Change Management Research Articles

Improving Adherence to Clinical Practice Guidelines for Managing Gastric Intestinal Metaplasia Among Gastroenterologists at a US Academic Institution.

Clinical guidelines reserve endoscopic surveillance after a gastric intestinal metaplasia (GIM) diagnosis for high-risk patients. However, it is unclear how closely guidelines are followed in clinical practice. We examined the effectiveness of a standardized protocol for the management of GIM among gastroenterologists at a US hospital. This was a preintervention and postintervention study, which included developing a protocol and education of gastroenterologists on GIM management. For the preintervention study, 50 patients with GIM were randomly selected from a histopathology database at the Houston VA Hospital between January 2016 and December 2019. For the postintervention study, we assessed change in GIM management in a cohort of 50 patients with GIM between April 2020 and January 2021 and surveyed 10 gastroenterologists. The durability of the intervention was assessed in a cohort of 50 GIM patients diagnosed between April 2021 and July 2021. In the preintervention cohort, GIM location was specified (antrum and corpus separated) in 11 patients (22%), and Helicobacter pylori testing was recommended in 11 of 26 patients (42%) without previous testing. Gastric mapping biopsies were recommended in 14% and surveillance endoscopy in 2%. In the postintervention cohort, gastric biopsy location was specified in 45 patients (90%, P <0.001) and H. pylori testing was recommended in 26 of 27 patients without prior testing (96%, P <0.001). Because gastric biopsy location was known in 90% of patients ( P <0.001), gastric mapping was not necessary, and surveillance endoscopy was recommended in 42% ( P <0.001). One year after the intervention, all metrics remained elevated compared with the preintervention cohort. GIM management guidelines are not consistently followed. A protocol for GIM management and education of gastroenterologists increased adherence to H. pylori testing and GIM surveillance recommendations.

Groundwater: Sinking Cities, Urbanisation, Global Drying, Population Growth

Groundwater: Sinking Cities, Urbanisation, Global Drying, Population Growth

PHYSICAL ACTIVITY AND SPINAL CORD INJURY: BEHAVIOUR, BARRIERS, MOTIVATIONS AND GAINS

INTRODUCTION &amp; AIMS To attain a comprehensive understanding of physical activity (PA) behaviour in individuals with a spinal cord injury (SCI) in Australia. Investigation and analysis included volumes, guideline-adherence, barriers, motivators, and perceived benefits of PA. METHODS Methodology included quantitative and qualitative approaches. Statistical tests were used on national survey data (n=1,579) to scrutinise PA volumes and guideline-adherence. Semi-structured interviews (n=105) were used to explore barriers to PA, whilst focus groups (six groups of six people) were used to uncover motivations for, and gains of, PA. RESULTS The average PA per week was 333 (+/-318) minutes, 42% of people were sedentary, and less than half (47%) of individuals met PA-specific guidelines. Sociodemographic and injury characteristics displayed very weak capacity (2-5% variance) in predicting PA volume. Barriers pertained to cost, accessibility, pain, self-consciousness, and a perceived lack of return of investment in PA. Whilst appearance/weight management and improved health appeared initially as motivators to PA, participants reported they gained more affiliation and revitalisation through PA, and less appearance/weight management and health change than they had anticipated. Focus group analysis highlighted that the primary (and more significant) motivators and benefits of PA include independence, reclamation of identity, restitution, reduced familial burden, and mitigation of perceived hastened aging. CONCLUSION People with SCI in Australia are amongst the most sedentary in the nation, and less than half of individuals meet PA guidelines. Specific attention is needed toward females, older individuals and people injured non-traumatically. Barriers are significant and affordable and accessible services, skilful and knowledgeable clinicians, and an inclusive environment are needed to improve consumer confidence. Motivation and perceived benefits extend beyond obvious physical advantages of PA. Clinicians and scientists need to understand the psychosocial influence of PA in this sedentary population and harness this knowledge to improve participation and quality of life.

