scholarly journals Ensuring successful implementation of communication-and-resolution programmes

2020 ◽  
Vol 29 (11) ◽  
pp. 895-904 ◽  
Author(s):  
Michelle M Mello ◽  
Stephanie Roche ◽  
Yelena Greenberg ◽  
Patricia Henry Folcarelli ◽  
Melinda Biocchi Van Niel ◽  
...  
Keyword(s):  
Improve Patient Safety ◽  
Project Managers ◽  
Collaborative Group ◽  
Successful Implementation ◽  
Full Time ◽  
Study Staff ◽  
Liability Costs ◽  
Implementation Progress ◽  
Injured Patients ◽  
Risk Managers

BackgroundCommunication-and-resolution programmes (CRP) aim to increase transparency surrounding adverse events, improve patient safety and promote reconciliation by proactively meeting injured patients’ needs. Although early adopters of CRP models reported relatively smooth implementation, other organisations have struggled to achieve the same. However, two Massachusetts hospital systems implementing a CRP demonstrated high fidelity to protocol without raising liability costs.Study questionWhat factors may account for the Massachusetts hospitals’ ability to implement their CRP successfully?SettingThe CRP was collaboratively designed by two academic medical centres, four of their community hospitals and a multistakeholder coalition.Data and methodsData were synthesised from (1) key informant interviews around the time of implementation and 2 years later with individuals important to the CRP’s success and (2) notes from 89 teleconferences between hospitals’ CRP implementation teams and study staff to discuss implementation progress. Interview transcripts and teleconference notes were analysed using standard methods of thematic content analysis. A total of 45 individuals participated in interviews (n=24 persons in 38 interviews), teleconferences (n=32) or both (n=11).ResultsParticipants identified facilitators of the hospitals’ success as: (1) the support of top institutional leaders, (2) heavy investments in educating physicians about the programme, (3) active cultivation of the relationship between hospital risk managers and representatives from the liability insurer, (4) the use of formal decision protocols, (5) effective oversight by full-time project managers, (6) collaborative group implementation, and (7) small institutional size.ConclusionAlthough not necessarily causal, several distinctive factors appear to be associated with successful CRP implementation.

scholarly journals Implementation of a Female External Urinary Catheter Reduces Indwelling Urinary Catheter Use and Catheter-Associated Urinary Tract Infections

2020 ◽  
Vol 41 (S1) ◽  
pp. s482-s483
Author(s):  
Paul Gentile ◽  
Jesse Jacob ◽  
Shanza Ashraf
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Improve Patient Safety ◽  
Academic Medical Center ◽  
Secondary Outcome ◽  
Successful Implementation ◽  
Urinary Catheters ◽  
Tract Infections ◽  
The Impact

Background: Using alternatives to indwelling urinary catheters plays a vital role in reducing catheter-associated urinary tract infections (CAUTIs). We assessed the impact of introducing female external catheters on urinary catheter utilization and CAUTIs. Methods: In a 500-bed academic medical center, female external catheters were implemented on October 1, 2017, with use encouraged for eligible females with urinary incontinence but not meeting other standard indications for urinary catheters. Nurses were educated and trained on female external catheter application and maintenance, and infection prevention staff performed surveillance case reviews with nursing and medical staff. We determined the number of catheter days for both devices based on nursing documentation of device insertion or application, maintenance, and removal. We used the CAUTI and DUR (device utilization ratio) definitions from the CDC NHSN. Our primary outcomes were changes in DUR for both devices 21 months before and 24 months after the intervention in both intensive care units (ICUs) and non-ICU wards. We used a generalized least-squares model to account for temporal autocorrelation and compare the trends before and after the intervention. Our secondary outcome was a reduction in CAUTIs, comparing females to males. Results: In total, there were 346,213 patient days in 35 months. The mean rate of patient days per month increased from 7,436.4 to 7,601.9 after the implementation of female external catheters, with higher catheter days for both urinary catheters (18,040 vs 19,625) and female external catheters (22 vs 12,675). After the intervention, the DUR for female external catheters increased (0 vs 0.07; P < .001) and for urinary catheters the DUR decreased (0.12 vs 0.10; P < .001) (Fig. 1). A reduction in urinary catheter DUR was observed in ICUs (0.29 vs 0.27; P < .001) but not wards (0.08 vs 0.08; P = NS) (Fig. 2). Of the 39 CAUTIs, there was no significant overall change in the rate per 1,000 catheter days (1.22 vs 0.87; P = .27). In females (n = 20 CAUTI), there was a 61% reduction in the CAUTI rate per 1,000 catheter days (0.78 vs 0.31; P = .02), but no significant change in the rate in males (0.44 vs 0.56; P = .64). The CAUTI rate per 1,000 catheter days among females decreased in the ICUs (1.14 vs 0.31; P = .04) but not in wards (0.6 vs 0.33; P = .96). Conclusions: In a setting with a baseline low UC DUR, successful implementation of female external catheters further modestly reduced UC DUR and was associated with a 61% decrease in CAUTI among females in the ICU but not in wards. Further interventions to better identify appropriate patients for female external catheters may improve patient safety and prevent patient harm.Funding: NoneDisclosures: None

