bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons from benchmarking environmental performance at automobile assembly plants
Authors: Rothenberg Sandra , Schenck Brian , Maxwell James
Published: January 2007

Purpose

The purpose of this paper is to better understand benefits and problems with different approaches to benchmarking environmental performance in manufacturing.

Design/methodology/approach

This paper shares the experience of a research program developing environmental benchmarking measures for the automobile industry.

Findings

In this paper, we categorize these options into four general categories: regulatory, gross emissions, efficiency, and life cycle. We found that firms emphasized different approaches to benchmarking depending upon regulatory context and company strategy. Product type, corporate and national culture, resource costs, stakeholder demands also all played a role in influencing their preferred benchmarking approach. Overall, the most robust environmental programs will incorporate elements of all four approaches.

Research limitations/implications

The primary limitation of this study is that it draws its data from only one industry. Another limitation of this paper is that it is focused primarily on performance benchmarking. Additional research needs to be done to understand the factors that influence a firm's choice of benchmarking metrics, the relationship between the different aspects of environmental performance benchmarking, and the relationship between performance and managerial benchmarking.

Practical implications

Firms must supplement strong environmental management systems with their benchmarking strategy. Using all four provides a more balanced benchmarking effort, and minimizes limitation that single measure of environmental performance present.

Originality/value

For manufacturing firms, this paper offers a framework to think about the costs and benefits of a range of environmental benchmarking strategies. For researchers, it outlines a number of areas for future research.
Cross‐national evaluation and benchmarking of manufacturing SMEs using an expert system based assessment tool (QuickView)
Authors: Ochoa‐Laburu Carlos , Simons Gene R. , Trachtenberg R.
Published: January 2007

Purpose

To determine whether: QuickView, that is a primary assessment and business planning tool that was designed in the USA in the 1990s, could be usable out of USA; and manufacturing SMEs outside of the US could be evaluated against the 3,400 US SMEs on the QuickView database.

Design/methodology/approach

The project consists of a survey of a sample of SMEs in different overseas regions, Northern Spain being one of them: revise and translate questionnaire to local language; train local agents; conduct a survey of a sample of 50 SMEs using the local agents; and review the results and draw conclusions as to the applicability of the model.

Findings

We think that we have demonstrated that QuickView is a valid tool to use on non‐US SMEs to help build local databases containing local companies. What is not so evident is how to establish direct comparisons between the two databases. To make this, the USA database should be partitioned by year of survey or by industry sector. We can draw some initial conclusions about the Spanish sample.

Research limitations/implications

The USA database should be partitioned by year of survey or by industry sector, to make direct comparisons. A further continuation of this project is, obviously, an in‐depth analysis of the Spanish sample. Another issue is whether an open structure can be developed for QuickView that would allow it to be modified into specialized questionnaires for service companies, for example, or a questionnaire dedicated to the SMEs in a particular country.

Practical implications

To create a database of spanish companies based on QuickView methodology to serve as a reference of management practices.

Originality/value

There are currently several projects trying to develop standard European benchmarking tools and databases. Our project presents an adaptation of another different tool already in use in the USA and proves its validity in an European context. This tool should be useful either for companies trying to evaluate themselves and compare with a local, though still small, database or for external agents trying to compare one particular company against the database.
The impact of information and communications technology on commercial real estate in the new economy
Authors: Dixon Tim
Published: January 2007

Purpose

This paper seeks to critically review the conceptual frameworks that have been developed for assessing the impact of information and communications technology (ICT) on real estate.

Design/methodology/approach

The research is based on a critical review of existing literature and draws from examples of previous empirical research in the field.

Findings

The paper suggests that a “socio‐technical framework” is more appropriate to examine ICT impact in real estate than other “deterministic” frameworks. Therefore, ICT is an important part of the new economy, but must be seen in the context of a number of other social and economic factors.

Research limitations/implications

The research is based on a qualitative assessment of existing frameworks, and by using examples from commercial real estate, assesses the extent to which a “socio‐technical” framework can aid understanding of ICT impact.

Practical implications

The paper is important in highlighting a number of the main issues in conceptualising ICT impact in real estate and also critically examines the emergence of a new economy in the information society within the general context of real estate. The paper also highlights research gaps in the field.

