Global ETD Search

31	An Application Framework for Monitoring Care Processes Baarah, Aladdin 17 December 2013 (has links) Care process monitoring is important in healthcare domains to provide precise and detailed analytics on patients, providers, and resources participating in a care process and their status. These analytics are used to keep track of whether the quality of care goals set by healthcare organizations are satisfied and ensure that legislative and organizational guidelines are followed. The complexity of care process monitoring can vary depending on whether the care process takes place in a hospital or out in the community, and it can vary depending on the complexity of the information technology infrastructure that is in place to support the care process. A Care Process Monitoring Application (CPMA) is a software application which collects and integrates data from various sources while a care process is being provided, in order to provide performance reporting of metrics that are used to measure how well the performance goals and guidelines for the care process are being met. In our research, we have studied how CPMAs are built in order to improve the quality of their engineering. The significant challenge in this context is how to engineer a CPMA so that the engineering process is repeatable, produces a CPMA of consistent high quality, and requires less time, less effort and less complexity. This thesis proposes an application framework for care process monitoring that collects and integrates events from event sources, maintains the individual and aggregate states of the care process and populates a metrics data mart to support performance reporting. Our contributions are the following: a state-based application meta-model of care process monitoring, a care process monitoring architectural pattern, and finally, a behavior driven development methodology for CPMAs based on our meta-model and architectural pattern. Our results are validated through three different case studies in which we collaborated with two different health care organizations to build and deploy CPMAs for two different care processes (one hospital-based, the other community-based) in collaboration with healthcare clinicians and researchers. Application Framework Architectural Pattern Meta-model Application Model Healthcare Wait time service time performance management Care Process Monitoring Business Process Management Real-time Location Service Business Intelligence Software Methodology
32	Unintended Consequences of Strategies Implemented in Canadian Healthcare Organizations to Reduce Wait Times for Elective Hip and Knee Surgeries Sabogal, Juan Carlos 12 1900 (has links) Introduction: En réponse aux exigences du gouvernement fédéral en ce qui concerne les temps d'attente pour les chirurgies électives d’hanche et du genou, les Organismes Canadiens de santé ont adopté des stratégies de gestion pour les listes d'attente. Cependant, il n'existe pas actuellement aucune information disponible concernant les effets imprévus, positive ou négative, de ces stratégies. Méthodologie: Un modèle qui a été construit est tombé en panne la gestion de la chirurgie d’hanche et du genou en différentes étapes, afin d'identifier les effets imprévus possibles pour chaque étape; le modèle a été validé auprès d'un panel d'experts. Cette étude a choisi quatre études de cas en fonction de leur durabilité: un cas qui a été durable, un cas qui a été modérément durable, et deux cas peu probable d'être durable. Dans cette étude qualitative, nous avons mené 31 entretiens semi-structurés entre Novembre 2010 et Juin 2011 avec les gestionnaires, les infirmières, les thérapeutes et les chirurgiens impliqués dans la gestion des stratégies du temps d’attente pour les chirurgies électives d’hanche et du genou. Les quatre cas ont été sélectionnés à partir de trois provinces / régions. Nous avons analysé les conséquences non intentionnelles aux niveaux systémique et organisationnelle en utilisant les stratégies dans chaque contexte. Enregistrements des entrevues ont été transcrits mot à mot et soumis à l'analyse du cadre. Résultats: Les effets négatifs sont la précarité des stratégies en raison du non-récurrente financement, l'anxiété chez les patients qui ne sont pas prêts pour la chirurgie, une redistribution du temps de chirurgie vers l’orthopédie au détriment des autres interventions chirurgicales, tensions entre les chirurgiens et entre les orthopédistes et anesthésistes, et la pression sur le personnel dans le bloc opératoire et postopératoire. Conclusion: La stratégie d’implémentation aux niveaux national et local devrait prendre en compte les conséquences potentielles, positives et négatives. Il y a des conséquences inattendues à chaque niveau de l'organisation des soins de santé. Individuellement et collectivement, ces conséquences peuvent positivement et négativement affecter les résultats. Par conséquent, la planification de la santé