Search results for: healthcare organization (HCO)

Authors: Ouzayr Rabhi, Ibtissam Arrassen

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To provide a complete analysis of the organization and to help decision-making, leaders need to have relevant data; Data Warehouses (DW) are designed to meet such needs. However, designing DW is not trivial and there is no formal method to derive a multidimensional schema from heterogeneous databases. In this article, we present a Model-Driven based approach concerning the design of data warehouses. We describe a multidimensional meta-model and also specify a set of transformations starting from a Unified Modeling Language (UML) metamodel. In this approach, the UML metamodel and the multidimensional one are both considered as a platform-independent model (PIM). The first meta-model is mapped into the second one through transformation rules carried out by the Query View Transformation (QVT) language. This proposal is validated through the application of our approach to generating a multidimensional schema of a Balanced Scorecard (BSC) DW. We are interested in the BSC perspectives, which are highly linked to the vision and the strategies of an organization.

Keywords: data warehouse, meta-model, model-driven architecture, transformation, UML

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Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

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Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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Authors: Laleh Boroumand, Muhammad Shiraz, Abdullah Gani, Rashid Hafeez Khokhar

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Cloud computing being the use of hardware and software that are delivered as a service over a network has its application in the area of health care. Due to the emergency cases reported in most of the medical centers, prompt for an efficient scheme to make health data available with less response time. To this end, we propose a mobile global healthcare village (MGHV) model that combines the components of three deployment model which include country, continent and global health cloud to help in solving the problem mentioned above. In the creation of continent model, two (2) data centers are created of which one is local and the other is global. The local replay the request of residence within the continent, whereas the global replay the requirements of others. With the methods adopted, there is an assurance of the availability of relevant medical data to patients, specialists, and emergency staffs regardless of locations and time. From our intensive experiment using the simulation approach, it was observed that, broker policy scheme with respect to optimized response time, yields a very good performance in terms of reduction in response time. Though, our results are comparable to others when there is an increase in the number of virtual machines (80-640 virtual machines). The proportionality in increase of response time is within 9%. The results gotten from our simulation experiments shows that utilizing MGHV leads to the reduction of health care expenditures and helps in solving the problems of unqualified medical staffs faced by both developed and developing countries.

Keywords: cloud computing (MCC), e-healthcare, availability, response time, service broker policy

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Authors: Haripriya Chakraborty

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The healthcare system in the United States is considered to be one of the most inefficient and expensive systems when compared to other developed countries. Consequently, there are persistent concerns regarding the overall functioning of this system. For instance, the large number of uninsured individuals and high premiums are pressing issues that are shown to have a negative effect on health outcomes with possible life-threatening consequences. The Affordable Care Act (ACA), which was signed into law in 2010, was aimed at improving some of these inefficiencies. This paper aims at providing a computational mechanism to examine some of these inefficiencies and the effects that policy proposals may have on reducing these inefficiencies. Agent-based modeling is an invaluable tool that provides a flexible framework to model complex systems. It can provide an important perspective into the nature of some interactions that occur and how the benefits of these interactions are allocated. In this paper, we propose a novel and versatile agent-based model with realistic assumptions to simulate the dynamics of a health insurance marketplace that contains a mixture of private and public insurers and individuals. We use this model to analyze the characteristics, motivations, payoffs, and strategies of these agents. In addition, we examine the effects of certain policies, including some of the provisions of the ACA, aimed at reducing the uninsured rate and the cost of premiums to move closer to a system that is more equitable and improves health outcomes for the general population. Our test results confirm the usefulness of our agent-based model in studying this complicated issue and suggest some implications for public policies aimed at healthcare reform.

Keywords: agent-based modeling, healthcare reform, insurance markets, public policy

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Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

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This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

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Authors: Hani Malik

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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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Authors: Carlos Olave Lopez de Ayala

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The concept of purpose has generated a remarkable interest as a subject of study by the scientific community in recent years. However, most authors have studied it from an organizational point of view. Concepts such as purpose-driven organization and purpose management have been the focal point of numerous research studies, as well as of empirical implementation in some organizations. On the other hand, theories of motivation have been traditionally focused on the purpose of an individual and have been used to refer to personal motivation. This paper aims to study the influence of organizational purpose on the dimensions of human motivations, involving the meaning that each individual gives to his/her work. The results show that the person’s alignment with the organizational purpose is connected with the meaning of work as a career, a calling, and a higher calling. This research adds to the knowledge of the impact of the organizational purpose and its influence on individuals.

