bluuebunny/crossref_metadata_2025 huggingface dataset:
Prioritising customer needs at spectator events
Authors: Tamayo Enríquez Francisco , Jaramillo Osuna Alejandro , González Bosch Verónica
Published: July 2006

To present a method for prioritising customer needs that was devised for a quality function deployment (QFD) project at a mass spectator event, due to the particular characteristics and constraints of this project. Standard methods for prioritising customer needs documented by several authors are reviewed, as well as their principal features and why they were not suitable for this particular QFD project. The devised method is presented together with an example extracted from this project. With the data available from the project, this method is briefly contrasted to a standard similar method. Presents the devised method as an effective solution for this particular QFD project. The method was useful for this particular QFD project due to the time and physical location constraints, but more research is needed in order to assess the real accuracy of this method compared to other documented practices. Sometimes standard practices may not be suitable for particular QFD applications, so methods should be adapted to the unique characteristics of specific QFD projects. This paper presents a review of documented practices for prioritising customer needs that was done for a particular QFD application, as well as a method that was devised because these standard practices were not effective enough for handling the constraints in the project. The process followed and results obtained may serve as a reference for QFD practitioners in the selection of a convenient method for prioritising customer needs.
Beyond technology – The human factor in business systems
Authors: Orshesky Christine M.
Published: July 2006

Looks at where companies go wrong in measuring supply chain performance. Gives a number of examples of those who are doing it right.
Finding new value in established businesses: Boise Cascade discovers Its core identity
Authors: Ackerman Larry
Published: July 2006

A staggering amount of value may go unseen and unrewarded by customers, investors and employees in complex organizations in widely disparate industries. In the case of Boise Cascade, once best known for forest products, the authors find a common denominator in the customer operations improvement business that defines all the company’s enterprises. The authors helped to create a brand strategy that changed perceptions among key stakeholders.
The “new” economy: complexity, coordination and a hybrid governance approach
Authors: Elsner Wolfram
Published: July 2006

The paper starts from the increasing spatial and functional fragmentation of value‐added chains, global de‐regulation and dis‐embedding of “markets”, and interdependencies among the Net‐based digital technologies. It develops a socio‐economic setting with ubiquitous direct interdependencies and interactions, Net‐externalities, “strategic” strong uncertainty, and omnipresent collective‐good and social‐dilemma problems. These entail co‐ordination failures, either in the form of conventional market failure (i.e. collective blockages of action) or of “wrong” or outmoded institutional co‐ordination and, thus, wide‐spread technological “lock‐ins” that are indicative of insufficient ability of collective action. This is particularly true for de‐regulated, individualistic cultures. In contrast, sustainable innovation, used in a broad, i.e. technological and institutional, sense, requires an effective collective action competence. This, in turn, requires a new and increased co‐ordination. Against this background, the global corporate economy has spontaneously developed private individualist substitute arrangements to cope with the new complexity, such as local clusters and hub‐and‐spoke networks, which all have severe shortcomings. With reference to what we call the “Linux” paradigm, the paper discusses the possibility of a spontaneous evolutionary, i.e. collectively learned, institutional co‐ordination through emergent collective action and networks with “good” governance. The paper argues that only a hybrid system that consists of “well‐governed” networks and a new approach towards more comprehensive and deliberate “interactive” and “institutional” public policy, supporting collective learning and emergent institutional co‐ordination, is capable of solving the complexity and co‐ordination problems of the “new” economy by increasing certainty, stability and more continuous and comprehensive innovation. This new policy approach is outlined at the end.
Child income poverty and child deprivation: an essay on measurement
Authors: Bastos Amélia , Leão Fernandes Graça , Passos José
Published: July 2006

This paper is a study on child poverty from two perspectives: child income poverty (derived from family income) and child deprivation (evaluated by non‐monetary indicators). On the one hand, empirical evidence supports the thesis that income‐based poverty measures and deprivation measures do not overlap. On the other hand, the relationship between poverty and the child's living conditions is not linear. Uses micro‐econometric techniques to analyse child income poverty and present deprivation indicators, and thereby an index of child deprivation, to study child poverty. The measurements used are centred on the child. The results obtained support the thesis that the study of child poverty differs whether the focus is on the child or on the family.
On making human development more humane
Authors: Dar Humayon A.
Published: July 2006

