The UK's National Programme for IT: Why was it dismantled?

2016 ◽  
Vol 30 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Taghreed Justinia

This paper discusses the UK’s National Programme for IT (NPfIT), which was an ambitious programme launched in 2002 with an initial budget of some £6.2 billion. It attempted to implement a top-down digitization of healthcare in England’s National Health Service (NHS). The core aim of the NPfIT was to bring the NHS’ use of information technology into the 21st century, through the introduction of an integrated electronic patient record systems, and reforming the way that the NHS uses information, and hence to improve services and the quality of patient care. The initiative was not trusted by doctors and appeared to have no impact on patient safety. The project was marred by resistance due to the inappropriateness of a centralized authority making top-down decisions on behalf of local organizations. The NPfIT was officially dismantled in September 2011. Deemed the world’s largest civil IT programme, its failure and ultimate demise sparked a lot of interest as to the reasons why. This paper summarises the underlying causes that lead to dismantling the NPfIT. At the forefront of those circumstances were the lack of adequate end user engagement, the absence of a phased change management approach, and underestimating the scale of the project.

2009 ◽  
Vol 29 (2) ◽  
pp. 135-141
Author(s):  
Roberto Pecoits–Filho

The bench-to-bedside approach to translational research is becoming increasingly important to efficiently advance understanding of the mechanisms underlying disease and to improve the quality of patient care. Although this investigation model has been practiced since the early days of the therapy, robust research platforms built to practice translational research have only recently been structured in the field of peritoneal dialysis. Experience with a translational research environment that generated most of the information cited in this overview is the core of this manuscript. The central investigation theme described is how to approach the cardiovascular complications of peritoneal dialysis. The research question was, could the continuous activation of inflammatory pathways be central in this process and represent a relevant target for interventions?


Author(s):  
Catherine R. Butler ◽  
Alvin H. Moss

Although the benefits of standard dialysis therapy for many older adults with complex comorbid conditions is equivocal, there continues to be substantial moral uncertainty in the practice of withholding and withdrawing dialysis treatment. This chapter reviews several ethical conundrums in palliative care of patients with advanced kidney disease, including uncertainty about the moral status of withholding dialysis and pursuing medical management without dialysis, challenges in decision-making when patients lack capacity to participate, and ethically relevant social and cultural factors influencing practice. Better understanding of the underlying causes of these conundrums reveals opportunities to improve quality of patient care at the individual and system levels by incorporating palliative practices. The chapter also suggests strategies for clinicians to identify and facilitate resolution of ethical conflicts around end-of-life care for patients with advanced kidney disease in clinical practice.


ABOUTOPEN ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 30-34
Author(s):  
Maila Mislej

The Author of the article summarizes the core aspects and theoretical assumptions of the “Enabling Approach” that has characterized the clinical practice of the ASUGI for years. The model has proved to be effective in positively influencing the quality of life of individuals assisted and in reducing the number of hospitalisations. The model affirms the need to establish relations of a mainly symmetrical nature with the individuals assisted and their caregivers. On the contrary, according to this approach, proposing a “top-down” asymmetric relationship with the patient means responding to an unconscious health professional’s need of power over the patient rather than to the patient’s real needs. This aspect, in the perspective of the Author, lies at the basis of the active involvement (Engagement) of patients in their health care processes.


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1311-1311
Author(s):  
Vishal Kukreti ◽  
Emma Mauti ◽  
Roxanne Macaskill ◽  
Christine Chen ◽  
Matthew D. Seftel