Keywords: human motivations, meaningful work, organizational purpose, purpose management, purpose-driven organization

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Authors: Eva Štěpánková

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Environmental management implementation is presently one of the ways of organization success and value improvement. Increasing an organization motivation to environmental measures introduction is caused primarily by the rising pressure of the society that generates various incentives to endeavor for the environmental performance improvement. The aim of the paper is to identify and characterize the key incentives and expectations leading organizations to the environmental management implementation. The author focuses on five businesses of different size and field, operating in the Czech Republic. The qualitative approach and grounded theory procedure are used in research. The results point out that the significant incentives for environmental management implementation represent primarily demands of customers, the opportunity to declare the environmental commitment and image improvement. The researched enterprises less commonly expect the economical contribution, competitive advantage increase or export rate improvement. The results show that marketing contributions are primarily expected from the environmental management implementation.

Keywords: environmental management, environmental management system, ISO 14001, Czech Republic

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Supattra Kanchanopast

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This article presents the process of change for innovation in the Thai public sector in order to create higher client satisfaction. Change management should concern the potentiality of the change agent or leader, the long-term vision or policy (political side) of the organization, the communication within the organization, suitable organizational culture and structure, preparedness of the personnel, and the fitness of the reward system. Sustaining innovation creation is not sophisticated, as traditionally believed. A basic management principle of identifying clarified and motivating goals needs to be followed by creating support systems after implementation and by ensuring the stakeholders’ benefit, derived from the innovation projects. Finally, creating an amiable atmosphere among the practitioners, including effective evaluation and reward schemes, will support the innovation. However, none of these will ever take place unless support is gained from the leaders of those organizations, and from the staff and clients involved also as well.

Keywords: change management, client satisfaction, innovation management, Thai public sector

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Authors: Shabeer Khan

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The main objective of Islamic Finance is to promote social justice thorough financial inclusion and redistribution of economic resources between rich and poor. The approach of Islamic finance is more comprehensive in nature and covers both formal and informal sectors of the economy, first, through reducing the gap between both sectors, and second by using specific Islamic values to reallocate the wealth between formal and informal sectors. Applying Generalized Method of Movements (GMM) to the annual data spanning from 1995-2015 for 141 countries, this study explores the determinants of informal business sector in Organization of Islamic Cooperation (OIC) countries and then compares with Non-OIC countries. Economic freedom and institutions variables as well as economic growth and money supply are found to reduce informal business sector in both OIC and Non-OIC nations while government expenditure are found to increase informal business sector in both group of nations. Informal Business sector remain the same in both types of countries but still the majority Muslim population in OIC economies create main difference between both groups of nations and justify the potential role of Islamic Finance in informal business sector in OIC nations. The study suggests that institutions quality should be improved and entrepreneurs’ friendly business environment must be provided. This study refines the main features of informal business sector and discuss their implications on policy designing and implementation, particularly in the context of Islamic finance fight against poverty, inequality and improving living standards of informal sector participants in OIC countries.

Keywords: Islamic finance, informal Business Sector, Generalized Method of Movements (GMM) and OIC

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Authors: Beenish Urooj, Ubaid Ullah, Sidra Riasat

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National Testing Service-Pakistan (NTS) is an agency in Pakistan that conducts student success appraisal examinations. In this research paper, we must present a security model for the NTS organization. The security model will depict certain security countermeasures for a better defense against certain types of breaches and system malware. We will provide a security roadmap, which will help the company to execute its further goals to maintain security standards and policies. We also covered multiple aspects in securing the environment of the organization. We introduced the processes, architecture, data classification, auditing approaches, survey responses, data handling, and also training and awareness of risk for the company. The primary contribution is the Risk Survey, based on the maturity model meant to assess and examine employee training and knowledge of risks in the company's activities.

