Dissertations / Theses on the topic 'Ward management systems'

Rapid Response Systems but is dependent upon nurses utilising EWS protocols and applying Acute Life-threatening Events: Recognition and Treatment (ALERT) course best practice guidelines. To date there is limited evidence on the effectiveness of EWS or ALERT as research has primarily focused on measuring patient outcomes (cardiac arrests, lCU admissions) following the implementation of a Rapid Response Team. The aim of this study was to evaluate factors that enabled and constrained the implementation and service delivery of Early Warnings Systems (EWS) and acute care training in practice in order to provide direction for enabling their success and sustainability. The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews, observation and documentary analysis of EWS compliance data and ALERT training records . Data synthesis found similar regularities or factors enabling or constraining successful implementation across the case study sites. Findings showed that personal (confidence; clinical judgement; professional accountability; personality). social (ward leadership; communication), organisational (workload; time pressures; staffing levels and skill-mix), educational (constraints on training and experiential learning) and cultural (delegation of observations. referral hierarchy; rigid recording practices) influences impact on EWS and acute care training outcomes. RRS theory refinement using realist evaluation explained what works, for whom in what circumstances. Future service provision needs to consider improved staffing levels; flexible implementation of protocols underpinned by empowerment and clinical judgement; on-going experiential ward-based learning and enhanced clinical leadership to enable the success and sustainability of Rapid Response Systems.

Healthcare is a complex system under great pressure for meeting the patients’ needs. Implementing technology at inpatient wards might possibly support healthcare professionals and improve quality of care. However, these technologies might come with issues and the system might not be used as intended. This master thesis project investigates how healthcare professionals communicate at an inpatient ward and how this might be affected by implementing a Mobile Healthcare Solution (MHS). Further, it sought to question why healthcare professions might, or might not, use the MHS as a support of their daily work and what some reasons for this might be. Research methods were of qualitative approach. Field studies were performed at an inpatient ward and further, two healthcare professionals were interviewed. Grounded Theory (GT) was chosen as a method to process the data and obtain understanding for communication at the inpatient ward. The results showed that healthcare professionals communicate verbally, written and by reading, using different tools. The most prominent ways of communication were verbally, where it was common to report or discuss about a patient. The means for communication did not get drastically affected by implementing the MHS and reasons for this were of social, technical and organizational types. Some reasons for not using the MHS were habits and due to healthcare professionals perceiving the MHS as more time consuming than manual handling. However, a specific investigation of whether this might affect the usage of the MHS is yet needed

The importance of ecological systems in supporting social systems has been identified as one of the most important facets of sustainable development. Consequently, a number of international and local laws and policy interventions have been established to ensure that natural resource use remains sustainable. In rural areas, overdependence on fuel wood has commonly been identified as one of the biggest threat to forestry ecosystems. This in turn has led to environmental degradation that includes among others species depletion, soil erosion and decline in water and air quality. Based on the myriad problems caused by over-reliance on fuel wood, this study sought to identify usage, management and perceived implication of woodland exploitation in Port St Johns local municipality in the Eastern Cape, South Africa. Using interviews and questionnaires for key respondents in the local community, the study identified two key threats to socio-ecological stability resulting from wood fuel exploitation namely; high poverty levels and lack of coordination in the management of wood fuel resources. Apart from using fuel wood for domestic use, local fuel wood exploitation has been commercialized to augment household incomes. Lack of coordination in the management of natural resources has also created a vacuum in the exploitation and management of fuel wood resources. The study did not have inclination towards statistics such as chi-square and t-tests since the research questions and objectives did not refer to any relationship or significance level. The study recommends non-wood based alternative sources of energy, improved coordination and harmonization of functions among different stakeholders and emphasis on collaboration between traditional and local governance in the management fuel wood and the local physical environment. The study further recommends resuscitation of indigenous knowledge and socio-ecological stability

Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, System Design and Management Program, 2019
Page 99 blank. Cataloged from PDF version of thesis.
Includes bibliographical references (pages 96-98).
In recent years, voice-powered digital assistants have exploded into the consumer mainstream as an important new form of human-computer interaction. Powered by dramatic improvements in speech recognition and artificial intelligence (Al) technologies over the last decade, digital voice assistants are now abundantly prevalent in modem consumer electronic devices ranging from mobile phones, to smart speakers, to wearables. As the technology matures and the availability of big data used by digital assistants proliferates, voice will soon become a primary modality by which people interact and accomplish tasks. Many of these tasks will be accomplished in consumer homes and digital voice assistants present a significant new opportunity where voice and the physical home intersect to dramatically reshape how consumers live in their home.
This also represents a tremendous opportunity for companies in the digital assistant industry, and, in order to successfully leverage this nascent technology, they will need to understand both their own strategic goals as well as their direct and indirect competitors' strategies in building a business ecosystem around voice-first digital assistants. A fierce struggle has begun - not just amongst current technology titans (i.e. Google, Amazon, Apple, Microsoft), but also involving key incumbent players in the home media and electronics industry (e.g. Samsung, Sonos, Bang & Olufsen).
The goals of this thesis, with respect to the current industry leaders in the digital assistant and smart home space, are to 1) understand the current landscape of the digital assistant voice ecosystem, 2) elucidate each major players' current voice-powered digital assistant platform strategy, 3) analyze the consumer adoption, selection, and diffusion mechanisms for digital voice assistants in the consumer smart home, and 4) determine what the likely outcomes are for each major player as well as the likelihood of success and associated risks with the current ecosystem and platforming strategies employed. Finally, through additional market analysis and industry projections, strategic recommendations will be presented to guide each key player over the next decade. Following these recommendations will be key to winning the digital assistant voice wars and for creating a successful and sustainable voice technology ecosystem in the personal digital assistant market.
by Hans Wang.
S.M. in Engineering and Management
S.M.inEngineeringandManagement Massachusetts Institute of Technology, System Design and Management Program

