Important Stakeholders Research Articles

Social conditions shaping outcomes of water use in the jeans industry: a multidimensional analysis

PurposeSince the early 1990s, Brazil has adopted an experimental approach to environmental management. Its reforms continue to this day and have produced robust water-management policies. This article reveals the different positions, the power structures involved, and the result of the disputes and agreements concerning the social construction of legitimate environmental behaviour in jeans manufacturing.Design/methodology/approachComparative case study. Data collection for this research started in 2017 and ended in 2020. The data were gathered by concentrating on a few cases in two clusters. The author visited public agencies, trade associations, and firms of all sizes and levels of specialization in the industry and conducted semi-structured interviews with them. The intention was to acquire systemic and deep knowledge of the local industry.FindingsThe article's findings demonstrate a divergence in typologies that reflects the ecological limits in the use of natural resources, law-enforcement policies, and firms' legal status. The article extends our understanding of the ability of organizations to respond to institutional pressures to become sustainable. This study's findings provide insights for policy design in times of increasingly catastrophic pollution in regions that are immersed in global competition.Research limitations/implicationsThe study focuses only on two industrial textile clusters in Brazil, which may not be representative of the wider industry in the country or in other regions. The findings may not be generalizable to other industries or locations with different ecological limits, legal frameworks, and firm structures.Practical implicationsThe article's practical implications include the need for tailored regulatory frameworks, effective law enforcement policies, promoting a culture of environmental responsibility among businesses, and collaboration among stakeholders in promoting sustainability. Policymakers, regulators, and businesses in industrial textile clusters in Brazil and other regions facing similar ecological and regulatory challenges can use these insights to develop more effective policies and practices that balance economic growth with environmental sustainability.Social implicationsState actors emerge as the most important stakeholder group in forging the upgrading of water-management systems and technology. The optimal solution to the problem is cross-institutional and multilevel collaboration and coalitions between the different authorities and organizations involved who need to pay due attention to the relevant ecological limits and social needs. Only when this multilevel collaboration is achieved and maintained will the state's agents be able to collaborate with industrial actors and society at large.Originality/valueThe article examines the various factors that influence water usage and analyses the dynamics of change in two distinct locations in an emerging market. It demonstrates that, despite the existence of the same regulatory framework in both locations, different outcomes can arise due to the construction of diverse coalitions between social actors.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0154

Engaging Cancer Care Physicians in Off-Label Drug Clinical Trials: Human-Centered Design Approach.

Using a human-centered design (HCD) approach can provide clinical trial design teams with a better understanding of the needs, preferences, and attitudes of clinical trial stakeholders. It can also be used to understand the challenges and barriers physician stakeholders face in initiating and completing clinical trials, especially for using off-label drugs (OLDs) to treat unmet clinical needs in cancer treatment. However, the HCD approach is not commonly taught in the context of clinical trial design, and few step-by-step guides similar to this study are available to demonstrate its application. This study aims to demonstrate the feasibility and process of applying an HCD approach to creating clinical trial support resources for physician stakeholders to overcome barriers to pursuing clinical trials for OLDs to treat cancer. An HCD approach was used to develop OLD clinical trial support concepts. In total, 45 cancer care physicians were contacted, of which 15 participated in semistructured interviews to identify barriers to prescribing OLDs or participating in cancer OLD clinical trials. Design research is qualitative-it seeks to answer "why" and "how" questions; thus, a sample size of 15 was sufficient to provide insight saturation to address the design problem. The team used affinity mapping and thematic analysis of qualitative data gathered from the interviews to inform subsequent web-based co-design sessions, which included creative matrix exercises and voting to refine and prioritize the ideas used in the final 3 recommended concepts. The findings demonstrate the potential of HCD methods to uncover important insights into the barriers physicians face in participating in OLD clinical trials or prescribing OLDs, such as recruitment challenges, low willingness to prescribe without clinical data, and stigma. Notably, only palliative care participants self-identified as "frequent prescribers" of OLDs, despite high national OLD prescription rates among patients with cancer. Participants found the HCD approach engaging, with 60% (9/15) completing this study; scheduling conflicts caused most of the dropouts. Over 150 ideas were generated in 3 co-design sessions, with the groups voting on 15 priority ideas that the design team then refined into 3 final recommendations, especially focused on increasing the participation of physicians in OLD clinical trials. Using participatory HCD methods, we delivered 3 concepts for clinical trial support resources to help physician stakeholders overcome barriers to pursuing clinical trials for OLDs to treat cancer. Overall, integrating the HCD approach can aid in identifying important stakeholders, such as prescribing physicians; facilitating their engagement; and incorporating their perspectives and needs into the solution design process. This paper highlights the process, methods, and potential of HCD to improve cancer clinical trial design. Future work is needed to train clinical trial designers in the HCD approach and encourage adoption in the field.

