bluuebunny/crossref_metadata_2025 huggingface dataset:
Interoperability provision in NGC: the case of Italian DTV
Authors: Matteucci Nicola
Published: October 2009

Purpose

The deployment of next generation communications (NGC) progresses unevenly, frequently suffering from insufficient interoperability. Interoperability remains a fundamental driver for NGC diffusion, but existing theories remain vague on how to ensure its provision. Since interoperability features increasing returns and public good regimes, its market provision may be hampered. At the same time, public efforts might be ineffective when colliding with private operators' incentives. Sometimes, the policy instruments used might even distort technological diffusion and competition in a way incompatible with a market‐neutral approach. This paper aims to investigate these issues.

Design/methodology/approach

This paper first reviews the literature on the economics of standardisation, the provision of private and public goods and the regulation of NGC. Then, it illustrates the EU policy on interactive television. Finally, it presents a research case study, analysing the recent implementation of this policy in Italy.

Findings

Coherently with the hypothesis of the literature, the case study confirms that the public‐private interplay for interoperability is complex, and that the public and subsidised provision of an open standard might be captured by private interests.

Research limitations/implications

The case study is representative of the dilemmas affecting future policy‐making in NGC. More case studies will corroborate the above findings, better clarifying the available options to ensure a virtuous public private interplay.

Practical implications

Policy should be carefully framed in a way to impose market‐neutral implementations. Further, open standards – although valuable – are not a panacea and can be useless when systemically tied to other proprietary intellectual property rights (IPRs).

Originality/value

This is a first case study in a new field of policy assessment. The evidence provided is valuable for scholars, practitioners and policy‐makers dealing with NGC.
Innovation in information society policy: rationale, policy mix and impact in The Netherlands
Authors: Poel Martijn , Kool Linda
Published: October 2009

Purpose

The purpose of this paper is to explore how innovation has become more important in information society policy and what the implications are for policy design, policy coordination and policy evaluation.

Design/methodology/approach

Against the background of European information society policy, a case study is done on the policy mix for ICT innovation in The Netherlands. A highly structured qualitative methodology is developed to analyse the relevant policy instruments in information society policy and innovation policy. The methodology includes a typology for rationale, policy instruments and element of the innovation process.

Findings

To a large extent, information society policy and innovation policy are complementary. There is some overlap between policy instruments. The rationale and objectives can be more explicit. The policy mix had a positive impact on information communication technology (ICT) knowledge, broadband and e‐government.

Originality/value

The paper presents the relevance, methods and results of a detailed study on the intersection of two policy fields: information society policy and innovation policy.
User‐led, citizen innovation at the interface of services
Authors: Pascu Corina , van Lieshout Marc
Published: October 2009

Purpose

The paper attempts to reflect on user empowerment enabled by three contemporary approaches, namely living labs, open innovation and social computing, as innovation instruments for innovating products and services based on next generation networks (NGNs).

Design/methodology/approach

The paper takes the form of a literature review, with limited environmental scanning of web sources, industry news, etc.

Findings

User‐centric services can be a catalyst for promoting future service ecosystems over NGN. Open strategies may prove to be profitable avenues for incumbents who may consider the extension of the market from access services into value added services. The living lab perspective, used as an approach of developing NGNs, introduces the opportunity to open new markets in new regions where new products and services can be tested and deployed. Living labs can also be used to go beyond the current “launch‐and‐learn” approach in online social communities to active end‐user participation in the online communities' development process. NGNs may be particularly useful for social computing, by offering incentives to create novel services that are fully created, developed and deployed by users.

Originality/value

This paper argues that user‐led innovation could be a significant paradigm shift for innovating products and services, particularly in the specific context of NGNs. It argues that this focus is lacking today, with most of the attention on specific NGN technology and infrastructure issues.
Project selection and its impact on the successful deployment of Six Sigma
Authors: Kumar Maneesh , Antony Jiju , Rae Cho Byung
Published: October 2009

Purpose

The purpose of this paper is to focus on the importance of the project selection process and its role in the successful deployment of Six Sigma within organizations.