Factors influencing success among collaborative sage-grouse management groups in the western United States

2010 ◽  
Vol 37 (3) ◽  
pp. 250-260 ◽  
Author(s):  
LORIEN R. BELTON ◽  
DOUGLAS JACKSON-SMITH
Keyword(s):  
Early Stage ◽  
Collaborative Group ◽  
Successful Implementation ◽  
Sage Grouse ◽  
Implementation Success ◽  
Management Plans ◽  
Collaborative Conservation ◽  
Process Factors ◽  
Group Success ◽  
The Impact

SUMMARYConsiderable efforts have been put into collaborative conservation efforts across the globe. In the western USA, concern about declines of two sage-grouse species (Centrocercus urophasianus and C. minimus) has led to the creation of over 60 collaborative wildlife management partnership groups to develop and implement local sage-grouse management plans. These sage-grouse local working groups (LWGs) share a common goal, information, and policy environment, but were implemented in diverse ways. As a result, they provide a rare opportunity to study systematically the impact of contextual, organizational, institutional and process factors on local collaborative group success. Data from document reviews and an extensive survey of over 700 group participants from 53 sage-grouse LWGs were used to assess the success of this collaborative conservation effort and identify those group attributes that were related to successful implementation and funding of projects. Specifically, external, internal and emergent group characteristics were considered as likely predictors of LWG implementation success. The LWGs varied broadly in their achievements. The presence of a neutral facilitator, participants' feelings of ownership, groups whose local plans had more authority and early-stage group successes were significantly related to implementation success at the group level.

scholarly journals Requirements Engineering: An Industrial Survey in the Gulf Cooperation Council Countries

2021 ◽  
pp. 107-129
Author(s):  
A. Alzayed ◽  
Keyword(s):  
Software Development ◽  
Requirements Engineering ◽  
United Arab Emirates ◽  
Gulf Cooperation Council ◽  
Project Managers ◽  
The State ◽  
Successful Implementation ◽  
Software Projects ◽  
Gcc Countries ◽  
Software Practitioners

Requirements engineering (RE), the process of defining the requirements of a system, is critical to the successful implementation of software projects. Although many studies have been globally conducted on the different facets of RE in software engineering, studies explicitly focusing on the countries of the Gulf Cooperation Council (GCC) have been scarce. GCC-specific RE research studies are needed because of the unique cultural characteristics and common work ethics in GCC countries. Besides, the investigation of the state of RE practices in the countries of the GCC is crucial as the globalization of software development becomes imminent. This study compares the state of RE practices within the six countries of the GCC, namely, the Kingdom of Saudi Arabia (KSA), the United Arab Emirates (UAE), Qatar, Kuwait, Bahrain, and Oman, using six RE factors. To understand commonalities and differences in the RE practices and methods, 163 software practitioners in GCC countries are surveyed in this study. The results show that the RE practices are relatively similar among the six countries, with subtle differences. Initiating software-related projects with unclear requirements and undefined project scopes are the two major limitations of the RE practices among the survey participants. The results of this study contribute to providing project managers and system analysts, who are working globally and within the GCC countries, with valuable decision-making tools to help them consider the identified RE techniques, methods, and challenges and their related risks early in their software development projects

scholarly journals Organizational culture and project management methodology: research in the financial industry

