Action Planning Process Research Articles

Implementation of best practice in advance care planning in an ‘ageing in place’ aged care facility

Background For many older people, a residential aged care facility is home, a place where they should have the choice to die comfortably with a sense of control of care and treatment. An advance care plan describes the process of planning end-of-life care while a person is still able to make decisions with the aim of using this information should a person become unable to communicate their wishes. In the residential aged care setting, an advance care plan should be based on discussions involving the resident, family members and caregivers regarding the beliefs, values and goals of the resident and their family. It is not limited to the final days and weeks before dying, it can encompass a positive and open attitude towards death and dying. Aim The aim of this project was to examine the process of how residents' end-of-life care wishes is recorded and to ensure that the implementation of an advance care plan is performed according to the best available evidence. Method There were four stages to the project. The first stage involved interpretation of the five audit criteria. The criteria related to involving residents and their families in an advance care plan, providing them with appropriate information about end-of-life issues, and ensuring that staff are appropriately trained about an advance care plan. Next, the records of staff and resident were audited using JBI-PACES, the Joanna Briggs Institute's Practical Application of Clinical Evidence System. The next stage (Getting Research into Practice, GRIP) involved a process of situational analysis, action planning and action taking to improve compliance with best practice, followed by a post-implementation audit. Results Initially, compliance with an advance care plan best practice was fairly poor - less than 50% for each audit criterion. The GRIP phase highlighted seven barriers which were addressed during the implementation part of the project. These barriers included deficits related to the knowledge and education of residents, families and staff members, and issues related to administration and documentation, and concerns that any implementation process would not be sustainable. The post-implementation compliance was greater than 75% for each criterion. Conclusion The project highlights the ongoing challenges of educating residents and families, as well as staff on the importance of discussing/completing an advance care plan. Several improvements were made to the facility's documentation and records keeping processes, including the identification of resident's wishes regarding end-of-life treatment. Residents and their families expressed a high level of satisfaction with these changes. Indeed, an increase in completed advance care plans at the facility had a clear benefit in improving care for residents towards the end of their life.

Urban Noise Action Planning ‐ an integrated approach towards noise abatement in the frame of urban development: Tools and recommendations developed within the SILENCE project

Noise action planning following the European Directive on Environmental Noise is for many cities a new, additional task. It will probably be not very successful when considered as mere duty separated from other urban policy areas. Today, noise does not rank high on the local political agenda. Human and financial resources provided for noise abatement tend to be low. Furthermore, looking at concrete noise abatement measures it becomes clear that most effective measures also impact on other policy areas (air quality, mobility, etc.). Therefore it is advisable to link noise action planning closely with other urban plans like development plans, mobility plans, clean air programmes, etc. This requires a strong involvement of the relevant stakeholders as well as knowledge about the potential impact of noise abatement measures on other policy areas. To support local authorities in this complex task the SILENCE project developed a guidebook which comprises recommendations on organisational settings, on the involvement of stakeholders and the public, the action planning process as well as on a range of noise abatement measures. The description of these measures refers not only to their noise abatement potential but takes also into account their ‐ positive or negative ‐ impact on other policy areas.

Managing Input Data Uncertainty within Strategic Noise Mapping by Utilising Data Schema Specifications

With the proclamation of the Directive on Environmental Noise (2002/49), the process of noise mapping and action planning has begun around Europe. Large scale wide area noise modelling requires an extensive range of data inputs. The requirements for these inputs are driven by several factors, including the noise calculation methodologies, noise mapping software system, GIS and the deliverables set out within the Directive and recommended Reporting Mechanism. Utilising a staged approach to project design led to the development of detailed noise mapping data schema specifications prior to the collation of input datasets for the calculation process. The data schema may be used throughout the mapping project as a framework to manage dataset concatenation, data capture or the use of defaults and GPGv2 Toolkits to infill data gaps. They also enable data pre‐processing guidelines to be passed to non‐acoustic GIS specialists, and help to guide and catalogue data processing steps. This paper presents experience gained whilst developing a number of noise mapping data schema specifications and their implementation within successful projects during the first round of mapping. Railway noise mapping is used as an example of how a data schema may be used to develop solutions to technical problems as well as coordinate data capture.