It is widely recognised that the human development index (HDI) does not totally capture the rich content of the human development concept, necessitating a more adequate measure of human development. This paper introduces an ethics‐augmented human development index (E‐HDI) as a new indicator of socio‐economic change and development. The E‐HDI incorporates freedom, faith, environmental concerns and the institution of family in the HDI and ranks countries of the world accordingly. It is envisaged to be of practical use in national policy making and may also be related to agenda of the bilateral and international development agencies. Just as the HDI has managed to shift discussions beyond gross national product, the E‐HDI is expected to inject ethical concerns more explicitly into policy making in the contexts in which the human development reports are used.
Are we doing enough for today's graduate student?
Authors: Offstein Evan H. , Larson Miriam B. , McNeill Andrea L. , Mjoni Mwale Hasten
Published: July 2006

Following approaches consistent with the qualitative research tradition, attempts to capture the essence of the full‐time graduate student experience. Using the constant comparative method, analyzes several sources of data to arrive at a grounded theoretical model of the graduate student experience. Findings suggest that stress is at the core of the graduate student experience and is amplified by conflicting demands and internal conflict unique to this type of student. Additionally, international graduate students appear to face some tremendous obstacles that span both their personal and professional lives. Also identified are several of the tactics and mechanisms that students adopt to reduce hardship as they proceed through their respective programs. Finally, implications for current administrative practice and future research are discussed.
Marketing informal education institutions in Israel: the centrality of customers' active involvement in service development
Authors: Oplatka Izhar
Published: July 2006

The current paper outlines a unique marketing perspective that prevails in some informal education institutions in Israel parallel with “traditional modes of marketing”, such as promotion, public relations and the like. Based on a case study research in five community centres, a service development based on active participation of the potential customers is discussed as a major marketing method in this organisation, and contrasted with “classic” models of the marketing process which have long been dominant in the non‐education sectors. Practical implications for marketing informal education institutions are provided.
Academic dishonesty in a global educational market: a comparison of Hong Kong and American university business students
Authors: Chapman Kenneth J. , Lupton Robert A.
Published: July 2006

Academic dishonesty in post‐secondary education is a widespread, insidious and global problem. Business educators hosting foreign students locally and teaching abroad more than ever need to understand the nuances and attitudes of different student populations and how these differences may manifest themselves in a course. This research contributes to the growing albeit still scanty body of literature demonstrating that significant cross‐national differences exist regarding students' attitudes, beliefs and propensities toward cheating. This study compares US and Hong Kong university business students on three areas: cheating behaviors and perceptions, relationships between academic dishonesty and gender, and prediction of academic dishonesty. A total of 443 usable surveys were collected in the USA and 622 in Hong Kong. Statistically significant differences are presented followed by discussion and implications.
Introduction: Democracy and leadership – or training for democratic leadership
Authors: Johansson Olof
Published: July 2006

The rationale behind the theme is that in most countries, there are mission statements in different laws and policy documents that describe the purpose of schools. Most of those statements contain two goals; passing on knowledge from one generation to the next and the upbringing of good and harmonious citizens who shall be able to take over and continue to develop the world's democratic societies. If it is decided to believe that the policy makers want to have democratic schools that foster the next generation, the style of leadership used in schools has to be reviewed. A question seldom asked is: What kind of leaders can be models for the goals and democratic values decided and what kind of training do they need? This special issue of Journal of Educational Administration presents a set of articles which explore this theme.
School leadership and leadership development
Authors: Gerhard Huber Stephan
Published: July 2006

This paper looks at the central role of school leadership for developing and assuring the quality of schools, as corroborated by findings of school effectiveness research and school improvement approaches. Then, it focuses on the growing importance placed on activities to prepare school leaders due to the ever‐increasing responsibilities they are facing. In many countries, this has led to the design and implementation of extensive programs. In this paper, international trends in school leader development are identified. As regards the aims of the programs, it becomes obvious that they are increasingly grounded on a more broadly defined understanding of leadership, adjusted to the core purpose of school, and based on educational beliefs integrating the values of a democratic society.
A democratic, learning and communicative leadership?
Authors: Johansson Olof
Published: July 2006

This paper focuses on the relationship between the national curriculum in Sweden and the training of head teachers. The original responsibility of the principal in the centralized system was to be a guarantor for good quality and to see that the state curriculum was carried out in accordance with the intentions in the law. The head teacher remains in charge of all educational activity in the school and should be familiar with everyday work in the school and promote educational change for school improvement. Since the mid‐1980s a national head‐teachers training programme has focused on pedagogical school leadership and school improvement. The aim of the present programme introduced in 2002 is that head teachers should develop and use a democratic, learning and communicative form of leadership that has its starting‐point in the national curriculum. After having completed the training, the head teacher should, on the basis of democratic principles and with regard to individuals' integrity and equal value, be able to lead and develop the school as well as asserting the rights of children and pupils to the education guaranteed in the government's legislation and regulations.
Leadership of the contested terrain of education for democracy
Authors: Starratt Robert J.
Published: July 2006

