Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…
Abstract
Purpose
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.
Design/methodology/approach
Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.
Findings
The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.
Practical implications
A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.
Originality/value
Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.
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Chi-Ling Joanna Sinn, Zain Pasat, Lindsay Klea, Sophie Hogeveen, Ceara Holditch, Carrie Beltzner and Andrew Costa
Remote patient monitoring (RPM) and virtual visits have the potential to transform care delivery and outcomes but require intentional planning around how these technologies…
Abstract
Purpose
Remote patient monitoring (RPM) and virtual visits have the potential to transform care delivery and outcomes but require intentional planning around how these technologies contribute to integrated care. Since maturity models are useful frameworks for understanding current performance and motivating progress, the authors developed a model describing the features of RPM that can advance integrated care.
Design/methodology/approach
This work was led by St. Joseph's Health System Centre for Integrated Care in collaboration with clinical and programme leads and frontline staff offering RPM services as part of Connected Health Hamilton in Ontario, Canada. Development of the maturity model was informed by a review of existing telehealth maturity models, online stakeholder meetings, and online interviews with clinical leads, programme leads, and staff.
Findings
The maturity model comprises 4 maturity levels and 17 sub-domains organised into 5 domains: Technology, Team Organisation, Programme Support, Integrated Information Systems, and Performance and Quality. An implementation pillars checklist identifies additional considerations for sustaining programmes at any maturity level. Finally, the authors apply one of Connected Health Hamilton's RPM programmes to the Team Organisation domain as an example of the maturity model in action.
Originality/value
This work extends previous telehealth maturity models by focussing on the arrangement of resources, teams, and processes needed to support the delivery of integrated care. Although the model is inspired by local programmes, the model is highly transferable to other RPM programmes.
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Adam Biggs and Joseph Hamilton
Evaluating warfighter lethality is a critical aspect of military performance. Raw metrics such as marksmanship speed and accuracy can provide some insight, yet interpreting subtle…
Abstract
Purpose
Evaluating warfighter lethality is a critical aspect of military performance. Raw metrics such as marksmanship speed and accuracy can provide some insight, yet interpreting subtle differences can be challenging. For example, is a speed difference of 300 milliseconds more important than a 10% accuracy difference on the same drill? Marksmanship evaluations must have objective methods to differentiate between critical factors while maintaining a holistic view of human performance.
Design/methodology/approach
Monte Carlo simulations are one method to circumvent speed/accuracy trade-offs within marksmanship evaluations. They can accommodate both speed and accuracy implications simultaneously without needing to hold one constant for the sake of the other. Moreover, Monte Carlo simulations can incorporate variability as a key element of performance. This approach thus allows analysts to determine consistency of performance expectations when projecting future outcomes.
Findings
The review divides outcomes into both theoretical overview and practical implication sections. Each aspect of the Monte Carlo simulation can be addressed separately, reviewed and then incorporated as a potential component of small arms combat modeling. This application allows for new human performance practitioners to more quickly adopt the method for different applications.
Originality/value
Performance implications are often presented as inferential statistics. By using the Monte Carlo simulations, practitioners can present outcomes in terms of lethality. This method should help convey the impact of any marksmanship evaluation to senior leadership better than current inferential statistics, such as effect size measures.
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Adam Biggs, Greg Huffman, Joseph Hamilton, Ken Javes, Jacob Brookfield, Anthony Viggiani, John Costa and Rachel R. Markwald
Marksmanship data is a staple of military and law enforcement evaluations. This ubiquitous nature creates a critical need to use all relevant information and to convey outcomes in…
Abstract
Purpose
Marksmanship data is a staple of military and law enforcement evaluations. This ubiquitous nature creates a critical need to use all relevant information and to convey outcomes in a meaningful way for the end users. The purpose of this study is to demonstrate how simple simulation techniques can improve interpretations of marksmanship data.
Design/methodology/approach
This study uses three simulations to demonstrate the advantages of small arms combat modeling, including (1) the benefits of incorporating a Markov Chain into Monte Carlo shooting simulations; (2) how small arms combat modeling is superior to point-based evaluations; and (3) why continuous-time chains better capture performance than discrete-time chains.
Findings
The proposed method reduces ambiguity in low-accuracy scenarios while also incorporating a more holistic view of performance as outcomes simultaneously incorporate speed and accuracy rather than holding one constant.
Practical implications
This process determines the probability of winning an engagement against a given opponent while circumventing arbitrary discussions of speed and accuracy trade-offs. Someone wins 70% of combat engagements against a given opponent rather than scoring 15 more points. Moreover, risk exposure is quantified by determining the likely casualties suffered to achieve victory. This combination makes the practical consequences of human performance differences tangible to the end users. Taken together, this approach advances the operations research analyses of squad-level combat engagements.
Originality/value
For more than a century, marksmanship evaluations have used point-based systems to classify shooters. However, these scoring methods were developed for competitive integrity rather than lethality as points do not adequately capture combat capabilities. The proposed method thus represents a major shift in the marksmanship scoring paradigm.