Use of Genres: Classroom Teaching Frequency and Usefulness in the Workplace.

Genres are integral to and critically important for any ESP writing course. As part of the needs analysis to design an ESP writing course, classroom teaching frequency and professional usefulness of writing genres for engineering students were matched and correlated. The four groups comprising students, teachers, operational and managerial engineers were compared in terms of their responses to the teaching and usefulness of genres. Accordingly, post hoc analysis was carried out, and means were compared wherever the differences were found to be significant. It has been established through this research that needs analysis of all the important stakeholders- students, professional engineers, teachers – should be done because there are gaps in their respective perceptions regarding the use of genres in an ESP course and through such a triangulated assessment, the gaps can be minimized.

Identifying and prioritizing the stakeholder linkages of dairy-based farmer producer companies in India: An analytical hierarchy process

The present study was proposed to identify stakeholders involved in the formation of FPCs, as related to the dairy-based farmer producer companies. The proposed study was conducted in Uttar Pradesh, Rajasthan, and Madhya Pradesh, as these three states are the major milk-producing states of India as well as have the highest number of dairy-based farmer producers. Four farmer producer companies from each state were selected randomly, based on three criterias. The sample size was 90 (60 officials of FPCs and 30 experts) for the study. The data were collected from primary and secondary sources. A semi-structured interview schedule based on the Satty,s nine continuum scale was developed to collect data related to stakeholder analysis. The study reported that 12 stakeholders were actively involved in the formation of FPCs. The farmers were the most important stakeholder and got the first rank in the AHP priority ranking.The linkage among the stakeholders were found medium to strong. Interest influence matrix categorized stakeholders into Key players, Context setters, Subjects and Crowd. The study suggests that there is a huge need to enhance and coordinate the backward and forward linkage among stakeholders for developing a sustainable ecosystem for the long-term viability of FPCs.

Identifying and prioritizing the stakeholder linkages of dairy-based farmer producer companies in India: An analytical hierarchy process

The present study was proposed to identify stakeholders involved in the formation of FPCs, as related to the dairy-based farmer producer companies. The proposed study was conducted in Uttar Pradesh, Rajasthan, and Madhya Pradesh, as these three states are the major milk-producing states of India as well as have the highest number of dairy-based farmer producers. Four farmer producer companies from each state were selected randomly, based on three criterias. The sample size was 90 (60 officials of FPCs and 30 experts) for the study. The data were collected from primary and secondary sources. A semi-structured interview schedule based on the Satty,s nine continuum scale was developed to collect data related to stakeholder analysis. The study reported that 12 stakeholders were actively involved in the formation of FPCs. The farmers were the most important stakeholder and got the first rank in the AHP priority ranking.The linkage among the stakeholders were found medium to strong. Interest influence matrix categorized stakeholders into Key players, Context setters, Subjects and Crowd. The study suggests that there is a huge need to enhance and coordinate the backward and forward linkage among stakeholders for developing a sustainable ecosystem for the long-term viability of FPCs.