Patient monitoring is a complex task, particularly during childbirth, where assessment of the baby's condition is inferred from the continuous electronic recording of the baby's heart rate pattern and maternal uterine contractions (CTG). Computerised decision support has long been advocated, as difficulties in the interpretation of the CTG have led to failure to intervene and unnecessary intervention. The problem is large, for obstetric litigation now accounts for 80% of the UK National Health Service litigation bill. The Plymouth Perinatal Research Group has developed a computerised decision support system for patient monitoring during childbirth and the UK Medical Research Council has agreed to fund a multicentre randomised trial. The work of this thesis was an investigation of the labour ward care system to inform the human-centred design of the decision support system for patient monitoring in childbirth, prior to the clinical trial. It was recognised that many decision support systems have failed to gain clinical acceptance, as conventional design models were inadequate. Lack of attention to the organisational context of the care system and the process of the direct patient care led to the design of inflexible 'expert' systems, which constrained working practices. A pilot ethnographic study of an existing decision support system, used for the analysis of umbilical cord blood samples, was undertaken to clarify the research approach required for the main study. It was found that barriers to effective use within the wider work system included inadequate implementation and lack of organisational support. A case study approach produced a more comprehensive account of the context and process of the use of the computer system. The main study combined qualitative with quantitative techniques to investigate the system of care in childbirth, both outside and within the delivery room, to provide a unique, holistic perspective. The organisational context of the labour ward was investigated by direct observation of clinicians over the course of their work for 220 hours. Observations were documented and transcribed to computer text files. Patterns of actions and events were coded using ATLAS(ti) data analysis software. The codes were counted and tabulated to model the main features of this labour ward care system, which was expressed in the form of a rich picture diagram. These findings were confirmed by a limited study of five other UK labour wards. The core qualitative categories, derived from the observation data, found a complex and problematic relationship between communication, decision making and accountability. Decisions were often made outside the delivery room and were subject to misinterpretation and bias. The organisational hierarchy made it difficult for junior staff to question clinical management decisions. A system of tacit practice, external demands upon clinicians and transient allocation of junior midwives to labour ward militated against teamwork. This increased the vulnerability of the care of mothers to error. The process of direct patient care, within the individual delivery room, of 20 mothers in labour was captured in a novel audio-video observation study. The 111 hours of first stage labour and 12 hours of second stage labour were recorded and digitised to computer files. Recurrent actions and patterns of behaviour were coded both quantitatively and qualitatively using ATLAS(ti) data analysis software. Midwives left the room on average every 15 minutes to be absent for 27% of the first stage of labour. Record keeping occurred on average every 10 minutes and accounted for 19% of midwives' time. Midwives had little time to talk with mothers and only sat down at the bedside for 15% of the time. Psychosocial support was not given priority. Parents were generally excluded from communication between clinicians yet 108 clinicians took part in the care of the 20 women. Pressures from medicolegal directives and task-orientated imperatives overshadowed meaningful interaction with parents and caused spurious care priorities. This work has revealed the need for a critical reassessment of the type of support that is required for monitoring situations in all areas of medicine. A range of functions, such as shared information displays and models, have been suggested to augment roles and relationships between clinicians and parents to support patient-centred care. The present work has revealed that a combination of computer-based technology and changes to working practice can support the parents, their individual carers and their various roles. In this way the system of care can be more aligned to the objective of a safe and emotionally satisfying birth experience for parents and staff. A further programme of research is required to follow-up the existing studies, develop these new forms of interaction between technology and clinicians, and evaluate their effectiveness. The research methods employed in the present work will provide a more comprehensive evaluation of the decision support system in the forthcoming multicentre trial. The methods of investigation have also been shown to be of relevance to patient safety research, service delivery and training.

This thesis considers management decision making at the ward level in hospitals especially by ward sisters, and the effectiveness of the intervention of a decision support system. Nursing practice theories were related to organisation and management theories in order to conceptualise a decision making framework for nurse manpower planning and deployment at the ward level. Decision and systems theories were explored to understand the concepts of decision making and the realities of power in an organisation. In essence, the hypothesis was concerned with changes in patterns of decision making that could occur with the intervention of a decision support system and that the degree of change would be governed by a set of 'difficulty' factors within wards in a hospital. During the course of the study, a classification of ward management decision making was created, together with the development and validation of measuring instruments to test the research hypothesis. The decision support system used was rigorously evaluated to test whether benefits did accrue from its implementation. Quantitative results from sample wards together with qualitative information collected, were used to test this hypothesis and the outcomes postulated were supported by these findings. The main conclusion from this research is that a more rational approach to management decision making is feasible, using information from a decision support system. However, wards and ward sisters that need the most assistance, where the `difficulty' factors in the organisation are highest, benefit the least from this type of system. Organisational reviews are needed on these identified wards, involving managers and doctors, to reduce the levels of un-coordinated activities and disruption.

