Factors influencing sustainability of health service innovation: Emergency nurse practitioner services

Introduction: Emergency department nurse practitioner services are one of the most frequently implemented service delivery models in Australian hospitals. This research examined factors influencing sustainability of this innovative service delivery model and offers some recommendations for future service integration. Background Many health service innovations have been implemented in an attempt to meet the growing demand for efficient, cost effective health care however, sustainability of many of these innovations has not been evaluated and is poorly understood. Aim The aim of the research was to identify factors that influence sustainability of emergency department nurse practitioner services and to operationalise a theoretical framework for evaluating innovation sustainability. Methodology The research used case study methodology. The case was emergency nurse practitioner services, and units of analysis were emergency department staff, emergency nurse practitioners and documents relating to nurse practitioner services. The data collection methods included, survey, one-on-one interviews, document analysis and telephone survey. Results This research shows that emergency nurse practitioner services partially comply with the factors of sustainability as described in the Sustainability of Innovation theoretical framework: Political, Organisational, Workforce, Financial and Innovation specific factors. Where services do not entirely meet the factors the existing benefits of the service may outweigh the barriers and other means of working around shortfalls are also implemented by staff to ensure patient safety. Conclusion The rapidly expanding emergency nurse practitioner service has been examined using case study methodology to find that certain factors may be threatening the sustainability of this health service innovation. Potentially an innovation may be sustained when only some factors are met in the short term, however, long term sustainability may be challenged if factors are not addressed and supported.

Sustainability, creativity and innovation in project management – Model development for assessing organizational performance through projects

Today a number of studies are published on how organizational strategy is developed and how organizations contribute to local and regional development through the realization of these strategies. There are also many articles dealing with the success of a project by identifying the criteria and the factors that influence them. This article introduces the project-oriented strategic planning process that reveals how projects contribute to local and regional development and demonstrates the relationship between this approach and the regional competitiveness model as well as the KRAFT concept. There is a lot of research that focuses on sustainability in business. These studies argue that sustainability is very important to the success of a business in the future. The Project Excellence Model that analyses project success does not contain the sustainability criteria; the GPM P5 standard consists of sustainability components related either to the organizational level. To fill this gap a Project Sustainability Excellence Model (PSEM) was developed. The model was tested by interviews with managers of Hungarian for-profit and non-profit organizations. This paper introduces the PSEM and highlights the most important elements of the empirical analysis.

Theoretical frameworks to support research of health service innovation

Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable however research in this field is limited with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach and therefore the accumulation of research findings in development of a body of knowledge. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. If left unaddressed, health services research will continue in an ad hoc manner preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The purpose of this paper is to provide an integrative review of the literature and introduce a theoretical framework for health services innovation sustainability research based on integration and synthesis of the literature. Finally recommendations for operationalising and testing this theory will be presented.

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

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

Bio-fuelling the Hummer? Transdisciplinary Thoughts on Techno-Optimism and Innovation in the Transition from Unsustainability

An overarching aim of this chapter is to offer an informed and critical analysis of ‘techno-optimism’, informed by an explicitly transdisciplinary approach. A transdisciplinary perspective is one in which knowledge production goes beyond the academy to include end non-academic stakeholders and users. In effect it seeks to ‘upstream’ the involvement of non-academic interests in research design and knowledge production, as opposed to limiting those non-academic interests to the dissemination end point stage of research, which is the dominant research model. Techno-optimism is understood as an exaggerated and unwarranted belief in human technological abilities to solve problems of unsustainability while minimising or denying the need for large-scale social, economic and political transformation. More specifically, techno-optimism is the belief that the negative environmental and social costs of high-consumption, affluent, consumer societies and associated ways of life within capitalist orthodox economic growth orientated socio-economic systems, can be solved or eradicated through technological innovation and breakthroughs. Business as usual can be ‘greened’; a capitalist, growth-based economy can be made more ‘resource efficient’, consumerism less ‘resource intensive’ (and maybe a little bit more ethical). Techno-optimism, to be deliberately provocative for a moment, can therefore be described as a ‘biofuel the hummer’ response to the challenges (and opportunities) of the crisis of unsustainability. What I mean by that analogy is the seductive promise and premise of techno-optimism of not questioning or doubting the status quo (the hummer), hence it’s putative (but entirely false) non-political character. The capitalist, consumerist, growth-based socio-economic system is thus removed from critical analysis (usually on the implicit or explicit assumption of either the normative rightness of this system, or on strategic political grounds that it is naive or utopian to envisage widespread support for a non or post-capitalist consumer system). Techno-optimism simply enables a different means (biofuel) to the same ends.

