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This study looks at the positive effect of psychological hardiness on organizational pride, with a particular emphasis on the mediating function of thriving at work along with the moderating function of perceived organizational support. Past research show that psychological hardiness benefits individuals and organizations. Based on resilience and organizational support theories, we argue that people with high psychological hardiness thrive at work, which enhances organizational pride. Perceived organizational support can boost the benefits of psychological hardiness on thriving at work. We used a quantitative research strategy, surveying 331 individuals from diverse service sector industries. This study employed structural equation modeling to examine the associations among variables under study. The findings indicate that there is a significant mediating effect of thriving at work on the relationship between psychological hardiness and organizational pride. Moreover, we found that when POS is high the positive relationship between psychological hardiness and thriving at work becomes strengthen. Results of the study necessitate to cultivate an environment of support within the organizations along with efforts to establish training programs for enhancing psychological hardiness of employees. These efforts would generate feelings of thriving at work ultimately leading to organizational pride.

An increasing number of young adults are using social media platforms in collectivist family cultures like Pakistan, but little is known about how social media use is associated with family connectedness in this population. This study is aimed (a) at examining the social media usage patterns in Pakistani young adults and how they use it to connect with their parents and (b) at exploring the possible association between social media use and perceived family connectedness and parental monitoring. Data came from an online survey conducted among young adults in Pakistan. Patterns of use across various popular social media platforms were recorded. Additionally, family connectedness and parental monitoring were measured. Multiple linear regression analyses were used to examine the relationship between social media used to connect with parents and family connectedness and parental monitoring. A total of 421 participants responded to the survey. All participants regularly used at least two popular social media platforms. WhatsApp was the most used platform irrespective of gender or age, with about 91% of the participants reporting daily usage. Overall, 63% of participants connected with their parents using social media. This varied significantly among male and female participants with 69% of female participants connecting with their parents on social media compared to 59% of males. Connecting with parents on both Facebook and Instagram was highly associated with participants' perception of parental monitoring before and after adjusting for age and gender. The study highlights that while family connectedness in collectivist societies like Pakistan is not associated with social media usage, adult children perceive parents monitoring their social media activities., Safety and Security Science

ChatGPT is a highly advanced AI language model that has gained widespread popularity. It is trained to understand and generate human language and is used in various applications, including automated customer service, chatbots, and content generation. While it has the potential to offer many benefits, there are also concerns about its potential for misuse, particularly in relation to providing inappropriate or harmful safety-related information. To explore ChatGPT's (specifically version 3.5) capabilities in providing safety-related advice, a multidisciplinary consortium of experts was formed to analyse nine cases across different safety domains: using mobile phones while driving, supervising children around water, crowd management guidelines, precautions to prevent falls in older people, air pollution when exercising, intervening when a colleague is distressed, managing job demands to prevent burnout, protecting personal data in fitness apps, and fatigue when operating heavy machinery. The experts concluded that there is potential for significant risks when using ChatGPT as a source of information and advice for safety-related issues. ChatGPT provided incorrect or potentially harmful statements and emphasised individual responsibility, potentially leading to ecological fallacy. The study highlights the need for caution when using ChatGPT for safety-related information and expert verification, as well as the need for ethical considerations and safeguards to ensure users understand the limitations and receive appropriate advice, especially in low- and middle-income countries. The results of this investigation serve as a reminder that while AI technology continues to advance, caution must be exercised to ensure that its applications do not pose a threat to public safety.

BACKGROUND: Mobile apps are a popular strategy for reducing mobile phone use and preventing maladaptive mobile phone use (MMPU). Previous research efforts have been made to understand the features of apps that have the potential to reduce mobile phone use and MMPU. However, there has been a lack of a comprehensive examination of the effectiveness of such apps and their features. OBJECTIVE: This paper investigated existing apps designed to reduce mobile phone use and prevent MMPU and examined the evidence of their effectiveness. The research aimed to provide a comprehensive analysis of app features that can reduce mobile phone use and MMPU, while also assessing their effectiveness. In addition, we explored users' perceptions of these apps and the various features the apps offer to understand potential adoption issues and identify opportunities. METHODS: This study used 3 methods: a review of scientific evidence, content analysis, and sentiment analysis. RESULTS: Our study comprehensively examine the common features of 13 apps designed to reduce mobile phone use. We extracted and classified the features into 7 types: self-tracking, social tracking, goal setting, blocking, gamification, simplification, and assessment. The effectiveness of these apps in reducing mobile phone use and MMPU varied from weak to strong. On the basis of content analysis, self-tracking and goal setting were the most frequently used features, whereas gamification and assessment were used the least frequently. The intervention strategies that effectively reduce mobile phone use and MMPU included using grayscale mode, app limit features, and mixed interventions. Overall, users tended to accept these apps, as indicated by sentiment scores ranging from 61 to 86 out of 100. CONCLUSIONS: This study demonstrates that app-based management has the potential to reduce mobile phone use and MMPU. However, further research is required to evaluate the effectiveness of app-based interventions. Collaborations, Safety and Security Science

ChatGPT is a highly advanced AI language model that has gained widespread popularity. It is trained to understand and generate human language and is used in various applications, including automated customer service, chatbots, and content generation. While it has the potential to offer many benefits, there are also concerns about its potential for misuse, particularly in relation to providing inappropriate or harmful safety-related information. To explore ChatGPT's (specifically version 3.5) capabilities in providing safety-related advice, a multidisciplinary consortium of experts was formed to analyse nine cases across different safety domains: using mobile phones while driving, supervising children around water, crowd management guidelines, precautions to prevent falls in older people, air pollution when exercising, intervening when a colleague is distressed, managing job demands to prevent burnout, protecting personal data in fitness apps, and fatigue when operating heavy machinery. The experts concluded that there is potential for significant risks when using ChatGPT as a source of information and advice for safety-related issues. ChatGPT provided incorrect or potentially harmful statements and emphasised individual responsibility, potentially leading to ecological fallacy. The study highlights the need for caution when using ChatGPT for safety-related information and expert verification, as well as the need for ethical considerations and safeguards to ensure users understand the limitations and receive appropriate advice, especially in low- and middle-income countries. The results of this investigation serve as a reminder that while AI technology continues to advance, caution must be exercised to ensure that its applications do not pose a threat to public safety., Safety and Security Science, Multi Actor Systems, System Engineering, Ethics & Philosophy of Technology

This study looks at the positive effect of psychological hardiness on organizational pride, with a particular emphasis on the mediating function of thriving at work along with the moderating function of perceived organizational support. Past research show that psychological hardiness benefits individuals and organizations. Based on resilience and organizational support theories, we argue that people with high psychological hardiness thrive at work, which enhances organizational pride. Perceived organizational support can boost the benefits of psychological hardiness on thriving at work. We used a quantitative research strategy, surveying 331 individuals from diverse service sector industries. This study employed structural equation modeling to examine the associations among variables under study. The findings indicate that there is a significant mediating effect of thriving at work on the relationship between psychological hardiness and organizational pride. Moreover, we found that when POS is high the positive relationship between psychological hardiness and thriving at work becomes strengthen. Results of the study necessitate to cultivate an environment of support within the organizations along with efforts to establish training programs for enhancing psychological hardiness of employees. These efforts would generate feelings of thriving at work ultimately leading to organizational pride.