Le présent travail essaye de démontrer que le littoral, à l’échelle du temps, est un domaine d’appropriation multiple par les sociétés. Il l’établit en trois étapes : définition de l’entité « littoral », prise en considération de l’eau dans l’aménagement et empreinte humaine néfaste. Il considère le littoral tel un organisme riche en vie et une interface entre les mondes terrestre et maritime. Il utilise les approches multiscalaire et géométrique pour appréhender l’hétérogénéité morphologique, la diversité biologique et la dimension spatiale. Il quantifie et qualifie, afin de caractériser les phénomènes naturels et les événements induits et afin d’énoncer une dominante révélatrice, l’eau, qui est à prendre en considération dans un aménagement respectueux de l’environnement littoral. Il analyse et synthétise les données des quatre terrains sélectionnés, fait émerger les spécificités et les problèmes environnementaux et recherche un état d’équilibre par une mise en valeur de la dynamique endogène. Il expose la relation diachronique de l’homme avec ces milieux et la prise de conscience a posteriori de la communauté scientifique sur le devenir des territoires littoraux, face aux nouvelles conditions climatiques. L’objectif de cette thèse est de mettre en évidence l’utilisation optimale de la ressource « littoral » et de révéler ses potentialités plurielles en vue d’un développement durable, où l’aménagement est la clé de voûte d’un nouveau modèle d’organisation bio–spatio–temporelle (BST). Cette approche holistique introduit la politique adaptative et la conscience collective, en vue d’un aménagement évolutif et d’une moralisation des usages du littoral et du 6ème continent
This work tries to demonstrate, on the time scale, that the littoral is a domain of multiple appropriations by the human societies. It is made up of three stages: the definition of the « coast » entity, the water consideration in the management and the negative human influences. It considers the coast as a lifelike organism and an interface between land and sea worlds. It uses the multistage and geometrical approach to apprehend the morphological heterogeneity, the biological diversity and the spatial dimension. It quantifies and qualifies to characterize the natural phenomenon and the induced events by human beings and to announce the importance of the water, which has to be considered into a respectful management of the coastal environment. It analyzes and synthesizes the data from four selected sites, it brings out the specificities and the environmental problems and looking for a steady state by an enhancement of endogenous dynamics. It describes the diachronic relationship of man with this environment of transition and the awareness subsequent of the scientific community on the future of the coastal areas, face to new climatic conditions. The aim of this thesis is to prove the optimized use of « coast » resource and to valorize its plural potentialities for a sustainable development, where the management is the keystone of a new model, the bio-spatial-temporal (BST) organization. This holistic approach introduces the adaptive politics and the collective consciousness, for an evolutionary management and for a moralization of coast and of 6th continent use

