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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Exploring the Influence of Targeted Coaching on Teachers' Planning and Instruction

January 2012 (has links)
abstract: When it comes to planning for instruction, many teachers may feel an overwhelming need to rely on prescribed curricular resources and when those are not available many teachers may feel lost. While several methods for improving instructional planning exist, research has shown that prioritizing standards, creating assessments aligned to those standards, and using the data from those assessments to make instructional decisions have positively impacted teachers' instructional planning practices. Grounded in participatory action research (PAR), this mixed methods action research study sought to investigate the influence that targeted coaching could have on teachers' planning practices. The study was conducted in a K-8 Title I school and included four participants who engaged in targeted coaching and professional development designed to help them improve their planning practices. It utilized surveys, observations, artifacts, and interviews to answer the research questions. From the surveys, interviews, lesson plans, artifacts and coaching conversations, the Coaching Model for Effective Planning provided helpful and beneficial professional development that was readily adaptable and useful to the participants' classroom. In addition, the findings exhibited that coaching can influence planning whether formally by being written into lesson plans or by incorporating it into instruction. Furthermore, the findings also raised the question of teacher efficacy in coaching relationships as wells the impact of coaching. / Dissertation/Thesis / Ed.D. Educational Leadership and Policy Studies 2012
32

PROPUESTA DE METODOLOGIA PARA LA IDENTIFICACION Y EL ANALISIS DE MODELOS DE NEGOCIO TRIPLEMENTE SOSTENIBLES EN EL SECTOR AGROALIMENTARIO