This paper summarizes and compares the perspectives of the prior essays in this issue. Goes on to argue that education for democracy requires dialogical, authentic learning rather than the commodification of uniform, standardized knowledge and its acquisition touted by those marketizing education primarily for economic purposes. The paper calls upon educators and university scholars to resist the identification of learning with text scores, and to defend the traditional role of learning in the human emancipation of citizens whose knowledge and life lessons learned in school contribute to their wise governance of themselves.
Improving business school courses by applying lean principles and practices
Authors: Emiliani M.L.
Published: July 2006

Describes the application of lean principles and practices to the design and delivery of a graduate business course on leadership taken by part‐time working professional students in a classroom setting. The principal objectives were to improve consistency between what was taught in the course and how the course was taught, eliminate waste, improve the quality and relevance of course materials, and deliver greater value as perceived by students. Results indicate a higher level of student satisfaction, in part through clearer expectations, less ambiguity regarding lectures and assignments, standard formats for assignments, smoothing individual and team assignments over the semester, and better management of students' time both in and outside class. This joins a growing body of work that demonstrates the applicability of lean principles and practices to service businesses, and the achievement of improved outcomes.
Embedding quality: the challenges for higher education
Authors: Lomas Laurie
Published: July 2006

This paper reviews recent research, literature and the views of a small sample of senior managers and academics in English higher education institutions on the challenges associated with embedding quality. When implemented by a university, quality enhancement models such as total quality management and the European Foundation for Quality Management need to be fitted in sympathetically with the organisation's culture and structures. If embedding is to occur, there needs to be a careful consideration of the opportunity costs of the various options that could bring about the necessary transformative change. The importance of transformative leadership and the creation of a conducive organisational culture are also explored, as are the major indicators of success. Senior managers and other change agents face major challenges but, by achieving the goal of embedding quality, students would receive greatly improved higher education and, as a consequence, their country's economy and society would also prosper.
The future of eLearning
Authors: Cross Jay
Published: July 2006

Corporate CEOs are finally telling the truth when they say “People are our most important assets”. Intellectual capital has become the primary factor of production. To raise their “corporate IQ”, managers treat workers as if they were customers of learning. This article explores why people learn much more about their jobs in the coffee room than in the classroom. It hypothesizes that equipping people intellectually to prosper will become a corporate discipline every bit as important as marketing or finance. Web services will mark the advent of workflow learning in real‐time organizations.
Factors affecting the adoption of manufacturing best practices
Authors: Ungan Mustafa
Published: July 2006

More recent survey‐based studies have indicated that, although many companies are involved in benchmarking, adoption of best practices is not as high as might be expected. This study was undertaken to identify the factors that have an impact on the adoption decision of manufacturing best practices. A review of the relevant literature identified ten potential factors. These can be classified into three categories: best practice factors, organizational factors, and environmental factors. Best practice factors include codification, complexity, compatibility, perceived operational benefits, and cost. Organizational factors include satisfaction with the existing practice, existence of champion, and organizational resource availability. Finally, environmental factors include perceived outside support and external pressures. The results indicated that cost of adoption, external pressures, and satisfaction with the existing practice are the main determinants of the adoption decision. These results should be of considerable interest to practitioners.
Achievements of the first wave personal medical services (PMS) pilots in England
Authors: Leese Brenda , Petchey Roland
Published: July 2006

Personal medical services pilots were introduced in England in 1998 to provide increased flexibility to general practitioners practising in deprived areas, to improve service provision and reduce inequalities. The aim of this study was to identify health authority perspectives of the achievements of their pilots. Less than half of the health authorities agreed that their pilots’ original objectives had been completely achieved. Support, commitment and enthusiasm from within and outside the pilots, and the ability to be flexible, were helpful in promoting change management. Obstacles were financial difficulties and a lack of understanding of personal medical services. The opinion was that personal medical services had made a highly regarded contribution to the local health economy, especially in the provision of new services and the promotion of new staff roles. The results provide lessons for primary care organisations in England and elsewhere in terms of the factors required to successfully implement change.
Developing the effectiveness of primary care organisations in the UK National Health Service
Authors: Willcocks Steve
Published: July 2006