National Variability in Soil Organic Carbon Stock Predictions: Impact of Bulk Density Pedotransfer Functions

Accurate soil organic carbon storage (SOCS) estimation is crucial for sustaining ecosystem health and mitigating climate change impacts. This study investigated the accuracy and variability of SOCS predictions, focusing on the role of pedotransfer functions (PTFs) in estimating soil bulk density (BD). Utilizing a comprehensive dataset from the Korean Rural Development Administration (RDA database), which includes 516 soil horizons, we evaluated 36 widely-used BD PTFs, well-established formulas that estimate BD by considering soil properties, including soil organic carbon (SOC), soil organic matter (OM), sand, gravel, silt, and clay. These PTFs demonstrated varying levels of precision, with root mean squared errors (RMSE) ranging from 0.177 to 0.377 Mg m-3 and coefficients of determination (R2) from 0.176 to 0.658; hence, the PTFs have been classified into excellent, moderate, and poor-performing groups for predicting BD. Further, a novel PTF based on an exponential function of SOC was developed, showing superior predictive power (R2 = 0.73) compared to existing PTFs, using an independent validation dataset. Our findings reveal significant differences in SOCS predictions and observations among the PTFs, with a p-value <0.05. The highest concentrations of SOCS were noted in forest soils, considerably above the national average, highlighting the importance of tailored soil management practices to enhance carbon sequestration. These findings are crucial for refining PTF precision to improve the accuracy of national SOCS estimates, supporting effective land management and climate change mitigation strategies.

Integrated 4D Design Change Management Model for Construction Projects

Integrated 4D Design Change Management Model for Construction Projects

High Rates of Discordant Ureteral Perfusion During Open Ureteral Reconstruction with Indocyanine Green: Does Near-Infrared Fluorescence Imaging Change Management or Stricture Outcomes?

OBJECTIVETo determine the role of near-infrared fluorescence imaging (NIFI) combined with indocyanine green (ICG) to assess ureteral tissue perfusion in a benign genitourinary reconstruction cohort with a high prevalence of prior abdominopelvic radiation and surgery. MATERIALS AND METHODSA prospective, single-surgeon series, between June 2018 and April 2022, of patients who underwent open genitourinary reconstructive surgeries in which NIFI/ICG was utilized to intraoperatively assess ureteral tissue perfusion prior to ureteral anastomosis. Primary outcome was ureteroanastomotic stricture (UAS). Secondary outcomes included impact of NIFI/ICG on surgical decision-making and ureter resection length. RESULTS39 patients, median age 66, underwent 40 multimodality reconstructive surgeries during which NIFI/ICG was utilized in the open setting. Radiation-induced etiology was present in 32 of 40 (80%) patients. UAS occurred in 1 of 57 (1.8%) anastomoses with median follow-up 23.4 months. Use of NIFI/ICG changed intraoperative decision-making in 63% of cases. Change in intraoperative decision-making was more common in patients with prior abdominopelvic radiation (66%) compared to non-radiated patients (13%), p=0.007. Discordance between subjective (white-light) and objective (NIFI/ICG) ureteral perfusion (white-light) occurred in 61% of ureters. Mean length of resected ureter was higher following objective assessment with NIFI/ICG (3.6 cm) versus subjective assessment (white light) conditions (1.8 cm), p=0.001. CONCLUSIONSUse of NIFI/ICG was associated with low rates of UAS at 2 years follow-up in a cohort with high prevalence of prior radiation. NIFI/ICG was associated with longer lengths of ureter resection and ureteral perfusion assessment discordance compared to subjective surgeon assessment under white-light conditions.

Efficacy of post-operative X-rays after operatively treated ankle fractures: What is their role?