Sjöräddning i Sverige sker genom samverkan mellan statliga verksamheter, kommuner och frivilligorganisationer för ett gemensamt mål att rädda personer som råkat i sjönöd. Tid är ofta en kritisk faktor i räddningsuppdragen men ett snabbt och oplanerat utryck riskerar samtidigt att sätta räddningsaktörerna själva i farozonen. Utvecklingen av obemannade autonoma farkoster för SAR (eng. Search And Rescue) ses som en lösning på behovet att kunna snabbt skicka hjälp till samt få ögon på incidentplatsen utan att försätta räddningsaktörerna för onödig risk. Nuvarande kommunikationssystem inom svensk sjöräddning kan dock inte hantera annan typ av information än muntlig varav räddningsaktörer endast känner till riktlinjer för hantering av muntlig information. Med ett framtida införande av autonoma farkoster kommer dock fler informationstyper att behöva hanteras i sjöräddningar varav oklarheten om vilka informationstyper autonoma farkoster samlar in och vilka datahanteringskrav som finns är problematiskt. Oklarhet om informationstyperna och deras datahanteringskrav är vidare problematiskt för utvecklingen och implementeringen av autonoma farkoster då risken finns att farkoster och tekniker utvecklas men inte får användas för att de inte är anpassade efter lagkraven på hantering av olika datatyper. I denna studie undersöks därför vilka informationstyper som autonoma farkoster kan samla in vid sjöräddning. Detta för att komma fram till vilka riktlinjer för datahantering som gäller vid sjöräddning med autonoma farkoster. Studien undersöker också vilka informationstyper som är kritiska för en SAR-sjöräddningssamverkan samt vilka informationsdelningsutmaningar som finns i dagens sjöräddning. Studien genomfördes i form av en kvalitativ fallstudie och har tillämpat ett socio-tekniskt systemperspektiv för att bättre se till helheten och besvara frågeställningarna. Resultatet av denna studie visar att autonoma farkoster kan samla in information om sin omgivning, vilket utgör grunden för att skapa en medvetenhet om situationen som är kritiskt för SAR-operationer, och kan även samla in information om sitt eget tillstånd. De lagverk som identifierats utgöra de huvudsakliga restriktionerna är kamerabevakningslagen, lagen för skydd av geografisk information, offentlighets- och sekretesslagen, GDPR och dataskyddslagen. Dessa lagverk innehåller riktlinjer för delning av information och personuppgiftsbehandling i SAR-sjöräddning. Kunskapsbidrag studien har genererat inkluderar bland annat identifiering av datatyper som kan samlas in av autonoma farkoster i en SAR-sjöräddning, och sannolikt andra typer av räddningsinsatser, och delning och hanteringskraven på de datatyperna i räddningsinsatser och därmed kunskap om vilka datatyper som är mest reglerade. Vidare kunskapsbidrag är kunskap om vilka informationstyper som är mest kritiska för SAR-sjöräddningar, och därför bör prioriteras att samlas in och delas, och identifieringen av utmaningar för informationsdelning mellan statliga verksamheter och frivilligorganisationer.
Maritime rescue in Sweden is performed through a cooperation between government agencies, municipalities and non-governmental organisations (NGOs) with the common goal of saving people in distress. Time is often a critical factor in the rescue missions but a fast and unplanned response may at the same time put the rescue workers in danger. The development of unmanned autonomous vehicles for SAR is seen as a solution to the need of being able to quickly sendhelp as well as get eyes on the scene of the incident without exposing the rescue workers for unnecessary risks. However, the current communications systems in Swedish maritime rescue are unable to handle any other type of information except verbal, meaning that rescue workers only know guidelines for handling verbal information. However, with a future implementation of autonomous vehicles, there will be a need to handle more information types in maritime rescue whereas the uncertainty regarding what kind of information autonomous vehicles collect and which data management requirements exist is problematic. The uncertainty about the information types and their data management requirements is also problematic for the development and implementation of autonomous vehicles as there is a risk that vehicles and technologies are developed but not allowed to be used because they are not adapted to the legal requirements on management of the different types of data. Therefore, in this study I examine what information types that autonomous vehicles can collect in a maritime rescue to find out what guidelines for data management that applies during a maritime rescue with autonomous vehicles. The study also examines what kind of information’s are critical for a SAR maritime rescue cooperation as well as what information sharing challenges exist in current maritime rescue. The study was performed as a qualitative case study and has used a socio-technical systems perspective so as to better see the overall picture and answer the research questions. The result shows that autonomous vehicles can collect information about their surroundings, which is the foundation for establishing situation awareness that is critical for SAR-operations, and that they can collect information about their own status. The main laws and regulations that have been identified as constituting the main restrictions are (translated from Swedish) the law of camera surveillance, the law for protection of geographical information, the public access to information and secrecy act, the GDPR and the data protection act. These contains guidelines for sharing information and the processing of personal data in SAR maritime rescue. The knowledge contributions of this study includes among others the identification of datatypes that can be collected by autonomous vehicles in SAR maritime rescue, and probably other types of rescue operations, and the sharing and management requirements on those datatypes in rescue operations and thus knowledge of what datatypes that are the most restricted. Further knowledge contributions is knowledge about which information types that are the most critical for SAR maritime rescue and thus should be prioritised for collection and sharing as well as the identification of challenges for information sharing between government agencies and NGOs.

This study is an investigation into how systems thinking was used in a school improvement initiative, which involved the implementation of the Integrated Quality Management System (IQMS) in a ward with twenty-two schools. The Superintendent of Education Management (SEM), as the practitioner, initiated the study in the form of an action research, using the soft systems methodology (SSM). The preference of the SSM was justified for its suitability to explore problem contexts of a pluralist complex nature. The School Development Team (SDT) Chairpersons were the participants that went through the learning process and provided insights from their worldviews and experiences as the leaders tasked with bringing about the requisite transformation and guidance aimed at the professional development of educators, their performance measurement and whole school evaluation. The reflective study interrogates the worldviews, perspectives, attitudes and values of the participants, promotes the use of systems tools and techniques and leads to the development of conceptual models which might constructively enhance school reform. The findings of this study highlight educators’ ability to engage in reflective activities and self-directed explorations, shared experience of educators learning to learn together and continuous professional development. The reflective educators learn to recall, consider and evaluate experiences in relation to a broader educational purpose. The study explores the possibility of using the IQMS systemically in action as leverage to enhance school improvement and bring about positive change in educator accountability.
Thesis (M.Com.)-University of KwaZulu-Natal, Westville, 2009.

The study reviews the implementation of DAS and IQMS in Vulindlela Circuit from 2003 to 2006. The systems thinking approach and Soft Systems Methodology served as a point of leverage in identifying problematic situations besetting the implementation of DAS and IQMS. The use of systems tools provided the means for creating dialogue between the facilitator and the SMT members and principals. The study illustrates the use of the systems maps, spray diagrams, iceberg tool, brainwriting and rich pictures in surfacing the assumptions and beliefs about the failure of DAS and IQMS. With this approach, SMTs and principals developed their ideas about the way they could implement DAS and IQMS. Systems thinking provided a perspective for approaching the problematic situations. A conceptual model for DAS and IQMS evolved though the collaborative efforts of SMT members and principals. A developmental and holistic model evolved from this process of school development. A new way of thinking about problematic situations is presented to participants. A process of dialogue set the stage for. school development. Notable improvements are highlighted as indicators of improvement during the implementation of DAS and IQMS. The approach promotes active participation, dialogue, reflection and continuous inquiry and a shared vision in the formulation of conceptual models.
Thesis (M.Com.)-University of KwaZulu-Natal, Westville, 2006.