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Katarzyna Piwowar-Sulej
Keyword(s):  
Organizational Culture ◽  
Project Management ◽  
Significant Relationship ◽  
Project Managers ◽  
Future Research ◽  
Successful Implementation ◽  
Financial Industry ◽  
Dominant Type ◽  
Content Type ◽  
Project Characteristics

PurposeOrganizational culture has an impact on various activities in organizations, including project management (PM). The aim of the study is to answer the following research questions: RQ1: what significance is attributed to organizational culture compared to the objective project characteristics when choosing the dominant PM methodology in organizations? RQ2: which type of organizational culture is preferred for successful implementation of different PM methodologies? RQ3: what kind (if any) of relationship exists between the dominant type of organizational culture in organizations and the dominant PM methodology?Design/methodology/approachThe author surveyed 100 project managers working in the financial industry in Poland with the use of personal structured interviews. The competing values framework (CVF) concept authored by Cameron and Quinn was used.FindingsProject managers find organizational culture more important than objective project characteristics when choosing the dominant PM methodology in an organization. Although statistical analysis revealed a significant relationship between the preferred type of organizational culture and PM methodology, there is no significant relationship between the existing type of organizational culture and the PM methodology which prevails in the company.Research limitations/implicationsFuture research should investigate other industries and other typologies of organizational culture.Practical implicationsThe paper provides recommendations for management practice on how to shape organizational culture in the context of successful PM with the application of different PM methodologies.Originality/valueThis study fills a gap in the theory of PM by identifying and empirically verifying the theoretical linkage between the type of organizational culture and PM methodology.

Factors affecting the ERP implementation in Indian retail sector

2015 ◽  
Vol 22 (7) ◽  
pp. 1315-1340 ◽  
Author(s):  
Poonam Garg ◽  
Ajay Chauhan
Keyword(s):  
Project Management ◽  
Theoretical Model ◽  
Project Managers ◽  
Equation Modeling ◽  
Successful Implementation ◽  
Retail Sector ◽  
Affecting Factors ◽  
Erp Implementation ◽  
Content Type ◽  
Team Members

Purpose – The purpose of this paper is to make an effort in identifying and exploring the factors which may affect the success of ERP implementation in Indian retail sector. This paper also analyses the between the factors and their impact on the successful implementation of ERP using the structured equation modeling (SEM) approach. “Organizational,” “Technological,” “People” and “Project Management” are the examined factors. Design/methodology/approach – A theoretical model is created that explains the factors which may affect the success of ERP implementation. Hypotheses were also developed to evaluate the interrelationship between affecting factors and success of ERP implementation. Empirical data is collected through survey questionnaire from practitioner like project sponsors, project managers, implementation consultants and team members who are involved in ERP implementation in retail sector to test the theoretical model. Findings – Using SEM, it is found that 62.7 percent of the variations of ERP implementation success can be explained with the help of the model suggested in the research study. The finding also confirms that there is significant positive interrelationship between “Organizational,” “Technological,” “People,” “Project Management” and success of ERP implementation in Indian retail sector. Research limitations/implications – The research is subject to the normal limitations of survey research. The study is using perceptual data provided by project sponsors, project managers, implementation consultants and team members who are involved in ERP implementation in retail sector, which may not provide clear measures of performance. However, this can be overcome using multiple methods to collect data in future studies. Practical implications – Findings from this paper can provide greater understanding in the area of ERP implementation. This study will provide valuable insights to researchers, practicing managers and those who are planning to implement ERP in retail sector. Originality/value – The study integrates the affecting factor with success of ERP implementation, i.e. “Organizational,” “Technological,” “People” and “Project Management” are the key drivers for the effectiveness and success of ERP implementation in Indian retail sector. Very few studies have been performed to investigate and understand this issue. Therefore, the research can make a useful contribution.

