Implementation Of Management Research Articles

Barriers and enablers of digital health use in managing chronic suppurative lung diseases in children and adolescents: Perspectives from healthcare professionals and parents.

Barriers and enablers of digital health use in managing chronic suppurative lung diseases in children and adolescents: Perspectives from healthcare professionals and parents.

Geriatric assessment and management with a question prompt list using a web-based application to reduce treatment toxicity in older patients with cancer: A randomized controlled trial (J-SUPPORT 2101 study).

1505 Background: Older adults with cancer experience aging-related physical, psychosocial and cognitive challenges that require comprehensive communication with their oncologists. Geriatric assessment (GA) can assess these aging-related problems and guide management. Communication support may further facilitate the implementation of GA-guided management (GAM). We report secondary outcomes of a single-blind, parallel-group, multicenter, randomized controlled trial evaluating the efficacy of a program combining GAM recommendations and communication support to facilitate aging-related communication between older Japanese patients with cancer and their oncologists. Methods: This study included patients aged ≥70 years with advanced or recurrent gastrointestinal cancers who were scheduled to receive first- or second-line systemic therapy and had impairment in at least one GA domain as assessed with a web-based application at baseline. In the intervention group, GAM recommendations and a question prompt list were given to patients by trained intervention providers to be shared with their oncologists at the first outpatient visit after randomization. During 5 months after the initial intervention, the implementation of the GAM recommendations was reviewed monthly by the intervention providers with the patients and their oncologists. The control group received usual care. Secondary outcomes included the incidence of grade 3-5 adverse events (National Cancer Institute Common Terminology Criteria for Adverse Events, ver. 5.0), dose modifications, early treatment discontinuation, unplanned hospital utilization during 3 months, overall survival rate at 6 months, and health-related quality of life and patient satisfaction at 3 and 6 months. Results: Between September 2021 and September 2023, 215 patients (99 women, 116 men; median age 75 [range 70-88] years) were randomized (n=108/107 in the intervention/control group). No differences were found between the groups in patient background characteristics. The incidence of any grade 3-5 adverse event was significantly lower in the intervention group than in the control group (50.9% vs. 66.4%, P<0.05); the incidence of hematologic toxicities was significantly reduced (37.0% vs 55.1%, P<0.01), while that of non-hematologic toxicities remained similar (29.6% vs 36.4%, P=0.31). Early treatment discontinuation was also significantly lower in the intervention group than in the control group (26.9% vs. 43.0%, P<0.05). No significances were found in other secondary outcomes including overall survival rate at 6 months (77.7% vs 78.7%, P=0.88) Conclusions: Our program combining GAM recommendations with communication support significantly reduced severe treatment toxicity without compromising survival in older patients with cancer. Clinical trial information: UMIN000045428 .

Identifying and addressing barriers to germline testing in ovarian cancer.

e17554 Title: Identifying and addressing barriers to germline testing in ovarian cancer Background: Ovarian cancer is the fifth leading cause of death in women, with 300,000 women diagnosed annually worldwide. Approximately 20% of cases are attributable to a hereditary predisposition (e.g., BRCA 1/2). All patients with a diagnosis of epithelial ovarian cancer should undergo germline genetic testing, though <50% of patients in the U.S. have received it. Within our health system, which includes over 60 cancer centers, approximately 2/3 of patients diagnosed with epithelial ovarian cancer have received germline testing. Knowledge of a germline pathogenic variant may inform prognosis, guide treatment, aid management of other cancer risks, and lead to testing and implementation of risk-appropriate management in family members. Our goal is to identify action areas for future quality improvement initiatives to increase testing rates. Methods: We conducted semi-structured individual and small group interviews with members of the Gynecologic Oncology and Cancer Genetics offices. Interview length varied by office member involvement in germline testing (10 – 60 minutes). Interviews focused on current workflow for germline testing for ovarian cancer patients, barriers to testing, and suggestions for improvement. Interviews were recorded and transcribed, coded, and analyzed using inductive thematic analysis, with at least two coders per interview. Results: Fifteen gynecologic oncologists, one medical geneticist, 11 advanced practice providers (physician assistants and nurse practitioners), seven genetic counselors, and 25 office staff members (nurses, surgery schedulers, medical assistants, administrative personnel) participated. Participants identified several barriers to germline testing, including lack of standardized process for testing and inconsistent follow up among providers and staff; patient concerns about cost; multifactorial logistical, emotional, and physical challenges of cancer care for patients; and patients’ lack of information about benefits of testing. Possible solutions included mainstream testing; alignment on one testing and follow-up pathway across providers; increased focus by providers on patient cost concerns; multidisciplinary clinic to streamline cancer care; increased use of telemedicine; and empowering patients with information about benefits of testing for themselves and their family members. Additional focus on equity was also identified as an area of need within ovarian cancer care. Conclusions: Approach to germline testing for ovarian cancer patients is currently dependent on individual workflow, resulting in persistent barriers to testing. Streamlining the testing process may make testing easier for clinicians and patients. Efforts to identify and evaluate interventions to increase testing rates, with a focus to ensure equity of care, are needed.

