Interdepartmental Collaboration Research Articles

A Business Model for Managing System Change Through Strategic Financing and Performance Indicators: A Case Study

This article describes how a system of care operated by a county government agency used a fiscal crisis as the opportunity to reform its children's system. A cross-system response to the crisis is outlined that includes a system of care framework coupled with a business model, inter-departmental collaboration and leadership, the use of strategic reinvestment strategies, and a quality improvement system that focuses on key indicators. Implementation of the system change is described with a specific focus on cross-system entry points, financing strategies that re-allocate funds from deep-end programs to community-based services, and management oversight through the use of performance indicators to monitor and support effectiveness. This article examines the results of the system change, including the diversion of youth from system penetration, the reduction in residential treatment bed days, the re-allocation of these savings to community-based services, and the outcomes of children who were diverted from residential care and served in the community. The article offers a number of recommendations for other communities contemplating system change.

프로스포츠구단의 고객관계관리가 비재무적 경영성과에 미치는 영향

The purpose of this study is to suggest a strategic plan for maximizing business performance of professional sports teams through verifying the influence of such CRM success factors of professional sports teams on business performance. The subject group of this study consisted of thirty-three domestic mainstream professional sports teams across three types of group sports. The study was conducted using a questionnaire format survey and collected data was analyzed through the statistical and analysis programs SPSS(version 18.0). The results of this study were as following; First, among CRM success factors, customer orientation, and organizational culture and staff of professional sports teams significantly influence customer performance of non-financial business performance factors. However, CEO support and interdepartmental collaboration did not significantly influence customer performance. Second, Organizational culture and staff of professional sports teams significantly influence the education and training of non-financial business performance matters. Moreover, CEO support, customer orientation, and interdepartmental collaboration do significantly influence education and training. Third, culture and staffs, interdepartmental collaboration, and customer orientation of professional sports teams significantly influence growth of non-financial business performance. However, CEO support negatively influence on growth. Fourth, organizational culture and staffs, interdepartmental collaboration, and customer orientation of professional sports teams significantly influence internal operational processes relating to non-financial business performance, however, CEO support does not significantly influence internal operational processes. It can be concluded that the role of chief executive officer in professional spots team should be increased to maximize the business performance of professional sports team introducing and utilizing CRM.

Professionalization and Retention Outcomes of a University–Service Mentoring Program Partnership

With the use of a university-service partnership to introduce mentoring and shared governance, the aim of this study was to evaluate the effect of these interventions on nurse perceptions of the supportive culture of the workplace environment, professional skill development, decisional involvement, and retention and vacancy rates. A nonequivalent pretest-posttest, noncontrol group design was used with mentors of newly hired mentees to evaluate their workplace perspectives following mentor classes, ongoing mentor support, and a formal mentor-management workforce governance board. A convenience sample of 89 RNs from two acute care facilities attended mentoring and professionalization classes and worked with 109 mentees over 1-3 years. Mentors reported improved teamwork and the ability to deal with conflict but wanted more administrative oversight of the quality and scope of practice of support staff and additional interdepartmental collaboration. One hospital's vacancy rate decreased by 80%, and the other facility's retention rate improved by 21%. The data suggest that a mentor program with comprehensive education and mentor-management alliances through formal workforce environment governance enhances professionalization of frontline nurses and helps sustain a positive, constructive workplace environment. Mentoring classes on communication and cultural sensitivity skills and other leadership concepts, followed by mentor support and mentor-administrative forums, have positive implications for sustained improvement of a supportive culture as perceived by hospital-based RNs and new nurse graduates.

The Johns Hopkins Delirium Consortium: A Model for Collaborating Across Disciplines and Departments for Delirium Prevention and Treatment

Delirium is an important syndrome affecting inpatients in various hospital settings. This article focuses on multidisciplinary and interdepartmental collaboration to advance efforts in delirium clinical care and research. The Johns Hopkins Delirium Consortium, which includes members from the disciplines of nursing, medicine, rehabilitation therapy, psychology, and pharmacy within the departments and divisions of anesthesiology, geriatrics, oncology, orthopedic surgery, psychiatry, critical care medicine, and physical medicine and rehabilitation at the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, is one model of such collaboration. This article describes the process involved in developing functional collaboration around delirium and highlights projects, opportunities, and challenges resulting from them.