Originality/value

The paper deconstructs the myths of the “death of real estate” and “productivity increase means jobs loss”, in relation to office real estate. Finally, it examines some of the ways in which ICT is impacting on real estate and suggests the most important components for a future research agenda in the field of ICT and real estate impact, and will be of value to property investors, facilities managers, developers, financiers, and others.
The ageing population and knowledge work: a context for action
Authors: Jorgensen Bradley
Published: January 2007

Purpose

This paper aims to investigate a workforce policy response to the ageing workforce, emerging social and demographic trends, ongoing and rapid change, the growth in complexity and the changing nature of work.

Design/methodology/approach

The main method for constructing this paper is analysis of selected texts rather than the more conventional empirical studies. The approach is that of scenario construction, guided by the criteria established by Nowotny et al. Evidence is gathered of emergent trends that affect management practices and structures now and in the foreseeable future. These trends are identified and woven into a commentary that links them in a focus on the priorities for Australian organizations.

Findings

The findings from this research suggest that “command‐based” management structures of the bureaucracy, given emergent trends, present as an impediment to organizational success. Rather, a workforce policy reform agenda for both understanding and managing noted historical conditions in a coherent way is proposed.

Practical implications

The conclusions of this paper are significant for large organizations faced with the dynamism of the modern era and the difficulties associated with emerging demographic and social trends. They suggest a workforce policy reform agenda for both understanding and managing these historical conditions in a coherent way.

Originality/value

This paper deals with a topic that is exercising policy makers in all the developed economies. It offers practical advice to assist the development of workforce policy to better manage emergent trends.
Biotechnology and foresight
Authors: Erik Solem Knut , Gaivoronskaia Galina
Published: January 2007

Purpose

To analyze several complex issues which are being addressed by biotechnological research and identify possible solutions to some concrete problems.

Design/methodology/approach

The objectives are achieved by the use of detailed data and literature search, decision analysis, case studies and personal involvement in research conferences on this and closely related problem areas. The approach to the topic is critical and constructive based on own work and that of colleagues and other analysts.

Findings

Significant issues are waiting to be properly addressed in decision making within the field of modern biotechnology; this applies to the USA as well as Europe. However, controversies about insufficient risk assessments, inadequate risk management or ethical acceptability in different applications of biotechnology co‐exist with controversies about their needs. Technology, politics and values must be integrated. Inadequacies in decision making may be at least partly resolved by proper planning mechanisms, the use of think tanks and applied foresight analysis.

Research limitations/implications

Better understanding of a more general problem, i.e. gaps in the framework in the introduction of biotechnology into the food sector must be pursued, as public reactions to this new technology and its usage will likely increase, as will fears associated with it. New ideas are needed. Future work must identify ways and means for assessment and evaluation of “think tanks” and their proper use if these are to be applied.

Practical implications

This paper will provide a very useful source of information on a complex and increasingly important subject for a target audience consisting of: decision makers in government, biotech companies, international and national experts, researchers and graduate students. It will broaden the practical understanding in the use of biotechnology.

Originality/value

The paper fulfils an identified information/resources need and offers insight and practical help to organizations and individuals involved with biotechnological research, applications and decision making.
Competitiveness between public, private and non‐profit organizations in the promising market for the elderly in France
Authors: Smida Ali
Published: January 2007

Purpose

To cover the main trends in health care for the elderly and the issues regarding the competitiveness between public and private organizations that are mainly small to medium‐sized enterprises.

Design/methodology/approach

A three‐dimensional longitudinal study: the social policy of public authorities; the ageing process of the French population; and the behavior of the elderly toward retirement homes.

Findings

Provides a better understanding of the competition between different modes of accommodation for the elderly. Underlines the crucial role played by non‐profit organizations in the French health sector, i.e. to act as a regulator and buffer between the public sector, which lacks flexibility, and the private sector, which gives a free hand to private interests.

Research limitations/implications

This study is limited to France. It would benefit from being enlarged to cover larger geographical areas, e.g. Europe.

Practical implications

For academics, this method could be replicated in different other fields and sectors. For public decision makers, this work shows how non‐profit organizations could improve cohabitation between public and private organizations in the health‐care system. For managers, this paper contributes toward a better understanding of the accommodation market for the elderly.

Originality/value

This paper deals with the care of the elderly that is nowadays a world‐wide problem. However, opportunities are emerging with a new market for the care for the elderly.
Clarifying the meaning of WTO telecommunications obligations: Mexico – measures affecting telecommunications services
Authors: Sherman Laura B.
Published: January 2007

Purpose

To provide the key findings of a WTO Panel regarding Mexico's commitments in basic telecommunications service in a way that will help telecom regulators and government policy makers implement their WTO commitments and to respond to criticism of the panel's findings.

