Background: Increasing numbers of women veterans (WV) present an organizational challenge to a healthcare system that primarily serves men. WV use reproductive services traditionally not provided by the Veterans Health Administration (VHA). Objective: Examine the association of organizational factors and adoption of comprehensive women’s health (WH) care in the VHA. Study Design: Cross-sectional secondary analysis of the 2007 VHA Survey of Women’s Veterans Health Programs and Practices. Methods: Dependent measures were (a) model of women’s health care: separate women’s health clinic (WHC), designated women’s health provider within primary care (DWHP), both (WHC/DWHP), or neither and (b) availability of five basic WH services: cervical cancer screening and evaluation and management of: vaginitis, menstrual disorders, contraception and menopause. Exposure variables were organizational factors drawn from an adaptation of the Greenhalgh model of diffusion of innovations including structural factors, measures of absorptive capacity and system readiness for innovation. Results: Compared to sites with DWHP or neither, WHC and WHC/DWHP were more likely at facilities with: a gynecology clinic, an academic affiliation, a WH representative on high impact committee, and a greater number of WV. Academic affiliation and high impact committee remained significant in multivariable analysis. All five basic WH services were more likely to be offered at sites with WHC or WHC/DWHP, remaining significant after adjusting for organizational factors. Conclusion: Facilities that adopt WHC are associated with greater absorptive capacity (academic affiliation and WH representation on high-impact committees) and are more likely to deliver basic WH services. Separate WHCs may promote more comprehensive care for WV.

The purpose of this phenomenological study was to examine the lived experiences of a homogeneous group of frontline child welfare workers in Los Angeles, CA. Data were collected using recorded in-depth, open ended interviews with 10 participants. Critical incident technique was used to collect data on specific incidents. Symbolic interactionism was the theoretical framework used. Five themes emerged during the analyses which are the main findings of this study: (1) Organizational factors contributed to the challenges and stress of the job, (2) participants shared a belief that management did not value them, (3) participants' morale and workloads were adversely affected by a highly publicized child fatality, (4) the job was rewarding and meaningful when participants felt they had protected children and helped families, and (5) participants reported being socialized to accept abusive behavior from clients through the omission or minimization of safety as a training topic in college and work sites. The positive social change implication includes information that may help facilitate a paradigm shift in the professional and academic socialization of social workers. The realistic picture on public child welfare work that participants shared has the potential to be useful to future social work students, researchers, professors, law enforcement, and administrators of public child welfare agencies. Realistic expectations may also increase retention of employees.

The loss of special education teachers is a problem for all school districts. The effects of special education teacher attrition are felt in the classrooms and by all school district personnel. The impact on student achievement can be profound, especially if the teacher leaves in the middle of a school year. This study examines the organizational factors that influenced the attrition of special education teachers in one Central Florida school district. Participation in the anonymous survey was voluntary. Invitations to participate were sent directly to 385 special education instructional personnel and distributed to all district personnel using an e-mail forum. After removing participants who did not meet the inclusion criteria, 250 completed surveys were included in the analysis. In addition to quantitative items, the survey also included open–ended items at the end of the survey. While special education instructional personnel were the focus of the study, data from general education instructional personnel were also collected for comparison. The findings indicated that the major organizational causes of attrition among exceptional education teachers were in the areas of the human resources, political and structural frames. Human resource factors included the emotional, physical, and mental toll of daily classroom responsibilities and the perceived lack of district administration support. The main structural frame factor was the lack of compensation for the extra duties that special education teachers must perform. The main political factor was the lack of time needed by the special education staff to complete assigned duties during an average school day. In addition, the symbolic frame factors suggested a lack of perceived support from the general education staff; however, respondents did not indicate that this was major factor affecting in the attrition of special education teachers in this district. The school district has implemented strategies to support teachers to meet State certification requirements, Federal mandates of being highly qualified, and with monthly district level support visits. However, based on these data, the school district needs to recognize organizational factors affecting attrition. The district should pinpoint and alleviate the daily factors that cause undue stress on the special education staff. It should also reallocate resources and personnel to provide more frequent district and school level administrative support. Additional monetary or non-monetary compensation for the extra duties or reducing the workload on the special education teachers may also reduce attrition.

