Predicting the likelihood of QA failure using treatment plan accuracy metrics

This study used automated data processing techniques to calculate a set of novel treatment plan accuracy metrics, and investigate their usefulness as predictors of quality assurance (QA) success and failure. 151 beams from 23 prostate and cranial IMRT treatment plans were used in this study. These plans had been evaluated before treatment using measurements with a diode array system. The TADA software suite was adapted to allow automatic batch calculation of several proposed plan accuracy metrics, including mean field area, small-aperture, off-axis and closed-leaf factors. All of these results were compared the gamma pass rates from the QA measurements and correlations were investigated. The mean field area factor provided a threshold field size (5 cm2, equivalent to a 2.2 x 2.2 cm2 square field), below which all beams failed the QA tests. The small aperture score provided a useful predictor of plan failure, when averaged over all beams, despite being weakly correlated with gamma pass rates for individual beams. By contrast, the closed leaf and off-axis factors provided information about the geometric arrangement of the beam segments but were not useful for distinguishing between plans that passed and failed QA. This study has provided some simple tests for plan accuracy, which may help minimise time spent on QA assessments of treatments that are unlikely to pass.

How emergent roles and structures create trust In hastily formed inter-organizational teams

Many activities, from disaster response to project management, require cooperation among people from multiple organizations who initially lack interpersonal relationships and trust. Upon entering inter-organizational settings, pre-existing identities and expectations, along with emergent social roles and structures, may all influence trust between colleagues. To sort out these effects, we collected time-lagged data from three cohorts of military MBA students, representing 2,224 directed dyads, shortly after they entered graduate school. Dyads that shared organizational identity, boundary-spanning roles, and similar network positions (structural equivalence) were likely to have stronger professional ties and greater trust.

Organizational probes : exploring playful interactions in work environment

Playfulness, with non-intrusive elements, can be considered a useful resource for enhancing social awareness and community building within work organizations. Taking inspirations from the cultural probes approach, we developed organizational probes as a set of investigation tools that could provide useful information about employees’ everyday playful experiences within their work organizations. In an academic work environment, we applied our organizational probes over a period of three weeks. Based on the collected data we developed two design concepts for playful technologies in work environments.

Interactions between organizational culture, trustworthiness, and mechanisms for inter-project knowledge sharing

This research used a multiple-case study approach to empirically investigate the complex relationship between factors influencing inter-project knowledge sharing—trustworthiness, organizational culture, and knowledge-sharing mechanisms. Adopting a competing values framework, we found evidence of patterns existing between the type of culture, on the project management unit level, and project managers’ perceptions of valuing trustworthy behaviors and the way they share knowledge, on the individual level. We also found evidence for mutually reinforcing the effect of trust and clan culture, which shape tacit knowledge-sharing behaviors.

Fostering rapid transitions to education for sustainable development through a whole-system approach to curriculum and organizational change

Despite decades of attempts to embed sustainability within higher education, literature clearly suggests that highly regulated disciplines such as engineering have been relatively slow to incorporate sustainability knowledge and skill areas, and are generally poorly prepared to do so. With current efforts, it is plausible that sustainability could take another two decades to be embedded within the curriculum. Within this context, this paper presents a whole system approach to implement systematic, intentional and timely curriculum renewal that is responsive to emerging challenges and opportunities, encompassing curriculum and organizational change. The paper begins by considering the evolution of curriculum renewal processes, documenting a number of whole system considerations that have been empirically distilled from literature, case studies, pilot trials, and a series of workshops with built environment educators from around the world over the last decade. The paper outlines a whole-of-institution curriculum renewal approach to embedding sustainability knowledge and skills within the DNA of the institutional offerings. The paper concludes with a discussion of research and practice implications for the field of education research, within and beyond higher education.

Stimulating organizational ingenuity with design methods

Organizations invest in ways to stimulate new ideas for new products and services for the benefit of the organization, engaging in tournaments and competitions to generate new ideas or to combine existing ideas in new ways for new products and services (Terweisch and Uhlrich, 2009). Specifically, some large companies have developed platforms for posting intractable problems to tap into the ideas and problem solving abilities of a broader range of people (Huston and Sakkab, 2006; Morgan and Wang, 2010), and to develop new and elegant solutions often in an open innovation approach (Chesbrough, 2003). The notion of ingenuity is often applied to individuals who create innovative solutions in situations of constraint, where ingenuity in the form of elegant solutions can be understood as one form of resourcefulness (Young, 2011). However, the notion of organizational ingenuity locates ingenuity more centrally to an organization's strategic decision making and implementation, embedding ingenuity into the company's culture. Studies of organizations displaying ingenuity indicate a range of possibilities from extreme ingenuity (Baker and Nelson, 2005) to less dramatic but substantial changes (Thomke, 2003), sometimes in an experimental phase or as part of a move towards a new and distinct identity for ongoing innovation.

Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results

The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The ‘small aperture score’ provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate.

Prostate radiotherapy treatment plan quality : effects of hip prostheses

Introduction This study aimed to examine the geometric and dosimetric results when radiotherapy treatment plans are designed for prostate cancer patients with hip prostheses. Methods Ten EBRT treatment plans for localised prostate cancer, in the presence of hip prostheses, were analysed and compared with a reference set of 196 treatment plans for localised prostate cancer in patients without prostheses. Crowe et al.’s TADA code [1] was used to extract treatment plan parameters and evaluate doses to target volumes and critical structures against recommended goals [2] and constraints [3, 4]. Results The need to avoid transmitting the radiation beam through the hip prostheses limited the range of gantry angles available for use in both the rotational (VMAT) and the non-rotational (3DCRT and IMRT) radiotherapy treatments. This geometric limitation (exemplified in the VMAT data shown in Fig. 1) reduced the overall quality of the treatment plans for patients with prostheses compared to the reference plans. All plans with prostheses failed the PTV dose homogeneity requirement [2], whereas only 4 % of the plans without prostheses failed this test. Several treatment plans for patients with hip prostheses also failed the QUANTEC requirements that less than 50 % of the rectum receive 50 Gy and less than 35 % of the rectum receive 60 Gy to keep the grade 3 toxicity rate below 10 % [3], or the Hansen and Roach requirement that less than 25 % of the bladder receive 75 Gy [4]. Discussion and conclusions The results of this study exemplify the difficulty of designing prostate radiotherapy treatment plans, where beams provide adequate doses to targeted tissues while avoiding nearby organs at risk, when the presence of hip prostheses limits the available treatment geometries. This work provides qualitative evidence of the compromised dose distributions that can result, in such cases.

Teacher organizational citizenship behaviours and job efficacy : implications for student quality of school life

The present study investigated the impact of teachers' organizational citizenship behaviours (OCBs) on student quality of school life (SQSL) via the indirect effect of job efficacy. A measure of teacher OCBs was developed, tapping one dimension of individual-focused OCB (OCBI – student-directed behaviour) and two dimensions of organization-focused OCB (OCBO – civic virtue and professional development). In line with previous research suggesting that OCBs may enhance job efficacy, as well as studies demonstrating the positive effects of teacher efficacy on student outcomes, we expected an indirect relationship between teachers OCBs and SQSL via teachers' job efficacy. Hypotheses were tested in a multi-level design in which 170 teachers and their students (N=3,057) completed questionnaires. A significant proportion of variance in SQSL was attributable to classroom factors. Analyses revealed that the civic virtue and professional development behaviours of teachers were positively related to their job efficacy. The job efficacy of teachers also had a positive impact on all five indicators of SQSL. In regards to professional development, job efficacy acted as an indirect variable in the prediction of four student outcomes (i.e., general satisfaction, student–teacher relations, achievement, and opportunity) and fully mediated the direct negative effect on psychological distress.

Organizational factors impacting on patient satisfaction : a cross sectional examination of service climate and linkages to nurses' effort and performance

Background Patient satisfaction is influenced by the setting in which patients are treated and the employees providing care. However, to date, limited research has explained how health care organizations or nurses influence patient satisfaction. Objectives The purpose of this study was to test the model that service climate would increase the effort and performance of nursing groups and, in turn, increase patient satisfaction. Method This study incorporated data from 156 nurses, 28 supervisors, and 171 patients. A cross-sectional design was utilized to examine the relationship between service climate, nurse effort, nurse performance and patient satisfaction. Structural equation modeling was conducted to test the proposed relationships. Results Service climate was associated with the effort that nurses directed towards technical care and extra-role behaviors. In turn, the effort that nurses exerted predicted their performance, as rated by their supervisors. Finally, task performance was a significant predictor of patient satisfaction. Conclusions This study suggests that both hospital management and nurses play a role in promoting patient satisfaction. By focusing on creating a climate for service, health care managers can improve nursing performance and patient satisfaction with care.