Design/methodology/approach

A review of the literature is presented, highlighting the importance of project selection in Six Sigma deployment, which is an area of extreme importance that has been less researched in the past. The paper, through a real‐life case study, proposes a hybrid methodology, which combines the analytical hierarchy process and the project desirability matrix to select a project for Six Sigma deployment.

Findings

The paper demonstrates the efficacy of proposed methodology by its application in a small and medium‐sized enterprise (SME) manufacturing die‐casting product. The example provided is a real‐life case study conducted by the authors in an organization embracing the Six Sigma business strategy within their day‐to‐day functioning.

Research limitations/implications

The proposed methodology is tested only in a case study SME, which is the limitation of the paper. The robustness of the methodology can be tested by conducting several case studies in organizations and comparing the results with other existing methodologies for project selection such as project prioritisation matrix or the failure mode and effect analysis.

Practical implications

The paper accentuates the importance of the project selection process for Six Sigma deployment, which can have a tremendous effect on the business profitability of an organization. The paper is relevant to both industry practitioners and researchers.

Originality/value

The paper presents a methodology linking the project selection process to successful deployment of Six Sigma within organizations, an important topic that has been neglected in the past. The paper will enable managers and practitioners to emphasize the importance of project selection and to identify and focus on the critical success factors in successful deployment of Six Sigma projects.
Understanding how project critical success factors affect organizational benefits from enterprise systems
Authors: Zhong Liu Ann , Seddon Peter B.
Published: October 2009

Purpose

The purpose of this paper is to present and test a model that seeks to answer Robey et al.'s challenge that “ERP's critical success factors offer few insights beyond conventional wisdom.” The model proposes that many so‐called critical success factors (CSFs) affect organizational benefits from enterprise systems use (OBESU) through their impact on three outcomes of an enterprise systems (ES) implementation process, namely functional fit, overcoming organizational inertia, and delivering a working system.

Design/methodology/approach

The model is tested using content analysis of 133 customer presentations at SAP's April 2007 Sapphire USA Conference.

Findings

The benefit‐driver approach appears to provide at least one good answer to Robey et al.'s challenge.

Research limitations/implications

It seems likely that the model is valid for most large Western organizations implementing ES.

Practical implications

The model provides new insights into how and why the CSFs affect benefits from ES.

Originality/value

No prior study to the best of one's knowledge has sought to explain in such depth how ES project CSFs affect OBESU.
Business process management (BPM) standards: a survey
Authors: Ko Ryan K.L. , Lee Stephen S.G. , Wah Lee Eng
Published: October 2009

Purpose

In the last two decades, a proliferation of business process management (BPM) modeling languages, standards and software systems has given rise to much confusion and obstacles to adoption. Since new BPM languages and notation terminologies were not well defined, duplicate features are common. This paper seeks to make sense of the myriad BPM standards, organising them in a classification framework, and to identify key industry trends.

Design/methodology/approach

An extensive literature review is conducted and relevant BPM notations, languages and standards are referenced against the proposed BPM Standards Classification Framework, which lists each standard's distinct features, strengths and weaknesses.

Findings

The paper is unaware of any classification of BPM languages. An attempt is made to classify BPM languages, standards and notations into four main groups: execution, interchange, graphical, and diagnosis standards. At the present time, there is a lack of established diagnosis standards. It is hoped that such a classification facilitates the meaningful adoption of BPM languages, standards and notations.

Practical implications

The paper differentiates BPM standards, thereby resolving common misconceptions; establishes the need for diagnosis standards; identifies the strengths and limitations of current standards; and highlights current knowledge gaps and future trends. Researchers and practitioners may wish to position their work around this review.

Originality/value

Currently, to the best of one's knowledge, such an overview and such an analysis of BPM standards have not so far been undertaken.
Improving decision making for sustainability: a case study from New Zealand
Authors: Geertshuis Susan
Published: October 2009

Purpose

The purpose of this paper is to describe and evidence a means of improving decision making within a sustainable resource management context.

