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Search Results: 1 - 10 of 299131 matches for " Bryan J Weiner "
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A theory of organizational readiness for change
Bryan J Weiner
Implementation Science , 2009, DOI: 10.1186/1748-5908-4-67
Abstract: Organizational readiness for change is a multi-level, multi-faceted construct. As an organization-level construct, readiness for change refers to organizational members' shared resolve to implement a change (change commitment) and shared belief in their collective capability to do so (change efficacy). Organizational readiness for change varies as a function of how much organizational members value the change and how favorably they appraise three key determinants of implementation capability: task demands, resource availability, and situational factors. When organizational readiness for change is high, organizational members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behavior. The result is more effective implementation.The theory described in this article treats organizational readiness as a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so. This way of thinking about organizational readiness is best suited for examining organizational changes where collective behavior change is necessary in order to effectively implement the change and, in some instances, for the change to produce anticipated benefits. Testing the theory would require further measurement development and careful sampling decisions. The theory offers a means of reconciling the structural and psychological views of organizational readiness found in the literature. Further, the theory suggests the possibility that the strategies that change management experts recommend are equifinal. That is, there is no 'one best way' to increase organizational readiness for change.Organizational readiness for change is considered a critical precursor to the successful implementation of complex changes in healthcare settings [1-9]. Indeed, some suggest that failure to establish sufficient readiness accounts for one-half of all un
Uncovering middle managers' role in healthcare innovation implementation
Sarah A Birken, Shoou-Yih Lee, Bryan J Weiner
Implementation Science , 2012, DOI: 10.1186/1748-5908-7-28
Abstract: Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation.Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation.Middle managers' responsibility in healthcare organizations has grown as teamwork designs have become popular in the industry. Teams of clinicians and administrators are often tasked with implementing healthcare innovations [1]. Middle managers--employees who are supervised by an organization's top managers and who supervise frontline employees [2]--oversee the implementation of these innovations [3]. As middle managers' responsibility in healthcare organizations increases, their potential influence over innovation implementation grows.Despite their potential influence, middle managers have received little attention in extant healthcare innovation implementation research. A comprehensive understanding of middle managers' role in innovation implementation is important because of the gap between evidence of effective care and practice. One study found that patients received just one-half of recommended preventive care, acute care, and care for chronic conditions; some patients received care that was not recommended and was potentially harmful [4]. Further, disparities in access to care and health outcomes exist among racial and ethnic minorities, low-income indivi
Effectiveness of a grant program's efforts to promote synergy within its funded initiatives: perceptions of participants of the Southern Rural Access Program
Donald E Pathman, Emmeline Chuang, Bryan J Weiner
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-263
Abstract: We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points.Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes hindered by turf issues and politics and the conflicting perspectives and cultures of participating organizations and racial groups. Inadequate funding through the SRAP, restricting program involvement to only a few needy counties, and instances of over- and under-involvement by the program's leadership were sometimes felt to inhibit synergies and/or their sustainability.Participants of the SRAP generally perceived that the SRAP's deliberate strategies yielded synergies that added to the program's impact.Foundations and public agencies often support society's health and social goals by creating grant programs that fund stand-alone "catego
Implementing community-based provider participation in research: an empirical study
Randall Teal, Dawn M Bergmire, Matthew Johnston, Bryan J Weiner
Implementation Science , 2012, DOI: 10.1186/1748-5908-7-41
Abstract: We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011.The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation.Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness.