Design/methodology/approach

The article assists government policy makers and telecommunications regulatory authorities to understand the WTO Panel's decision which concluded that Mexico failed to carry out its WTO obligations in basic telecom services. It analyzes the WTO Panel decision and articles criticizing the decision, reviews relevant WTO documents and draws on the author's participation in the WTO basic telecom services negotiations. It provides a brief introduction to the relevant WTO agreements, describes the key findings of the WTO Panel and lessons for telecom regulators and policy makers based on those findings, sets out the claims made by the USA against Mexico, and describes the WTO Panel findings. The article also includes a response to criticisms leveled against the WTO Panel decision.

Findings

The WTO Panel decision provides important guidance in interpreting the scope of obligations in cross‐border supply of international telecom services, cost‐oriented interconnection, access to and use of the public switched network on reasonable terms and conditions and the scope of anti‐competitive conduct that needs to be regulated. Much of the criticism of the WTO Panel decision is based on incorrect interpretation of WTO obligations, lack of knowledge of the negotiating history and exaggerated readings of the panel decision.

Practical implications

The WTO Panel decision clarifies many of the most important WTO obligations related to basic telecom services. Government policy makers and regulatory authorities need to understand the WTO Panel decision as they take action to implement their own WTO obligations and as they consider undertaking new obligations.

Originality/value

The article offers practical advice to government policy makers and regulatory authorities on how to implement their WTO commitments in basic telecom services.
The dark side of ambient intelligence
Authors: Wright David
Published: January 2007

Purpose

To survey ambient intelligence research in Europe, the USA and Japan and, in particular, in the context of the issues of privacy, identity, security and trust and the safeguards proposed to protect them.

Design/methodology/approach

This paper is based on research being conducted by the SWAMI consortium under the EC's Sixth Framework Programme. SWAMI stands for Safeguards in a World of Ambient Intelligence. The consortium comprises five partners: the Fraunhofer Institute (Germany), the Technical Research Center of Finland (VTT Electronics), Vrije Universiteit Brussel (Belgium), the Institute for Prospective Technological Studies (IPTS) (Spain) and Trilateral Research & Consulting (UK). The 18‐month SWAMI project began in February 2005.

Findings

Most AmI projects do not take into account privacy, security and related issues. However, a reasonable number do (perhaps a quarter of those in Europe) to a greater or lesser extent and some have proposed safeguards.

Research limitations/implications

This paper references only a limited set of the research projects being carried out in Europe, the USA and Japan. More detailed information can be found on the SWAMI web site (http://swami.jrc.es).

Practical implications

A mix of different safeguards will be needed to adequately protect privacy, etc. in the new world of AmI.

Originality/value

Until now, there has been no reasonably comprehensive survey of AmI research projects in Europe, the USA and Canada focused on privacy, security, identity and trust issues. None has considered the range of safeguards needed to protect privacy, etc.
Structural metrics for goal based business process design and evaluation
Authors: Balasubramanian S. , Gupta Mayank
Published: January 2007

Purpose

The paper aims to provide business process designers a formal yet user friendly technique to evaluate the implications of a process design on process performance even before its implementation.

Design/methodology/approach

Based on practical experience, the paper has built on past research to hypothesize structural metrics for business processes that help assess the influence of process design on organizational goals.

Findings

This paper suggests a list of structural metrics that can be used to approximate common performance goals (i.e. soft goals) at the stage of process design. Distinct views for process depiction are discussed to explain how each metric can be calculated and what kind of performance goals it can approximate.

Research limitations/implications

The paper has assumed an intuitive relationship between process structure and process performance which has to be validated empirically. There is scope for developing formal methods to translate changes in structural metrics to monetary value for business and also to refine the structural metrics further if required.

Practical implications

The suggested list of structural metrics and the corresponding process views can be used to compare process design alternatives to select a process design better aligned to organization goals.

Originality/value

A list of structural metrics based on practical experience can be easily applied by business process designers to create a formal yet user friendly approach for process design evaluation.
Transforming strategic goals of CRM into process goals and activities
Authors: Heinrich Bernd
Published: January 2007

Purpose

The purpose of this paper is to address two questions: what is the difference between relationship processes and purely product‐oriented processes? And to answer this question we should bear in mind what we mean by relationship, and why a customer is willing to establish and maintain a relationship at all.

