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The experience of policymaking in healthcare : the interaction of policy formulation and frontline staff practiceWarwick, Robert James January 2010 (has links)
My research focuses on the experience of policy development and implementation. It draws on my involvement in a government policy taskforce, the development of an organisation’s strategy to the taskforce’s recommendations and the commissioning of frontline services. The research material is my personal experience contained in a number of narrative accounts of important happenings. These are then used as a basis to engage with literature and conversation with practitioners, academics and fellow researchers. It is from this iterative process that the argument develops. The approach is therefore qualitative and reflexive in nature. I have argued against the traditional separation between the content of research and methodology. This is on the basis that human experience does not distinguish between the two as we make sense of new emerging situations. The research has been heavily influenced by analogies drawn from complexity sciences as a way of increasing our understanding of ongoing human interaction, namely complex responsive processes of relating (Stacey et al, 2000). By paying careful attention to the experience of policy development and implementation over an extended period of time I am illuminating that the development of policy can often be seen in literature and in the techniques people use as an activity that is isolated from the work of frontline staff. For example, a policy group is formed, policy or a strategy is drafted and the work is then seen to be done. This can be demonstrated by paying attention to the modus operandi of how policy and strategy groups work and how performance criteria are established. When it comes to frontline practice, policy is often silent to the multitude of unfolding interconnected possibilities that present themselves to practitioners as they seek to go about their activities. The way that policy is often presented implies that there is linearity from policy to implementation. Drawing on Elias’s notion of Involvement and Detachment (1987) I am highlighting a paradoxical relationship between policy and implementation. In introducing the notion of paradox, there is a “vitality” that is required to prevent a collapse to one of the two ends of a continuum; for example a conscious or unconscious rejection of policy in favour of embracing frontline practice, or an over reliance on policy to blindly drive through organisational change. In spending three years looking at the policy and implementation I argue that it is more helpful to consider policy and implementation as a “flow”, rather than a series of discrete activities that are seen to be completed before moving to the next policy area. In looking at policy as something that occurs over a span of time (as opposed to an isolated bounded activity) there is an opportunity to prevent the collapse of the paradox outlined above. By accepting the concept of paradox and considering policy from a temporal perspective, rather than one that is a spatially bound system, the issue of policymaking practice can be considered. There are books and management experts that recommend that managers should “walk the walk”, and get closer to frontline activity. My research has sought to add clarity here, arguing for an experiential and temporal form of reflexivity of practice (as opposed to reflective practice). In this context working and being present with frontline practitioners, paying very careful attention to the experience of the unfolding contingent nature of activity influences the practice of policy making. This is a different experience from simply being present, and being seen to be present. It would be ironic for my research to be converted into a policy document with key elements extracted and condensed into bullet points to be applied like a rule. Instead my research is best kept alive in evoking stories and reminiscences between people as they make sense of their experience of policymaking and implementation together.
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Using Observers for Model Based Data Collection in Distributed Tactical OperationsThorstensson, Mirko January 2008 (has links)
<p>Modern information technology increases the use of computers in training systems as well as in command-and-control systems in military services and public-safety organizations. This computerization combined with new threats present a challenging complexity. Situational awareness in evolving distributed operations and follow-up in training systems depends on humans in the field reporting observations of events. The use of this observer-reported information can be largely improved by implementation of models supporting both reporting and computer representation of objects and phenomena in operations.</p><p>This thesis characterises and describes observer model-based data collection in distributed tactical operations, where multiple, dispersed units work to achieve common goals. Reconstruction and exploration of multimedia representations of operations is becoming an established means for supporting taskforce training. We explore how modelling of operational processes and entities can support observer data collection and increase information content in mission histories. We use realistic exercises for testing developed models, methods and tools for observer data collection and transfer results to live operations.</p><p>The main contribution of this thesis is the systematic description of the model-based approach to using observers for data collection. Methodological aspects in using humans to collect data to be used in information systems, and also modelling aspects for phenomena occurring in emergency response and communication areas contribute to the body of research. We describe a general methodology for using human observers to collect adequate data for use in information systems. In addition, we describe methods and tools to collect data on the chain of medical attendance in emergency response exercises, and on command-and-control processes in several domains.</p>
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Using Observers for Model Based Data Collection in Distributed Tactical OperationsThorstensson, Mirko January 2008 (has links)
Modern information technology increases the use of computers in training systems as well as in command-and-control systems in military services and public-safety organizations. This computerization combined with new threats present a challenging complexity. Situational awareness in evolving distributed operations and follow-up in training systems depends on humans in the field reporting observations of events. The use of this observer-reported information can be largely improved by implementation of models supporting both reporting and computer representation of objects and phenomena in operations. This thesis characterises and describes observer model-based data collection in distributed tactical operations, where multiple, dispersed units work to achieve common goals. Reconstruction and exploration of multimedia representations of operations is becoming an established means for supporting taskforce training. We explore how modelling of operational processes and entities can support observer data collection and increase information content in mission histories. We use realistic exercises for testing developed models, methods and tools for observer data collection and transfer results to live operations. The main contribution of this thesis is the systematic description of the model-based approach to using observers for data collection. Methodological aspects in using humans to collect data to be used in information systems, and also modelling aspects for phenomena occurring in emergency response and communication areas contribute to the body of research. We describe a general methodology for using human observers to collect adequate data for use in information systems. In addition, we describe methods and tools to collect data on the chain of medical attendance in emergency response exercises, and on command-and-control processes in several domains.
