Internal Expertise Research Articles

Delay Identification of the HVAC Project on West Madura Offshore Oil Company Using the House of Risk Method

This research is focused on the analysis of delays or risks to the implementation of the "Procurement and Installation HVAC Installation" contract at West Madura Offshore Oil Company, which has a working area in the Offshore area. This study uses the HOR (House of Risk) method as an alternative to the ISO31000: 2009 risk management method that has been used internally by West Madura Offshore Oil Company The basis for selecting the HOR (House of Risk) method is the existence of a tool to see the impact (severity) and relations (relations) between the event of a delay and the factoring agent. In identification of the cause of the delay the method used are collecting data primary through Focus Group Discussion between Internal Expert and Secondary data which use project data for Offshore HVAC Project in the period of the year 2016-2018. The HOR (House of Risk) method in conducting this process is presented as follow review historical data and related document, Focus Group Discussion as information gathering techniques, Risk analysis and Risk Register. There are five significant risks from the results of research using the HOR (House of Risk) method, namely Poor-quality shop and coordination drawings, weather constraints, limited quantity and quality of HR (contractors and subcontractors), Absence of duct fabrication workshops at the site and lack of communication between contractor and subcontractor.

DEVELOPMENT OF AN ECONOMIC-MATHEMATICAL MODEL FOR PROJECT TEAM FORMATION IN MODERN CONDITIONS: KNOWLEDGE ASPECT

An economic-mathematical model of forming the optimal composition of the project team according to the level of knowledge in modern conditions has been developed, which allows to successfully implement the project. The objective function is to maximize the integrated indicator for the selected combination of employees of one division of the enterprise, which will be part of the project team. This integrated indicator is the average value of the appropriate level of knowledge of employees in each required area of knowledge, taking into account the relevant weighting factor. This takes into account the restriction that a potential team member’s level of knowledge in the established areas of knowledge should not be lower than the minimum level set by experts. As well as the average value of a group of employees from one unit in each area of knowledge should not be lower than the average level set by experts. If there are no employees with the appropriate level of knowledge in the divisions of the enterprise, a combination of employees with a minimum deviation is selected. The model involves the use of elements of combinatorics to determine possible combinations of employees of units. Expert knowledge and the Fishburne method were also used to determine the weights of the areas of knowledge. The map of knowledge of the enterprise, a hierarchical tree of areas of knowledge of the project with use of system of relations of advantages is constructed. A modified Harrington scale was used to assess the level of knowledge of potential project team members. The practical implementation of the model was carried out for a machine-building enterprise that plans to produce a new type of product. Out of 52 candidates, 23 were selected to form the project team. 4 of them require additional training from internal experts who are employees of the enterprise. The created model can be used by a wide range of enterprises taking into account the specifics of their activities.

Water Management in the Western U.S.: An Economic Research Agenda

This report discusses water management in the western U.S. and investigates related problems. The first part reviews theoretical and empirical economics literature on the motivations for water management. Following that, it discusses barriers to effective water management and potential knowledge gaps. The final part of the report presents three broad research topics, as well as related researchable questions that may contribute to ongoing policy debates. Research topics come from literature reviews and interviews with Environmental Defense Fund internal experts, academic communities and stakeholders. Topics include fragmented water management, groundwater market design and agricultural adaptation to reduced water supplies.

Capacity Improvement for Transfer Molding Trough Reduction of Mold Curing Time

This paper will discuss the improvement made to increase machine capacity in order to be prepare for incoming demand ramp-up and to free up machine allocation to back-up automotive machine. Using DMAIC methodology (Define, Measure, Analyze, Improve and Control) approach, mold curing time identified as the top contributor during time study of the process with 120 secs consumed time per shot. A Differential Scanning Calorimetry (DSC) and Curability Curve study for molding compound was conducted from both internal and external expertise to get the optimum lower range of cure time. Considering all the quality risk using Risk assessment, the success of reducing Mold curing time from 120secs to 80secs increases 25% machine capacity of transfer Molding for Quad Flat No leads(QFN) / Quad Flat No leads multi-Row(QFN-mR) with significant cost savings. The project was able also to free up 3 molding system to support upcoming products.

