scholarly journals When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

2021 ◽  
Author(s):  
Justin Avery Aunger ◽  
Ross Millar ◽  
Joanne Greenhalgh
Keyword(s):  
Health Systems ◽  
Realist Theory ◽  
Risk Threshold ◽  
Collaborative Performance ◽  
Healthcare Work ◽  
Improved Performance ◽  
Realist Methodology ◽  
Core Characteristics ◽  
Future Work

Abstract Background Health systems are facing unprecedented socioeconomic pressures as well as responding to the ongoing strains and surges brought about by the Covid-19 pandemic. In response, the reconfiguration of health systems to encourage greater collaboration and integration has been promoted with a variety of collaborative shapes and forms being encouraged and developed. Despite this continued interest, evidence for success of these various arrangements is lacking with the links between collaboration and improved performance often remaining uncertain. To date, many examinations of collaborations have been undertaken, but use of realist methodology may shed additional light on how and why collaboration works, and whom it benefits. Methods This paper seeks to test initial context-mechanism-outcome configurations (CMOCs) of interorganisational collaboration with the view to producing a refined realist theory. This phase of the review used case study and evaluation literature; combined with supplementary systematic searches. These searches were screened for rigour and relevance, after which CMOCs were extracted from included literature and compared against existing ones for refinement, refutation, or affirmation. We also identified demi-regularities to better explain how these CMOCs were interlinked.Results Fifty-one papers were included, from which 338 CMOCs were identified, where many were nonunique. This resulted in new mechanisms such as ‘risk threshold’ and refinement of many others, including trust, confidence, and faith, into more well-defined constructs. Refinement and addition of CMOCs enabled the creation of a ‘web of causality’ depicting how contextual factors form CMOC chains which generate outputs of collaborative behaviour. Core characteristics of collaborations, such as whether they were mandated or cross-sector, were explored for their proposed impact according to the theory.Conclusion The formulation of this refined realist theory allows for greater understanding of how and why collaborations work and can serve to inform both future work in this area and the implementation of these arrangements. Future work should delve deeper into collaborative subtypes and the underlying drivers of collaborative performance.Review registration This review is part of a larger realist synthesis, registered at PROSPERO with ID CRD42019149009.

scholarly journals When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Justin Avery Aunger ◽  
Ross Millar ◽  
Joanne Greenhalgh
Keyword(s):  
Health Systems ◽  
Realist Synthesis ◽  
Realist Theory ◽  
Collaborative Performance ◽  
Healthcare Work ◽  
Improved Performance ◽  
Realist Methodology ◽  
Core Characteristics ◽  
Future Work

Abstract Background Health systems are facing unprecedented socioeconomic pressures as well as the need to cope with the ongoing strain brought about by the COVID-19 pandemic. In response, the reconfiguration of health systems to encourage greater collaboration and integration has been promoted with a variety of collaborative shapes and forms being encouraged and developed. Despite this continued interest, evidence for success of these various arrangements is lacking, with the links between collaboration and improved performance often remaining uncertain. To date, many examinations of collaborations have been undertaken, but use of realist methodology may shed additional light on how and why collaboration works, and whom it benefits. Methods This paper seeks to test initial context-mechanism-outcome configurations (CMOCs) of interorganisational collaboration with the view to producing a refined realist theory. This phase of the realist synthesis used case study and evaluation literature; combined with supplementary systematic searches. These searches were screened for rigour and relevance, after which CMOCs were extracted from included literature and compared against existing ones for refinement, refutation, or affirmation. We also identified demi-regularities to better explain how these CMOCs were interlinked. Results Fifty-one papers were included, from which 338 CMOCs were identified, where many were analogous. This resulted in new mechanisms such as ‘risk threshold’ and refinement of many others, including trust, confidence, and faith, into more well-defined constructs. Refinement and addition of CMOCs enabled the creation of a ‘web of causality’ depicting how contextual factors form CMOC chains which generate outputs of collaborative behaviour. Core characteristics of collaborations, such as whether they were mandated or cross-sector, were explored for their proposed impact according to the theory. Conclusion The formulation of this refined realist theory allows for greater understanding of how and why collaborations work and can serve to inform both future work in this area and the implementation of these arrangements. Future work should delve deeper into collaborative subtypes and the underlying drivers of collaborative performance. Review registration This review is part of a larger realist synthesis, registered at PROSPERO with ID CRD42019149009.