Abstract Introduction: Quality of health care is a major focus for providers, patients, payers and accreditors. Blood and marrow transplantation (BMT) is a complex and specialized process with unique quality needs. Accreditation bodies for BMT programs expect an implemented and coordinated management system. Currently, hospitals performing BMT have many tiers of quality evaluation from hospital accreditation, BMT accreditation, self-evaluation and in Ontario, provincial quality measurement. Hence, a quality framework with a clearly defined process of quality indicator (QI) prioritization, development and measurement is required. Methods: At Princess Margaret Cancer Centre, we conducted a structured review of the literature to identify published QI for BMT. The literature review from 1999 to 2014 focused on BMT with MESH terms including quality improvement/assurance, quality of health care, benchmarking, performance measures/indicators and standards of care. Focus was on the clinical aspects of care and laboratory/cell collection was excluded. We included Medline, Pubmed, Embase and CINAHL databases and a structured “grey zone” literature review. The identified QI were evaluated by a core expert panel and like concepts were merged and quality domains identified. Thereafter, end user engagement of the multidisciplinary team was completed through a modified Delphi Process. QI definitions were evaluated as medidata tables to link to data collection sources. Management/operational related and hospital accreditation QI were evaluated by the expert panel for relevance. A quality framework was then modeled off the Cancer System Quality Index to include the domains of safe, effective, efficient, integrated, equitable, responsive, accessible and innovative. QI were aligned to relevant domains in the framework to give an overall program evaluation and future direction. Results: Structured literature review identified 2211 citations with 111 abstracts meeting the inclusion criteria and only 20 full papers reporting on 114 QI. Grey zone literature review revealed a further 10 sources reporting on 100 QI. Of the 214 QI, 120 were quality domains or quality concepts (“Big Dot”) and not clearly defined QI. With consensus review, 214 QI were merged into 22 clinical and 12 operational/managerial “Big Dot” QI. Of the clinical QI, there were 8 only relevant to allogeneic BMT and 14 were relevant to both autologous and allogeneic BMT (see Table 1). Concurrently, mapping of QI within the framework as well as, alignment of both hospital and provincial BMT QI to the framework and to the 22 clinical QI indicators was done. . Conclusions: An integrated and comprehensive quality management plan is required for BMT which is standards based. We report a framework and strategy to align all quality endeavors occurring at local-regional to national levels as it relates to BMT. We also present a detailed literature review of QI in BMT and the need for more detailed, reproducible indicators in this area. As end-user engagement in quality improvement is necessary, the clinical multidisciplinary team will set QI prioritization for near term and future reporting though a modified Delphi exercise. Table 1: Big Dot Clinical QI in BMT for Prioritization and Development Apheresis Not Performed Due to Insufficient Mobilization Apheresis Not Performed Due to Other Reasons (i.e. progression) Appropriate Donor Screening and Testing Complications During Apheresis Complications During Bone Marrow Harvest Donor Outcomes (i.e. adverse events) Incidence and Measurement of Acute and Chronic Graft vs Host Disease Incidence of ICU Transfers Length of Stay in Hospital Routine Chimerism Analysis Median Time to Engraftment (in days) Number of Patients who enter the program that are not transplanted Nurse Sensitive Outcomes i.e. central venous catheter complications Need for Stem Cell Boost or Second Transplant for Graft Failure Patient Satisfaction at Discharge and at Transitions Rate of Serious Bacterial, Viral and Fungal Infections Readmissions within 30 Days of Discharge Relapse Rate Overall Survival Time to Find an Unrelated Compatible Donor Treatment Related Mortality Whether a Product was Collected From a Donor and Not Infused Disclosures No relevant conflicts of interest to declare.


In construction production, the safety of constructing buildings and structures is achieved by ensuring the required quality as a result of systematic construction control based on the implementation of a complex of technical, economic and organizational measures at all stages of the object's life cycle. The article deals with the actual problem of improving the quality of construction products-buildings and structures in conjunction with the activities of construction control bodies. The article presents the advanced foreign and domestic experience of ensuring the quality control at the construction sites, providing for the prevention of the underlying causes of defects and increasing the interest of the contractors directly. On the basis of the analysis of the current situation with quality control at the construction market, ways to improve its efficiency by developing a unified system of technological implementation of relevant requirements for the quality of construction products, determining the rational number and business load of construction control engineers, as well as the active activities of self-regulatory organizations in this area are offered.


2017 ◽  
Vol 4 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Diana Effendi

Information Product Approach (IP Approach) is an information management approach. It can be used to manage product information and data quality analysis. IP-Map can be used by organizations to facilitate the management of knowledge in collecting, storing, maintaining, and using the data in an organized. The  process of data management of academic activities in X University has not yet used the IP approach. X University has not given attention to the management of information quality of its. During this time X University just concern to system applications used to support the automation of data management in the process of academic activities. IP-Map that made in this paper can be used as a basis for analyzing the quality of data and information. By the IP-MAP, X University is expected to know which parts of the process that need improvement in the quality of data and information management.   Index term: IP Approach, IP-Map, information quality, data quality. REFERENCES[1] H. Zhu, S. Madnick, Y. Lee, and R. Wang, “Data and Information Quality Research: Its Evolution and Future,” Working Paper, MIT, USA, 2012.[2] Lee, Yang W; at al, Journey To Data Quality, MIT Press: Cambridge, 2006.[3] L. Al-Hakim, Information Quality Management: Theory and Applications. Idea Group Inc (IGI), 2007.[4] “Access : A semiotic information quality framework: development and comparative analysis : Journal ofInformation Technology.” [Online]. Available: http://www.palgravejournals.com/jit/journal/v20/n2/full/2000038a.html. [Accessed: 18-Sep-2015].[5] Effendi, Diana, Pengukuran Dan Perbaikan Kualitas Data Dan Informasi Di Perguruan Tinggi MenggunakanCALDEA Dan EVAMECAL (Studi Kasus X University), Proceeding Seminar Nasional RESASTEK, 2012, pp.TIG.1-TI-G.6.


Author(s):  
Mark Oprenko

The definition of the multimorbidity concept reveals insufficient specificity of the comorbidity and multimorbidity definitions and, as a result, confusion in the use of these terms. Most authors are unanimous that the “core” of multimorbidity is presence of more than one disease in a patient. These coexisting diseases can be pathogenetically interconnected and non-interconnected. Regardless, the degree of multimorbidity always affects prognosis and quality of life.