Scanning Beyond the Horizon: Exploring the Ontological and Epistemological Basis for Scenario Planning

The two-step process of scenario building and action planning that constitutes scenario planning enables methodological rigor, theory testing, and good inquiry to be demonstrated by researchers through established criteria. This article focuses on the philosophical underpinnings of scenario planning that have not been addressed in the human resource development literature and that are treated as problematic from a theoretical perspective because of the conjectural nature of the future. This article categorizes these underpinnings and reviews the claims that can be made with respect to their ontological and epistemological status. A pragmatic perspective that builds on critical realist and constructivist—interpretive paradigms to emphasize decision-making utility as the outcome of inquiry rather than testable knowledge production is proposed.

Managing Risk by Utilising an Integrated Approach to Quality Assurance During Strategic Noise Mapping

With the proclamation of the Directive on Environmental Noise (2002/49), the process of noise mapping and action planning has begun around Europe. As the development of strategic noise maps is arguably a new experience for many end-users, the first round of noise mapping could potentially lead to uncertainties within many aspects of the process. Noise maps represent a baseline for the implementation of noise management systems and any systematic errors within the noise maps could reduce the effective implementation of the whole management system. The extensive range of data inputs required in strategic noise mapping are usually obtained from different data sources or base datasets and as such, cataloguing with the use of metadata is key. The implementation of a quality assurance system is imperative to maintain consistency between technicians and within multi-disciplinary teams. It is also essential to ensure the control of processes and the ability to review inputs, intermediaries and deliverables. A similar approach may also be applied to calculation and post processing of noise levels. This paper presents collective experience of the implementation of quality assurance procedures used in several EU countries during the successful completion of projects within the first round of mapping.

Strategic noise mapping in slovak republic

In the EU there is an ongoing process of strategic noise mapping and action planning. The goal is to determine the noise produced by the main noise sources - road, rail and air transport and industrial facilities and the exposure caused by them in densely populated agglomerations. Subsequently it is necessary to consider possibilities, how to reduce additional increase of noise levels in the environment. Authors participated in the strategic noise map development process and this paper comprises the information about the measurement and calculation results of traffic and industrial noise in Bratislava and in the slovak republic. Presentation of strategic noise maps and actions plans in Slovakia.

Supporting and sustaining national responses to children orphaned and made vulnerable by HIV and AIDS: Experience from the RAAAP exercise in sub-Saharan Africa

The growing number of children orphaned and made vulnerable by HIV and AIDS in sub-Saharan Africa presents an enormous socioeconomic and public policy challenge. Despite international commitments to increase resource allocation and scale up services and support for AIDS-affected children, families and communities, the national- and sub-national-level state responses have been inadequate. The rapid assessment, analysis and action planning (RAAAP) process for orphans and vulnerable children, conceived in late 2003, was intended as a multicountry incentive to identify and resource immediate actions that can be taken to scale in 16 heavily affected countries. This review of experiences to date with the RAAAP process highlights some key areas of learning, including: (a) fund mobilization has been slow and has reached approximately only one-third of what is required; (b) ownership and integration into development planning of the issue of orphans and vulnerable children at country level has been undermined by the perception that the response is an ‘emergency’ and externally (donor) driven exercise; (c) centralized planning has failed to appreciate the complexity of context and responses at the meso- and micro-levels within countries, entailing the need to support a comprehensive decentralization process of planning and implementation; (d) comprehensive multisectoral and interagency collaboration, involving civil society, is an important but overlooked element of the planning process; and (e) definitional variation between countries has led to large variations in budgets and coverage targets. While the RAAAP process has undoubtedly raised awareness at state level of the nature and extent of the ‘orphan crisis’ and raised vital resources, only full integration of the new planning process for orphans and vulnerable children within the range of macro and national development tools will allow the response to be sustainable in the longer term.

A methodological approach and framework for sustainability assessment in NGO-implemented primary health care programs.