Bakgrund: Svensk sjukvård står inför stora utmaningar de kommande åren med en åldrande befolkning som kommer att kräva allt mer vård. Samtidigt väljer allt fler sjuksköterskor att lämna sitt yrke vilket försämrar vårdkvalitén och riskerar patientsäkerheten, det är därför viktigt att undersöka vilka faktorer som får sjuksköterskor att avsluta eller byta sin anställning. Metod: En litteraturöversikt med kvalitativa och kvantitativa artiklar. Syfte: Syftet med denna studie var att beskriva faktorer som påverkar sjuksköterskor att lämna sitt yrke. Resultat: Ur analysen framkom två kategorier; hinder i organisationen och bristande samarbete på arbetsplatsen med fyra underkategorier. Konklusion: Ogynnsamma arbetsförhållanden som skapar stress leder till ett försämrat psykiskt och fysiskt välbefinnande hos sjuksköterskor. Sjuksköterskor upplever en konflikt mellan tid för arbets- och privatliv, vilket kan vara ett resultat av hög arbetsbelastning, brist på personal, långa och ofta varierande arbetstider. På individnivå finns olika förutsättningar att hantera den påfrestande arbetssituationen och där upplevt bristande stöd från arbetsgivaren kan leda till att sjuksköterskor lämnar sitt arbete. Speciellt utsatta är de nyexaminerade sjuksköterskorna som behöver mycket stöd från medarbetare och chef. / Background: Swedish healthcare is facing major challenges in the coming years with an aging population that will require more and more care. At the same time, more and more nurses choose to leave their profession, which deteriorates the quality of care and risks patient safety. It is therefore important to investigate which factors cause nurses to end or change their employment. Method: A literature review with qualitative and quantitative articles. Aim: To describe factors that influence nurses to quit their profession. Findings: The analysis revealed two categories; obstacles in the organization and lack of cooperation in the workplace with four subcategories. Conclusion: Unfavorable working conditions that create stress lead to a deterioration in the mental and physical well-being of nurses. Nurses experience a conflict between time for work and personal life, which can be a result of high workload, shortage of staff, long and often varying working hours. At the individual level, there are different conditions for dealing with the stressful work situation and where a perceived lack of support from the employer can lead to nurses leaving their jobs. Especially vulnerable are the newly qualified nurses who need a lot of support from co-workers and manager

Research background: Digitization, technological advancements, such as AI, the global customer base and varying ownership structures can be seen as a few of the largest challenges that contemporary international MNEs face with regards to their internal operations. Such disruptive factors require firms to be innovative in their products, services, and operations, to retain a competitive advantage and thrive in the international markets – at the foundation of which lies having an entrepreneurial orientation (EO). This is applicable not only to HQs, but also to subsidiaries, which possess the local knowledge needed to succeed in that market. From this, the whole MNE can and should benefit, enabled through effective diffusion of initiatives – realizable through central roll-out from the HQ.  Research purpose: This study explores how HQs behave when faced with initiatives from their foreign subsidiaries. The main goal of this study is to identify behavioural patterns and how this influences the ultimate decision-making of the HQ. This study aims to join the discussion on HQ-subsidiary relationships with regards to initiative realization. The growing interest in research on the role of HQs in contemporary MNEs, the lack of research on central initiative realization, and the centralization of knowledge at HQ are fundamental to this study.  Research question: What internal organizational factors influence HQs’ decisions on the central realization of their foreign subsidiaries’ initiatives?  Research method: This thesis is based on the research paradigm of relativistic ontology and social constructionist epistemology, meaning reality is shaped by people and their observations. I adopted an explorative, holistic, single-case study design of a Dutch MNE with subsidiaries in Germany and Sweden. I used the approach of heterogeneous purposive sampling, denoting various inclusion criteria beforehand. In total, I conducted seventeen interviews. The collected data was consequently analyzed using the principles of the template approach.  Conclusion: The findings are consolidated in a conceptual model (see Figure 2) that denotes knowledge sharing and autonomy as the direct internal influences on the HQ’s decision to centrally realize foreign subsidiaries’ initiatives. These effects are moderated by managerial and HQ intentionality, the pursuit of a common strategy, trust as a dual relationship, the perceptions of alignment of organizational culture and the subsidiary’s motivation to engage in initiatives.