The grazing management project in the Okhombe ward of the Amazizi Tribal Authority formed part of the National Department of Agriculture's LandCare program to address communal natural resource management issues. Okhombe land is communal whereby every member of the community is the legal owner of the rangeland with individual ownership of stock with the chieftaincy playing a major role in land allocation. In order to avoid critics of the past and address the top-down approach of the past interventions, a participatory approach was conducted in the planning and implementation of the grazing system. The service providers held a series of visioning workshops with the community in an effort to better understand community resource use patterns, needs, constraints and opportunities as part of the participatory approach. Issues identified by the community were the need for fencing grazing camps, animal health improvement, subdivision of rangeland and crop fields and the development of a rotational grazing system. The main aims of this study were to develop a participatory grazing plan with the community, develop and support institutional structures governing range management, and build capacity of the community in range management. The effect of the current grazing system on species composition was determined. In addition to these, the project investigated the potential different fodder trees has on alleviating feed and nutritional deficit, particularly during the dry winter months of the Upper Thukela. Among the main achievements of this study was the development and strengthening of local institutional structures and effective liaison by all structures with the Inkosi and the tribal council. The community developed a rotational grazing plan, marked the camp boundaries, produced digital maps and successfully built fence boundaries (approximately 20 kms of fencing) to divide their land. The fence boundaries separated the crop fields and rangeland, closed ward boundaries in the upland to prevent access by cattle from neighbouring wards, and divided the land into three camps. Six crush pens were constructed in each subward of the Okhombe ward. A communal herders fund opened and fence construction improved crop yields due to a decrease in crop damage by cattle. Okhombe ward, located in the Highland Sourveld region of KwaZulu-Natal, experiences feed and nutrition deficits to ruminants during winter. The prevailing species composition in Okhombe was investigated as part of the grazing plan. The veld condition of the sites ranged from poor (40.7%) in the bottomland to an averaged of 47.0% in upland sites. The most distinctive feature of the rangeland in this area was the loss of highly palatable Decreaser grass species (P <0.05), such as Themeda triandra in the bottom slopes « 1300 m) when compared to the upland (> 1800 m). The proportional abundance of Decreaser species accounted for an averaged of 1.02% of the bottomland and an averaged of 11.5% of the upland compared to the values of 49% in the benchmark (grassland in optimal condition). The composition of the less palatable Increaser Il species was very high at all elevations (1200 m -80.7%, 1400 m - 75.8% and 1700 m - 55.7%) when compared to the low benchmark composition of 19%. The dominant grasses of the bottom slopes were Increaser Il species, such as Eragrostis curvula, Eragrostis plana and Sporobolus africanus and unpalatable Increaser III species such as Aristida junciformis. A significant difference (P < 0.05) in the composition of Decreaser, Increaser I and Increaser Il species was found between the bottom and slopes compared to the upland region. However, the grass cover formed by these tufted species was generally high, making it more resistant to physical degradation. The bottom slope ranged from reasonable to excellent cover (16.9%), the middle slope ranged from reasonable (15.9%) to a good cover of 18.1%, averaging 16.7% and a range of 16.1% to 17.9% for the upland plateau. In the agroforestry trial the potential of different fodder species for supplementing fodder was examined. Leucaena leucocephala had the potential of being a suitable fodder tree species for use in alley cropping (P < 0.05) compared to Morus alba and Acacia karroo. Results from the partially intercropped treatments showed that L. leucocephala yield (665 kg ha-I) varied significantly (P < 0.05) from the A. karroo (378 kg ha-I) and M alba yield (345 kg ha-I). Treatments that were fully intercropped varied, but no significant difference (P > 0.05) were recorded. Morus alba produced the least yield of 345 kg ha-I, A. karroo yielded 378 kg ha-1 and 1. leucocephala recorded the high of 664 kg ha-I. Results from the second season showed similar trend in that 1. leucocephala yielded a significant (P < 0.05) fodder production of 1715 kg ha-I in comparison to M. alba (1101 kg ha-I) and A karroo (1140 kg ha-I). M alba yielded the least dry matter production (P < 0.05) but had high potential (P < 0.05) for addressing lack of firewood in rural areas. Morus alba yielded high fuel wood production from both two seasons. There were no significant differences in fuel