Maladaptive Mobile Phone Use (MMPU) (also known as Smartphone Addiction, Nomophobia, Fear of Missing Out, or Problematic Mobile Phone Use) is a growing mental health problem. However, the health and safety consequences of MMPU remain unexplored in many real-life contexts. A potential setting where MMPU may have some negative repercussions is on the road. It is well established that road users (e.g., drivers, motorcyclists, pedestrians, and cyclists) increasingly injure themselves or others due to distractions such as phone use while on the road. Emerging research suggests that MMPU is a possible determinant of this risky behaviour. Therefore, it is essential to investigate the relationship between MMPU and mobile phone use behaviour on the road, as it could help guide and improve interventions aimed at increasing road safety. This systematic review investigated the relationship between maladaptive mobile phone use and mobile phone use behaviour on the road in terms of attitudes and risk perception, intention, phone use engagement, performance changes, and safety outcomes. A total of 44 studies were identified with 47 unique samples of road users, of which 68.1% (32/47) were comprised of drivers, 19.1% (9/47) were pedestrians, 8.5% (4/47) were unspecified road users, and there was one group of motorcyclists and cyclists. Our findings confirmed that MMPU is related to risky behaviour on the roads. In the 29 studies considering observed or self-reported behaviour, 90.9% (30/33) found that road users who scored higher in MMPU are more likely to use their phones on the road as cyclists, drivers, motorcyclists, and pedestrians. Of the nine studies that analysed performance changes, 55.6% (5/9) showed evidence that MMPU changes the performance of road users engaging in mobile phone use, meaning that there is evidence suggesting that MMPU determines the level of impairment. Of the nine studies that analysed the safety-related-outcomes, 66.7% (6/9) found that the higher the, Safety and Security Science

ChatGPT is a highly advanced AI language model that has gained widespread popularity. It is trained to understand and generate human language and is used in various applications, including automated customer service, chatbots, and content generation. While it has the potential to offer many benefits, there are also concerns about its potential for misuse, particularly in relation to providing inappropriate or harmful safety-related information. To explore ChatGPT's (specifically version 3.5) capabilities in providing safety-related advice, a multidisciplinary consortium of experts was formed to analyse nine cases across different safety domains: using mobile phones while driving, supervising children around water, crowd management guidelines, precautions to prevent falls in older people, air pollution when exercising, intervening when a colleague is distressed, managing job demands to prevent burnout, protecting personal data in fitness apps, and fatigue when operating heavy machinery. The experts concluded that there is potential for significant risks when using ChatGPT as a source of information and advice for safety-related issues. ChatGPT provided incorrect or potentially harmful statements and emphasised individual responsibility, potentially leading to ecological fallacy. The study highlights the need for caution when using ChatGPT for safety-related information and expert verification, as well as the need for ethical considerations and safeguards to ensure users understand the limitations and receive appropriate advice, especially in low- and middle-income countries. The results of this investigation serve as a reminder that while AI technology continues to advance, caution must be exercised to ensure that its applications do not pose a threat to public safety.

Aim: To conduct a systematic synthesis of existing evidence reviews on interventions to enhance medication safety in residential aged-care settings (RACS) to establish and compare their effectiveness. Method: This umbrella review included examination of meta-analyses, scoping and systematic reviews. Four electronic databases were examined for eligible reviews. Two authors critically appraised those meeting the inclusion criteria using the Joanna Briggs Institute Critical Appraisal Instrument. Results: Fifteen reviews covering 171 unique, primary studies were included. Of the variety of interventions identified in the literature, five main categories of interventions were commonly reported to be effective in promoting medication safety in RACS (medication review, staff education, multidisciplinary team meetings, computerised clinical decision support systems and miscellaneous). Most reviews showed mixed evidence to support intervention effectiveness due to the significant heterogeneity between studies in their sites, sample sizes and intervention periods. In all intervention categories, pharmacists' collaboration was most beneficial, showing definitive evidence for improving medication safety and quality of prescribing in RACS. Eight reviews recommended multicomponent interventions, particularly medication reviews and staff education, but specific details were infrequently provided. Only five reviews presented insights into implementation facilitators and barriers, while the sustainability of interventions was only discussed in one review. Conclusion: There is strong evidence to support the four main categories of interventions identified. However, limited details are available regarding the most appropriate design and implementation of multicomponent interventions and the sustainability of all interventions, thus solid recommendations cannot be made. Future research in this field should focus on producing theoretically informed, methodologica

Despite the ubiquitous use of social media platforms by people of all ages, there is limited synthesis of evidence on their effect on family connectedness. This systematic review assesses the quantitative evidence around relationship between social media use and family connectedness. We searched articles published between January 2010 and April 2020. Nine of the 14 included studies examined the effect of social media on parent-child communication, while the rest explored the effect on broader family relationships. Overall evidence is mixed, highlighting some aspects of social media use that may strengthen family connectedness, while others that may negatively impact meaningful interactions within families. This review illustrates the complex nature of this research domain with limited consensus on how to measure family connectedness in context of social media use. We discuss the limitations of the studies and the greater need for high-quality research in the fast-paced world of social media.

