Collaboration Of Multiple Stakeholders Research Articles

Creating synergies among education/research, practice, and policy environments to build capacity for the scholar role in occupational therapy and physiotherapy in the Canadian context.

Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.

Trust and its relations to vaccine beliefs: a latent class analysis on 140,000 individuals worldwide

Abstract Background Research shows that vaccine-related beliefs (i.e., about efficacy, safety, purpose) may reflect a host of within-person and contextual factors yielding homogeneous subgroups of individuals. This study aims to characterize distinct subgroups of people and identify ideal targets for tailored public health interventions to increase vaccine adherence. Methods Latent class analysis was used to derive subgroups based on unique response profiles using the 2019 Gallup survey of 140 countries (>140,000 individuals). We modeled a composite of vaccine beliefs as a distal outcome examining differences for the obtained classes, with and without covariates in the model. Results A 5-class model fit best with classes distinguished primarily on whether individuals possessed or sought personal knowledge about science, medicine, and health, whether they trusted science, scientists and have confidence in the healthcare system. The lowest levels of vaccine beliefs were reported by a class not endorsing any of these indicators and the highest levels by a class endorsing all the indicators (p < 0.001). Age class showed a U-shaped relation with vaccine beliefs, while higher educational level (p = 0.025), higher subjective income (p = 0.006) and employment (p < 0.001) were related to higher vaccine beliefs. Country-level income was moderately related to class membership and vaccine beliefs were higher in lower-income countries (p < 0.001). Conclusions Our findings suggest that more work is needed to improve trust in science and medical providers. Tailored interventions grounded in a community-based and empowering approach with the collaboration of multiple stakeholders seems to be needed to improve vaccination rates. This can only be achieved when individuals trust science, scientists and healthcare providers and accrue the necessary wisdom to make good healthcare decisions that affect not only themselves but their fellow citizens. Key messages • Efforts to alter vaccine beliefs should touch on where people access information on science and health, the processes that build trust, and their belief whether science improves well-being. • Public health interventions should focus on reassuring individuals that science and health workers are benevolent. An essential first step in the health worker-patient relations is building trust.

Development and delivery of an allied health team intervention for older adults in the emergency department: A process evaluation.

There is encouraging evidence that interdisciplinary teams of Health and Social Care Professionals (HSCPs) can enhance patient care in the Emergency Department (ED), especially for older adults with complex needs. However, no formal process evaluations of implementations of ED-based HSCP interventions are available. The study aimed to evaluate the development and delivery of a HSCP team intervention for older adults in the ED of a large Irish teaching hospital. Using the Medical Research Council (MRC) Framework for process evaluations, we investigated implementation and delivery, mechanisms of impact, and contextual influences on implementation by analysing the HSCP team's activity notes and participant recruitment logs, and by carrying out six interviews and four focus groups with 26 participants (HSCP team members, ED doctors and nurses, hospital staff). Qualitative insights were analysed thematically. The implementation process had three phases (pre-implementation, piloting, and delivery), with the first two described as pivotal to optimise care procedures and build positive stakeholders' involvement. The team's motivation and proactive communication were key to promote acceptability and integration in the ED (Theme 1); also, their specialised skills and interdisciplinary approach enhanced patient and staff's ED experience (Theme 2). The investment and collaboration of multiple stakeholders were described as essential contextual enablers of implementation (Theme 4). Delivering the intervention within a randomised controlled trial fostered credibility but caused frustration among patients and staff (Theme 3). This process evaluation is the first to provide in-depth and practical insights on the complexities of developing and delivering an ED-based HSCP team intervention for older adults. Our findings highlight the importance of establishing a team of HSCPs with a strong interdisciplinary ethos to ensure buy-in and integration in the ED processes. Also, actively involving relevant stakeholders is key to facilitate implementation. ClinicalTrials.gov, NCT03739515; registered on 12th November 2018.

Are collecting agencies a model that fits to SEP licensing?

Every day, more and more devices are connected to wireless networks and need to exchange vast amounts of data in a reliable manner. This high-performance connectivity and interoperability between devices are achieved thanks to standards. In particular, standards such as 5G (ie cellular) offer cutting-edge technologies which serve as the foundation of the Internet of Things (IoTs).1 Standards are typically developed in Standard Development Organizations (SDOs) with the collaboration of multiple stakeholders.2 A patent that protects a technology that is essential for the implementation of a standard is known as a Standard-Essential Patent (SEP). In order to balance the interests of the SEP holders and its users, SDOs encourage their members that own SEPs to make them available on Fair, Reasonable and Non-Discriminatory (FRAND) terms and conditions. This allows for a broad dissemination of the standard (thanks to access to the standardized technology) and a fair and adequate...