Assessment of Appropriateness of Antimicrobial Therapy in Resource-Constrained Settings: Development and Piloting of a Novel Tool-AmRAT.

Inappropriate antimicrobial prescribing is considered to be the leading cause of high burden of antimicrobial resistance (AMR) in resource-constrained lower- and middle-income countries. Under its global action plan, the World Health Organization has envisaged tackling the AMR threat through promotion of rational antibiotic use among prescribers. Given the lack of consensus definitions and other associated challenges, we sought to devise and validate an Antimicrobial Rationality Assessment Tool—AmRAT—for standardizing the assessment of appropriateness of antimicrobial prescribing. A consensus algorithm was developed by a multidisciplinary team consisting of intensivists, internal medicine practitioners, clinical pharmacologists, and infectious disease experts. The tool was piloted by 10 raters belonging to three groups of antimicrobial stewardship (AMS) personnel: Master of Pharmacology (M.Sc.) (n = 3, group A), Doctor of Medicine (MD) residents (n = 3, group B), and DM residents in clinical pharmacology (n = 4, group C) using retrospective patient data from 30 audit and feedback forms collected as part of an existing AMS program. Percentage agreement and the kappa (κ) coefficients were used to measure inter-rater agreements amongst themselves and with expert opinion. Sensitivity and specificity estimates were analyzed comparing their assessments against the gold standard. For the overall assessment of rationality, the mean percent agreement with experts was 76.7% for group A, 68.9% for group B, and 77.5% for group C. The kappa values indicated moderate agreement for all raters in group A (κ 0.47–0.57), and fair to moderate in group B (κ 0.22–0.46) as well as group C (κ 0.37–0.60). Sensitivity and specificity for the same were 80% and 68.6%, respectively. Though evaluated by raters with diverse educational background and variable AMS experience in this pilot study, our tool demonstrated high percent agreement and good sensitivity and specificity, assuring confidence in its utility for assessing appropriateness of antimicrobial prescriptions in resource-constrained healthcare environments.

International Perspectives on COVID-19 Communication Ecologies: Public Health Agencies’ Online Communication in Italy, Sweden, and the United States

Communicating during a crisis can be challenging for public agencies as their communication ecology becomes increasingly complex while the need for fast and reliable public communication remains high. Using the lens of communication ecology, this study examines the online communication of national public health agencies during the COVID-19 pandemic in Italy, Sweden, and the United States. Based on content analysis of Twitter data (n = 856) and agency press releases (n = 95), this article investigates two main questions: (1) How, and to what extent, did national public health agencies coordinate their online communication with other agencies and organizations? (2) How was online communication from the agencies diversified in terms of targeting specific organizations and social groups? Our findings indicate that public health agencies relied heavily on internal scientific expertise and predominately coordinated their communication efforts with national government agencies. Furthermore, our analysis reveals that agencies in each country differed in how they diversify information; however, all agencies provided tailored information to at least some organizations and social groups. Across the three countries, information tailored for several vulnerable groups (e.g., pregnant women, people with disabilities, immigrants, and homeless populations) was largely absent, which may contribute to negative consequences for these groups.

The Quality of Electronic Local History Products: Experience of Development of Criteria and Expertise

Libraries provide the variety of electronic local history products to preserve local history and transmit it via remote access. Due to the development of information technologies the quality of these products needs to be evaluated. In the course of study, the authors developed the working definitions of the concepts “Electronic local history products” and “Quality of electronic local history products”. To determine the quality of an electronic local history product, the study considers the existing approaches to their assessment in libraries, museums, archives, as well as in the area of higher education. The article determines the quality criteria, which are formed into four groups: formal, ergonomic, informative and local history. In the course of an expert online survey of 44 practitioners of the central and municipal libraries of the Kemerovo region, the authors coordinated the basic criteria for evaluating the quality of electronic local history products. Based on the developed criteria, there was carried out expert examination of electronic local history products of the V.D. Fedorov State Scientific Library of Kuzbass. The article analyses the digests “Environmental problems of the Kemerovo region” and “Calendar of significant and memorable dates in the Kemerovo region” that prevail on the library’s website. The conformance of quality criteria for calendars of significant and memorable dates and digests published by the library is presented in a matrix format. The study showed that the requirements for the quality of electronic information products in professional press are ambiguous. Specific approaches are required to reflect the local history component. To improve the system of electronic local history products, there is required the constant internal control and expertise of the products presented on the websites. The working list of criteria for their quality is open for completion. In the future, it needs to be approbated on the example of local history products from other libraries.