An estimated 10.8 million children under 5 continue to die each year in developing countries from causes easily treatable or preventable. Non governmental organizations (NGOs) are frontline implementers of low-cost and effective child health interventions, but their progress toward sustainable child health gains is a challenge to evaluate. This paper presents the Child Survival Sustainability Assessment (CSSA) methodology--a framework and process--to map progress towards sustainable child health from the community level and upward. The CSSA was developed with NGOs through a participatory process of research and dialogue. Commitment to sustainability requires a systematic and systemic consideration of human, social and organizational processes beyond a purely biomedical perspective. The CSSA is organized around three interrelated dimensions of evaluation: (1) health and health services; (2) capacity and viability of local organizations; (3) capacity of the community in its social ecological context. The CSSA uses a participatory, action-planning process, engaging a 'local system' of stakeholders in the contextual definition of objectives and indicators. Improved conditions measured in the three dimensions correspond to progress toward a sustainable health situation for the population. This framework opens new opportunities for evaluation and research design and places sustainability at the center of primary health care programming.

Overview of Scottish plant conservation: Problems, research needs and policy issues

Summary Although Scotland's vascular plant flora is depauperate in comparison with that of Mediterranean countries, it has a particularly rich bryophyte and lichen flora of international importance. It is a country with great habitat diversity including unique habitats like the woodlands and mountains of the west coast. Conservation of plant species and habitats in Scotland has been directed through targeted action plans since 1995. Analyses have been made of their effectiveness and of the research needs arising from these targets. Monitoring and survey work are essential for effective target setting, and for reviewing progress. Important cross-cutting issues include the science for conservation and genetic diversity, ecosystem function, the impact of non-native species and climate change. The Biodiversity Action Plan process has proved to be an effective tool. However, we also need to consider a broader spectrum of the flora, to include other key habitats or species with Scottish populations of internati...

Managing improvement in the public sector

Roads Service is an Executive Agency within the Department for Regional Development. The Department is the sole road authority in Northern Ireland. In recent years there has been a variety of improvement initiatives within the public sector in the UK and the purpose of this paper is to highlight the key determinants of how to successfully introduce, manage and measure such initiatives. The paper will include a brief introduction giving a description of the organization and the service that Roads Service provides to its customers. This will be followed by details of how the use of the Excellence Model in Roads Service has evolved over 4 years. The main part of the paper will look at how Roads Service has integrated the use of European Foundation for Quality Management (EFQM) self-assessment into its business planning process and will include details of the action planning process including the use of champions. The results of the most recent self-assessment will be discussed. Of particular interest will be the effects of organizational change. Roads Service has recently undergone an organizational restructuring. The paper will conclude with details of how the EFQM Excellence Model has been promoted within Roads Service to encourage ‘buy-in’ to the process at all levels throughout the organization. The lessons learned from the individual organizational context will be shown to be equally applicable in the wider public sector context.

Co-opting learners: addressing their learning support needs through a learning support needs questionnaire. part two. a comparison of the learning support needs of campus and distance-based community nurse students

This article is a continuation of a previous article (Moreland & Carnwell, 2000) where the development and background of the Learning Support Needs Questionnaire (LSNQ) was explained. The LSNQ identifies and elicits practical, emotional and academic learning support needs, and is followed by an action planning process designed to assist the students to address any learning needs considered important but not met. Following on, this article presents the results of the first application of the questionnaire to two groups of nursing students - one group of distance learning based and one group of campus-based students. Whilst the distance education students overall had lower expectations of the different types of support than campus based students, both groups had significant but slightly different learning support needs. The failure to address the significant unmet learning needs by both the learners themselves and the providing institutions is likely to lead to unsatisfactory learning experiences and reduced achievements, though the results do have to be treated with caution until further research is carried out.

Communities and biodiversity: Lessons from South Asia

In this paper the authors have profiled a number of community-led conservation initiatives underway in several South Asian countries. Faced with degraded landscapes and resulting impoverishment, the local people who are most affected by the loss or increase of biodiversity are taking action. Altogether, the initiatives show that decentralized and site-specific decision-making, which considers the livelihoods of people and provides impartial information to those affected, is fundamental to success Neema Pathak is a member of Kalpavriksh, an environmental research and action group. She has coordinated a directory of protected areas in Maharashtra state in India, and jointly coordinated a project on community involvement in wildlife management in South Asia. She is currently putting together a detailed directory of community conservation biodiversity areas in India. Ashish Kothari is a founder-member of Kalpavriksh. Over the last two decades he has coordinated or worked on a number of processes relating to conservation, local communities, and development. He is the author or editor of over 10 books, and is on two expert commissions of The World Conservation Union (I.U.C.N.). He is currently coordinating the Technical and Policy Core Group of India's National Biodiversity Strategy and Action Plan process