Under de senaste åren har ett ökande antal ensamkommande barn kommit till Sverige för att söka asyl. Majoriteten av barnen blir placerade på hem för vård eller boende (HVB). Denna kvalitativa studie syftar till att få en djupare förståelse för hur arbetet på tre HVB-hem i en medelstor kommun kan se ut och vara organiserat. Data har samlats in genom semistrukturerade intervjuer med sex anställda vid HVB-hem; tre sektionschefer och tre personal. Organisationskultur har använts som huvudsakligt analysinstrument med organisationsstruktur som komplement. Resultatet visar att fyra organisatoriska faktorer som är viktiga för personal i arbetet med ensamkommande barn är enhet, meningsfullhet, struktur och flexibilitet samt kompetens. Dessa faktorer kan ses som viktiga i arbetet med att utveckla verksamheterna. En välorganiserad verksamhet kan bättre leda till den stabilitet som de ensamkommande barnen behöver. / During the past years, an increasing amount of unaccompanied children have come to Sweden to apply for asylum. The majority are placed in residential care units. This qualitative study aims to get a deeper understanding of how the work in three residential care units in a medium-large municipality can look and be organized. Data has been collected through interviews with six employees at residential care units; three executives and three staff members. Organizational culture has been used as the main analysis instrument with organizational structure as complement. The findings show that four organizational factors that are important for staff when working with unaccompanied children are unity, meaningfulness, structure and flexibility, and competence. These factors can be viewed as important in developing the establishments. A well-organized establishment is superior in the way that it can lead to the stability that the unaccompanied children need.

Critical success factors (CSFs) are those things that must be done correctly for a project to be successful; however, CSFs are not sufficient by themselves to guarantee success. CSFs, as identified in the literature, vary from study to study. In addition, previous studies have not typically included contextual details for the projects studied. As a result, it is difficult to know how the particulars of a project impact (or not) CSFs. Researchers have suggested that CSFs can be affected by contextual details. Knowledge about the effect of contextual factors on CSFs would allow organizational leaders and project managers to more effectively use resources to achieve project success. Enterprise system implementation projects have exhibited high failure rates. Both Enterprise Resource Planning (ERP) and Electronic Health Record (EHR) system implementations have proven to be challenging for organizations. For enterprise system implementation projects, a variety of contextual factors may be important. Examples of contextual factors include the number of software modules implemented, the number of sites undergoing implementation, the geographic dispersion of the sites, the number of people in the organization, and the percentage of personnel in the organization whose daily tasks are disrupted by the new enterprise system. This research was designed to shed light on the role of contextual factors on CSFs for enterprise system implementation projects. A survey was created to evaluate the effects of contextual factors on CSF ratings. The survey included questions related to 17 CSFs, 14 of the CSFs included in the study have been well-cited in the project management literature. Three additional CSFs were also included in the study to capture important elements of change management, which more recent studies have shown to be relevant to enterprise system implementations. The survey included questions related to eight contextual variables for ERP projects and 11 contextual variables for EHR system projects. The research focused on small to medium-size organizations, which have been less studied than larger organizations. The target respondents for the survey were enterprise system (ERP or EHR) project managers from software companies or consulting firms and government project managers whose implementation projects were within six months of completion. Data were collected on 17 ERP projects and 26 EHR system implementation projects in 43 different organizations. The survey data and subsequent analyses provided evidence that EHR system implementation projects are impacted by contextual factors. The results for the ERP implementations are not conclusive. The results suggest that contextual factors should be taken into consideration when determining how best to manage enterprise system implementations. In addition, the results of this research did not support previous research findings, which indicated that similar CSFs exist for ERP and EHR system projects. CSFs were found to vary substantially in a number of key areas, especially with respect to training. The User Training and Support CSF for the ERP projects included in this study was rated less important than prior research results suggest (Finney & Corbett, 2007). One of