The meaning and measurement of implementation climate
Bryan J Weiner, Charles M Belden, Dawn M Bergmire, Matthew Johnston
Implementation Science , 2011, DOI: 10.1186/1748-5908-6-78
Abstract: Implementation climate differs from constructs such as organizational climate, culture, or context in two important respects: first, it has a strategic focus (implementation), and second, it is innovation-specific. Measuring implementation climate is challenging because the construct operates at the organizational level, but requires the collection of multi-dimensional perceptual data from many expected innovation users within an organization. In order to avoid problems with construct validity, assessments of within-group agreement of implementation climate measures must be carefully considered. Implementation climate implies a high degree of within-group agreement in climate perceptions. However, researchers might find it useful to distinguish implementation climate level (the average of implementation climate perceptions) from implementation climate strength (the variability of implementation climate perceptions). It is important to recognize that the implementation climate construct applies most readily to innovations that require collective, coordinated behavior change by many organizational members both for successful implementation and for realization of anticipated benefits. For innovations that do not possess these attributes, individual-level theories of behavior change could be more useful in explaining implementation effectiveness.This construct has considerable value in implementation science, however, further debate and development is necessary to refine and distinguish the construct for empirical use.Katherine Klein and Joann Sorra's [1] theory of innovation implementation has become increasingly prominent in the field of implementation science. The article in which the theory first appeared has been cited 258 times since its publication in 1996. Reflecting the theory's popularity in health and human services research, one-third of the 258 citing articles focus on innovation implementation in hospitals, physician practices, community health centers, su
Characterizing biobank organizations in the U.S.: results from a national survey
Gail E Henderson, R Jean Cadigan, Teresa P Edwards, Ian Conlon, Anders G Nelson, James P Evans, Arlene M Davis, Catherine Zimmer, Bryan J Weiner
Genome Medicine , 2013, DOI: 10.1186/gm407
Variation in use of surveillance colonoscopy among colorectal cancer survivors in the United States
Talya Salz, Morris Weinberger, John Z Ayanian, Noel T Brewer, Craig C Earle, Jennifer Elston Lafata, Deborah A Fisher, Bryan J Weiner, Robert S Sandler
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-256
Abstract: We studied CRC survivors enrolled in the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Eligible survivors were diagnosed between 2003 and 2005, had curative surgery for CRC, and were alive without recurrences 14 months after surgery with curative intent. Data came from patient interviews and medical record abstraction. We used a multivariate logit model to identify predictors of colonoscopy use.Despite guidelines recommending surveillance, only 49% of the 1423 eligible survivors received a colonoscopy within 14 months after surgery. We observed large regional differences (38% to 57%) across regions. Survivors who received screening colonoscopy were more likely to: have colon cancer than rectal cancer (OR = 1.41, 95% CI: 1.05-1.90); have visited a primary care physician (OR = 1.44, 95% CI: 1.14-1.82); and received adjuvant chemotherapy (OR = 1.75, 95% CI: 1.27-2.41). Compared to survivors with no comorbidities, survivors with moderate or severe comorbidities were less likely to receive surveillance colonoscopy (OR = 0.69, 95% CI: 0.49-0.98 and OR = 0.44, 95% CI: 0.29-0.66, respectively).Despite guidelines, more than half of CRC survivors did not receive surveillance colonoscopy within 14 months of surgery, with substantial variation by site of care. The association of primary care visits and adjuvant chemotherapy use suggests that access to care following surgery affects cancer surveillance.Colorectal cancer (CRC) survivors need ongoing preventive care even after their cancer treatment is complete. Because CRC survivors are at risk for both local recurrences and second primary cancers[1], clinical practice guidelines from several gastroenterological and oncological societies have long recommended routine surveillance colonoscopy for survivors who have been treated for cure[2-11]. By detecting second colorectal cancers and local recurrences early enough to treat, surveillance colonoscopy may increase treatment options and decrease mortality. Until re
Comment on ``Enhanced transmission of light through a gold film due to excitation of standing surface-plasmon Bloch waves"
J. Weiner
Physics , 2007, DOI: 10.1103/PhysRevB.77.036401
Abstract: The purpose of this comment is first to correct a misapprehension of the role played by composite wave diffraction on surface-wave generation at subwavelength structures and second to point out that periodic Bloch structures are unnecessary for the efficient production of the surface plasmon polariton (SPP) guided mode either as traveling or standing waves. Guided surface waves originate from simple slit or groove edges illuminated under normal incidence, and one-dimensional (1-D) surface cavities from these standing waves are easily realized.
Effect of grain dust on the friction factor in sliding kinematic pairs of plastic-steel
Szefler J.,Weiner W.
International Agrophysics , 1999,
Abstract: The studies on the polymer-metal friction nodes operating in the presence of corn dust have been presented. The results of studies prove the feasibility of plastic application in designing machines for corn and feed processing.
Deep slitless infrared spectroscopic surveys with HST/WFC3
Benjamin J. Weiner
Physics , 2012,
Abstract: HST is commonly thought of as an optical-IR imaging or UV-spectroscopy observatory. However, the advent of WFC3-IR made it possible to do slitless infrared spectroscopic surveys over an area significant for galaxy evolution studies (~0.15 deg^2). Slitless infrared spectroscopy is uniquely possible from space due to the reduced background. Redshift surveys with WFC3-IR offer probes of the astrophysics of the galaxy population at z=1-3 from line features, and the true redshift and spatial distribution of galaxies, that cannot be done with photometric surveys alone. While HST slitless spectroscopy is low spectral resolution, its high multiplex advantage makes it competitive with future ground based IR spectrographs, its flux calibration is stable, and its high spatial resolution allows measuring the spatial extent of emission lines, which only HST can do currently for large numbers of objects. A deeper slitless IR spectroscopic survey over hundreds of arcmin^2 (eg one or more GOODS fields) is one of the remaining niches for large galaxy evolution studies with HST, and would produce a sample of thousands of spectroscopically confirmed galaxies at 1
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