It has consistently been documented in many countries and sectors that there are difficulties in implementing public policy effectively. A priori, the Australian health care system is no exception to this general proposition. While governments issue directives with particular goals in mind these goals are not always met, because of the modifications, interpretations or lack of uptake by targeted populations. However it is not clear the extent to which these difficulties occur in the public hospital sector, and we lack clear empirical data on this phenomenon. This thesis investigates the effects of a state government directive on the development and implementation of elective admission policies in New South Wales public hospitals. It did this by three separate but related studies that examined the impact of the directive at the hospitals??? management and staff levels. The first two studies were quantitative and qualitative surveys of hospital managers and admission staff. The management survey aimed to ascertain the extent to which managers responded to the directive in terms of developing and implementing hospital policies. The staff survey sought to investigate staff awareness and knowledge of the developed policies. The third study was a qualitative analysis of the policy contents to determine the extent to which they reflected the aims and objectives of the government directive guidelines. All three studies found a general lack of relevance and applicability of the government directive and its guidelines to individual hospital organisations. The manager survey showed a disconnection between the central government office responsible for implementing the directive and hospital managers??? perspectives. This was apparent by the lack of response to the directive by many hospitals and the fact that managers often passed on the task of implementing the directive and its guidelines to other hospital staff. The findings of the qualitative analysis of policies showed evidence of hospital strategies to manage pressures created by the directive. These difficulties were corroborated by the surveyed staff that reported difficulties in translating the directive???s requirements (as reflected by the hospital policy), into the reality of their daily work; a lack of organisational commitment to policy enforcement; and a suspicion regarding the directive???s political motives. The findings of this thesis show that, as with other public service sectors effective policy implementation in the public hospital arena is problematic, with government agendas frequently not aligned with the requirements of stakeholders, and inadequate understanding of implementation barriers. Recommendations are made regarding methods to improve the synchronicity of political directives with organisational realties in the public hospital sector.

Background and purpose: The needs for the post-discharge care increases in tandem with the rapid growth of the ageing population. Discharge planning, as part of continuity of care, is parallel with nursing care. The nurses play the key role in the discharge planning process. Their understanding and attitudes towards discharge planning are likely to affect the practice and the effectiveness of discharge planning. Therefore, this study aimed to explore the nurses¡¦ understanding of the discharge planning process and their attitudes towards it. Methods: The self- administrated questionnaires were delivered to all the nurses working in a general care units in the medical center in southern Taiwan. 332 nurses were approached. The data were analyzed by SPSS 12.0 applying descriptive statistics, ANOVA, chi-square test and Pearson correlation analysis. The reliability of the questionnaire is 0.882. Results: The net response rate is 69.9 percent. About 43 percent of the respondents are with the employment length over 10 years. 43 percent of the respondents had received discharge planning education. Only 10.7 percent of respondents got involved in the discharge planning meetings frequently. The mean value of the understanding between the respondents with the discharge planning training and those without were significantly different (p < 0.001). The significant difference was found in the understanding among the respondents with the different level of involvement in the discharge planning meetings (p< 0.001). There was a significant difference found in the mean value of attitudes among the respondents with different frequency of involvement in the discharge planning meetings. The mean scores of the whole attitudes were significantly higher in the respondents with training than in those without training (p=0.014). Understanding was associated with duration of employment, the discharge planning training or education, and level of involvement in the discharge planning meetings. Attitudes were associated with the level of involvement in the discharge planning meetings and workload. The strong correlation was found between the respondents¡¦ understanding and attitudes. Conclusion: Understanding of the discharge planning process and the attitudes towards discharge planning were influenced by the duration of employment, the involvement in the discharge planning meetings and the education or training regarding discharge planning. Therefore, to increase the understanding and to change the attitudes, the nurses should be provided with the more discharge planning education and opportunities to participate in the discharge planning meetings.

This thesis is a theoretical model and experimental study of the physics of a low pressure (5-50 mtorr), low electron temperature (1-10 eV), high density (J017 _J01Bm-J ) inductively coupled plasma. This type of plasma is similar to those much used in plasma etching, deposition, and other plasma aided materials processing of devices [1-5]. A two-dimensional, electromagnetic, finite-element model has been set up to simulate the operation of the inductively coupled plasma using the external coil configuration used in the experimental work. Given fixed external RF coil current and voltage and the measured plasma density profile, Maxwell's equations and magnetohydrodynamical (MHD) fluid equations are used to calculate the self-consistent electromagnetic field. A number of predictions are presented and compared with experiments. A symmetric, cylindrical inductively coupled discharge system has been set up. A single tum loop magnetic probe has been used to measure electromagnetic (EM) field in the discharge chamber. A Langmuir double probe has been designed to measure the plasma density and electron temperature. An emissive probe was used to measure the time averaged plasma potential, while a capacitive probe was used to measure the RF component of the plasma potential. A retarding field energy analyser has been used to measure the total ion flux flowing to the vessel on the midplane. Experimental results show that (1) the inductively coupled plasma is well confined inside the induction coil in the pressure range of 5-50 mtorr and RF power range of 10-400 W; (2) the measured electrostatic RP field «1.0 V/cm) in the whole discharge chamber is negligible, compared with the large induction RF field, which is in the order of 10 V/cm; (3) the RF power is coupled into the discharge through the nonlinear electron motion and corresponding collision processes; (4) it has been shown that the induction-field-ionization, electrostatic-field-modulation and various collision processes together influence the velocity distribution function of ions at the boundary surfaces.

No description available.

No description available.

It has consistently been documented in many countries and sectors that there are difficulties in implementing public policy effectively. A priori, the Australian health care system is no exception to this general proposition. While governments issue directives with particular goals in mind these goals are not always met, because of the modifications, interpretations or lack of uptake by targeted populations. However it is not clear the extent to which these difficulties occur in the public hospital sector, and we lack clear empirical data on this phenomenon. This thesis investigates the effects of a state government directive on the development and implementation of elective admission policies in New South Wales public hospitals. It did this by three separate but related studies that examined the impact of the directive at the hospitals??? management and staff levels. The first two studies were quantitative and qualitative surveys of hospital managers and admission staff. The management survey aimed to ascertain the extent to which managers responded to the directive in terms of developing and implementing hospital policies. The staff survey sought to investigate staff awareness and knowledge of the developed policies. The third study was a qualitative analysis of the policy contents to determine the extent to which they reflected the aims and objectives of the government directive guidelines. All three studies found a general lack of relevance and applicability of the government directive and its guidelines to individual hospital organisations. The manager survey showed a disconnection between the central government office responsible for implementing the directive and hospital managers??? perspectives. This was apparent by the lack of response to the directive by many hospitals and the fact that managers often passed on the task of implementing the directive and its guidelines to other hospital staff. The findings of the qualitative analysis of policies showed evidence of hospital strategies to manage pressures created by the directive. These difficulties were corroborated by the surveyed staff that reported difficulties in translating the directive???s requirements (as reflected by the hospital policy), into the reality of their daily work; a lack of organisational commitment to policy enforcement; and a suspicion regarding the directive???s political motives. The findings of this thesis show that, as with other public service sectors effective policy implementation in the public hospital arena is problematic, with government agendas frequently not aligned with the requirements of stakeholders, and inadequate understanding of implementation barriers. Recommendations are made regarding methods to improve the synchronicity of political directives with organisational realties in the public hospital sector.

Thesis (M.H.A.)--University of Michigan, 1977.

Thesis (M.H.A.)--University of Michigan, 1977.

Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1991.