Preface

The Department of Mechanical Engineering, Bannari Amman Institute of Technology (BIT) is honoured to bring out the proceedings of the 2nd International Conference on Materials, Manufacturing and Machining for Industry 4.0 (ICMMM 2020) – A Virtual Conference in soft form. This is an extensive Mechanical Engineering associated conference to take place in India. The conference was virtually held during 09-10, October 2020 hosted by Bannari Amman Institute of Technology, Sathyamangalam.The conference was designed to be conducted virtually that consists of three parallel technical paper presentation sessions on each day. Authors were given 12 min for their presentation and 3 min for question and answers session. In addition to this, five technical keynote lecture sessions were offered by eminent professors, scientists and leading industry experts on both the days. Q & A sessions were provided to the delegates to update their field of expertise according to industrial and social needs.182 quality papers were scrutinized out of 230 by the editorial team and they were presented in the conference. The quality of the technical papers is ensured by Single Blind review process carried out by the external and internal experts as a review member. Each paper is checked for its similarity by Turnitin software, and ensured to have <15%. The reviewers suggestions are scrupulously considered as one of the criteria for accepting the 76 papers for possible publication.List of Advisory Committee, Conference Committee, Glimpses of ICMMM 2020, images are available in this pdf.

Peculiarities of certification of led products of Ukrainian origin in the introduction of export direction to European Countries

Introduction. In conditions of intensified market competition, the quality and safety of goods play an important role in the economic, social and environmental position of the state in the international market. To regulate the circulation of goods in foreign and domestic markets and prevent oversaturation, countries are actively using the tools of technical regulation of products. Foreign economic entities engaged in foreign economic transactions must first adapt the characteristics and features of the goods to the requirements of the host country, regulating the conformity of the components of the goods to the conditions, norms, standards and technical regulations of the country. The purpose of the paper is to define the procedure for certification of LED products intended for export to the markets of the European Union. Results. The paper analyzes the features of certification of LED products intended for export to the markets of the European Union. It is determined that LED panels and lamps can be placed on the EU electronic market subject to compliance with Directives 2014/30/EU, which are designed to protect work from electromagnetic interference. In order to confirm that the products meet the requirements specified in the Directive, it is necessary to pass a conformity assessment, in particular, to conduct internal control of production and examination of the EU. The publication also contains the requirements for internal production control and EU expertise, the features of labeling of LED products. When placing electrical or electronic products on the EU market covered by Directive 2014/30/EU, it must bear the CE mark. The mark must be placed on each unit of production, on the packaging, on the accompanying documents. The CE marking must be visible, clear and legible. Energy-related products sold in the EU must meet the energy labeling requirements set by EU Regulation 2017/1369. In addition, the basic requirements for the development of labels for LED products intended for export are also defined. Conclusions. Compliance with all EU requirements for the quality of goods and compliance with the Directives allows domestic companies to export goods to European markets. Access to EU markets has a positive effect on the country's economy as a whole.

Is dominant logic a value or a liability? On the explorative turn in the German power utility industry