Salience-based stakeholder selection to maintain stakeholder coverage in solving the next release problem

Stakeholders quantification plays a basic role in selecting the appropriate requirements because their judgement is a major criteria since not all of them have the same importance. Original proposals quantified stakeholders assigning them a weight. Nonetheless, actual projects manage a numerous stakeholders community hindering the inclusion of all their weights. This work proposes grouping strategies as means to reduce the number of stakeholders to manage in requirements selection keeping a proper coverage (i.e. howthe selection fulfils stakeholder demands). Our approach is based on stakeholders' salience, defined in terms of power, legitimacy and urgency attributes. Diverse strategies are applied selecting important stakeholders groups in a specific project. We use k-means}, k-medoids and hierarchical clustering, after deciding the number of cluster (4 and 3) based on validation indices. Either for all the stakeholders and each important group several requirements selection optimization problems have been solved. Tests find no significant differences for coverage when important stakeholders are filtered using clustering, regardless of the technique and number of groups, with a reduction between 66.32% to 87.75% in the number of stakeholders being considered. Applying clustering methods on data obtained from a real-world project is useful to identify the group of important stakeholders. The number of groups suggested matches the stakeholders theory and the coverage values in the requirements selection is kept.

Stakeholder Ecosystems and Corporate Sustainability: A Nexus for Value Creation in the Age of Sustainability

Abstract The present-day interconnected global society has seen a diminished significance of borders and a growing interdependence between companies and their stakeholders. For every organization the influence wielded by these key stakeholders plays a pivotal role. The interdependence between stakeholders and corporate sustainability forms the foundation for generating economic, social, and environmental performance, as well as long-term sustainable value for the stakeholder ecosystem. The aim of the paper is to examine significant aspects related to the stakeholder dimension of corporate sustainability. This research employs a methodology that draws upon both literature review and bibliometric analysis, performed using VOSviewer. The research has identified stakeholder engagement as a critical and emerging theme. Moreover, a modern stakeholder approach is essential for understanding stakeholder dynamics holistically. Amid current challenges, a growing discourse advocates a multi-stakeholder approach, recognizing wider society and the natural environment as important stakeholders. In the context of sustainability, key trends include: promoting a pro-sustainability mindset among all stakeholders, fostering shared interests in sustainability, and empowering stakeholders to advocate for nature and sustainable development. The paper concludes with recommendations derived from the research results, providing insights for academics, researchers, and managers in formulating and implementing corporate strategies aligned with sustainability opportunities and challenges.

IDENTIFYING THE CAUSES OF ARCHITECTURAL DESIGN PROCESS FAILURES

Construction is performed with interdisciplinary cooperation, as it requires the preparation of various projects across numerous areas of engineering and architecture. To ensure that projects are complete and coherent, it is important to manage the design process efficiently. It is known that several design failures occur which cause construction reworks if design process could not manage well. Therefore, the current study analyzed causes of design process failures, and adverse effects regarding these failures during the construction. The opinions of architects who were actively involved in design and construction stages of projects were recorded through 354 questionnaires. The opinions of building audit firm employees and employers, that one of the important stakeholders, took in consideration regarding design failures. A total of 351 survey forms were collected from the building audit firms. Data were analyzed using SPSS 22 software. Results indicated that the architectural projects did not include detailed drawings and that concurrent engineering was not applied during the architectural design process. This incompatibility among the projects negatively influenced the construction process.

Parents’ Perception Towards Online Education

Due to COVID-19 pandemic educational institutions of Bangladesh was forced to shut down and had no option but to operate online education for the continuation of education by maintaining social distancing. As an important stakeholder of children’s education, parents played an influential role for supporting students’ online education during the crisis moment. However, despite numerous benefits of online education for the continuation of learning it is comparatively newer concept for many of the parents in Bangladesh. This study was an attempt to explore parents’ perception of online education through different factors. A total of 350 parents were asked regarding the online education and its usefulness in the context of global crisis by using a survey. A descriptive statistic is used to analyze the responses of the parents and the results indicated that parents were overall satisfied with the introduction and application of online education during the pandemic. However, parents claimed lack of digital devices and ability to use technology, poor or unstable internet connection, physical absence of teacher/instructor, lack of assessment and poor self-regulation are the barriers of online education. Moreover, parents considered that traditional learning is preferable to online learning.