Galeano Revert, Ana María 02 October 2017 (has links)
The agri-food industry is an important economic and social engine in many countries, not only because of its economic importance, but also because of its vital significance. For years, it has been possible to consider that this sector evolution has conducted to the development of centralized and global distribution networks. These global distribution networks, in a market of low value-for-weight products, are more efficient the more centralized their logistics be. This new paradigm has a collateral effect which is the difficult survival of the small producer-sellers with the problems that this entails for citizens as society members. This thesis is part of a project conducted by the Universitat Politècnica de València professors named as HOF3M (Heterarchical Open Food 3-sustainable Market). The project aims to facilitate the development of a triple bottom-line food product market, generating the technological and business bases to reduce entry barriers, so that anyone, anywhere in the world can become an agent that approaches any producer to any consumer. The aim of this thesis is to "provide a methodology for identifying and analysing business models through case studies, with the objective of creating a triple bottom-line, replicable and non-scalable business model bank in the agri-food industry". The application of this methodology provides a tool that facilitates the replicability of business models in the agri-food business context. In addition, it allows to identify those triply sustainable and non-scalable models that can be implemented by consumers, producers and intermediaries. The research work is carried out from literature reviews to understand the business models scope, triple bottom-line business and the context of the agri-food economy, as well as the application of the case study research methodology, for which the proposal is validated. This thesis gives three fundamental contributions: a methodology to identify and analyse a business model through study cases, a triple bottom-line assessment model within the agri-food economy framework, and three food retailing business model analysis. / El sector agroalimentario supone un importante motor económico y social en muchos países, no solo por su relevancia económica, sino también por su significado vital. Desde hace años se puede considerar que la evolución del sector ha derivado en el desarrollo de redes de distribución centralizadas y globales. Estas redes de distribución globales, en un mercado de productos de bajo ratio valor/peso, son más eficientes cuanto más centralizada esté su logística. Este nuevo paradigma tiene como efecto colateral la difícil pervivencia del pequeño productor-vendedor con los problemas que esto supone para el ciudadano en cuanto a miembro de la sociedad. Esta tesis se enmarca en un proyecto de profesores de la Universitat Politècnica de València denominado HOF3M (Heterarchical Open Food 3-sustainable Market). El proyecto tiene el objetivo de facilitar el desarrollo de un mercado triplemente sostenible de productos alimentarios, generando las bases tecnológicas y de negocio que reduzcan las barreras de entrada para que, cualquiera, en cualquier lugar del planeta pueda convertirse en un agente que acerque cualquier productor a cualquier consumidor. El objetivo de esta tesis se concreta en "proporcionar una metodología para la identificación y el análisis de modelos de negocio, a través del estudio de casos prácticos en empresas, con el objeto de confeccionar un banco de modelos de negocio triplemente sostenibles, replicables y no escalables en el sector agroalimentario". La aplicación de esta metodología proporciona una herramienta que facilita la replicabilidad de modelos de negocio en el tejido empresarial agroalimentario. Además, permite identificar aquellos modelos triplemente sostenibles y no escalables, que pueden ser implementados por consumidores, productores e intermediarios. El trabajo de investigación se realiza desde las revisiones de literatura para el entendimiento del ámbito de los modelos de negocio, de la triple sostenibilidad empresarial y del contexto de la economía agroalimentaria, además de la aplicación de la metodología de investigación a tres casos de estudio, con los cuales se valida la propuesta. De esta tesis se extraen tres aportaciones fundamentales: una metodología para identificar y analizar un modelo de negocio a través de casos de estudio, un modelo de evaluación de la triple sostenibilidad en el marco de la economía agroalimentaria, y tres análisis de modelos de negocio de venta al por menor de alimentos. / El sector agroalimentari suposa un important motor econòmic i social en molts països, no només per la seva rellevància econòmica, sinó també pel seu significat vital. Des de fa anys es pot considerar que l'evolució del sector ha derivat en el desenrotllament de xarxes de distribució centralitzades i globals. Estes xarxes de distribució globals, en un mercat de productes de baix ràtio valor/pes, són mes eficients quant mes centralitzada estiga la seua logística. Este nou paradigma té com a efecte col·lateral la difícil pervivència del xicotet productor-venedor amb els problemes que açò suposa per al ciutadà quant a membre de la societat. Esta tesi s'emmarca en un projecte de professors de la Universitat Politècnica de València denominat HOF3M (Heterarchical Open Food 3-sustainable Market). El projecte té l'objectiu de facilitar el desenrotllament d'un mercat triplement sostenible de productes alimentaris, generant les bases tecnològiques i de negoci que reduïsquen les barreres d'entrada perquè, qualsevol, en qualsevol lloc del planeta puga convertir-se en un agent que acoste qualsevol productor a qualsevol consumidor. L'objectiu d'esta tesi es concreta en "proporcionar una metodologia per a la identificació i l'anàlisi de models de negoci, a través de l'estudi de casos pràctics en empreses, amb l'objecte de confeccionar un banc de models de negoci triplement sostenibles, replicables i no escalables en el sector agroalimentari". L'aplicació d'esta metodologia proporciona una ferramenta que facilita la replicabilidad de models de negoci en el teixit empresarial agroalimentari. A més, permet identificar aquells models triplement sostenibles i no escalables, que poden ser implementats per consumidors, productor i intermediaris. El treball d'investigació es realitza des de les revisions de literatura per a l'enteniment de l'àmbit dels models de negoci, de la triple sostenibilitat empresarial i del context de l'economia agroalimentària, a més de l'aplicació de la metodologia d'investigació a tres casos d'estudi, amb els quals es valida la proposta. D'esta tesi s'extrauen tres aportacions fonamentals: una metodologia per a identificar i analitzar un model de negoci a través de casos d'estudi, un model d'avaluació de la triple sostenibilitat en el marc de l'economia agroalimentària, i tres anàlisis de models de negoci de venda al detall d'aliments. / Galeano Revert, AM. (2017). PROPUESTA DE METODOLOGIA PARA LA IDENTIFICACION Y EL ANALISIS DE MODELOS DE NEGOCIO TRIPLEMENTE SOSTENIBLES EN EL SECTOR AGROALIMENTARIO [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/88395 / TESIS
33

The Politics of Teaching Financial Literacy Education: A Case Study of Critical High School Teachers’ Beliefs and Practices in Ontario and Québec

