Browsing by Subject "Delphi method"

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  • Tapio, P. (Elsevier Science Ltd., 2002)
    The paper contributes a ‘soft’ way of making scenarios for climate policy that takes into account the diverse views of various interest groups. A two-rounded Delphi method is used to produce scenarios for a transport CO2 policy for Finland. Quantitative statements of the interest groups are run with cluster analysis and qualitative arguments for the statements are attached to the clusters. The resulting six clusters are interpreted in the light of theoretical strategic scenarios of transport and environment, which take different positions on dematerialisation and immaterialisation. Although one could observe only little dematerialisation and no immaterialisation in the relationships between GDP, road traffic volume and CO2 emissions from road traffic in Finland from 1970– 1996, all of the clusters anticipate dematerialisation and five, immaterialisation during 1997–2025.
  • Toivio, Matti (Helsingfors universitet, 2011)
    Finnish forest industry is in the middle of a radical change. Deepening recession and the falling demand of woodworking industry´s traditional products have forced also sawmilling industry to find new and more fertile solutions to improve their operational preconditions. In recent years, the role of bioenergy production has often been highlighted as a part of sawmills´ business repertoire. Sawmilling produces naturally a lot of by-products (e.g. bark, sawdust, chips) which could be exploited more effectively in energy production, and this would bring more incomes or maybe even create new business opportunities for sawmills. Production of bioenergy is also supported by government´s climate and energy policies favouring renewable energy sources, public financial subsidies, and soaring prices of fossil fuels. Also the decreasing production of domestic pulp and paper industry releases a fair amount of sawmills´ by-products for other uses. However, bioenergy production as a part of sawmills´ by-product utilization has been so far researched very little from a managerial point of view. The purpose of this study was to explore the relative significance of the main bioenergy-related processes, resources and factors at Finnish independent industrial sawmills including partnerships, cooperation, customers relationships and investments, and also the future perspectives of bioenergy business at these sawmills with the help of two resource-based approaches (resource-based view, natural-resource-based view). Data of the study comprised of secondary data (e.g. literature), and primary data which was attracted from interviews directed to sawmill managers (or equivalent persons in charge of decisions regarding bioenergy production at sawmill). While a literature review and the Delphi method with two questionnaires were utilized as the methods of the study. According to the results of the study, the most significant processes related to the value chain of bioenergy business are connected to raw material availability and procurement, and customer relationships management. In addition to raw material and services, the most significant resources included factory and machinery, personnel, collaboration, and geographic location. Long-term cooperation deals were clearly valued as the most significant form of collaboration, and especially in processes connected to raw material procurement. Study results also revealed that factors related to demand, subsidies and prices had highest importance in connection with sawmills´ future bioenergy business. However, majority of the respondents required that certain preconditions connected to the above-mentioned factors should be fulfilled before they will continue their bioenergy-related investments. Generally, the answers showed a wide divergence of opinions among the respondents which may refer to sawmills´ different emphases and expectations concerning bioenergy. In other words, bioenergy is still perceived as a quite novel and risky area of business at Finnish independent industrial sawmills. These results indicate that the massive expansion of bioenergy business at private sawmills in Finland is not a self-evident truth. The blocking barriers seem to be connected mainly to demand of bioenergy and money. Respondents´ answers disseminated a growing dissatisfaction towards the policies of authorities, which don´t treat equally sawmill-based bioenergy compared to other forms of bioenergy. This proposition was boiled down in a sawmill manager´s comment: “There is a lot of bioenergy available, if they just want to make use of it.” It seems that the positive effects of government´s policies favouring the renewables are not taking effect at private sawmills. However, as there anyway seems to be a lot of potential connected to emerging bioenergy business at Finnish independent industrial sawmills, there is also a clear need for more profound future studies over this topic.
  • Kihlström, Laura (Helsingfors universitet, 2010)
    Towards the year 2030 in Finland, sustainability issues will be dominated by climate change, the worsening state of the Baltic Sea, technological and technical development, globalization, the degradation of ecosystem services and increasing energy consumption. At the decision-making level, setting strategic objectives towards the year 2030 should consist of increasing energy efficiency, halting the reduction of biodiversity and changing consumption habits. Furthermore, promoting public transportation, limiting greenhouse gas emissions, increasing the proportion of renewable energy sources and linking climate policy to all sustainable development policies should be targeted in strategic long-term planning. This master’s thesis research was implemented as a Delphi study, a method commonly used in futures research. In a Delphi study the expertise of a chosen panel is utilized to gather information on a given topic. The research aimed at investigating the experts’ views on 1) the most important driving forces – changes and trends – affecting sustainable development towards the year 2030 2) the desirability and probability of different sustainability objectives and 3) recognizing the potential political conflicts brought by these strategies. The Delphi study was carried out during February 2010 – April 2010. It consisted of two rounds. The first round questionnaire was sent 43 experts (response rate 56 %). During the second round the most interesting first round results were completed with qualitative arguments (response rate 50 %). The results were analyzed in the manner that the research issues of most interest were 1) the trends having the most importance towards the year 2030 2) the most desirable strategic objectives with a high probability for political conflicts. The results indicate a high risk for political conflict especially with the targets on halting the reduction of biodiversity and changing consumption habits. These two objectives were considered difficult to grasp and often overruled by economic interests. Changing the current societal system based on continuous growth and consumption would require profound alterations in economy, society and individual values. The results also indicate that energy is a key issue for the coming decades: setting strategic objectives for replacing fossil fuels should be among the top priorities of the Finnish national government. Also, in addition for climate change being an important trend, the deviation of rankings in importance among the panel indicated a possibility for social and economic trends to have unexpected, sudden effects as we move towards the year 2030. These include global poverty and inequality, changing age structures and the sustainability of the Finnish economy.
