This paper presents four Destination Stewardship scenarios based on different levels of engagement from the public and private sector. The scenarios serve to support destination stakeholders in assessing their current context and the pathway towards greater stewardship. A Destination Stewardship Governance Diagnostic framework is built on the scenarios to support its stakeholders in considering how to move along that pathway, identifying the key aspects of governance that are either facilitating or frustrating a destination stewardship approach, and the required actions and resources to achieve an improved scenario. Moreover, the scenarios and diagnostic framework support stakeholders to come together to debate and scrutinise how tourism is managed in a way that meets the needs of the destination, casting new light on the barriers and opportunities for greater destination stewardship.
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Aims: In-hospital prescribing errors may result in patient harm, such as prolonged hospitalisation and hospital (re)admission, and may be an emotional burden for the prescribers and healthcare professionals involved. Despite efforts, in-hospital prescribing errors and related harm still occur, necessitating an innovative approach. We therefore propose a novel approach, in-hospital pharmacotherapeutic stewardship (IPS). The aim of this study was to reach consensus on a set of quality indicators (QIs) as a basis for IPS. Methods: A three-round modified Delphi procedure was performed. Potential QIs were retrieved from two systematic searches of the literature, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. In two written questionnaires and a focus meeting (held between the written questionnaire rounds), potential QIs were appraised by an international, multidisciplinary expert panel composed of members of the European Association for Clinical Pharmacology and Therapeutics (EACPT). Results: The expert panel rated 59 QIs and four general statements, of which 35 QIs were accepted with consensus rates ranging between 79% and 97%. These QIs describe the activities of an IPS programme, the team delivering IPS, the patients eligible for the programme and the outcome measures that should be used to evaluate the care delivered. Conclusions: A framework of 35 QIs for an IPS programme was systematically developed. These QIs can guide hospitals in setting up a pharmacotherapeutic stewardship programme to reduce in-hospital prescribing errors and improve in-hospital medication safety.
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Research suggests that construction clients, as building owner-occupier, are struggling to implement smart maintenance. This thesis assumes that this is due to a failure to fully understand the institutional complexities of smart maintenance. Hence, the aim of this thesis was to improve our understanding of these complexities and to develop theoretical and practical knowledge on the professionalization of construction clients in commissioning smart maintenance through stewardship. Stewardship theory portrays managers and employees as collectivists, pro-organizational and trustworthy, and can be used for designing collaborations based on intrinsic motivation and trust. A first insight from this thesis relates to how institutional complexity in smart maintenance management (SMM) can be understood (study 1). Institutional complexity is defined as the combined effect of 15 interorganizational and intraorganizational tensions that are active simultaneously. A second insight from this thesis relates to the capabilities that construction clients need to address the institutional complexities of SMM and connect various institutional fields (study 2). Using data collected from four cases involving two construction clients, a framework with eight maturity dimensions, involving 23 sub-dimensions, has been developed and validated. The third insight from this thesis relates to the role of the purchasing function in commissioning smart maintenance and emerged from considering the service triad concept (study 3). The findings indicate that the service triad concept fails to provide sufficient detail to adequately describe the construction client’s role in SMM. Hence, the service triad is extended to a service hexad. Our fourth insight relates to intrapreneurial stewardship (study 4). A process model for change implementation through stewardship interventions has been developed and then evaluated in a case study. The process model combines constructs from stewardship theory with intrapreneurship concepts and describes how employees can be coached by leaders during periods of organizational change. Together, the insights from the four studies are synthesized in a framework for client-led innovation in SMM and describe how construction clients can increase SMM maturity in institutionally complex environments through stewardship.
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Door COVID-19 crisis zijn er extra uitdagingen om de verdere doorontwikkeling van het praktijkgerichte onderzoek en de onderliggende infrastructuur en professionalisering kwalitatief en kwantitatief te realiseren. De Hogeschool van Arnhem en Nijmegen (HAN) zet de IMPULS 2020 middelen in om de rol van het praktijkgericht onderzoek hierin te bestendigen en versterken. Het betreft een academie overstijgende aanvraag. Het beschikbare budget vanuit de regeling bedraagt 550.000 euro en zal in 2021 via twee lijnen worden ingezet: 1. Netwerk- en visievorming Dit richt zich op de versterking van de strategische netwerkvorming en samenhang overstijgend aan de zwaartepunten als focus gebieden voor de samenwerking onderwijs, onderzoek en werkveld (deels is hier aandacht voor de ontwikkeling en samenwerking bij regelingen als SPRONG of MMIP). Dit moet leiden tot het ontwikkelen van een meerjarige roadmap SLIM, SCHOON & SOCIAAL (S3). De regie ligt bij dit deel bij het zwaartepunt management. (Sustainable Energy & Environment (SEE), Smart Region en Health). 2. Professionalisering onderzoeksondersteuning Dit gedeelte betreft het vervolg op het project professionalisering onderzoeksondersteuning en richt zich (in lijn met het nationale project DCC) op de doorontwikkeling van: datastewardship, FAIR data & open access, ICT kennisinfrastructuur en communicatie rondom onderzoek en ondersteuning, verdere ontwikkeling van een Open Science Platform en voorbereiding op een HAN Open Access Fonds. Dit deel zal vanuit Services Onderwijs, Onderzoek en Kwaliteitszorg gecoördineerd worden. Middels deze inzet geeft de HAN een extra stimulans aan de strategische samenwerking en de verdere ontwikkeling van een consistente en herkenbare onderzoeksprogrammering en -ondersteuning.
De wereldwijde COVID-19 crisis heeft de dagelijkse werkzaamheden in het onderwijs en onderzoek ernstig verstoord. De kennisgemeenschap ontmoet elkaar digitaal, onderzoeksprojecten worden uitgesteld, stilgelegd. Aan de andere kant komt de urgentie van verschillende domeinen volop in beeld met een hele duidelijke impact van ‘applied sciences’ op de maatschappij. De effecten van de crisis geven extra uitdagingen om door te bouwen aan praktijkgericht onderzoek en de daarbij benodigde infrastructuur. Hiermee wordt de regionale impact versterkt en worden de verschillende maatschappelijke transities versneld. De beschikbare middelen € 475.000,= worden ten behoeve van de doorontwikkeling van praktijkgericht onderzoek als volgt, drieledig, geïnvesteerd: 1. het op peil houden van de beschikbaarheid van onderzoekspersoneel 2. professionalisering van datamanagement. Het betreft ondersteuning met het accent op het uitbouwen van de digitale voorzieningen. 3. strategische positionering en profilering van praktijkgericht onderzoek: communicatie en profilering, netwerkvorming, het onderhouden van partnerschappen