Design/methodology/approach

An empirical analysis subjected the motives of customers and factors for the establishment and expansion of customers' relationships. In this context the relationship motives and factors can act as base to derive strategic goals of CRM and relationship processes in a further step.

Findings

Based on strategic relationship goals the paper will give answers to a systematic identification and engineering of relationship activities and processes. Thereby relationship‐oriented activities complement present product‐oriented processes. In contrast to this we derive purely relationship‐oriented processes as well, such as the customer recovery process. Such processes do not target product sales any more than rather the sustainability of relationship (in particular to valuable customers).

Originality/value

The benefit of the paper is an integrated and goal‐oriented derivation and design of relationship processes and activities. An example in financial services illustrates the approach and shows its application in parts.
An experimental study of process representation approaches and their impact on perceived modeling quality and redesign success
Authors: Danesh Azim , Kock Ned
Published: January 2007

Purpose

The purpose of research is to examine the communication optimization theory by comparing two business process representation approaches and related redesign guidelines through an experiment.

Design/methodology/approach

The experiment examined two process representation approaches involving 114 subjects. Each method gravitated around a different business process representation – one placed emphasis on business process activities and their sequencing, and the other on the web of communication interactions found in business processes.

Findings

The key finding was that an emphasis on a communication‐oriented view of processes seems to increase perceived modeling quality and redesign success.

Research limitations/implications

Data were collected from various information systems classes at a university. The participants were not redesign team members in an actual organizational redesign project. Future studies should focus on the characteristics of the designers.

Practical implications

The findings should allow managers and practitioners involved in operational‐level process redesign to acknowledge and focus on the flow of information rather than just the activities performed or at least determine a balance between these two approaches. Further, the information system developers and designers should be able to better align information systems design with business processes techniques. Using communication flow methodologies in the analysis stage should significantly help the design and the development processes.

Originality/value

This research was one of the first experimental studies to test the communication flow optimization theory and its effect on business process redesign.
Forming a community partnership to enhance education in sustainability
Authors: Allen‐Gil Susan , Walker Liz , Thomas Garry , Shevory Tom , Elan Shapiro
Published: January 2007

Purpose

To provide an example of how colleges can partner with local EcoVillages to further sustainability curriculum on campus and the educational mission of the EcoVillages, and to strengthen ties with the community.

Design/methodology/approach

Describes four structured courses developed for the Environmental Studies Program, including sustainable communities, sustainable land use, sustainable energy and environmental futures. Additionally, independent research opportunities in wind energy, solar photovoltaics, and GIS/GPS developed as part of the curriculum. Describes numerous ancillary activities that have promoted sustainability across campus and the community.

Findings

Provides information about how to develop educational partnerships with community groups, foster sustainability education on campus, recruit additional faculty involvement, and influence college operations with respect to sustainability.

Practical implications

A very useful source of information for those involved in building sustainability curriculum and linking it to campus operations and community outreach.

Originality/value

This paper describes a unique partnership between a college and an intentional community that serves as a model for other colleges and universities.
A comparative analysis of web image and textual queries
Authors: Pu Hsiao‐Tieh
Published: January 2007

Purpose

This study aims to examine the differences between web image and textual queries.

Design/methodology/approach

A large number of web queries from image and textual search engines were analysed and compared based on their factual characteristics, query types, and search interests.

Findings

Useful results include the findings that web users tend to input short queries when searching for visual or textual information; that image requests have more zero hits and higher specificity, and contain more refined queries; that web image requests are more focused than textual requests on some popular search interests, and that the variety of textual queries is greater than that of image requests.

Originality/value

This study provides results that may enhance one's understanding of web‐searching behaviour and the inherent implications for the improvement of current web image retrieval systems.
The IP's guide to the galaxy of portal planning: Part II. Content management
Authors: Augustyniak Rebecca H. , Aguero Dawn B. , Finley Amy
Published: January 2007

Purpose

This article is the second in a four‐part series that aims to illustrate the process involved in planning a portal and creating a portal definition document.

Design/methodology/approach

Based on a review of the academic and industry literature and using a case study, the authors share their experience in planning the Florida ExpertNet Research portal.