two CSFs included in the survey to capture change management requirements, Early Adopter/Super-user, was found to be an important CSF for the ERP projects included in this study. The EHR system projects were found to be affected by contextual factors, with nine different instances of significant relationships identified between individual CSFs and one or more contextual factor. Eight of the 17 CSFs for the EHR system implementation projects in this study were affected by contextual factors. Contextual factors impacted the ERP and EHR system implementations quite differently, suggesting that more research is needed to better understand the phenomenon leading to these differences. The findings from this research can be used by organizational leaders and project managers to more effectively achieve project success. These results provide project managers and organizational leaders in small and medium-size organizations with a much deeper and relevant understanding of the factors that are most important to manage in successfully implementing either ERP or EHR system projects. As this study focused on small and medium-size organizations and both ERP and EHR system implementation projects, the findings are relevant across a wide range of organizations. As smaller organizations have not typically been the focus of CSF research, this study makes an important contribution to the understanding of CSFs for both ERP and EHR system implementation projects. More generally, this research also expands the broader body of knowledge on the identification of CSFs, as this study has provided empirical evidence for the important role played by contextual factors. Every project is carried out within a broader organizational setting. This broader organizational setting appears, based on the results of this study, to have a strong effect on the importance of CSFs for each specific project and as such, may explain some of the seemingly contradictory findings related to CSFs in the existing literature. While further research is needed to understand the means by which contextual factors impact CSFs, this study has provided a significant contribution in validating the relationship between contextual factors and CSFs for a broad range of enterprise system projects in a wide range of industries. / Graduation date: 2012

Descreve o panorama do surgimento da aviação e das teorias de investigação de acidentes aeronáuticos. Objetivo - Analisar a investigação dos acidentes e incidentes aeronáuticos ocorridos na Aviação Geral no Estado de São Paulo no período de 2000 a 2005 e verificar sua associação a fatores organizacionais. Método - Foram comparadas as atuações das agências de investigação de acidentes aeronáuticos dos Estados Unidos, União Européia e Brasil, identificado os métodos de investigação de acidentes empregados. Foi realizado o levantamento das ocorrências com as aeronaves classificadas na categoria de aviação geral no estado de São Paulo no período 2000 a 2005 e feita a análise comparativa de 36 relatórios finais de acidentes utilizados pelo Centro de Investigação e Prevenção de Acidentes (CENIPA) com o Human Factors Analysis and Classification System (HFACS). Resultados Identificou-se que as agências de investigação dos Estados Unidos e União Européia atuam de forma sistêmica e a brasileira atua isoladamente. Foi constatado que houve 636 ocorrências com aeronaves da aviação geral, sendo que 92 por cento foram incidentes, que não foram investigados. Dos acidentes, 5,5 por cento possuíam relatórios finais concluídos. A análise dos relatórios finais, segundo o CENIPA, apontou 163 fatores contribuintes, sendo que o principal fator foi o deficiente julgamento presente em 80,5 por cento dos acidentes. A utilização do modelo HFACS identificou a presença de 370 fatores contribuintes e os erros de habilidade, de decisão e planejamento inadequado foram os principais fatores contribuintes com 86,1 por cento . Considerações Finais O estudo possibilitou a identificação da falta de integração de diversos órgãos governamentais na investigação dos acidentes aeronáuticos. A ausência de investigação de incidentes aeronáuticos dificultando a prevenção. A análise do CENIPA não contempla de forma adequada os fatores organizacionais. O HFACS não deve ser uma ferramenta apenas quantificadora das causas de acidentes aeronáuticos / Introduction Describes the birth of aviation and aeronautical accidents factors. investigation theories. Objective Analyze the investigation of aeronautical accidents and incidents occurring in the General Aviation in the State of São Paulo during the period of 2000 through 2005 and verify their association with organizational factors. Method The air accident agencies of the United States, European Union and Brazil were studied, identifying and comparing the accident investigation methods used. It was registered the number of events with aircrafts in the State of Sao Paulo from 2000 to 2005, and performed the comparative analysis of 36 accident final reports used by the Centro de Investigação e Prevenção de Acidentes (CENIPA; Accident Prevention and Investigation Center) using