scholarly journals What risks to sustainability are identified throughout care bundle implementation and how can they be addressed? A mixed methods case study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048815
Author(s):  
Laura Lennox ◽  
Linda Eftychiou ◽  
Dionne Matthew ◽  
Jackie Dowell ◽  
Trish Winn
Keyword(s):  
Business Case ◽  
Care Bundle ◽  
Optimal Care ◽  
Care Bundles ◽  
Mixed Methods Case Study ◽  
Documentary Analysis ◽  
Treat Heart Failure ◽  
Sustainability Challenges ◽  
Long Term Impact

ObjectivesDespite national guidance on how to identify and treat heart failure (HF), variation in HF care persists across UK hospitals. Care bundles have been proposed as a mechanism to deliver reliable optimal care for patients; however, specific challenges to sustain care bundles in practice have been highlighted. With few studies providing insight into how to design or implement care bundles to optimise sustainability, there is little direction for practitioners seeking to ensure long-term impact of their initiatives. This study explores the sustainability risks encountered throughout the implementation of a HF care bundle (HFCB) and describes how these challenges were addressed by a multidisciplinary team (MDT) to enhance sustainability over time.DesignA longitudinal mixed method case study examined the HFCB improvement initiative from September 2015 to August 2018. A standardised sustainability tool was used to collect perceptions of sustainability risks and actions throughout the initiative. Observations, key-informant interviews and documentary analysis were conducted to gain in-depth understanding of how the MDT influenced sustainability through specific actions. A qualitative database was developed using a consolidated sustainability framework to conduct thematic analysis. Sustainability outcomes were explored 1-year post funding to ascertain progress towards sustainment.ResultsThe MDT identified six sustainability challenges for the HFCB: infrastructure limitations, coding reliability, delivery consistency, organisational fit, resource stability and demonstrating impact. The MDT undertook multiple actions to enhance sustainability, including: (1) developing a business case to address infrastructure limitations; (2) incorporating staff feedback to increase bundle usability; (3) establishing consistent training; (4) increasing reliability of baseline data; (5) embedding monitoring and communication; and (6) integrating the bundle into current practices.ConclusionThrough the description of challenges, actions and learning from the MDT, this study provides practical lessons for practitioners and researchers seeking to embed and sustain care bundles in practice.

scholarly journals The Rise of Emergent Corporate Sustainability: A Self-Organised View

Systems ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 35
Author(s):  
Roger Maitland ◽  
Walter Baets
Keyword(s):  
Mixed Methods ◽  
Financial Services ◽  
Corporate Sustainability ◽  
Evolutionary Process ◽  
Ecological Systems ◽  
Mixed Methods Case Study ◽  
Sustainability Challenges ◽  
Climate Crisis

Escalating climate crisis activism highlights the potential of self-organised approaches in sustainability to address the disconnect between corporate sustainability activities and globally declining ecological systems. This paper argues that corporate sustainability is a co-evolutionary process of emergence which may enable organisations to address this disconnect by creating a context supportive of emergence within the organisation rather than reacting to pressures from outside. An exploratory mixed-methods case study was used to explore how corporate sustainability emerged in two financial services institutions. This article develops the idea of corporate sustainability as a co-evolutionary process of emergence and presents a framework to assist organisations to cultivate sustainability. It adopts a complexity view and posits that reductionism associated with Newtonian thinking has contributed to the sustainability issues faced by humanity. This study suggests that the paradigmatic assumptions that have contributed to the sustainability crisis must be interrogated to create an environment which is conducive to the emergence of corporate sustainability. Through examining corporate sustainability as an emergent process, this paper sheds light on how businesses can foster conditions in which a self-organised response to sustainability challenges is distributed across the organisation whilst being embedded in the containing system.

Disability in the Australian workplace: corporate governance or CSR issue?