Purpose: This study aims to explain the value co-creation and co-destruction practices of older adults in an online community (OC). Design/methodology/approach: Adopting practice theory and service-dominant logic as a theoretical perspective, this paper examined an OC of older adults by conducting an inductive thematic analysis of the interactions of the participants in the community. Findings: The analysis revealed older adults engage with three value co-creation plus one value co-destruction practices in the OC including, communal coping practices, happiness creation practices, social capital generation practices and disparaging practices for older adults. Research limitations/implications: Illustrated in a conceptual model, this study extends previous work evidencing OCs serve as a platform for value co-creation and value co-destruction activities in the context of older adults. Further, it suggests OCs facilitate resilience of older adults through value co-creation practices. Recognition of value co-destruction in OCs is critical as it is detrimental to the resilience of older adults. This study provides the needed foundation to advance knowledge on the use of OCs by older adults and suggests future research directions. Practical implications: Identifying co-creation and co-destruction practices of older adults in OCs enables service providers (e.g. caregivers) to engage better in online value co-creation practices. Further, the findings of this study address one of the main priorities of service science to investigate the impact of value co-creation on well-being. Originality/value: Despite the significant engagement of older adults in OCs, there is a lack of enough knowledge in the literature regarding value co-creation and co-destruction practices of older adults in OCs. This study addressed this gap by explaining how older adults co-create and co-destruct value in online spaces.

The aim of this paper is twofold. Firstly, to investigate the potential benefits of online health communities (OHCs) for informal caregivers by conducting a systematic literature review. Secondly, to identify the relationship between the potential benefits of OHCs and resilience factors of older adults. Performing a thematic analysis, we identified the potential benefits of OHCs for informal caregivers of older adults, including two salient themes: (a) caregivers sharing and receiving social support and (b) self and moral empowerment of caregivers. Then, we uncovered how these potential benefits can support resilience of older adults. Our findings show that sharing and receiving of social support by informal caregivers, and self and moral empowerment of informal caregivers in OHCs, can support four resilience factors among older adults, including self-care, independence, altruism and external connections. This review enables a better understanding of OHCs and Gerontology, and our outcomes also challenge the way healthcare and aged-care service providers view caregivers and older adults. Furthermore, the identified gap and opportunities would provide avenues for further research in OHCs.

Aim This study aimed to determine the impact of alert frequency and relevance on alert dwell time. Method A 2 × 3 design was used where 127 university students completed 60 prescribing tasks and were presented with a variable frequency of computerized alerts (low, medium and high) with variable relevance (low and high). Participants were instructed to override an alert if it was not relevant to their prescription, and to cancel the order if the alert signalled an error in their order. Results Participants presented with a small number of alerts spent more time attending to alert content than participants presented with a medium or high number of alerts (respectively median 15.6 s vs 10.8 vs 10.2 s). Alert relevance had no impact on alert dwell time. Alerts requiring an override response were 4.5 times more likely to be correctly actioned than alerts requiring the order to be cancelled. Discussion Dwell time was influenced by alert frequency, with greater exposure to alerts associated with shorter dwell times. We hypothesize that this was because participants came to learn that spending time on alert information was unnecessary. We propose that when users experience no consequences or feedback from overriding alerts they quickly learn that this action is more efficient and so more rewarding than taking any other action.

Background â Transdermal medication patches have caused serious adverse events in residential aged care facilities (RACFs). Preliminary research suggests that facilities are using a workaround consisting of manually entered reminders in their electronic medication administration records (eMARs) to prompt staff to check and remove patches, because the eMAR does not support these tasks. However, the prevalence and factors associated with use of this workaround among facilities is unknown. Objectives â The objectives of this study were to (1) examine the frequency and consistency with which manual reminders to check and remove transdermal patches were used in facility eMARs, and (2) identify resident and facility factors associated with reminder use, to inform eMAR redesign. Methods â This was a retrospective cross-sectional analysis of eMAR data from 66 Australian RACFs including 4,787 permanent residents, aged ≥65 years in January 2017. Prevalence of the use of reminders to check and remove patches, and consistency in their application within facilities were examined. Generalized estimating equations were used to determine factors associated with use of manual reminders. Results â One in five (n = 937) residents used a patch, and 83.6% of patches contained opioids, a high-risk medicine. 56.9% of facilities implemented manually entered check patch reminders in the eMAR, and 72.3% implemented remove reminders. The reminders were applied inconsistently, with only half of these facilities having reminders for all residents with patches. Residents in facilities in regional areas were more likely to have a check reminder compared with those in major cities (adjusted odds ratio = 4.72 [95% confidence interval: 1.69-13.20]). Conclusion â Transdermal patches containing high-risk medicines are frequently used in RACFs, but their safe administration is not supported by a widely implemented eMAR. The frequent, but inconsistent use of a workaround to manually enter reminders i

Background: Clinical documentation is a fundamental component of patient care. The transition from paper based to electronic medical records/electronic health records has highlighted a number of issues associated with documentation practices including duplication. Developing new ways to document the care provided to patients and in turn, persuading clinicians to accept a change, must be supported by evidence that a change is required. In Australia, there has been a limited number of studies exploring the clinical documentation practices and beliefs of clinicians. Objective: To gain an in-depth understanding of clinician documentation practices. Method: A qualitative design using semi-structured interviews with clinicians (allied health professionals, doctors (physicians) and nurses) working in a tertiary-level hospital in South-East Queensland, Australia. Results: Several themes emerged from the data: environmental factors, including departmental policy and systemic issues, and personal factors, including verification, clinical reasoning and experience influencing documentation practices. Conclusion: Our study identified that the documentation practices of clinicians are complex, being driven by both environmental and systemic factors and personal factors. This in turn leads to duplication and some redundancy. The documentation burden of duplication could be reduced by changes in policy, supported by multidisciplinary documentation procedures and electronic systems aligned with clinician workflows, while retaining some flexible documentation practices. The documentation practices of individuals, when considered from the perspective of enhancing quality care, are considered legitimate and therefore will continue to form part of the health (medical) record regardless of the format.

