The research was directed at assessing the strengths and weaknesses in the application-to-approval process of social grants up to the payment of social grants at pay-points in the South African Social Security Agency (hereafter SASSA). The general aim of the research project was to assess the application-to-approval process of grant administration in SASSA up to the payment of social grants at pay-points. The specific objectives of the study were therefore: * To describe the current application-to-approval process of grant administration; * To assess the strengths and weaknesses in the grant administration process of specified administrative procedures and structural issues as perceived by attesting officials (front-line staff responsible for taking down the grant applications), data-capturer officials (staff responsible for capturing the information on the application form onto the SOCPEN system, pay-point team members (staff responsible for rendering services at pay-points) and beneficiaries at pay-points; and * To provide a report on the strengths and weaknesses of the grant administration process from application to pay-out to the top management of SASSA. The study was conducted in two regions, namely the Northern Cape and the Western Cape. Various offices in the Northern Cape and the Western Cape were therefore part of the research. The grant administration process from application-to-approval includes various stages. The staff members include the screening official (step one) who checks the completeness of the required documentation, followed by attesting official (step two) who takes down the application and captures it on SOCPEN and then forwards it to the next level, namely quality control (step three). Thereafter a verifying official verifies the information captured on SOCPEN against documentation submitted and approves or rejects the application on SOCPEN (step four). Staff at pay-points (where beneficiaries receive their payments) and beneficiaries at pay-points were also part of the research focus. Four different data-collection instruments were therefore used during the research project. The first data-collection instrument was designed to collect data on the actual grant application process and problems and strengths in this regard (questionnaire front-line staff). The empirical investigation revealed the following with regard to the front-line staff: * The majority of front-line staff have considerable working experience (more than five years) in SASSA; * The majority of front-line staff have inadequate work space; * Training, supervision and mentoring support from supervisors and colleagues occurs haphazardly; * The majority of front-line staff receive between 11-29 applications per day and spent 30 minutes or less to take down an application; * Policy documents that regulate the implementation of new policy changes are not always available; * Grant application files get misplaced or lost after processing; * Staff carelessness is one of the main reasons why files get lost or misplaced and * Front-line staff experience technical difficulties with the computer on a regular basis and it takes one to three days to resolve technical difficulties. The second data-collection instrument was developed to collect data on the capturing of the application (questionnaire data-capturer) onto the SOCPEN system. The empirical investigation revealed the following with regard to data-capturers: * The majority of data-capturers have solid work experience as data-capturers in SASSA although some data-capturers have inadequate work space; * Training on the implementation of new policy changes occurs irregularly; * Supervision, mentoring and support from supervisors happen haphazardly; * Data-capturers receive between 20 and 29 applications per day and they capture all applications successfully; * Data-capturers receive support from colleagues on a more regular basis than from supervisors; * Documents or guidelines that regulate the implementation of policy changes are not always available in the work place; * Applications sometimes get misplaced or lost after capturing; * No proper mechanisms are in place to record the movement of files, staff carelessness and either lack of office space or filing space, are the main reasons why applications get lost or misplaced; * Data-capturers sometimes experience technical problems with computers and it takes one to less than five days to resolve technical difficulties; * Data-capturers receive sometimes incomplete applications from the attesting officials (those staff officials who are responsible for taking down the application) and they usually take such applications back to the first attesting officer; * Backlogs in the capturing and approving of normal applications exist and staff shortages and system-related problems are the main reasons why backlogs exist; * Backlogs exist with regard to the capturing and approving of review cases and * Staff shortages, a centralized review management approach, lack of office space and lack of connectivity points constitute the main reasons why review backlogs exist. The third data-collection instrument (questionnaire pay-point team member) was developed to measure services at pay-points and to determine the problems experienced at pay-points. The empirical investigation revealed the following with regard to this category as seen by pay-point team members: * Some pay-points are not disabled-friendly; * There are not always enough chairs, toilet facilities or drinking water available at pay-points; * Payment contractors and SASSA staff sometimes arrive late at pay-points; * Payments are usually delayed between 15 minutes to less than an hour, but beneficiaries are not always informed about delays; * There