Findings

Portal development is a complex and costly endeavour that requires meticulous planning and design. As with any system development initiative, the time and energy spent in the planning process is reflected in the success or failure of the end product. Content management is the keystone of a portal. The components of a portal CM strategy include the content inventory and analysis, content acquisition, access structures, classifying content, content life cycle, CM software, and metadata standards.

Originality/value

This series will be useful to the information professional who is contemplating portal development and may be used as a model in developing a blueprint – the portal definition document. Whether the IP is considering doing development or outsourcing, it is important to understand the architectural requirements of a portal.
Relevance in the eye of the search software
Authors: Jacsó Péter
Published: January 2007

Purpose

The purpose of this article is to look into relevance ranking and its importance in trying to bring some order to the deluge of results in response to a query.

Design/methodology/approach

A large‐scale analysis of detailed web logs of various search engines was performed. Sample tests were made on five to eight versions of MEDLINE, ERIC, and PsycINFO on hosts which have comparable versions of the databases and offer relevance ranking.

Findings

It was found that, for fairness, it must be ensured that the implementations are identical, they have the same retrospective coverage, the same MEDLINE/PubMed subsets, and (quasi) identical update.

Research limitations/implications

The tests were made early September 2005. As databases are updated at different times, perfect synchronicity is not easy to achieve. When new records are added to the database, they may change the ranking of the test result set. Similarly, a small change in the fine‐tuning of the algorithm may yield different rank order positions of the same record the next time.

Originality/value

Brings together important research findings and suggests a topic for the next column.
The IC Rating™ model by Intellectual Capital Sweden
Authors: Jacobsen Kristine , Hofman‐Bang Peder , Nordby Reidar
Published: January 2007

Purpose

The purpose of this paper is to introduce the IC Rating™ approach as a management consulting approach to measure intellectual capital and to report on the implementation and experience in one case study firm.

Design/methodology/approach

The paper describes the IC Rating™ model in the context of the exiting literature in the field of IC measurement and uses a case study to demonstrate its practical application.

Findings

Based on the presented case study as well as implementations in other organizations we find the IC Rating™ model a useful tool to facilitate the analysis and discussion about intellectual capital in organizations.

Practical implications

The article gives a complementary view to the most commonly used score card methods and guidelines for intangibles on how intangibles can be measured. IC Rating™ focuses on the comparability between companies and industries as well as a simplification of how to interpret intangible measures.

Originality/value

The original idea for the paper was to answer the question “Why do companies really need to measure and develop intangibles?”. The answer is “To improve company financial performance”. The IC Rating™ methodology is therefore based on the answers to two other questions: “Which parameters does an executive manager need to have insightful knowledge of, in order to make the right decisions for the future?” and “From where and whom should the executive manager receive this information?”.
“Exposing the cracks”
Authors: Gauld Robin
Published: January 2007

Purpose

Hong Kong was particularly affected by the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS). During the epidemic, it seemed as if the Hong Kong government and health system were barely coping, leading to calls of mismanagement and governance incapacity. In the wake of the SARS outbreak, two inquiries were conducted. The purpose of this article is to review the Hong Kong's response to SARS from the perspective of two inquiries.

Design/methodology/approach

An historical analysis of the institutional arrangements for health care delivery in Hong Kong is undertaken, followed by a chronology of developments in the SARS outbreak. The article then reviews outbreak management and the findings of the two inquiries. Finally, it considers whether the Hong Kong health system can be reformed to manage any future infectious disease epidemic better.

Findings

Both leadership and coherency were lacking in Hong Kong's response to SARS. These are age‐old problems in the Hong Kong health sector. The prospects for mending the health system appear limited, given that leadership and coherency have been consistently absent features of post‐1997 governance in Hong Kong.

Research limitations/implications

This article reviews events in the immediate period following the SARS outbreak. A future follow‐up study of the Hong Kong government and health system's capacity to respond to infectious disease outbreaks would be useful.

Practical implications

This article provides a review that will be useful to policymakers and researchers.

Originality/value

No other article reviews the Hong Kong health system's SARS response.
Examining leadership through critical feminist readings
Authors: Ford Jackie
Published: January 2007

Purpose

This paper seeks to explore a critique of the limitations of mainstream leadership research and publications and offers a critical management analysis through drawing on a feminist reading of leadership in organizations.

