Search results

The purpose of this paper is to examine an essential component of enacting an improvement network: facilitation. In it, the author surfaces synthesizing as a core, power-laden facilitation practice that brought together network members from disparate institutions to converge on a shared network aim and theory of improvement.

This study is situated within a teacher preparation improvement network. Forty-four teacher educators from seven university-based teacher preparation programs participated in the network. Guided by practice theory (Feldman and Orlikowski, 2011), the author collected and analyzed network meetings and artifacts to unveil facilitation practices and their relation to power.

Synthesizing emerged as a central facilitation practice. Facilitators' engagement in this practice produced power by constraining and enabling how network members participated. Finally, facilitators were systematically and advantageously positioned to prioritize some network members' perspectives while peripheralizing others'.

This paper offers a concrete, detailed window into a core facilitation practice in a network and problematizes it to enable network leaders to be deliberate about facilitation decisions.

Facilitation is a central component of effective networks (Rincón-Gallardo and Fullan, 2016) and is considered central to the work of networked improvement (Bryk et al., 2015), but there exists a dearth of research that offers insights into how facilitation comes to be enacted in practice. This study offers detailed insights into one such facilitation practice.

A method to engage salient organisational stakeholders in identifying and ranking measures of healthcare improvement programs is described. The method is illustrated using Executive WalkRounds (EWRs) in a multi-site Australian Health District.

Subject matter experts (SMEs) conducted document analysis, identified potential EWRs measures, created driver diagrams and then eliminated weak measures. Next, a panel of executives skilled in EWRs ranked and ratified the potential measures using a modified Delphi technique.

EWRs measurement selection demonstrated the feasibility of the method. Of the total time to complete the method 79% was contributed by SMEs, 14% by administration personnel and 7% by executives. Document analysis revealed three main EWRs aims. Ten of 28 potential measures were eliminated by the SME review. After repeated Delphi rounds the executive panel achieved consensus (75% cut-off) on seven measures. One outcome, one process and one implementation fidelity metric were selected to measure and monitor the impact of EWRs in the health district.

Perceptions of weak relationships between measures and intended improvements can lead to practitioner scepticism. This work offers a structured method to combine the technical expertise of SMEs with the practical knowledge of healthcare staff in selecting improvement measures.

This research describes and demonstrates a novel method to systematically leverage formal and practical types of expertise to select measures that are strongly linked to local quality improvement goals. The method can be applied in diverse healthcare settings.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.

The purpose of this paper is to improve the quality of monitoring of risk factors that predict the likelihood of people with severe mental illness (SMI) developing cardiovascular disease (CVD), diabetes and obesity, major contributors to poor physical health and risk of premature mortality.

The first phase of the AQuA “Don’t just screen-intervene” initiative supported five specialised community-based Early Intervention for Psychosis services in North West England to assess the effectiveness of monitoring of cardiometabolic risk in their patients using standards derived from the Lester Positive Cardiometabolic Health Resource, a nationally acknowledged framework for people with psychosis receiving antipsychotic medication. The initial findings formed the basis for a quality improvement programme which ran from November 2012 until May 2013.

By the end of a six month quality improvement programme the likelihood of a patient receiving a comprehensive cardiometabolic risk screening (evidenced by recorded measurement of body mass index or waist circumference, blood pressure, blood glucose and lipid profile, assessment of smoking status and enquiry of relevant family history) had increased from 10 to between 63 and 80 per cent.

Cardiometabolic risk monitoring from the onset of psychosis and its treatment can be improved utilising quality improvement methodology in real-world specialist mental health services. Earlier identification and treatment of risk factors that predict higher rates of obesity, diabetes and SMI may help people with SMI avoid life-restricting and life-shortening physical disorders.

Given the National Audit of Schizophrenia findings of inadequate screening in those with established SMI alongside evidence that CVD risk can emerge early in the course of psychosis, a group of early intervention in psychosis services in North West England decided to examine this aspect of their routine clinical practice. This service evaluation describes the effectiveness of a quality improvement programme based on the Lester Positive Cardiometabolic Health Resource (referred to as Lester resource henceforth) to improve the effectiveness of monitoring of risk factors that predict the likelihood of people experiencing psychosis and schizophrenia developing CVD diabetes and obesity.

