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Precision or “Personalized Medicine” and “Big Data” are growing trends in the biomedical research community and highlight an increased focus on access to larger datasets to effectively explore disease processes at the molecular level versus the previously common one-size-fits all approach. This focus necessitated a local transition from independent lab and siloed projects to a single software application utilizing a common ontology to create access to data from multiple repositories. Use of a common system has allowed for increased ease of collaboration and access to quality biospecimens that are extensively annotated with clinical, molecular, and patient associated data. The software needed to function at an enterprise level while continuing to allow investigators the autonomy and security access they desire. To identify a solution, a working group comprised of representation from independent repositories and areas of research focus across departments was established and responsible for review and implementation of an enterprise-wide biospecimen management system. Central to this process was the creation of a unified vocabulary across all repositories, including consensus around source of truth, standardized field definitions, and shared terminology.
From an economic perspective, the appeal of a product diminishes over time. However, volatile markets and divergent technological advancements make it challenging to anticipate when and to what extent changes will be necessary. Therefore, it is important to be able to integrate changes after a product's launch. This paper provides an overview of different perspectives on the product lifecycle. In addition, the paper presents an empirical study on implementing changes at an automobile manufacturer.
The Digital Thread is a system that connects different phases of the product lifecycle and the related data across one or more companies in the supply chain. This work aims to develop a graph data model of the Digital Thread, in the context of the vision of polyglot persistence, that interconnects the different phases of the lifecycle and their corresponding data models, processes, and IT systems. This work proposes a Digital Thread Graph that integrates a Digital Model and a derived Digital Twin, using object and relation attributes for view creation and filtering while minimizing redundancy.
Effective public health practice requires a combination of expertise and influence. Yet gaining expertise in the subject matter is only one element of practice: the ability to influence outcomes, policy, services and the people who make decisions is crucial. To deploy your expertise to have an impact, you must hone leadership and management skills to persuade, encourage and empower others. This chapter, therefore, aims to:
offer a brief overview of different schools of thought in leadership;
propose a simple framework of eight core domains for identifying skills and areas for professional development;
introduce some popular theories for understanding others, which can enable you to work more effectively with individuals and influence within teams and organizations; and
signpost to some key models of conceptualizing change and how to lead or manage change.
Edited by
Rob Waller, NHS Lothian,Omer S. Moghraby, South London & Maudsley NHS Foundation Trust,Mark Lovell, Esk and Wear Valleys NHS Foundation Trust
Self-awareness is a central characteristic of all complex systems including biological and organisational. The successful introduction of novel and complex IT systems to an organisation such as the NHS both enables, and requires, this self-awareness. IT systems promise great improvements in terms of process control, audit, governance as well as the direct delivery of clinical care. They require however that the organisation appreciates this kind of change is ‘adaptive’ as well as technical. Successful adoption requires strong, informed leadership, an honest appraisal of the degree of digital maturity, awareness of weaknesses and realism about timescales and scope. In this chapter, we will briefly survey the development of health informatics in the UK, examine some conspicuous examples of failed IT introductions and attempt to extract some lessons of use to clinicians asked to take part in such introductions. We will also survey some of the main current issues in mental health informatics from a UK perspective and make some tentative predictions for future developments.
Organizational change is an inherently temporal phenomenon which unfolds over time. Change processes are difficult to predict, take unforeseen turns, and are often implemented sequentially. This typically causes uncertainty and ambiguity and affects employees’ appraisal of a change project and the related beliefs, expectations, emotions, and behavioral reactions. The unfolding of change processes over time is addressed in only few theoretical conceptualizations (e.g., the "change curve"). In this chapter we explore the time-related psychological aspects of organizational change. More specifically, we explore how change processes can be theoretically modeled to include a temporal perspective, how change recipients’ cognitive and emotional experiences and reactions to change evolve over time, and how individual and organizational factors influence change recipients’ experiences and reactions over time. We propose a phases model in which we describe the development of change recipients’ reactions over the course of a change project. Here, we integrate literature from the fields of organizational psychology and organizational behavior as well as change management and sensemaking.