Influence of sanctuary disturbance, weather, and landscape characteristics on waterfowl harvest opportunity in western Tennessee

AbstractThe North American Waterfowl Management Plan (NAWMP) recognizes waterfowl hunters and non‐consumptive users as important stakeholders to sustain waterfowl populations through economic and political support for habitat conservation initiatives. Opportunities to shoot at and harvest ducks are key determinants of achievement‐oriented hunt satisfaction and quality. Therefore, identifying factors influencing harvest opportunity would help hunters and wildlife managers identify optimal days afield and promote hunter recruitment, retention, and reactivation (R3) efforts in support of NAWMP. Waterfowl extensively use spatial sanctuaries during hunting seasons, especially diurnally, which could limit their perceived availability to hunters. Thus, a possible management action to support R3 is allowing limited public access on sanctuaries, which could offer diverse recreational opportunities for non‐consumptive users and potentially increase harvest opportunities for hunters in traditional hunting areas if the limited disturbance caused waterfowl to leave sanctuaries. Therefore, we evaluated to what extent experimental sanctuary disturbance, landscape characteristics, and weather influenced local harvest opportunities. We conducted disturbance treatments including travel by a covered truck (i.e., truck with enclosed cab), a pedestrian on foot, and an uncovered vehicle (e.g., motor boat or all‐terrain vehicle [ATV]). To measure harvest opportunity, we used autonomous recording units (ARU) to enumerate daily shotgun volleys at a landscape‐scale across western Tennessee, USA, during 2019–2021 waterfowl hunting seasons. We identified 339,391 distinct shotgun volleys ( = 73 shotgun volleys/day/ARU). Shotgun volleys decreased 50% within 2 weeks of opening day and did not notably increase for the remainder of the hunting season. Contrary to our predictions, sanctuary disturbance decreased harvest opportunity. Specifically, the pedestrian disturbance and covered vehicle disturbance decreased daily shotgun volleys by 32% and 31%, respectively. Additionally, harvest opportunity decreased 20% with every 5‐km increase in distance from a sanctuary. Harvest opportunity increased 2% for every 1°C decrease from mean low temperatures and 9% with every 10‐hPa increase in barometric pressure from the previous day. Conversely, harvest opportunity was unaffected by changes in cloud cover, daily precipitation, waterfowl abundance, or surface water inundation. Our results suggest disturbing sanctuaries decreases harvest opportunity and, in turn, may reduce hunt quality and satisfaction. If increasing harvest opportunity is a primary management objective, we recommend limiting sanctuary disturbance to maximize local harvest opportunities. Furthermore, greater harvest opportunity nearer sanctuaries indicates that additional disturbance‐free areas may increase local harvest opportunities and hunter satisfaction.

Information collection and protection strategy based on platform competition model for advertiser and user

In the era of digital economy, people pay more attention to the protection of users' personal information. The smart goods platform and advertisers who advertise on this platform understand the behavior and preferences of users by collecting users' personal information and undergoing professional processing and analysis. And accordingly, to provide users with corresponding personalized products and services, while improving consumer satisfaction and loyalty, you can obtain higher profits. However, the collection, processing and use of personal information by smart goods companies have raised privacy concerns among users. By establishing a model of the participation of the smart commodity platform, users and advertisers, analyze the amount of user data collected by the smart commodity platform and the degree of efforts made by the smart commodity to protect data for maximizing the interests of the three parties. Through balanced analysis and static analysis, it can be obtained that the total utility of the user increases first and then decreases. Under the premise that the smart commodity platform makes efforts to ensure the security of users' personal information, the profit of advertisers increases with the increase of users. As collecting too much user data can lead to the loss of some users and collecting too little amount of user data can lead to the platform losing some revenue from advertising. Therefore, smart goods platforms should collect a certain amount of user data and make certain efforts in data protection in order to maintain the balanced rights and interests of important stakeholders such as advertisers, users and themselves.