Re-envisioning organizational complexity using a multiple perspectives model

Abstract Organizations are now more complex and require collaboration to function effectively across multiple stakeholders. Consequently, they need to be familiar with collaborative projects and participate consciously in shared processes for the accomplishment of particular goals. In order to support and strengthen business partnerships, organizations could use a model based on a multi-perspective approach, as a way of visualizing effective decision-making processes and gaining an understanding regarding how they can establish and maintain stable relationships with other organizations and strategic alliances. The benefits of the new multi-perspective model could be utilized for the collaboration of multiple stakeholders and to drive future organizational change. This study presents a case study which explores the use of a multiple perspective framework in Australian Government Organizations. The results from this study suggest that a multi-perspective model may be used to address organizational complexity through the holistic integration of stakeholder perspectives and sustained knowledge flow.

Transitions in Mental Health Care: the European Psychiatric Association contribution to reform in Bulgaria.

Abstract Background: The Bulgarian Ministry of Health invited the European Psychiatric Association (EPA) to evaluate Bulgarian mental health care service provision in 2018. Bulgarian mental health services face very significant challenges including a legacy of historic underfunding, internal conflicts, poor planning, and the emigration of very high numbers of younger skilled staff that had followed accession to the European Union. There were significant disputes between stakeholders regarding the way forward and had been at least two unsuccessful previous external agency interventions that had attempted to find solutions. Method: This EPA position paper describes in detail the EPA mission to Bulgaria including methodology, findings, recommendations, and finally the positive actions and changes that are now underway as a result of the EPA report and intervention aimed at contributing towards improving Bulgarian mental health services. Results: After meetings with multiple stakeholders in the Bulgarian mental health system and analysis of data on service delivery, workforce, funding and configuration the EPA Panel agreed a list of twenty recommendations for change. Conclusions: The EPA mission, with the collaboration of multiple stakeholders in Bulgaria, was successful in stimulating high level government action to improve mental health services. Despite longstanding differences, it was possible to involve the stakeholders in constructive dialogue. The importance of “speaking with one voice” was a key lesson learned.

Identifying and Managing Hearing and Vision Loss in Older People in Care Homes: A Scoping Review of the Evidence.

Poor identification of sensory impairments in care homes can be due to multiple factors. This scoping review identifies and synthesizes the literature into the detection of hearing and vision loss in the care home environment, and the management of these sensory losses once identified. A scoping review methodology was used to identify primary research of any design published from 1985 to September 2018. Six electronic databases were searched, and articles were also sourced from reference lists, relevant charity organizations and published experts. Six electronic databases and multiple gray literature sources identified 51 articles for inclusion. The evidence confirmed that lack of knowledge in care home staff, poor management of assistive aids, unsuitable environment, lack of connections with optometrists and audiologists, underuse of effective screening tools, and the added complexity of assisting those with dementia are all barriers to effective practice. Conversely, flexible training programs, availability of a variety of assistive aids, simple screening tools, and adaptions to the environment are effective facilitators. This review acknowledges that the barriers to identification and management of hearing and vision loss in care homes are multifaceted and that collaboration of multiple stakeholders is required to implement change and improve the residents' ear and eye care. Recommendations are offered to support more effective service provision tailored to meet the needs of people with sensory impairments living in care homes, and this could subsequently improve best practice.

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea

PurposeThe implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. MethodsThematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. ResultsFour major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. ConclusionThe findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea.

Smart energy city development: A story told by urban planners

The smart energy city is an emerging concept in urban development, aiming to optimize urban energy systems and improve the quality of life for citizens. However, smart energy city development requires a well-defined and consistent conceptual core in order to ensure its accurate interpretation and successful implementation. This research aims to define smart energy city development not only in a theoretical context, but also in terms of practical solutions. We adopt the 5W+1H (why, what, who, where, when, how) model integrated with literature review and expert knowledge elicitation, i.e., focus groups and interviews. This results in: (i) clarification of general interrelationship between smart energy city, smart city, and sustainable city; (ii) a holistic, multidisciplinary, and comprehensive conceptual framework of smart energy city, revealing its principles, objectives, domains of intervention, stakeholders, and time and spatial scales; and (iii) a set of smart energy practical solutions and technologies categorized in the eight domains of intervention: buildings and districts, transportation and mobility, energy and ICT (information and communication technology) infrastructures, collaborative planning, consumer behavior management, energy and data management, as well as two cross-cutting domains. We suggest that sustainable, rational, and integrated application of new technologies, collaboration of multiple stakeholders, and integration of multiple urban energy domains, mainstreamed in energy specific targets, enable distinguishing real from labeled smart energy city development. We suggest that smart energy solutions are mostly effective when combined with other sustainable solutions. This research is applicable for all smart energy city stakeholders, particularly decision makers and researchers, in order to enhance a common and comprehensive understanding of the smart energy city concept and its practical solutions to foster sustainable smart energy city development.