Design/methodology/approach

A set of competencies required by effective decision makers is developed. Methods of improving decision making are reviewed and used to develop a continuing education programme that addressed each competency. Following piloting, 1,300 lay and professional decision makers are trained and assessed.

Findings

It is possible to capture the skills required of decision makers and to develop decision‐making performance within relatively short courses.

Practical implications

To be of any real value education for sustainability must not only increase awareness and knowledge but must also impact on decision making. The paper argues for an explicit consideration of decision making in learning design and describes the use of techniques that can be readily appropriated by others.

Originality/value

The paper demonstrates the effectiveness of training in decision making delivered to a wide range of practitioners. The paper also illustrates the contribution universities can make in working to improve sustainability outcomes through continuing education at a national level.
Institutionalizing a greenhouse gas emission reduction target at Yale
Authors: Rauch Jason N. , Newman Julie
Published: October 2009

Purpose

The purpose of this paper is to analyze the development and implementation of how a greenhouse gas (GHG) reduction target at Yale University has resulted in broad and long‐term institutional commitment.

Design/methodology/approach

Interviews are conducted with key individuals representing those most directly involved in developing and implementing Yale's GHG target.

Findings

The development of an institutional GHG reduction target calls upon a recursive process. A goal starts with a vision, followed by development, endorsement and implementation, and leads to institutional change. With change, comes new perspective to define a new vision. Upfront development of an implementation plan is critical not only for successful goal implementation, but also for endorsement from institutional leadership.

Research limitations/implications

A process for the development of a GHG reduction target is extrapolated from only one case study. Further case examples would be helpful.

Practical implications

This case study relays an experience that may help other institutions to implement their own GHG reduction targets, and other sustainability goals more generally.

Originality/value

This paper highlights the importance of institutional goals in creating sustainable universities. A process by which institutions can follow to achieve GHG emission reductions is suggested.
An empirical study of the use of e‐security seals in e‐commerce
Authors: Chien‐Ta Ho Bruce , Oh Kok‐Boon
Published: October 2009

Purpose

The purpose of this paper is to examine the use of e‐security seals on web sites and their relative impact on e‐commerce firm reputation in influencing customers' perceptions of trust in a service provider.

Design/methodology/approach

Two interrelated empirical studies are conducted to evaluate the use and impacts of e‐security seals in e‐commerce. An exploratory study methodology investigates the use of e‐security seals and a questionnaire survey is used to gauge consumer knowledge of seals.

Findings

Using survey data from 211 web users, the results show that 106 respondents are cognitive and affective of e‐security seals. The results also provide further clarification of the relationship between e‐security seals and sales effectiveness. The findings point towards a positive belief by consumers in e‐security seals.

Research implications

Third‐party e‐security seals organisations should undertake more promotional activities and advertising to educate comsumers about the use and benefits of e‐security seals.

Originality/value

An important issue in e‐commerce is how trust is developed between consumers and e‐vendors. This paper investigates the use of e‐security seals and their influence on consumer confidence in the online environment.
Structure‐preserving and query‐biased document summarisation for web searching
Authors: Canan Pembe F. , Güngör Tunga
Published: October 2009

Purpose

The purpose of this paper is to develop a new summarisation approach, namely structure‐preserving and query‐biased summarisation, to improve the effectiveness of web searching. During web searching, one aid for users is the document summaries provided in the search results. However, the summaries provided by current search engines have limitations in directing users to relevant documents.

Design/methodology/approach

The proposed system consists of two stages: document structure analysis and summarisation. In the first stage, a rule‐based approach is used to identify the sectional hierarchies of web documents. In the second stage, query‐biased summaries are created, making use of document structure both in the summarisation process and in the output summaries.

Findings

In structural processing, about 70 per cent accuracy in identifying document sectional hierarchies is obtained. The summarisation method is tested on a task‐based evaluation method using English and Turkish document collections. The results show that the proposed method is a significant improvement over both unstructured query‐biased summaries and Google snippets in terms of f‐measure.

Practical implications

The proposed summarisation system can be incorporated into search engines. The structural processing technique also has applications in other information systems, such as browsing, outlining and indexing documents.

Originality/value

In the literature on summarisation, the effects of query‐biased techniques and document structure are considered in only a few works and are researched separately. The research reported here differs from traditional approaches by combining these two aspects in a coherent framework. The work is also the first automatic summarisation study for Turkish targeting web search.
The identification of distinguishing term characteristics from relevance feedback
Authors: Chou Shihchieh , Chang Weiping
Published: October 2009

Purpose

The purpose of this paper is to identify distinguishing term characteristics from among the information of term appearance situations (tas) residing in the relevant/irrelevant documents retrieved for use. Terms with specific characteristics could be used in the distinguishing of user profiles, documents, pages or concepts to assist in information retrieval.

Design/methodology/approach

First, a method to apply the potential term characteristics in the distinguishing of user profiles in the information retrieval environment is designed. Then, an information retrieval system is developed to demonstrate the realisation and sustain the study of the method. Formal tests are conducted to examine the distinguishing capability of the potential term characteristics proposed in the method.

Findings

The results of the tests show that the potential term characteristics proposed in this study are successfully applied in the distinguishing of user profiles in the information retrieval environment.

Originality/value

Identification of distinguishing term characteristics would expand the ground for the IR community in the design of feature‐extraction algorithms or systems that try to cull information from structured or unstructured documents.
Intellectual capital disclosure and the fashion industry
Authors: Davey Janet , Schneider Lily , Davey Howard
Published: October 2009

Purpose

The purpose of this paper is to examine the nature and extent of intellectual and marketing capital disclosure among fashion companies, specifically to compare intellectual capital (IC) disclosure between European and North American fashion companies as well as between fashion industry sectors.

Design/methodology/approach

A coding framework proposed by Guthrie and Petty and adapted by Shareef and Davey was further developed for the fashion context and the top 15 European companies and the top 15 North American companies with accessible 2005 annual reports were analysed.

Findings

The voluntary annual report disclosures confirmed brands as highly valuable capital assets, central to competitiveness and differentiation in this industry. Fashion firm disclosures also reflected organisational change processes and philosophies in several cases. However it is concluded that fashion companies do not value the role of the consumer in the brand value dynamic, customer satisfaction, nor customer loyalty as intellectual capital assets.

Research limitations/implications

The limitations include the subjectivity of the coding process and because many fashion houses remain in private ownership.

Practical implications

Many items of IC are marketing related, however the disclosure of marketing capital and the implications for value adding potential needs better understanding. Traditional accounting practices only partially recognise the value of an organisation's intellectual capital and therefore, the organisation's ability to generate wealth in the future is poorly represented.

Originality/value

The findings contribute to the IC disclosure literature in a fresh and unique way by analysing the fashion industry for the first time.
Intellectual capital prospectus disclosure and post‐issue stock performance
Authors: Singh Inderpal , Mitchell Van der Zahn J‐L.W.
Published: October 2009

Purpose

The primary purpose of this paper is to investigate the association between intellectual capital disclosures in initial public offerings (IPOs) and post‐issue stock performance.

Design/methodology/approach

The analysis is based on a sample of 259 IPOs listing on the Singapore Stock Exchange (SGX) between July 1, 1999 and June 30, 2005. Post‐issue stock performance is measured using market‐adjusted buy‐and‐hold returns across a 500 trading day observation window after listing. Intellectual capital disclosure is measured using an 81‐item index.

Findings

The study's major finding is a negative association between the level of intellectual capital disclosure in IPO prospectuses and post‐issue stock performance. The negative association persists regardless of industry type but is stronger for small IPOs relative to larger counterparts.

Research limitations/implications

The study includes only Singapore IPOs within a specific timeframe concentrating on a single disclosure mechanism. Furthermore, the analysis focuses on an association rather than causal relationship.