Keywords: NTS, risk assessment, threat factors, security, services

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Authors: Nusrat Zabeen Islam

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Partnership between local Non-Government organizations (NGO) and International development organizations has become an important feature in the development sector of Bangladesh. It is an important challenge for International development organizations to work with local NGOs with proper HR practice. Local NGOs have a lack of quality working environment and this affects the employee’s work experiences and overall performance at individual, partnership with International development organizations and organizational level. Many local development organizations due to the size of the organization and scope do not have a human resource (HR) unit. Inadequate Human Resource Policies, skills, leadership and lack of effective strategy is now a common scenario in Non-Government organization sector of Bangladesh. So corruption, nepotism, and fraud, risk of Political Contribution in office /work space, Sexual/ gender based abuse, insecurity take place in work place of development sector. The Complaint Management Mechanism (CMM) in human resource management could be one way to improve human resource competence in these organizations. The responsibility of Complaint Management Unit (CMU) of an International development organization is to make workplace maltreating, discriminating communities free. The information of impact of CMM was collected through case study of an International organization and some of its partner national organizations in Bangladesh who are engaged in different projects/programs. In this mechanism International development organizations collect complaints from beneficiaries/ staffs by complaint management unit and investigate by segregating the type and mood of the complaint and find out solution to improve the situation within a very short period. A complaint management committee is formed jointly with HR and management personnel. Concerned focal point collect complaints and share with CM unit. By conducting investigation, review of findings, reply back to CM unit and implementation of resolution through this mechanism, a successful bridge of communication and feedback can be established within beneficiaries, staffs and upper management. The overall result of Complaint management mechanism application indicates that by applying CMM accountability and transparency of workplace and workforce in development organization can be increased significantly. Evaluations based on outcomes, and measuring indicators such as productivity, satisfaction, retention, gender equity, proper judgment will guide organizations in building a healthy workforce, and will also clearly articulate the return on investment and justify any need for further funding.

Keywords: human resource management in NGOs, challenges in human resource, workplace environment, complaint management mechanism

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Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

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Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

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Authors: Miraç Savaş Turhan, Ali Danışman

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New institutional theorists in organization theory have used institutional logics perspective to explain the contradictory practices in modern western societies. Accordingly, distinct institutional logics are embedded in central institutions such as the market, state, democracy, family, and religion. Individual and organizational actors and their practices are restricted and guided by institutional logics in a particular field. Through this perspective, actors are assumed to have a situated, embedded, boundedly intentional, and adaptive role against the structure in social, cultural and political context. Since the early 1990's, increasing number of studies has attempted to explain the role of actors in creating, maintaining, and changing institutions. Yet, most of these studies have focused on organizational field-level actors, ignoring the role that can be played by individual actors within organizations. As a result, we have much information about what organizational field level actors can do, but relatively little knowledge about the ability of organizational change agents within organization in relation to institutional orders. This study is an attempt to find out how the ability of individual actors who attempt to change their organization is constrained and shaped by institutional logics dominating the field. We examine this issue in a private school in the Turkish Education field. We first describe dominating institutional logics in the Turkish Education field. Then we conducted in-depth interviews and content analysis in the school. The early results indicate that attempts and actions of organizational change agents are remarkably directed and shaped by the dominating institutional logics in the Turkish Education field.

Keywords: Institutional logics, individual actors, organizational change, organizational change agent

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Authors: A. R. Nor Azlina, H. Salwana, I. Zuraeda, A. R. Rashidah, O. Normah

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Transitioning towards globalization in the business environment has necessitated more essential growing changes such as competition, business strategy, innovation in technology and effectiveness of societal trends on adopting corporate governance are seen to be drivers of the future. This transformations on business environment has a significant impact to organizations’ performances. Many organizations are demanding for more proactive entrepreneurs with dynamic team, who can run and steer their business to success. Changing on strategy, roles, tasks, entrepreneurial skills and implementing corporate governance in relationship development is important to enhance the organization’s performance towards being more cost-efficient and subsequently increase its efficiency. Small Medium Enterprises (SMEs) in most developing countries are contributors to the economic growth of a nation. However, the potential of Microfinance Institutions (MFIs) is always overlooked in contributing towards SMEs development. The adoption of corporate governance and accountability in MFIs as driving forces for these SMEs is not incorporated in measurements of organization performance. This paper attempts to address some of the governance issues associated with dimensions of accountability in improving performances of microfinance institutions. Qualitative approach was adopted in this study to analyze the data collected. The qualitative approach emerges as contributing factor in understanding and critiquing accountability processes, as well as addressing the concerns of practitioners and policymakers. A close researcher engagement with the field which concerns process, embracing of situational complexity, as well as critical and reflective understandings of organizational phenomena remain as hallmarks of the tradition. It is concluded that in describing and scrutinizing an understanding of managerial behavior, organizational factors and macro-economic relationship in SMEs firm need to be improved. This is also the case in MFIs. A framework is developed to explore the linkage of corporate governance and accountability issues related to entrepreneurship as factors affecting MFIs performances in facing ongoing transformation of organization performance within Malaysian SMEs industries.