Rock, paper, scissors : reflective practice for design process in the novice landscape architect

We describe a pedagogical approach that addresses challenges in design education for novices. These include an inability to frame new problems and limited-to-no design capability or domain knowledge. Such challenges can reduce student engagement with design practice, cause derivative design solutions as well as the inappropriate simplification of design assignments and assessment criteria by educators. We argue that a curriculum that develops the student’s design process will enable them to deal with the uncertain and dynamic situations that characterise design. We describe how this may be achieved and explain our pedagogical approach in terms of methods from Reflective Practice and theories of abstraction and creativity. We present a landscape architecture unit, recently taught, as an example. It constitutes design exercises that require little domain or design expertise to support the development of conceptual thinking and a design rationale. We show how this approach (a) leveraged the novice’s existing spatial and thinking skills while (b) retaining contextually-rich design situations. Examples of the design exercises taught are described along with samples of student work. The assessment rationale is also presented and explained. Finally, we conclude by reflecting on how this approach relates to innovation, sustainability and other disciplines.

A sustentabilidade de iniciativas na gestão do SUS a partir da experiência de Aracaju: entre o instituinte e o instituido

Este trabalho tem como objeto as estratégias de construção de sustentabilidade do Projeto Saúde Todo Dia, no SUS de Aracaju - SE. As dimensões estudadas foram o Projeto de Saúde Municipal, a Política de Educação Permanente, o SAMU e a Política de Saúde Mental, no período de 2001 a meados de 2008. A abordagem do objeto se deu através de entrevistas semi-estruturadas com membros das três gestões da saúde no período, ligados às quatro dimensões descritas. Observaram-se diferentes trajetórias nas dimensões estudadas ao longo as gestões, com continuidades e descontinuidades, a partir das quais se construíram eixos de análise baseados nas Relações entre Política de Saúde e Dinâmica da Política Municipal, nas Lógicas e Modos de Operar da Gestão Formal, na Articulação entre Projeto Setorial e sociedade Civil e em Perspectivas de Sustentabilidade. Adotando como referência o conceito de Sustentabilidade Instituinte, produzido no decorrer do trabalho, concluiu-se que no Projeto Saúde Todo Dia foram produzidas inúmeras inovações nos modelos de atenção e de gestão, desencadeadas algumas estratégias de construção de sustentabilidade, em sua maioria de elementos estruturados, sendo mais limitadas, porém, as iniciativas de construção micropolítica junto aos trabalhadores e usuários, bem como as tentativas de constituição de redes de coletivos e de movimentos junto a estes segmentos.

Experiment on Qinghai-Tibet railroad subgrade temperature monitoring based on FBG sensors

Qinghai-Tibet Railway is the longest and highest plateau railway in the world. A long term monitoring system of the stability of the subgrade in the permafrost regions should be put forward immediately to prevent damage to the railway. As it's very difficult to set up the long-distance automatic monitoring system which contains a lot of measure points along the 550 kilometers railway in the permafrost area, we present a subgrade temperature monitor system based on fiber Bragg grating (FBG). In this paper the principles of the FBG was presented, and the feasibility of the FBG sensors in the permafrost area of Qinghai-Tibet plateau was analysized. We embedded fifteen FBG temperature sensors and thermal resistance temperature sensors. A contrast experiment is made while the two kinds of sensors are arranged in the same position. The result of the experiment shows that the accuracy of the FBG temperature sensors is less than 0.1 degrees C. and the FBG sensors can do well in the measurement of pattern which the temperature varies with the depth of the permafrost soil. The result also shows the stability of the FBG sensors in the bad environmental condition of Qinghai-Tibet plateau, which proves the feasibility of the application of FBG sensors and our monitoring system on the Qinghai-Tibet railway.

