The purpose of this research study was to determine what service attributes were perceived as important factors for a successful Office of Research Administration (ORA) to provide to principal investigators and department administrators. Initially established more than 50 years ago, The Office of Research Administration (ORA) has evolved into an integral component for the fiscal sustainability of many institutions of higher education. Existing performance metrics based on financial measures do not sufficiently capture the quality of the level of service demands placed on the ORA by the two internal user groups. The conceptual basis of the Balanced Scorecard modified for the non-profit sector served as the theoretical framework. The study involved 668 respondents (433 principal investigators and 235 department administrators) from 72 research universities. Principal investigators and department administrators agreed on 18 service items as important performance metrics for successful Offices of Research Administration. However, the two groups did vary somewhat in the degree of importance of these 18 service items. Four services, responding to email and phone messages within 24-48 hours, easy access to forms, and timely setup of the internal award account were identified as priority factors by greater than 90 percent of the principal investigators. In addition to these four items, another six items-trainings for new employees and training updates for existing employees, equal treatment by the ORA, easy access to policies, and promoting a team effort approach to research-were identified as prior factors by greater than 90% of the department administrators. Demographics did not display a significant relationship in the perceptions of either group. Principal investigators did display a higher satisfaction for level of performance for the items of importance, especially related to the priority factors at their current institutions.

A challenge for healthcare organizations is that operational efficiency suffers from variation in production. This is because variation in healthcare is hard to predict and the methods and IT-support tools for handling variation are suboptimal. The concept of production control can be used to describe the coordination of activities so that healthcare can be delivered on time, of adequate quality and at a reasonable cost, and thus includes the use of IT-support tools to handle variation. The objective of this report is to suggest improvements for production control in hospital departments through the development of a prototype for a new IT-support tool. In order to achieve this, a case study was conducted at the pediatric oncology department at Karolinska University Hospital (KS). The case study includes observations and interviews to investigate production control at department Q84, as well as associated roles and IT-support tools. Four IT-support tools were identified at the department, two of which were used interchangeably. Due to lack of integration between these systems and the fact that one system contained data manually synchronized from the other, handling changes required double labor. An improvement suggestion is therefore presented, consisting of a prototype which demonstrates that production control can be improved by automating the maintenance of a system at the department while fulfilling the organization’s information security policy. The development of the prototype was aligned with the lean philosophy which KS strives to adopt. Through an investigation of the production system, a role for production control and associated IT-support tools at a hospital department can be identified and analyzed and through the prototyping of an IT-support tool for production control, improvements and optimizations can be made.

A challenge for healthcare organizations is that operational efficiency suffers from variation in production. This is because variation in healthcare is hard to predict and the methods and IT-support tools for handling variation are suboptimal. The concept of production control can be used to describe the coordination of activities so that healthcare can be delivered on time, of adequate quality and at a reasonable cost, and thus includes the use of IT-support tools to handle variation. The objective of this report is to suggest improvements for production control in hospital departments through the development of a prototype for a new IT-support tool. In order to achieve this, a case study was conducted at the pediatric oncology department at Karolinska University Hospital (KS). The case study includes observations and interviews to investigate production control at department Q84, as well as associated roles and IT-support tools. Four IT-support tools were identified at the department, two of which were used interchangeably. Due to lack of integration between these systems and the fact that one system contained data manually synchronized from the other, handling changes required double labor. An improvement suggestion is therefore presented, consisting of a prototype which demonstrates that production control can be improved by automating the maintenance of a system at the department while fulfilling the organization’s information security policy. The development of the prototype was aligned with the lean philosophy which KS strives to adopt. Through an investigation of the production system, a role for production control and associated IT-support tools at a hospital department can be identified and analyzed and through the prototyping of an IT-support tool for production control, improvements and optimizations can be made.

Purpose: Access to the full range of contraceptive options is essential to providing patient-centered reproductive health care. Women living in rural areas often experience more barriers to contraceptive care than women living in urban areas. Therefore, federally funded family planning clinics are important for ensuring women have access to contraceptive care, especially in rural areas. This study examines contraceptive provision, factors supporting contraceptive provision, and contraceptive utilization among federally funded family planning clinics in 2 Southern states. Methods: All health department and Federally Qualified Health Center clinics in Alabama and South Carolina that offer contraceptive services were surveyed in 2017-2018. Based on these surveys, we examined differences between rural and urban clinics in the following areas: clinic characteristics, services offered, staffing, staff training, policies, patient characteristics, contraceptive provision, and contraceptive utilization. Differences were assessed using Chi-square tests of independence for categorical variables and independent t-tests for continuous variables. Findings: Urban clinics had more staff on average than rural clinics, but rural clinics reported greater ease in recruiting and retaining family planning providers. Patient characteristics did not significantly vary between rural and urban clinics. While no significant differences were observed in the provision of long-acting reversible contraceptives (LARCs) overall, a greater proportion of patients in urban clinics utilized LARCs. Conclusions: While provision of most contraceptives is similar between rural and urban federally funded family planning clinics, important differences in other factors continue to result in women who receive care in rural clinics being less likely to choose LARC methods.