Evaluation Of Total Quality Management (TQM) In Improving The Quality Of Graduates

Graduates of Vocational High Schools (SMK) play a crucial role in fulfilling the workforce requirements of the industrial sector. This condition represents a strategic opportunity for SMK to provide students with technical skills and moral fortitude, preparing them to become competent employees. This study seeks to assess the application of Total Quality Management (TQM) in enhancing the quality of graduates, particularly within the Motorcycle Engineering and Business Study Programme at a vocational school in Bandung. The study concentrates on the strategy for implementing Total Quality Management (TQM), the evaluation procedures for TQM, the factors that facilitate or impede TQM implementation, and the ways to address these challenges. This study employs a qualitative methodology utilizing a case study approach, with data gathering conducted via in-depth interviews, direct observation, and pertinent document analysis. The study's findings suggest that the Total Quality Management implementation strategy commences with a comprehensive understanding of the organization's vision and mission, which guide its objectives. This is reinforced by human resource development, the provision of sufficient facilities and infrastructure, the enhancement of a curriculum aligned with industry requirements, the cultivation of positive attitudes, and the establishment of a supportive learning environment. The processes for evaluating TQM involve establishing a collective commitment to enforce discipline, cultivating accountability, and sustaining concentration on attaining primary objectives. Factors that facilitate TQM implementation include skilled human resources, comprehensive facilities, a flexible curriculum, and a conducive learning environment. Concurrently, impediments consist of restricted human resources, inadequate facilities, and a deficiency in comprehensive comprehension of the TQM concept among all stakeholders within the school. The adopted method to address these challenges is to align all organizational components, including leaders, educators, and students, with the school's vision and goal, fostering a robust quality culture within the educational environment. This study concludes that a robust integration of human resources, facilities, curriculum, and an effective learning environment can attain the caliber of vocational high school graduates. Consequently, vocational high school graduates possess standardized abilities that align with the requirements and expectations of the business and industrial sectors (DUDI), rendering them a workforce prepared to participate effectively.

An Assessment of the Suitability of a Total Quality Management Approach to Identify the Positive Measurable Impacts for the Construction Phase of a Project

An increased demand of quality in the construction industry has been a major cause of finding new systems and developing frameworks that are fit for purpose. Construction companies around the world are trying to increase their productivity and index of quality and they are developing new methodologies through research and development. This research work has identified and addresses the important issues related to the implantation of Total Quality Management (TQM) in the construction industry. The main aim of the study is to improve the understanding of TQM within the construction sector, and to highlight current barriers faced by construction companies in the implementation of Total Quality Management (TQM) philosophy. The findings of this study suggest that TQM can be successfully implemented among construction companies. The conclusions and recommendations are drawn from the best practice of TQM implementation as a guideline for construction companies to consider in adopting the TQM philosophy, which in turn will increase productivity, stream line the processes and improves the quality of the services and the products offered by the construction industry.