BACKGROUND: Increased access to the internet has facilitated widespread availability of health information. Thus, electronic health (eHealth) literacy-the ability to seek, find, understand, and appraise health information from electronic resources and apply that knowledge in making a health-related decision-is a crucial skill. Despite the increasing use of the internet as a source of health information in developing countries, only a few studies have examined the eHealth literacy of young adults, who frequently use the internet to access health information in these developing countries. OBJECTIVE: The aim of this study was to assess the patterns of internet use and eHealth literacy levels among university students pursuing a non-health-related degree in Pakistan. We also examined the association of the eHealth literacy levels of these young adults with their physical activity levels and dietary supplement intake. METHODS: Students from 2 leading engineering universities in Pakistan were invited to participate in a cross-sectional anonymous web-based survey in order to collect data on their internet use, eHealth literacy, and dietary supplement intake. Of the 900 eligible university students who were invited to participate, 505 (56.1%) students who completed the questionnaire were included in the analysis. The findings were converted to median values and frequency analyses were performed. The associations between the variables were determined using the chi-square test; P≤.05 was considered significant. RESULTS: In this study, the median eHealth literacy scale (eHEALS) score was 29, which did not vary across gender. The most common type of health-related information that was searched by the participants was that related to maintaining a healthy lifestyle (305/505, 60.4%). Participants with high eHEALS scores were those who used the internet frequently for finding people with similar health issues (P<.0

Background: Pakistan has one of the highest reported incidence of Vitamin D deficiency in studies conducted worldwide. However, there has been very limited exploration of Vitamin D related knowledge, attitudes and practices among healthy youth in Pakistan. Methods: A cross-sectional survey was conducted among youth (aged > 16 years) from two engineering universities in Pakistan. Participants were asked questions on their concern about Vitamin D levels, testing, and supplementation practices. Knowledge was examined using questions about food sources, health benefits and factors affecting Vitamin D production within the human body. Of the 900 eligible students invited to participate, 505 (56%) completed the questionnaire and were included in the analysis. Results: Only 9% participants were able to identify the correct food sources of Vitamin D, 33% were aware of the bone health benefits (bone health and calcium absorption) of Vitamin D and 36% identified sunlight exposure as a factor influencing Vitamin D production. Knowledge about food sources and health benefits of Vitamin D was not associated with gender and individuals concern about their levels. Those tested and taking supplements were more likely to identify bone related health benefits and factors affecting Vitamin D production. Forty percent male and 52% female students expressed concern that their Vitamin D levels were too low. However, 72% participants reported that they had never been tested for Vitamin D levels. Use of supplements was significantly higher among female students (F = 52% vs M = 37%; P = 0.003). Those who had been tested for Vitamin D deficiency were more likely to take supplements. Conclusion: Despite being identified as a high-risk population, knowledge about Vitamin D was limited among university students. Interventions are needed to increase awareness about the importance of Vitamin D for health, including the need for ex

Objectives: 27% of children under age 6 were using private health services with full or partial fee for services although they have been granted health insurance coverage by the Vietnamese government if they go to public providers. Therefore, it is important to understand what makes these children go to private over public providers. This study aims to examine predisposing, enabling (income per capita by quintiles, education level of the household other than health insurance) and medical need factors associated with the choice of private over public healthcare services in Vietnamese children under age 6. Methods: Using Andersen Model of Health Services Utilization as a thematic framework, this study applied binary logistic regression models of private and public health service utilization, using nationally representative data from the Vietnam Household Living Standards Survey 2016. Results: 2898 children under age 6 (50.2% male, 68% living in rural areas and 80.2% ethnic majority) were included in the study. Private healthcare services are more likely to be used by children who are living in urban areas while public healthcare services are preferred by children living in the Midland and Mountainous area. Income per capita does not correlate with the use of private over public health care services. However, children living in a household with education of university degree or higher are more likely to use public healthcare services. In terms of medical needs, the odds of using private over public services are 44 times higher for non-severe illness (95% CI: 25.9 - 74.6, p<0.001) than for vaccinations, followed by health check-ups with 22 times higher (95% CI: 12.3 - 39.7, p<0.001). Conclusions: The private health services are more likely to be used by children who live in urban area and who need non-severe treatment or health check-ups.

Objective: To conduct a systematic synthesis of the literature evaluating the use of the Internet and social media by people with bladder cancer (BCa) and their carers, and to synthesize the evidence on the quality of available online resources for patients with BCa. Methods: We selected studies published between January 2000 and September 2018, written in the English language and meeting the inclusion criteria. Data sources included PubMed, PsycINFO, EMBASE, Web of Science and Scopus. Results: A total of 15 studies were included in the review. Four studies explored patterns of Internet use among patients with BCa, five studies investigated social media use related to BCa and six studies evaluated the quality of online resources available for patients with BCa. Evidence in all these three dimensions was limited in its ability to establish rigorously if use of the Internet, social media and online resources for BCa is effective in improving the care outcomes for patients with BCa. Conclusion: Our review emphasizes the forgotten status of BCa by establishing that, despite its high global incidence, it remains underrepresented in the building of evidence on patient information needs and the possible role of online spaces. Our synthesis establishes that further research is needed to examine the full impact of online information and social media use on the health management of people with BCa.

This book offers a detailed account of a range of mHealth initiatives across South, Southeast and East Asia. It provides readers with deep insights into the challenges such initiatives face on the ground, and a view of the diverse cultural contexts shaping strategies for overcoming these challenges. The book brings together various discussions on the broader mHealth literature, and demonstrates how a research focus on diverse Asian contexts influences the success and/or failure of current mHealth initiatives. It also highlights the important roles social scientists can play in advancing theoretical approaches, as well as planning, implementing and evaluating mHealth initiatives. The book is a valuable resource for project planners, policy developers in NGOs and government institutions, as well as academics, researchers and students in the fields of public health, communications and development studies.

mHealth solutions represent an exciting new frontier in the fight against myriad health challenges faced in the developing world, where the use of mobile phones has become pervasive across various socioeconomic boundaries. The principal users of these solutions are frontline healthcare workers; mostly women, often working at the lowest rung of health hierarchy. The distinctive value of this workforce lies in its ability to successfully deliver health services whilst being sensitive to the culture and context of their communities. Since these women are from the client communities, they can speak to them in ways outsiders cannot. Using a contextualized case study of lady health workers (LHWs) working in rural areas of Pakistan, this chapter demonstrates how the potential represented by such frontline health workers can be maximized. To this end, it draws upon in-depth longitudinal qualitative accounts of eight LHWs involved in a 2-year pilot mHealth project to improve antenatal health care. This chapter uncovers how sociocultural barriers—such as prohibitive financial concerns and gender-based discrimination— inhibit acceptance of mHealth solutions in Pakistan. The study found that these barriers adversely impact both LHWs’ initial adoption of mobile devices as well their inclination to continue using mHealth solutions. This chapter explores how macro- and micro-level communication strategies can be used to ease these barriers. It also explores how LHWs themselves can use mobile technology to better connect with their client communities. If mHealth is to be the brave new frontier in the domain of health innovations, we need to do more to understand the finer points of its contextually sensitive applications. This chapter seeks to explore how this can become a reality for rural areas of Pakistan.