  • Toppinen, Anne Maarit Kristiina; Sauru, Miska Eemil; Pätäri, Satu; Lähtinen, Katja; Tuppura, Anni (2019)
    In transitioning to a renewable material-based bio economy, growing public and industry interest is apparent for using wooden multistory construction (WMC) as a sustainable urban housing solution in Europe, but its business implications are not well understood. In our study, we evaluate, which internal and external factors of competitiveness are shaping the future of WMC, especially in the context of Finland and Sweden. Based on a multi-level perspective of socio-technical transitions, we conducted a three-stage dissensus-based Delphi study. The identified internal and external factors affecting the future competitiveness of the WMC business emphasize the importance of skilled architects and builders and the role of standardized building systems. Based on our results, the key aspects influencing the future competitiveness of WMC in the region are related to the development of technical infrastructure and project-based business networks, while additional changes in regulatory framework are perceived as less important. We conclude that towards 2030, the strong cognitive rules founded in the concrete-based building culture in these countries is likely to inhibit the dynamics of the socio-technical regime level. A change is also needed in the WMC business culture towards more open cross-sectoral collaboration and new business networks between different-sized players.
  • Andersson, Ville (Helsingfors universitet, 2019)
    The Finnish Medicines Agency, Fimea, is the authority responsible for supervision pharmacies in Finland. Recently, there has been more interest in Fimea to improve its supervision of community pharmacies. For this purpose, a questionnaire was made. Prior to the making of the questionnaire, community pharmacy supervision practices were studied in Nordic countries and in the UK. Additionally, faults found in Finnish community pharmacy inspections in 2016–2018 were classified by analysing anonymized fault lists (n=94) separated from inspection reports. When the most common faults were identified, it was possible to include questions concerning these faults into the questionnaire. A modified version of the Delphi method was used when developing the questionnaire. Comments on the applicability of the questions were given by a panel of experts consisting of inspectors of Fimea. The questionnaire was subsequently edited in accordance with the given comments. Separate versions of the questionnaire form were developed for community pharmacies and for their subsidiary pharmacies. At the end of this study, the questionnaire was sent to seven pharmacies and to three subsidiary pharmacies. After the results of the questionnaire were collected, Fimea gave feedback on the questionnaire. 25 categories were created by classifying faults found from pharmacy inspections. The most common inspection observations were faults in storage condition monitoring (97 % of pharmacies), narcotics (86 %), implementation of code of conduct (86 %), product errors (86 %) and preparation of medicines ready for use (81 %). The questionnaire begins by asking basic information about the pharmacy. Following questions concern the personnel and their further adequacy training. The questionnaire also includes several questions on the code of conduct within the pharmacy. Additionally, there are questions about storage condition monitoring, dispensary and accounting of narcotics. At the end of the questionnaire, there are also a few questions about the European Medicines Verification System (EMVS) which will be implemented by February 2019. Support from the inspectors of Fimea and studying regulations of pharmacies helped identify appropriate questions for the questionnaire. However, the perspective of the questionnaire may be limited due to the questionnaire being developed based up on faults found from inspections. The faults observed from inspections across pharmacies in Finland have been very similar with some of them being also alarmingly common. Because many of the observed faults are relatively easy to fix, simple corrective measures could be implemented to improve the situation across several pharmacies. Thus, usage of questionnaires, such as one made in this study, could be considered a feasible way of improving supervision of pharmacies.
  • Lias, Noora (Helsingin yliopisto, 2021)
    Medication reviews can be used to assess the appropriateness of a patient’s medication and to identify and resolve clinically significant drug-related problems. Medication reviews have been highlighted in several health and medicines policy documents as ways to improve medication safety in older adults. Collaborative practices and their development are key strategies in promoting the coordinated care of patients. Medication reviews have been previously defined from a multi-professional perspective but no definition based on multi-professional consensus has been established. The aim of this study was to harmonize the definition of medication review from a multi-professional perspective to suit various healthcare contexts in Finland. The goal was to create a shared understanding for physicians, nurses, pharmacists, information management professionals for their collaboration in reviewing medications. Furthermore, the aim was to define the tasks and responsibilities of different professional groups in collaborative medication reviews in order to support its implementation. The study was conducted as a 3-round survey using the Delphi method. The Delphi method is a qualitative consensus method based on the views of experts aiming at reaching consensus on the studied subject. The Delphi rounds were conducted as electronic surveys in September-December 2020. Expert panelists assessed the proposed definition of a collaborative medication review and the tasks and responsibilities of health care professionals involved in conducting it. The expert panel consisted of 41 participants: 12 physicians, 13 pharmacists, 10 nurses, and 6 information management professionals. The results of the study were analyzed both quantitatively and qualitatively. Consensus was reached on the definition of medication review from a multi-professional perspective, while no consensus was reached on most of the responsibilities and tasks of different healthcare professionals involved. Most challenging was to define patient groups benefiting from medication reviews and the situations in which medication reviews should be performed. Therefore, further research is needed to define the division of responsibilities between care team members, for example by defining separately the responsibilities and tasks in different healthcare contexts. This is the most comprehensive attempt taken in Finland to define medication review as a concept from a multi-professional perspective. The results of the study imply to the development and harmonizing of medication review practices and standardizing patient data documentation. The expected outcomes relate to enhanced patient and medication safety, improved coordination in medication management with integrated medication reviews.
  • Lindholm, Tanja (Helsingin yliopisto, 2021)
    Medication reviews have been highlighted as one of the most important strategies for improving medication safety and medication management especially in older adults. Current electronic health records document and communicate e-prescriptions but their medication use related patient information content should be extended to cover e.g. medication review documentation. The documentation should be in structured format to be useful in clinical practice and evidence-informed decision-making. The aim of this study was to identify medication review related patient information and other patient data that should be in a structured form in electronic health record systems (EHRs) at a national and organizational level. The aim was also to determine which medication review related patient information should be documented in electronic health record systems. The study was conducted as 3-round survey using the Delphi-method. The Delphi method is a qualitative consensus method based on the views of experts aiming at reaching consensus of the experts on the studied subject. The Delphi rounds were conducted as electronic surveys in September-December 2020. Expert panelists assessed which medication-related patient data and other data generated by healthcare providers should be documented in a structured form in EHRs and in which national digital data system services (Kanta and My Kanta Pages) the medication review related patient information should be accessible and by whom. The expert panel consisted of 41 participants: 12 physicians, 13 pharmacists, 10 nurses, and 6 information management professionals. The results of the study were analyzed both quantitatively and qualitatively. Consensus was reached on a total of 108 medication review related patient information topics that should be documented in a structured form in EHRs and that should be available for medication reviews through EHRs. Of the topics, 39 related to medication reviews in general, 25 to adverse drug reaction symptoms, 11 to the burden of adverse drug effects, 12 to laboratory tests and other test results, 12 to medication adherence and 9 to the use of intoxicants. Structuring the data was considered as important or important to some extent in most of the presented medication review related information topics. Especially, the documentation of renal function was rated by the expert panelists as a crucial piece of information to be structured. Medication adherence information and information related to the use of intoxicants were rated as less important to be documented in a structured form than other topics. Consensus was also reached on the accessibility of medication review documentation in the Kanta and My Kanta services. The expert panel of this study had a common and strong view that data related to medication reviews should be structured in EHRs. The expert panel reached a strong consensus that almost all of the data presented in the study should be structured. Based on this Delphi study, the expert panel identified the benefits of structuring and standardized recording. Because not all data can be structured at once, further prioritization of the data identified in this study is still needed. The practical implementation of the structured information could be accomplished in the form of a checklist. The study addresses a very current problem related to the shortcomings of medication information management and overall medication management.
  • Kangasniemi, Mari; Arala, Katariina; Becker, Eve; Suutarla, Anna; Haapa, Toni; Korhonen, Anne (2017)
    Background: Nurses' collegiality is topical because patient care is complicated, requiring shared knowledge and working methods. Nurses' collaboration has been supported by a number of different working models, but there has been less focus on ethics. Aim: This study aimed to develop nurses' collegiality guidelines using the Delphi method. Method: Two online panels of Finnish experts, with 35 and 40 members, used the four-step Delphi method in December 2013 and January 2014. They reformulated the items of nurses' collegiality identified by the literature and rated based on validity and importance. Content analysis and descriptive statistical methods were used to analyze the data, and the nurses' collegiality guidelines were formulated. Ethical considerations: Organizational approval was received, and an informed consent was obtained from all participants. Information about the voluntary nature of participation was provided. Results: During the first Delphi panel round, a number of items were reformulated and added, resulting in 32 reformulated items. As a result of the second round, 8 of the 32 items scored an agreement rate of more than 75%, with the most rated item being collegiality means that professionals respect each other. The item with second highest rating was collegiality has a common objective: what is best for patients, followed by the third highest which was professional ethics is the basis of collegiality. Conclusion: Nurses' collegiality and its content are well recognized in clinical practice but seldom studied. Collegiality can be supported by guidelines, and nurses working in clinical practice, together with teachers and managers, have shared responsibilities to support and develop it. More research in different nursing environments is needed to improve understanding of the content and practice of nursing collegiality.