doit analyser et prendre en compte les conséquences inattendues en termes de bonnes résultats inattendues, compromis et les conséquences négatives afin d'améliorer les résultats. / Introduction: In response to federal government requirements regarding wait times for elective hip and knee surgeries, Canadian healthcare organizations have adopted wait list management strategies. However, there is currently no information available regarding the unanticipated effects, positive or negative, of these strategies. Methodology: A model was constructed that broke down the management of elective hip and knee surgery into different steps, in order to identify the unanticipated potential effects for each step; the model was validated with a panel of experts. This study chose four case studies based on their sustainability: one case that was sustainable, one case that was moderately sustainable, and two cases considered unlikely to be sustainable. In this qualitative study, we conducted 31 semi-structured interviews between November 2010 and June 2011 with managers, nurses, therapists and surgeons involved in wait time management strategies for hip and knee surgeries. The four cases were selected from three provinces/areas. We analyzed potential unintended consequences at the systemic and organizational levels of using these strategies in each setting. Interview recordings were transcribed verbatim and subjected to framework analysis. Results: Negative effects were the strategies’ precariousness due to non-recurrent funding, anxiety in patients not ready for surgery, a redistribution of surgical time toward orthopaedics at the expense of other surgeries, tensions between surgeons and between orthopaedic surgeons and anaesthesiologists, and significant pressure on personnel in the operating suite and in post-operative care. Conclusions: Strategy implementation at the national and local levels should take into consideration any potential consequences, positive and negative. There are unintended consequences at each level of healthcare organization. Individually and jointly, these consequences can positively and negatively affect outcomes. Therefore, health planning should analyze and take into account unintended consequences in terms of serendipities, trade-offs and negative consequences in order to improve results. Conséquences inattendues bons résultats inattendus compromis conséquences négatives stratégies du temps d’attente Unintended consequences serendipities trade-offs negative consequences wait time strategies.
33	An Application Framework for Monitoring Care Processes Baarah, Aladdin January 2014 (has links) Care process monitoring is important in healthcare domains to provide precise and detailed analytics on patients, providers, and resources participating in a care process and their status. These analytics are used to keep track of whether the quality of care goals set by healthcare organizations are satisfied and ensure that legislative and organizational guidelines are followed. The complexity of care process monitoring can vary depending on whether the care process takes place in a hospital or out in the community, and it can vary depending on the complexity of the information technology infrastructure that is in place to support the care process. A Care Process Monitoring Application (CPMA) is a software application which collects and integrates data from various sources while a care process is being provided, in order to provide performance reporting of metrics that are used to measure how well the performance goals and guidelines for the care process are being met. In our research, we have studied how CPMAs are built in order to improve the quality of their engineering. The significant challenge in this context is how to engineer a CPMA so that the engineering process is repeatable, produces a CPMA of consistent high quality, and requires less time, less effort and less complexity. This thesis proposes an application framework for care process monitoring that collects and integrates events from event sources, maintains the individual and aggregate states of the care process and populates a metrics data mart to support performance reporting. Our contributions are the following: a state-based application meta-model of care process monitoring, a care process monitoring architectural pattern, and finally, a behavior driven development methodology for CPMAs based on our meta-model and architectural pattern. Our results are validated through three different case studies in which we collaborated with two different health care organizations to build and deploy CPMAs for two different care processes (one hospital-based, the other community-based) in collaboration with healthcare clinicians and researchers. Application Framework Architectural Pattern Meta-model Application Model Healthcare Wait time service time performance management Care Process Monitoring Business Process Management Real-time Location Service Business Intelligence Software Methodology