This book offers a detailed account of a range of mHealth initiatives across South, Southeast and East Asia. It provides readers with deep insights into the challenges such initiatives face on the ground, and a view of the diverse cultural contexts shaping strategies for overcoming these challenges. The book brings together various discussions on the broader mHealth literature, and demonstrates how a research focus on diverse Asian contexts influences the success and/or failure of current mHealth initiatives. It also highlights the important roles social scientists can play in advancing theoretical approaches, as well as planning, implementing and evaluating mHealth initiatives. The book is a valuable resource for project planners, policy developers in NGOs and government institutions, as well as academics, researchers and students in the fields of public health, communications and development studies.

Background: The dynamic environment that characterizes patient care in hospitals requires extensive communication between staff. Electronic status board applications are used to improve the flow of communication in hospitals. To date there has been limited work exploring the adoption of these applications in general acute ward settings. Aim: This study aimed to identify barriers to the adoption of an electronic patient journey board (EPJB)1 application in acute wards of a hospital. Method: Data were collected at a large public teaching hospital in Sydney, Australia. The EPJB was implemented across all hospital wards with the aim of improving multidisciplinary communication in wards. Observations (29.5 h) and contextual interviews (n = 33) with hospital staff were conducted in two acute wards of the hospital. Results: Two manual whiteboards were used on wards, in addition to the EPJB, to compensate for information not being available or accessible on the EPJB. Despite the stated purpose of the EPJB, the tool did not appear to support team communication on wards. Barriers to adoption and optimal use of the EPJB included inappropriate location and configuration of the system, limitations in information timeliness, quality and lack of customisation (for different user groups), inconsistent information updates and the absence of a shared understanding of the purpose of the EPJB among the various user groups. Conclusion: Multiple socio-technical barriers influenced uptake and optimal use of the EPJB by healthcare providers. Engaging users early in the design and implementation of electronic status board applications is required to ensure effective use of these complex interventions on general wards.

Abstract Closed-loop electronic medication management systems (EMMS) are recognised as an effective intervention to improve medication safety, yet evidence of their effectiveness in hospitals is limited. Few studies have compared medication turnaround time for a closed-loop electronic versus paper-based medication management environment. Objective To compare medication turnaround times in a paper-based hospital environment with a digital hospital equipped with a closed-loop EMMS, consisting of computerised physician order entry, profiled automated dispensing cabinets packaged with unit dose medications and barcode medication administration. Method Data were collected during 2 weeks at three private hospital sites (one with closed-loop EMMS) within the same organisation network in Queensland, Australia. Time between scheduled and actual administration times was analysed for first dose of time-critical and non-critical medications located on the ward or sourced via pharmacy. Key findings Medication turnaround times at the EMMS site were less compared to the paper-based sites (median, IQR: 35 min, 8–57 min versus 120 min, 30–180 min, P < 0.001). For time-critical medications, 77% were administered within 60 min of scheduled time at the EMMS site versus 38% for the paper-based sites. Similar difference was observed for non-critical medications, 80% were administered within 60 min of their scheduled time at the EMMS site versus 41% at the paper-based facilities. Conclusion The study indicates medication turnaround times utilising a closed-loop EMMS are less compared to paper-based systems. This improvement may be attributable to increased accessibility of medications using automated dispensing cabinets and electronic medication administration records flagging tasks to nurses in real time.

In Pakistan, the number of educated people at graduate level is quite high but according to that number employments are limited. This causes job dissatisfaction and also abolishes the relationship with the co-workers (Farooq, Ahmad, & Ali, 2008). This study aimed to explore the effect of first low wages’ job on self-esteem of Pakistani fresh graduates in terms of satisfaction level, hope level, productivity and wellbeing using a constructivist grounded theory approach (Charmaz, 2014). In this study qualitative approach is used. For data collection, purposive sampling technique was used along with the semi structured interviewing from local private schools. Four female teachers with an age range of 20- 25 years were the sample of the study. One-to-one interviews with the participants were conducted after taking their permission to participate voluntarily in the research, and tape recording of their interviews for transcription of data. Grounded theory approach was used to analyze collected data as no work has been done in Pakistan in this context and I want to develop theory which will be helpful in employer’s context and working satisfaction. For reliability check, triangulation method was used. The theory of self-esteem grounded here suggested that first low wages’ job for the Pakistani fresh graduates has negative effect on the level of hope and satisfaction whereas their productivity and wellbeing has positive effect on them.

In Pakistan, the number of educated people at graduate level is quite high but according to that number employments are limited. This causes job dissatisfaction and also abolishes the relationship with the co-workers (Farooq, Ahmad, & Ali, 2008). This study aimed to explore the effect of first low wages’ job on self-esteem of Pakistani fresh graduates in terms of satisfaction level, hope level, productivity and wellbeing using a constructivist grounded theory approach (Charmaz, 2014). In this study qualitative approach is used. For data collection, purposive sampling technique was used along with the semi structured interviewing from local private schools. Four female teachers with an age range of 20- 25 years were the sample of the study. One-to-one interviews with the participants were conducted after taking their permission to participate voluntarily in the research, and tape recording of their interviews for transcription of data. Grounded theory approach was used to analyze collected data as no work has been done in Pakistan in this context and I want to develop theory which will be helpful in employer’s context and working satisfaction. For reliability check, triangulation method was used. The theory of self-esteem grounded here suggested that first low wages’ job for the Pakistani fresh graduates has negative effect on the level of hope and satisfaction whereas their productivity and wellbeing has positive effect on them.

Introduction There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

Objective - To examine the impact of an electronic Results Acknowledgement (eRA) system on emergency physicians’ test result management work processes and the time taken to acknowledge microbiology and radiology test results for patients discharged from an Emergency Department (ED). Methods - The impact of the eRA system was assessed in an Australian ED using: a) semi-structured interviews with senior emergency physicians, and; b) a time and motion direct observational study of senior emergency physicians completing test acknowledgment pre and post the implementation of the eRA system. Results - The eRA system led to changes in the way results and actions were collated, stored, documented and communicated. Although there was a non-significant increase in the average time taken to acknowledge results in the post period, most types of acknowledgements (other than simple acknowledgements) took less time to complete. The number of acknowledgements where physicians sought additional information from the Electronic Medical Record (EMR) rose from 12% pre to 20% post implementation of eRA. Conclusions - Given that the type of results are unlikely to have changed significantly across the pre and post implementation periods, the increase in the time physicians spent accessing additional clinical information in the post period likely reflects the greater access to clinical information provided by the integrated electronic system. Easier access to clinical information may improve clinical decision making and enhance the quality of patient care. For instance, in situations where a senior clinician, not initially involved in the care process, is required to deal with the follow-up of non-normal results.