A combination of social disadvantage and unhealthy lifestyles, adverse cardiometabolic impacts of antipsychotic medication and inequitable access to physical healthcare combine to put people with SMI at particular risk from CVD, the single biggest cause of premature death, and much more common than suicide (Brown et al., 2010). Despite higher rates of potentially modifiable CVD risk factors (De Hert et al., 2009) people with SMI appear to be missing out on opportunities to actively prevent conditions like CVD and diabetes compared to the general population.

People with SMI such as schizophrenia die 15-20 years earlier on average than the general population. Around 20 per cent of premature deaths can be explained by suicide and injury, but the remainder arise from a variety of natural causes such as CVD, chronic obstructive pulmonary disorder and certain cancers and infections (Nordentoft et al., 2013). The authors worked with five mental health trusts in the North West of England covering a sample of over 500 cases within early intervention services.

This study aims to recognize the significant barriers of small and medium-sized enterprises (SMEs) in Bangladesh, hindering the adoption of total quality management (TQM). Additionally, this research intends to explore the interrelations among these barriers to develop essential managerial insights for promoting TQM implementation in SMEs.

The interpretive structural modeling (ISM) approach and Matrice d'impacts croisés multiplication appliquée á un classment (MICMAC) a cross-impact matrix multiplication applied to classification show the relationship among the barriers and classification of the barriers to TQM implementation respectively, and partial least squares structural equation modeling (PLS-SEM) is applied for ISM model validation.

This study examined previous literature and conducted interviews with professionals to identify 17 barriers. The study then develops and investigates a model that outlines the relationships and priorities among these barriers and categorizes them based on their impact and interdependence. This analysis can assist SMEs in implementing TQM during their operations successfully.

This research emphasizes the crucial obstacles that greatly affect other barriers and require immediate attention. Furthermore, this study provides valuable information for SMEs to effectively prioritize their resources and efforts to overcome these obstacles.

This study delves into the primary obstacles impeding the integration of TQM in SMEs through a novel approach. Additionally, this study constructs a verified contextual framework that depicts the hierarchies and interconnections among these barriers.

Lack of appropriate student support and drawbacks in academic progression signify the importance of enhancing assessment and feedback in higher education (HE). Although assessment and feedback are significant in HE, minimal empirical research holistically explores the best practices. This study aims to address the niche and develop a decisive guideline for enhancing assessment setting and feedback provision within HE curricula.

A systematic approach was taken to obtain data for the study: a literature review underpinning the thematic content analysis of study documents, followed by semi-structured interviews. Document analysis contained mid-module reviews/student feedback; rubrics used in assessment; and formative/summative feedback provided for the graded work. Documental analysis informed the key attributes of the semi-structured interview. Interpretive structural modelling (ISM) analysis identified the influence and reliance of each driver.

This study revealed 15 drivers – 4 fundamental, 6 significant and 5 important – for enhancing assessment and feedback. The level partitioning from the ISM analysis established that all assessment and feedback needs to be underpinned by the university policy and fed into the assessment regime and marking scheme. This study identified that National Student Survey results were significantly improved due to implementing said drivers compared with the national and sector benchmarks.

The developed drivers enable the best practices in assessment setting and feedback provision. The level partition diagram can be used as a decisive guideline or a provisional framework in assessment and feedback provision for quality assurance in HE.

This study is one of, if not the only, to develop a guideline for signposting drivers and their influence and reliance to enhance assessment and feedback in a holistic HE setting. The developed drivers and the level partition diagram bring novelty and add to the current body of knowledge.

This study aims to explore the chicken and egg paradox in the taxi e-hailing business contributing to define a condition of system emergence. This paradox is a meaningful one as these platforms represent a system where the passengers systems have no reason to participate if they have no drivers-systems to answer their call, but, at the same time, the platform is not useful to the drivers-system if there are no passengers-systems using the platform.

To understand how this paradox has been dealt with in the taxi e-hailing business, this study focused on a case study on a best practice in Italian taxi e-hailing industry (i.e. MyTaxi/FreeNow). This study wants to comprehend which actions have been implemented to solve this paradox and has tried to identify the interconnections between the various strategies to create a closed loop diagram for further testing.

This study has found that the company did not choose a single “subsystem” (passenger or driver), but it has stimulated the creation of several mutually reinforcing motivation for have both subsystems interact to help the company grow.