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Danielle A. Tucker and Stefano Cirella
In the context of organizational change, identifying, and organizing the various roles of change agents remains a challenge for practitioners and scholars alike. This chapter…
Abstract
In the context of organizational change, identifying, and organizing the various roles of change agents remains a challenge for practitioners and scholars alike. This chapter examines how different agents can enable an effective change process. Empirical evidence from three hospitals illustrates the process of transformation and its underlying arrangements to identify agents and their roles. The findings underline the importance of designing a coherent system of agents, determining where they come from, their role during the process, and how this may change throughout the change process. Managerial choices in the cases are discussed, leading to implications for theory and practice.
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Amrita Ghai, Irena Milosevic, Michele Laliberte, Valerie H. Taylor and Randi E. McCabe
The purpose of this paper is to assess multidimensional body image concerns in a sample of obese women seeking bariatric surgery at an outpatient hospital clinic in Hamilton…
Abstract
Purpose
The purpose of this paper is to assess multidimensional body image concerns in a sample of obese women seeking bariatric surgery at an outpatient hospital clinic in Hamilton, Ontario, Canada.
Design/methodology/approach
A sample of obese adult women seeking bariatric surgery at an outpatient medical clinic in Hamilton, Ontario, Canada (n=148) completed various self-report measures of body image concerns, including body image dysphoria, body image quality of life, body image investment, and appearance satisfaction. Participant scores were compared to normative data. Correlations between body image concern measures and body mass index (BMI) were examined.
Findings
Participants endorsed more body image dysphoria, more negative body image quality of life, and less appearance satisfaction than normative samples. BMI was not correlated with body image concern scores.
Practical implications
Interventions aimed at reducing body image disturbance in obese women should target multiple components of body image concern. Decisions about who should receive interventions should not be based on BMI status.
Originality/value
The majority of research on body image concerns focuses exclusively on evaluative constructs such as body image dissatisfaction. The current study examined affective, cognitive, and behavioural body image constructs. A better understanding of the multidimensional nature of body image concerns in obese women seeking bariatric surgery informs the development of effective, targeted interventions.
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Michele M. Laliberte, Daniel Balk, Stacey Tweed, Jessica Smith and Amrita Ghai
The purpose of this paper is to investigate whether reading a self-help chapter on the body's regulation of weight can change weight control beliefs, and whether such changes in…
Abstract
Purpose
The purpose of this paper is to investigate whether reading a self-help chapter on the body's regulation of weight can change weight control beliefs, and whether such changes in turn predict improvements in body dissatisfaction and self-esteem.
Design/methodology/approach
Participants of a mixed racial sample of undergraduate college women (n=154) completed measures of personal weight control beliefs, body dissatisfaction, self-esteem and knowledge before and after they read a self-help education chapter.
Findings
Exposure to the education was associated with improvement in knowledge, body dissatisfaction and self-esteem and change in weight control beliefs. Increase in the belief in “striving for a healthy lifestyle with acceptance of one's natural weight” predicted improvement in body dissatisfaction and self-esteem.
Research limitations/implications
This paper provides preliminary evidence that realistic information about weight control can impact weight control beliefs, and that this in turn is associated with improvement in body satisfaction and self-esteem. The major limitation of the study is the lack of control group to ensure changes are not due to factors like social desirability. Future directions would be to replicate this research using a control group, and to look at the role of education and weight control beliefs in eating disordered and bariatric populations.
Originality/value
This is the first study to look at the impact of providing young women with realistic information about the body's regulation of weight and weight loss outcomes on their beliefs about weight control, body dissatisfaction and self-esteem. This information is valuable for health care providers and educators working with young women.
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Deborah Milinkovic, Jeremiah Hurley, Arthur Sweetman, David Feeny, Jean-Éric Tarride, Christopher J. Longo and Susan McCracken
This paper analyzes two types of potential intangible public-sector assets for consideration by public-sector accounting boards. Government investments in health and social…
Abstract
Purpose
This paper analyzes two types of potential intangible public-sector assets for consideration by public-sector accounting boards. Government investments in health and social programs can create two potential intangible assets: the intangible infrastructure used to deliver the health or social program and the enhanced human capital embodied in the recipients of program services. Because neither of these assets is currently recognized in a government's year-end financial statements or broader general-purpose financial reports (GPFR), these reports may underrepresent the government's true fiscal and service capacity.
Design/methodology/approach
The paper uses an international accounting standards framework to analyze: whether investments in health and social programs create intangible assets that meet the definition of an asset as set out by International Public Sector Accounting Standards (IPSAS), whether they are assets of the government and whether they are recognizable for the purpose of financial reporting.
Findings
The intangible infrastructure asset created to facilitate the delivery of health and social programs would often qualify as a recognizable asset of the government. However, the enhanced recipient human capital asset created through the delivery of health and social programs would, in most instances, not qualify as a recognizable asset of the government, though there likely would be benefits from reporting on it through GPFRs or other mechanisms.
Originality/value
This paper makes two contributions. First, it identifies a previously overlooked intangible asset – the infrastructure created to facilitate the delivery of health and social programs. Second, it presents an argument regarding why, even when it fails to generate a recognizable intangible asset to government, it would be valuable for government to report such investments in supplementary statements.
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Charles V. Callahan and Joseph Nemec jr.
Information technology has emerged as a key component of competitive advantage. In assessing how and where to invest senior executives must realize that the past few years have…
Abstract
Information technology has emerged as a key component of competitive advantage. In assessing how and where to invest senior executives must realize that the past few years have witnessed a fundamental change in what IT can do for a company that adds a revolutionary new factor to their decision‐taking.