34	Wait Time Estimation in Distributed Multitenant Systems : Using Queuing Theory / Väntetids Estimering i Distribuerade Multitenanta System : Med Användning av Köteori Alsaadi, Zainab January 2022 (has links) Queueing theory is widely used in practical queuing applications. It can be applied for specific models of queuing systems, especially the ones that follow the Markovian property. Its purpose is to predict system behaviour in order to be used for performance optimization. In this case study, it was used to evaluate an extended queuing model with agents serving multiple queues. The purpose was to try to capture more variability and input factors into the theoretical model and test its applicability on more extended models. The main objective was to use relevant queuing theory models to estimate the wait time using real contact center data. Different from the theoretical model, the service rates of the system model depended on how many queues an agent served concurrently, which increased the complexity of the model. The obtained results demonstrated some limitations that made the models too restrictive to be applied to a model with multi-skilled agents that were not equally available. Moreover, it was shown that heuristical approaches might be more suitable for more complex queuing systems that are not covered in queueing theory models. / Köteori används i stor utsträckning i praktiska kö-applikationer. Den kan tillämpas för specifika modeller av kö-system, speciellt de som följer Markovegenskapen. Dess syfte är att förutse systembeteende för att kunna användas för prestandaoptimering. I denna fallstudie användes den för att utvärdera en utökad kömodell med agenter som betjänade flera köer. Syftet var att försöka fånga mer variabilitet och inputfaktorer i den teoretiska modellen och testa dess tillämplighet för mer utökade modeller. Huvudmålet var att använda relevanta kö-teorimodeller för att estimera väntetiden med användning av riktiga contact center data. Till skillnad från den teoretiska modellen, betjäningsintensiteten för systemmodellen berodde på hur många köer en agent betjänade samtidigt, vilket ökade komplexiteten av modellen. De erhållna resultaten visade begränsningar som gjorde modellen för restriktiv för att appliceras på en modell med fler-kvalificerade agenter som inte var lika tillgängliga. Utöver detta så visade det sig att heuristiska metoder kan vara mer lämpliga för mer komplicerade system som inte täcks av kö-teori modeller. Queue management Estimated Wait Time Position in Queue Multi-tenant architecture Queuing models Queuing theory The theory of mass service Köhantering Estimerad väntetid Plats i kö Fleranvändarsystem Betjäningssystem Köteori Teorin för masservice Software Engineering Programvaruteknik
35	The use of questioning as a teaching strategy : a case study of Social Studies in grade seven / Gebruik van vraagstelling as 'n onderrigstrategie : 'n gevallestudie van Sosiale Wetenskappe in graad 7 / Kusetjentiswa kwekubuta njengelisu lekufundzisa : sifundvo sekuhlola se-Social Studies kulibanga 7 Vilakati, Phumzile Patience 01 1900 (has links) Abstracts in English, Afrikaans and Zulu / This study explored teachers’ effective use of questioning as a teaching strategy in Social Studies in grade seven within a primary school in the Kingdom of Eswatini (formerly known as Swaziland). The advent of free primary education has brought about large class sizes, but the desire to produce quality education persists. The literature distilled in the study showed that, although a considerable body of studies has established that questioning in the classroom helps direct learning, many teachers fail to utilise it as such. Those who endeavour to use it succeed in engaging their learners, and this results in teaching effectiveness and good outcomes for their learners. The study employed the interpretive paradigm because of the in-depth nature of the investigation. It therefore was a qualitative study that used observation and in-depth semi-structured interviews to gather data and attain the objectives of the study. It was a case study in which four Social Studies teachers took part. Observations were made for at least for 60 minutes in each classroom. Field notes were taken and later analysed. Individual interviews were conducted with the teachers. The results of the study showed that teachers did not use questions to direct teaching and learning, and had no knowledge of the concept of wait time. They also said that they had not been taught questioning strategies in their pre- service teacher training. This was consistent with the literature. Though research shows that questioning promotes effective teaching, the studies reviewed indicated that few teachers use it as an instructional tool. The implications derived from the present study are therefore that pre-service teacher training has to be improved to cater for