are sometimes broken machines at pay-points and this causes 15 to 45 minutes delay in payments; * There is not always enough money at pay-points and it takes an hour to just under two hours to get more money; * Grant recipients hardly ever receive wrong grant amounts; * Hawkers and vendors operate mainly outside the pay-point; * Security guards are available at pay-points and there is access control at pay-points (mainly driven by security guards from the payment contractor) * Not all pay-points are fenced all round and * First Aid kits are available at pay-points most of the time. The fourth data-collection instrument (questionnaire for beneficiaries) was developed to target the beneficiaries who receive grant payments at pay-points. The empirical investigation revealed the following: * Some pay-points are not disabled-friendly; * There are not always enough chairs, toilet facilities or drinking water available at pay-points; * Payment contractors and SASSA staff sometimes arrive late at pay-points; * Payments are usually delayed between 15 minutes to less than an hour, but beneficiaries are not always informed about delays; * There are sometimes broken machines at pay-points and this causes 15 to 45 minutes‟ delay in payments; * There is not always enough money at pay-points and it takes an hour to less than two hours to get more money; * Grant recipients rarely receive wrong grant amounts; * Hawkers and vendors operate mainly outside the pay-point, but there are exceptional cases where they operate inside the pay-points; * Beneficiaries do feel safe at pay-points most of the time; * Beneficiaries mostly live within walking distance from the pay-point; * Beneficiaries hardly experience problems at pay-points and if they do, their problems get resolved; * Not all pay-points provide shelter from the elements; * Beneficiaries are satisfied with the services SASSA renders and the grant has improved their quality of life. Grant administration processes in SASSA are labour-intensive and officials play a vital role in the correct administration of social grants. The study has revealed that although there is clearly some strength in the grant administration process from application-to-approval up the payment of social grants at pay-points, it is unfortunately true that the weaknesses are overwhelming. / Thesis (PhD (Social Work))--North-West University, Potchefstroom Campus, 2013

p. 1-116 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-11T19:03:33Z No. of bitstreams: 1 Diss ANA PAULA.pdf: 1432337 bytes, checksum: 9a4dcad5eb26749b4cfa495150e9dc03 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-04-11T19:21:04Z (GMT) No. of bitstreams: 1 Diss ANA PAULA.pdf: 1432337 bytes, checksum: 9a4dcad5eb26749b4cfa495150e9dc03 (MD5) / Made available in DSpace on 2013-04-11T19:21:04Z (GMT). No. of bitstreams: 1 Diss ANA PAULA.pdf: 1432337 bytes, checksum: 9a4dcad5eb26749b4cfa495150e9dc03 (MD5) Previous issue date: 2009 / A implantação do Plano Diretor de Vigilância Sanitária impulsionada, a partir de 2007, por meio de sua divulgação, distribuição e mediante a elaboração e execução dos Planos de Ação em Visa, ainda não dispõe de critérios e padrões para sua avaliação. Esse estudo buscou elaborar e validar um instrumento para avaliar a implantação do Plano Diretor da Vigilância Sanitária (PDVISA) no âmbito estadual. A estratégia do trabalho consistiu numa pesquisa avaliativa, direcionada a apreciação do grau de implantação da intervenção. Foi delineado o modelo lógico do PDVISA, a partir do qual foram selecionados níveis, dimensões, sub-dimensões e critérios que compuseram uma matriz da situação-objetivo relativa à sua implantação no âmbito estadual. Esta matriz foi submetida a especialistas usando-se a técnica de consenso, método Delfos modificado. Entrevistas semi-estruturadas foram conduzidas, junto a coordenadores e técnicos da vigilância em saúde no estado de Santa Catarina. O estudo revelou que este estado encontra-se avançado na implantação do Plano Diretor e que dentre os quatro níveis avaliados, a Organização da Ação Regulatória no Estado e a Organização e Gestão do SNVS, no âmbito do SUS foram considerados os mais avançados, enquanto os níveis Participação e Controle Social na Visa e Construção na Visa da Atenção Integral à S aúde apresentaram-se intermediários, a partir da situação-objetivo construída. Esse instrumento pode ser uma referência para avaliações da vigilância sanitária em outros estados, e pode colaborar na tomada de decisão para melhoria da implementação das ações de Visa em todo o país. / Salvador

Problématique : Implanté en 2004 au Bénin, le programme national de prévention de la transmission du VIH de la mère à l’enfant (PTME) semble globalement bien implanté. Toutefois une enquête, en 2005, révèle certaines difficultés, particulièrement au niveau de la couverture du programme: seulement 70 à 75 % des femmes enceintes vues en consultations prénatales ont été dépistées et 33 % des 1150 femmes dépistées séropositives ont accouché suivant le protocole de PTME. En outre, d’un site à un autre, on relève une grande variation dans la couverture en termes de dépistage et de suivi des femmes enceintes infectées. Cette faiblesse dans la couverture nous a amené à questionner le contexte organisationnel dans lequel le programme est implanté. Objectif : L’objectif général de cette thèse est d’analyser l'implantation de la PTME au Bénin. Le premier objectif spécifique consiste à identifier et comprendre les enjeux reliés à la façon de rejoindre les femmes enceintes dans le cadre du dépistage. Le second consiste à comprendre le contexte d’implantation et son influence sur la mise en œuvre de la PTME. Méthodologie : Cette recherche évaluative s’appuie sur une étude de cas. Six