This paper aims to explore the early experiences of a new primary care organisation in the NHS. It reports the findings of a longitudinal qualitative case study of one primary care group in its first year of operation. It concludes and makes recommendations in four key areas relevant to the development of the primary care group: the experiences of individuals and their readiness for change; clarity and consensus about roles and responsibilities in the new organisation; the process of change, and the impact of culture/power structures; and developing relationships with internal and external stakeholders.
Do star ratings really reflect hospital performance?
Authors: Snelling Iain
Published: July 2006

The publication of performance ratings for NHS Trusts (star ratings) is an important part of NHS policy. There are significant benefits to a Trust in being awarded the top rating of three stars. The methodology for awarding stars to acute hospitals is explained. The most significant areas of performance in determining a hospital's star rating are identified. The Department of Health claimed that performance in 2002 was better than in 2001, against standards that are getting tougher. This claim is assessed but no clear evidence is found to substantiate it. An alternative performance rating system using the same data is developed and compared with the official version to illustrate the importance of methodology – this system used only the outcome measures of hospital services included within the star ratings system, and not process measures. Only 41 per cent of hospitals would have received the same number of stars as their official rating. Some implications of the system of performance ratings are discussed.
Doing the analysis differently
Authors: Rea Anthony James
Published: July 2006

The aims and objectives of this paper were to understand the key influences hindering patients, participation in the contact tracing process for sexually transmissible infection exposure; to study the anatomy of a complex sexual network through the eyes of a committed contact tracer and a group of teenagers; and to identify lessons from the research. Unstructured and group interviews were undertaken with a group of sixth form students and an unstructured interview with a contact tracer. Cue (storyboards) cards and hypothetical sexual networks were used – the outcome demonstrated that generated narrative about sexual network experiences can be analysed using a schema of representation of experience and could be subjected to Labov's structural categories for assignment of spheres of action, to undertake interpretation. Themes identified include: confidentiality, secrecy, friendship, community, the law and social sanctions. We conclude that contact tracing is under the spotlight and that we need to understand the personal experiences of being subjected to a process where little consideration has been given to the social and psychological consequences. Narrative analytic strategies can be applied to gain this much‐needed rich data.
Clinical management and prioritisation criteria
Authors: Myllykangas Markku , Ryynänen Olli‐Pekka , Lammintakanen Johanna , Isomäki Veli‐Pekka , Kinnunen Juha , Halonen Pirjo
Published: July 2006

The aim of this study was to investigate the acceptability of 14 prioritisation criteria from nurses’, doctors’, local politicians’ and the general public's perspective. Respondents (nurses, n=682, doctors, n=837 politicians, n=1,133 and the general public, n=1,178) received a questionnaire with 16 imaginary patient cases, each containing 2‐3 different prioritisation criteria. The subjects were asked to indicate how important it was for them that the treatments in the presented patient cases be subsidised by the community. All respondents preferred treatments for poor people and children. With the exception of the doctors, the three other study groups also prioritised elderly patients. Treatment for institutionalised patients, those with self‐induced disease, diseases with both poor and good prognosis, and mild disease were given low priorities. Priority setting in health care should be regarded as a continuous process because of changes in attitudes. However, the best method for surveying opinions and ethical principles concerning prioritisation has not yet been discovered.
Building a research conscious workforce
Authors: Hurst Keith
Published: July 2006

With the aim of building a research conscious workforce, the former Northern and Yorkshire Research and Development office explored the nature and purpose of research and development (R&D) support for NHS staff. Part of the study used a questionnaire to seek healthcare professionals’ R&D education and training needs. Some findings were unexpected, such as the significant differences between professional groups’ needs and preferences. Recommendations, therefore, include local, flexible R&D education and training programmes.
The frontier of control: doctors and managers in the NHS 1966 to 1997
Authors: Harrison Stephen , Lim Jennifer N.W.
Published: July 2006

Summarises the impact of challenges of reorganization faced by the UK medical profession over a 30‐year period up to the arrival in government of New Labour in 1997 in order to provide a historical context for the appearance of clinical governance. Investigates the NHS manager as a “diplomat”, the era of “general management” and the National Health Service quasi‐market. States that: managerial supremacy has increased over a long period; managerial control over medicine seemed uncertain in 1997; and a good deal of secular change has arisen from government imposing macro‐level reorganization. Concludes that it remains to be seen whether these elements are capable of allowing the development of local clinical governance arrangements that carry the support of the medical profession.
Towards better prescribing – a model for implementing clinical guidelines in primary care organisations in the NHS
Authors: Rashidian Arash , Russell Ian
Published: July 2006