Practical implications

The findings imply greater intellectual capital prospectus disclosure may contribute to investor over‐optimism leading to higher IPO mispricing. As information becomes available post‐issue, and over‐optimistic expectations are not immediately met, investors aggressively discount shares leading to greater negative post‐issue stock performance for high IC disclosing IPOs. Pre‐listing owners/management may exploit the speculative environment generating higher wealth transfers from investors. Policymakers may need to introduce (some) uniform intellectual capital disclosure requirements to reduce speculative market conditions.

Originality/value

This paper documents the first study to provide empirical evidence of the association between intellectual capital disclosures and post‐issue stock performance; thus, it offers a new path for future intellectual capital disclosure research and understanding.
Inspiring a global workforce in an era of change and consolidation: introducing the Luvata Way
Authors: Roux Justin
Published: October 2009

Purpose

The purpose of this paper is to share the key findings of a program of change at global metals/manufacturing group Luvata, and its impact on leadership, motivational and communications strategy. Luvata's story involves the development of a new global brand based on the acquisition of 65 companies and the management of a mainly blue‐collar workforce in multiple locations around the world. Luvata's business strategy is summed up in the phrase “partnerships beyond metals” – moving towards providing higher value services to its customers instead of just products or materials. To achieve this strategy, it needed everyone in the company to adopt a problem‐solving culture.

Design/methodology/approach

The paper is built around the findings of a third‐party external auditing group, which runs an annual internal survey to measure employees' attitudes on a range of measures, including internal communications, chain of leadership and how well connected they feel to Luvata's purpose.

Findings

The annual survey shows significant improvements over the past few years. Three years ago, 54 percent of Luvata people had no access to a PC and 18 percent of staff felt “alienated from the purpose of the group.” The 2008 survey found that 72 percent are familiar with Luvata's values, while 70 percent feel they have a “passion for results” and 68 percent say “we deliver on our promises.” A total of 72 percent of respondents believe they work towards clear quality objectives.

Originality/value

Until now, Luvata has kept its corporate story under the radar and has not communicated it externally. This is the first time that Luvata has published a case study about its journey so far, and believes that it raises some valuable points of interest for companies in a similar position.
How we transformed our culture in 100 days: the story behind an intensive culture change program at HSBC Argentina
Authors: Losada Antonio , Bajer Javier
Published: October 2009

Purpose

This paper aims to inspire and support leaders wanting to change the culture of large and complex organizations by sharing what HSBC experienced in Argentina, describing how and why an entire organization recently went through 100 days of intense activity, significantly changing the culture of over 6,000 employees.

Design/methodology/approach

Details of this case study are given using two different “voices” and perspectives: one from the CEO and the other one from a program implementation angle. The connection between the people and business perspectives runs throughout, describing the major elements of the culture change program used and the results achieved.

Findings

The experience provides evidence that it is possible to change the culture of an organization in about three months, regardless of how challenging it might seem at the start. Most importantly, the new culture can be sustained over time when a tipping point is reached across the organization.

Originality/value

The program described here challenges traditional culture change approaches, presenting a concrete and proven method that does not rely on communication campaigns or rewards strategies to drive real change in record time.
Micro data assessment of Russian drug benefit monetization
Authors: Besstremyannaya Galina
Published: October 2009

Purpose

The drug benefit reform implemented in Russia in 2005 allowed benefit groups to choose between the fixed monetary compensation or the in‐kind benefits. This paper seeks to study the efficiency of the in‐kind drug benefit system before and after the reform by comparing mandated groups of monetary savings within each of the schemes.

Design/methodology/approach

Pair‐wise correlation analysis using the Federal Social Insurance Fund benefit groups database (85 regions in 2005‐2006) and two representative consumer expenditure surveys: the National Assessment of Population Welfare and Participation in Social Programs – NOBUS (47 regions, over 40,000 households, 2003) and the Russia Longitudinal Monitoring Survey – RLMS (32 regions, over 4,000 households, 2003).

Findings

The paper finds that giving the mandated population a choice between the two schemes led to an increase in demand for drugs and adverse selection within the in‐kind drug provision system.