maternités ont été sélectionnées avec le souhait de représenter les différents contextes d’organisation des services. Les données ont été collectées par observation non participante, entrevues semi-dirigées (n=41) réalisées avec des prestataires de services, analyse documentaire des rapports d’activités des maternités et par questionnaires administrés aux femmes enceintes en consultations prénatales (n=371). Résultats : Le premier article a permis d'apprécier le caractère libre et éclairé du consentement au dépistage. Une majorité des femmes enceintes, suivies dans les centres privés, ont été dépistées sans être effectivement informées de la PTME alors que les femmes fréquentant les autres maternités connaissent mieux les composantes de la PTME. Le caractère volontaire du consentement des femmes est généralement respecté sur tous les sites. Le deuxième article porte sur l'analyse de la qualité du conseil pré-test. Seulement 54% des femmes enceintes ont participé à un conseil en groupe et 80% à un conseil individuel. Dans les centres où sont dispensées des séances d'information de groupe, la qualité est meilleure que dans les centres qui dispensent un conseil individuel exclusif. Le troisième article analyse l'influence du contexte d'implantation sur la mise en œuvre du programme. Parmi les facteurs qui contribuent favorablement à la mise en œuvre on relève la proximité d’un centre de référence et la coordination des activités de PTME dans une zone géographique, la responsabilisation du prestataire dédié à la PTME, la supervision formative régulière accompagnée de séances de discussion collective et l’implication des médiatrices dans la recherche active des perdues de vues. A l’opposé, la responsabilisation des médiatrices pour la réalisation du conseil individuel et du dépistage ne favorise pas une bonne mise en œuvre de la PTME. Conclusion : Nos résultats montrent qu'il est possible de jouer sur l'organisation des services de santé dans le cadre du programme du PTME pour améliorer la façon dont le programme est implanté tant dans les centres privés que publics, sans que cela ne représente un ajout net de ressources. C'est le cas de l’amélioration de la qualité du conseil et du dépistage, de l’implantation du processus interne d’apprentissage organisationnel et de la coordination des services. / Problem: Launched in 2004 in Benin, the national program for prevention of mother-to-child transmission (PMCTC) of HIV appears to have been well implemented. Nevertheless, a 2005 survey revealed certain problems, particularly with respect to the program’s coverage: only 70% to 75% of pregnant women seen in prenatal consultation were screened, and only 33% of the 1,150 women found to be HIV-infected were delivered according to the PMCTC protocol. In addition, there was great variation in coverage from one site to another in terms of screening and of follow-up for infected pregnant women. This inadequate coverage raised questions about the organizational context in which the program is implemented. Objectives: The overall objective of this thesis is to analyze the implementation of the PMTCT program in Benin. The first specific objective is to identify and understand the issues related to how pregnant women are contacted as part of the screening process. The second is to understand the implementation context and its influence on how the PMTCT program is carried out. Methodology: This evaluative research is based on a case study. Six maternity units were selected in order to provide a representative sample of the different service organization settings. Data were collected through non-participant observation, semi-structured interviews (n=41) with service providers, documentary analysis of the maternity centres’ activity reports, and questionnaires administered to pregnant women at prenatal consultations (n=371). Results: The first article, whose objective was to appreciate the free and informed nature of consent to screening, revealed differences between maternity. A majority of pregnant women followed in private centres were screened without being adequately informed about the PMTCT program, whereas the women in others centres were better informed about the specifics of the program. The voluntary nature of the consent was generally respected. The second article analyzes the quality of the pre-test counselling. Only 54% of the pregnant women in our sample participated in group pre-test counselling sessions and 80% in individual counselling. In centres, which organize group information sessions, the quality is better than in centres, where counselling is provided exclusively to individuals. The third article analyzes the influence of the implementation context on how the program is carried out. Among the factors that contribute positively to implementation are: the proximity of a referral centre and the coordination of PMTCT activities within a geographic area; designating a care provider to oversee the PMTCT program; conducting regular formative supervision with group discussion sessions; and involving mediators—HIV-positive women hired by the program to provide psychological accompaniment—in actively seeking out women who have been lost to follow-up. Conversely, putting mediators in charge of individual counselling or of screening does not foster good implementation of the PMTCT program. Conclusion: Our results show that it is possible to adjust the organization of healthcare services for the PMTCT program in order to improve implementation in both the private and public sectors with no net increase in resources. This is the case for improving the quality of counselling and of screening, the implementation of the internal process of organizational learning, and the coordination of services.