Free to read on publisher website Community aged care in Australia is facing both challenges and opportunities with the introduction of consumer-directed care and its goal to provide clients with greater choice and control over their care services. Such policy changes impact not only aged care organisations, but front line staff who manage and deliver care. This study investigated the work of front line staff and their perceptions of the impact of a changing policy landscape. Focus groups were conducted with thirteen care workers and six case managers from one Australian aged care organisation. The data revealed valuable information about the: daily activities of front line staff; information exchange mechanisms facilitating front line work; management of clients and client relationships; and implications of policy and organisational changes on front line work and clients. Front line staff highlighted the importance of care coordination, communication and continuity of care delivery, all of which impact on client relationships and quality of care. For aged care organisations and policy makers, the findings identify important areas for consideration when making decisions about changes to community care, including the key role of front line staff in fostering client relationships, providing consistency and continuity, balancing the needs and expectations of clients, and providing support and advocacy of care options.

Aim To evaluate usability of a decision support system for telephone triage nurses. Background Telephone triage by nurses has become an internationally accepted form of health service delivery to cope with increasing demands on primary and emergency care. Decision support software systems are used by nurses to facilitate the telephone triage process, yet, the usability of these systems is rarely assessed. Method We applied a multi-method human factors approach to evaluate the usability of decision support software used by Healthdirect Australia nurses during telephone triage. Methods included: (1) stakeholder discussions; (2) heurstic analysis by two independent experts across ten usability heuristics; and (3) interviews with system end users (n = 9). A list of heuristic violations with their severity ratings was developed. Qualitative content analysis of the interview transcripts was undertaken to validate the results of the heuristic evaluation. Findings Forty one unique heuristic violations were identified in the interface design of the decision support software with median severity of 2.25 (range 0–4, with 0 = no problem to 4 = catastrophic problem). The highest number of violations was observed for flexibility and efficiency of use (n = 12, median severity = 2.5) and for aesthetic and minimalist design (n = 11, median severity = 2). Interviews with nurses verified many of the violations identified in the heuristic analysis. Improving the navigational design of the system for flexibility and efficiency of use was identified as necessary by both the experts and end users. Conclusion In adopting a multi-method human factors approach, we identified a number of system design features which may be impacting on the safety and efficiency of the nurse telephone triage process. Addressing the identified usability issues and using feedback from end-users to modify the decision support system would optimise system use and so improve the t

Quantifying alert override has been the focus of much research in health informatics, with override rate traditionally viewed as a surrogate inverse indicator for alert effectiveness. However, relying on alert override to assess computerized alerts assumes that alerts are being read and determined to be irrelevant by users. Our research suggests that this is unlikely to be the case when users are experiencing alert overload. We propose that over time, alert override becomes habitual. The override response is activated by environmental cues and repeated automatically, with limited conscious intention. In this paper we outline this new perspective on understanding alert override. We present evidence consistent with the notion of alert override as a habitual behavior and discuss implications of this novel perspective for future research on alert override, a common and persistent problem accompanying decision support system implementation.

Health information management (HIM) is the heart of a health organization; with each beat, it supplies much-needed information to users such as physicians, staff nurses, allied health professionals, health administrators, insurance companies and government health departments. The traditional role of a HIM professional has been to maintain organized and accurate data, which is available for patient care and for management purposes. HIM professionals undertake numerous tasks to fulfil this goal. HIM specialists, therefore, need to integrate a variety of skills, such as a strong knowledge of medical terminology and disease processes, application of clinical classification systems, excellent managerial skills and computer and information technology (IT) expertise, to manage the range of health information and human services for which they are responsible. However, the growth in information technology has had a huge influence on HIM responsibilities. Technology has automated many of the routine functions of data collection and thus the role of the HIM professional has become more divergent and strategic in nature, particularly with the increasing development of electronic health records. Records must now be made available to increasing numbers of health care providers and various other parties simultaneously. The changing role of HIM personnel in health care has increased the need for HIM professionals who understand the use and meaning of health record information as well as the language used to describe the reality of clinical treatments and financial operations. In addition, more employment pathways and opportunities have become available for HIM professionals. However, many HIM experts still believe that providing a simple answer to the question, “What is HIM?” is one of the greatest challenges in the current electronic world. HIM professionals believe that, unless they can clearly articulate what they do and what makes them unique, the profession will struggle to co

Background - Gout is an arthritic condition that is characterised by extremely painful, debilitating acute attacks and eventual joint and organ damage if not controlled. Despite the availability of very effective therapies that, if adhered to, will prevent acute attacks and long-term damage, the disorder is increasingly prevalent. There is an urgent need to improve self-management of gout. Objectives - Mobile health (mHealth) applications (‘apps’), designed to facilitate management of chronic conditions, present novel opportunities for supporting patient self-management of gout. The aim of this review was to assess features of available gout management apps designed to assist consumers in managing their gout and their consistency with guidelines for gout management. Methods - English-language, smart-device apps designed to assist self-management of gout were identified using search term “gout” and downloaded from Apple and Google Play app stores. To be included in the review, apps had to allow users to monitor their gout disease (e.g. serum uric acid (sUA) tracking, record acute attacks) and/or educate patients about gout. Investigators derived patient-focused recommendations for gout management from contemporary guidelines. Features of reviewed apps were independently assessed by two reviewers for their facilitation of these recommendations. Results - The search identified 57 apps possibly relevant to gout management, of which six met the inclusion criteria. One app incorporated all recommendations for patient-focused gout management from guidelines including monitoring sUA, recording attacks and lifestyle advice. However, the majority of these elements were not functional within the app, and instead required users to manually complete printouts. Conclusions - Currently, only one app exists that includes all recommendations to facilitate patient self-management of gout, however some features can only be actioned manually. G

Background Limited studies have explored the actual usage of the ‘after hours GP helpline’ (AGPH). Objective/s The objectives of the article are to describe medication-related calls to the AGPH and compare callers’ original intentions versus the advice provided by the general practitioner (GP). Methods We performed a detailed descriptive statistical analysis of medication-related queries received by the AGPH in 2014. Results In 2014, 13,600 medication-related calls were made to the national AGPH. For 86.56% of calls, GPs advised callers to either self-care only, or self-care overnight and see their GP during business hours. Of the 1442 calls where the caller had originally intended to visit the emergency department (ED), 76.70% were advised by GPs to self-care, and only 5.48% were advised to call 000 or visit an ED. Overall, less than 2.26% of callers were directed to the ED, despite 10.60% of people originally calling with this intention. Discussion The availability of an after-hours service potentially prevented 1363 people from unnecessarily attending an ED and directed 228 people who had originally underestimated the seriousness of their condition to an ED.