Council of Great Lakes Industries Position Statement on the Remedial Action Plan Process

Council of Great Lakes Industries Position Statement on the Remedial Action Plan Process

Landcare in Australia: Beyond the expert farmer

The landcare program has been embraced by governments, farmer organizations and conservation groups throughout Australia as offering a model for effective community action to assist the move to more sustainable resource use. Over 2,500 landcare-type groups now operate across Australia with 65,000 members including almost 30% of the farming community. This research used surveys of landcare group activity in most Australian states, a study of the regional landcare action plan (RLAP) process in the state of Victoria, and a survey of landholders in north east Victoria to assess landcare program effectiveness, and particularly, the assumptions underlying the program logic. Information provided revealed the vast scale of community participation in landcare and the considerable amount of onground work undertaken by groups and landholders. Analysis of north east landholder surveys indicated landcare participation had a significant impact upon landholder awareness of issues, level of knowledge, and adoption of best bet practices. However, research findings also highlighted a number of concerns about the program logic and implementation, and the authors suggest it is time to adopt a revised landcare program model.

FORMENTOR: Real-time operator advisory system for loss control. Application to a petro-chemical plant

This paper describes FORMENTOR, a real-time expert system that offers on-line decision support to operators of a complex plant who are faced with unusual and potentially hazardous situations. After the overall project background has been described, the essential requirements of such a system are outlined. The paper will then focus on one of the developed pilot applications, a supervisory and decision support system for operators of an extractive distillation unit of a petro-chemical plant. The most important techniques and models used will be discussed. A number of generic and well defined tasks have been identified for a plant supervisory system like FORMENTOR to allow it to monitor on-line sensor data and detect precursor signs of abnormal plant behaviour, to diagnose the causes of the malfunction and finally to yield operational advice for managing the abnormal situation. This set of tasks include data retrieval, monitoring, diagnosing, assessing the current situation, assessing the consequences of the current situation, countermeasure planning and finally generation of advice. These generic tasks are instantiated in this particular application. In addition, main technical features of this pilot application are a functional model used to provide a global overview of the plant state and to guide the action planning process, a multi-layered structural model used to represent the functional components of the plant in a hierarchical way, and the use of two distinct but complementary reasoning modules for diagnosis, both based on this multi-level model. Of the two diagnostic reasoning modules one, the Heuristic Causal Reasoning module, identifies known problems, looks up the known solutions, and then adapts the implementation of these high-level solutions to the plant state. The other, the Model-Based Reasoning module, uses a more sophisticated model-based reasoning to find the root causes of a disturbance. The developed FORMENTOR system has been installed on an extractive distillation plant operated by BP-Chemicals Ltd. Its performance in responding to real plant upsets has been evaluated. The main results of this testing campaign are also reported.

Changing the economics of environmental degradation in Madagascar: Lessons from the national environmental action plan process

This paper examines the economic logic and implicit assumptions used to develop and support the National Environmental Action Plan (NEAP) process in Madagascar. The study focuses on three key issues: how were the costs of the main environmental problems identified and estimated; what underlying factors were identified as causing these problems; and how is the NEAP implementation strategy designed to change these underlying factors. The most difficult tasks for NEAPs will continue to be identifying the key specific underlying factors causing the problem and determining which of these factors are actually feasible for a NEAP process to change. The analysis of the Madagascar makes clear that key environmental problems are driven by land use decisions of large numbers of geographically dispersed rural and urban inhabitants. These problems are not easy or even feasible targets for specific “environmental” policy changes. If this is the case, as it seems to be in Madagascar, then it is perhaps unrealistic to hope that NEAPs as constituted can provide a framework for both understanding and alleviating a country's key environmental problems.

Fundamentals of clinical methodology: 1. Differential indication

Progress in the theory and practice of artificial intelligence in medicine requires awareness of basic issues in medical problem solving. To stimulate discussion and research on this subject, in a series of articles some logical, methodological and metatheoretical problems of clinical practice will be studied. The present paper reconstructs clinical decision-making as a computable process of action planning.