Clinical guidelines aim to disseminate evidence and thus to change behaviour. This process is complex and needs a coherent approach. Aims to develop a model for implementing clinical guidelines in primary care and thus influencing prescribing by general practitioners (GPs). A total of 25 semi‐structured interviews were conducted with GPs and primary care academics. To enrich the model an ongoing literature review of guideline implementation and changing prescribing behaviour was used. A simple model was derived to guide primary care organisations and GPs in implementing guidelines for prescribing, which comprises six steps: choose the condition; choose the guideline; identify influential people; identify organisational factors; plan and adopt an implementation strategy; and monitor the resulting adherence. The model provides a framework for planning the implementation of guidelines, and recognising barriers that hinder adherence to guidelines. It may help to explain why clinical guidelines vary in their uptake.
Janus: the two faces of the Commission for Health Improvement
Authors: Rowland Hilary
Published: July 2006

A complex, competing and paradoxical array of roles is ascribed to the Commission for Health Improvement (CHI). This contrast in roles is perhaps best epitomised by descriptions of its role as to support and aid development of trusts and health authorities, whilst at the same time being the reviewer and investigator. Is it possible to accommodate these competing roles in one organisation? How has it been done? And how real is its much‐trumpeted prized independence? This paper provides a brief contemporary history of CHI in its first two years, and a commentary on this first generation organisational regulator prior to its transformation to CHAI, the second generation manifestation.
Getting a word in edgeways? Patient group participation in the appraisal process of the National Institute for Clinical Excellence
Authors: Quennell Pauline
Published: July 2006

This paper examines patient organisations’ participation in the technology appraisals process of the National Institute for Clinical Excellence (NICE). In particular, it considers two policy areas prominent in recent UK government health reforms – patient participation and evidence‐based medicine (EBM). Data have largely been obtained from unstructured interviews with patient/carer groups involved in NICE’s technology appraisals, patient/carer representatives from NICE’s committees, and NICE personnel, supplemented by observation of NICE’s Board and Partners’ Council meetings, and analysis of documentary evidence. The paper focuses on the nature of “evidence” in NICE’s appraisals process, in particular patient groups’ concerns about the relative “weights” attached to patient and scientific evidence. NICE has taken some steps to allay such concerns, but more clarity is needed about how evidence from disparate sources is handled, if patient groups are to feel that their submissions of evidence have had more than marginal impact.
The value of visits to non‐involved and single‐handed practices from a primary care audit group
Authors: Holden John D.
Published: July 2006

Two series of visits to practices in a district in north west England were undertaken to encourage significant event review. The first was to non‐participants in audit projects who discussed lumbar‐sacral spine X‐rays and deaths with the GP facilitator. The second was to single‐handed GPs who discussed new diagnoses. Levels of participation and completion were high and there was a significant fall in the number of X‐rays requested compared with neighbouring controls. This method of influencing professional performance is compared with others. An evaluation questionnaire suggested that the method was acceptable and useful. It is suggested that academic detailing/practice visiting has a vital place in developing clinical governance in primary care, especially in recruiting those who have seldom been involved in audit activities in the past.
Bacterial meningitis: audiological follow‐up – closing the audit cycle
Authors: McCulloch Renee , Martin Katherine , Robertson Clare
Published: July 2006

Sensorineural hearing loss is a common sequel of bacterial meningitis in childhood and hearing assessment post‐meningitis is therefore essential. An audit performed of practice in a tertiary centre paediatric unit over 24 months in 1994‐1995 showed an 89 per cent referral and 81 per cent attendance rate for audiological assessment following bacterial meningitis. A repeat retrospective audit was performed over 12 months in 1998‐1999 following the introduction of guidelines and measures to improve education of medical staff and communication between professionals. This achieved a 100 per cent referral and attendance rate in a series of 27 children surviving bacterial meningitis in 1998‐1999, demonstrating the success of the process of the complete audit cycle in improving clinical practice.
The forgotten wait: official waiting times often misleading
Authors: Pope Vanessa , Sykes Peter A.
Published: July 2006

Official waiting times rarely take account of the wait for investigations needed prior to determining what treatment to offer. A postal survey was carried out of hospitals in the northwest of England, to gauge waiting times for commonly requested investigations. Waiting times were shortest when there was a high suspicion of underlying malignancy, with 92 per cent under four weeks. When malignancy was thought unlikely, the wait for investigations was much longer, with some departments quoting waits of over eight months. It is concluded that the wait for investigations is often considerable and should be included in official waiting times.
Prevent medication errors on admission
Authors: Dutton Karen , Hedger Neil , Wills Simon , Davies Pauline
Published: July 2006