Soroko, Agata 01 October 2021 (has links)
Teachers’ voices have been largely excluded from the academic and political debates regarding the aims and merits of financial literacy education. Through case study research, this project examined the beliefs, practices, and lives of 10 teachers in Québec and Ontario who teach financial literacy at the intermediate and senior levels. Specifically, the teachers in this study report taking a critical approach to financial literacy education–a subject that tends to be framed in simplistic and individualistic terms as mere personal financial decision-making. In an analysis of in-depth interviews and deliberative inquiry focus groups with self-identifying critical teachers and investigation into various documentary sources, I detail the ways in which some of these teachers adhere to mainstream understandings of financial literacy education while others work to reframe it towards more critical and economically just ends. This research results in the development of a framework for critical economic literacy education, documenting the intellectually demanding set of skills, knowledge, and pedagogical strategies a critical economic literacy requires of students and teachers. Findings also bring forth distinctions in teachers’ ideas about criticality, revealing that teachers navigate between common, critical, and transformative sense orientations in sophisticated ways to achieve their pedagogical aims. Last, I investigate how criticality emerges in teachers, narrating the ways in which their personal biographies, professional and political activities, and intellectual pursuits inform their critical teaching in relation to financial literacy. This case study is further contextualized by the current political moment in which escalating economic inequality and the widening racial wealth gap, the current financial crisis, impending climate disasters, and antidemocratic politics worldwide convey a sense of urgency and a timely relevance for a more critical and transformative financial literacy education.
34

What Makes Classroom Observation Feedback Useful? The Perceptions of Secondary Math and English Teachers

Frasier, Amanda 28 December 2022 (has links) (PDF)
Teachers (n=14) at four high schools in North Carolina were interviewed about their perspectives of evaluation policy at two time points during the 2016-2017 school year. This study specifically examined statements teachers made about feedback from observations using de-identified interview transcripts. Teachers discussed feedback from formal observations along with other sources of informal observational feedback (e.g., coaches, peers). Overall, teachers described useful feedback as that which provided actionable recommendations informed by the observer’s knowledge of three domains: the classroom context (as aided by the frequency and timing of observations), subject area, and pedagogy. Teachers also identified two aspects of formal evaluation that interfered with feedback: breadth of the observational standards and use as a growth measure.
35

Screening for misconceptions and assessing these by using metacognition in a mathematics course for N2 engineering students at a Northern Cape FET college / Susan Cecilia Beukes

Beukes, Susan Cecilia January 2015 (has links)
This study investigated misconceptions in Algebra of students enrolled for a N2 Engineering certificate at a Further Education and Training College. The study aimed to investigate these students’ misconceptions relating to Algebra which prohibited them to successfully complete their artisanship. The purpose of the research was to determine (i) the nature of these misconceptions, and (ii) the value of screencasts as a technology-enhanced learning (TEL) tool to improve instruction. The research gap that the researcher addressed related to the Mathematics misconceptions that the N2 students had, and whether these misconceptions could be adequately addressed by screencasts. The study method used was a case study design and methodology while simultaneously collecting quantitative and qualitative data. The findings encompassed the determining of main Mathematics misconceptions, producing screencasts, and assessing the screencasts with the intended target group. The study followed a four-phase strategy of testing, interviewing and analysing, and reflection based on qualitative and quantitative research strategies. During the quantitative research the research participants completed a biographical questionnaire, as well as a customised diagnostic Algebra test. The study sample comprised two groups from different trimesters at a rural FET college in the Northern Cape in Kathu, South Africa. The total population of full-time N2 Engineering students related to 113 participants. The diagnostic test comprised twelve questions from the three main Algebra concepts relating to: (i) exponents, (ii) equations, and (iii) factorisation. The same customised diagnostic test confirmed the misconceptions within the same group. Six questions from the customised diagnostic test identified the central misconceptions. The researcher consequently designed, developed, implemented and evaluated screencasts with the intended student population according to the design principles identified during the study. The six questions formed the basis of a second diagnostic test, which was used in phase three with interviews of ten research participants as part of phase 4 of the evaluation of the screencasts. At the end of the second trimester students were ask to complete a questionnaire regarding their use and perceptions of the screencasts—23 participants completed this voluntary questionnaire. At the end of the trimester ten participants were asked to explain their method of calculations during a walk-through evaluation while answering Algebra problems. The results indicated a number of misconception categories: (i) The main reason for misconceptions relating to equations was the participants’ inadequate understandings of the basic concepts of multiply methods used in equations; (ii) Index laws seemed to be the biggest misconception where participants demonstrated insufficient understanding of the laws; and (iii) The participants did not comprehend the basic concepts of factorisation—they could not identify which method to use while factorising. The qualitative findings indicate that the participants found the screencasts valuable when they prepared for tests and examinations, as well as when they did not understanding a basic Mathematics concept. Access to technology in rural areas remains an obstacle to integrate technology learning tools on a large scale at the FET College. / MEd (Curriculum Development), North-West University, Potchefstroom Campus, 2015
36

