Insider ethnographic analysis is used to analyze change processes in an engineering department. Distributed leadership theory is used as conceptual framework.
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Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.
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Mainstream views of Dutch foreign policy seem to be based upon a persistent assumption that, as a small Western European country, foreign policy is characterized by fundamental stability and continuity. In some regards this stability has almost become a policy and organizational guideline; however, this emphasis on stability as an empirical reality and management standard may be the result of inadequate concepts and models of foreign policy and organizational change. The following research questions are addressed in this article. What are the main carriers and barriers in Dutch foreign policy and organizational change? How can insights from international relations studies, and policy and organization studies be combined to give a model of foreign policy and organizational change? We propose a model based on 11 carriers and barriers for change at four levels of analysis: the international system; the national system; the organizational system; and the individual system. These carriers and barriers are used to explain three types of foreign policy change: policy instruments; strategy and goals; and political and normative foundations. Organizational change concerns: (1) change of roles; (2) change of tasks; (3) change of size of tasks and roles; (4) change of division of tasks and roles; and (5) change of the portfolio of tasks and roles. We discuss Dutch foreign policy towards its former colony Surinam and end with some suggestions for further research.
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This project builds upon a collaboration which has been established since 15 years in the field of social work between teachers and lecturers of Zuyd University, HU University and Elte University. Another network joining this project was CARe Europe, an NGO aimed at improving community care throughout Europe. Before the start of the project already HU University, Tallinn Mental Health Centre and Kwintes were participating in this network. In the course of several international meetings (e.g. CARe Europe conference in Prague in 2005, ENSACT conferences in Dubrovnik in 2009, and Brussels in April 2011, ESN conference in Brussels in March 2011), and many local meetings, it became clear that professionals in the social sector have difficulties to change current practices. There is a great need to develop new methods, which professionals can use to create community care.
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Malnutrition is a serious and widespread health problem in community-dwelling older adults who receive care in hospital and at home. Hospital and home care nurses and nursing assistants have a key role in the delivery of high-quality multidisciplinary nutritional care. Nursing nutritional care in current practice, however, is still suboptimal, which impacts its quality and continuity. There appear to be at least two reasons for this. First, there is a lack of evidence for nutritional care interventions to be carried out by nurses. Second, there are several factors, that influence nurses’ and nursing assistants’ current behaviour, such as lack of knowledge, moderate awareness of the importance and neutral attitudes. This results in a lack of attention towards nutritional care. Therefore, there is a need to generate more evidence and to focus on targeting the factors that influence nurses’ and nursing assistants’ current behaviour to eventually promote behaviour change. To increase the likelihood of successfully changing their behaviour, an evidence-based educational intervention is appropriate. This might lead to enhancing nutritional care and positively impact nutritional status, health and well-being of community-dwelling older adults. The general objectives of this thesis are: 1) To understand the current state of evidence regarding nutrition-related interventions and factors that influence current behaviour in nutritional care for older adults provided by hospital and home care nurses and nursing assistants to prevent and treat malnutrition. 2) To develop an educational intervention for hospital and home care nurses and nursing assistants to promote behaviour change by affecting factors that influence current behaviour in nutritional care for older adults and to describe the intervention development and feasibility.
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Over recent years aspects of sustainability have claimed a central role in many countries. As a result research for sustainability has become an important driver for innovation. This paper describes developing a model that supports SMEs in integrating sustainability in their business and innovation processes. In general innovation and entrepreneurship are important in the realm of national economies because they hold the key to the continuity and growth of companies and economic growth within a country. National governments are spending vast sums of money to enable and improve innovation management and entrepreneurial behaviour within organizations. This is also the case in The Netherlands. Partnerships involving universities (education), companies (preferably SMEs) and industrial associations (business) and representatives from governmental organizations (community) are stimulated and should be geared towards: the development of sustainable networks, a contribution to regional economic growth within sectors, the development of learning communities in which best practices are shared, knowledge circulates and knowledge is created through applied research and last but not least sustainable relations are developed between universities and the business community. Within the centre for innovation and entrepreneurship at our university we have taken the initiative to develop an innovation programme for entrepreneurs in the construction industry to help them integrate sustainability in their business processes, while simultaneously professionalizing students and teachers. Sustainability and concern for the environment are two of the main reasons for entrepreneurs to look for opportunities to innovate. Policy measures are aimed at reduction of CO2 emission, waste management and alternative use of energy sources and materials. In line with these measures companies are urged to integrate sustainability in their business processes and search for innovative sustainable solutions. This paper describes the experiences with a number of SMEs in the construction industry and the barriers entrepreneurs encounter on the road towards sustainability. We focus on the role of the entrepreneur in the process of sustainable innovation and development. We conducted exploratory research and through an organisational analysis and in-depth interviews with the owners/managers of the companies insight was gained in innovation processes towards sustainable development. Conclusions show that one of the main bottlenecks is the dilemma posed by the need for profit for the continuity of a company, while taking into account people and planet. The dilemmas of innovation are described as issues that need to be addressed and which influence the innovative capacity of companies and organizations. This paper deals with the underlying factors related to the dilemma between sustainability and growth/profit.