wood yield (P > 0.05) from the partially intercropped M alba (507.9 kg ha-I) and 1. leucocephala (455.0 kg ha-I) but the yield from both species varied significantly from the A. karroo yield (103.kg ha-I). With regard to fully intercropped plots, fuel wood yield from all tree species varied significantly, A karroo resulting in low yield (63 kg ha-I), 1. leucocephala recorded 243 kg ha-l and M alba the highest yield of 444 kg ha-I. In the second season, M. alba yielded an averaged fuel wood production of 728 kg ha-l and a low of 439 kg ha-I from 1. leucocephala. Acacia karroo, a slow growing indigenous tree, might be preferred by farmers due to its less branches resulting in minimal light competition with crops. Leucaena leucocephala tend to grow slowly in its initial establishment stage, but once roots become well established, it grows fast and produces high quantity of fodder. The effect all fodder trees had on crop yield was not negative during the trial period and further research on long term effects of alley cropping is recommended. The conclusions drawn here were based on tree growth and their likely impact in alley cropping. Leucaena leucocephala was also recommended as a preferred species for rural ruminants based on the forage quality study. The results showed high content of crude protein (19.27%), low NDF content (50.38%) and very low tannin content (1.19%) from 1. leucocephala compared to A. karroo with a high tannin content of 5.69%. Acacia karroo had a crude protein content of 13.60%, NDF percentages of 44.16 and 34.64% of ADF content. Morus alba also had a recommended chemical composition of 11.71% of CP, 42.86% of NDF, 36.96% of ADF and a low tannin content of 0.65%. L. leucocephala foliage proven is readily degradable under different diet ranging within 24 hrs of intake (P < 0.001) compared to other feeds. L. leucocephala had high dry matter loss degraded from the rumen under Eragrostis hay diet with poor nutrients to high protein concentrates diet. Under the Eragrostis hay diet for instance, L. leucocephala tend to degrade rapidly with values of dry matter loss ranging from 32.2% to 39% at 4 hrs to 16 hrs, when compared to low dry mater loss of 26% at 4 hrs to 31.33% at 16 hrs. Feeds such as M alba tend to degrade slowly within 24 hrs of intake and rapidly degrades after the stated period. The ep content of maize stover was very low ranging from 1.60% in maize stalks to 2.63% in maize leaves. The fibre content in maize stover was very high when compared to lower values in fodder samples. The NDF content ranged from 77.92% in maize leaves to 81.60% in maize stalks. Maize leaves when compared to a combination of maize leaves and maize stalks sole tend to degrade better within 24 hrs of intake. This was due to low (P < 0.05) degradability rate of maize stalks compared to a combination of maize stalks and leave and leaves sole and least NDF content in maize leaves might have attributed to these results. Due to poor chemical compositions of these roughage samples, the study recommended the establishment of fodder banks and agroforestry systems to curb the nutrients deficit during winter. In conclusion therefore, this study highlight that the sustainability of rural systems to manage communal grazing land should be further explored. Most of the challenging issues in communal range management are social in nature rather than technical concepts. These include ways of improving social contributions from cattle to the community while maintaining cultural values of the use of cattle. The interventions in communal range management by service providers should understand the institutional arrangements within a community and an attempt to strengthen such existing structures is recommended. Further interventions by service providers in Okhombe ward should bring in the planning discussions, experts from social sciences, to deal with understanding of community dynamics. Complexities in communal range management involve dealing with non-stock owners within project boundaries. Communities from neighbouring wards should not be ignored and ways of improving communications and updating project details to them should be formulated. Shortage of land and closing of ward boundaries to prevent access to land by neighbouring wards is among community complexities to be explored. Communities in rural lands do share land and in most cases boundaries are known but invisible by an outsider to identify. It is important to strengthen and maintain every success in communal lands as that may form core of the project. Successes on grazing management by locals is far from being the improvement in veld but there are rather various factors to the successes of grazing projects in rural areas. Examples of successes based on Okhombe project are reduction in stock theft, improved in relationship between community and locals institutions, a reduction in stock mortalities during winter and improved animal health. Veld improvement is among successes but there are accomplishments phases to fulfil before focusing on improvement of species composition.
Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