Water resources management in the urban agglomeration of the Lake Biwa region, Japan: An ecosystem services-based sustainability assessment.

An innovative ecosystem services-based sustainability assessment was conducted in the important urban agglomeration of the Lake Biwa region, Japan, covering the time period from 1950 to 2014. A 22-indicator system was established that was based on the major ecosystem services of Lake Biwa and its water courses, i.e., provisioning services regarding aquatic products and water; regulating services regarding floods and water quality; cultural services regarding recreation and tourism, scientific research, and environmental education; and supporting services regarding biodiversity. First, changes in the eight ecosystem services were discussed together with the considerable experience and difficult lessons that can be drawn from the development trajectory. Next, with the indicators rearranged according to sustainability principles, the regional sustainability over the past six-plus decades was assessed. In general, this urban agglomeration has been progressing in terms of its sustainability, although economic and social development was achieved at the cost of environmental degradation in the past, and the current economic downturn is hurting the balanced development and integrated benefits. The results lead directly to recommendations for regional development, especially in terms of economic rejuvenation, from the perspective of improving management of Lake Biwa's water resources. Moreover, the relevant knowledge is educational and inspirational for other places in the world that are facing similar development issues. For example, the effective and even pioneering countermeasures that have been taken against environmental degradation, as well as the participation and collaboration of multiple stakeholders, could be useful as a model. Moreover, the study invites increased understanding of ecosystem vulnerability to anthropogenic devastation and emphasizes the priority of precautionary measures over countermeasures in the context of holistic urban planning and sustainable urban development.

Introduction and reflection on benchmarking for the delivery of water and sanitation services to the urban poor

A dedicated benchmarking system to assess the availability of water supply and sanitation services for the urban poor will be explained. These services require the involvement of the utility and a host of other stakeholders, such as national and local government, a regulator, NGOs or CBOs and the slum dwellers themselves. Distributional justice arguments can be used to justify the development of systems for providing to the poor. The dedicated system covers both drinking water supply and sanitation, and emphasises and assesses the involvement and contributions by all stakeholders. It considers piped and non-piped drinking water and sanitation solutions, the mix of which often characterises the reality in the slums and the urban periphery of Third World countries. The lessons from the PROBE research project on this topic will be summarised. These comprise the need for the right policy and institutional environment, the provision of financial and other incentives to reach the poor, the involvement and collaboration of multiple stakeholders in mobilising the local resources, and the availability of a set of organisational, financial and technical tools with the concerned utility. When all these requirements are fulfilled there is a good chance to achieve the MDGs and SDGs in water and sanitation.

Care services ecosystem for ambient assisted living

Effective provision of care and assistance services in ambient assisted living requires the involvement and collaboration of multiple stakeholders. To support such collaboration, the development of an ecosystem of products and services for active ageing plays an important role. This article introduces a conceptual architecture that supports such care ecosystem. In order to facilitate understanding and better interrelate concepts, a 3-layered model is adopted: Infrastructure layer, Care and assistance services layer and Ambient Assisted Living ecosystem layer. A holistic perspective of ambient assisted living, namely considering four important life settings is adopted: (1) independent living; (2) health and care in life; (3) occupation in life and (4) recreation in life. The proposed architecture is designed in the context of a national Portuguese project and in accordance with the findings of a large European road mapping initiative on ICT and ageing.

Pedestrian Safety Programs in Centers of Large Cities: Institutional Settings and Identified Barriers