Objective(s) - To identify system-related risk factors perceived to contribute to prescribing errors in Australian long-term care settings, that is, residential aged care facilities (RACFs). Design and setting - The study used qualitative methods to explore factors that contribute to unsafe prescribing in RACFs. Data were collected at three RACFs in metropolitan Sydney, Australia between May and November 2011. Participants included RACFs managers, doctors, pharmacists and RACFs staff actively involved in prescribing-related processes. Methods included non-participant observations (74 h), in-depth semistructured interviews (n=25) and artefact analysis. Detailed process activity models were developed for observed prescribing episodes supplemented by triangulated analysis using content analysis methods. Results - System-related factors perceived to increase the risk of prescribing errors in RACFs were classified into three overarching themes: communication systems, team coordination and staff management. Factors associated with communication systems included limited point-of-care access to information, inadequate handovers, information storage across different media (paper, electronic and memory), poor legibility of charts, information double handling, multiple faxing of medication charts and reliance on manual chart reviews. Team factors included lack of established lines of responsibility, inadequate team communication and limited participation of doctors in multidisciplinary initiatives like medication advisory committee meetings. Factors related to staff management and workload included doctors’ time constraints and their accessibility, lack of trained RACFs staff and high RACFs staff turnover. Conclusions - The study highlights several system-related factors including laborious methods for exchanging medication information, which often act together to contribute to prescribing erro

Background - Medication is the most common intervention in health care, and written medication information can affect consumers’ medication-related behavior. Research has shown that a large proportion of Australians search for medication information on the Internet. Objective - To evaluate the medication information content, based on consumer medication information needs, and usability of 4 Australian health websites: Better Health Channel, myDr, healthdirect, and NPS MedicineWise . Methods - To assess website content, the most common consumer medication information needs were identified using (1) medication queries to the healthdirect helpline (a telephone helpline available across most of Australia) and(2) the most frequently used medications in Australia. The most frequently used medications were extracted from Australian government statistics on use of subsidized medicines in the community and the National Census of Medicines Use. Each website was assessed to determine whether it covered or partially covered information and advice about these medications. To assess website usability, 16 consumers participated in user testing wherein they were required to locate 2 pieces of medication information on each website. Brief semistructured interviews were also conducted with participants to gauge their opinions of the websites. Results - Information on prescription medication was more comprehensively covered on all websites (3 of 4 websites covered 100% of information) than nonprescription medication (websites covered 0%-67% of information). Most websites relied on consumer medicines information leaflets to convey prescription medication information to consumers. Information about prescription medication classes was less comprehensive, with no website providing all information examined about antibiotics and antidepressants. Participants (n=16) were able to locate medication information on websites in most cases (accuracy ranged from 84% to 9

Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care.

The aim of this study was to examine the actions of geographically dispersed process stakeholders (doctors, community pharmacists and RACFs) in order to cope with the information silos that exist within and across different settings. The study setting involved three metropolitan RACFs in Sydney, Australia and employed a qualitative approach using semi-structured interviews, non-participant observations and artefact analysis. Findings showed that medication information was stored in silos which required specific actions by each setting to translate this information to fit their local requirements. A salient example of this was the way in which community pharmacists used the RACF medication charts to prepare residents' pharmaceutical records. This translation of medication information across settings was often accompanied by telephone or face-to-face conversations to cross-check, validate or obtain new information. Findings highlighted that technological interventions that work in silos can negatively impact the quality of medication management processes in RACF settings. The implementation of commercial software applications like electronic medication charts need to be appropriately integrated to satisfy the collaborative information requirements of the RACF medication process.

Introduction Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. Methods A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. Results The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues.We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Discussion Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

Medication safety is a pressing concern for residential aged care facilities (RACFs). Although failures in information exchange (IE) between multiple providers have been identified as a primary cause of medication errors, there is limited evidence about the way IE impacts on medication safety. This thesis aimed to explicate the IE processes across different stages of RACF medication management and identify the gaps in these processes which increase the risk of medication errors. To achieve these aims, a naturalistic inquiry approach was employed. The research was conducted over two phases within the context of Australian RACF settings. A pilot study was conducted in one RACF to scope and describe the complex IE processes. This was followed by a multi-site study involving three RACFs to investigate gaps in IE processes across key stages of medication management and the associated risks for medication errors. Data were collected over a period of seven months. Methods included direct observations (89 hours), semi-structured interviews (n=23) and artefact analysis. Process mapping and thematic coding were used to analyse the triangulated data. Medication management in RACFs is organised around a series of information-intensive tasks. These tasks are undertaken by the physically distributed team (RACF staff, general practitioners [GPs] and community pharmacists) relying on heterogeneous communication mediums and artefacts. Several gaps were identified in IE processes which often act together to hinder medication management. They include limited information access, double handling, limited communication bandwidth, manual auditing and inadequate information handover. Findings identify that different stages of medication management are executed in isolated organisational islands and do not interact in optimal ways. The absence of coordination mechanisms and a clear division of responsibilities increase medication safety risk. To address these gaps, multifaceted technologica

Health information technology (IT) can have a profound effect on the temporal flow and organisation of work. Yet research into the context, meaning and significance of temporal factors remains limited, most likely because of its complexity. This study outlines the role of communications in the context of the temporal and organizational landscape of seven Australian residential aged care facilities displaying a range of information exchange practices and health IT capacity. The study used qualitative and observational methods to identify temporal factors associated with internal and external modes of communication across the facilities and to explore the use of artifacts. The study concludes with a depiction of the temporal landscape of residential aged care particularly in regards to the way that work is allocated, prioritized, sequenced and coordinated. We argue that the temporal landscape involves key context-sensitive factors that are critical to understanding the way that humans accommodate to, and deal with health technologies, and which are therefore important for the delivery of safe and effective care.