ObjectiveThe utility of routine post-operative imaging in clinically asymptomatic patients is unclear. We sought to determine how frequently X-rays following operatively treated ankle fractures result in a change in management. DesignRetrospective cohort study conducted with hospital electronic health record SettingSingle level 1 trauma center in major urban city. Patients/Participants193 patients with operatively treated ankle fractures at our institution between January 2020 and December 2021. Main Outcome MeasuresPatient radiographs were categorized as surveillance X-rays and clinically indicated X-rays. Changes in management were defined as alteration in follow-up, deviation from standard post-operative protocols, or revision surgery. A logistic regression was performed looking at factors predicting whether an X-ray changes management. A cost analysis was also performed looking at the financial implications of asymptomatic surveillance of ankle fractures. Results438 post-operative X-rays were found and included in analysis. Of these, 391 were considered surveillance X-rays and 47 clinically indicated. 23 X-rays were determined to have resulted in changes in management (18 clinically indicated, 5 taken in asymptomatic patients). The number of management changing X-rays was significantly higher in the clinically indicated group (p < 0.0001). The only factor associated with whether an X-ray changed management was whether the patient was symptomatic at the visit (p < 0.0001). Asymptomatic surveillance X-rays cost our institution 21,825.62 USD per year. ConclusionsRadiographs in clinically asymptomatic patients with operatively managed ankle fractures have a low likelihood of changing management. Such imaging represents costs to the healthcare system, increased time for patients during clinic visits, and radiation exposure. The use of screening radiographic studies remains commonplace because the risk of delayed diagnosis is great, and the goal of any surgeon should be the swift identification of complications in order to minimize patient morbidity. Future surveillance protocols should consider the findings of this and other studies on the use of screening radiographs and strike a careful balance between minimizing unnecessary imaging, maximizing early complication detection, and ensuring a personalized approach towards patient-level factors to optimize care and efficiency for both patient and health system. Level of EvidenceLevel III

An economic assessment of alternative antimicrobial use scenarios on pig farms.

This paper explores the theoretical economic outcome of management changes that result in different levels of antimicrobial use (AMU) in two types of UK pig farm. A static farm economic pig production model (FEPM) was used on a representative 'Top-third' most profitable farm and a representative 'Mid-range' profitable farm. Three AMU theoretical management scenarios were investigated; (a) management changes leading to a reduction of AMU by 35% (AMU35); (b) more extensive management changes leading to a reduction of AMU by 95% (AMU95); and (c) implementing depopulation of the herd (AMU Depop). A sensitivity analysis was conducted to determine the effect of increases or decreases in pig revenue and feed price on farm gross margin under these scenarios. Over a single year, the AMU35 scenario was estimated to have a small positive impact (+3%) on both farm types. The other two AMU reduction scenarios had higher AMU reduction on farms but required higher variable cost and hence they resulted in lower farm profitability. There was a substantial reduction (up to -50%) in farm gross margin under these two AMU reduction scenarios in the modeled short-term time-period. The impact of the alternative AMU scenarios was slightly higher on a farm representing the 'Top-third' farm type, reducing farm gross margin further by 7% compared to the 'Mid-range' farm. Nevertheless, both farm types stay profitable under all three AMU scenarios. The results showed that in the modeled short-term implementing management changes that result in a reduction of on-farm AMU by 35% had a good economic outcome. In practice, the other two scenarios would be considered as longer-term strategies. Although both require higher initial costs to implement, the improved biosecurity and hygiene will benefit from lower disease occurrence for a longer term. Farm gross margins were, however, found to be highly sensitive to changes on market prices especially increasing feed prices. An increase of more than 15% in feed price moved a profitable farm into a loss-making farm. It will be economically challenging for uptakes of these, or similar, AMU reduction scenarios on farms if the market prices become un-favorable to pig farmers.

Design and Evaluation of A Module in Climate Change and Disaster Risk Management (CCDRM)