such important topics as classroom questioning. Also to be improved is further professional development. There is a significant need for action at the macro- and micro-levels of the educational system towards improvement. The actions at the micro-level will be determined by diligent policies designed and executed at that level, that is, the level of the school. / Hierdie studie verken onderwysers se benutting van vraagstelling as onderrigstrategie in Sosiale Studies in Graad 7 by ŉ primêre skool in die koninkryk Eswatini (voorheen Swaziland). In weerwil daarvan dat gratis primêre onderrig groot klasse tot gevolg het, moet gehalteonderwys steeds nagestreef word. Volgens die literatuur wat geraadpleeg is, toon talle studies dat vraagstelling in die klas regstreekse leer bevorder. Onderwysers wat vrae aan leerders stel, gee doeltreffend onderwys omdat hulle leerders betrek, en sodoende ŉ goeie uitkoms behaal. Desondanks pas min onderwysers hierdie strategie toe. Op grond van die aard van hierdie ondersoek, is ŉ vertolkende paradigma gevolg. In hierdie kwalitatiewe studie is data deur waarneming en halfgestruktureerde onderhoude ingesamel. Elke klas is vir minstens 60 minute waargeneem en veldaantekeninge is gemaak wat later ontleed is. Vier onderwysers wat Sosiale Studies onderrig, was deel van die gevallestudie. ŉ Onderhoud is met elkeen gevoer. In hierdie studie is bevind dat die onderwysers geen vrae in die klas gestel het nie. Hulle het ook nie die begrip van wagtyd geken nie, aangesien hulle nooit in vraagstellingstrategieë opgelei is nie. Dit verklaar bevindings in die literatuur dat min onderwysers vraagstelling in die klas gebruik. Vraagstelling moet dus deel van onderwysers se opleiding uitmaak. Hierbenewens moet die professionele ontwikkeling van onderwysers aandag geniet. Voorts is dit noodsaaklik dat die onderwysstelsel op sowel mikro- as makrovlak verbeter word. Ingryping op mikrovlak sal deur die uitvoering van beleid op skoolvlak bepaal word. / Lesifundvo sihlose kusebentisa ngemphumelelo inchubo yekubuta njengelisu lekufundzisa ku-Social Studies kuLibanga 7 ngekhatsi kwesikolwa semabanga laphasi Eswatini (lebeyatiwa ngeSwaziland ngaphambilini). Kufika kwemfundvo yamahhala yemabanga laphasi kwente kwekutsi emaklasi agcwale kakhulu, kodvwa sifiso sekukhicita imfundvo leyikhwalithi siyachubeka. Ilitheretja lebuyeketiwe esifundvweni ikhombisa kwekutsi, nanobe umtimba lobantana wetifundvo utfole kwekutsi inchubo yekubuta eklasini isita kucondzisa kufundza, bothishela labanyenti bayehluleka kukusebentisa ngendlela lefanele. Laba labetama kukusebentisa bayaphumelela ekumbandzakanyeni bafundzi babo, futsi loku kuholela ekufundziseni ngemphumelelo kanye nemiphumela lemihle kubafundzi babo. Lesifundvo sisebentise umcondvo lohumushako ngesizatfu seluhlobo lolujulile lwekuphenya. Ngako-ke bekusifundvo sebunyenti lapho kusetjentiswe khona kubuka kanye nekubuta lokungakahleleki ngalokuphelele lokujulile kugcogca idatha kanye nekutfola tinjongo tesifundvo. Kuhlanganyele bothishela labane beSocial Studies kulesifundvo sekuhlola. Luhlelo lwekubuka lwentiwe lokungenani imizuzu lengema-60 eklasini ngalinye. Kutsatfwe emanotsi futsi ahlatiywa ngemuva kwesikhatsi. Kubutwe bothishela ngamunye. Imiphumela yesifundvo ikhombisa kwekutsi bothishe abakasebentini imibuto kucondzisa kufundzisa nekufundza, futsi bebangenalwati ngemcondvo wesikhatsi sekulindza. Baphindze baphawula kwekutsi abakafundzisiswa emasu ekubuta ekucecesheni kwabo kwangaphambi kwekufundzisisa. Loku bekufanana ngelitheretja. Nanobe lucwaningo lukhombisa kwekutsi kubuta kugcugcutela kufundzisa ngemphumelelo, letifundvo letibuyeketiwe tikhombisa kwekutsi bothishela labambalwa bakusebentisa njengelithuluzi lekuyalela. Imiphumela letfolwe kulesifundvo samanje kutsi kucecesha kwabothishela kwangaphambi kwekufundzisa kumele kwentiwencono kute kufake tihloko letifana nekubuta eklasini. Loku lokumele kwentiwencono kuchubeka ngekutfutfukiswa kwalobucwepheshe. Kunesidzingo lesikhulu sesinyatselo etigabeni letincane kakhulu nasetigabeni letincane teluhlelo lwemfundvo ngasekwentenincono. Letinyatselo esigabeni lesincane titawuncunywa nguletinchubomgomo letihlelwe futsi tasetjentiswa kuleso sigaba, lekusigaba sesikolo. / Curriculum and Instructional Studies / M. Ed. (Curriculum and Instructional Studies) Critical thinking Classroom dialogue Dialogic education Metacognition Questioning Taxonomy of knowledge Teacher-learner interaction Wait time Klaskamerdialoog Kritiese denke Dialogiese onderrig Metakognisie Vraagstelling Taksonomie van kennis Onderwyser-leerderwisselwerking Wagtyd Inkhulumiswano yaseklasini Kucabanga lokubucayi Imfundvo yetingcogco Kucondza kusebenta kwengcondvo Kubuta Intsela yelwati Kutsintsana kwathishela nemfundzi Sikhatsi sekulinga 372.89096887