Research limitations/implications

The Federal Social Insurance Fund aggregated data allow one to make post‐reform estimations only for an average representative of a certain benefit group. Employing micro data on both pre‐ and post‐reform consumer behavior would become a tool for more precise econometric analysis.

Practical implications

The results of the correlation analysis demonstrate an imbalance in the solidarity principle and the need for introducing health and drug insurance mechanisms in the Russian drug benefit programme.

Originality/value

The paper represents an attempt to use a large sample statistical analysis along with the Federal Social Insurance Fund data in order to assess drug benefit groups of behavior in Russian regions before and after the drug benefit reform.
Authentic leadership: a new theory for nursing or back to basics?
Authors: Wong Carol , Cummings Greta
Published: October 2009

Purpose

Authentic leadership is an emerging theoretical model purported to focus on the root component of effective leadership. The purpose of this paper is to describe the relevance of authentic leadership to the advancement of nursing leadership practice and research and address the question of whether this is a new theory for leadership or an old one in new packaging.

Design/methodology/approach

The paper outlines the origins and key elements of the model, assesses the theoretical, conceptual and measurement issues associated with authentic leadership and compares it with other leadership theories frequently reported in the nursing literature.

Findings

The emerging authentic leadership theory holds promise for explaining the underlying processes by which authentic leaders and followers influence work outcomes and organizational performance. Construct validity of authentic leadership has preliminary documentation and a few studies have shown positive relationships between authenticity and trust. Furthermore, the clarity of the authenticity construct and comprehensiveness of the overall theoretical framework provide a fruitful base for future research examining the relationship between authentic leadership and the creation of healthier work environments.

Originality/value

A clear focus on the relational aspects of leadership, the foundational moral/ethical component, a potential linkage of positive psychological capital to work engagement and the emphasis on leader and follower development in the authentic leadership framework are closely aligned to current and future nursing leadership practice and research priorities for the creation of sustainable changes in nursing work environments.
Matching surgical operating capacity to demand using estimates of operating times
Authors: Westbury Sarah , Pandit Meghana , Pandit Jaideep J.
Published: October 2009

Purpose

This paper sets out to investigate whether demand for gynaecological theatre time could be described in terms of the time required to undertake elective operations booked for surgery, and so help match the capacity to this.

Design/methodology/approach

A questionnaire assessed the estimates for total operation time for seven common operations, sent to surgeons, anaesthetists and nursing staff in one tertiary referral and one district general hospital (total 49 staff; response rate 58 per cent), and estimates were obtained from theatre computer logs. Average timings for each operation were then applied to cases added from clinics to the waiting list at the district general, to yield the mean demand for elective surgery, and were also applied to emergencies to estimate emergency workload. Finally these demand estimates were compared with the theatre capacity available.

Findings

The paper found no difference between the estimates of the three staff groups or between these and the theatre logs (p=0.669), nor did it find that estimates differed between the two centers (p=0.628). Including emergencies, the mean (95 per cent confidence intervals) demand at the district general was 2,438 (1,952‐2,924) min/week.

Research limitations/implications

Although the paper modelled the variation in demand using the relevant variation in operation times, any additional variation caused by differences in booking rates from clinics over time was not nodelled. The minimum period over which data should be collected was not established.

Practical implications

The paper finds that the existing capacity of 1,680 min/week did not match these needs and, unless it was increased, a rise in waiting lists was predictable.

Originality/value

The paper concludes that time estimates for scheduled operations can be better used to assess the need for surgical operating capacity than current measures of demand or capacity.
Independent feedback on clinical audit performance: a multi‐professional pilot study
Authors: Bowie Paul , Quinn Pat , Power Ailsa
Published: October 2009

Purpose

The purpose of this paper is to investigate the acceptability and educational impact of independent feedback on the clinical audit performance of different groups of healthcare professionals by trained colleagues.