How Texaco R&D Improved Its Organization

OVERVIEW: The managerial climate of Texaco's R&D Department was improved through the combined use of employee surveys and enhanced delegation skills. Employee surveys were conducted by an independent consultant who analyzed the returns and, based on the survey results, made recommendations to the department's management. Management developed and implemented an action plan to address the most pressing issues, which included communication, the incentive system, establishing and prioritizing objectives, training, and ability to get things done. The survey, feedback, and action planning process was repeated three times over a period of four years. The results show that the managerial climate improved significantly. In 1984, the Texaco Research and Development Department at Beacon, New York, recognized the need to increase both the pace of research and the Department's contribution to the company's bottom line. In some areas, the R&D function was viewed as a drain on corporate funds, a view that pervaded many other companies also. In the spring of 1985, the R&D Department suffered a layoff, the first in its more than 50-year history. As a result of the layoff, morale of those remaining was at an all-time low. People felt insecure and uncertain about their future. Indeed, they were uncertain about the future of the organization. Turnover had increased to 8 percent in 1984 (compared to a normal around 3 percent). Absenteeism had increased to 7 days (compared to 5.4 days for Texaco Inc.). To pull the Department out of the turmoil of the layoff and to improve employee morale, R&D management decided to improve its own effectiveness and to begin by conducting a series of delegation skills seminars. We felt that by developing the delegation skills of our management team, the research process would progress faster. We also felt that decisions would be made faster and that better delegation would improve the morale of the organization because employees would be involved with making many decisions that impact their work and their livelihood. Management asked one of us--consultant Donald Huffmire--to survey employees to gauge their perception of management in various areas and to present the delegation skills seminars. Professor Huffmire conducted the survey and, based on his analysis of the feedback, made recommendations. He also conducted the delegation skills seminars tailored to our organization's needs. R&D developed and implemented an action plan based on Prof. Huffmire's recommendations. Follow-up surveys were conducted about nine months and about three years after the first to determine progress. The R&D Department implemented action plans over broad categories after each survey and report by Prof. Huffmire. The purpose of this paper is to share our positive experience with improved delegation skills. THE 1985 STUDY The survey that was conducted in May 1985 was the first of its kind at the Research Center in which all employees had a chance to participate. Many employees were skeptical about voicing their concerns on the survey, and also about whether management would pay any attention to the results. Yet, 271 out of 540 employees participated. The survey consisted of three questionnaires. One was the Likert Profile of Organizational Characteristics questionnaire, which was designed to measure the managerial climate of the Department, and of each unit, in regard to: Leadership, motivation, communication, decision making, goal setting, and controlling. The second questionnaire, Suggested Improvements, asked employees to indicate which three things they would like to see done in their unit to improve their own satisfaction and the unit's overall effectiveness. This questionnaire generated the Comments (described later) in regard to various management areas perceived as needing improvement. The third questionnaire, Performance Planning and Review, was designed to measure the management ability of each individual manager. …

Leadership Change and Action Planning: A Case Study

* This article describes the effective use of action planning during a period of changing leadership in the Food and Drug Administration (FDA). It describes how an action planning process ameliorated the organizational adjustments that can be expected during a major transition in the organization. The article reviews the previously observed organizational responses to change and describes the organizational setting in FDA at the time the action planning effort was undertaken. It then reviews the criteria used to design the agency's action planning process, describes the implementation and some problems encountered, and reviews lessons learned and unexpected benefits of action planning. Action planning contributed to an effective leadership transition by focusing the agency's attention on productive activities, by involving a significant portion of the agency's managers and staff in a highly visible and high priority activity, by increasing the effectiveness of communication between management and staff, and by orienting the new leadership to the agency's operations and responsibilities. The authors caution that the process must be in harmony with the organization's culture and previous experience in planning.

Critical Issues for Planned Change in Human Service Organizations: A Case Study and Analysis

This article discusses the critical issue emerging in the implementation of change strategies designed to improve the effectiveness of human service delivery systems. A review of the literature supports the notion that human service organizations have been largely ignored in the development of change and intervention theories. As a result, little specific information is available regarding the implementation of improvement strategies in human service delivery systems. The article describes the process by which change was intro duced and implemented in a human service organization. Entry activities, data collection techniques, the action planning process, and the evaluation procedures used in the present intervention are discussed. The article concludes with a dis cussion of the differences in implementing planned change in human service, as opposed to business and industrial, organizations. Suggestions, theoretical guidelines, and a model are provided for future interventions.