Introduction: The National Unified Health Research Agenda is a major document whose creation by the Philippine National Health Research Systems is mandated by Philippine Law. Multiple frameworks, methods, and approaches for the development of a health research agenda exists. Available literature on research priority setting have mostly focused on its methods, results, or implementation. There are limited studies on the operations management of conducting a national health research priority-setting exercise. Objectives: This paper aims to describe the operational components utilized to develop the NUHRA 2017-2022 and provide lessons learned for future research priority setting endeavors. Methods: This paper identified and categorized the operational components to develop the NUHRA 2017-2022 using the Enabler Criterion of the European Foundation for Quality Management’s (EFQM) Excellence Model. Results: Operationalizing the development of a national health research agenda requires the harmonization of multiple components. Having region-based staff involved in the production of a regional situational analysis improved its context and accuracy. The workload for each cluster team must be considered and anticipated by the management. Stakeholder engagement requires political, diplomatic, advocacy, marketing, management, and technical skills. The process requires building relationships with various institutions. In a largescale project, management processes must be in place to effectively track and monitor its progress. Conclusion Operations and management are usually a neglected area in research and development projects. In a bottoms-up research priority-setting approach, iteration and flexibility is needed which requires a lot of management skills and insight. Duration of the project, planning, resources available, and quality of outputs have a strong interconnected relationship.
Health Priorities ; Organizational Innovation

This study was conducted to gather basic data on the tasks and roles of nutrition teachers by analyzing the changes inwork importance, performance frequency, and organizational environment after dietitians were transposed to nutrition teachers. E-mail surveys were sent to 100 newly assigned nutrition teachers who previously served as dietitians in Gyeonggi province. A total of 72 teachers responded to the survey. The respondents were asked the importance and frequency of 9 work-related duties performed as a dietitian and nutrition teacher, respectively. They were also surveyed regarding their satisfaction perceptions for 5 organizational changes. The majority of respondents were 36 to 40 years old (48.6%) and had 10~20 years of work experience (58.3%). Significant differences were found for work importance after changing to the role of nutrition teacher (p<0.001). In addition, work performance frequency differences were found for the categories of nutrition education, nutrition counseling, and dietary guidance. These results were attributable to the differences in work importance and performance frequency by now being a nutrition teacher rather than a dietitian. The respondents had increased satisfaction levels after changing from dietitian to nutrition teacher (p<0.001) in terms of 'pride for change in work', 'satisfaction level for pay', and 'satisfaction level for change in the organizational environment'. In order for nutrition teachers to have effective work performance, 'personal capabilities' and 'school manager support' should be coordinated. Overall, the results of this study suggest that effective training programs should be developed for nutrition teachers they can effectively complete newly assigned work tasks.
Counseling ; Surveys and Questionnaires ; Electronic Mail ; Organizational Innovation

Constant change is inevitable in medical education. Medical education is continually influenced as medical schools adapt to new environments, as the society redefines the role of doctors, by ongoing advancements in medical practice, and as educational theory and practice continues to improve. In addition, the external stakeholders such as consumers, government, and accreditation bodies and internal stakeholders such as professors and students are seeking for changes in medical education. Developing an adequate response to the ongoing change in medical education is not easy. Making changes in a complex system like medical education has been compared to 'moving a graveyard'. In order to facilitate successful adaptation to the evolving social and educational parameters involved in medical education, leadership would benefit greatly by the study and application of change management theory that has proven successful in corporate manage ment. A number of authors have suggested that 'in loosely coupled organizations like medical schools, a campaign approach is more effective than a general change management approach'. To make the campaign approach successful, change leaders in medical education need to be facilitative leaders who can stimulate and guide constructive dialogue between faculty members and students, and who can promote a sense of ownership of the ongoing changes developing in the consultations between the internal stakeholders comprising the professors and students.
Accreditation ; Education, Medical ; Humans ; Leadership ; Organization and Administration ; Organizational Innovation ; Ownership ; Referral and Consultation ; Schools, Medical

Long-term morbidity, long-term cognitive impairment and hospitalization-associated disability are common occurrence in the survivors of critical illness, with significant consequences for patients and for the caregivers. The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing ICU patient recovery and outcomes. The ABCDEF bundle includes: Assess, Prevent, and Manage Pain, Both Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT), Choice of analgesia and sedation, Delirium: Assess, Prevent, and Manage, Early mobility and Exercise, and Family engagement. The purpose of this review is to describe the core features of the ABCDEF bundle.
Analgesia ; Caregivers ; Cognition Disorders ; Critical Illness ; Delirium ; Humans ; Organizational Innovation ; Respiration ; Survivors ; Ventilator Weaning