Relay Selection-aware Non-orthogonal Multiple Access Networks: Direct and Relaying Mode

2020 ◽  
Vol 13 (3) ◽  
pp. 348-354
Author(s):  
Dinh-Thuan Do ◽  
Minh-Sang V. Nguyen
Keyword(s):  
Relay Selection ◽  
Multiple Access ◽  
Decode And Forward ◽  
Selection Scheme ◽  
Fixed Power ◽  
Transmission Quality ◽  
Improved Performance ◽  
Outage Probabilities ◽  
Future Work ◽  
The Impact

Objective: In this paper, Decode-and-Forward (DF) mode is deployed in the Relay Selection (RS) scheme to provide better performance in cooperative downlink Non-orthogonal Multiple Access (NOMA) networks. In particular, evaluation regarding the impact of the number of multiple relays on outage performance is presented. Methods: As main parameter affecting cooperative NOMA performance, we consider the scenario of the fixed power allocations and the varying number of relays. In addition, the expressions of outage probabilities are the main metric to examine separated NOMA users. By matching related results between simulation and analytical methods, the exactness of derived formula can be verified. Results: The intuitive main results show that in such cooperative NOMA networks, the higher the number of relays equipped, the better the system performance can be achieved. Conclusion: DF mode is confirmed as a reasonable selection scheme to improve the transmission quality in NOMA. In future work, we will introduce new relay selections to achieve improved performance.

scholarly journals Extending Multilevel Statistical Entropy Analysis towards Plastic Recyclability Prediction

2021 ◽  
Vol 13 (6) ◽  
pp. 3553
Author(s):  
Philippe Nimmegeers ◽  
Alexej Parchomenko ◽  
Paul De Meulenaere ◽  
Dagmar R. D’hooge ◽  
Paul H. M. Van Steenberge ◽  
...  
Keyword(s):  
Circular Economy ◽  
Real Life ◽  
Plastic Waste ◽  
Entropy Analysis ◽  
Waste Collection ◽  
Statistical Entropy ◽  
Waste Streams ◽  
Material Component ◽  
Future Work

Multilevel statistical entropy analysis (SEA) is a method that has been recently proposed to evaluate circular economy strategies on the material, component and product levels to identify critical stages of resource and functionality losses. However, the comparison of technological alternatives may be difficult, and equal entropies do not necessarily correspond with equal recyclability. A coupling with energy consumption aspects is strongly recommended but largely lacking. The aim of this paper is to improve the multilevel SEA method to reliably assess the recyclability of plastics. Therefore, the multilevel SEA method is first applied to a conceptual case study of a fictitious bag filled with plastics, and the possibilities and limitations of the method are highlighted. Subsequently, it is proposed to extend the method with the computation of the relative decomposition energies of components and products. Finally, two recyclability metrics are proposed. A plastic waste collection bag filled with plastic bottles is used as a case study to illustrate the potential of the developed extended multilevel SEA method. The proposed extension allows us to estimate the recyclability of plastics. In future work, this method will be refined and other potential extensions will be studied together with applications to real-life plastic products and plastic waste streams.

scholarly journals Organisational change in hospitals: a qualitative case-study of staff perspectives

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chiara Pomare ◽  
Kate Churruca ◽  
Janet C. Long ◽  
Louise A. Ellis ◽  
Jeffrey Braithwaite
Keyword(s):  
Health Systems ◽  
Early Stage ◽  
Organisational Change ◽  
Hospital Staff ◽  
Hospital Environment ◽  
Structured Interviews ◽  
Metropolitan Hospital ◽  
The Face ◽  
Negative Expectations

Abstract Background Organisational change in health systems is common. Success is often tied to the actors involved, including their awareness of the change, personal engagement and ownership of it. In many health systems, one of the most common changes we are witnessing is the redevelopment of long-standing hospitals. However, we know little about how hospital staff understand and experience such potentially far-reaching organisational change. The purpose of this study is to explore the understanding and experiences of hospital staff in the early stages of organisational change, using a hospital redevelopment in Sydney, Australia as a case study. Methods Semi-structured interviews were conducted with 46 clinical and non-clinical staff working at a large metropolitan hospital. Hospital staff were moving into a new building, not moving, or had moved into a different building two years prior. Questions asked staff about their level of awareness of the upcoming redevelopment and their experiences in the early stage of this change. Qualitative data were analysed using thematic analysis. Results Some staff expressed apprehension and held negative expectations regarding the organisational change. Concerns included inadequate staffing and potential for collaboration breakdown due to new layout of workspaces. These fears were compounded by current experiences of feeling uninformed about the change, as well as feelings of being fatigued and under-staffed in the constantly changing hospital environment. Nevertheless, balancing this, many staff reported positive expectations regarding the benefits to patients of the change and the potential for staff to adapt in the face of this change. Conclusions The results of this study suggest that it is important to understand prospectively how actors involved make sense of organisational change, in order to potentially assuage concerns and alleviate negative expectations. Throughout the processes of organisational change, such as a hospital redevelopment, staff need to be engaged, adequately informed, trained, and to feel supported by management. The use of champions of varying professions and lead departments, may be useful to address concerns, adequately inform, and promote a sense of engagement among staff.