The effectiveness of their teaching strategies has always been a concern for every professional teacher. Teaching strategies include students in every step of the learning process and encourage them to study. For this study, frequency (f), percentage (%), mean (M), and standard deviation (SD) and mixed factorial analysis of variance (MANOVA) were used. The intervention was given to the treatment group which was the synchronous learning modality, while the control group was represented by the asynchronous /self-regulated learning modality from 100 students of Isabela State University – Jones Campus under the new normal condition. The research instrument was developed for “Design and Evaluation of a Module in Climate Change and Disaster Risk Management (CCDRM)”. It is revealed that the overall results on the teachers’ and student evaluation of the CCDRM learning module show relatively high using the set indicators. During the pre-test, there was a higher proportion of students with moderate performance for asynchronous classes and fewer students with low performance compared to those who would undergo synchronous classes and during the post-test, there was a higher proportion of students with moderate performance for asynchronous classes and fewer students with low performance compared to those who underwent synchronous classes. As to the student’s performance, there was no statistically significant difference in the scores for synchronous and asynchronous classes. To teach university students about climate change and disaster risk management, it is advised that this research demonstrated the effectiveness of both the asynchronous and synchronous strategy. Keywords: Asynchronous, Synchronous, Climate Change and Disaster Risk Management, Teaching strategies

Pemanfaatan Teknologi Digital dalam Upaya Memperkuat Ekonomi Digital pada Koperasi Simpan Pinjam di Desa Sobangan Mengwi

Cooperatives as a form of microfinance institutions are known as pillars or cornerstones of the economy. However, not much has been heard of the actions of cooperatives that are capable of becoming cooperatives on a national, international scale or using digital financial services. The existence of digitalization of cooperatives has a goal orientation for convenience, speed of service, comfort, and security when making transactions with cooperatives. In addition, efforts to digitize cooperatives are expected to accelerate the growth of cooperatives. With digitalization, cooperatives are able to expand their business scale to remote areas. Based on the situation analysis of Candra Sedana's KSP partners, various problems and limitations have been found which can be identified as follows: partners' lack of knowledge about the concept of digital transformation regarding cooperative financial information systems that are connected to the banking system and QRIS adoption and partners' lack of knowledge about the concept of change management. The solutions offered related to partner problem solving are as follows: Providing counseling regarding the concept of 'change management', Providing counseling regarding the concept of digital transformation regarding literacy regarding cooperative financial information systems that are connected to banking and the QRIS concept of optimal utilization, as well as implementing assistance and direct practice regarding the adoption of information systems and QRIS development.

Cross-industry frameworks for business process reengineering: Conceptual models and practical executions

Cross-industry frameworks for business process reengineering (BPR) have emerged as pivotal tools in enhancing organizational efficiency, agility, and competitiveness across diverse sectors. These frameworks amalgamate conceptual models with practical executions to streamline operations, optimize resource allocation, and foster innovation. This review delves into the essence of cross-industry frameworks for BPR, elucidating their conceptual underpinnings and real-world applications. At the core of cross-industry frameworks lies the recognition that business processes transcend sector boundaries, encompassing common elements such as customer interactions, supply chain management, and operational workflows. Conceptual models form the foundational framework by articulating key principles, methodologies, and best practices for BPR initiatives. One prominent conceptual model is the Business Process Reengineering (BPR) methodology, which advocates for radical redesign rather than incremental improvement of processes. This approach emphasizes fundamental questioning of existing practices, aiming to achieve dramatic enhancements in efficiency, quality, and customer satisfaction. Another influential model is the Capability Maturity Model Integration (CMMI), which provides a roadmap for organizations to systematically improve their processes by advancing through defined maturity levels. Practical executions of cross-industry frameworks entail the translation of conceptual models into actionable strategies tailored to specific organizational contexts. This involves a multifaceted approach encompassing process analysis, stakeholder engagement, technology integration, and change management. Process analysis entails mapping current workflows, identifying bottlenecks, and pinpointing areas for optimization. Stakeholder engagement is crucial for garnering buy-in and fostering a culture of continuous improvement. Technology integration plays a pivotal role in modern BPR initiatives, leveraging digital tools such as business process management (BPM) software, data analytics, and robotic process automation (RPA) to streamline operations and enhance decision-making. Moreover, emerging technologies like artificial intelligence (AI) and blockchain offer new avenues for process innovation and optimization. Change management constitutes a critical component of practical executions, as BPR initiatives often entail significant organizational transformation. Effective change management involves communication, training, and leadership support to mitigate resistance and facilitate smooth transition. Real-world applications exemplify the effectiveness of cross-industry frameworks in driving tangible business outcomes. Case studies spanning diverse sectors, including manufacturing, healthcare, finance, and retail, demonstrate how organizations have leveraged BPR to achieve breakthrough improvements in efficiency, cost reduction, and customer satisfaction. In the manufacturing sector, for instance, companies have adopted lean manufacturing principles to streamline production processes, minimize waste, and enhance flexibility. In healthcare, BPR initiatives have led to streamlined patient care pathways, reduced administrative burdens, and improved clinical outcomes. Financial institutions have leveraged BPR to optimize loan approval processes, mitigate risk, and enhance regulatory compliance. Similarly, retailers have utilized BPR to optimize supply chain management, enhance omnichannel capabilities, and personalize customer experiences. Cross-industry frameworks for business process reengineering represent a potent paradigm for organizational transformation in today's dynamic business landscape. By integrating conceptual models with practical executions, these frameworks empower organizations to enhance operational efficiency, drive innovation, and maintain competitive advantage across diverse sectors.