When leadership meets organizational change : the influence of the top management team and supervisory leaders on change appraisals, change attitudes, and adjustment to change

Despite the importance of adaption and change for firm survival, the failure rate of organizational change efforts remains alarmingly high (Beer and Nohria, 2000; Kotter, 1995). In a recent global survey of over 3,000 executives,Meaney and Pung (2008) reported that two-thirds of executives indicated that their firm had failed to successfully implement organizational changes. Similarly, academic researchers have also concluded that difficulties in implementing and managing organizational change efforts often precipitate organizational crises (Probst and Raisch, 2005). As a result, attention has been directed to identify the factors that improve the likelihood of successfully implementing organizational change efforts. While there has been practitioner-oriented discussion around the pivotal role of workplace leaders in reducing resistance to change, only a limited number of empirical studies have examined relationships between leader behavior and employee change attitudes (e.g., Bommer, Rich, and Rubin, 2005; Herold, Caldwell, and Liu, 2008; Nemanich and Keller, 2007; Oreg and Berson, 2011). However...

Informed systems approach : new directions for organizational learning

The Informed Systems Approach offers models for advancing workplace learning within collaboratively designed systems that promote using information to learn through collegial exchange and reflective dialogue. This systemic approach integrates theoretical antecedents and process models, including the learning theories of Peter Checkland (Soft Systems Methodology), which advance systems design and informed action, and Christine Bruce (informed learning), which generate information experiences and professional practices. Ikujiro Nonaka’s systems ideas (SECI model) and Mary Crossan’s learning framework (4i framework) further animate workplace knowledge creation through learning relationships engaging individuals with ideas.

Organizational work-related road safety situational analysis: More than just an audit tool

Although safety statistics indicate that road crashes are the most common form of work-related fatalities, many organizations fail to treat company vehicles in the same manner as other physical safety hazards within the workplace. Traditionally, work-related road safety has targeted primarily driver-related issues and not adequately addressed organizational processes, such as the organizations’ safety system and risk management processes and practice. This inadequacy generally stems from a lack of specific contextual knowledge and basic requirements to improve work-related road safety, including the supporting systems to ensure any intervention strategy or initiative’s ongoing effectiveness. Therefore, informed by previous research and based on a case study methodology, the Organizational Work-Related Road Safety Situational Analysis was developed to assess organizations’ current work-related road safety system, including policy, procedures, processes and practice. The situational analysis tool is similar to a safety audit however is more comprehensive in detail, application and provides sufficient evidence to enable organizations to mitigate and manage their work-related road safety risks. In addition, data collected from this process assists organizations in making informed decisions regarding intervention strategy design, development, implementation and ongoing effectiveness. This paper reports on the effectiveness of the situational analysis tool to assess WRRS systems across five differing and diverse organizations; including gas exploration and mining, state government, local government, and not for profit/philanthropy. The outcomes of this project identified considerable differences in the degree by which the organizations’ addressed work-related road safety across their vehicle fleet operations and provides guidelines for improving organizations’ work-related road safety systems.

Balancing organizational and professional commitments in professional service firms : the HR practices that matter

Due to their potential to positively influence sales quality and performance and reduce employee turnover in service organizations, HR practices targeting employee commitment have received considerable attention in the HRM literature in recent years. Parallel to this, there has been increasing focus on the nature of commitment, and in particular the existence of multiple commitment foci. In this paper, we examine how HR practices influence professionals' commitment to their organization, to their profession or to both organization and profession, in a qualitative study of three Danish financial investment firms. Our findings suggest that in professional service firms, HR practices encourage high levels of organizational commitment primarily and most often through their influence on professional commitment and that HR practices related to flexible work design are essential in creating balance between an employee's commitment to organization and commitment to their profession. Further, the findings suggest that these same HR practices may foster such high levels of professional commitment that labor turnover will increase when opportunities for pursuing professional goals afforded by work design are restricted.

Organizational support and enterprise web 2.0 adoption : a qualitative study

The emerging growth of Web 2.0 has been observed by users in the workplace, and has therefore encouraged organisations to introduce Web 2.0 technologies in their businesses. Although its adoption is beneficial, it could meets with employees resistance due to some organisational factors. The successful implementation of Enterprise Web 2.0 is based on employee adoption of such social technology. Using a qualitative study, this research explores how organizational support can influence employees’ adoption of Enterprise Web 2.0. The findings show that organisational support encourages and facilitates a smooth adoption. Such support can be provided by management and colleagues in several forms: developing a Web 2.0 strategy, providing required resources for such training, recognising and encouraging adopters, and involving managers in the adoption.