scholarly journals Decision Making About Rural Physiotherapy Service Provision Varies With Sector, Size and Rurality

2015 ◽  
Author(s):  
Robyn Adams ◽  
Anne Jones ◽  
Sophie Lefmann ◽  
Lorraine Sheppard
Keyword(s):  
Decision Making ◽  
Service Provision ◽  
Service Sector ◽  
Decision Makers ◽  
System Level ◽  
Research Approach ◽  
Local Health ◽  
Large Area ◽  
Physiotherapy Service ◽  
Local Health Service

Introduction: Decisions about physiotherapy service provision occur within the context of organisations, locations, and settings. The uniqueness of rural communities means it is important to consider contextual factors when making decisions about rural health services. As literature describing decision making about rural physiotherapy services is limited, this study sought perspectives on service level decision making (SLDM) from a range of stakeholders. The research approach needed to support consideration of both location and the broader health system. Method: A sequential mixed methods approach within a systems theory-case study heuristic provided the framework to explore rural physiotherapy SLDM. The investigation site, a large area of one Australian state, contained a mix of regional, rural, and remote communities. Perspectives on SLDM were obtained through surveys of physiotherapists, colleagues, and managers, with follow up interviews of a purposeful sample of participants. Results: Responses from physiotherapists, colleagues, manager surveys (n=34), and in-depth interviews (n=19) revealed commonalities and differences between sites and sectors. Available skill and expertise were common considerations across sites. Decisions about prioritisation of services occurred in both public and private settings; however, organisational priorities were a greater influence in the public sector and financial viability in the private sector. Service size influenced the perceived degree of autonomy of physiotherapists in SLDM, with physiotherapists in smaller sites having more independence. Directions from health facility management and the increasing need to prioritise services were reflected in physiotherapy responses from larger facilities. National health reforms and state level priorities were noted as influencing factors, as were connection to community, rurality, and the distance from decision makers. Conclusion: This study provides insight into decisions informing rural physiotherapy service provision. Understanding context and diversity is important to understanding local health service decisions. System level influences from macro and meso level decision makers provide the framework within which micro level physiotherapy SLDM occurs. Service sector, size and rurality then further qualify local service options and influence SLDM. Decisions about service provision need to take into consideration the current availability of services, the context of each location and skill mix required.

scholarly journals Embedding an economist in regional and rural health services to add value and reduce waste by improving local-level decision-making: protocol for the ‘embedded Economist’ program and evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrew Searles ◽  
Donella Piper ◽  
Christine Jorm ◽  
Penny Reeves ◽  
Maree Gleeson ◽  
...  
Keyword(s):  
Decision Making ◽  
Program Evaluation ◽  
Economic Evaluation ◽  
Health Service ◽  
Health Services ◽  
Local Level ◽  
Decision Makers ◽  
Local Health ◽  
Local Health Service ◽  
The Impact

Abstract Background Systematic approaches to the inclusion of economic evaluation in national healthcare decision-making are usual. It is less common for economic evaluation to be routinely undertaken at the ‘local-level’ (e.g. in a health service or hospital) despite the largest proportion of health care expenditure being determined at this service level and recognition by local health service decision makers of the need for capacity building in economic evaluation skills. This paper describes a novel program – the embedded Economist (eE) Program. The eE Program aims to increase local health service staff awareness of, and develop their capacity to access and apply, economic evaluation principles in decision making. The eE program evaluation is also described. The aim of the evaluation is to capture the contextual, procedural and relational aspects that assist and detract from the eE program aims; as well as the outcomes and impact from the specific eE projects. Methods The eE Program consists of a embedding a health economist in six health services and the provision of supported education in applied economic evaluation, provided via a community of practice and a university course. The embedded approach is grounded in co-production, embedded researchers and ‘slow science’. The sites, participants, and program design are described. The program evaluation includes qualitative data collection via surveys, semi-structured interviews, observations and field diaries. In order to share interim findings, data are collected and analysed prior, during and after implementation of the eE program, at each of the six health service sites. The surveys will be analysed by calculating frequencies and descriptive statistics. A thematic analysis will be conducted on interview, observation and filed diary data. The Framework to Assess the Impact from Translational health research (FAIT) is utilised to assess the overall impact of the eE Program. Discussion This program and evaluation will contribute to knowledge about how best to build capacity and skills in economic evaluation amongst decision-makers working in local-level health services. It will examine the extent to which participants are able to improve their ability to utilise evidence to inform decisions, avoid waste and improve the value of care delivery.