Keywords: accountability, corporate governance, microfinance, organization performance

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Authors: Hassan Kian

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The future of millions of people and consequently, the future of societies and humanity is threatened by a great threat which is called wasted human resources. Perhaps Pasteur, Beethoven and Avicenna, Lavoisier and Einstein and millions of genius individuals and thinkers may have never been discovered and could not found a chance of being known due to various reasons such as poverty or social status, and other problems. So without being able to serve humanity, their talents are fully wasted. While, if a global mechanism exists to discover their talents in different countries and provide to them the right direction, during less than a generation, human society will face to a profound transformation and sustainable social justice will be formed as the basis of sustainable development of human resources. Therefore, the situation of the institution which organizes the affair of discovering and guiding talents was vacant at the level of the international community and its necessity has been felt. So in this plan, the establishment and development of such an organization have been suggested in the international context.

Keywords: talent identification, comparative advantage, sustainable justice, sustainable development

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Everdeanne Javier, Kelvin Louie Abat, Alodia Rizzalynn Cabaya, Chynna Allyson Manzano, Vlasta Sai Espiritu, Raniah May Puzon, Michelle Tobler

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Teledermatology is becoming a more popular form of providing dermatologic healthcare worldwide, and it will almost certainly play a larger role in the future. As the current pandemic continues to worsen, Teledermatology is seen as the primary alternative to face-to-face dermatology consultation; therefore, it needs to be enhanced and developed to become as convenient and reliable as it can be for both patients and doctors. This research paper seeks to know the processes used in teledermatology regarding delivery modalities and proper consultation. This study's research design is a Qualitative Descriptive approach to describe further the processes used by teledermatologists. An online survey questionnaire was used to collect data from Teledermatology Clinics in San Fernando City, La Union. Research showed that patients tend to embrace and be pleased with teledermatology as a way of accessing healthcare. On the other hand, clinicians have usually reported positive outcomes from teledermatology. Furthermore, it is not intended to be used instead of a face-to-face appointment with a dermatologist.

Keywords: teledermatology, online dermatology consultation, dermatology, dermatologist

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Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

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Authors: Shreya Borthakur, Aastha Vartak

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This behavioral experiment aimed to investigate the global precedence phenomenon in a South Asian sample and its correlation with mobile screen time. The global precedence effect refers to the tendency to process overall structure before attending to specific details. Participants completed attention tasks involving global and local stimuli with varying consistencies. The results showed a tendency towards local precedence, but no significant differences in reaction times were found between consistency levels or attention conditions. However, the correlation analysis revealed that participants with higher screen time exhibited a stronger negative correlation with local attention, suggesting that excessive screen usage may impact perceptual organization. Further research is needed to explore this relationship and understand the influence of screen time on cognitive processing.

Keywords: global precedence, visual attention, perceptual organization, screen time, cognition

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Authors: H. Nur Görkemli, Mehmet Fidan

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After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. According to Turkish Statistical Institute’s 2013 data, internet usage in Turkey between 16-74 age group is 48,9%. Hospitals are one of the areas where internet is being intensively used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 31 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in terms of public and private institutions.

Keywords: websites, hospital, health communication, internet, webpages

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Authors: Ellie Abdi

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This paper is a review of a recently published book (April 2018) by Dr. Ellie Abdi. The book divides into two sections of 1) leadership in school organization and 2) pragmatic research in physical education professional development. The first part of the book explores school organizational development in terms of 1) communication development, 2) community development, and 3) decision making development. It concludes to acknowledge that decision making is the heart of educational management. This is while communication and community are essential to the development of the school organization. The role of a leader in a professional learning community (PLC) is acknowledged with the organizational development plan and moves onto 5 overall objectives of a professional development plan. It clarifies that professional learning community (PLC) benefits both students and professionals in education. Furthermore, professional development needs to be involved in opportunities to value diversity and foundations of learning, in addition to search for veteran teachers who offer a rich combination of experience and perspective. School educational platform in terms of teacher training in physical education is discussed in the second part. The book reviews that well-designed programs are powerful and constructive ways to identify the strength and weaknesses of teachers. Post-positivism, constructivism, advocacy/participatory, and pragmatism in teacher education are also disclosed. The book specifically unfolds pragmatic research in professional development of physical education. It provides researchers, doctoral, and masters level students with defined examples. In summary, the book shows how appropriate it is when many different traditions are displayed in a pragmatic way, following the stages of research from development to dissemination.