No description available.

Problématique : Implanté en 2004 au Bénin, le programme national de prévention de la transmission du VIH de la mère à l’enfant (PTME) semble globalement bien implanté. Toutefois une enquête, en 2005, révèle certaines difficultés, particulièrement au niveau de la couverture du programme: seulement 70 à 75 % des femmes enceintes vues en consultations prénatales ont été dépistées et 33 % des 1150 femmes dépistées séropositives ont accouché suivant le protocole de PTME. En outre, d’un site à un autre, on relève une grande variation dans la couverture en termes de dépistage et de suivi des femmes enceintes infectées. Cette faiblesse dans la couverture nous a amené à questionner le contexte organisationnel dans lequel le programme est implanté. Objectif : L’objectif général de cette thèse est d’analyser l'implantation de la PTME au Bénin. Le premier objectif spécifique consiste à identifier et comprendre les enjeux reliés à la façon de rejoindre les femmes enceintes dans le cadre du dépistage. Le second consiste à comprendre le contexte d’implantation et son influence sur la mise en œuvre de la PTME. Méthodologie : Cette recherche évaluative s’appuie sur une étude de cas. Six maternités ont été sélectionnées avec le souhait de représenter les différents contextes d’organisation des services. Les données ont été collectées par observation non participante, entrevues semi-dirigées (n=41) réalisées avec des prestataires de services, analyse documentaire des rapports d’activités des maternités et par questionnaires administrés aux femmes enceintes en consultations prénatales (n=371). Résultats : Le premier article a permis d'apprécier le caractère libre et éclairé du consentement au dépistage. Une majorité des femmes enceintes, suivies dans les centres privés, ont été dépistées sans être effectivement informées de la PTME alors que les femmes fréquentant les autres maternités connaissent mieux les composantes de la PTME. Le caractère volontaire du consentement des femmes est généralement respecté sur tous les sites. Le deuxième article porte sur l'analyse de la qualité du conseil pré-test. Seulement 54% des femmes enceintes ont participé à un conseil en groupe et 80% à un conseil individuel. Dans les centres où sont dispensées des séances d'information de groupe, la qualité est meilleure que dans les centres qui dispensent un conseil individuel exclusif. Le troisième article analyse l'influence du contexte d'implantation sur la mise en œuvre du programme. Parmi les facteurs qui contribuent favorablement à la mise en œuvre on relève la proximité d’un centre de référence et la coordination des activités de PTME dans une zone géographique, la responsabilisation du prestataire dédié à la PTME, la supervision formative régulière accompagnée de séances de discussion collective et l’implication des médiatrices dans la recherche active des perdues de vues. A l’opposé, la responsabilisation des médiatrices pour la réalisation du conseil individuel et du dépistage ne favorise pas une bonne mise en œuvre de la PTME. Conclusion : Nos résultats montrent qu'il est possible de jouer sur l'organisation des services de santé dans le cadre du programme du PTME pour améliorer la façon dont le programme est implanté tant dans les centres privés que publics, sans que cela ne représente un ajout net de ressources. C'est le cas de l’amélioration de la qualité du conseil et du dépistage, de l’implantation du processus interne d’apprentissage organisationnel et de la coordination des services. / Problem: Launched in 2004 in Benin, the national program for prevention of mother-to-child transmission (PMCTC) of HIV appears to have been well implemented. Nevertheless, a 2005 survey revealed certain problems, particularly with respect to the program’s coverage: only 70% to 75% of pregnant women seen in prenatal consultation were screened, and only 33% of the 1,150 women found to be HIV-infected were delivered according to the PMCTC protocol. In addition, there was great variation in coverage from one site to another in terms of screening and of follow-up for infected pregnant women. This inadequate coverage raised questions about the organizational context in which the program is implemented. Objectives: The overall objective of this thesis is to analyze the implementation of the PMTCT program in Benin. The first specific objective is to identify and understand the issues related to how pregnant women are contacted as part of the screening process. The second is to understand the implementation context and its influence on how the PMTCT program is carried out. Methodology: This evaluative research is based on a case study. Six maternity units were selected in order to provide a representative sample of the different service organization settings. Data were collected through non-participant observation, semi-structured interviews (n=41) with service providers, documentary analysis of the maternity centres’ activity reports, and questionnaires administered to pregnant