Evaluating edge artificial intelligence-driven supply chain management platforms using collaborative large-scale fuzzy information fusion

The rapid development of edge artificial intelligence (AI) has brought about revolutionary changes in supply chain management (SCM). It not only provides real-time data processing capabilities but also accelerates the decision-making process, injecting more innovative elements into SCM. In this context, SCM platforms require new technological developments and effective evaluations, as they collectively drive the efficient coordination of complex business processes. SCM platforms enable the seamless coordination of various supply chain elements, facilitating streamlined operations and enhanced decision-making processes. The evaluation of these platforms not only serves to validate their performance and effectiveness, but also contributes to continual improvements in design and application, and addressing the evolving demands within the realms of global commerce and dynamic market conditions. The ongoing assessment and enhancement of SCM platforms play a crucial role in optimizing resource allocation, improving production efficiency, and fostering adaptability to changing market dynamics. However, the acquisition of assessment data often introduces imprecise data. Additionally, the large-scale nature and bounded rationality of decision-makers (DMs) significantly impact the evaluation of SCM platforms. This article aims to explore a collaborative large-scale information fusion approach and provide a robust fuzzy framework for evaluating SCM platforms. This approach employs a combination of spherical fuzzy sets (SFSs), large-scale group decision-making (LSGDM), behavioral theories and three-way decisions (TWD) to thoroughly explore collaborative large-scale information fusion and its practical application in assessing SCM platforms. It introduces an innovative spherical fuzzy (SF) LSGDM technique and integrates TWD with the inclusion of prospect theory (PT) and regret theory (RT) to mitigate potential decision risks. The developed collaborative large-scale information fusion approach is assessed for validity, effectiveness and practicality in the context of evaluating SCM platforms using online data. Experimental results demonstrate that this approach provides reasonable evaluation outcomes, considering uncertain information processing capabilities, large-scale characteristics, bounded rationality and decision risks.

The Impact of Educational Management Information Systems (EMIS) on Effective School Management in Tanzania

The rapid advancement of science and technology has ushered in transformative changes in education management, embracing innovative tools and methods for more efficient and effective educational processes. The purpose of this study was to investigate the use of EMIS in enhancing effective school management and explore the challenges associated with it. The data were collected through semi-structured interviews with five principals of selected secondary schools found in Dodoma City, Tanzania. Qualitative data analysis techniques were used to analyze data with an audit trail and member checks to ensure the quality of the collected data. The research results show that EMIS plays a crucial role in efficiently managing schools. Principals rely on EMIS as a dependable repository for school data, for tracking attendance of both teachers and students, managing student enrollments, ensuring the efficient operation of school finances, enhancing communication, and improving the management of academic activities. However, challenges such as a shortage of ICT experts, inadequate internet connectivity, limited budgets, frequent electricity outages, the absence of user-friendly software, and difficulties in system integration and interoperability have been identified as hindrances to the effective utilization of EMIS in school management

Nutritional Status, Dietary Intake, and Nutrition-Related Interventions Among Older Adults With Type 1 Diabetes: A Systematic Review and Call for More Evidence Toward Clinical Guidelines.