To the best of the authors’ knowledge, this paradox has never been studied using the complex adaptive system perspective. This perspective is particularly useful in this case and in the similar ones with several different interacting factors that cannot be really studied without using a higher order perspective.

The purpose of this paper is to investigate the complex interdependence of the factors in driving or hindering construction productivity at the industry, project and activity levels in a systemic manner.

A mixed-methods design, which combines a critical literature review, an interview-based survey with 32 industry experts and five focus group meetings participated in by 109 representatives of a wide range of industry stakeholder groups, was employed to identify the drivers for and constraints on construction productivity enhancement in Hong Kong and explore the interrelated insights into the drivers and constraints.

The study conceptualised and validated a systemic framework for examining construction industry productivity, and developed three causal loop diagrams (CLDs) for illustrating the dynamic structures that underpin the complex systems of the drivers and constraints.

Although the scope of the study was limited to Hong Kong, the results could be interpreted for critical learning in other urban contexts.

The systemic perspective of construction productivity and the CLDs of the drivers and constraints support the systems thinking of industry stakeholders in the formulation of holistic strategies for long-term construction industry productivity enhancement.

The study conceptualises construction productivity from a systemic perspective and provides empirically supported CLDs to facilitate future investigations into the complex system of construction productivity.

The Indian marble and stone industry has got the potential to contribute well to the development of the emerging economy. However, unlike the other Indian industries, stone and marble industries are highly underrated sectors, which may become a critical factor for development. This paper analyses the sustainability factors in supply chain management practices.

A literature review is used to identify the barriers and drivers in sustainable supply chain management practices. Interpretive structural modeling has been used to obtain a hierarchy of barriers and drivers along with driving power and dependence power analysis. Further, MICMAC analysis is used for segregating the barriers and drivers in terms of their impact on sustainability.

The findings of the work of this research are that the attention of society, government, and commercial banks should be more toward the unorganized condition of stone and marble sector. There should be an increase in the commitment of stakeholders to reduce pollution and install safety, by enforcing more relevant laws and regulations and creating the importance of environmental awareness.

The main contribution of this research is to identify the barriers and drivers of sustainable supply chain management in a stone and marble industry. The paper proposes a sound mathematical model to prioritize the critical factors for responsible production and consumption of resources from sustainability perspectives of stone industry.

The aim of this study is to evaluate Big Data Analytics (BDA) drivers in the context of food supply chains (FSC) for transition to a Circular Economy (CE) and Sustainable Operations Management (SOM).

Ten different BDA drivers in FSC are examined for transition to CE; these are Supply Chains (SC) Visibility, Operations Efficiency, Information Management and Technology, Collaborations between SC partners, Data-driven innovation, Demand management and Production Planning, Talent Management, Organizational Commitment, Management Team Capability and Governmental Incentive. An interpretive structural modelling (ISM) methodology is used to indicate the relationships between identified drivers to stimulate transition to CE and SOM. Drivers and pair-wise interactions between these drivers are developed by semi-structured interviews with a number of experts from industry and academia.

The results show that Information Management and Technology, Governmental Incentive and Management Team Capability drivers are classified as independent factors; Organizational Commitment and Operations Efficiency are categorized as dependent factors. SC Visibility, Data-driven innovation, Demand management and Production Planning, Talent Management and Collaborations between SC partners can be classified as linkage factors. It can be concluded that Governmental Incentive is the most fundamental driver to achieve BDA applications in FSC transition from linearity to CE and SOM. In addition, Operations Efficiency, Collaborations between SC partners and Organizational Commitment are key BDA drivers in FSC for transition to CE and SOM.

The interactions between these drivers will provide benefits to both industry and academia in prioritizing and understanding these drivers more thoroughly when implementing BDA based on a range of factors. This study will provide valuable insights. The results from this study will help in drawing up regulations to prevent food fraud, implementing laws concerning government incentives, reducing food loss and waste, increasing tracing and traceability, providing training activities to improve knowledge about BDA and focusing more on data analytics.

The main contribution of the study is to analyze BDA drivers in the context of FSC for transition to CE and SOM. This study is unique in examining these BDA drivers based on FSC. We hope to find sustainable solutions to minimize losses or other negative impacts on these SC.