Benefits and Challenges of Implementing Research Data Management in Open Science

Abstract—The research data management in open science is a movement that aims to make scientific research more transparent, accessible, and reproducible. A key aspect is the proper organization, storage, and sharing of research data so that others can verify and build upon research findings. The purpose of implementing research data management in open science is to promote transparency, reproducibility, collaboration, data preservation, innovation, impact, data integrity, ethical considerations, and compliance with funding requirements in research practices. This paper discusses the implementation of research data management in open science and the benefits and challenges of implementing it. Implementing research data management in open science offers many benefits, including improved transparency, collaboration, and impact. However, overcoming challenges such as data sharing concerns, quality issues, and technical limitations is essential to realize the full potential of open science. Collaborative efforts among researchers, institutions, and funders are crucial to advancing research data management practices and promoting open science principles. Keywords – open science, research data management, data sharing, data standards, open access, reproducibility

Machine learning techniques for predictive maintenance of building services: a comprehensive review and research outlook

Purpose Predictive maintenance in buildings is crucial for minimising unplanned downtime and extending lifespan of building components, yet its implementation remains complex. Machine learning (ML) offers a transformative approach by enabling systematic predictions and automation. The purpose of this study is to analyse the interrelationship between ML techniques and predictive maintenance of building services, identifying key research trends and future directions. Design/methodology/approach A bibliographic analysis was conducted on 118 journal articles using VOSviewer to examine co-authorship and co-occurrence patterns. The key themes generated were then explored semi-systematically, focusing on the most frequently used ML techniques and predictive maintenance applications. Findings The results reveal a strong relationship between ML and predictive maintenance, with increasing research interest post-2021. Co-occurrence analysis highlights the evolution of research themes, shifting from conventional ML models to advanced techniques such as digital twins and lifelong learning with deep generative replay modelling. Among the most frequently applied ML techniques, Extreme Gradient Boosting, Artificial Neural Networks and Deep Neural Networks have demonstrated the best predictive performance in fault diagnostics and system optimisation. Practical implications The findings advocate for stronger interdisciplinary collaborations among researchers, institutions and industries to bridge the gap between research advancements and real-world implementation in facilities management and building life cycle. Originality/value This study provides a comprehensive examination of research trends, highlighting underexplored ML applications in building services predictive maintenance.

Emerging technologies in healthcare data integration: A microservices approach

Emerging technologies in healthcare data integration are transforming the landscape of medical information systems through microservices architecture. Healthcare organizations face significant challenges with fragmented, monolithic systems that impede efficient patient care delivery and operational performance. This comprehensive article on healthcare data integration reveals the evolution from isolated electronic health record systems with point-to-point interfaces to modern, cloud-native architectures leveraging microservices. The transition demonstrates quantifiable improvements across multiple dimensions of healthcare operations. By decomposing complex integration challenges into discrete, independently deployable services, healthcare institutions achieve faster deployment cycles, enhanced system reliability, and substantially reduced maintenance costs. The implementation of advanced API management, real-time data streaming, and cloud-based integration tools within a microservices framework has enabled healthcare providers to break down persistent data silos, resulting in improved clinical decision-making, streamlined administrative processes, and enhanced regulatory compliance. The adoption of domain-driven design methodologies and container orchestration platforms provides the foundation for secure, scalable integration that adapts to the unique demands of healthcare environments while maintaining data integrity and patient privacy.

Balancing efficiency and security: The role of voluntary standards and emerging technologies in cyber risk management framework in the global space

This research investigates the evolving balance between operational efficiency and security controls in global cyber risk management frameworks. Through a mixed-methods approach combining quantitative survey data from 183 organizations across 27 countries and qualitative insights from 42 in-depth interviews with cybersecurity leaders, the study examines how voluntary standards and emerging technologies shape contemporary risk management practices. Findings reveal that organizations achieving optimal security-efficiency balance demonstrate three key characteristics: integrated risk governance structures, dynamic adaptation of voluntary frameworks, and strategic implementation of automation technologies. The research identifies significant variations in framework adoption across different regions, with harmonization challenges stemming from regulatory fragmentation, organizational maturity disparities, and technological capability gaps. A novel "Adaptive Security-Efficiency Model" is proposed, offering organizations a structured approach to calibrating security controls with operational needs while remaining responsive to evolving threat landscapes. This study contributes to both scholarly understanding and practical implementation of balanced cyber risk management in an increasingly complex global environment.