Purpose: This study seeks to specify the role of ‘dominant logic’ in an organization. So doing, the ambiguous character of the dominant logic emerges, as on the one hand, a dominant logic can make sense of a change, provide useful guidelines and keep the company focused. However, on the other hand, a dominant logic may provide reasons why preventing change could be ‘logical’ or work as a blinder when it comes to interpreting up-and-coming developments. Therefore, a dominant logic can be a value and a liability in times of change. Methodology: This study sets out to contribute to prior research by raising two questions. First, how can we re-conceptualize the construct of dominant logic to address both the driving and the hampering role in the case of explorative turns? And, second, which factors restrain and which allow explorative turns? With special regard to the German energy transition in the 2010s, this research grounds on explorative qualitative empirical research and employs a single case-study design for a traditional German power utility company, which – as an incumbent – has to deal with the high complexity in the German power industry. Data sources are in-depth and problem-centered interviews with both internal and external experts as well as field observations. An inductive procedure allows the development of research propositions from data, framed by prior research. Findings: As a result, this study delivers a six-factor framework to shine a light on the micro-foundations of dominant logic. Whether a dominant logic is of value or is a liability in organizational change and allows an explorative turn, depends on the identified abilities to unlearn, to explore, to change and to manage. Data suggests that an explorative turn, driven by dominant logic, works better in the case of combined learning and unlearning capacities, an ambidextrous balance of exploration and exploitation, co-existing logics, continuous adaptations of dominant logic and lower levels of leadership power and formal structures. Implications for theory and practice: This study specifies the roles of dominant logic that may hamper explorative turns in times of severe disruptions. Originality and value: It contributes to the research of managerial cognition by refining and applying the concept of dominant logic. It provides empirical evidence on how this phenomenon creates inertia, drives change, and discusses the needs for and the barriers to an explorative turn. From a managerial viewpoint, dominant logic serves as a filter to identify required changes and to tune the speed of change. This, however, depends on managerial reflection on the appropriateness of dominant logic in the run of events.

Is dominant logic a value or a liability? On the explorative turn in the German power utility industry

Purpose: This study seeks to specify the role of ‘dominant logic’ in an organization. So doing, the ambiguous character of the dominant logic emerges, as on the one hand, a dominant logic can make sense of a change, provide useful guidelines and keep the company focused. However, on the other hand, a dominant logic may provide reasons why preventing change could be ‘logical’ or work as a blinder when it comes to interpreting up-and-coming developments. Therefore, a dominant logic can be a value and a liability in times of change. Methodology: This study sets out to contribute to prior research by raising two questions. First, how can we re-conceptualize the construct of dominant logic to address both the driving and the hampering role in the case of explorative turns? And, second, which factors restrain and which allow explorative turns? With special regard to the German energy transition in the 2010s, this research grounds on explorative qualitative empirical research and employs a single case-study design for a traditional German power utility company, which – as an incumbent – has to deal with the high complexity in the German power industry. Data sources are in-depth and problem-centered interviews with both internal and external experts as well as field observations. An inductive procedure allows the development of research propositions from data, framed by prior research. Findings: As a result, this study delivers a six-factor framework to shine a light on the micro-foundations of dominant logic. Whether a dominant logic is of value or is a liability in organizational change and allows an explorative turn, depends on the identified abilities to unlearn, to explore, to change and to manage. Data suggests that an explorative turn, driven by dominant logic, works better in the case of combined learning and unlearning capacities, an ambidextrous balance of exploration and exploitation, co-existing logics, continuous adaptations of dominant logic and lower levels of leadership power and formal structures. Implications for theory and practice: This study specifies the roles of dominant logic that may hamper explorative turns in times of severe disruptions. Originality and value: It contributes to the research of managerial cognition by refining and applying the concept of dominant logic. It provides empirical evidence on how this phenomenon creates inertia, drives change, and discusses the needs for and the barriers to an explorative turn. From a managerial viewpoint, dominant logic serves as a filter to identify required changes and to tune the speed of change. This, however, depends on managerial reflection on the appropriateness of dominant logic in the run of events.

Bootstrapping implementation research training: A successful approach for academic health centers.

Demand for building competencies in implementation research (IR) outstrips supply of training programs, calling for a paradigm shift. We used a bootstrap approach to leverage external resources and create IR capacity through a novel 2-day training for faculty scientists across the four Texas Clinical & Translational Science Awards (CTSAs). The Workshop combined internal and external expertise, targeted nationally established IR competencies, incorporated new National Institutes of Health/National Cancer Institute OpenAccess online resources, employed well-known adult education principles, and measured impact. CTSA leader buy-in was reflected in financial support. Evaluation showed increased self-reported IR competency; statewide initiatives expanded. The project demonstrated that, even with limited onsite expertise, it was possible to bootstrap resources and build IR capacity de novo in the CTSA community.