Engineering changes are necessary to stay competitive, unavoidable and occur more frequently with increased product complexity. Currently, scheduling of engineering changes into production and supply chain is a manual process. With new possibilities in the field of artificial intelligence, this publication presents the vision of a flexible multi-agent system with four agents and a single shared database. By autonomously scheduling changes and predicting KPI impacts of implementation dates, the agent-system provides additional capacity and decision-making support to the organisation.
Engineering change management is a central part of the product development process. This paper investigates how variations from the PGE - Product Generation Engineering can improve the evaluation of engineering changes from the wiring harness. Engineering changes that occur in an automotive wiring harness development process are analysed in a case study, evaluated in expert interviews with regard to the risk and effort connected to the implementation and compared to the types of variations. Additional influencing factors are discussed. The variations provide an indication on risk and effort.
Requirements changes are a leading cause for project failures. Due to propagation effects, change management requires dependency analysis. Existing approaches have shortcomings regarding ability to process large requirement sets, availability of required data, differentiation of propagation behavior and consideration of higher order dependencies. This paper introduces a new method for advanced requirement dependency analysis based on machine learning. Evaluation proves applicability and high performance by means of a case example, 4 development projects and 3 workshops with industry experts.
Each year, automotive OEMs implement a variety of Engineering Changes (ECs) in their production. In the timing of ECs, different KPIs are often in conflict with one another or even unknown to the OEMs. Therefore, OEMs struggle to identify the optimal date to implement an EC. This paper presents a method to determine the cost-optimal implementation date for each EC, considering time, cost, and quality KPIs based on a new EC classification rule-set. To evaluate the presented method, case-studies at a German automotive OEM were performed, two of which are discussed.
Whilst remanufacture is identified as a key enabler for sustainable manufacture in future industry, its role within the context of new product development remains unclear. Where prototypes often go through multiple iterations with varying degrees of change, could remanufacture be adopted to reduce the time and cost components of design iteration? This paper presents a computational study to explore the potential savings afforded by remanufacture across stages of a rapid prototyping process. Results suggest significant reductions to development time and cost can be achieved.
Process modelling (PM) is used to support designers by providing guidance on what needs to be done. Change processes in development organizations accompany introduction of new procedures, new methods (also digital form), tools that have to integrated into existing processes. Objective of this paper is to provide guidance to designers in selecting the appropriate PM language to support structured changes in processes. Requirements are derived from frequent change needs in SME and a PM morphology is provided assisting the selection and use of suitable PM languages for change processes.
This chapter summarizes the key themes from the preceding chapters by experts in the field of psychosis: the connection between mental healthcare and the larger social climate; the need to combat stigma and change beliefs and attitudes; the important role of training; the necessity of breaking down silos; and the essential nature of learning from others. Given that successful implementation and dissemination will likely require interventions at multiple levels of the system, we apply best practices from organizational change management to provide a path forward. Using the ADKAR model to develop awareness of the need for change, foster desire to be involved in the change, generate the knowledge and ability to participate in the change, and reinforce desired behaviors are essential steps forward. We provide concrete suggestions to promote change of the mental healthcare system as each step of the change process.
Provides a response to the standard arguments against a Geriatric ED: we don’t need it; we don’t have time, money, expertise; we don’t want it. Suggests some opportunities to get support: “what’s in it for me?” Provides some sample scripts to use with colleagues to move to “Yes, and . . .”
A lively debate progresses about change to the professions, including law, especially change in the form of managerialism. ‘Managerialism’ covers the methods and beliefs of managers within organisations, used to actively influence, evaluate, and ‘market’ professional work. But what about when that managerialism is change itself? How do we understand managerialism-as-change? This paper reports on an interview study with change managers, or ‘transformation leaders’ in the legal profession. Transformation leaders offer rich insights into the dynamics of professional change because they are incontrovertibly change agents. They are also themselves a form of managerial change as a new cadre of managers within the professions; managers with ‘hybrid’ identities whose legitimacy in professional settings is not assured. The findings presented include: the change leaders’ identities; the types of change being introduced; the constraints on and affordances for change in legal practices; and how change leaders secure, and sometimes struggle to secure, the authority needed to implement change. The concluding discussion highlights the study's contributions to our understanding of professional change and managerialism in the legal context – both what changes are being pursued and how they are materialising through certain ‘managerial’ goals, strategies, and the interactions of those with mixed identities and status.