Keywords: leadership, physical education, pragmatic, professional development

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Authors: Mehdi Rastegari Ghiri, Mohammad Reza Baradaran, Zahra Mirsanjari

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The aim of the present study was the investigation of DNA Corporate General Administration of Sports and Youth in Fars province. The descriptive research method is a survey that was conducted by field survey. For data collection, questionnaires were used that designed based on Hnald and Silverman model. In this model the organizational DNA model is stated in four types: objective, individualistic, field-oriented and Spiritual. The reliability of the questionnaire by the researcher obtained by using Cronbach's alpha equal to 89/0 respectively. The statistical population includes all managers and specialists of Fars Province Directorate of Youth and Sport that 48 of them were selected as the samples of the research. The results showed the organizational DNA Directorate General for Youth and Sports Organization of Fars province has a field –oriented and nearly field-oriented DNA.

Keywords: organizational, DNA, Hnald, Silverman model

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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Authors: F. Demir

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Strategic Management is highly critical for all types of organizations. This paper examines maturity level of strategic management practices of public and private sector organizations in Turkey, and presents a conceptual model for assessing the maturity of strategic management in any organization. This research focuses on R&D intensive organizations (RDO) because it is claimed that such organizations are more innovative and innovation is a critical part of the model. The Strategic management maturity model (S-3M) is basically composed of six maturity levels with five different dimensions. Based on 63 organizations, the findings reveal that the average maturity of all organizations in the sample group is three out of five. It corresponds to the stage of ‘performed’. Results simply show that the majority of organizations from various industries and sectors implement strategic management activities; however, they experience multiple challenges to optimize strategic management processes and integrate organizational components with business strategies. Briefly, they struggle to become an innovative organization.

Keywords: strategic management maturity, innovation, developing countries, research and development

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Authors: Frank Fan

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PharmD (Doctor of Pharmacy) education has confronted an increasing challenge — curricular overload, a phenomenon resulting from the expansion of curricular requirements, as PharmD education strives to produce graduates who are practice-ready. The aftermath of the global pandemic has amplified the need for healthcare professionals, leading to a growing trend of assigning more responsibilities to them to address the global healthcare shortage. For instance, the pharmacist’s role has expanded to include not only compounding and distributing medication but also providing clinical services, including minor ailments management, patient counselling and vaccination. Consequently, PharmD programs have responded by continually expanding their curricula adding more requirements. While these changes aim to enhance the education and training of future professionals, they have also led to unintended consequences, including curricular overload, student burnout, and a potential decrease in program quality. To address the issue and ensure program quality, there is a growing need for evidence-based curriculum reforms. My research seeks to integrate Cognitive Load Theory, emerging machine learning algorithms within artificial intelligence (AI), and statistical approaches to develop a quantitative framework for optimizing curriculum design within the PharmD program at the University of Toronto, the largest PharmD program within Canada, to provide quantification and measurement of issues that currently are only discussed in terms of anecdote rather than data. This research will serve as a guide for curriculum planners, administrators, and educators, aiding in the comprehension of how the pharmacy degree program compares to others within and beyond the field of pharmacy. It will also shed light on opportunities to reduce the curricular load while maintaining its quality and rigor. Given that pharmacists constitute the third-largest healthcare workforce, their education shares similarities and challenges with other health education programs. Therefore, my evidence-based, data-driven curriculum analysis framework holds significant potential for training programs in other healthcare professions, including medicine, nursing, and physiotherapy.

Keywords: curriculum, curriculum analysis, health professions education, reflective writing, machine learning

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Authors: Simon Samwel Msanjila

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Networked environments which provides platforms and environments for business organizations are configured in different forms depending on many factors including life time, member characteristics, communication structure, and business objectives, among others. With continuing advances in digital technologies the distance has become a less barrier for business minded collaboration among organizations. With the need and ease to make business collaborate nowadays organizations are sometimes forced to co-work with others that are either unknown or less known to them in terms of history and performance. A promising approach for sustaining established collaboration has been establishment of trust relationship among organizations based on assessed trustworthiness for each participating organization. It has been stated in research that trust in organization is dynamic and thus assessment of trust level must address such dynamic nature. This paper assess relevant aspects of trust and applies the concepts to propose a semi-automated system for assessing the Sustainability and Evolution of trust in organizations participating in specific objective in a networked organizations environment.

Keywords: trust evolution, trust sustainability, networked organizations, dynamic trust

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Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

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