Let natural learning arise!: optimizing organizational learning through a customized leadership development program

PurposeThis paper examined a tiered leadership development program (LDP) designed to optimize natural organizational learning.Design/methodology/approachThe heuristic design of the tiered LDP linked learning pragmatic to the leaders’ workplace to the LDP content instructed in real-time.FindingsThe longitudinal study showed that real-time connected natural learning and LDP instruction fortified the participants’ competencies systemically throughout the organization easily measured through continuous assessment and feedback from multiple sources.Research limitations/implicationsThe study relied on assessment data perceived by workplace observers. Though perception bias is prevalent in studies dependent on qualitative feedback, the feedback in this study was useful to determine the heuristic value of the study parameters. Future research focused on identifying specific elements of natural learning influencing leadership development would enrich the customized content of the tiered LDP. Organizations considering a tiered LDP are cautioned to contemplate if their organization has the internal expertise to implement and facilitate such a program or require external affordable consultancies for the LDP.Originality/valueThis paper introduces a unique and comprehensive tiered leadership development program that promotes stackable and transferable learning symbiotic of leaders’ relationships and organizational tasks at a variety of organizational levels.

PNS176 Is the Door for Rwe in Benefit Assessment in German HTA NOW OPEN?

GSAV, the German law for more safety in drug supply, stipulates that routine clinical practice data may be included in the benefit (re-)assessment of drugs and since 2019 the G-BA may ask for their collection to supplement submitted data. The concepts for generation of routine practice data and their use for the benefit assessment have recently been published by IQWiG. The objective of this study was to critically assess these. We analysed published evidence and engaged in discussions with internal and external experts in the fields of German assessment methodology, RWE and statistics, focusing on the proposed criteria for routine practice data generation and their potential use for conducting treatment comparisons as part of German benefit assessment, comparing to other markets. In A19-43, IQWiG rules out using EMR and claims data for the benefit assessment, due to limited data availability and inconsistent quality. Disease registries are described as the only suitable tool for data collection for benefit assessment. For non-randomised studies, propensity score methods are described as the main acceptable approach to balance treatment groups. In contrast, other HTA bodies (e.g. NICE) allow for more methodological flexibility when generating treatment effect estimates (e.g. multivariate regression analyses). IQWiG concludes that even following the stringent criteria for establishing a registry and guidelines for confounder adjustment, only evidence of ‘low-qualitative certainty’ can be generated. Therefore, our expert panel recommends exploring the use of EMR or claims data, which may fulfil the outlined quality requirements in some cases, in combination with registries. By not making use of the available routine practice data, IQWiG overlooks a data source widely accepted by other HTA bodies. However, the door for RWE in German HTA has now been opened. Other analyses based on propensity score methods, e.g. matched adjusted comparisons may become acceptable in the future.

PCV18 Use of Human-Centred Design Thinking to Reimagine Access to Innovative Medicines in Africa for Patients, Undetected for Heart Failure, WHO Have NO Access to Healthcare and Diagnostics - an Experimental Case Study

To explore the use of a human-centred approach to co-create patient access solutions to innovative heart failure (HF) medicines in Africa. We targeted patients undetected for HF who currently have no access to healthcare and diagnostics. We used a Design Thinking framework collaborating with a multidisciplinary cross-country team from Nigeria and South Africa and developed patient ecosystem maps to identify key stakeholders (e.g., community workers) for interviews to reveal access hurdles for these patients. A targeted literature review, accompanied with insights from Energy sector, inspired an outside-in perspective to the solution-finding process. We applied creative techniques and visual thinking to ideate and prototype solution concepts, addressing hurdles to access for the target patient population. We obtained the initial feedback from internal disease and access experts. Key hurdles for these patients were “low access to healthcare infrastructure” and “lack of disease awareness”. We identified government officials and community nurses as key stakeholders in the access path of HF patients. Lack of robust data supporting evidence-based decision-making, disease awareness, disease management systems and allocation of funds due to low priority of cardiovascular diseases for governments, are perceived as main challenges. Prototypes of solution concepts co-created by the African team consider (1) community-based multi-stakeholder HF management networks, (2) partnerships with professional associations for systematic real-world evidence generation using local diagnostics, mobile clinics and digital infrastructure to ultimately reach patients with no access to healthcare and (3) engage policy makers with data to enable policy change to improve the management of HF patients. A human-centred collaborative approach focusing on patient ecosystem can foster new ideas to solve complex and persistent healthcare problems. We can facilitate win-win situations to benefit inaccessible patients with HF by understanding their needs and deep diving into the pains and gains of key decision-makers and influencers.