Planning for walkable cities in Africa: Co-producing knowledge on conditions, practices, and strategies

This study sought to unravel the conditions of the walking environment, and residents lived experiences of walking in two urban neighbourhoods in the Greater Accra Metropolitan Area (GAMA). Drawing on a participatory mapping exercise and a total of 70 community and institutional qualitative interviews, the results revealed that the study neighbourhoods have precarious walking conditions manifested by the absence of road markings, inadequate traffic lights and other road-calming infrastructure such as speed ramps. The results also show that previous and current national and local development plans do little to plan for the walking environment. This study demonstrates the impacts of the failure of planning and policy responses to the walking environment on urban residents. In an important stakeholder engagement workshop involving a total of 40 participants, our study brought academics, institutional representatives and residents from the two neighbourhoods together to discuss the findings and establish a stronger collaborative relationship for designing an equitable and sustainable walking environment. Based on the findings from the qualitative interviews and stakeholder engagement workshop, we therefore recommend a community-based participatory planning strategy for improving walkability conditions.

Millî Eğitim Bakanlığı Uzaktan Hizmet İçi Eğitim Faaliyetleri Hakkında Öğretmen Görüşlerinin Araştırma Bulgularının Değerlendirilmesi

In this study, the research findings of teachers' opinions about the distance in-service training activities of the Ministry of National Education were evaluated. Change and transformation are taking place very fast in the world. This rapid realization of change and transformation has made education very important. One of the most important stakeholders of education is teachers. Teachers need to give importance to their professional development in order to keep up with the developing world conditions. When it comes to professional development, we come across in-service training activities. In the research group of this study, there are seven teachers working in Konya-Meram in the 2022-2023 academic year and participating in distance in-service training activities. As a result of this research, according to the findings obtained from data analysis, studies can be carried out to improve the systematic infrastructure on the platforms where distance in-service trainings are held in order to prevent systemic problems that may occur. Teachers need trainings specific to their own branches. The number of branch-specific trainings that will enable teachers' development can be increased. Teachers have the expectation that there should be pre-informative studies about the trainings they will apply for. In this regard, a pre-introductory video can be added to the system screen during the application. In this way, teachers can be informed about the training they apply for and the preparations to be made by the teachers about the training can be made. Keywords: In-Service Training, Distance Education, Teacher Training, Research Findings

Perceptions of novice driver education needs; Development of a scale based on the Goals for driver education using young driver and parent samples

Professional driver education and training has traditionally been used to improve the driving skills of young people with the expectation that they will drive more safely and therefore be less likely to crash. Despite this, much research has failed to find such an effect. The Goals for Driver Education (GDE) is a theoretical framework developed to improve the effectiveness of driver education. The GDE seeks to draw attention to a broader array of factors that may influence the driving of young people and hence increase the scope of what is included in driver education and training. Within the GDE, factors affecting driving and driver education are grouped into combinations of four hierarchical levels that represent influences on driving at increasing levels of abstraction (GDE level 1: Vehicle manoeuvring; GDE level 2: Mastery of traffic situations; GDE level 3: Goals and contexts of driving; GDE level 4: Goals for life and skills for living) and three types of individual competencies (Knowledge and skills; Risk-increasing factors; Self-evaluation skills). However, to date there have been few, if any, attempts to operationalise the GDE in a quantitative way. In response, the Perceptions of Driver Education Scale (PDES) was developed to gain an understanding of what two important stakeholder groups in the driver education and training ecosystem perceived to be important to be taught to novice drivers. Understanding these perceptions may lead to greater acceptance of the driver education and training that is designed and make it more effective. Following rigorous scale development procedures, thirty-five items were developed a priori using expert opinion and deployed, via an online survey, to a sample of parents of novice drivers (N = 518) and a separate sample of novice drivers (N = 247), both from Queensland, Australia. Exploratory Factor Analysis was performed on the parent responses and Confirmatory Factor Analysis was performed using the novice driver responses. A 29-item 9 factor solution was judged to be the best fit with the overall scale and each of the factors displaying strong levels of internal consistency. The 9 factors cover most hierarchical level and competency combinations, although removal of items meant that there is no representation concerning perceptions of Self-evaluation skills related to Level 3: Goals and contexts of driving within the PDES. Overall, the PDES is a valid and reliable instrument for investigating the aspects of driver education and training that are perceived as important by novice drivers and parents. The scale may also be applicable for use with other stakeholder groups and could also be used to evaluate pre-existing driver education and training programs.