Comparative Analysis of the Factors Contributing to the Successful Implementation of Projects in Russia and EU Countries

2019 ◽  
Vol 8 (1) ◽  
pp. 39-48
Author(s):  
Лилит Керопян ◽  
Lilit Keropyan
Keyword(s):  
Economic Development ◽  
Comparative Analysis ◽  
Research Group ◽  
Negative Impact ◽  
Scientific Work ◽  
Project Managers ◽  
Successful Implementation ◽  
Factors Affecting ◽  
British Research ◽  
The Eu

Currently, rapid economic development successful implementation of projects is necessary for the activities of organizations. In some industries, such as construction, spacecraft production, film production and other, activities are carried out mainly through projects where a failed project can have a large negative impact on such organizations. The study based on the scientific work of the British research group BMG and the results of a survey of project managers in the Skolkovo Innovation Center, allowed to identify and compare the most important factors affecting the successful implementation of projects in the EU and Russia.

scholarly journals Implementation and spread of a simple and effective way to improve the accuracy of medicines reconciliation on discharge: a hospital-based quality improvement project and success story

2019 ◽  
Vol 8 (3) ◽  
pp. e000363 ◽  
Author(s):  
Shady Botros ◽  
John Dunn
Keyword(s):  
Improve Patient Safety ◽  
Successful Implementation ◽  
Patient Harm ◽  
Success Story ◽  
Improvement Project ◽  
Medicines Reconciliation ◽  
Improvement Methodologies ◽  
The Right ◽  
Do The Right Thing ◽  
Improve Patient

BackgroundChanges are often made to medications at times of transitions in care. Inadequate reconciliation during admission, transfer and discharge causes medication errors and increases risks of patient harm. Despite well-established multidisciplinary medicines reconciliation (MR) processes at hospital admission, our MR process at discharge; however, was poor. The main errors included failure to recommence withheld medicines and lack of documentation explaining changes made to medications on discharge. Our objective was to develop an intervention that supports prescribers to follow a simple standardised MR process at discharge to reduce these errors.MethodsWorking closely as a multidisciplinary team, we used improvement methodologies to design and test a process that reliably directs prescribers in surgery to use the inpatient prescribing chart as well as the MR on admission form as sources to create accurate discharge prescriptions. The project was segmented into testing, implementation, spread and sustainability.ResultsThe tested intervention helped the accuracy of discharge prescriptions steadily and quickly improve from 45% to 96% in the pilot ward. Following the successful implementation and sustainability in two separate pilot wards, the intervention was spread to the remaining eight wards producing a similar improvement.ConclusionsTo improve patient safety, it is crucial to ensure that information about medicines is effectively communicated when care is transferred between teams. Although this can be challenging, we’ve shown that it can be done effectively and reliably if this responsibility is equally shared by healthcare professionals from all disciplines while being supported by safe systems that make it easy to do the right thing. Successfully implementing a standardised multidisciplinary MR process at discharge can also reduce the reliance on pharmacists therefore freeing them to undertake other clinical roles.

scholarly journals Aligning Documentation With Congenital Muscular Torticollis Clinical Practice Guidelines: Administrative Case Report

2016 ◽  
Vol 96 (1) ◽  
pp. 111-120 ◽  
Author(s):  
Dennis Gutierrez ◽  
Sandra L. Kaplan
Keyword(s):  
Quality Improvement ◽  
Case Report ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Medical Center ◽  
Successful Implementation ◽  
Full Time ◽  
Congenital Muscular Torticollis ◽  
Muscular Torticollis