scholarly journals Integrated approach for risk management in servitization decision-making process

2020 ◽  
Vol 26 (7) ◽  
pp. 1949-1977 ◽  
Author(s):  
Sarra Dahmani ◽  
Xavier Boucher ◽  
Didier Gourc ◽  
Sophie Peillon ◽  
François Marmier
Keyword(s):  
Decision Making ◽  
Decision Process ◽  
Positive Impact ◽  
Practical Implication ◽  
Risk Identification ◽  
Decision Makers ◽  
Decision Making Process ◽  
Research Approach ◽  
Content Type ◽  
Action Research Approach

PurposeThe paper proposes an innovative systemic method helping decision-makers to control servitization transition process, through decision process risk diagnosis.Design/methodology/approachThe proposed method is based on the modeling of decision processes and risk identification and analysis. This method was based on an action-research approach, in close relationship with two companies (SMEs). The paper develops the feasibility experiment at Automelec company.FindingsThe method was successfully implemented and delivered concrete diagnosis results.Research limitations/implicationsThe generalization of the applicability of the method needs to be tested on several different cases.Practical implicationsThe first practical implication is related to the efficiency of the method to help decision-makers in a servitization context to limit uncertainty and get a global view of the weaknesses of their decision-making process, it raises their awareness about servitization transition for their companies. Furthermore, the method also helps to explain the strategy of a servitization transition. It enhances the level of maturity of the decision process of the company, and can be used as a training/learning tool for managers.Social implicationsThe results brought by the research contribute to give the decision-making boards for organization living a servitization transition and especially SMEs a better control over the servitization decision process and related risks, which will increase the economic stability of the company and its vision over long, medium and short horizons. This will bring positive impact on the overall economic and social environment and networks of the servitized SME, and enhance the confidence of coworkers, subcontractors and clients.Originality/valueThe first originality of the paper is related to the new way of considering risk, not only as an analysis criterion but as the central driver in steering a strategic transition for the company, such as servitization. The second originality of the study is about assessing risk occurrence over a decision-making process through decision reliability and decision confidence.

scholarly journals Characterization of the healthcare tourism in the city of Bogotá and the district of Cartagena

2020 ◽  
Vol 14 (28) ◽  
pp. 486-492
Author(s):  
Francisco José Arias-Aragonés ◽  
Alexander Mauricio Caraballo-Payares ◽  
Javier Enrique Jiménez-Osorio
Keyword(s):  
Health Care ◽  
Quantitative Research ◽  
Health Care Services ◽  
Medical Tourism ◽  
Research Approach ◽  
Local Health ◽  
Service Needs ◽  
Sources Of Information ◽  
Care Services ◽  
Local Health Service

The article characterizes the medical tourism subsector in Bogota and Cartagena to detect potential service offers to foreign patients. We performed a comparative analysis between these two cities to identify the weaknesses, opportunities, strengths, and threats they have. The study has a quantitative research approach using primary sources of information to characterize the subsector in these cities. In Bogota, the quality of health care services, specialized infrastructure, the accreditation of some health care institutions, and the formation of the health care cluster stand out as competitive elements. Meanwhile, Cartagena shows attractive prices but has scarce health care infrastructure and health professionals, low levels of bilingual proficiency, and increased local health service needs. We conclude that there is a need to strengthen the subsector’s competitiveness in both cities, as the trend points to the growth of this type of tourism in the coming years.

VP66 Perception Of Decision Makers And Researchers Towards Health Technology Assessment In Ghana

2017 ◽  
Vol 33 (S1) ◽  
pp. 179-180 ◽  
Author(s):  
Rebecca Addo ◽  
Jane Hall ◽  
Stephen Goodall ◽  
Marion Haas
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Health System ◽  
Human Resource ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Research Approach ◽  
Human Data ◽  
Effective Manner