Screening for misconceptions and assessing these by using metacognition in a mathematics course for N2 engineering students at a Northern Cape FET college / Susan Cecilia Beukes

Beukes, Susan Cecilia January 2015 (has links)
This study investigated misconceptions in Algebra of students enrolled for a N2 Engineering certificate at a Further Education and Training College. The study aimed to investigate these students’ misconceptions relating to Algebra which prohibited them to successfully complete their artisanship. The purpose of the research was to determine (i) the nature of these misconceptions, and (ii) the value of screencasts as a technology-enhanced learning (TEL) tool to improve instruction. The research gap that the researcher addressed related to the Mathematics misconceptions that the N2 students had, and whether these misconceptions could be adequately addressed by screencasts. The study method used was a case study design and methodology while simultaneously collecting quantitative and qualitative data. The findings encompassed the determining of main Mathematics misconceptions, producing screencasts, and assessing the screencasts with the intended target group. The study followed a four-phase strategy of testing, interviewing and analysing, and reflection based on qualitative and quantitative research strategies. During the quantitative research the research participants completed a biographical questionnaire, as well as a customised diagnostic Algebra test. The study sample comprised two groups from different trimesters at a rural FET college in the Northern Cape in Kathu, South Africa. The total population of full-time N2 Engineering students related to 113 participants. The diagnostic test comprised twelve questions from the three main Algebra concepts relating to: (i) exponents, (ii) equations, and (iii) factorisation. The same customised diagnostic test confirmed the misconceptions within the same group. Six questions from the customised diagnostic test identified the central misconceptions. The researcher consequently designed, developed, implemented and evaluated screencasts with the intended student population according to the design principles identified during the study. The six questions formed the basis of a second diagnostic test, which was used in phase three with interviews of ten research participants as part of phase 4 of the evaluation of the screencasts. At the end of the second trimester students were ask to complete a questionnaire regarding their use and perceptions of the screencasts—23 participants completed this voluntary questionnaire. At the end of the trimester ten participants were asked to explain their method of calculations during a walk-through evaluation while answering Algebra problems. The results indicated a number of misconception categories: (i) The main reason for misconceptions relating to equations was the participants’ inadequate understandings of the basic concepts of multiply methods used in equations; (ii) Index laws seemed to be the biggest misconception where participants demonstrated insufficient understanding of the laws; and (iii) The participants did not comprehend the basic concepts of factorisation—they could not identify which method to use while factorising. The qualitative findings indicate that the participants found the screencasts valuable when they prepared for tests and examinations, as well as when they did not understanding a basic Mathematics concept. Access to technology in rural areas remains an obstacle to integrate technology learning tools on a large scale at the FET College. / MEd (Curriculum Development), North-West University, Potchefstroom Campus, 2015
37

The provision of recreation opportunities for people with disabilities : a tale of two cities

Dowsing, V. A. January 2008 (has links)
Disabled people comprise seventeen per cent of all New Zealanders and face barriers to participation in community life. This research examines the ways in which two local authorities - Manukau City Council and Christchurch City Council - provide recreation opportunities for people with disabilities and how these local authorities implement national legislation, policies and strategies which bear upon the provision of recreation services for the disabled. To achieve these aims, a comparative method which uses primary (interview) and secondary (documentary) data, is adopted. Central government plays an important role in the provision of recreation to communities, including the disabled community. It develops legislation, strategies and policies that guide the provision of recreation services for people with disabilities at a local level. Local authorities provide ‘spaces’ for recreation including parks, waterways and facilities, as part of their wider services and programmes. Their services respond to broader, including national, concerns, but also reflect local priorities and needs, including those of other ‘special’ populations. The results of this research indicate that Manukau and Christchurch Cities consult the disabled community and its representatives and address the specific needs of this community. Both local authorities have policies which outline how disability issues will be addressed; a disability-specific position which acts as an “internal advocate” for the disabled community; and a reference group made up of members of the disabled community. In the case of Christchurch City Council, the “KiwiAble” programme, “KiwiAble Recreation Network”, “KiwiAble Leisure Card” and Inclusive Communities Coordinator are all disability-specific mechanisms that focus on the recreational needs of the disabled community. However, only one policy in these two cities - the Manukau City Council Disability Policy and Action Plan – draws explicit links to a national strategy. On the basis of these results, a number of recommendations are made for future research and local authority action. It is hoped that the current study will provide practical advice and examples which local authorities can adopt, to further enhance recreational provisions for people with disabilities.
38