Background and Purpose A hospital-based pediatric outpatient center, wanting to weave evidence into practice, initiated an update of knowledge, skills, and documentation patterns with its staff physical therapists and occupational therapists who treat people with congenital muscular torticollis (CMT). This case report describes 2 cycles of implementation: (1) the facilitators and barriers to implementation and (2) selected quality improvement outcomes aligned with published clinical practice guidelines (CPGs). Case Description The Pediatric Therapy Services of St Joseph's Regional Medical Center in New Jersey has 4 full-time, 1 part-time, and 3 per diem staff. Chart audits in 2012 revealed variations in measurement, interventions, and documentation that led to quality improvement initiatives. An iterative process, loosely following the knowledge-to-action cycle, included a series of in-service training sessions to review the basic anatomy, pathokinesiology, and treatment strategies for CMT; reading assignments of the available CPGs; journal review; documentation revisions; and training on the recommended measurements to implement 2 published CPGs and measure outcomes. Outcomes A previous 1-page generic narrative became a 3-page CMT-specific form aligned with the American Physical Therapy Association Section on Pediatrics CMT CPG recommendations. Staff training on the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, classification of severity, type of CMT, prognostication, measures of cervical range of motion, and developmental progression improved documentation consistency from 0% to 81.9% to 100%. Clinicians responded positively to using the longer initial evaluation form. Discussion Successful implementation of both clinical and documentation practices were facilitated by a multifaceted approach to knowledge translation that included a culture supportive of evidence-based practice, administrative support for training and documentation redesign, commitment by clinicians to embrace changes aimed at improved care, and clinical guidelines that provide implementable recommendations.

scholarly journals Lessons from a Successful Implementation of a Computerized Provider Order Entry System

2007 ◽  
Vol 12 (2) ◽  
pp. 102-114
Author(s):  
Brian R. Jacobs ◽  
Craig K. Hallstrom ◽  
Kim Ward Hart ◽  
Daniela Mahoney ◽  
Gayle Lykowski ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Information System ◽  
Improve Patient Safety ◽  
Medical Center ◽  
Regulatory Compliance ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Order Entry ◽  
Specific Patient ◽  
Computerized Provider Order Entry

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success.

scholarly journals Plan-Do-Check-Act Framework: Effects on Pediatric Students Nurses Compliance toward Using Intravenous Smart Pump

2019 ◽  
pp. 1-14
Author(s):  
Nehal. A. Allam ◽  
Norah A. AlSadhan
Keyword(s):  
Nursing Students ◽  
Clinical Skills ◽  
Improve Patient Safety ◽  
Infusion Pump ◽  
Medication Administration ◽  
Simple Random Sample ◽  
Successful Implementation ◽  
Pediatric Nursing ◽  
Significant Difference ◽  
Smart Pump

Background: Using Intravenous Smart Pump by pediatric nursing students has shaped the challenge of finding innovative ways to teach clinical skills. The study aimed to assess the effect of PDSA framework on pediatric nurses compliance in using smart pump technology for intravenous medication administration in the pediatric intensive care unit. Design: A Quasi-Experimental quantitative, pre/post-test design was used to conduct the study. A purposive sample of 90 pediatric nursing students chosen based on the simple random sample for the academic year 2016– 2017, participated in the study. Methods: Three tools were designed by the researchers to collect the necessary data to implement the Plan Do Study Act (PDSA) framework. Statistical Analysis: The collected data were coded, analyzed and tabulated using frequencies and percentage, mean, standard deviation & chi-square tests. Results: There was a statistically significant difference and marked improvement in nurses students’ total knowledge and skills levels of smart pump intravenous administration (Pre and Post Plan Do Study Act (PDSA) framework) pre/post periods of assessment. It was observed that the majority of studied sample had good scores (100%, 97.8%, 97.8% & 93.3%) respectively post-intervention compared to (73.3%, 64.5%, 52.2%, 36.7%, 16.7%, 13.3%) pre-program and respectively (p<0.01). Conclusion: Administration of intravenous therapy for neonates can be risky but when supported by the use of smart pump systems with proper programming, compliance nurses students and staff education by reporting, monitoring, it will be a valuable tool to avoid actually catastrophic damage related to medication and infusion errors. Recommendation: Collaboration between health professionals is the key of successful implementation of smart infusion pump technology which can improve patient safety.

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