Edupedia ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 45-53
Author(s):  
Ilzam Dhaifi

The world has been surprised by the emergence of a COVID 19 pandemic, was born in China, and widespread to various countries in the world. In Indonesia, the government issued several policies to break the COVID 19 pandemic chain, which also triggered some pro-cons in the midst of society. One of the policies government takes is the closure of learning access directly at school and moving the learning process from physical class to a virtual classroom or known as online learning. In the economic sector also affects the parents’ financial ability to provide sufficient funds to support the implementation of distance learning applied by the government. The implications of the distance education policy are of course the quality of learning, including the subjects of Islamic religious education, which is essentially aimed at planting knowledge, skills, and religious consciousness to form the character of the students. Online education must certainly be precise, in order to provide equal education services to all students, prepare teachers to master the technology, and seek the core learning of Islamic religious education can still be done well.


Author(s):  
Juan Alfredo Lino-Gamiño ◽  
Carlos Méndez-González ◽  
Eduardo José Salazar-Araujo ◽  
Pablo Adrián Magaña-Sánchez

In the value chain it is important to keep in mind the core business of the company, since it depends largely on the competitiveness of the company and its overall performance, bearing in mind that all business indicators depend on it. In this work we will study the washing process within the company WASH CONTAINERS SA DE CV, to improve the washing processes and in this way reduce times and movements in the process leading the company to reduce costs considerably within the operations company daily, having a more competitive operation and with greater profit margin in its business process. Goals: It Improve the logistics of the movement of containers for washing and with it the core business of the company. Methodology: The action research will be applied applying Business Process Management for the improvement of processes in situ, it will be developed in a certain period of time and with that it will establish an improvement projection. Contribution: The improvement of the times for the disposal of the containers and their subsequent use, allows a better competitiveness and with it the income of the company, on the other hand, the transport companies improve in performance in quantity, quality of disposition and with it their income.


Author(s):  
María- José Foncubierta-Rodriguez ◽  
Rafael Ravina-Ripoll ◽  
Eduardo Ahumada-Tello ◽  
Luis Bayardo Tobar-Pesantez

Since the end of the 20th century, economists have been attracted to the study of the economics of happiness (e.g., Singh, & Alexandrova, 2020; Crespo & Mesurado, 2015; Ferrer-i-Carbonell,2013). The use of the term happiness characterizes an essential volume of this bibliographical production as a synonym for the words satisfaction, well-being, or quality of life (Teixeira&Vasque, 2020; Carlquist et al., 2017). Under this umbrella, the culture of happiness management teaches us that a management model or direction oriented to the holistic search for happiness or job satisfaction of its employees is one of the essential axial pieces that organizations have to increase the commitment of their human capital, and therefore, their productivity and business performance (Ravina et al., 2019). Public administration employees are not exempt from this reality, a group that is characterized by job stability compared to private company employees. This article is dedicated to them. The era of Industry 4.0 is a period that is characterized, among other things, by the high precariousness of labor that is originated by the implementation of management models in advanced economies. This phenomenon is derived from the technological point of view by the automation and massive robotization of production processes and the supply chain. Together with the digitalization of companies, both factors are very present in the ecosystems of the Covid-19, and have come, perhaps, to stay in the future (Bragazzi, 2020; Ghadge et al., 2020). In line with the above, a more holistic examination of this issue seems likely to show that there is a keen interest among people to enter into Work mostly in public administrations, in search of a permanent contract for their entire working life. As is known, this is especially true in countries with high unemployment levels, such as Spain. Its unemployment rate is 20.1% in mid-2020. In the collective imagination of these individuals, there is the conviction that this type of Work constitutes ambrosia of eudaimonic happiness, job security, and quality of life, especially at present, in times of the Covid-19 pandemic (Fernández-Urbano, & Kulic, 2020). In this sense, it should be noted that in the last decades of the 21st century, there has been a growing interest in researching public employees' job satisfaction (e.g., Ryu&Bae, 2020; Steijn &Van der Voet, 2019; Luechinge et al., 2010). Most of the studies carried out on this scientific topic to date show empirically that public sector workers are happier than individuals in the private sphere. It's basically due to the intrinsic benefits (flexibility, vacation, or family reconciliation, among others) that this type of government entity offers concerning for-profit organizations (e.g., Lahat&Ofek, 2020; Sánchez-Sánchez, & Puente, 2020; Danzer,2019). In this context, this article aims to examine, as a priority in the era of Industry 4.0, whether there are observed differences in the levels of congratulations between human capital working in the private sector and that working in the public sector in Spain, by analyzing a set of variables that define positions: hours, salary, stability, promotion, and stress. Finally, we must indicate, on the one hand, that the choice of this spatial framework is motivated by the scarce literature investigating the happiness of Spanish public employees in an economy with high levels of youth unemployment (Núñez-Barriopedro et al., 2020). On the other hand, the results achieved in this study may be useful in the future for the implementation of public policies aimed at significantly promoting the welfare of working citizens through the happiness management approach (Ravina-Ripoll et al., 2019), or for taking this management concept to private companies to increase the motivation of their employees (Foncubierta-Rodríguez & Sánchez-Montero, 2019). Keywords: Happiness, human resources, Industry 4.0, public sector.


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