INTRODUCTION:In recent years, the Ghana health system has been faced with the challenge of financial sustainability. New ways of making decisions in a cost-effective manner that ensure efficient use of available resources is being explored. Consequently, Ghana has been pursuing the formal introduction of Health Technology Assessment (HTA) for decision making in the health system.However, the limited use and impact of HTA on health systems has been associated with reasons including, and not restricted to, the knowledge and perception of decision makers towards it (1-3). Therefore as Ghana gears towards using HTA formally, it is important to assess the knowledge and attitude of potential users and producers of HTA. This will provide useful information for the setting up of an HTA agency.METHODS:A qualitative research approach using in-depth interviews was utilized. Twenty-three decision makers both at the national and district levels, and four researchers were interviewed. Thematic analysis was conducted using NVivo software.RESULTS:Only seven respondents had knowledge about HTA. Respondents perceived HTA differently, and the word ‘technology’, was often misconstrued as a device for communication such as mobile phone. Two main barriers to the use of HTA emerged; lack of resources (human, data, and finance) and politico-cultural issues. To address these barriers respondents recommended that stakeholders be involved in decisions concerning the guidelines for its conduct, composition of the appraisal team, and the focus of HTA. Generating of human, data and financial resources were also indicated.CONCLUSIONS:There is paucity of knowledge about HTA in Ghana. For Ghana to successfully introduce HTA for health decision making and realize its expected benefits, there will be a need to address the perceived barriers in a comprehensive manner. Also, to mitigate data and human resource barrier, Ghana will have to examine the available local data and human resource to build on.

scholarly journals Communication and the Decision Making Process among Couples with HIV/AIDS in Bulawayo, Zimbabwe

2014 ◽  
Vol 2014 ◽  
pp. 1-10
Author(s):  
V. Ndlovu
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Hiv Positive ◽  
Decision Making Process ◽  
Research Approach ◽  
Reproductive Decisions ◽  
Sexual Preferences ◽  
Interpretive Analysis ◽  
Depth Interviews ◽  
Insight Into

The study explores how HIV-positive couples negotiate and make reproductive and sexually related decisions. The broader aim of the paper is to understand how men and women with HIV make decisions about contraception and reproduction and what those decisions indicate about the realities of HIV-positive relationships. In line with the study’s aim to explore meanings related to the decision making process, a qualitative research approach was adopted. In-depth interviews were conducted with 15 couples in which at least one of them was HIV-positive. A critical interpretive analysis of the data was adopted in order to gain insight into decision making among the HIV-positive couples. The results indicate that decisions made were usually a result of negotiation and compromise between partners. However, women’s fertility and sexual preferences were found to be a major factor in determining the outcome of the decision making process. Couples who intended to have a child were found to be active decision makers while those who only desired or did not desire to have a child were mainly passive decision makers. The study concludes that women exercise significant power over contraceptive and reproductive decisions among both active and passive decision makers.

Decision making based on intuitionistic fuzzy preference relations with additive approximate consistency

2020 ◽  
Vol 39 (3) ◽  
pp. 4041-4058
Author(s):  
Fang Liu ◽  
Xu Tan ◽  
Hui Yang ◽  
Hui Zhao
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Real Interval ◽  
Preference Relations ◽  
Intuitionistic Fuzzy ◽  
Proposed Model ◽  
Fuzzy Preference Relations ◽  
Novel Concept ◽  
Fuzzy Weights ◽  
Fuzzy Preference

Intuitionistic fuzzy preference relations (IFPRs) have the natural ability to reflect the positive, the negative and the non-determinative judgements of decision makers. A decision making model is proposed by considering the inherent property of IFPRs in this study, where the main novelty comes with the introduction of the concept of additive approximate consistency. First, the consistency definitions of IFPRs are reviewed and the underlying ideas are analyzed. Second, by considering the allocation of the non-determinacy degree of decision makers’ opinions, the novel concept of approximate consistency for IFPRs is proposed. Then the additive approximate consistency of IFPRs is defined and the properties are studied. Third, the priorities of alternatives are derived from IFPRs with additive approximate consistency by considering the effects of the permutations of alternatives and the allocation of the non-determinacy degree. The rankings of alternatives based on real, interval and intuitionistic fuzzy weights are investigated, respectively. Finally, some comparisons are reported by carrying out numerical examples to show the novelty and advantage of the proposed model. It is found that the proposed model can offer various decision schemes due to the allocation of the non-determinacy degree of IFPRs.

strategi dalam pengambilan keputusan

2019 ◽  
Author(s):  
Suci Handayani Handayani ◽  
Hade Afriansyah
Keyword(s):  
Decision Making ◽  
Imperfect Information ◽  
Economic Value ◽  
Decision Makers ◽  
Decision Making Process ◽  
Administrative Process ◽  
Left Behind ◽  
Information Time ◽  
Complex Matter ◽  
General Individuals

Decision making is one element of economic value, especially in the era of globalization, and if it is not acceptable in the decision making process, we will be left behind. According to Robins, (2003: 173), Salusu, (2000: 47), and Razik and Swanson, (1995: 476) say that decision making can be interpreted as a process of choosing a number of alternatives, how to act in accordance with concepts, or rules in solving problems to achieve individual or group goals that have been formulated using a number of specific techniques, approaches and methods and achieve optimal levels of acceptance.Decision making in organizations whether a decision is made for a person or group, the nature of the decision is often determined by rules, policies, prescribed, instructions that have been derived or practices that apply. To understand decision making within the organization it is useful to view decision making as part of the overall administrative process. In general, individuals tend to use simple strategies, even if in any complex matter, to get the desired solution, because the solution is limited by imperfect information, time and costs, limited thinking and psychological stress experienced by decision makers.