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from Narcis: "What is known and objective Medication discrepancies are common at hospital discharge, and medication reconciliation is widely endorsed as a preventive strategy. However, implementation is difficult for instance due to the unreliability of patients medication histories. In the Netherlands, community pharmacies are well-informed about their patients’ pre-admission medication status which enables thorough post-discharge reconciliation. Our aim was to study the frequency and nature of medication discrepancies, missing patient's knowledge and administrative problems at admission to primary care. Methods A cross-sectional study was conducted in pharmacies belonging to the Utrecht Pharmacy Practice network for Education and Research in the Netherlands. Structured checklists were used to evaluate all discharge prescriptions presented by adult patients discharged from the hospital to their own home during the study period. The primary outcome was all possible problems with continuity of care, defined as (i) the number and type of medication discrepancies, (ii) administrative problems and (iii) the necessity for patient education. Results and discussion In forty-four pharmacies, checklists were completed for 403 patients. Most discharge prescriptions (92%) led to one or more problems with continuity of care (n = 1154, mean 2·9 ± 2·0), divided into medication discrepancies (31%), administrative problems (34%) and necessity for further education (35%). Medication discrepancies (n = 356) resulted mainly from missing pre-admission medication (n = 106) and dose regimen changes (n = 55) on the discharge prescription. Administrative problems (n = 392) originated mainly from administrative incompleteness (n = 177), for example missing reimbursement authorization forms, or supply issues (n = 150), for example insufficient pharmacy stock. The patients’ lack of medication knowledge post-discharge was illustrated by the high need for patient education (n = 406). What is new and conclusion Community pharmacists are still confronted with problems due to inadequate documentation at discharge which can inflict harm to patients if not properly addressed. To reduce these problems, a rigorous implementation of the medication reconciliation process at all transition points, standardized electronic transfer of all medication-related information and interdisciplinary collaboration are crucial."
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In this entry communicating organizational change will be discussed. Organizational change is one of the most published topics within business and organizational studies and communication during organizational change received a lot of attention as well. In this entry episodic, top-down change approaches versus continuous, developmental approach of organizational change will be discussed, also the distinction between information and relational aspects of communication during change.
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Hoofdstuk 20 Part II in Understanding Penal Practice van Ioan Durnescu en Fergus McNeill Criminological and penological scholarship has in recent years explored how and why institutions and systems of punishment change – and how and why these changes differ in different contexts. Important though these analyses are, this book focuses not so much on the changing nature of institutions and systems, but rather the changing nature of penal practice and practitioners The first part of the book focuses on understanding practice and practitioners, exploring how changing social, cultural, political, and organisational contexts influence practice, and how training, development, professional socialisation and other factors influence practitioners. The second part is concerned with how practitioners can be best supported to develop the skills and approaches that seem most likely to generate positive impacts. It contains accounts of new practice models and approaches, as well as reports of research projects seeking both to discover and to encourage effective practices
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Behaviour Change Support Systems (BCSS), already running for the 10th time at Persuasive Technology, is a workshop that builds around the concept of systems that are specifically designed to help and support behaviour change in individuals or groups. The highly multi-disciplinary nature of designing and implementing behaviour change strategies and systems for the strategies has been in the forefront of this workshop from the very beginning. The persuasive technology field is becoming a linking pin connecting natural and social sciences, requiring a holistic view on persuasive technologies, as well as multi-disciplinary approach for design, implementation, and evaluation. So far, the capacities of technologies to change behaviours and to continuously monitor the progress and effects of interventions are not being used to its full potential. The use of technologies as persuaders may shed a new light on the interaction process of persuasion, influencing attitudes and behaviours. Yet, although human- computer interaction is social in nature and people often do see computers as social actors, it is still unknown how these interactions re-shape attitude, beliefs, and emotions, or how they change behaviour, and what the drawbacks are for persuasion via technologies. Humans re-shape technology, changing their goals during usage. This means that persuasion is not a static ad hoc event but an ongoing process. Technology has the capacity to create smart (virtual) persuasive environments that provide simultaneously multimodal cues and psycho-physiological feedback for personal change by strengthening emotional, social, and physical presence. An array of persuasive applications has been developed over the past decade with an aim to induce desirable behaviour change. Persuasive applications have shown promising results in motivating and supporting people to change or adopt new behaviours and attitudes in various domains such as health and wellbeing, sustainable energy, education, and marketing. This workshop aims at connecting multidisciplinary researchers, practitioners and experts from a variety of scientific domains, such as information sciences, human-computer interaction, industrial design, psychology and medicine. This interactive workshop will act as a forum where experts from multiple disciplines can present their work, and can discuss and debate the pillars for persuasive technology.
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