Comparative case study analysis of adaptive groundwater governance and management regimes: Exploring ecosystem services in South Africa, Spain and Germany

Knüppe, Kathrin 22 October 2012 (has links)
Our daily lives depend on the provision of services by different ecosystems in which an important contribution is made by groundwater. To balance competing demands placed on groundwater for socioeconomic and ecological benefits constitute major challenges for water managers. At the policy-science interface the ecosystem service concept represents an appropriate approach to communicate management challenges in which researchers and politicians must take into account human and biophysical characteristics as intertwined systems. This study investigated the complexity of groundwater governance, and linkages between management and corresponding effects on ecosystem services. Empirical insights were derived from case studies in South Africa, Spain and Germany. The analytical focus includes (a) the degree of vertical (multi-level) and horizontal (cross-sectoral) integration which frame crucial characteristics of an adaptive governance regime and (b) the role of formal and informal institutions governing groundwater. In doing so, an conceptual and analytical approach was applied, especially developed to support a systematic and consistent investigation of policy and management processes. Evidence highlights that higher degrees of integration: (i) opens up the political arena for environmental perspectives, (ii) increases the quality of management plans, (iii) accelerates the implementation of measurements, (iv) mitigates conflicts between different groundwater users, and (v) increases the awareness of various ecosystem services. Further the results indicate that having well-crafted institutions in place does not automatically indicate successful groundwater management in the sense of bringing about positive results for socioeconomic or ecological sustainability. This work made a significant contribution to interdisciplinary research in the field of groundwater governance and ecosystem service management that builds the foundations for improving the policy-science interface.
39

The use of market segmentation theory in practice: business-to-business marketing practitioners' perspectives

Visser, Johannes Hendrik 05 1900 (has links)
The reality of a so-called theory/practice divide between what the academic world research and teach and how it is applied by practitioners has existed for decades. Academics commented about the practical applicability of theories concerning business management applications. This research attempts to understand a concept from a practitioners’ viewpoint. The focus of the research was on marketing and management practitioners’ application of market segmentation principles in their businesses. The study was qualitative in nature. Discussion guidelines were used in in-depth interviews from purposefully selected case study organisations. The analysis indicated that practitioners readily apply the economic principle of market segmentation. That is to divide the broad market into parts (segments) and then focus their attention on selected segments. The analysis also indicated that practitioners deviate from the current marketing theory on market segmentation. It was further found that management practitioners could benefit from applying some of the principles taught in market segmentation theory. The implications from the findings are twofold. The first is that an alternative theory regarding market segmentation emerged from management practitioners’ perspectives. The second is that it is possible to integrate aspects of other market segmentation schemes with the alternative theory to ensure a market segmentation approach that confirms management intuition as well as existing market segmentation theory. Merging these approaches creates a possible improvement in the practical application of current market segmentation theory. / Business Management / D. Phil. (Business Management)
40

Value Creation in Healthcare through Secondary Activities : A Case study investigating food processes / Värdeskapande inom Vård med hjälp av Sekundära Aktiviteter : En fallstudie med fokus på matprocessen