Change in American higher education is occurring at a rapid pace. The increasing reemergence of civic or community engagement as a key component in the overall landscape of American higher is emblematic of that change. Academic departments play a critical role in higher education change, including institutionalizing community engagement on campuses. Yet, designing a way of measuring community engagement specifically at the level of the academic department has not been undertaken. Based on advice from national expert/key informant interviews and the recognition of the importance of the role of academic departments in the overall institutionalization of community engagement in higher education, this study addresses a methodological gap in the literature concerning the measurement of community engagement. Several instruments have been developed primarily for institution-wide application, and some have been applied to academic units including colleges, schools, departments and programs. This study employs a grounded theory research strategy to develop and test a self-assessment rubric solely for use in academic departments. To ascertain the utility and validity of the rubric, this study pilot tests the explanatory framework in twelve social science departments located in five, geographically-diverse American universities. A secondary purpose of the study is to initiate an exploration of the potential use of institutional theory to more completely understand the constitutive role of the academic unit in the institutional transformation process. The research confirms the utility and validity of the departmental engagement self-assessment rubric. Additionally, the study categorizes and displays via histograms six overarching dimensions by level of support for community engagement for each of the twelve test departments. Finally, this research recommends instrumental as well as substantive areas for future research, including those that better connect institutional theory with efforts to embed civic engagement in the mission of traditional academic departments.

Organizational Resilience is defined as the ability of an organization to anticipate sudden disruptions, effectively respond, and adapt in a changing environment to deliver its objectives, as well as successfully recover. In order to increase resilience at an organizational level, it is important to understand how individuals collectively contribute to resilience capability of an organization. Emergency Departments (EDs) are considered to be particularly well suited to investigating resilience capability due to their highly unpredictable and complex operating environment. Further, the resilience capability of EDs and their staff is suggested to be essential to successful delivery of safe, high-quality, and timely medical care to all patients in cases of mass disruptive events. The purpose of this research is to develop a model of staff resilience to support the improvement of organizational resilience in EDs in the United States. The study was organized into two phases: Initial Model Development based on a Thematic Analysis of existing conceptual models and Preliminary Model Validation via deductive evaluation of published Empirical Case Studies on ED response to mass casualty events. As a result of the first phase, Initial Model was proposed that consists of five dimensions of resilience: Triggers, Factors Affecting Resilience, Resilience Capability, Characteristics of ED Complexity and Outcomes. The results of the second phase determined that the Initial Model was comprehensive and only minor additions were made. Further, recommendations for improving case studies on ED responses were developed. The results of the study provide a model that demonstrates how ED staff supports the organizational resilience capability of the EDs. This research contributes to the general knowledge base of resilience as a critical organizational capability in EDs when dealing with unexpected disruptions as well as provides guidance for EDs in the United States when seeking to become more resilient.

No description available.

Thesis: M.S., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 1975 / Bibliography: leaves 129-130. / M.S. / M.S. Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science

Bakgrund: Säker vård innebär att sjuksköterskor ska arbeta förebyggande mot att minskaoch förhindra vårdskador, vilket både Svensk sjuksköterskeförening ochPatientsäkerhetslagen omnämner. Det är en viktig del i det dagliga omvårdnadsarbetet försjuksköterskor att bedriva patientsäker omvårdnad. Trots att det ingår både ikompetensbeskrivningen och svensk lagstiftning drabbas över 100 000 patienter årligen avnågon form av vårdskada i Sverige.Syfte: Syftet med denna litteraturöversikt är att undersöka hur sjuksköterskor upplever attarbetsbelastningen påverkar patientsäkerheten på akutmottagningar.Metod: Examensarbetet utfördes som en litteraturöversikt där 15 kvalitativa vetenskapligaartiklar inkluderades. Databaserna som användes när artiklarna söktes fram var CINAHL ochPubMed. De artiklar som inkluderades var publicerade mellan åren 2011 - 2021.Resultat: Sjuksköterskorna upplevde flera områden som bidrog till brister ipatientsäkerheten där tidsbrist och teamarbete var de mest framträdande. Andra områden somvar bidragande var svårarbetad arbetsmiljö, konsekvenser av personalbrist och bristandekommunikation. Sammantaget av dessa områden kunde utgöra svårigheter försjuksköterskorna att arbeta patientsäkert och prioritera den grundläggande omvårdnaden.Slutsats: Sjuksköterskor är ofta medvetna om patientens risker och hur det förebyggandearbetet ska gå till för att undvika vårdskada, men det som visas i resultatet tyder på att det ärområden som påverkar patientsäkerheten. Det som i grund och botten skapar vårdskador är attsjuksköterskorna inte har tid att vara noggrann i sitt arbete. Sammanfattningsvis pekarresultatet på att det finns ett glapp mellan den forskning som finns om patientsäkerhet och hurverksamheten är utformad och strukturerad. / Background: Nurses must work to reduce and prevent injuries caused by healthcare thatsafe care entails, which both Svensk sjuksköterskeförening and Patientsäkerhetslagenmention. It is an important part of the daily care for nurses to conduct patient-safe care.Despite the fact that it is included in both the competence description and Swedish legislation,more than 100,000 patients suffer from some form of healthcare injury annually in Sweden.Aim: The aim is to explore how nurses experience that the workload affects patient safety inemergency departments.Method: This study was conducted as a literature review which included 15 qualitativearticles. The databases used when searching for the articles were CINAHL and PubMed. Thearticles that were included were published between the years 2011 - 2021.Results: The nurses experienced several factors that contributed to deficiency in patientsafety, where lack of time and teamwork were the most outstanding. Other factors that werecontributed were difficult work environment, staff shortages and lack of communication.Overall, these factors made it difficult for the nurses to work patient safely and prioritize basiccare.Conclusions: Nurses are often aware of the patient's risks and how the preventive workshould be done to avoid injuries, but what is shown in the results indicates surroundingfactors. What basically creates care injuries is that the nurses do not have time to be accuratein their work. In summary, the results indicate that there is a gap between the research thatexists on patient safety and how the organization is designed and structured.

Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States. Methods. In this repeated cross-sectional study, we examined rural–urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data. Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P < .05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P < .05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P < .05). Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs’ reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them. Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy.