Browsing by Subject "implementation"

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  • Hilska, Matias; Leppänen, Mari; Vasankari, Tommi; Aaltonen, Sari; Raitanen, Jani; Räisänen, Anu M.; Steffen, Kathrin; Forsman, Hannele; Konttinen, Niilo; Kujala, Urho M.; Pasanen, Kati (2021)
  • Samuelson, Olle; Björk, Bo-Christer (2011)
    Three strategically important uses of IT in the construction industry are the storage and management of project documents on webservers (EDM), the electronic handling of orders and invoices between companies (EDI) and the use of 3-D models including non-geometrical attributes for integrated design and construction (BIM). In a broad longitudinal survey study of IT use in the Swedish Construction Industry the extent of use of these techniques was measured in 1998, 2000 and 2007. The results showed that EDM and EDI are currently already well-established techniques whereas BIM, although it promises the biggest potential benefits to the industry, only seems to be at the beginning of adoption. In a follow-up to the quantitative studies, the factors affecting the decisions to implement EDM, EDI and BIM as well as the actual adoption processes, were studied using semi-structured interviews with practitioners. The theoretical basis for the interview studies was informed by theoretical frameworks from IT-adoption theory, where in particular the UTAUT model has provided the main basis for the analyses presented here. The results showed that the decisions to take the above technologies into use are made on three differ- ent levels: the individual level, the organizational level in the form of a company, and the organiza- tional level in the form of a project. The different patterns in adoption can to some part be explained by where the decisions are mainly taken. EDM is driven from the organisation/project level, EDI mainly from the organisation/company level, and BIM is driven by individuals pioneering the technique.
  • Kujala, Sari; Ammenwerth, Elske; Kolanen, Heta; Ervast, Minna (2020)
    Background: The number of public eHealth services that support patient self-management is rapidly increasing. However, the implementation of these eHealth services for self-management has encountered challenges. Objective: The purpose of this paper was to analyze the challenges and opportunities of implementing eHealth services for self-management by focusing on the fit between the technical solution and clinical use. Methods: We performed in-depth interviews with 10 clinical project coordinators and managers who were responsible for developing and implementing various eHealth services for self-management interventions in five university hospitals in Finland The results were analyzed using content analysis and open coding. The Fit between Individuals, Task, and Technology (FITT) framework was used to interpret the findings. Results: The implementation of self-management services involved many challenges related to technical problems, health professional acceptance, patient motivation, and health organization and management. The implementers identified practices to manage the identified challenges, including improving the design of the technology, supporting health professionals in the adoption of the eHealth services, changing the work processes and tasks, involving patients, and collectively planning the implementation inside an organization. The findings could be mostly attributed to the dimensions of the FITT framework. Conclusions: The FITT framework helped to analyze the challenges related to the implementation, and most of them were related to poor fit. The importance of patients as stakeholders in eHealth services for patient self-management needs to be highlighted. Thus, we propose that patients should be added as a different type of individual dimension to the FITT framework. In addition, the framework could be extended to include organization and management in a new context dimension.
  • Haapala, Juho; White, Pamela (2018)
    This article considers the little studied role of local implementation staff and their institutional operational environment at the grassroots of a rural development intervention in Nepal. The study describes the challenges the implementing staff encounters in relation to the steering policies, project modalities, local communities, partners in government administration, and their personal motivations. It observes the ways in which the implementing individuals must collaborate with their partners and facilitate the planned changes in local institutions and individual behaviours. The findings indicate that much of the actual implementation process at the grassroots is determined by informal, improvised, and fuzzy institutional surroundings, quite different to designed or regulated governance environs. The ability to operate in these less-regulated environs determines many of the implementation outcomes at the grassroots. Researchers, managers and decision-makers would benefit from incorporating institutional bricolage to the analyses of development interventions.
  • Cavonius-Rintahaka, Diana; Aho, Anna Liisa; Billstedt, Eva; Gillberg, Christopher (2021)
    Aim: To describe the development and implementation of a Dialogical Family Guidance (DFG) intervention, aimed at families with a child with neurodevelopmental disorders (NDD). Design: The DFG components are presented and the content of a DFG training course. Professionals' experiences after the DFG training were evaluated. Methods: Dialogical Family Guidance development phases and implementation process are examined. The Revised Standards for Quality Improvement Reporting Excellence checklist (SQUIRE 2.0) was used to provide a framework for reporting new knowledge. Results: The DFG training course seemed to increase possibilities of a more independent role as a nurse to deliver the DFG family intervention. The project showed that the use of dialogue can be difficult for some professionals. Analysis of the questionnaire completed after DFG training reported a high level of satisfaction. DFG training offered a new approach to deliver knowledge and understanding to families using dialogue, including tailored psychoeducation and emotional and practical guidance.
  • Sallinen, Katri (Helsingin yliopisto, 2019)
    Accounting firms need to stay along in the development of financial management digitali-zation. An important part of that is to implement new systems and develop a high-level expertise in them, creating a major competitive advantage. That way the growing demands of modern customers can be fulfilled. One part of the development is ERP expertise and implementations as new service products. The purpose of this research is to find out how those service products could be built to be as functioning as possible for different types of customers of an accounting firm and what are the main challenges to be considered. The research was conducted as a case study in a Finnish accounting office. The case was their own implementation project. Challenges occurred in the project were used to build up a suggestion on how to avoid the same ones in future projects. Based on the results of the research it can be said that the main challenges in an ERP im-plementation, for a company operating in Finland, relate to automation and especially monetary transactions and usage of reference numbers and their automatic allocations, foreign consultant’s understanding of the Finnish business environment, understanding the importance of testing and resourcing, process and system reengineering, change manage-ment, motivation and commitment of the employees and management as well as staying in budget and schedule.
  • Hautala, Maria; Koskela, Ulla; Pokka, Tytti; Rantala, Heikki; Uhari, Matti; Serlo, Willy; Mikkonen, Kirsi (2021)
    Aim To investigate the usefulness of the National Emergency X-Radiography Utilization Study (NEXUS) II head trauma decision rule in clinical practice for paediatric patients in a tertiary university hospital serving as the only paediatric hospital in the area. Methods We compared how doctors evaluated and examined patients with head injury during two time periods, before and after the introduction of NEXUS II decision rule. Multiple implementation strategies were used as follows: education, tutoring and written instructions for the use of NEXUS II. Results Two hundred and forty-four head injury patients visited the hospital before and 385 after the introduction of the NEXUS II decision rule. The number of hospital admissions (56%) and the mean duration of hospitalisation (2.5 days) remained the same during the two periods. In the NEXUS II evaluated group, there was a decrease of 40% in the number of hospital admissions. NEXUS II was applied in only 62 (16%) cases. The number of head imaging procedures remained the same. No patients with a clinically significant head injury were missed with the NEXUS II evaluation. Conclusion NEXUS II was ineffective as our implementation failed. When used, NEXUS II reduced expenses in our study population by decreasing the number of hospital admissions.
  • Mettänen, Ritva (Helsingfors universitet, 2017)
    The risk for a very preterm child to develop cerebral palsy is significantly higher than for child born at term or later than 32 weeks of gestation. Doyle et al. published an updated systematic review of five RCT's in 2009 in which they proved, that antenatal magnesium sulfate administration markedly decreased the risk of cerebral palsy and substantial gross motor dysfunction in preterm infants. In a research of Magee et al. it was noted, that the NNT to prevent 1 CP or death was 43 and NNT to prevent one CP only was 50 at 32 weeks of gestation. The use of antenatal magnesium sulfate for fetal neuroprotection was launched in HUCH on June 7 th, 2012. After the pilot period of approximately two months, the implementation was evaluated and the decision to set-up the upper gestational age of 31+6 weeks for the fetal neuroprotection has been done (August 21st, 2012). Our main objective was to compare the implementation of antenatal magnesium sulfate for fetal neuroprotection, the proximity of the magnesium exposure to delivery and the determination of the delivery-related blood loss in those that received MgSO4 compared to the cohort of the same gestational age that have not received MgSO4. Pregnancy characteristics and fetal neuroprotection data were collected retrospectively and retrieved from the hospital records. The overall implementation rate during both periods was 83,7%. The rate of 86.2% in period 2012-2016 was higher than expected with an increase of 8,56% compared to the period A. To determine the accurate implementation rate (83,0%) we excluded those with elective CS. The implementation rate was found very successful and higher than that in any of the previous published study. Mean duration of magnesium administration was 7,13 hours and mean dose of MgSO4 was 17,61g. There was a decrease of 33% in women who did not receive magnesium sulfate even though indicated from period A to period B. The decrease of 77,9% from period A to period B with those who did not receive magnesium sulfate for an unknown reason is a huge accomplishment. We found the proximity of the magnesium exposure to delivery to be on a very satisfying level. Altogether 68,0% of women gave birth <12 hours after the exposure to MgSO4 had ceased, and as much as 58,4% delivered <6 hours after the exposure to magnesium. With 29,6% of those eligible for magnesium treatment, magnesium administration time was miscalculated (maintenance dose shorter 30 minutes). This non-adherence to the local guidelines has been noted and an auditing with midwives will be made. In conclusion, MgSO4 administration for fetal neuroprotection has been successfully and safely implemented in our institution.