36	From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times MacLeod, Suzanne 26 March 2014 (has links) As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive. / Graduate / 0452 / 0680 / 0351 / macsuz@shaw.ca social determinants of health social exclusion crisis discourse Alzheimer's Alzheimer Society of Canada Suzanne MacLeod Susan Strega Donna Jeffery poststructural poststructuralism admission to long-term care funding for long-term care acute care aging demographic BC Psychogeriatric Association biomedical British Columbia Canada Health Act collective social responsibility competition corporate profit corporatization deresponsibilization elder friendly elderly citizens family caregivers Foucault found poetry genealogy of power knowledge incompetent Ministry of Health moral economics pharmaceutical bed blocker stigmatized tsunami absent-person action plan aging population alternative discourse apocalyptic demography appropriate archaeology archaeology of knowledge archaeological British Columbia burden Canada caregiver charity charitable collective collective car community community care condition of possibility conditions of possibility corporate counter-discourse dementia dementia care dementia policy dementia social policy dependent depoliticize discourse discourse analysis disruptive discourse economic burden economics economy elder emergency epidemic exclusion fear-monger Foucauldian found poem genealogy genealogical health authority health care health care staff health care system health policy document healthy lifestyle home and community care homogenization homogenize hospital imaginaries imaginary incapable individual responsibility individualism knowledge long-term care material effect materiality of discourse media moral panic national strategy neoliberal neoliberalism neoliberal rationality not prepared object objectification other person-centered people living with dementia person living with dementia persons living with dementia person with dementia poem poetic representation poetry policy policies political politics power power knowledge power relations private privatize privatization productivity of dominant discourse public health care residential care resistance responsibility responsibilization rising tide safety net shift costs to caregivers responsibility social policy imaginary social well-being social work social worker solidarity specialized stakeholder state stigma subject matter expert taxpayer threat unprepared unproductive voluntary volunteer wait time wave social policy
37	From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times MacLeod, Suzanne 26 March 2014 (has links) As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive. / Graduate / 0452 / 0680 / 0351 / macsuz@shaw.ca social determinants of health social exclusion crisis discourse Alzheimer's Alzheimer Society of Canada Suzanne MacLeod Susan Strega Donna Jeffery poststructural poststructuralism admission to long-term care funding for long-term care acute care aging demographic BC Psychogeriatric Association biomedical British Columbia Canada Health Act collective social responsibility competition corporate profit corporatization deresponsibilization elder friendly elderly citizens family caregivers Foucault found poetry genealogy of power knowledge incompetent Ministry of Health moral economics pharmaceutical bed blocker stigmatized tsunami absent-person action plan aging population alternative discourse apocalyptic demography appropriate archaeology archaeology of knowledge archaeological British Columbia burden Canada caregiver charity charitable collective collective car community community care condition of possibility conditions of possibility corporate counter-discourse dementia dementia care dementia policy dementia social policy dependent depoliticize discourse discourse analysis disruptive discourse economic burden economics economy elder emergency epidemic exclusion fear-monger Foucauldian found poem genealogy genealogical health authority health care health care staff health care system health policy document healthy lifestyle home and community care homogenization homogenize hospital imaginaries imaginary incapable individual responsibility individualism knowledge long-term care material effect materiality of discourse media moral panic national strategy neoliberal neoliberalism neoliberal rationality not prepared object objectification other person-centered people living with dementia person living with dementia persons living with dementia person with dementia poem poetic representation poetry policy policies political politics power power knowledge power relations private privatize privatization productivity of dominant discourse public health care residential care resistance responsibility responsibilization rising tide safety net shift costs to caregivers responsibility social policy imaginary social well-being social work social worker solidarity specialized stakeholder state stigma subject matter expert taxpayer threat unprepared unproductive voluntary volunteer wait time wave social policy

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