The aim of this study is to quantify prescribing errors relating to pre‐admission medication in patients admitted to hospital. It also assesses the impact of a hospital pharmacist in identifying and correcting these errors. Standard prescription monitoring by the pharmacist took place on admission in phase 1 (526 patients). This was compared with an extension of the pharmacist’s role in phase 2 (506 patients) by taking a detailed medication history, including assessment of patients’ own drugs (PODs). A significant increase (p < 0.001) in errors detected and corrected was identified. In phase 2, 45.1 per cent of prescription charts contained one or more errors. Of these errors, 74.8 per cent could not be identified from checking the drug chart alone. As this is the principal method by which many hospital pharmacists check patients’ medication charts this is an area of concern. More than 50 per cent of errors were considered likely to cause destabilisation of a chronic medical condition, or serious adverse events. It has been shown that an effective way to prevent these errors and ensure the continuity of medication between primary and secondary care is for pharmacists to take a detailed drug history on admission.
Failed appointments – do telephone reminders always work?
Authors: Blankenstein Ronald
Published: July 2006

This audit was undertaken to determine whether there would be a decrease in failed appointments (did not attend DNA) from an average of 26 per cent over the previous nine months, by telephoning patients the day before their appointments as a reminder. The audit took place at a Community Dental Clinic in an area of high socio‐economic need. Of the 214 people telephoned during the six week audit period, 131 were contacted and 7 per cent failed their appointments, but the failure rate for the 83 people who could not be contacted was 43 per cent. It is probable that the overall DNA rate would have been considerably higher without this audit. However, the trend of failed appointments did not improve compared with the previous nine months. The reasons for failed appointments are complex but this audit has resulted in a change of protocol for clinics dealing with failed appointments. The issue of estimating the cost of missed appointments in a salaried service is difficult due to the lack of easily accessible treatment‐specific costs.
Medical assessment and direct admissions to a community hospital
Authors: Young John , Sharan Umesh
Published: July 2006

A new tier of intermediate care services for older people is being introduced in England and one function of these services will be district general hospital (DGH) admission avoidance. Concern has been expressed that this situation might compromise a prompt medical assessment. Reports recent experience with the medical assessment of directly admitted patients to a community hospital. The records of 81 of 87 patients admitted directly to the community hospital were available. The expected contributions to the medical assessment were not achieved by general practitioners in 27 patients (33 per cent); by hospital practitioners in 56 patients (69 per cent); and by consultants in 18 patients (22 per cent). Eight patients (10 per cent) had illnesses of greater complexity than initially considered and required transfer to the DGH. Concludes that, it can be difficult to ensure a timely medical assessment for patients admitted directly to an intermediate care service and critical incident reporting of patients who require transfer to a DGH should become a routine clinical governance activity for these services.
Benchmarking assertive community treatment: a report from Waltham Forest
Authors: Mirza Ilyas , Green Debbie , Luyombya Godfrey
Published: July 2006

Aims to describe the change in bed day usage of patients referred to an assertive outreach team. The setting is an outer borough of London. Describes the method as a retrospective longitudinal study in a group of 62 patients, examining their bed day usage before and after they were referred to the assertive outreach team. States the results and clinical implications as in‐patient bed day utilisation, a useful marker of service utilisation, was reduced significantly for patients following referral to the assertive outreach team. Provides a benchmark for newly established assertive outreach teams, which can be used to compare and evaluate the performance of other such services.
Piloting a systematic, evidence‐informed approach to service development in primary care
Authors: Bateman Hilarie , Emery Jon , Bastable Ruth , Bailey Peter
Published: July 2006

A systematic and evidence informed approach to new service developments (the “spotlight” approach) was developed with members of a new primary health care team. The approach aimed to ensure that service developments were relevant, grounded in evidence, documented and clearly owned by the practice team. A total of 13 spotlight developments were defined and documented during the first nine months. All considered relevance to local policy, all used research evidence and/or other accepted sources of appropriate expertise and all were discussed at team meetings. The spotlight approach quickly became accessible and familiar to new team members. It provides a common structure and language for discussion and documentation and is applicable to a wide range of service‐linked developments. It provides a vehicle for translating research into practice and the documentation to facilitate transfer of what has been learnt to others in the community for whom the development and its evidence base is relevant.
Informed consent for orthopaedic surgery: a prospective audit
Authors: Sharma Pankaj , Arya Anand , Singh Samrendu
Published: July 2006