OBJECTIVES: The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. METHODS: Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. RESULTS: Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. CONCLUSIONS: Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management.
Cost Savings ; Hospitals, General ; Information Systems* ; Organizational Innovation ; Outsourced Services* ; Surveys and Questionnaires

With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive-correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2 (SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change.This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.
Delivery of Health Care ; Education ; Nursing ; Nursing Process ; Nursing, Supervisory ; Organizational Innovation* ; Patient Care

The expansion of applications of medical devices has attracted the increased attention of government regulatory bodies around the world to the safety and effectiveness of these products. Most developed countries, such as the United States and European Union, have developed well-established regulatory systems for medical devices, which have also consistently been amended to accommodate the changing requirements of safety and the trend of globalization.The current "Regulations for the Supervision and Administration of Medical Device (China)", established in 2000, has brought about great improvements for the safety and effectiveness of products, safeguarding public health. But there are still, at present, a lot of counterfeit and poor quality devices and device-related adverse events for lack of powerful post -market and in-use regulatory controls for products. It is therefore very urgent for the Chinese government to reform its medical device administration and management. This research paper analyses and compares the different requirements and executions of medical devices regulations in the EU, the US and China, to draw some experiences of the EU and US regimes that are very useful to China's regulatory reform. It is suggested that when developing a new scheme of medical devices regulatory reform in China, two prominent aspects have to be considered by policy makers and regulators. Firstly, the global trend of medical devices regulations has to be taken into account. Secondly, the experiences learned from the EU and US systems should be applied to the Chinese regulatory reform in combination with the concrete practice of China.
China ; Device Approval ; legislation & jurisprudence ; Equipment Safety ; Equipment and Supplies ; standards ; European Union ; Organizational Innovation ; United States

Long-term morbidity, long-term cognitive impairment and hospitalization-associated disability are common occurrence in the survivors of critical illness, with significant consequences for patients and for the caregivers. The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing ICU patient recovery and outcomes. The ABCDEF bundle includes: Assess, Prevent, and Manage Pain, Both Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT), Choice of analgesia and sedation, Delirium: Assess, Prevent, and Manage, Early mobility and Exercise, and Family engagement. The purpose of this review is to describe the core features of the ABCDEF bundle.
Analgesia ; Caregivers ; Cognition Disorders ; Critical Illness ; Delirium ; Humans ; Organizational Innovation ; Respiration ; Survivors ; Ventilator Weaning

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.
Education, Medical, Undergraduate ; organization & administration ; standards ; Faculty, Medical ; Germany ; Humans ; Organizational Case Studies ; Organizational Innovation ; Problem-Based Learning ; organization & administration ; Schools, Medical ; organization & administration ; Total Quality Management

BACKGROUND: Organizational changes that involve healthcare hospital departments and care services of health districts, and ongoing technological innovations and developments in society increasingly expose healthcare workers (HCWs) to work-related stress (WRS). Minimizing occupational exposure to stress requires effective risk stress assessment and management programs. METHODS: The authors conducted an integrated analysis of stress sentinel indicators, an integrated analysis of objective stress factors of occupational context and content areas, and an integrated analysis between nurses and physicians of hospital departments and care services of health districts in accordance with a multidimensional validated tool developed in Italy by the National Network for the Prevention of Work-Related Psychosocial Disorders. The purpose of this retrospective observational study was to detect and analyze in different work settings the level of WRS resulting from organizational changes implemented by hospital healthcare departments and care services of health districts in a sample of their employees. RESULTS: The findings of the study showed that hospital HCWs seemed to incur a medium level risk of WRS that was principally the result of work context factors. The implementation of improvement interventions focused on team development, safety training programs, and adopting an ethics code for HCWs, and it effectively and significantly reduced the level of WRS risk in the workplace. CONCLUSION: In this study HCW resulted to be exposed to occupational stress factors susceptible to reduction. Stress management programs aimed to improve work context factors associated with occupational stress are required to minimize the impact of WRS on workers.
Codes of Ethics ; Delivery of Health Care* ; Education ; Hospital Departments ; Inventions ; Italy* ; Observational Study ; Occupational Exposure ; Organizational Innovation ; Retrospective Studies