Design/methodology/approach

There has recently been witnessed a growing interest in the promotion of effective leadership within both organizational studies literature and organisational policy as the route to ensuring employee commitment and enhanced organisational performance and the achievement of ever demanding goals and targets. This turn to leadership is represented in both an upsurge of research studies and a proliferation in the promotion of leadership as the organisational panacea. An analysis of the literature on leadership was undertaken, giving due consideration to mainstream and more critical accounts in relation to illustrations drawn from the UK National Health Service (NHS).

Findings

This paper explores mainstream literature on leadership and finds it wanting, in terms of its failure to deliver a common understanding of the concept, in its generally uncritical accounts, and its inability to expose the androcentric nature of the core assumptions within hegemonic discourses of leadership. Drawing on critical feminist readings in relation to the UK NHS, a more critical account of leadership is presented.

Practical implications

Greater awareness is required for the adoption of culturally sensitive and locally‐based approaches that take account of individuals' experiences, identities and power relations and that allows for the presence of a range of masculine and feminine workplace behaviours.

Originality/value

This paper provides an overview of the dominant themes within the literature on leadership as they relate to the UK NHS, and presents a feminist critique of the more subtle ways in which notions of leadership in organisations fail to consider their potential for bias.
Riding the emotional roller‐coaster
Authors: McFadzean Fiona , McFadzean Elspeth
Published: January 2007

Purpose

To examine the literature on employee morale and to construct a model of this area pertaining to nurses. This framework seeks to present morale in a holistic manner, illustrating the causal factors that influence nursing morale, the changes that occur in morale when these input variables are altered, and the consequences to patient care and individual and group nursing practices.

Design/methodology/approach

A number of published works on morale, its causal factors and resulting consequences are critiqued. The findings from this literature review are used to develop a framework for nursing morale.

Findings

The paper presents a definition of morale and, from the literature review, concludes that previous models on morale are fragmented; only tending to explore the variables that influence the employees' emotional state. Consequently, a framework of nursing morale is constructed in order to illustrate this topic from a holistic point‐of‐view.

Practical implications

The paper concludes with a number of management and research implications. The management implications consist of a number of useful suggestions for senior nurses to enhance the morale within their units.

Originality/value

This paper fulfils an identified gap in the literature, namely the lack of a holistic model of nursing morale, and offers practical help to senior nurses so that they can initiate processes within their wards that can improve their subordinates' morale.
Emotion in health care: the cost of caring
Authors: Brunton Margaret
Published: January 2007

Purpose

The purpose of this paper is to understand the centrality of emotion, and how that emotion both created and contributed to meaning, in the communication of health professionals who worked in a regional pilot program for cancer screening.

Design/methodology/approach

As the third phase of a larger study, thematic analysis of semi‐structured interviews was carried out with the 19 members of the professional groups, which comprised the service. Brief comments were included from the questionnaire survey in phases 1 and 2 of the study to demonstrate the overflow effects on those served by the organization.

Findings

Emotion was found to be a critical component in the communication interface between the groups. The complexity of the way in which emotion was managed with the client group overflowed into the management of the communication process between the professional groups in the organization. However, it was not always recognised, and thus created difficulties for a number of staff.

Research limitations/implications

Although the research was limited to one health‐care organization, it is possible that other health professions are experiencing similar situations as they cope with the certainty of unending change. Also, although secondary interviews were carried out to ensure that themes were credible to participants, it is possible that carrying out the interviews in the work environment may have constrained some participants.

Originality/value

Stresses the importance of the emotional component of communication and how it is recognised to facilitate effective working relationships and support staff coping with change and heavy workloads in health‐care organizations.
Women paediatricians: what made them choose their career?
Authors: Moorkamp Martina
Published: January 2007

Purpose

To explore why women paediatricians have chosen paediatrics as their specialty when previous research has shown that this was the least favourite career option.

Design/methodology/approach

In this qualitative study ten semi‐structured interviews with open‐ended questions were carried out. The interviews were taped and transcribed by a professional transcriber. Two tapes could not be transcribed because of technical problems. This dissertation focuses on the responses of the eight women in relation to the research question. Interviews were carried out face‐to‐face. There were no additional questionnaires. Common themes were identified and content analysis used for data analysis.

Findings

All the women felt that they had chosen paediatrics because of the good work atmosphere, supportive colleagues and the attraction of working in a multi‐disciplinary team. All had pursued their career in a dedicated way working full‐time for most of their careers. The women paediatricians interviewed were happy with their career but they realised that they had made sacrifices in terms of family and personal commitments. The work environment has to change for everybody, not just for women, to improve quality of life. Career advice is still thought to be poor and many doctors enter a career without knowing what is expected of them. Modernising medical careers will considerably shorten medical training and the time individuals can spend in a particular specialty.