Agile management and organizational flexibility and their role in achieving high performance

Background. This research investigates the relationship between the application of Agile management principles and the adoption of organizational flexibility in sports clubs, highlighting their essential role in enhancing performance levels. Objectives. The main objective is to explore how Agile management and organizational flexibility contribute to the performance of football club administrative bodies in Dhi Qar Governorate. Methods. The study employed a descriptive and analytical approach. A total of 133 questionnaires were distributed to selected members of the administrative bodies of football clubs in Dhi Qar Governorate using a purposive sampling method. Data were collected through a structured questionnaire, and statistical analysis was conducted to determine the levels of Agile management implementation, organizational flexibility, and performance impact. Results. Findings revealed that respondents showed an average level of awareness and application of Agile management principles within their clubs. The influence of both Agile management and organizational flexibility on administrative performance was modest. However, the data indicate a positive, albeit limited, correlation between these variables. Conclusion. The study concludes that while Agile management and organizational flexibility are present to a moderate extent in the administrative practices of football clubs, their full potential in improving performance remains underutilized. The research recommends greater commitment by club administrations to Agile management principles to better meet performance and quality standards.

Comprehensive Care Management Variation between Rural and Non-rural Maryland Primary Care Program (MDPCP) Practices

Abstract Objective Primary care-based care management services are effective ways to care for high-needs and high-risk patients. Despite experiencing higher chronic disease burden, rural Medicare beneficiaries have decreased access to primary care. The MDPCP is the nation’s largest voluntary state-led Medicare demonstration seeking to improve primary care infrastructure and chronic disease prevention and management. With varying access to primary care resources and health care needs among rural and non-rural Medicare beneficiaries, it is important to assess whether there is variation in the implementation of MDPCP care management among rural and non-rural practices. Methods The analyses used CMS Claims and Claim Line Feed data, MDPCP data, and care transformation requirement reports from 2020–2023 to examine rural and non-rural differences in MDPCP primary care practice-based care management comprehensiveness. Results MDPCP primary care practice rural status was associated with providing more comprehensive care management services when compared to non-rural primary care practices. Rural MDPCP primary care practices also experienced a greater increase in the comprehensiveness of the care management services provided over time. Conclusion These results demonstrate how state-led Medicare demonstration programs, such as the MDPCP can improve rural primary care infrastructure and increase access care management services.

The Role and Application of Comprehensive Budget Management in Hospital Cost Control

With the continuous deepening of China’s medical reform policy, it has had a considerable impact and influence on the application of public hospitals. Comprehensive budget management is an important component of hospital internal management and an effective measure to improve the overall operation and management level of hospitals. This article analyzes the role and application of comprehensive budget management in hospital cost control under the new medical reform situation. It conducts an analysis of the importance of comprehensive budget, the application status of comprehensive budget, discusses the existing problems, and proposes targeted and effective solutions, thereby providing useful references for the implementation of comprehensive budget management in public hospitals.

Fortalecendo a qualidade na auditoria interna para promover a integridade pública: o papel do programa de gestão e melhoria da qualidade do DenaSUS

Public integrity is a central element of good governance and institutional legitimacy, especially in complex environments such as the Brazilian Unified Health System (SUS). This article analyzes how the implementation of the Internal Audit Quality Management and Improvement Program (ProQuali), led by the National Department of SUS Audit (DenaSUS), can strengthen internal auditing as a tool for promoting integrity. Based on normative, theoretical, and practical frameworks, the study examines the strategic role of the "Tone at the Top," compliance with international auditing standards, and the challenges faced during ProQuali’s implementation. The results indicate that the program contributes to institutionalizing qualified auditing practices aligned with ethics, transparency, and the generation of public value, making it a potentially replicable experience in other areas of SUS.