Yes
Objective: To assess developments over time in the capture, curation and use of quality and safety information in managing hospital services. Setting: Four acute National Health Service hospitals in England. Participants: 111.5 hours of observation of hospital board and directorate meetings, and 72 hours of ward observations. 86 interviews with board level and middle managers and with ward managers and staff. Results: There were substantial improvements in the quantity and quality of data produced for boards and middle managers between 2013 and 2016, starting from a low base. All four hospitals deployed data warehouses, repositories where datasets from otherwise disparate departmental systems could be managed. Three of them deployed real-time ward management systems, which were used extensively by nurses and other staff. Conclusions: The findings, particularly relating to the deployment of real-time ward management systems, are a corrective to the many negative accounts of information technology implementations. The hospital information infrastructures were elements in a wider move, away from a reliance on individual professionals exercising judgements and towards team-based and data-driven approaches to the active management of risks. They were not, though, using their fine-grained data to develop ultrasafe working practices.
NIHR Health Service and Delivery Research (HS&DR) programme, project 13/07/68.

This study uses a practitioner research approach to focus on poorly performing schools in grades 10 –12 in the Samungu Ward, and looks at the value of using a systems thinking approach to address the problems of poor performance, as compared to the traditional, reductionist approach that is usually applied by the schools and the Department of Education in the implementation of its policies. The research moves from the premise that schools are complex learning organisations and that their problems should be addressed within the context of the systems thinking approach, in which the organisation is seen as a whole with emergent properties, a layered structure, and with processes which enable it to adapt in response to environmental pressures (Checkland, 1999:21). The research has used some aspects of the Soft Systems Methodology as a tool to process the information collected from the participants, because the Soft Systems Methodology “concentrates on learning from organizational and contextual ambiguity and appreciating socially conditioned problem situations with a view to changing relationships and making improvements.” (Jacobs 2004:140) The study has looked at the problem formulated during the discussion with the stakeholders and has juxtaposed the value of the use of Systems Thinking with that of the traditional approach, either in the intervention programmes or in the formulation of solutions. The research concludes with recommendations made in terms of the systems thinking approach, having discovered that the traditional approach fell short in yielding the desired outcome during the implementation process of the policies. From a practitioner research perspective, the study has also led to the implementation of some of its recommendations, which seem to be viable and has produced the desired outcome.
Thesis (M.Com.)-University of KwaZulu-Natal, Westville, 2009.

This thesis study evaluates access to care at an internal medicine unit with solely semi-private rooms at Baystate Medical Center (BMC). Patients are divided into two types: Type I patient consumes one bed; Type II patient occupies two beds or an entire semi-private room as a private space for clinical reasons, resulting in one empty but unavailable (blocked) bed per Type II patient. Because little data is available on blocked beds and Type II patients, unit-level hospital bed planning studies that consider blocked beds have been lacking. This thesis study bridges that gap by building a single-stream and a two-stream discrete micro-simulation model in Excel VBA to describe unit-level bed queue dynamics at hourly granularity in the next 48-hour time horizon, using historical arrival rates and census-dependent discharge rates, supplemented with qualitative results on complexity of patient-level discharge prediction. Results showed that while we increase additional semiprivate beds, there was notable difference between the traditional single-stream model and the two-stream model concerning improvement in bed queue size. Possible directions for future research include patient-level discharge prediction considering both clinical and nonclinical milestones, and strategic redesign of hospital unit(s) considering overflows and internal transfers.

This study examines the experiences of the school management teams and educators of Mayville ward schools regarding the implementation of Integrated Quality Management Systems (lQMS) policy at school level. The research was conducted as a case study in the Mayville Ward Schools in Durban, KwaZulu Natal, South Africa. This study was looking at the recently introduced educator evaluation system that is being in schools called Integrated Quality Management System (IQMS). This study also elaborates on the changes in the education history from the apartheid system to the democratic system of education. Three schools participated in the study (two secondary schools and one primary school). These schools were purposively selected using convenience and easy access, as well as, the fact that they had started implementing the IQMS policy, as the main criteria for selection. Semi-structured interviews were used to gather data from principals, heads of departments as well as post-level one educators about their experiences of IQMS implementation. The findings indicated that while the IQMS policy was good on paper but it was extremely difficult to implement. Issues of honesty and trust were at the root of the difficulties that make IQMS implementation difficult. The participants' understanding of IQMS was that it was meant for the provision of quality education and development.
Thesis (M.Ed.)-University of KwaZulu-Natal, 2007.

碩士
國立臺灣體育大學(桃園)
運動科學研究所
96
It has been a successful policy to promote the Tug of War among all levels of schools by the Ministry of Education. However, to host a Tug of War contest is not operated effectively, and a completed database for all competition results and related information are not managed in appropriate ways. A thorough online contest management system for Tug of War can efficiently reduce the costs of labor and time, and increase the quality of the contest management. This online system covers all stages of a Tug of War competition by smooth the processes of activities. The programming languages used are: PHP & HTML for web, and MySQL for database management. Two major functions are web and contest management. The web provides online registration, latest news, and contest result publishing. The contest management offers schedule arrangement, score entries, printouts of registration forms, weight forms, chart positions, and results book. In addition, the database collects the weight information of team players, competition time, win-lose result and tracks materials. Eventually such information can benefit the Tug of War training and strategy application in future studies and researches.

碩士
國立體育學院
教練研究所
90
The Tug of War is originated from China it is a sport of strength and teamwork. This system is aimed at helping coaches to better organize training practice such as training record, making training plan, integration analysis and interaction between athletes and coach. The system is developed under MS windows 2000 server, IIS 5.0 and uses Access 2000 as Database provider. The ASP, HTML/DHTML and VBScript were used to create active interaction with users. The functions include built up training plan, message transmission, online liaison album, personal training data module, coaching administration, supervisor administration, interactive discussing, the analysis of training data, acquaintanceship record, sport psychological examination, online user calling. The expert and user evaluation methods were used through out the development stage of this system. The findings were: 1. There was positive reaction and promote training recognition toward the web-based learning. 2. Perforate the system coach and athlete can extend training time round the clock. 3. The ability to master computer will affect the attitude of coach and athlete using the web-based system.