  • Ahtiainen, Raisa (Helsingfors universitet, 2010)
    The educational reform, launched in Finland in 2008, concerns the implementation of the Special Education Strategy (Opetusministeriö 2007) under an improvement initiative called Kelpo. One of the main proposed alterations of the Strategy relates to the support system of comprehensive school pupils. The existed two-level model (general and special support) is to be altered by the new three-level model (general, intensified and special support). There are 233 municipalities involved nationwide in the Kelpo initiative, each of which has a municipal coordinator as a national delegate. The Centre for Educational Assessment [the Centre] at the University of Helsinki, led by Professor Jarkko Hautamäki, carries out the developmental assessment of the initiative's developmental process. As a part of that assessment the Centre interviewed 151 municipal coordinators in November 2008. This thesis considers the Kelpo initiative from Michael Fullan's change theory's aspect. The aim is to identify the change theoretical factors in the speech of the municipal coordinators interviewed by the Centre, and to constitute a view of what the crucial factors in the reform implementation process are. The appearance of the change theoretical factors, in the coordinators' speech, and the meaning of these appearances are being considered from the change process point of view. The Centre collected the data by interviewing the municipal coordinators (n=151) in small groups of 4-11 people. The interview method was based on Vesala and Rantanen's (2007) qualitative attitude survey method which was adapted and evolved for the Centre's developmental assessment by Hilasvuori. The method of the analysis was a qualitative theory-based content analysis, processed using the Atlas.ti software. The theoretical frame of reference was grounded on Fullan's change theory and the analysis was based on three change theoretical categories: implementation, cooperation and perspectives in the change process. The analysis of the interview data revealed spoken expressions in the coordinators' speech which were either positively or negatively related to the theoretical categories. On the grounds of these change theoretical relations the existence of the change process was observed. The crucial factors of reform implementation were found, and the conclusion is that the encounter of the new reform-based and already existing strategies in school produces interface challenges. These challenges are particularly confronted in the context of the implementation of the new three-level support model. The interface challenges are classified as follows: conceptual, method-based, action-based and belief-based challenges.
  • Kauhanen, Henri (Helsingfors universitet, 2010)
    According to certain arguments, computation is observer-relative either in the sense that many physical systems implement many computations (Hilary Putnam), or in the sense that almost all physical systems implement all computations (John Searle). If sound, these arguments have a potentially devastating consequence for the computational theory of mind: if arbitrary physical systems can be seen to implement arbitrary computations, the notion of computation seems to lose all explanatory power as far as brains and minds are concerned. David Chalmers and B. Jack Copeland have attempted to counter these relativist arguments by placing certain constraints on the definition of implementation. In this thesis, I examine their proposals and find both wanting in some respects. During the course of this examination, I give a formal definition of the class of combinatorial-state automata , upon which Chalmers's account of implementation is based. I show that this definition implies two theorems (one an observation due to Curtis Brown) concerning the computational power of combinatorial-state automata, theorems which speak against founding the theory of implementation upon this formalism. Toward the end of the thesis, I sketch a definition of the implementation of Turing machines in dynamical systems, and offer this as an alternative to Chalmers's and Copeland's accounts of implementation. I demonstrate that the definition does not imply Searle's claim for the universal implementation of computations. However, the definition may support claims that are weaker than Searle s, yet still troubling to the computationalist. There remains a kernel of relativity in implementation at any rate, since the interpretation of physical systems seems itself to be an observer-relative matter, to some degree at least. This observation helps clarify the role the notion of computation can play in cognitive science. Specifically, I will argue that the notion should be conceived as an instrumental rather than as a fundamental or foundational one.