Multidisciplinary DRG management for rational medication in obstetrics: a cost analysis in Zhejiang Province

BackgroundZhejiang Province introduced diagnosis-related group (DRG) payment reform in 2020, covering all hospitalizations to reduce costs and improve services. However, its emphasis on financial indicators and overlooks the evaluation of medical rationality, especially for pregnant women. To bridge this gap, this study developed an obstetric multidisciplinary team (MDT) model in which pharmacists are integrated into prenatal decision-making. This represents a transformation from reactive cost control to proactive medication optimization.MethodsThis study collected DRG data of obstetric patients from a hospital between 2020 and 2024. First, we descripted the overall DRG operational performance and identified OZ13 (Other Pregnancy-Related diseases, with General Complications and Comorbidities) as the target disease groups by the Boston Matrix analysis. Subsequently, we employed Spearman correlation and Kruskal-Wallis H tests to identify key cost drivers. Finally, we applied a generalized linear model with gamma distribution and log-link function to determine key factors influencing medical costs.ResultsAfter the implementation of the multidisciplinary team management, the Time Consumption Index (TCI) decreased from 1.06 to 0.9 and the Cost Consumption Index (CCI) dropped from 1 to 0.91. Meanwhile, the Case Mix Index (CMI) increased to 0.51. The OZ13 group was selected for follow-up analysis using the Boston Matrix analysis because group exhibited decreased average hospitalization expenditure but an increased Cost Consumption Index. OZ13 group analysis revealed hospitalization costs strongly correlated with pharmaceutical costs (p = 0. 81, P < 0. 01), with significant expenditure differences between 2020 and 2024 (P < 0. 05). Furthermore, the generalized linear model identified several factors influencing hospitalization costs for OZ13 patients, including a history of recurrent miscarriage or IVF status, gestational weeks, parity, age, and length of hospital stay.ConclusionsThe research findings show that early pharmacist involvement in the multidisciplinary team management has positively impacted hospital functioning, including quality, efficiency, and costs. It identifies pharmaceutical costs as the main adjustable expenditure in OZ13 disease group and highlights the necessity of differentiated management for complex cases.

Artificial Intelligence in Ecuadorian SMEs: Drivers and Obstacles to Adoption

This study analyzes the current state of artificial intelligence (AI) adoption among micro-, small-, and medium-sized enterprises (MSMEs) in Ecuador, with a focus on its application across core business functions. Using a stratified random sample of 385 firms from the most representative economic sectors, a survey instrument was designed to assess three dimensions: access to AI-enabling conditions, degree of AI utilization, and organizational characteristics. The results reveal that AI adoption remains limited and highly concentrated in marketing-related functions, particularly in content generation and social media automation, with minimal implementation in finance, logistics, and human resource management. The study also identifies the main barriers hindering AI adoption. The lack of qualified professionals and the unavailability of structured databases emerged as the most critical obstacles, followed by limited financial capacity. One-way ANOVA and Kruskal–Wallis tests confirmed significant differences in AI adoption levels based on company size and sector, especially in areas such as inventory optimization and design prototyping. These findings highlight a gap between the potential of AI technologies and their real-world implementation in Ecuadorian MSMEs. They underscore the need for targeted strategies focused on workforce training, digital infrastructure development, and institutional support to promote broader and more effective AI integration.

Analysis of Knowledge Management Implementation on SME’S (Study on SME’s Tofu)

Knowledge management is currently applied at various levels of the company. Its implementation can generate competitive advantages, ensure business sustainability, and enhance company performance. At the SME level, knowledge management serves as a strategy to sustain operations, addressing a key challenge: the inability of many SMEs to survive due to the potential loss of knowledge held by individuals and the lack of successor expertise in business processes. This study examines the implementation of knowledge management in Tahu Putra Soma, a tofu SME that has remained operational after transitioning ownership to the second generation. Using a qualitative case study method, the researcher analyzes the SME’s application of knowledge management based on Fernandez and Sabherwal’s process framework. This framework consists of four key processes—knowledge discovery, knowledge capture, knowledge sharing, and knowledge application—along with their sub-processes.