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"En stridsplan överlever sällan första stridskontakt" : Slaget om Darwin – Goose GreenNilsson, Nicklas January 2009 (has links)
<p>Den 26 maj 1982 påbörjas anfallet mot samhällena Darwin och Goose Green. Anfallande styrka är brittiska, 2 Paras, på plats och försvarsgrupperade är Taskforce Mercedes. Britterna vinner slutligen över en numerärt överlägsen och försvarsgrupperad argentinsk styrka. Hur kommer det sig att detta kan ske? Jag kommer, för att kunna besvara mina frågeställningar, i det här självständiga arbetet att med utgång i de grundläggande förmågorna, ledning, verkan, skydd, rörlighet, uthållighet och und/info, analysera slaget. Dessa frågeställningar är:</p><p> - Vilken av de grundläggande förmågorna var avgörande för 2 Paras seger?</p><p>- Vilken av de grundläggande förmågorna var avgörande för Taskforce Mercedes förlust?</p><p>Jag har kommit fram till följande; britterna kunde tack vare en kombination av förmågorna ledning och verkan avgöra striden till deras fördel. För argentinarna var det förmågan ledning som bäddade för deras förlust. Vill du veta hur jag kommit fram till detta och varför uppmanar jag dig att läsa detta arbete.</p> / <p>My name is Nicklas Nilsson. I’m a cadet studying at the Swedish Land warfare Centre. As a part of becoming a commissioned officer I’m obligated to write an essay at fundamental level. I have written about the Battle for Darwin – Goose Green. A battle between 2 Para and Taskforce Mercedes. I have used (de grundläggande förmågorna) six fundamental abilities as an analysis instrument. The questions I am going to answer with this essay are:</p><p> -What ability was decisive for 2 Para’s victory?</p><p>-What ability was decisive for Taskforce Mercedes defeat?</p><p> Initially I will conduct a literature study, followed by a comparative case study.</p><p>I have come to the following conclusions:</p><p>The Argentines lost due to their lack of a good leadership and</p><p>The British won due to the abilities, better trained, better motivated and with more experience. They also, contrary to the Argentines, had leaders that was present and tried to resolve the situations they’ve gotten in to. If you want to read more about this and how I’ve come to these conclusions, please read this essay.</p>
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"En stridsplan överlever sällan första stridskontakt" : Slaget om Darwin – Goose GreenNilsson, Nicklas January 2009 (has links)
Den 26 maj 1982 påbörjas anfallet mot samhällena Darwin och Goose Green. Anfallande styrka är brittiska, 2 Paras, på plats och försvarsgrupperade är Taskforce Mercedes. Britterna vinner slutligen över en numerärt överlägsen och försvarsgrupperad argentinsk styrka. Hur kommer det sig att detta kan ske? Jag kommer, för att kunna besvara mina frågeställningar, i det här självständiga arbetet att med utgång i de grundläggande förmågorna, ledning, verkan, skydd, rörlighet, uthållighet och und/info, analysera slaget. Dessa frågeställningar är: - Vilken av de grundläggande förmågorna var avgörande för 2 Paras seger? - Vilken av de grundläggande förmågorna var avgörande för Taskforce Mercedes förlust? Jag har kommit fram till följande; britterna kunde tack vare en kombination av förmågorna ledning och verkan avgöra striden till deras fördel. För argentinarna var det förmågan ledning som bäddade för deras förlust. Vill du veta hur jag kommit fram till detta och varför uppmanar jag dig att läsa detta arbete. / My name is Nicklas Nilsson. I’m a cadet studying at the Swedish Land warfare Centre. As a part of becoming a commissioned officer I’m obligated to write an essay at fundamental level. I have written about the Battle for Darwin – Goose Green. A battle between 2 Para and Taskforce Mercedes. I have used (de grundläggande förmågorna) six fundamental abilities as an analysis instrument. The questions I am going to answer with this essay are: -What ability was decisive for 2 Para’s victory? -What ability was decisive for Taskforce Mercedes defeat? Initially I will conduct a literature study, followed by a comparative case study. I have come to the following conclusions: The Argentines lost due to their lack of a good leadership and The British won due to the abilities, better trained, better motivated and with more experience. They also, contrary to the Argentines, had leaders that was present and tried to resolve the situations they’ve gotten in to. If you want to read more about this and how I’ve come to these conclusions, please read this essay.
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