Trainees in obstetrics and gynaecology are the future of women’s healthcare and they deserve optimal training. This chapter is a cookbook for a high-quality training site. Both trainees and faculty responsible for the training may benefit from reading it. An optimal training site is a co-creation between responsible faculty, trainees and the context in which the training is provided. When we speak to you in this chapter, we address both trainees and faculty. We hope you will enjoy this cookbook and that you will find the best recipe for your own training context.
Bipolar disorder is a chronic mental health condition, which can result in functional impairment despite medication. A large evidence base supports use of psychological therapies and structured care in the treatment of mood disorders, but these are rarely implemented. e-Pathways are digital structures that inform and record patient progress through a healthcare system, although these have not yet been used for bipolar disorder.
Aims
To assess the perceived benefits and costs associated with implementing a collaborative NICE-informed e-pathway for bipolar disorder.
Method
Healthcare professionals and people with bipolar disorder attended a workshop to share feedback on e-pathways. Data were collected through questionnaires (n = 26) and transcription of a focus group, analysed qualitatively by a framework analysis.
Results
Patients and healthcare professionals welcomed the development of an e-pathway for bipolar disorder. There were five elements to the framework: quality and delivery of care, patient–clinician collaboration, flexibility and adaptability, impact on staff and impact on healthcare services.
Conclusions
Identification of benefits and costs ensures that future development of e-pathways addresses concerns of healthcare professionals and people with bipolar disorder, which would be essential for successful implementation. Recommendations for this development include making e-pathways less complicated for patients, ensuring sufficient training and ensuring clinicians do not feel their skills become invalidated. Limitations of the study, and directions for future research, are discussed.
In this article Michael Maher writes about the declining print needs for law libraries within UK law firms in the context of the Covid-19 pandemic. The article begins by looking at the initial financial impact Covid-19 had across UK law firms. The second part of the article covers how home-working patterns have become the preferable option to working in the office. Finally, the author takes a change management approach, addressing what information professionals need to do to best manage and embed the change so as to continue to play a key part of the future, post-pandemic, law firm business.
The Royal College of Physicians and Surgeons of Canada (RCPSC) emergency medicine (EM) programs transitioned to the Competence by Design training framework in July 2018. Prior to this transition, a nation-wide survey was conducted to gain a better understanding of EM faculty and senior resident attitudes towards the implementation of this new program of assessment.
Methods
A multi-site, cross-sectional needs assessment survey was conducted. We aimed to document perceptions about competency-based medical education, attitudes towards implementation, perceived/prompted/unperceived faculty development needs. EM faculty and senior residents were nominated by program directors across RCPSC EM programs. Simple descriptive statistics were used to analyse the data.
Results
Between February and April 2018, 47 participants completed the survey (58.8% response rate). Most respondents (89.4%) thought learners should receive feedback during every shift; 55.3% felt that they provided adequate feedback. Many respondents (78.7%) felt that the ED would allow for direct observation, and most (91.5%) participants were confident that they could incorporate workplace-based assessments (WBAs). Although a fair number of respondents (44.7%) felt that Competence by Design would not impact patient care, some (17.0%) were worried that it may negatively impact it. Perceived faculty development priorities included feedback delivery, completing WBAs, and resident promotion decisions.
Conclusions
RCPSC EM faculty have positive attitudes towards competency-based medical education-relevant concepts such as feedback and opportunities for direct observation via WBAs. Perceived threats to Competence by Design implementation included concerns that patient care and trainee education might be negatively impacted. Faculty development should concentrate on further developing supervisors’ teaching skills, focusing on feedback using WBAs.