Developing a Local Cultural Indicator Framework in Australia: A Case Study of the City of Whittlesea

This paper critically examines the cultural planning agenda of the City of Whittlesea, a local government municipality in Australia, and considers its impact on the region‟s multicultural communities. Located on the metropolitan fringe, the City is geographically one of the largest and most diverse municipalities in greater Melbourne, with more than half of the residents from non-Anglo-Celtic backgrounds. First, the paper shows how sustainability is achieved through a structure of inter-departmental collaboration as well as in a cultural planning focus on community cultural development. Next, it examines how sustainability is implemented in its policies and programs through the development of cultural citizenship. Finally, it evaluates two community events to consider the extent of cultural participation. Combining empirical data and theoretical research, this paper aims to produce a working model for developing local cultural indicators to measure the cultural participation of non-Anglo Celtic communities. Specifically, this paper hopes to establish cultural indicators with direct policy relevance for local government, and incorporate a detailed consideration of the „use-context‟ of the cultural indicators in the City in order to provide a template for best practice at municipal program levels. A localized cultural indicator framework will enable robust tools of measurement to account for thick narratives of multicultural participation that can continue to enhance well-being, place making, and belonging.

The Bottom Line Challenge: Demonstrating Effectiveness beyond Press Ganey

Though families of patients who die in hospitals receive many hours of care from chaplains, no systematic feedback about this care is available through satisfaction surveys. In response, chaplains at Hennepin County Medical Center (HCMC), Minneapolis, MN, initiated a process improvement project to obtain this information. This article describes methods chaplains might use to demonstrate their effectiveness in improving patient/family satisfaction despite a resource-limited environment. The reader will learn how securing a grant, assembling a task force and building interdepartmental collaboration achieved mission alignment and accountability for HCMC's chaplaincy department.

Costs and benefits of inter-departmental innovation collaboration

Inter-departmental innovation collaboration facilitates innovation performance. At the same time, it has been identified as a source of increased coordination costs. Using organizational information processing theory, this paper builds and tests hypotheses on the costs and benefits of innovation-related collaboration within firms. Based on a sample of 433 German manufacturing firms we show inter-departmental innovation collaboration to increase process innovation performance, but also to produce costs in terms of project delay and project termination. These costs, however, do not affect innovation performance at the firm level. This finding suggests firms to be well able to balance the costs and benefits of inter-departmental collaboration across their innovation project portfolio. Theoretical and managerial implications are discussed.

La coordinación de esfuerzos en casos clínicos complejos: un valor añadido de cuidados paliativos en un hospital universitario

Palliative care is generally understood on caring for terminal patients in chronic settings but more recently these units are developing also in acute care settings or university hospitals as consultants teams. We report the case of a complex patient with rectal adenocarcinoma and four problems of difficult approach: uncontrolled neuropathic pain despite opioids treatment, systemic infection, depression with intense demoralisation and open surgery wound. We show the measures adopted and how an excellent inter-departmental collaboration under the co-ordination of palliative medicine consultant team helped to resolve the untenable situation.

Interdepartmental Simulation Collaboration in Academia: Exploring Partnerships With Other Disciplines

Multidisciplinary collaboration provides opportunities for growth in any simulation program. Simulation coordinators pursuing excellence may find unlikely partners among health care and non–health care professionals. Non-nursing collaborations can offer students, faculty, and simulation coordinators fresh views about simulation in an interdisciplinary climate. Examples of cooperative work with instructors and researchers in radiology, sports medicine, and criminal justice studies are described. Sports medicine students participated in scenarios involving a school-aged child with a spontaneous pneumothorax, a coach who was having a stroke, a pregnant yoga instructor experiencing an asthma attack, and a football player who had been momentarily unconscious after a tackle. Nursing students were asked to participate in criminal justice scenarios because of their understanding of simulation principles.

Pre-Parallelization Exercises in Budget-Constrained HPC Projects: A Case Study in CFD

Projects associated with the Grand Challenge Applications (GCAs) often involve large multi-disciplinary teams, are well funded and have access to good computational resources. The code base used in these projects is mature and well maintained and may have gone through multiple revisions spanning decades. Parallelization of this serial code to enable execution on a distributed multi-computer architecture or a shared memory multiprocessor system is the next immediate step. Parallelization of serial code used by young researchers working on GCA-related applications in privately-funded institutions, on the other-hand, is not as straightforward. These researchers work under tight budget and resource constraints and do not have much access to funds or experienced programmers as their other counterparts. Initial findings from a case study are presented that show how such limitations can be alleviated by inter-departmental collaboration involving undergraduate students’ final year projects. Code developed by a single programmer over a period of about three years for the Conjugate Heat Transfer problem in Computational Fluid Dynamics (CFD) has been used for the study.

Leiomyosarcoma Arising in the Pancreatic Duct: A Case Report and Review of the Current Literature

Context. Leiomyosarcomas are rare malignant smooth muscle tumors that may arise in any organ or tissue that contains smooth muscle, commonly within the gastrointestinal tract. They are most often found in the stomach, large and small intestines, and retroperitoneum. Primary pancreatic leiomyosarcoma is extremely rare, and to the best of our knowledge only 30 cases have been reported in the world literature since 1951. Our case represents the first to have a clear origin from the main pancreatic duct. Case Report. This case was diagnosed in a large, tertiary care center in Tampa, Florida. Pertinent information was obtained from chart review and interdepartmental collaboration. A mass in the tail of the pancreas was identified with large pleomorphic and spindle-shaped cells. Immunohistochemistry for vimentin, smooth muscle actin, and desmin was positive. All remaining immunohistochemical markers performed were negative. The tumor clearly originated from the pancreatic duct wall, filled and expanded the duct lumen, and was covered with a layer of benign biliary epithelium. Conclusion. Leiomyosarcoma of the pancreas is an extremely rare malignancy with few reported cases in the literature. The prognosis is poor, and treatment consists of alleviating symptoms and pain management. To our knowledge, this represents the first reported case demonstrating clear origin of a leiomyosarcoma from the pancreatic duct.

Factors Contributing to Door-to-Balloon Times of ≤90 Minutes in 97% of Patients with ST-Elevation Myocardial Infarction: Our One-Year Experience with a Heart Alert Protocol

Prompt percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI) can significantly reduce mortality and morbidity, although its effectiveness may be limited by delays in delivery. In March 2008, our hospital implemented a Heart Alert protocol to rapidly identify and treat patients with STEMI presenting to our Emergency Department (ED) with PCI, using strategies previously described to reduce door-to-balloon times. Before the Heart Alert protocol start date, patients with STEMI presenting to our ED were treated with thrombolysis. We evaluated data from patients with STEMI after one year of use of our Heart Alert protocol to determine protocol success on the basis of the percentage of patients for whom the recommended door-to-balloon times of ≤90 minutes were met. We examined factors involved in implementation of the protocol that contributed to these results. We conducted a retrospective data and chart review for patients in the ED with STEMI who underwent PCI after a Heart Alert protocol activation between March 17, 2008, and March 17, 2009. During the study period, our staff met the recommended door-to-balloon time of ≤90 minutes (mean door-to-balloon time, 57.3 ± 17.6 minutes) for 70 of 72 patients (97%) presenting to our ED with STEMI. Sixty-five of the 72 patients (90.3%) survived to hospital discharge. Initiation of a Heart Alert protocol at our hospital resulted in achievement of door-to-balloon times of ≤90 minutes for 97% of patients with STEMI. This achievement was obtained through careful preparation, training, and interdepartmental collaboration and occurred despite immediate conversion from a previous thrombolytic protocol.

Design and Implementation of Students’ Information System for Tertiary Institutions Using Neural Networks

This paper identifies the causes associated with delays in processing and releasing results in tertiary institutions. An enhanced computer program for result computation integrated with a database for storage of processed results simplifies a university grading system and overcomes the short-comings of existing packages. The system takes interdepartmental collaboration and alliances into consideration, over a network that speeds up collection of processed results from designated departments through an improved centralized database system. An empirical evaluation of the system shows that it expedites processing of results and transcripts at various levels and management of and access to student results on-line. The technological approach for the implementation of the proposed system is based on open source solutions. Apache is used as Web server extended with PHP for server side processing. In recognition of the confidentiality of data contained in the system, communication networks are protected with open-ssl library for data encryption and role-based authentication. This system increases efficient service delivery and benefits both administration and students.

Evolving in Collaboration: Electronic Thesis and Dissertation Workflows in North Carolina

Thirty-seven colleges and universities in North Carolina offer advanced degrees, and most require a thesis or dissertation. The websites of thirteen (35%) indicate they accept or require electronic submission of dissertations and/or theses (ETD). How do these institutions handle the interdepartmental communication and collaboration needs of ETD programs? To begin answering this question, this study examines current practices among ETD administrators in North Carolina and in current national literature, paying special attention to communication, collaboration, workflows, and divisions of labor. The literature review surveys current (since 2003) library and higher education articles on topics related to collaboration, workflows, and divisions of labor in ETD programs. Then the authors use a brief web survey (sixteen questions) that was emailed to twenty-three individuals identified on institutional websites as being involved in the ETD program. Fifty percent of recipients completed the survey, and the results tend to support common themes found in the literature: ETD depositories require a great variety of skill sets and thus will involve multiple departments; libraries and graduate schools are primary players, but not exclusively, in ETD workflows; and communication and collaboration between departments are important from start to finish.

Identifying Collaborative Innovation Networks: At the Inter-Departmental Level

Collaborative Innovation Networks (COINS) are typically defined using individuals as nodes. Departments in organizations or higher order units can, however, be considered as forming COINs of interest. WORDij 3.0 software enables locating COINS at various levels of analysis including organizational departments. This paper reports on an analysis of interdepartmental collaboration networks of a college based on co-occurrence of department names in news stories about the college. It demonstrates the face validity and utility of using WORDij 3.0 to identify COINS at levels of analysis higher than the individual.

Continuing Professional Development: Survivability of PreHospital Cardiac Arrest: A Survey

Overview Prehospital cardiac arrest patients are historically known to have low survival rates. It is also a common medical presentation that ambulance clinicians have to treat. This survey looks at survivability figures of these patients brought into one hospital over a 12-month period, and discusses factors such as return of spontaneous circulation (ROSC), advanced life support (ALS) and basic life support (BLS). It also discusses the difficult choice of whether to ‘stay on scene’ or ‘load and go’. Learning Outcomes After completing this module you will be able to: • Appreciate the appropriate use of data and how it is affected by the Data Protection Act. • Appreciate that effective basic life support (BLS) is the most important factor in achieving a successful outcome from prehospital cardiac arrest. • Understand the importance of interprofessional and interdepartmental collaboration in allowing research and data compilation. • Understand that each prehospital cardiac arrest case is unique, and accept that each clinician must make their decision in a dynamic environment. • Reflect on future cardiac arrest patients, and be more open to the two options of ‘load and go’ or ‘stay on scene’.

Walk the Talk: Promoting Control of Nursing Practice and a Patient-Centered Culture

Walk the Talk: Promoting Control of Nursing Practice and a Patient-Centered Culture

6. Finding and Fostering Clinical Trial Doctors

Item 2 of the new, 5-year action plan to revitalize clinical trials comprises ‘fostering and securing personnel to conduct clinical trials and research’ . Accordingly, the fostering and securing of clinical research coordinators, biostatisticians and data managers are being promoted comparatively proactively; however, the situation regarding doctors remains unsatisfactory. Herein, we introduce initiatives taken by Ehime University Hospital to tackle this. Ehime University has constructed 1)an internal hospital medical team based on inter-departmental collaboration within the University Hospital to conduct identical clinical trials, and 2)a clinical trial medical group including local institutions, as a way of creating an internationally competitive structure. The process of creating this structure makes it possible to find doctors to proactively conduct clinical trials. The results of an attitude survey conducted to assist with creating an environment to foster doctor involvement revealed that 1)few doctors thought it would increase their self-evaluation, 2)many doctors were not using their research budgets, and 3)many doctors thought that clinical trials take time and effort and so did not want to conduct them. In accordance with these requests, we introduce initiatives already undertaken to improve the image surrounding clinical trials. Our goal is to further promote the creation of an environment that motivates doctors to conduct clinical trials.

Evolution and Revolution: The Curriculum Reform Process at UCSF

The challenges, problems, and solutions for developing a more streamlined and integrated curriculum at the University of California, San Francisco, School of Dentistry (UCSF) centered on thematic streams are presented. The central feature of the approach was that the curriculum reform efforts were initiated, developed, and implemented for the 2004-05 academic year primarily as a grassroots faculty effort with support by the administration. In addition, the issues in obtaining the consensus support of the faculty, students, and administration in order to proceed to implementation are discussed. Under the direction of a newly created position of assistant dean of curricular affairs and a faculty curriculum oversight group initiated in 2002, curriculum hours were adjusted to thirty-two hours per week. Departments conformed to this schedule, resulting in reductions in all areas of the curriculum, except clinical instruction, in order to provide time for independent study and electives. A new two-week introduction to the curriculum and an online course support system were also instituted. The new courses were generally well reviewed by students and faculty. Formal course evaluations and focus groups provided specific indications of needed adjustments. National Board scores were monitored and found to be unchanged from past experience. Curriculum change at UCSF required many changes in faculty behavior, including interdepartmental collaboration and efforts to improve teaching. Although many issues were anticipated and addressed in this multiyear reform process, careful faculty and administrative oversight continues to be required to maintain this structure. Continuing challenges include better integration of course materials and incorporating more learner-centered teaching strategies into the curriculum.

Leading Complex Health Care Delivery Systems

Leading Complex Health Care Delivery Systems