Although pedestrian fatalities in the United States have decreased, walking remains one of the more dangerous travel modes. Concern for pedestrian safety is likely to be felt more strongly in the centers of large cities (defined as cities with populations of greater than 500,000) than in other, smaller cities. The needs and the issues in the centers of large cities need to be understood when planning officials develop and implement pedestrian safety programs. Planning officials from 13 large cities (Chicago, Illinois; Columbus, Ohio; Denver, Colorado; Indianapolis, Indiana; Los Angeles, California; Milwaukee, Wisconsin; New York; Philadelphia, Pennsylvania; Phoenix, Arizona; San Francisco and San Jose, California; Seattle, Washington; and Washington, D.C.) were interviewed to discuss institutional settings, interagency collaboration, high-risk population groups, and institutional barriers. Results revealed that collaboration of multiple stakeholders was typical, but several barriers needed to be addressed to further improve pedestrian safety. The barriers included competing priorities between agencies, lack of resources, auto-dependent culture, and data gaps. More holistic approaches are needed as safety countermeasures alone may not always be sufficient for the enhancement of pedestrian safety. Often, pedestrian safety is related to pedestrians’ socioeconomic status, physical environment, and even adverse local issues. Thus, participation and formalized policy integration among multiple parties are required to create a win–win safety policy that can be built on the basis of frequent dialogue, information sharing, and identification of shared goals and objectives.

Between a rock and a hard place: incompatible objectives at the heart of river basin planning?

River Basin Management Planning (RBMP) is a policy that seeks to integrate multiple objectives for water bodies, that is enacted at multiple scales and through the collaboration of multiple stakeholders, using an adaptive management cycle. Insights from spatial planning and community planning literatures illustrate how many challenges are not particular to RBMP but are fundamental to strategic planning in modern society. The literatures draw attention to the institutional arrangements governing these complex collaborations. The emerging findings are a series of tensions that resonate with the wider literatures (such as between efficiency and inclusion of all voices, quick delivery and implementing best practice). Thus, to what extent are these short-term implementation problems or a deeper and more fundamental clash of policy objectives?

Developing a framework for safety validation of multi-stakeholder changes in air transport operations

The high volume of air traffic over Europe is expected to double within the next 15 years. This requires changes in the airspace structure and in the organisation of air transport operations that involve multiple stakeholders. Changes, by regulation, require a sufficient safety validation, in order to show that the changed situation is safe and will remain safe during an applicable period. Many methods and techniques exist that can be used to support such safety validation process. However, for air transport operations, the stakeholders involved are numerous and diverse, and there are no guidelines on how to address their roles, responsibilities and goals during development and validation. This paper develops a safety validation framework that emphasises the active roles and collaboration of multiple stakeholders during the development phases of air transport operations. The framework is developed in three steps: First, established validation views from literature are identified and analysed to reveal open issues when it comes to their use for multi-stakeholder changes in air transport operations. Next, validation views emerging beyond the established ones are identified, and evaluated on whether they address the open issues. Finally, the strong points of established and emerging views are combined into a novel framework.

A Conservation Health Program in Indonesian Borneo: Lessons Learned

This commentary provides a synopsis and evaluation of the Kelay Conservation Health Program (KCHP) and “lessons learned” through the program that may be applicable to other conservation projects. The KCHP is an example of a collaboration of multiple stakeholders (university, non-governmental organization, and local government) that uses medicine in the service of conservation. The program site in Indonesian Borneo (Kalimantan) is noted for its exceptionally high biodiversity value, with a human population whose health and well-being are deeply linked to the rainforest ecosystem. The KCHP has a dual agenda: (1) to improve health for local people, and (2) to allow more effective conservation of critical rainforest habitat. As such, it is a unique example of a conservation agency collaborating with a government health department to improve health and healthcare for people living in a conservation target area. A comprehensive evaluation indicated that the program has had significant positive impacts on both health and conservation in the area it serves, at a total cost of about $62,500 (USD). The KCHP has allowed an international conservation organization to further its orangutan conservation goals while addressing human needs in the conservation area. Environmental Practice 10:20–28 (2008)

Dynamic Optimization Of Systems Of Systems Using Value Measurement

Many systems of systems (SoS) occur today through the collaboration of multiple stakeholders, without any clear authority or direction at the SoS level. Examples include a supply chain, an airport, and the Internet. Because of the uncontrolled interactions, such a SoS exhibits complexity behaviors such as reflexivity, emergence, self-organization, and adaptation. This paper presents underlying theory to explain a methodology for dynamic optimization of SoS, in which the stakeholders make changes based on local perceptions of the value of the SoS. Each stakeholder has a different local perception of value, measured against an objective function that may be unique to the stakeholder. As the stakeholder compares perceived value to desired value, the stakeholder attempts to optimize the SoS from its own point of view by making decisions that lead to SoS changes. These changes then affect other stakeholders, resulting in a dynamic architecture and implementation of the SoS. We present the optimizing value proposition of each stakeholder in terms of a quantifiable objective function based on the life-cycle value of the SoS to that stakeholder, and we present the dynamic interaction as a model of self-organization. An example based on supply chain management demonstrates the approach.