Management of personal protective equipment during the COVID-19 pandemic in England and the state of New York: A comparative case study

2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA
Keyword(s):  
New York ◽  
Supply Chain ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
New York State ◽  
The United States ◽  
Mitigation Strategies ◽  
Comparative Case Study ◽  
Protective Equipment

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.

scholarly journals Benjamin’s ‘flâneur’ and serial murder: An ultra-realist literary case study of Levi Bellfield

2018 ◽  
Vol 15 (3) ◽  
pp. 523-543
Author(s):  
Adam Lynes ◽  
Craig Kelly ◽  
Pravanjot Kapil Singh Uppal
Keyword(s):  
Urban Landscape ◽  
Modern Society ◽  
Criminological Theory ◽  
Serial Killer ◽  
Serial Murder ◽  
Realist Theory ◽  
Cultural Concepts ◽  
Literary Device ◽  
Literary Devices

This article seeks to develop criminological theory with the application of a literary device known as the ‘flâneur’ – an individual described as a ‘stroller’ – to serial murderer Levi Bellfield. With this application of the ‘flâneur’ to the phenomenon of serial murder, this article provides a fresh theoretical ‘lens’, and specifically sheds light on how particular serial murderers operate and evade detection in modern society. The importance of modernity to the phenomenon of serial murder is also considered utilizing Ultra-Realist theory, resulting in both a micro and macro examination into how the modern urban landscape has subsequently created an environment in which the serial killer both operates and comes to fruition. This synthesis between the application of literary devices, criminological theory and socio-cultural concepts not only raises important and previously neglected questions pertaining to serial murder, but also assists in forming the more sinister relative of the flâneur: the ‘dark flâneur’.

scholarly journals Ekstraksi Informasi Halaman Web Menggunakan Pendekatan Bootstrapping pada Ontology-Based Information Extraction

2015 ◽  
Vol 9 (2) ◽  
pp. 111 ◽  
Author(s):  
Erma Susanti ◽  
Khabib Mustofa
Keyword(s):  
Information Extraction ◽  
Language Processing ◽  
Semantic Content ◽  
Extraction Process ◽  
Web Pages ◽  
Structured Information ◽  
Improved Performance ◽  
Types Of Information ◽  
Unstructured Information

AbstrakEkstraksi  informasi  merupakan suatu bidang ilmu untuk pengolahan bahasa alami, dengan cara mengubah teks tidak terstruktur menjadi informasi dalam bentuk terstruktur. Berbagai jenis informasi di Internet ditransmisikan secara tidak terstruktur melalui website, menyebabkan munculnya kebutuhan akan suatu teknologi untuk menganalisa teks dan menemukan pengetahuan yang relevan dalam bentuk informasi terstruktur. Contoh informasi tidak terstruktur adalah informasi utama yang ada pada konten halaman web. Bermacam pendekatan untuk ekstraksi informasi telah dikembangkan oleh berbagai peneliti, baik menggunakan metode manual atau otomatis, namun masih perlu ditingkatkan kinerjanya terkait akurasi dan kecepatan ekstraksi. Pada penelitian ini diusulkan suatu penerapan pendekatan ekstraksi informasi dengan mengkombinasikan pendekatan bootstrapping dengan Ontology-based Information Extraction (OBIE). Pendekatan bootstrapping dengan menggunakan sedikit contoh data berlabel, digunakan untuk memimalkan keterlibatan manusia dalam proses ekstraksi informasi, sedangkan penggunakan panduan ontologi untuk mengekstraksi classes (kelas), properties dan instance digunakan untuk menyediakan konten semantik untuk web semantik. Pengkombinasian kedua pendekatan tersebut diharapkan dapat meningkatan kecepatan proses ekstraksi dan akurasi hasil ekstraksi. Studi kasus untuk penerapan sistem ekstraksi informasi menggunakan dataset “LonelyPlanet”. Kata kunci—Ekstraksi informasi, ontologi, bootstrapping, Ontology-Based Information Extraction, OBIE, kinerja Abstract Information extraction is a field study of natural language processing by converting unstructured text into structured information. Several types of information on the Internet is transmitted through unstructured information via websites, led to emergence of the need a technology to analyze text and found relevant knowledge into structured information. For example of unstructured information is existing main information on the content of web pages. Various approaches  for information extraction have been developed by many researchers, either using manual or automatic method, but still need to be improved performance related accuracy and speed of extraction. This research proposed an approach of information extraction that combines bootstrapping approach with Ontology-Based Information Extraction (OBIE). Bootstrapping approach using small seed of labelled data, is used to minimize human intervention on information extraction process, while the use of guide ontology for extracting classes, properties and instances, using for provide semantic content for semantic web. Combining both approaches expected to increase speed of extraction process and accuracy of extraction results. Case study to apply information extraction system using “LonelyPlanet” datasets. Keywords— Information extraction, ontology, bootstrapping, Ontology-Based Information Extraction, OBIE, performance

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