Paying for expertise: The effect of experience on insurance demand

AbstractThis paper investigates whether corporations purchase insurance for the real services that insurers provide. We examine the real‐service efficiency hypothesis in the insurance industry by exploiting within firm‐year variation in reinsurance usage and experience at the line of business level. Our results show that insurers purchase reinsurance to access reinsurers’ expertise and specialized knowledge. We find that, within the same year, the average multi‐line insurer purchases 2.4%–3.3% points more reinsurance for new lines relative to existing lines. The demand for reinsurance declines by 0.55%–0.80% points with each additional year of experience. The size of these effects differs by the line of business, indicating that the development of internal expertise and specialized knowledge varies by line.

KUALITAS SISTEM INFORMASI UNTUK MENINGKATKAN EFEKTIVITAS LAYANAN PENGADUAN MASYARAKAT BERBASIS ONLINE DI DINAS KOMUNIKASI DAN INFORMATIKA KOTA BANDUNG PROVINSI JAWA BARAT

This research focuses on describing and analyzing the effectiveness of the Online-Based Public Complaints Information System which been known LAPOR! from information system quality’s perspective in Bandung city. LAPOR! is a concrete step to integrate the management of public service complaints so that it requires all Ministries / Institutions and Local Governments to be involved in its management. The phenomenon of problems that occur in Bandung related to the application of LAPOR! are complaints channels of each agency that have not been integrated in LAPOR!, LAPOR!'s socialization which is still uneven, also there are reports of complaints that have not been resolved, and public perceptions about complaints online itself.&#x0D; The researcher used the information systems theory of DeLone and McLean (2013). Combining a qualitative theory with a descriptive approach and also using interview, observations and documents about LAPOR! conducted by the Agency of Communication and Information of Bandung city, these are how the researcher works.&#x0D; The results showed that the quality of information system of LAPOR! can increase the effectiveness of managing public service complaint. LAPOR! with its features and menu has been able to facilitate several community problems through the system. Some problems of information system that occur such as network, maintenance, and features availability, or technical errors still can be handled by internal experts in the agency. In terms of website interface of LAPOR!, the addition of graph report of complaint in website can improve its management.&#x0D; Keywords: LAPOR!, effectiveness, information systems&#x0D;

Teletrabajo: fortaleciendo el trabajo en tiempos de pandemia por COVID-19.