Design/methodology/approach

This is a pilot study involving review of the criterion audit and significant event analysis (SEA) attempts of west of Scotland dentists, pharmacists, physiotherapists, practice managers and nurse practitioners by trained colleagues using validated instruments. Audit, SEA and feedback reports were content‐analysed. Data on pre‐ and post‐study attitudes, experiences and knowledge levels were collected by questionnaire. T‐tests for differences in mean group scores were calculated, along with 95 per cent confidence intervals for mean differences. A difference in mean scores of 1.0 or greater would be indicative of educational gain.

Findings

A total of 34 participants submitted 54 audit and SEA reports, with 20 submitting both (58.9 per cent). In total, 14/20 audits (75.0 per cent) and 26/34 SEAs (76.5 per cent) contained evidence of appropriate learning needs and action(s) implemented for healthcare improvement. Feedback focused on knowledge and skills in applying audit methods; demonstrating insight into deficiencies; highlighting appropriate learning needs; and implementing change. Audit knowledge and skill scores increased by a mean difference of ≥1.0 for most stages of audit and SEA method (p<0.001). Strong agreement on the value of independent feedback on clinical audit was reported.

Research limitations/implications

The study highlights some of the difficulties in applying audit methods across professions and highlights the added value of feedback by trained colleagues, but is limited in size.

Practical implications

Integrating clinical audit and peer feedback with continuing professional development obligations may facilitate greater engagement and more effective quality improvement, but will require a policy change and additional resource.

Originality/value

This small study provides further evidence of the acceptability and educational impact of independent feedback on clinical audit performance for healthcare professionals.
What were the lessons learned from implementing clinical audit in Latin America?
Authors: Siddiqi Kamran , Newell James
Published: October 2009

Purpose

This paper seeks to study the process of clinical audit to improve tubercolosis (TB) diagnosis in Cuba, Peru and Bolivia. It aims to present the lessons learned in implementing clinical audit in the three specific study sites and highlight what may be relevant to low‐income settings in general.

Design/methodology/approach

The lessons are based on observations and qualitative data collected from 22 health centres that completed a minimum of two audit cycles in the three study countries. Local audit committees selected audit criteria, collected relevant data, compared their performance against the agreed standards and proposed ways for improvement.

Findings

Lessons for the development of clinical audit for TB diagnosis in the study countries include the difficulties in setting achievable standards based on appropriate criteria; the need to establish clinical guidelines and routine data; and the need to address patients' beliefs and attitude. Lessons for the development of clinical audit in low‐income countries include the need for preparation (e.g. through clinical guidelines) before introducing quality improvement tools and the importance of a visible relationship between audit activity and patient care. Crucially, local clinicians struggle in developing evidence‐based audit criteria that should be developed at national level.

Research limitations/implications

The lessons learned presented here are derived from interviews, document analysis and participant observation. Such techniques are liable to observers' and informants' bias. Similarly, conclusions drawn from an inquiry into contextual factors also threaten their external validity. The paper used chronological analysis and explanation building to overcome these limitations.

Practical implications

In low‐income countries, audit needs to be fully integrated in the national and local disease control programmes. The lessons presented here provide practical guidance for those considering developing or improving clinical audit in low‐income countries.

Originality/value

Clinical audit has major potential for improving health care delivery in low‐income countries within existing resource constraints. The lessons presented here have relevance to audit across the entirety of health systems in low‐income countries.
Traffic Lights
Authors: Ashir Mohammed , Marlowe Karl
Published: October 2009

Purpose

The current risk management system for community mental health patients in England is based around the Care Programme Approach (CPA). This system is not responsive to changes in risk for community patients. This paper aims to introduce a practical system to manage risk that has been developed for an Early Intervention Service in East London on the basis of need.

Design/methodology/approach

Coding of red, amber and green is associated with specific criteria agreed by all disciplines in the team. The change of a code leads to a rapid change in risk level and management. An agreed clinical and non‐clinical action plan leads to a whole team response. The limitation of use is dependent on the size of the case load and the number of clinical staff attending a daily clinical briefing.

Findings

Zoning according to the traffic lights system could complement the CPA system and support a clinical governance structure utilising a whole team response.

Research limitations/implications

The risk management system described has not been tested empirically. Currently it has been used in early intervention mental health teams but will need to be adapted for other teams with bigger case loads.