2017 ◽  
Vol 36 (3) ◽  
pp. 206-221 ◽  
Author(s):  
Belinda Rachael Williams
Keyword(s):  
Corporate Governance ◽  
Gender Diversity ◽  
Business Case ◽  
Workplace Diversity ◽  
Case Study Methodology ◽  
Content Type ◽  
Documentary Analysis ◽  
Current State ◽  
Study Methodology

Purpose The purpose of this paper is to determine the current state of play for workplace diversity disclosures, specifically disability by investigating the recently revised Australian Securities Exchange (ASX) Corporate Governance Principles and Recommendations. Design/methodology/approach Case study methodology using documentary analysis techniques. Findings With gender diversity recommendations introduced in 2010 based on the business case perspective, the process of revising the ASX Corporate Governance Principles and Recommendations provided an opportunity for the ASX to expand its diversity focus, with disability diversity specifically identified in the draft third edition. However, the key amendments were subsequently removed when the approved edition was released in 2014 with justification provided on the grounds that disability is a social issue, not a corporate governance issue. Through a widening of the corporate governance lens beyond the business case perspective, this paper calls for a re-imagining of corporate governance to incorporate an ethical viewpoint on diversity. Social implications Disability diversity disclosure is merely the first step towards reform in helping to bring about deep change within organisations. Without both administrative reform and institutional reform, any future revisitation of the disability disclosure recommendations may become little more than a “tick the box” approach. Originality/value The paper is unique in reviewing the ASX Corporate Governance developmental processes towards workplace disability in its recently revised edition.

scholarly journals Why do stroke survivors not receive recommended amounts of active therapy? Findings from the ReAcT study, a mixed-methods case-study evaluation in eight stroke units

2018 ◽  
Vol 32 (8) ◽  
pp. 1119-1132 ◽  
Author(s):  
David J Clarke ◽  
Louisa-Jane Burton ◽  
Sarah F Tyson ◽  
Helen Rodgers ◽  
Avril Drummond ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Information Exchange ◽  
Patient Specific ◽  
Guideline Recommendation ◽  
Structured Interviews ◽  
Stroke Units ◽  
Mixed Methods Case Study ◽  
Documentary Analysis ◽  
Study Evaluation

Objective: To identify why the National Clinical Guideline recommendation of 45 minutes of each appropriate therapy daily is not met in many English stroke units. Design: Mixed-methods case-study evaluation, including modified process mapping, non-participant observations of service organisation and therapy delivery, documentary analysis and semi-structured interviews. Setting: Eight stroke units in four English regions. Subjects: Seventy-seven patients with stroke, 53 carers and 197 stroke unit staff were observed; 49 patients, 50 carers and 131 staff participants were interviewed. Results: Over 1000 hours of non-participant observations and 433 patient-specific therapy observations were undertaken. The most significant factor influencing amount and frequency of therapy provided was the time therapists routinely spent, individually and collectively, in information exchange. Patient factors, including fatigue and tolerance influenced therapists’ decisions about frequency and intensity, typically resulting in adaptation of therapy rather than no provision. Limited use of individual patient therapy timetables was evident. Therapist staffing levels were associated with differences in therapy provision but were not the main determinant of intensity and frequency. Few therapists demonstrated understanding of the evidence underpinning recommendations for increased therapy frequency and intensity. Units delivering more therapy had undertaken patient-focused reorganisation of therapists’ working practices, enabling them to provide therapy consistent with guideline recommendations. Conclusion: Time spent in information exchange impacted on therapy provision in stroke units. Reorganisation of therapists’ work improved alignment with guidelines.

scholarly journals Työuupumuksesta toipumisen yksilölliset polut

Kuntoutus ◽  
2021 ◽  
Vol 39 (4) ◽  
pp. 4-16
Author(s):  
Heli Siltala ◽  
Anne Mäkikangas ◽  
Marja Hätinen ◽  
Ulla Kinnunen ◽  
Mika Pekkonen
Keyword(s):  
Mixed Methods ◽  
Recovery Process ◽  
Rehabilitation Centre ◽  
Related Factors ◽  
Mixed Methods Case Study ◽  
Rehabilitation Period ◽  
The Individual ◽  
Long Term Impact

