Aim: To evaluate healthcare professionals' performance and treatment fidelity in the Cardiac Care Bridge (CCB) nurse-coordinated transitional care intervention in older cardiac patients to understand and interpret the study results. Design: A mixed-methods process evaluation based on the Medical Research Council Process Evaluation framework. Methods: Quantitative data on intervention key elements were collected from 153 logbooks of all intervention patients. Qualitative data were collected using semi-structured interviews with 19 CCB professionals (cardiac nurses, community nurses and primary care physical therapists), from June 2017 until October 2018. Qualitative data-analysis is based on thematic analysis and integrated with quantitative key element outcomes. The analysis was blinded to trial outcomes. Fidelity was defined as the level of intervention adherence. Results: The overall intervention fidelity was 67%, ranging from severely low fidelity in the consultation of in-hospital geriatric teams (17%) to maximum fidelity in the comprehensive geriatric assessment (100%). Main themes of influence in the intervention performance that emerged from the interviews are interdisciplinary collaboration, organizational preconditions, confidence in the programme, time management and patient characteristics. In addition to practical issues, the patient's frailty status and limited motivation were barriers to the intervention. Conclusion: Although involved healthcare professionals expressed their confidence in the intervention, the fidelity rate was suboptimal. This could have influenced the non-significant effect of the CCB intervention on the primary composite outcome of readmission and mortality 6 months after randomization. Feasibility of intervention key elements should be reconsidered in relation to experienced barriers and the population. Impact: In addition to insight in effectiveness, insight in intervention fidelity and performance is necessary to understand the mechanism of impact. This study demonstrates that the suboptimal fidelity was subject to a complex interplay of organizational, professionals' and patients' issues. The results support intervention redesign and inform future development of transitional care interventions in older cardiac patients.
De markt voor Business Process Management (BPM) software groeit razend snel. Voor 2010 wordt er een marktomvang voorspeld van tussen de 1 tot 6 miljard dollar, dit betekend dat deze markt sinds 2005 meer dan verdubbeld is. BPM krijgt ook in toenemende mate publiciteit in de markt echter dan gaat het veelal om wat BPM nu precies wel en niet is en niet over hoe het toegepast kan worden. Hetzelfde geldt voor BPM software, beter bekend als Business Process Management Systemen (BPMS). Het onderzoek beschreven in dit proefschrift focust op BPMS, het ontstaan, waar het naartoe gaat en wat er allemaal komt kijken bij de invoering en het gebruik ervan. De hoofdonderzoeksvraag in dit proefschrift is: Welke factoren en competenties bepalen het succes van de implementatie van Business Process Management Systemen in een specifieke situatie? Centraal in dit proefschrift staan de volgende onderzoeksvragen: 1. Wat zijn de succes factoren bij de implementatie van Business Process Management Systemen? 2. Welke competenties hebben stakeholders in een Business Process Management Systeem implementatie project nodig? 3. Hoe ziet een Business Process Management Systeem implementatie methodiek eruit welke rekening houdt met de omgevingsfactoren van een organisatie?
MULTIFILE
Abstract Business Process Management (BPM) is an important discipline for organizations to manage their business processes. Research shows that higher BPM-maturity leads to better process performance. However, contextual factors such as culture seem to influence this relationship. The purpose of this paper is to investigate the role of national culture on the relationship between BPM-maturity and process performance. A multiple linear regression analysis is performed based on data from six different countries within Europe. Although the results show a significant relationship between BPM-maturity and process performance, no significant moderation effect of national culture has been found. The cultural dimension long term orientation shows a weak negative correlation with both BPM-maturity and process performance. Through a post-hoc moderation analysis on each dimension of BPM-maturity, we further find that long term orientation negatively moderates the relationship between process improvement and process performance. Three other moderation effects are also discovered. The results of this study contribute to insights into the role of culture in the field of BPM.
MULTIFILE
Carboxylated cellulose is an important product on the market, and one of the most well-known examples is carboxymethylcellulose (CMC). However, CMC is prepared by modification of cellulose with the extremely hazardous compound monochloracetic acid. In this project, we want to make a carboxylated cellulose that is a functional equivalent for CMC using a greener process with renewable raw materials derived from levulinic acid. Processes to achieve cellulose with a low and a high carboxylation degree will be designed.
Digital transformation has been recognized for its potential to contribute to sustainability goals. It requires companies to develop their Data Analytic Capability (DAC), defined as their ability to collect, manage and analyze data effectively. Despite the governmental efforts to promote digitalization, there seems to be a knowledge gap on how to proceed, with 37% of Dutch SMEs reporting a lack of knowledge, and 33% reporting a lack of support in developing DAC. Participants in the interviews that we organized preparing this proposal indicated a need for guidance on how to develop DAC within their organization given their unique context (e.g. age and experience of the workforce, presence of legacy systems, high daily workload, lack of knowledge of digitalization). While a lot of attention has been given to the technological aspects of DAC, the people, process, and organizational culture aspects are as important, requiring a comprehensive approach and thus a bundling of knowledge from different expertise. Therefore, the objective of this KIEM proposal is to identify organizational enablers and inhibitors of DAC through a series of interviews and case studies, and use these to formulate a preliminary roadmap to DAC. From a structure perspective, the objective of the KIEM proposal will be to explore and solidify the partnership between Breda University of Applied Sciences (BUas), Avans University of Applied Sciences (Avans), Logistics Community Brabant (LCB), van Berkel Logistics BV, Smink Group BV, and iValueImprovement BV. This partnership will be used to develop the preliminary roadmap and pre-test it using action methodology. The action research protocol and preliminary roadmap thereby developed in this KIEM project will form the basis for a subsequent RAAK proposal.
Door producten en diensten inclusief te ontwerpen kunnen ontwerpers een belangrijke bijdrage leveren aan een inclusievere samenleving, waarin iedereen op eigen wijze kan participeren. In AID gaan negen mkb-ontwerpbureaus Afdeling Buitengewone Zaken (A/BZ), theRevolution, Design Innovation Group, Greenberry, Ideate, Keen Public, Muzus, Netrex Internet Solutions (Leer Zelf Online) en Vrienden van verandering) die rijke maar uiteenlopende ervaring hebben met inclusief ontwerpen op zoek naar antwoorden op de vraag hoe hun vermogen voor inclusief ontwerpen kan worden versterkt. Ze doen dit middels actie-onderzoek in hun eigen beroepspraktijk en door hun ervaringen te delen met onderzoekers, docenten en co-ontwerpers in een ‘learning community’.