El teletrabajo se convierte en la alternativa por excelencia que adoptan los empleadores para dar continuidad a sus operaciones una vez se publica el Decreto Ejecutivo 42227-MP-S del 16 de marzo del 2020 de emergencia nacional por el COVID-19 en Costa Rica. El Ministerio de Trabajo y Seguridad Social es el ente de la Administración pública que regula la aplicación del teletrabajo, que se basa en lo dispuesto por la Ley para Regular el Teletrabajo, Ley N° 9738 del 18 de setiembre de 2019, su Reglamento, Decreto Ejecutivo N° 42083 del 20 de diciembre de 2019 y la Directriz N°073-S-MTSS del 09 de marzo de 2020. Con la declaratoria de pandemia la directriz No.073-S-MTSS establece una serie de medidas de coordinación interinstitucional para garantizar el cumplimiento de los protocolos de las autoridades de salud e implementar lineamientos de teletrabajo en las oficinas estatales en ocasión de la alerta sanitaria. Es importante mencionar que esta medida es de carácter temporal para el sector público, a pesar de que varias dependencias del estado implementan esta práctica en su quehacer institucional desde años atrás, enfocado hacia puestos profesionales y que además impacta costos operativos en el uso de espacio o infraestructura. En tanto, para el sector privado el teletrabajo es una práctica común que impacta en menor grado la transición del trabajo presencial hacia una modalidad a distancia. Lo anterior es respuesta a las nuevas exigencias de mercado e interacción con clientes, se rompe con el paradigma de que el trabajo está sujeto a un lugar específico y se comprueba que para la realización de las actividades en puestos teletrabajables, estas se pueden llevar a cabo en cualquier sitio que disponga de facilidades a través de la conectividad, el uso de tecnologías modernas, la comunicación, las medidas de seguridad en materia laboral y riesgos del trabajo y el compromiso de las partes. Es relevante señalar que la normativa aprobada en materia de teletrabajo para Costa Rica post COVID-19, promueve que las organizaciones públicas y privadas, adapten las directrices a protocolos y políticas internas, que clarifiquen las responsabilidades, deberes y derechos de empleadores y colaboradores, las cuales deben guiarse por expertos internos o externos que garanticen la implementación de medidas seguras para la salud laboral y ocupacional, y que indirectamente incide en la salud social y familiar, ya que el hogar se transforma en una extensión de la oficina. La nueva realidad global hace que el mercado laboral deba repensarse y evolucionar hacia nuevos conceptos de cómo hacer las cosas. El teletrabajo se anticipa a la emergencia nacional en el caso de Costa Rica para algunos sectores de la industria, fortaleciendo a ciertas empresas que cuenten con esta alternativa para enfrentar las demandas y necesidades de sus socios estratégicos, a partir del cumplimiento de estándares de calidad y seguridad en la prestación de bienes y servicios, con solo el acceso al trabajo virtual, remoto o a distancia. La metodología utilizada es la consulta bibliográfica a nivel de leyes y decretos sobre el tema, además de una encuesta dirigida a personas que cumplen con la condición de trabajador activo en una organización y que deben acogerse a la modalidad del teletrabajo por contingencia a raíz de la declaratoria de emergencia en el país.

Breaking Silos: The Team-Based Approach to Coronavirus Disease 2019 Pandemic Staffing.

Breaking Silos: The Team-Based Approach to Coronavirus Disease 2019 Pandemic Staffing.

Establishment of a Perinatal Quality Network

The guiding premise of care at University Hospitals is based on high reliability organization (HRO) principles. With the acquisition of six community hospitals that provided obstetric services and an established regional perinatal leader, the opportunity was created to integrate standardized practice to decrease variation and improve patient outcomes. The establishment of an obstetric network that fosters collaborative inter- and intrahospital efforts and partnerships that promoting HRO principles. These partnerships form the basic governance of the UH OB Network. The foundation of this unique network is the equal ownership of vision and design shared by the chief of systems quality, obstetrics, and the senior quality improvement nurses. This team recruited self-identified obstetric champions (nurses, providers, quality and risk) from each institution to generate consensus and lead process improvement at the local level The adoption of multidisciplinary care guidelines informed by best evidence and internal expert opinion serves as the lynchpin for consensus-driven practice. Customization of the electronic record to reflect care guidelines provides additional crucial support integral to their implementation. The formation of robust local quality assurance committees focused on perinatal care identifies unique risk to drive process improvement. Participation in an online learning and individual risk assessment is required for all nurses and providers. The inception of rigorous quality assurance processes has led to a significant decrease in the rate of patient serious safety events (SSE) using the American Society for Healthcare Management preventable-harm classification system. A reduction in the number of malpractice suits and a decrease in total obstetric litigation costs occurred after the formation of the UH OB Network. Clinician knowledge and judgment scores demonstrated improvement in all modules of the system’s online learning platform. The interprofessional collaborative approach to perinatal care advances the science of health and the art of compassion while maximizing team cohesiveness. The shared partnership model engenders equal ownership of patient care and subsequent patient outcomes. The multidisciplinary approach empowers nurses to advocate and innovate on behalf of patients and their families in achieving best possible outcomes.