Originality/value

A qualitative study like this can give both male and female students an insight into what it is like to have a career in paediatrics.
Are head injury guidelines being met?
Authors: Campbell Anna , Reilly David
Published: January 2007

Purpose

To assess how the 2003 NICE guidelines about head‐injured patients are implemented at a large district general hospital, and how the existing shortfalls might be improved.

Design/methodology/approach

A six‐month audit was performed and the care of all head‐injured patients discharged or dying over a six‐month period was assessed in the following fields: admission criteria, number of responsible consultants, number of wards receiving patients, timing of transfer to specialist centres and CT scanning and skull X‐rays (SIGN guidelines were used for the latter as NICE currently recommends CT for all patients needing imaging), quality of neurological observations, criteria for re‐scanning, transfer for rehabilitation, advice and arrangements for follow‐up, and assignment of case managers.

Findings

Imaging rates were poor, observation timing was inadequate and discharge information or follow‐up arrangements were unsatisfactory. Care could be much improved by allowing one unit/ward and one firm to be in sole charge of head‐injured patients.

Originality/value

This case study provides practical advice for any busy hospital striving to maintain national standards in the care of head‐injured patients.
Clinical governance – the turn of continuous improvement?
Authors: Peak Matthew , Burke Rebecca , Ryan Steven , Wratten Karen , Turnock Rick , Vellenoweth Christopher
Published: January 2007

Purpose

To provide an overview of a model for clinical governance in the National Health Service that incorporates continuous improvement and innovation as a core theme.

Design/methodology/approach

The paper considers the core functions of clinical governance and how these are related to established structures and roles within the modern NHS. A case study approach is used to describe the implementation of a theoretical model in a large teaching NHS Trust.

Findings

A clinical governance cycle is described that comprises three functional domains: accountability, assurance, and innovation. For each domain there is a definable outcome and a key role. Critical success factors for implementation of the model are described.

Originality/value

This paper introduces a new model for clinical governance that focuses on continuous improvement. The paper will be of particular interest to managers and lead clinicians responsible for the development of robust systems for clinical governance and modernisation in the NHS.
Day case surgery from the wards or a dedicated unit – do the same standards apply?
Authors: Cosker T.D.A. , Elsayed S. , Michael P. , Preece M.
Published: January 2007

Purpose

Day surgery is now a major element of surgical practice. The paper aims to examine if those patients undergoing day surgery from in‐patient wards receive the same standard of care as those attending a formal day case surgical unit (DCSU), which is important.

Design/methodology/approach

Two cohorts of 50 consecutive patients undergoing day surgery either on an in‐patient ward or in the DCSU were asked about the pre‐operative checks that had been made in relation to their safe discharge.

Findings

Confirmation by in‐patient ward staff of safety issues outlined in guidelines published by the Royal College of Surgeons of England was variable. Of particular concern was that at least two of the recommendations relate to important safety issues such as driving a motor vehicle.

Originality/value

This paper is of use because ensuring that patients fulfil the Royal College's guidelines for day case surgery is important, no matter what surgery the patient undergoes. Patient safety may be compromised by failing to verify that patients are being discharged into a safe environment.
Patient assessment of surgeons' interpersonal skills
Authors: Al‐Shawi A.K. , MacEachern A.G. , Greco M.J.
Published: January 2007

Purpose

Aims to assess the surgeons' communication skills with patients in the orthopaedic department of the authors' district general hospital.

Design/methodology/approach

A departmental prospective audit was conducted involving all consultants and middle grade surgeons. Then authors used a validated questionnaire (Doctors' Interpersonal Skills Questionnaire (DISQ)) completed by patients and analysed independently. Feedback was obtained through individual confidential reports and a study group meeting.

Findings

A total of 402 patient evaluations were received and the average interpersonal skills index was 72 per cent ranging between 55 per cent and 87 per cent. The highest scores were given for respect shown, warmth of greeting and patients' confidence in the surgeon's abilities. The lowest scores were given for time given to patients to express their concerns.

Research limitations/implications

The research has an incomplete audit circle. A second audit is required following appropriate training to alleviate the deficiencies reported in the first audit and prove the benefit.

Practical implications

This audit highlighted important deficiencies in our interpersonal skills that could potentially be addressed by way of targeted training. This kind of assessment should become an essential part of the annual appraisal process of all hospital doctors.