women at prenatal consultations (n=371). Results: The first article, whose objective was to appreciate the free and informed nature of consent to screening, revealed differences between maternity. A majority of pregnant women followed in private centres were screened without being adequately informed about the PMTCT program, whereas the women in others centres were better informed about the specifics of the program. The voluntary nature of the consent was generally respected. The second article analyzes the quality of the pre-test counselling. Only 54% of the pregnant women in our sample participated in group pre-test counselling sessions and 80% in individual counselling. In centres, which organize group information sessions, the quality is better than in centres, where counselling is provided exclusively to individuals. The third article analyzes the influence of the implementation context on how the program is carried out. Among the factors that contribute positively to implementation are: the proximity of a referral centre and the coordination of PMTCT activities within a geographic area; designating a care provider to oversee the PMTCT program; conducting regular formative supervision with group discussion sessions; and involving mediators—HIV-positive women hired by the program to provide psychological accompaniment—in actively seeking out women who have been lost to follow-up. Conversely, putting mediators in charge of individual counselling or of screening does not foster good implementation of the PMTCT program. Conclusion: Our results show that it is possible to adjust the organization of healthcare services for the PMTCT program in order to improve implementation in both the private and public sectors with no net increase in resources. This is the case for improving the quality of counselling and of screening, the implementation of the internal process of organizational learning, and the coordination of services.

Made available in DSpace on 2014-12-17T15:24:28Z (GMT). No. of bitstreams: 1 KalineSA_DISSERT.pdf: 2243045 bytes, checksum: 9dabba13b96342942efddd4c92702632 (MD5) Previous issue date: 2014-05-19 / The considerable expansion of Distance Education registered in recent years in Brazil raises the importance of debate about how the implementation of this policy has been happening so that formulators and implementers make better informed decisions, maximizing results, identifying successes and overcoming bottlenecks. This study aims to evaluate the implementation process of Distance Education policy by Secretary of Distance Education of the Federal University of Rio Grande do Norte. For this, we sought to use an evaluation proposal consistent with this policy, and came to the one developed by Sonia Draibe (2001), which suggests an analysis called anatomy of evaluation general process. To achieve the objectives, we made a qualitative research, case study type, using documentary research and semi-structured interviews with three groups of subjects who belong to the policy: managers, technicians and beneficiaries. It was concluded that: the implementation process needs a open contact channel between the management and technicians and beneficiaries; the lack of clarity in the dissemination of information between technicians produces noises that affects the outcomes; the absence of dissemination of internal and external actions contributes to the perpetuation of prejudice in relation to Distance Education; using selection criteria based on competence and merit contributes to form a team of skilled technicians to perform their function within the policy; an institution that do not enable technicians generates gaps that possibly will turn into policy implementation failures; all subjects involved in politics need internal evaluations to contribute to improvements in the implementation process, however, a gap is opened between the subjects if there is no socialization of results; the existence of an internal structure that manipulates financial resources and balances the budget from different maintainer programs is essencial; the consortium between IES and municipalities in presential support poles are bottlenecks in the process, since beneficiaries are exposed to inconsistency and lack of commitment of these local municipalities / A consider?vel expans?o da Educa??o a Dist?ncia (EaD) registrada nos ?ltimos anos no Brasil levanta a import?ncia do debate sobre como vem sendo feita a implementa??o desta pol?tica, para que formuladores e implementadores tomem decis?es com maior conhecimento, maximizando resultados, identificando ?xitos e superando pontos de estrangulamento. Este trabalho procura avaliar o processo de implementa??o da pol?tica de EaD pela Secretaria de Educa??o a Dist?ncia da Universidade Federal do Rio Grande do Norte. Para isso, buscou-se utilizar uma proposta de avalia??o compat?vel com a referida pol?tica, chegando-se ? desenvolvida por Sonia Draibe (2001), a qual sugere uma an?lise denominada anatomia do processo geral de