Background Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. Methods The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May–September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. Results The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Conclusions Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in

E-health can facilitate communication and interactions among stakeholders involved in pandemic responses. Its implementation, nevertheless, represents a disruptive change in the healthcare workplace. Organisational preparedness assessment is an essential requirement prior to e-health implementation; including this step in the planning process can increase the chances of programme success. The objective of this study is to develop an e-health preparedness assessment model for pandemic influenza (EHPM4P). Following the Analytic Hierarchy Process (AHP), 20 contextual interviews were conducted with domain experts from May to September 2010. We examined the importance of all preparedness components within a fivedimensional hierarchical framework that was recently published. We also calculated the relative weight for each component at all levels of the hierarchy. This paper presents the hierarchical model (EHPM4P) that can be used to precisely assess healthcare organisational and providers' preparedness for e-health implementation and potentially maximise e-health benefits in the context of an influenza pandemic. Copyright © 2013 Inderscience Enterprises Ltd.

Medication information is a critical part of the information required to ensure residents' safety in the highly collaborative care context of RACFs. Studies report poor medication information as a barrier to improve medication management in RACFs. Research exploring medication work practices in aged care settings remains limited. This study aimed to identify contextual and work practice factors contributing to breakdowns in medication information exchange in RACFs in relation to the medication administration process. We employed non-participant observations and semi-structured interviews to explore information practices in three Australian RACFs. Findings identified inefficiencies due to lack of information timeliness, manual stock management, multiple data transcriptions, inadequate design of essential documents such as administration sheets and a reliance on manual auditing procedures. Technological solutions such as electronic medication administration records offer opportunities to overcome some of the identified problems. However these interventions need to be designed to align with the collaborative team based processes they intend to support.

Information exchange (IE) is a critical component of the complex collaborative medication process in residential aged care facilities (RACFs). Designing information and communication technology (ICT) to support complex processes requires a profound understanding of the IE that underpins their execution. There is little existing research that investigates the complexity of IE in RACFs and its impact on ICT design. The aim of this study was thus to undertake an in-depth exploration of the IE process involved in medication management to identify its implications for the design of ICT. The study was undertaken at a large metropolitan facility in NSW, Australia. A total of three focus groups, eleven interviews and two observation sessions were conducted between July to August 2010. Process modelling was undertaken by translating the qualitative data via in-depth iterative inductive analysis. The findings highlight the complexity and collaborative nature of IE in RACF medication management. These models emphasize the need to: a) deal with temporal complexity; b) rely on an interdependent set of coordinative artefacts; and c) use synchronous communication channels for coordination. Taken together these are crucial aspects of the IE process in RACF medication management that need to be catered for when designing ICT in this critical area. This study provides important new evidence of the advantages of viewing process as a part of a system rather than as segregated tasks as a means of identifying the latent requirements for ICT design and that is able to support complex collaborative processes like medication management in RACFs. © 2012 IEEE.

Background Poor clinical handover has been associated with inaccurate clinical assessment and diagnosis, delays in diagnosis and test ordering, medication errors and decreased patient satisfaction in the acute care setting. Research on the handover process in the residential aged care sector is very limited. Purpose The aims of this study were to: (i) Develop an in-depth understanding of the handover process in aged care by mapping all the key activities and their information dynamics, (ii) Identify gaps in information exchange in the handover process and analyze implications for resident safety, (iii) Develop practical recommendations on how information communication technology (ICT) can improve the process and resident safety. Methods The study was undertaken at a large metropolitan facility in NSW with more than 300 residents and a staff including 55 registered nurses (RNs) and 146 assistants in nursing (AINs). A total of 3 focus groups, 12 interviews and 3 observation sessions were conducted over a period from July to October 2010. Process mapping was undertaken by translating the qualitative data via a five-category code book that was developed prior to the analysis. Results Three major sub-processes were identified and mapped. The three major stages are Handover process (HOP) I “Information gathering by RN”, HOP II “Preparation of preliminary handover sheet” and HOP III “Execution of handover meeting”. Inefficient processes were identified in relation to the handover including duplication of information, utilization of multiple communication modes and information sources, and lack of standardization. Conclusion By providing a robust process model of handover this study has made two critical contributions to research in aged care: (i) a means to identify important, possibly suboptimal practices; and (ii) valuable evidence to plan and improve ICT implementation in residential aged care. The mapping of this process enabled analysis of gaps in information flow and

Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

Health challenges present arguably the most significant barrier to sustainable global development. The introduction of ICT in healthcare, especially the application of mobile communications, has created the potential to transform healthcare delivery by making it more accessible, affordable and effective across the developing world. However, current research into the assessment of mHealth from the perspective of developing countries particularly with community Health workers (CHWs) as primary users continues to be limited. The aim of this study is to analyze the contribution of mHealth in enhancing the performance of the health workers and its alignment with existing workflows to guide its utilization. The proposed research takes into account this consideration and aims to examine the task-technology alignment of mHealth for CHWs drawing upon the task technology fit as the theoretical foundation.

Health challenges present arguably the most significant barrier to sustainable global development. The introduction of ICT in healthcare, especially the application of mobile communications, has created the potential to transform healthcare delivery by making it more accessible, affordable and effective across the developing world. However, current research into the assessment of mHealth from the perspective of developing countries particularly with community Health workers (CHWs) as primary users continues to be limited. The aim of this study is to analyze the contribution of mHealth in enhancing the performance of the health workers and its alignment with existing workflows to guide its utilization. The proposed research takes into account this consideration and aims to examine the task-technology alignment of mHealth for CHWs drawing upon the task technology fit as the theoretical foundation.

Health challenges present arguably the most significant barrier to sustainable global development. The introduction of ICT in healthcare, especially the application of mobile communications, has created the potential to transform healthcare delivery by making it more accessible, affordable and effective across the developing world. However, current research into the assessment of mHealth from the perspective of developing countries particularly with community Health workers (CHWs) as primary users continues to be limited. The aim of this study is to analyze the contribution of mHealth in enhancing the performance of the health workers and its alignment with existing workflows to guide its utilization. The proposed research takes into account this consideration and aims to examine the task-technology alignment of mHealth for CHWs drawing upon the task technology fit as the theoretical foundation.