Concept of sustainable human resources management

Sustainable human resources management is a new concept proposed by scientists as a response to the global transformation of the human resource management system in companies. The concept aims at the effective use of human resources to achieve the economic, social and environmental goals of an organization, without compromising the ability of future generations to meet their own needs. Sustainable human resource management aims at the harmonious and long-term development of all important stakeholders of the company – employees, organization and society. With the transition of the whole world towards sustainable development, this approach to human resource management is relevant. The attitude to development of employees and company with the strategy of long-term development positively influences such key indicators as satisfaction, loyalty, involvement of employees, and these indicators lead to the growth of productivity and development of the company as a whole. The purpose of this article is to reveal the essence of the concept of sustainable human resource management and to make the author’s model of the concept. The method of literature review on the basis of Scopus database for the whole period was applied in the work. The selection of works was carried out according to the method of the authors Schiederig, Titze, Herstatt in three stages. On the basis of the selected works the analysis of the origin and development of the concept was made, definitions were given, the main characteristics and models of the concept of sustainable human resource management were identified and systematized, and the author’s model of this concept was presented. The study can serve as a theoretical and practical basis in companies to achieve long-term development goals

CEO ethical leadership as a unique source of substantive and rhetorical ethical signals for attracting job seekers: The moderating role of job seekers' moral identity

SummaryResearch suggests that CSR is increasingly becoming an ambiguous signal of ethical information for external stakeholders. This is because a variety of firms—including those that are morally responsible and those that have been implicated in corporate scandals—routinely adopt CSR policies and invest in CSR initiatives. Not surprisingly, this trend has contributed to rising public skepticism of CSR. In the current research, we examine the unique role of CEO ethical leadership (i.e., relative to CSR) as an alternate source of substantive and rhetorical ethical signals for an important stakeholder group: job seekers. Integrating signaling theory, and the elaboration likelihood model, we argue that CEO ethical leadership substantively signals how fairly an organization treats its employees and its commitment to social and environmental responsibility. We further propose that ethical CEOs serve as a source of rhetorical signal that triggers moral elevation in job seekers. Using a policy capturing methodology in Study 1, we find that real job seekers place significantly greater weight on CEO ethical leadership in making job pursuit decisions compared to CSR. CEO ethical leadership also uniquely predicts job pursuit intentions relative to traditional factors such as salary, person‐job fit, and person‐organization fit. In a second, quasi‐experimental field study (Study 2), we find support for the three hypothesized signaling mechanisms through which CEO ethical leadership influences job seekers. In a third, quasi‐experimental field study (Study 3), we find that job seekers with strong (versus weak) moral identities are more likely to weigh the nuanced ethical information signaled by CEO ethical leadership compared to CSR. We discuss the implications of proactively advertising CEO ethical leadership during the recruitment process.

CHALLENGES AND OPPORTUNITIES IN IMPLEMENTING SMART CITY INITIATIVES IN SMALL METROPOLITAN AREAS: LESSONS FROM ASAYISH TOWNSHIP, BALKH

In order to execute smart city programs in small metropolitan regions, there are both possibilities and obstacles that need to be considered. A mixed-methods approach is used in the study, which is based on a case study of ASAYISH Township in Balkh and includes interviews with important stakeholders and a review of pertinent literature. The findings showthat although implementing smart city programs in small metropolitan areas presents special obstacles, doing so has the potential to address a number of urban concerns, including those connected to transportation, energy, and public services. The study finishes by emphasizing the necessity for policymakers to give small metropolitan regions top priority when implementing smart city efforts.