A prospective audit of 76 patients undergoing elective orthopaedic surgery was performed. The aim of this audit was to assess how effectively patients are consented at a busy teaching hospital, and to suggest improvements to the process. Evaluates the level of information attained by patients after giving consent and their overall satisfaction with the process by use of a questionnaire. Results demonstrated that patients were often given incomplete information about their management. Despite this, patients themselves felt that the level of information given to them was appropriate, and allowed them to make an informed decision. Suggests the use of written information sheets and Internet Web sites to supplement the provision of information to patients. These modalities will allow patients to access as much information as they desire, while avoiding any potential anxiety due to provision of excess information.
Quality of documentation during consent procedures in a UK plastic surgery unit
Authors: Elliott Bruce , Cawrse Nicholas
Published: July 2006

Reports a retrospective review of 78 plastic surgery records comparing the quality of documentation of consent with agreed local policy in a district general hospital. Only 54 consent forms (69 per cent) were signed by a competent clinician, 21 (27 per cent) were signed by non‐competent staff and no consent form was found for three patients. Treatment options were noted to have been discussed in 14 records (18 per cent), anticipated benefits in seven (9 per cent), potential complications in 25 (32 per cent), and discussion of the proposed procedure and aftercare in 22 (28 per cent). These figures highlight the need for change identified recently in the UK and brought to the forefront by the “Good practice in consent” documents and deadlines. The implications of our results and future directions are discussed.
Risk management, records and the Laming Report
Authors: Cowan Jane
Published: July 2006

This article examines the substance and recommendations of the Laming Report into the death of Victoria Climbié. It discusses the implications from a risk‐management perspective, for clinical and non‐clinical professionals involved in child healthcare. It examines relevant recent literature, concerning general principles in adverse clinical outcomes, and discusses the specific advice of the Laming Report. It focuses on information handling, active and latent failures and record keeping. It aims to provide a framework in which to consider change in paediatric healthcare and system management, in order to decrease the risk of adverse outcomes of the type experienced in the case of Victoria Climbié.
Responding to variations in mortality due to intrapartum asphyxia
Authors: Thomas S.C. , Guildea Z.E.S. , Stewart J.H. , Cartlidge P.H.T.
Published: July 2006

The mortality rate due to intrapartum asphyxia is generally considered a good guide to the quality of perinatal care. Using a routine system of surveillance, we identified a six‐fold difference in mortality rate due to intrapartum asphyxia depending on the hospital of birth, with the lowest rate (95 per cent confidence intervals) of 0.25 (0.10, 0.64)/1,000 births and the highest rate of 1.59 (0.77, 3.27)/1,000 births. A framework of internal and external reviews of the clinical services was developed, that is able to tackle such clinical governance issues in a robust but sensitive manner. The outcome included specific improvements in service provision. The model is generally applicable and is thus suitable for use wherever such clinical governance issues are identified.
Ischaemic heart disease guidelines and cardiac medications use in veterans administration hospitals
Authors: Neugaard Britta I. , Zoble Robert G. , Beckstead Jason W. , Nelson Audrey L.
Published: July 2006

This study was designed to determine if health care provider utilization of cardiac medications has been influenced by the US Department of Veterans Affairs (VA) ischemic heart disease (IHD) guidelines dissemination. Retrospective chart reviews were conducted on a random sample of 1,397 IHD patients at six VA hospitals. Use of IHD medications was high even in the pre‐IHD guideline period, which may explain the lack of observed differences between the pre‐ and post‐guideline dissemination eras.
Copying letters to patients: using clinical risk management to minimise problems
Authors: Cowan Jane
Published: July 2006

From April 2004 doctors’ letters will be copied to patients. This article examines the potential benefits and pitfalls of the initiative. The issues are discussed from both the health professional’s and the patient’s perspective, with particular reference to consent and confidentiality.
Using benchmarking data for assessing performance in occupational therapy
Authors: Enderby Pam , John Alexandra , Hughes Anthony , Petheram Brian
Published: July 2006

Comparing outcome data derived from patients receiving treatment in different sites can identify different practice worthy of further examination. This paper illustrates an approach to benchmarking with data collected on 1,711 patients who have received occupational therapy in nine healthcare trusts. Detailed results of 288 patients indicate that there were differences between the services in the patients referred for occupational therapy, they were discharged at different points in their recovery and different amounts of gain were achieved during the treatment period. In order to interpret the reasons for the variation meaning needs to be added to the data. While casemix is an important consideration and may account for many of these differences, it would also appear that investigation of the different processes of care in different trusts may warrant further study.
The power of cultural influence on managerial behavior in organizations
Authors: Oh Alvin
Published: July 2006