Originality/value

This paper is the first to report the results of a departmental assessment process of hospital doctors using the DISQ.
Clinical guidelines in severe pre‐eclampsia and eclampsia
Authors: Whitworth M.K. , Reid F. , Arya R. , Smith R.A. , Baker P.N. , Myers J.
Published: January 2007

Purpose

This article aims to assess the standard local recommended management of women with severe pre‐eclampsia and eclampsia in relation to recommendations in a national clinical guideline using a criterion‐based survey.

Design/methodology/approach

A total of 227 maternity units in the UK were asked to provide a copy of their guideline for the management of severe pre‐eclampsia and eclampsia. Responses were obtained from 107 units (47.1 per cent), 37 units were using regional guidelines and 72 guidelines were available for assessment. A total of ten audit criteria were agreed by committee, based on national recommendations. Guidelines were then audited to assess concurrence with these criteria.

Findings

The standard of guidelines was highly variable with only four guidelines (4.5 per cent) satisfying all ten key guideline points. The majority of guidelines had clear criteria for inclusion (87.5 per cent) but in almost a quarter of all guidelines no mention was made of informing consultant staff once these criteria were met.

Practical implications

The study shows that the standard of local guidelines for management of these potentially fatal conditions is highly variable. Confidential inquiry has repeatedly recommended the use of regional guidelines. Perhaps it is time for the development of a national guideline representing consensus agreement of an evidence‐based approach.

Originality/value

In the UK eclampsia and pre‐eclampsia continue to be a leading cause of maternal mortality and morbidity. This paper provides a valuable insight into the standard of guidelines used in the management of these conditions.
Mental health tribunals: an issue for clinical governance
Authors: Dibben Claire , Luen Wong Mai , Hunt Neil
Published: January 2007

Purpose

The purpose of this article is to examine reasons given by Mental Health Review Tribunals for discharging patients from detention and the effect the length of detainment had on the immediate outcome of discharged patients and to examine the effect on outcome from quality of reports and sources of evidence presented to the MHRTs.

Design/methodology/approach

All documentation pertaining to MHRTs heard in the Cambridge area over a 12‐month period were reviewed.

Findings

A quarter of tribunals heard were discharged, as they did not fulfil the legal criteria for detention. RMO non‐attendance was significant in this group. Unfavourable short‐term outcomes suggest that half of these discharges were premature. Improved aftercare compliance was associated with longer duration on a Section of the Mental Health Act prior to MHRT discharge.

Research limitations/implications

This study reflects practice in the service (with a relatively small number of in‐patient sections) and may not be generalisable to other populations.

Practical implications

Improvement in the quality of evidence including risk assessments provided at tribunals should prevent premature discharges whilst maintaining the balance between civil liberties and good clinical care.

Originality/value

This paper highlights the need for improvement in clinical practice and training. Whilst it is primarily of interest to doctors, all professionals involved in MHRTs can learn from it.
Commander's evaluation in the context of business decision‐making: a multi‐perspective approach
Authors: Schraeder Mike , Morrison Rodger
Published: January 2007

Purpose

The purpose of this article is the application of commander's evaluation, used for making decisions in military organizations, to the context of business decisions.

Design/methodology/approach

The scope of this article incorporates salient issues related to business decision making. This is followed by an overview of how commander's evaluation is used to make decisions.

Findings

While used predominantly in military organizations, commander's evaluation has important implications for business decision making. Developmental advantages associated with incorporating this method of making decisions into non‐military organizations are elucidated.

Practical implications

Utilizing a commander's evaluation approach provides the business decision‐maker with multiple perspectives and options, while also increasing the likelihood of success.

Originality/value

This article makes a unique contribution to the literature by providing practical strategies for incorporating the use of commander's evaluation into the process of making decisions in business.
Organizational change, learning and metrics: hard and soft ways to effective organizational change
Authors: Garratt Bob
Published: January 2007

Purpose

To explore the nature of learning in organizations. To link organizational change to learning.

Design/methodology/approach

The article looks initially at some historical factors before getting into practical issues.

Findings

Learning and organizational change need to be linked. The use of the Organizational Capability Survey is outlined.

Practical implications

The article shows how an Organizational Capability Survey can be used. It also alludes to the use of web‐based approaches.

Originality/value

The article will be of value to anyone in organizations struggling with major change.