Internal Capabilities and SMEs Sustainability: The Role of Results-Based Management and Deep Knowledge Implementation in Mozambique

Abstract: This study investigates the impact of internal capabilities, particularly Results-Based Management (RBM) and Deep Knowledge Implementation (DKI), on the sustainability of Small and Medium Enterprises (SMEs) in Mozambique, between 2005-2023. Using Structural Equation Modeling (SEM) and Principal Component Analysis (PCA), we analyze data from Mozambican SMEs to explore how these management practices influence organizational resilience and long-term survival. Our findings reveal that while RBM significantly contributes to SME sustainability, DKI presents mixed effects, suggesting the need for a more integrated approach to internal knowledge application. Additionally, statistical models reveal that firms with high absorptive capacity benefit more from DKI, emphasizing the moderating role of organizational learning. This study contributes to the literature on SME management by providing empirical insights into the role of internal capabilities in emerging markets.

The Green Dilemma: The Impact of Inconsistent Green Human Resource Management and Innovation on Employees’ Creative Performance

With increasing global attention on environmental sustainability, fostering employees’ green creativity has become crucial for organizations. However, the high costs and complexity of green initiatives frequently result in superficial measures rather than genuine innovation, creating a contradiction between corporate green rhetoric and actual practices. Drawing on cue consistency theory and social information processing theory, this study examines how the inconsistent implementation of green human resource management (GHRM) and organizational green innovation (OGI) impacts employees’ green creativity, with uncertainty perception as a critical psychological mediator. Data were collected from 410 employees across diverse industries using structured surveys and we validated the model through polynomial regression and response surface analysis. We found that both green human resource management and organizational green innovation were positively correlated with employees’ green creativity. Perceived uncertainty mediated the relationship between their synergistic effects and green creativity. Notably, alignment between green human resource management and organizational green innovation amplified their positive impact on green creativity. When the two were misaligned, their combined effect on employees’ green creativity exhibited a U−shaped relationship. This study demonstrates that organizations should implement coherent environmental strategies that align GHRM with OGI to foster sustainable innovation in practice.

Future of knowledge-intensive work: stakeholder perceptions on technology-driven changes in the accounting profession

Abstract Digitalization and technological advancements are reshaping knowledge-intensive work, transforming the conventional roles and tasks of knowledge professionals. Focusing on one domain that exemplifies knowledge-intensive business services, this study examines technology-driven changes in the accounting profession. Stakeholder perceptions are crucial for organizational change management and successful implementation; for this reason, this study explores and compares the perceptions of three stakeholder groups—Finnish accounting students, employers, and employees—regarding predefined projections of future work. The results show that changes driven by emerging technologies and automation are widely expected by the actors involved. Despite an overall positive attitude toward these changes, differences emerge among stakeholder groups; in particular, students express more optimistic perceptions about several changes compared to employees and employers. The findings also provide empirical evidence on how individual characteristics, such as educational level and possessed skills, influence stakeholder perceptions. By presenting a multi-stakeholder perspective and a two-dimensional analysis of probable and desirable futures in accounting, the study offers valuable insights about managing change and designing work arrangements (intended for organizations), as well as preparing professionals and addressing future research needs (aimed at educators and academics).

Implementasi Manajemen dan Digitalisasi Perpustakaan di SDN Rungkut Menanggal I Surabaya

Effective and digitally-based school library management plays a crucial role in supporting the learning process and strengthening students' literacy skills. This study aims to investigate the implementation of library management and digitalization at SDN Rungkut Menanggal I Surabaya, focusing on organizational structure, collection classification and cataloging systems, library services, and literacy programs. A descriptive qualitative approach was used, with the research conducted at SDN Rungkut Menanggal I. Data were collected through observation, in-depth interviews with the librarian, and documentation, and then analyzed descriptively. The results show that the library has a complete and functional organizational structure with clearly defined roles. The classification and cataloging process uses the Dewey Decimal Classification (DDC) system, supported by the Inlis Lite 3.2 application, which improves collection management efficiency. The library provides services such as reading rooms, circulation services, and scheduled class visits, all designed to encourage students’ reading habits. Additionally, literacy programs are held regularly and include various activities such as reading books, watching educational videos, and completing summaries or quizzes, all of which have proven to increase students’ reading interest and thinking skills. These findings demonstrate that a well-structured library management system and the integration of technology contribute to creating a more active and enjoyable learning environment in elementary schools.