Young Adults’ Contextualization of Environmental and Sustainability Issues: A Critical Issue for Environmental Education Intervention

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Anthony KOLA-OLUSANYA
Keyword(s):  
Young Adults ◽  
Environmental Education ◽  
Lived Experiences ◽  
Critical Issue ◽  
Decision Makers ◽  
Research Approach ◽  
Face To Face ◽  
Research Questions ◽  
Depth Interviews ◽  
Insight Into

As soon as decision makers are expected to make differences towards sustainable future, young adults’ ability to make informed and sound decisions is considered essential towards securing our planet. This study provides an insight into young adults’ knowledge of key environment and sustainability issues. To answer the key research questions, data were obtained using a qualitative phenomenographic research approach and collected through 18 face-to-face in-depth interviews with research participants. The findings of this study suggest that young adults lived experiences that play a huge role in their level of awareness of topical environmental and sustainability issues critical to humanity’s future on earth. 

A Soft Hierarchical Process Approach for Decision Making in A Supply Chain

2015 ◽  
Vol 4 (1and2) ◽  
Author(s):  
Rajeev Dhingra ◽  
Preetvanti Singh
Keyword(s):  
Decision Making ◽  
Process Approach ◽  
Decision Makers ◽  
Analytic Hierarchy ◽  
Conflicting Objectives ◽  
Realistic View ◽  
Hierarchy Process ◽  
Pair Wise Comparison ◽  
Supplier Selection Problem ◽  
Selection Of

Decision problems are usually complex and involve evaluation of several conflicting criteria (parameters). Multi Criteria Decision Making (MCDM) is a promising field that considers the parallel influence of all criteria and aims at helping decision makers in expressing their preferences, over a set of predefined alternatives, on the basis of criteria (parameters) that are contradictory in nature. The Analytic Hierarchy Process (AHP) is a useful and widespread MCDM tool for solving such type of problems, as it allows the incorporation of conflicting objectives and decision makers preferences in the decision making. The AHP utilizes the concept of pair wise comparison to find the order of criteria (parameters) and alternatives. The comparison in a pairwise manner becomes quite tedious and complex for problems having eight alternatives or more, thereby, limiting the application of AHP. This paper presents a soft hierarchical process approach based on soft set decision making which eliminates the least promising candidate alternatives and selects the optimum(potential) ones that results in the significant reduction in the number of pairwise comparisons necessary for the selection of the best alternative using AHP, giving the approach a more realistic view. A supplier selection problem is used to illustrate the proposed approach.

scholarly journals An Innovative Grey Approach for Group Multi-Criteria Decision Analysis Based on the Median of Ratings by Using Python

Axioms ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 124
Author(s):  
Dragiša Stanujkić ◽  
Darjan Karabašević ◽  
Gabrijela Popović ◽  
Predrag S. Stanimirović ◽  
Florentin Smarandache ◽  
...  
Keyword(s):  
Decision Making ◽  
Decision Analysis ◽  
Likert Scale ◽  
Decision Makers ◽  
Interval Numbers ◽  
Multi Criteria Decision Analysis

Some decision-making problems, i.e., multi-criteria decision analysis (MCDA) problems, require taking into account the attitudes of a large number of decision-makers and/or respondents. Therefore, an approach to the transformation of crisp ratings, collected from respondents, in grey interval numbers form based on the median of collected scores, i.e., ratings, is considered in this article. In this way, the simplicity of collecting respondents’ attitudes using crisp values, i.e., by applying some form of Likert scale, is combined with the advantages that can be achieved by using grey interval numbers. In this way, a grey extension of MCDA methods is obtained. The application of the proposed approach was considered in the example of evaluating the websites of tourism organizations by using several MCDA methods. Additionally, an analysis of the application of the proposed approach in the case of a large number of respondents, done in Python, is presented. The advantages of the proposed method, as well as its possible limitations, are summarized.

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