There is an emerging population of older adults (≥65 years) living with type 1 diabetes. Optimizing health through nutrition during this life stage is challenged by multiple and ongoing changes in diabetes management, comorbidities, and lifestyle factors. There is a need to understand nutritional status, dietary intake, and nutrition-related interventions that may maximize well-being throughout the life span in type 1 diabetes, in addition to nutrition recommendations from clinical guidelines and consensus reports. Three reviewers used Cochrane guidelines to screen original research (January 1993-2023) and guidelines (2012-2023) in two databases (MEDLINE and CENTRAL) to characterize nutrition evidence in this population. We found limited original research explicitly focused on nutrition and diet in adults ≥65 years of age with type 1 diabetes (six experimental studies, five observational studies) and meta-analyses/reviews (one scoping review), since in the majority of analyses individuals ≥65 years of age were combined with those age ≥18 years, with diverse diabetes durations, and also individuals with type 1 and type 2 diabetes were combined. Further, existing clinical guidelines (n = 10) lacked specificity and evidence to guide clinical practice and self-management behaviors in this population. From a scientific perspective, little is known about nutrition and diet among older adults with type 1 diabetes, including baseline nutrition status, dietary intake and eating behaviors, and the impact of nutrition interventions on key clinical and patient-oriented outcomes. This likely reflects the population's recent emergence and unique considerations. Addressing these gaps is foundational to developing evidence-based nutrition practices and guidelines for older adults living with type 1 diabetes.

Big Data Analytics: Future of Database

Abstract: Big data analytics is a revolutionary method for processing massive and complicated datasets, analysing them, and drawing important conclusions from them. Big data's introduction has caused a paradigm change in data management and analysis, giving businesses previously unheard-of opportunity to gain insightful information and make informed decisions. This study explores how big data analytics affects how well organization’s function, concentrating on the methods and tools applied across a range of sectors. We undertook an empirical analysis of case studies from businesses in the retail, healthcare, and financial sectors after conducting a thorough assessment of the literature. According to our research, using big data analytics leads to better decision-making, increased operational effectiveness, and a stronger competitive advantage. Data quality, analytics tools, and corporate culture are the main success determinants. However, issues with data privacy and the necessity for qualified data experts make the effective application of big data analytics difficult. This study adds to our understanding of big data analytics' revolutionary potential and offers useful information for practitioners and decision-makers who want to use data to their advantage.

Navigating the green future: The transformative role of big data in climate change and environmental sustainability

This article explores the profound impact of big data in the realm of climate change and environmental management. It delves into various aspects such as climate modeling and predictions, the assessment of climate change impacts, the role of data in policy making, ecosystem health monitoring, and strategies for sustainable resource management. Employing case studies and specific examples, the article demonstrates how big data analytics are transforming our approach to understanding and mitigating environmental challenges. It highlights the use of advanced computational techniques in modeling climate phenomena, assessing biodiversity shifts, optimizing waste management, and enhancing agricultural practices. The article underscores the significance of integrating big data into environmental strategies to facilitate informed decision-making and develop sustainable solutions.

Mapping dynamic human sentiments of heat exposure with location-based social media data

Understanding urban heat exposure dynamics is critical for public health, urban management, and climate change resilience. Near real-time analysis of urban heat enables quick decision-making and timely resource allocation, thereby enhancing the well-being of urban residents, especially during heatwaves or electricity shortages. To serve this purpose, we develop a cyberGIS framework to analyze and visualize human sentiments of heat exposure dynamically based on near real-time location-based social media (LBSM) data. Large volumes and low-cost LBSM data, together with a content analysis algorithm based on natural language processing are used effectively to generate near real-time heat exposure maps from human sentiments on social media at both city and national scales with km spatial resolution and census tract spatial unit. We conducted a case study to visualize and analyze human sentiments of heat exposure in Chicago and the United States in September 2021. Enabled with high-performance computing, dynamic visualization of heat exposure is achieved with fine spatiotemporal scales while heat exposure detected from social media data can be used to understand heat exposure from a human perspective and allow timely responses to extreme heat. HIGHLIGHTS Near real-time and high spatial resolution mapping of human sentiments of heat exposure with Twitter data An integrated cyberGIS and machine learning framework for visualizing heat exposure with Twitter data Human sentiment of heat exposure mapping in the City of Chicago and the United States

Action learning for change management in digital transformation

Action learning for change management in digital transformation

The impact of banks’ climate engagement on systemic risk. Does committing a little or a lot make a difference?