implementa??o. Para alcan?ar os objetivos, realizou-se uma pesquisa de car?ter qualitativo do tipo estudo de caso, utilizando-se de pesquisa documental e de entrevistas semiestruturadas com tr?s grupos de sujeitos pertencentes ? pol?tica: gestores, t?cnicos e benefici?rios. Concluiu-se, principalmente, que: o processo de implementa??o carece de um canal de contato aberto da gest?o com os t?cnicos e benefici?rios; a falta de clareza na dissemina??o de informa??es entre os t?cnicos produz ru?dos que interferem nos outcomes (produtos); a aus?ncia de divulga??o das a??es interna e externamente contribui com a perpetua??o do preconceito em rela??o ? modalidade a dist?ncia; utilizar crit?rios de sele??o pautados na compet?ncia e no m?rito contribui para formar um corpo de t?cnicos habilitados para exercer a sua fun??o dentro da pol?tica; uma institui??o que n?o capacita t?cnicos gera lacunas que possivelmente ir?o se transformar em falhas de execu??o da pol?tica; todos os sujeitos envolvidos na pol?tica necessitam de avalia??es internas para contribuir com melhorias no processo de implementa??o, no entanto, abre-se uma lacuna entre os sujeitos caso n?o haja a socializa??o dos resultados; a exist?ncia de uma inst?ncia interna que gerencie os recursos financeiros e balanceie o or?amento oriundo dos diferentes programas mantenedores ? fundamental; os cons?rcios entre IES e munic?pios nos polos de apoio presencial se revelam como um ponto de estrangulamento do processo, pois os benefici?rios ficam expostos ? inconst?ncia e ? falta de compromisso das prefeituras nestes locais

The new regulation on medical devices, EU 2017/745, came into force in May 2021 meaning that all economic operators in the industry need to adhere to new, stricter requirements. As there is yet no common practice on how to implement and comply with the new requirements, many struggles with this.  In this thesis, the implementation of a distributor company operating in the medical device industry, currently in the middle of the implementation, is qualitatively evaluated to identify areas of improvement. This is done by conducting a case study where the company's implementation approach is mapped and evaluated with regard to good practice, and implemented organizational changes due to the regulation are identified and benchmarked against similar companies. Their interpretation and implementation appear to be rather strict and ambitious based on the overviewing benchmark with similar distributors. Their implementation moreover largely followed good practice, but several areas of improvement could nevertheless be identified.  Additionally, this thesis aimed to explore how the result of the final implementation of EU 2017/745 can be assessed. A literature review was conducted where general parameters to assess regulatory implementation were identified, followed by a literature review where it was investigated how these parameters can be adapted to assess the result of the implementation of EU 2017/745. Several parameters of interest to assess the result were identified together with examples of indicators that can be used. More research is however needed to be able to establish a complete, adequate method to assess the final implementation result. / Den nya förordningen för medicintekniska produkter, EU 2017/745, trädde i full kraft i maj 2021. Det betyder att alla ekonomiska aktörer verksamma i den medicintekniska industrin måste anpassa sig till nya, hårdare krav. Många upplever dock svårigheter eftersom det ännu inte finns någon praxis för hur kraven ska implementeras och efterlevas. I den här uppsatsen genomförs en kvalitativ utvärdering av implementeringen hos en medicinteknisk distributör som befinner sig mitt i implementeringsarbetet, för att identifiera förbättringsmöjligheter. Detta görs genom en case study, där företagets implementering kartläggs och utvärderas i relation till good practice. Vidare identifieras organisatoriska förändringar som genomförts som en följd av förordningen, och benchmarkas mot andra, liknande företag. Utvärderingen visade att företagets tolkning och implementeringen av kraven stod sig väl i relation till det övergripande benchmark som tillhandahölls. Vidare följde implementeringen i stora drag good practice, men ett antal förbättringsmöjligheter kunde ändå identifieras.  Vidare syftar uppsatsen till att utforska hur resultatet av implementeringen av EU 2017/745 kan bedömas när implementeringen är färdig. En literaturstudie på allmän regulatorisk utvärdering samt organisatorisk förändringsutvärdering genomfördes, där områden relevanta för att utvärdera regulatorisk implementering identifierades. Detta följdes av en vidare literaturstudie för att undersöka hur dessa områden kan anpassas för bedöma resultatet av EU 2017/745. Ett antal intressanta områden tillsammans med exempel på indikatorer som kan användas för en sådan bedömning identifierades. Vidare arbete behövs dock för att fastställa en heltäckande, ändamålsenlig metod för att bedöma implementeringsresultatet.