the Human Factors Analysis and Classification System (HFACS). Results It was observed that the investigation agencies of the United States and the European Union work in a systemic way, and that the Brazilian one works alone. It was observed that there were 636 events with aircrafts of the general aviation, of which 92 per cent were not-investigated incidents. Of the accidents, 5.5 per cent had their final reports finished. The analysis of the final reports according to CENIPA pointed out 163 contributing factors, being the main factor \"inadequate evaluation\", present in 80.5 per cent of the accidents. The HFACS model identified 370 contributing factors, and the \"skill errors\", \"decision\" and \"inadequate planning\" were the main contributing factors, being present in 86.1 per cent of the cases. Final Considerations The study allowed identifying the lack of integration of several administration agencies when investigating air accidents. The non investigation of air incidents hinders the prevention. The CENIPA analysis does not study properly the organizational factors. HFACS must not be just a quantifying tool of the air accidents causes.

Descreve o panorama do surgimento da aviação e das teorias de investigação de acidentes aeronáuticos. Objetivo - Analisar a investigação dos acidentes e incidentes aeronáuticos ocorridos na Aviação Geral no Estado de São Paulo no período de 2000 a 2005 e verificar sua associação a fatores organizacionais. Método - Foram comparadas as atuações das agências de investigação de acidentes aeronáuticos dos Estados Unidos, União Européia e Brasil, identificado os métodos de investigação de acidentes empregados. Foi realizado o levantamento das ocorrências com as aeronaves classificadas na categoria de aviação geral no estado de São Paulo no período 2000 a 2005 e feita a análise comparativa de 36 relatórios finais de acidentes utilizados pelo Centro de Investigação e Prevenção de Acidentes (CENIPA) com o Human Factors Analysis and Classification System (HFACS). Resultados Identificou-se que as agências de investigação dos Estados Unidos e União Européia atuam de forma sistêmica e a brasileira atua isoladamente. Foi constatado que houve 636 ocorrências com aeronaves da aviação geral, sendo que 92 por cento foram incidentes, que não foram investigados. Dos acidentes, 5,5 por cento possuíam relatórios finais concluídos. A análise dos relatórios finais, segundo o CENIPA, apontou 163 fatores contribuintes, sendo que o principal fator foi o deficiente julgamento presente em 80,5 por cento dos acidentes. A utilização do modelo HFACS identificou a presença de 370 fatores contribuintes e os erros de habilidade, de decisão e planejamento inadequado foram os principais fatores contribuintes com 86,1 por cento . Considerações Finais O estudo possibilitou a identificação da falta de integração de diversos órgãos governamentais na investigação dos acidentes aeronáuticos. A ausência de investigação de incidentes aeronáuticos dificultando a prevenção. A análise do CENIPA não contempla de forma adequada os fatores organizacionais. O HFACS não deve ser uma ferramenta apenas quantificadora das causas de acidentes aeronáuticos / Introduction Describes the birth of aviation and aeronautical accidents factors. investigation theories. Objective Analyze the investigation of aeronautical accidents and incidents occurring in the General Aviation in the State of São Paulo during the period of 2000 through 2005 and verify their association with organizational factors. Method The air accident agencies of the United States, European Union and Brazil were studied, identifying and comparing the accident investigation methods used. It was registered the number of events with aircrafts in the State of Sao Paulo from 2000 to 2005, and performed the comparative analysis of 36 accident final reports used by the Centro de Investigação e Prevenção de Acidentes (CENIPA; Accident Prevention and Investigation Center) using the Human Factors Analysis and Classification System (HFACS). Results It was observed that the investigation agencies of the United States and the European Union work in a systemic way, and that the Brazilian one works alone. It was observed that there were 636 events with aircrafts of the general aviation, of which 92 per cent were not-investigated incidents. Of the accidents, 5.5 per cent had their final reports finished. The analysis of the final reports according to CENIPA pointed out 163 contributing factors, being the main factor \"inadequate evaluation\", present in 80.5 per cent of the accidents. The HFACS model identified 370 contributing factors, and the \"skill errors\", \"decision\" and \"inadequate planning\" were the main contributing factors, being present in 86.1 per cent of the cases. Final Considerations The study allowed identifying the lack of integration of several administration agencies when investigating air accidents. The non investigation of air incidents hinders the prevention. The CENIPA analysis does not study properly the organizational factors. HFACS must not be just a quantifying tool of the air accidents causes.