Tutkimuksen tarkoituksena oli selvittää työuupumuksesta toipumisen kehityspolkuja ja näihin yhteydessä olevia tekijöitä 1,5 vuoden seurannan aikana. Erityisenä kiinnostuksen kohteena oli toimijuus ja sen rakentumisen yhteys työuupumuksesta toipumiseen. Tutkimusaineisto koostui Kuntoutus Peurungan Virveli-kuntoutuskursseille osallistuneista ja kuntoutuksesta lähtökohtaisesti hyötyneistä henkilöistä (n = 9). Kyseessä on tapaustutkimus, jossa näiden henkilöiden toipumisprosessia tutkittiin monipuolisesti sekä haastattelun että kyselyiden avulla. Tulokset osoittivat, että monet työympäristöön liittyvät tekijät olivat yhteydessä toipumisprosessiin, mutta ne eivät yksinään selittäneet sitä, oliko henkilöiden työuupumus uusiutunut vai ei. Aineistosta löydettiin kolme erilaista kehityspolkua, jotka olivat ”työuupumuksesta toipuneet”, ”uudestaan uupuneet” ja ”kovia kokeneet, mutta positiiviseen keskittyvät”. Kuntoutujien toipumispolkuun näyttäisi tämän tutkimuksen perusteella olevan yhteydessä heidän kokemansa henkilökohtainen toimijuus, joka ilmeni erityisesti uskona omaan pärjäämiseen kuntoutusjakson lopussa. Näihin tekijöihin olisikin hyvä kiinnittää huomiota sekä jatkotutkimuksissa että työuupumusinterventioiden kehitystyössä, jotta kuntoutuksen vaikuttavuutta voitaisiin tehostaa. Abstract The individual recovery paths from job burnout: a mixed methods case study on the long-term impact of a rehabilitation intervention The purpose of this study was to examine the developmental paths of burnout recovery and factors associated with it during a 1.5-year follow-up period. A special interest of the study was in agency and whether it is connected to burnout recovery. The study sample (n = 9) included people, who had benefitted from a rehabilitation period arranged earlier in Peurunka Rehabilitation Centre. This research was a case study, which was basedon data collected by interviews and questionnaires in analyzing the recovery process of the participants. Analysis showed that many job-related factors were connected to the recovery process, but none of them was able to explain alone whether participants’ burnout had relapsed or not. Three different recovery paths were found among the sample: ”recovered participants”, ”relapsed participants” and ”participants with difficult experiences but positive mindset”. The results indicate that the personal agency of the people participating in rehabilitation is connected to their recovery paths. Agency was manifested, for example, in participants’ self-efficacy estimates at the end of the rehabilitation period. These factors should be paid more attention in future studies as well as in developing burnout interventions in order to improve the effectiveness of burnout rehabilitation. Keywords: burnout, rehabilitation, agency, follow-up study, mixed methods

Blockchain in Supply Chain: Case Study of Lottemart Ciputat

2019 ◽  
Vol 5 (1) ◽  
pp. 38-49 ◽  
Author(s):  
B. K. Handoyo ◽  
M. R. Mashudi ◽  
H. P. Ipung
Keyword(s):  
Decision Making ◽  
Supply Chain ◽  
Supply Chain Management ◽  
Information Asymmetry ◽  
New Technology ◽  
Business Case ◽  
Analysis Method ◽  
Chain Management ◽  
Production Processes

Current supply chain methods are having difficulties in resolving problems arising from the lack of trust in supply chains. The root reason lies in two challenges brought to the traditional mechanism: self-interests of supply chain members and information asymmetry in production processes. Blockchain is a promising technology to address these problems. The key objective of this paper is to present qualitative analysis for blockchain in supply chain as the decision-making framework to implement this new technology. The analysis method used Val IT business case framework, validated by the expert judgements. The further study needs to be elaborated by either the existing organization that use blockchain or assessment by the organization that will use blockchain to improve their supply chain management.

Toying With Engineering: Teaching Engineers to Be Entrepreneurial by Developing a Toy

2021 ◽  
pp. 251512742110290
Author(s):  
Smitesh Bakrania
Keyword(s):  
Engineering Students ◽  
Business Case ◽  
Stem Fields ◽  
The Past ◽  
Middle Schoolers ◽  
Assembly Instructions ◽  
Design Projects ◽  
Product Assembly ◽  
Engineering Concept

Most engineering design projects focus primarily on the engineering fundamentals. Studying the business case or manufacturability of a design is often left for other courses, if at all. To address this gap, an existing mechanical engineering course project was modified by embedding the interdependent entrepreneurial dimensions. In the past, junior engineering students developed a reciprocating air engines over two semesters. The modified project extended the engineering fundamentals into an entrepreneurial venture. To accomplish this, students were asked to propose an air engine toy for middle schoolers. The proposed toy had to be assembled, provide a learning opportunity, and demonstrate utility. The students had to ensure the product appealed to those interested in the STEM fields. The students, working in groups, created renders of the final product, assembly instructions, and a guided worksheet for the kids to explore the underlying engineering concept. The groups produced a website with a video pitching their toy concepts. This case study exemplifies how any engineering endeavor can be modified to capture a more holistic simulation of the profession.

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