Avaliação do estado de conservação de fachadas e ensaios de arrancamento de elementos em aço de pré-esforço colados com resina Epoxy a provetes de pedra natural

O ingresso no mercado de trabalho e primeiro contacto com a realidade na construção em Portugal motivaram a realização deste relatório. O qual tem como base o estágio realizado na Sika® Portugal Produtos da Construção e Indústria, S.A. como elemento do Departamento Técnico. O trabalho desenvolvido incide sobre a escolha de soluções de reabilitação e na avaliação preliminar do estado de conservação dos edifícios outrora reabilitados com soluções Sika®. A primeira parte deste relatório descreve a adaptação do método de avaliação do estado de conservação de edifícios (MAEC) de forma a realizar esta avaliação apenas no sistema construtivo que compõe a fachada, aplicado num estudo desenvolvido para 100 obras de reabilitação em edifícios distribuídos no território nacional. Numa segunda parte do relatório são apresentados documentos desenvolvidos durante a actividade profissional aquando de visitas às obras e respectivas análises preliminares e especificações técnicas. Nesta segunda parte do relatório mais relacionada com as actividades diárias são ainda apresentados documentos técnicos de apoio a tecnologias e ou selecção de soluções mais adequadas às exigências e necessidades de comportamento dos materiais. É ainda abordado o tema sustentabilidade que actualmente é uma das preocupações nas escolhas e tomadas de decisão de soluções para a reabilitação e construção nova. Apresenta-se ainda um estudo realizado em laboratório que visa determinar o comprimento de amarração de fios ou cordões de pré-esforço colados com resina epoxy a provetes de diferentes tipos de pedra natural.

Liderazgo e innovación dentro del sistema de negocio. Estudio de caso de la campaña AmeriTel en Teleperformance Colombia

Uno de los retos más complejos que enfrentan los líderes de las empresas es obtener resultados que las hagan perdurables a lo largo del tiempo. Usualmente, la innovación es vista como una estrategia para mejorar los resultados a corto plazo y el liderazgo como habilitador de su implementación. Sin embargo, la innovación también puede ser vista como parte central del sistema de negocio, y las prácticas del liderazgo como facilitadores que permitan mejorar los resultados no sólo a corto, sino también a mediano y largo plazo. Con base en lo anterior, se realizó un estudio de caso en la campaña de AmeriTel en Teleperformance Colombia para analizar la asociación que tiene el liderazgo y la innovación con sus resultados, y cómo esta relación se refleja en la perdurabilidad de la campaña. De acuerdo a los hallazgos de la investigación, se puede observar el desempeño de una campaña que está enfocada en resultados, en cómo cambia la perspectiva y efectividad de todo el personal, pasando de la innovación de un nuevo modelo de gestión visto como estrategia, al mismo modelo visto como innovación dentro del modelo de negocio, el círculo del cambio y la aplicación de un liderazgo efectivo.

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.

Factors influencing sustainability of health service innovation, emergency nurse practitioner service

Escalating health care delivery costs and consumer expectations have led to a range of health service and workforce innovations in the provision of high quality cost effective patient care. This research has operationalised a theoretical framework to examine factors that influence sustainability of health service innovations, in particular, emergency nurse practitioner service. The results of this research will inform health service policy and practice for future implementation of innovative workforce models and add to the understanding of factors that influence sustainability.

Profitability and the poor: corporate strategies, innovation and sustainability

Based on empirical evidence, the article looks at the implications of private sector participation (PSP) for the delivery of water supply and sanitation to the urban and peri-urban poor in developing countries, with particular reference to Africa and Latin America. More precisely, the article addresses the impact produced by multinational companies’ (MNCs) strategies, in light of the pursuit of profitability, on the extension of connections to the pipeline network. It does so by questioning the assumptions that greater private sector efficiency and innovation, together with contract design, will enable the sustainable extension of service coverage to low income dwellers. The strategies of the major water MNCs are considered both in relation to the global expansion of their operations and the adjustment of local strategies to commercial considerations. The latter might result in identifying proWtable markets, modifying contractual provisions, attempting to reduce costs and increase income, reducing risks and exiting from non-performing contracts. The evidence reviewed allows for re-assessing the relative roles of the public and private sectors in extending and delivering water services to the poor. First, the most far reaching innovative approaches to extending connections are more likely to come from communities, public authorities and political activity than from MNCs. Secondly, whenever MNCs are liable to exit from non-profitable contracts, the public sector has no other option than to deal with external risks aVecting continuity of provision. Finally, market limitations affecting MNCs’ ability to serve marginal populations and access cheap capital do not apply to well-organised, politically led public sector undertakings