Les organisations de santé sont caractérisées par la complexité de leurs activités et un haut niveau de fragmentation des soins qui amènent inévitablement des enjeux de coordination de services. Le principal mécanisme de coordination à leur disposition, la standardisation des connaissances et de l’expertise, est un mécanisme à la fois essentiel, mais limité. Ainsi, le défi demeure pour une organisation de santé de favoriser une utilisation des connaissances à un plan organisationnel. Le présent projet évalue comment une structure organisationnelle visant la mobilisation et l’utilisation des connaissances dans les prises de décision contribue à améliorer la coordination des services d’une organisation de santé. La recherche s’appuie sur un cas précis : le Bureau de soutien à la transition (BST) du Centre universitaire de santé de McGill (CUSM). L’analyse utilise un cadre conceptuel de création des connaissances organisationnelles inspiré des travaux de Nonaka et al. Les données ont été récoltées à partir d’observations, d’analyses documentaires et d’entrevues. Cette évaluation fondée sur la théorie explique comment les processus de conversion des connaissances tacites et explicites permettent la création de nouvelles connaissances organisationnelles et contribue à l’amélioration de la coordination des services. L’évaluation démontre l’influence des facteurs contextuels sur les processus de création/utilisation de connaissances. La recherche montre qu’il est nécessaire de conceptualiser différemment l’utilisation des données empiriques dans les prises de décision en mettant en évidence leur rôle spécifique dans le processus social de création des connaissances. Nous proposons une nouvelle typologie d’utilisation des connaissances dans les prises de décision. Nous démontrons également comment une structure organisationnelle comme le BST peut contribuer à la coordination des soins et services dans une organisation de santé. Les résultats enrichissent aussi le corpus de connaissances scientifiques sur la gouvernance et la transformation des organisations. / Health organizations are characterized by the complexity of their activities and a high level of care fragmentation that inevitably result in service coordination stakes. Their main coordination mechanism, knowledge and expertise standardization is an essential, but limited, mechanism. Thus, the challenge still stands for a health organization to promote knowledge utilization at an organizational level. This project evaluates how an organizational structure aiming at mobilization and knowledge utilization in decision making helps to improve the coordination services in a health organization. This research relies on a specific case: the Transition Support Office (TSO) of the McGill University Health Center (MUHC). The analysis uses a conceptual framework of organizational knowledge creation inspired by the work of Nonaka et al. Data have been collected by observations, documentary and interview analyses. This theory driven evaluation explains how the conversion process of tacit knowledge to explicit knowledge allows the dissemination and creation of new organizational knowledge and contributes to the improvement of service coordination. The evaluation demonstrates the influence of contextual factors on the processes of knowledge creation/utilization. The research shows that it is necessary to otherwise conceptualize the use of empirical data in decision making by highlighting their specific role in the social process of knowledge creation. We propose a new knowledge use typology in decision making. We also show how an organizational structure like the TSO can contribute to the care and service coordination in a health organization. Results also enrich the scientific knowledge on governance and organization transformation.