We investigate the relationship between climate change commitment and systemic risk using a sample of 211 international banks over the period 2011–2020. We hypothesize that banks that are more committed to climate change, which is measured by a score scale provided by the Carbon Disclosure Project, contribute less to systemic risk. Furthermore, we expect that banks that slip into the lowest score category by not even providing sufficient information on their climate change activity (“worst rating”), and banks that reduce their commitment along the climate change score scale will increase their exposure to systemic risk (“downgrade” effect). The results confirm all our hypotheses. Banks’ commitment to climate change is an important driver of systemic risk, and the level of this commitment also matters. We demonstrate the effectiveness of climate change management in reducing a bank’s contribution to the overall financial crisis and thereby increasing financial stability. Our study confirms the importance of the efforts to combat climate change for the benefit of financial stability.

Planning the implementation of a new oncology compounding information system in an aseptic compounding unit: a mixed methods study

Abstract Introduction Systemic anti-cancer therapy (SACT) compounding is a high-risk process. Traditional mixed method systems for workflow management in aseptic compounding units (ACUs) are inherently prone to risk. Workflow management systems (WFMSs) are recognised internationally to improve safety, reduce costs, and increase ACU capacity.[1] Planning of the implementation of a WFMS has not been characterised before. In our ACU, Clinichemo® will be replaced with BD-CATO®. BD-CATO® is a WFMS and is the vendor for the National Cancer Information System (NCIS), implemented by the National Cancer Control Programme (NCCP).[2] Aim The aim of this study was to demonstrate how the implementation of a new WFMS can be safely planned, managed, and assessed. This aim was achieved using the following objectives: 1. Describe and risk assess the current workflows for SACT compounding. 2. Investigate agreed and published standards for SACT compounding. 3. Define the change management process. 4. Describe and evaluate the benefits, challenges and risks associated with the introduction of a new SACT compounding system. 5. Interview adopters of NCIS/BD-CATO® to assess their experience of the barriers encountered, how challenges were overcome, risks identified, mitigated, and eliminated through the change management process and ongoing. Methods The current workflow and future workflow for SACT compounding were characterised and current process risk assessed. Semi-structured interviews were carried out to evaluate pharmacist and pharmacy technicians’ attitudes and opinions towards the implementation of BD-CATO® in their organisations and the system itself. Participants were recruited by means of purposive and snowball sampling from ACUs across the country that had implemented/were in the process of implementing BD-CATO®/NCIS. Themes identified in interviews were compared to those found in the literature and guidelines. Interviews, a review of guidelines, published standards and the literature were used to guide and risk assess future process development. The change management plan was also defined. Results Nine participants (8 pharmacists and 1 pharmacy technician) were interviewed in June-August 2023. The interviews were conducted across 7 ACUs in Ireland. Thematic analysis of interview data yielded four key themes: 1. Participants discussed the importance of planning activities, such as communication with key stakeholders, discussions around phased implementation, and development of training material. 2. Having a designated individual tasked with change implementation improved outcomes of the implementation project. 3. Participants also discussed benefits and risks associated with BD-CATO®. 4. Participants discussed their reasons for perceived complexity of the system. A combination of interview data, review of guidelines, published standards and the literature were used to devise future process workflow and the change management plan. The future process workflow was also risk assessed using bowtie analysis. Conclusion The introduction of WFMSs has been interpreted both in the literature and within the Irish healthcare setting to increase efficiencies, reduce error rates, and improve the accuracy of SACT compounding. A formal change management strategy devised with resourcing, training, and obtaining stakeholder engagement is key to successful implementation.