Grimmeiss, Andrea, WANG, KATHERINE January 2018 (has links)
The world is facing the challenge of an increasingly growing and aging population which leads to increasing requirements on the healthcare system. This has led to higher financial pressure on operational managers to do more with less resources. Hospitals are characterised by rigid routines, strict hierarchical structures and lack of consistent definitions of value which creates challenges for improvement projects and implementation. To explore an alternative perspective of how to increase value in healthcare, the concept of secondary activities is introduced. Secondary activities are defined as activities that are indirectly related to healthcare and medical processes in hospitals. Presently, secondary activities are not prioritised in healthcare since the distinction has not been made before and therefore is the value-gain interesting to investigate. The purpose of this report is to investigate how to increase value in healthcare through improved secondary activities and the following research questions are used to fulfill the purpose: What are the challenges of defining value in healthcare? 2. What process improvement strategy is suitable for improving secondary activities? 3. What implementation strategy is suitable when improving secondary activities? The method used to conduct this study consisted of a literature study covering the fields of value creation, Lean in healthcare and change management in hospital management, followed by a case study at Norrtälje Sjukhus where the food process was investigated. Results of the study showed that the challenges of defining value in healthcare are the different mindsets between professions operating in hospitals and the required balance between ethical and financial aspects. II At Norrtälje Sjukhus, the assistant nurses valued time spent with patients. In order to free more time for them, secondary activities have great potential of increasing value through improvement projects. The combination of Lean and Biodesign based on comprehensive observations proved to be a suitable process improvement strategy for improving secondary activities. Moreover, secondary activities lag well behind primary activities regarding digitalisation which can increase the value of secondary activities through improved workflows. When value is defined as time spent with patients this process improvement strategy proved to be successful. Results of improving the food process in the case study showed that the total annual savings for the hospital were 3212 work hours which corresponds to 761 244 kr. Prerequisites for a successful implementation strategy are awareness of problems, needs and to have an improvement strategy that fits the situation. Introduction of changes should made together with the personnel and be incremental to minimise disturbances to other healthcare activities. A remaining challenge is the lack of responsibility and managerial competence in the regular hospital organisation that is needed for future, continuous and sustainable improvements for secondary activities. / Världen står inför en stor utmaning med en växande och åldrande befolkning vilket ställer högre krav på sjukvårdssystemet. Detta har lett till ökat finansiellt tryck på verksamhetsansvariga att prestera mer med mindre resurser. Sjukhus karaktäriseras ofta av oflexibla rutiner, strikt hierarkiska strukturer och inkonsekvent definition av värde vilket innebär utmaningar för förbättringsarbeten och implementation. Konceptet sekundära aktiviteter introduceras för att utforska ett alternativt perspektiv av hur man ökar värde i sjukvården. Sekundära aktiviteter definieras som indirekt sjukvårdsrelaterade aktiviteter som stöttar medicinska processer. I nuläget prioriteras inte sekundära aktiviteter i sjukvården eftersom denna särskiljning inte tidigare gjorts och därför blir den potentiella värdeökningen intressant att undersöka. Syftet med denna rapport är att undersöka hur värdet kan öka i sjukvården genom förbättring av sekundära aktiviteter. Följande forskningsfrågor bidrar till att uppfylla syftet med rapporten: 1. Vilka är utmaningarna med att definiera värde i sjukvården? 2. Vilken processförbättringsstrategi är lämpligast för att förbättra sekundära aktiviteter? 3. Vilken implementationsstrategi är lämpligast för att förbättra sekundära aktiviteter? Metoden som användes i denna studie bestod av en litteraturstudie som behandlade områdena värdeskapande, Lean i sjukvården och förändringsarbete inom sjukhusledningen, följt av en fallstudie på Norrtälje Sjukhus för att undersöka matprocessen. Resultat från studien visade att utmaningarna med att definiera värde inom sjukvården är skillnader mellan professioner och en avvägning mellan etiska och finansiella faktorer. Undersköterskorna på Norrtälje Sjukhus värderar tiden med patienterna högst. Sekundära aktiviteter har stor potential att öka i värde genom förbättringsarbeten för att kunna frigöra mer tid för undersköterskorna. IV Kombinationen av Lean och Biodesign baserat på omfattande observationer visade sig vara en lämplig processförbättringsstrategi för att förbättra sekundära aktiviteter. Sekundära aktiviteter ligger efter primära aktiviteter vad gäller digitalisering som kan öka värdet av sekundära aktiviteter genom förbättrat arbetsflöde. När värde definieras som tid spenderad med patienter är den här processförbättringsstrategin framgångsrik. När matprocessen förbättrades i fallstudien resulterade det i en årlig besparing för hela sjukhuset på 3212 arbetstimmar vilket motsvarar 761 244 kr. Förutsättningar för en framgångsrik implementationsstrategi är medvetenhet kring problemen, behoven samt att anpassa strategin efter situationen. Introduktion av förändringarna bör ske stegvis i samarbete med personalen för att minimera störningsmoment gentemot andra vårdaktiviteter. En kvarstående utmaning är bristen på ansvar och chefskompetens i sjukhusorganisationen för framtida, kontinuerliga och hållbara förbättringar av sekundära aktiviteter.

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