has also introduced a useful facilitating technology for developing knowledge networks. This paper presents findings from a research program concentrating on ICT innovation diffusion in the Australian construction industry. One way in which ICT diffusion is taking place was found to be through within-company communities of practice. We undertook in-depth unstructured interviews with three of the major 10 to 15 contractors in Australia to discuss their ICT diffusion strategies. We discovered that in all three cases,within company networked communities of practice was a central strategy. Further, effective diffusion of ICT groupware tools can be critical in developing COP where they are geographically dispersed.

Knowledge channelization and innovation

This paper examines knowledge management and innovation in the Australian Construction Industry. A conceptual model is presented, based upon analysis of the literature and a series of preliminary construction industry interviews. Extensive knowledge management (KM) research has focused upon types of knowledge contained within specific organizational settings. However, we argue that a crucial missing link in KM research concerns the interface between flows of knowledge from external sources of innovations and its channelization in and out, and between organizations. This interface, regulating and facilitating knowledge from external sources of innovation into the organisation, operates under the influence of two main forces visualized as “pulling” and “pushing” forces in the model presented in this paper. The premise of the model lies in a hypothesis that as an organization changes itself into a more mature, learning organization (LO) over time, knowledge flows into it through “pull” rather than “push” forces. We conclude that a successful knowledge management initiative installs a learning and knowledge sharing culture, which is easily adaptable to new learning offering little resistance to new knowledge that flows into the organisation. The model bridges the gap between research and its application in construction practice.

Submission to the House of Representatives Standing Committee on Environment and Heritage : Inquiry into a Sustainability Charter by the Cooperative Research Centre for Construction Innovation

The Cooperative Research Centre for Construction Innovation1 (hereafter called Construction Innovation) supports the notion of the establishment of a Sustainability Charter for Australia and is interested in working collaboratively to achieve this outcome. A number of challenges need to be addressed to develop this Charter. This submission outlines these challenges and possible responses to them by a Sustainability Commission.

Social change grant-making : a failure of innovation?

Focusing primarily on Anglophone countries, this article begins by looking at the changing environment of foundations, the pressures on foundations and some responses to those pressures. It then focuses on the potential of a structural change approach - often known as 'social change' or 'social justice' grant-making - as a solution to some of the modern dilemmas of foundations, and considers why this approach has, with some exceptions, gained relatively little support. This raises the wider issues of why and how resource-independent, endowed foundations change when conventional explanations of organisational change do not easily apply. Researching a 'lack' is clearly difficult; this article adopts an analytic perspective, examining the characteristics of the structural change approach as a mimetic model, and draws on the work of Rogers (2003) on the characteristics required for the successful diffusion of innovations. It suggests that the structural change approach suffers from some fundamental weaknesses as a mimetic model, failing to meet some key characteristics for the diffusion of innovations. In conclusion, the article looks at conditions under which these weaknesses may be overcome.