Pharmacy Students’ Perspective on Business Management for the Community Pharmacist

ObjectivePharmacy students are important future stakeholders in community pharmacy, with business management being an integral part of practice. Thus, this study aims to determine pharmacy students’ perceptions of the business management skills required of the community pharmacist and how these skills should be taught within the pharmacy curriculum. MethodsAn explanatory sequential mixed-methods design involved the administration of an online survey to pharmacy students in years 1 and 4 across 2 Australian universities, followed by focus groups to gather in-depth perceptions. Survey responses were analyzed using descriptive statistics, and associations between years 1 and 4 and outcomes were explored. A hybrid approach of inductive and deductive thematic analysis was used for focus group transcriptions. ResultsA total of 51 pharmacy students responded to the online survey, with 85% agreeing that business management is an essential part of the community pharmacist’s skill set. Students indicated a preference for learning management during their community pharmacy placement, university workshops, and via mentorship. Although thematic analysis of student focus groups revealed a preference for learning clinical skills during their university education, business management was also recognized as important. Enthusiasm for management, however, could be increased by exposure to mentors who display leadership and are passionate about business management. ConclusionPharmacy students considered business management as intrinsic to the role of community pharmacists and recommended a multimethod teaching approach to learning these skills. These findings could be used by pharmacy educators and the profession to inform both the content and the delivery of business management in pharmacy curricula.

Surgeon-Perceived Requirements for a Platform to Integrate Patient-Reported Outcome Measures into Clinical Practice

Abstract Background Patient-reported outcome measures (PROMs) are standardized, validated tools that translate subjective patient-reported concerns about their health status into quantitative data. PROMs were initially developed as research instruments; however, they have more recently been recognized as important clinical tools. PROMs have not been widely adopted into surgical practices and this study sought to uncover the system requirements of a platform to integrate PROMs into surgical practice, as perceived by surgeons. Methods Semi-structured interviews were performed from November 2019 until August of 2020. Interviews continued until thematic saturation was achieved. All interviews were recorded and transcribed verbatim. Qualitative interview data were thematically analyzed using an inductive approach. Results Analysis revealed 12 system features desired by surgeons for a platform to integrate PROMs into clinical use. These were further grouped into four unique overarching themes. Surgeons asserted that the platform must (1) be user-friendly, (2) promote information transparency, (3) incorporate validated questionnaires while still allowing for some degree of customizability, and (4) support the collection and display of longitudinal data. Conclusions Health care systems planning to develop a platform to integrate PROMs into their clinical practices should investigate the feasibility of the system features identified as essential by this study. While surgeons represent an important stakeholder group when designing a new platform for use in surgical practice, it will also be crucial to explore the features desired by patients before designing or adopting a platform for clinical use.

A qualitative descriptive study exploring clinicians’ perspectives of the management of older trauma care in rural Australia

BackgroundFor older trauma patients who sustain trauma in rural areas, the risk of adverse outcomes associated with advancing age, is compounded by the challenges encountered in rural healthcare such as geographic isolation, lack of resources, and accessibility. Little is known of the experience and challenges faced by rural clinicians who manage trauma in older adults. An understanding of stakeholders’ views is paramount to the effective development and implementation of a trauma system inclusive of rural communities. The aim of this descriptive qualitative study was to explore the perspectives of clinicians who provide care to older trauma patients in rural settings.MethodWe conducted semi-structured interviews of health professionals (medical doctors, nurses, paramedics, and allied health professionals) who provide care to older trauma patients in rural Queensland, Australia. A thematic analysis consisting of both inductive and deductive coding approaches, was used to identify and develop themes from interviews.ResultsFifteen participants took part in the interviews. Three key themes were identified: enablers of trauma care, barriers, and changes to improve trauma care of older people. The resilience of rural residents, and breadth of experience of rural clinicians were strengths identified by participants. The perceived systemic lack of resources, both material and in the workforce, and fragmentation of the health system across the state were barriers to the provision of trauma care to older rural patients. Some changes proposed by participants included tailored education programs that would be taught in rural centres, a dedicated case coordinator for older trauma patients from rural areas, and a centralised system designed to streamline the management of older trauma patients coming from rural regions.ConclusionsRural clinicians are important stakeholders who should be included in discussions on adapting trauma guidelines to the rural setting. In this study, participants formulated pertinent and concrete recommendations that should be weighed against the current evidence, and tested in rural centres.