One of the key management and leadership issues for the year 2000 and beyond has been a concern over the ability to manage in different countries and cultures. The models of leadership that we have come across so far deal with context in a comparatively narrow manner. The country and the culture in which an organization operates is another critical aspect of context which creates other demands on corporate managers.
Older people and the process of learning
Authors: Gray Harry
Published: July 2006

We all tend to think of older people as being about 15 years older than we are – whatever our age is – and yet it is now generally true that old people are a lot younger than they ever were. This means that almost everything that has been said and written about – for example – the over 50s no longer applies. Because of the demographic changes that are increasing healthy longevity, there has to be a reappraisal of the nature of work and the organization of employment, but unhappily there is little sign of this either on the part of governments or HRD managers and there has been little lead from the UK Employers Forum on Age which was supposed to address these issues.
The future of learning at work
Authors: Teare Richard
Published: July 2006

For the first time the US corporate university conference included a panel discussion with questions from corporate university leaders attending the event. The panel facilitator asked panelists to imagine that we were looking back on the developments that took place between 2002 and 2007. I have captured my responses to the questions posed.
360 aggregate reporting advances human asset management
Authors: Hallam David
Published: July 2006

A multi‐hospital health system was facing urgent new demands related to staff development, driven by internal and external factors. To improve the standard of care, and to counter increasing public criticism, its leaders wanted to offer more effective skill development opportunities for employees. At the same time, they needed to respond to governing bodies which had begun to demand more data about the levels of staff competency.
Developing knowledge workers on the factory floor
Authors: DiGiovanni Michael
Published: July 2006

The term “knowledge worker”, coined by management guru Peter Drucker, generally describes an employee whose job activities are associated with the refining, manipulating and trading of information. Contrast this with the description of the typical industrial worker, whose activities are centered on the production and development of tangible objects and commodities. In today’s fluid, rapidly evolving global marketplace, labor‐intensive low‐skilled manufacturing jobs will continue to migrate to countries where a lower wage can be paid, while manufacturing enterprises in developed nations will remain under pressure to increase both productivity gains and product quality.
Making the most of informal mentoring
Authors: Clutterbuck David
Published: July 2006

One of the goals of many formal mentoring programs is to bring the organization to the point where the majority of mentoring is carried out informally, without the need for substantial, structured support from HR and elsewhere. The problem, in most cases, is that completely informal mentoring – where people come together without guidance and without clarity about the mentoring role – is a hit and miss affair. Not only is the quality of the relationships highly variable, but the pairings tend to exclude people who do not fit the mould, by virtue of their gender, race, culture or some other differentiating factor.
Feature articles Leadership development
Authors: Bennett Ben
Published: July 2006

Interest and investment in leadership development continues to grow at a considerable pace, where organizations view it as an important source of competitive advantage. Over the years research into leadership has moved from concerns with supervisory leadership (leadership in the organization) to strategic leadership (leadership of the organization). With the creation of what have been termed the “new leadership” theories, from the 1980s onwards we have had the promotion of concepts such as transformational, charismatic and visionary leadership.
Designing the workplace for learning and innovation
Authors: van der Sluis Lidewey E.C.
Published: July 2006

It is clear that when one considers learning and innovation in organizations, the work environment is a highly important influence in terms of facilitators or inhibitors of learning, and creative behavior on the job. The climate for learning and innovation of the department, business unit or organization is important.
Prepared minds
Authors: Pool Steven W.
Published: July 2006

Strategic planning is a management process preparing executives’ minds for identifying major opportunities within the organization that impact future decisions. This planning process entails managerial choices and signals organizational commitment to specific markets, competitive approaches, and methods of operation.
Managing change during a transition period
Authors: Palo Sasmita , Panigrahi Sweta
Published: July 2006

Over the past two decades, several countries across the globe have been restructuring their power sector. Orissa has earned the distinction of being the first state in the Indian Union as well as the first region in South Asia to bring about reform in the electricity sector. Under the reform program, the former Orissa State Electricity Board was unbundled into generation, transmission and distribution and the four distribution zones were privatized through the process of international competitive bidding.
Closing the learning gap
Authors: Thorpe Caroline
Published: July 2006

The proliferation of e‐learning is challenging the convention, not only of where and how it is possible to learn, but also of who is able to learn. For a number of the UK’s disabled, those whose early education either was not completed or was not even possible, online courses have enabled them to finally close the gaps in their education and gain the skills necessary to further their careers.