碩士
國防管理學院
國防資訊研究所
93
War-Game System is that Computer War game System replaces Field Training Exercise to reduce training cost and risk, further to promote Armed Force Joint Operation Performance. It is main trend. Owing to War-game System accompanies with Armed Force Combat Readiness requirement, exercise items are different every year. The process in War-Game System can be viewed as a Process Management Process. OPM3，Organization Process Management Maturity Model applies to understand and assess organization project management and provide the tools and methods to measure, compare and improve project management ability. This model can be applied to different scale, type of organization project and assess organization project management maturity. The paper describes the basic theory of Organization Process Management Maturity Model and discusses how to apply Organization Process Management Maturity Model into war-game system of joint training project and provide best practice, included five phases－Prepare for Assessment, Perform Assessment, Plan for Improvement, Implement Improvements, and Repeat the Process, as well as eight steps－Study the Standard, Assess organization, Determine Focus of Improvements, Determine Path to Improvements, Evaluate Current Capabilities, Plan for Improvements, Implement Improvements, Repeat the Process, and so on. By assessing Organization Process Management Maturity Model, to understand the cons of Operational War-Game system and look for the steps of improvement to have replace of promoting War-Game system of Joint Training Project . Key Words: War-game System, Project Management, Organizational Process Management Maturity Model, OPM3

Thesis (M. Tech. (Office management & Technology)) -- Vaal University of Technology
The primary objective of this research project was primarily to investigate filing methods and mailing practices in the computer support or administrative environment with specific focus on the abuse of paper. The research design consisted of an exploratory investigation in selected Higher Education Institutions in the Province of Gauteng whereby a structured questionnaire was used as a measuring instrument. The investigation was sub-divided into two categories, namely, paper-based filing systems and mailing systems as opposed to electronic filing and mailing systems. In the empirical findings, analysis and interpretations, correlation and cross-tabulation were done on all sets of variables in order to determine whether any meaningful associations could be found. With reference to the title of this study "Combating the corporate paper war: optimising electronic mail and electronic filing", it has been proven that the war against paper abuse is far from over. Perceptions regarding a future paperless office and assumptions that technology such as the electronic mail facility and electronic filing could assist organisations to combat paper abuse were unfounded, due to a lack of guidance and control measures in the corporate environment. Consequently, it is recommended that an e-filing and e-mailing model be created and followed in conjunction with specified computer software features in order to counteract the abuse of paper. Follow-up research could focus on electronic filing methods versus scanning of documents for filing purposes.

Submitted in fulfillment of the requirements for the degree of Doctor in Public Management, School of Public Management and Economics, Durban University of Technology, Durban, South Africa, 2016.
The shortage of staff in hospitals resulted in the overcrowding of outpatients departments (OPDs) and long waiting times. The problems of the current health care system include the lack of access to transportation and high transport fees which cause delays in health seeking behaviours by patients or them resorting to traditional medicine in their neighbourhood. To alleviate the above issues, the new Primary Health Care (PHC) approach provides health care at a ward based and household level through community care giver (CCGs) and outreach teams. The study evaluated the management of rural ward-based primary health care in the UThukela District Municipality (UDM). The study intended to evaluate current performance systems in order to provide effective and efficient PHC; identify the role of the operational manager (OM) in the provision of PHC; and identify the factors affecting the performance of CCGs. A mixed methods approach was used amongst 368 CCGs and 17 OMs. Data was collected from CCGs using questionnaires while an interview schedule was used to collect data from OMs. The study showed that the performance management systems currently being used were not providing the desired performance management outputs. There were no performance bonuses to recognise best performing staff and therefore no increase in performance. The study also showed a significant relationship between the management of referrals and participation in the activities of PHC outreach teams. The clinic was not regularly giving feedback to the respondents and also not consistently conducting performance reviews. The findings indicated that OMs were playing various roles in the provision of PHC, namely policy and strategy implementation; leadership and governance; clinical care; allocation of resources; clinic budget management; supply chain management; and writing clinic reports. The extent of the allocation of resources to the wards varied from 43% for medicines and equipment to 31% for financial resources and only 18% for human resources. More than 95% of the CCGs viewed the availability of transport, resources, training and the provision of a stipend to be strong enabling factors for them to perform their work. Respondents indicated that monitoring and evaluation was done through reporting, performance reviews, feedback and supervision. The findings indicated that ward-based outreach teams are crucial in the delivery of PHC services in rural municipal wards within the Operation Sukuma Sakhe programme. Lack of management and supervisory support contribute to high rates of dissatisfaction amongst CCGs, as well as poor quality of work for community caregivers. There is a need for the Department of Health (DoH) to invest in the ward-based outreach teams (WBOTs) and allocate CCG budgets within the ward-based outreach teams. The study recommended that a review of monitoring and evaluation policy is required to clearly state the tools, activities and benefits of the implementation of the M & E performance management systems. The use of point-of-care technology by the WBOTs should be strengthened especially in deep rural wards. Therefore, biomedical technology will enhance point-of-care diagnosis, for instance, rapid home test kits for HIV diagnosis and pregnancy tests. The KwaZulu-Natal DoH should fast-track development of the sub-districts in order strengthen service delivery at a local level with top management ensuring development of OMs and PHC Supervisors in order to increase the level of competence and thereby improve service delivery at the PHC facilities. Another recommendation was to strengthen implementation of Operation Sukuma Sakhe (OSS) where the war room and the ward committee increase commitment to designing community-specific interventions with the engagement of community structures and government departments and local municipality through social planning, social action and locality development. Therefore, the results of the study should also influence the formulation of policies, programmes, methods and interventions which will enable UThukela District Municipality to improve health outcomes.
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