Este trabalho apresenta uma proposta de modelo de análise de risco para embarcações, incorporando em sua formulação a influência das interações entre os sistemas de alarmes e os fatores humanos e organizacionais presentes a bordo. De acordo com estatísticas de sociedades classificadoras, o homem é o maior responsável por acidentes marítimos, e, desta forma, é um dos principais componentes da segurança de uma embarcação. A relevância do elemento humano se dá pelo fato de que ações e decisões humanas estão relacionadas tanto à causa, quanto à prevenção de acidentes. O sistema de alarmes é um equipamento de segurança obrigatório, e com direta participação na dinâmica de um acidente, fornecendo informação para a tomada de decisão das ações por parte da tripulação na resolução do problema. O estudo da interação entre este equipamento e o elemento humano a bordo permite a gestores e armadores elaborar diretrizes para investimentos em sistemas de segurança e políticas que influenciam o desempenho humano, e, portanto, a segurança a bordo. O modelo proposto, inspirado em relatório de acidentes marítimos, tem como ponto de partida uma estrutura sequencial do acidente e leva em consideração uma sucessão usual e simplificada dos eventos ocorridos, iniciando a partir de uma falha no sistema físico. O elemento humano, então, é incorporado à análise de risco através das técnicas de análise de confiabilidade humana, as quais têm como princípio a visão do homem como mais um componente do sistema, ou o liveware interagindo com software e hardware. Sob este ponto de vista, uma abordagem sócio-técnica é aplicada, ou seja, considera-se que um navio é composto não apenas de sua estrutura e máquinas, mas também de toda a tripulação. Com o objetivo de exemplificar passos e hipóteses de uma aplicação do modelo proposto, é apresentada a aplicação ao caso do acidente da embarcação Maersk Doha, ocorrido em outubro de 2006 nos Estados Unidos, cujo relatório de investigação do acidente é de acesso público via Internet, no site da Marine Accident Investigation Branch MAIB. / This work presents a risk analysis model for ships, focusing on the scenarios where the crew interacts with the alarm and monitoring system. According to statistics of classification societies, humans are largely responsible for accidents on board and, therefore, are considered a major component of the safety of vessels. The relevance of the human element is given by the fact that human decisions and actions are related to the cause of accidents, either being the direct causative factor of failure or influencing the probability of failure, and the prevention of accidents or mitigation of the consequences. The alarm system is a mandatory component of certified vessels, with direct participation in an accident. It supplies information for the decision making process of the crew, considering their actions to recover the system. The study of the interactions between this automation equipment and the human element on board provides guidelines to managers and owners to invest in proper security systems and policies that influence human behavior, and therefore the safety on board. The model, inspired in accident reports, has as starting point a sequential structure of the accident, and takes into account a typical and simplified sequence of events, starting from a failure in the physical system. The human element is incorporated into the risk analysis through techniques of human reliability analysis, which place man as another component of the system, or the \"liveware\" interacting with software and hardware. From this point of view, a socio-technical approach is applied, considering that a ship is composed of not only its structure and machinery, but also of the entire crew. In order to illustrate the steps and assumptions to be done by an analyst applying the proposed model, the accident of the vessel Maersk Doha, occurred in October of 2006 in the United States, is analyzed. The report on the investigation of this accident is public and accessible via the Internet site of the Marine Accident Investigation Branch MAIB.