Originality/value

This practical risk management system is aligned with the statuary CPA requirements. A dynamic and flexible management of risk is central to early intervention in psychosis teams but the risk management system described can suit any community mental health team and fits well with the distributed responsibility model of functionalised teams according to new ways of working.
ADHD service provision by paediatricians: UK survey
Authors: Banerjee Somnath , Kewley Geoff
Published: October 2009

Purpose

Various guidelines are available to help effectively manage attention deficit hyperactivity disorder (ADHD) in children. This paper aims to determine the current service provision for children with ADHD in the UK.

Design/methodology/approach

A cross‐sectional survey of the UK paediatricians was conducted online.

Findings

A total of 93 completed survey forms were received. Of the clinicians, 71 per cent assessed one to five new cases every month; 51.6 per cent clinicians followed up six to 20 children, whereas 29 per cent followed up 31 to 50 cases per month. A total of 77.4 per cent worked jointly with CAMHS. There was no support by a nurse to 83.9 per cent and a junior doctor to 71 per cent clinicians. Share care was in place in 74.2 per cent; 19.3 per cent did not have a local guideline. Audit of the ADHD clinic was done by 71 per cent responders.

Originality/value

The paper reveals that service for children with ADHD offered by paediatricians showed wide variation. There is a need for more provision of resources to enable comprehensive assessment and multimodal treatment for ADHD.
POA, HAC and never events
Authors: Birnbaum David
Published: October 2009

Purpose

This paper seeks to summarize recent developments announced by the USA's third‐party payers, changing the basis on which they reimburse hospitals for services rendered. Outcome, not just service delivery, now matters more than ever.

Design/methodology/approach

The paper takes the form of a narrative review starting from public records of events which the author attended.

Findings

In 2006, the Centers for Medicare and Medicaid Services announced an intention to investigate ways of using their purchasing power to promote reduction or elimination of serious and costly errors in the provision of health care services – costly errors that should never happen. In 2008, they announced their new policy. CMS will start denying payment of bills for service in cases where various adverse outcomes occur unless those complications are present on admission. This represents important leadership toward rewarding quality, but raises many important questions about operational details.

Research limitations/implications

The impact and effectiveness of pay‐for‐performance initiatives need to be monitored as new initiatives become operational

Practical implications

Until recently, bills were tendered and paid regardless of quality of care. Leading hospitals and third‐party payers are giving more attention to best practices for dealing with medical error, including not presenting a bill in egregious cases. Hospitals now also face denial of additional payment for treating complications where those complications are deemed preventable.

Originality/value

Historically, financial disincentives diminished the monetary value of steadily improving the safety and quality of patient care. Now, healthcare providers are being put on notice by influential third parties that the payment formula is being corrected. That change has been announced, and responses are being debated, in a very public manner.
Creating opportunity from crisis: taking a strategic and learning‐focused perspective
Authors: Ahmed Arif
Published: October 2009

Purpose

The recession is forcing many businesses to downsize and in doing so they are losing valuable knowledge and skills. Arif Ahmed, co‐founder & director of ikonami, examines how organizations can maintain their knowledge base and still remain competitive during difficult times.

Design/methodology/approach

Approached positively, organizations can do more than passively survive this recession; they can re‐evaluate their operations, pinpoint where they deliver value, and identify the knowledge, skills and abilities required by the optimum number of people to deliver the vision.

Findings

HR needs to go back to basics, focusing on the fundamentals and moving to integrate learning into the broader management strategy. With money tight, decisions might need to be made as to whether to fund operational development to deliver immediate impact to the bottom line or longer‐term talent management programmes. The recession is a great opportunity for organizational learning – if employees can deliver business success now that bodes well for the future, but it is important to capture the learning and lessons. HR and L&D managers must demonstrate the contribution they can make and earn their place at the strategic planning table.

Originality/value

Approached positively, organizations can do more than passively survive this recession and prepare for the upturn; they can re‐evaluate their operations, pinpoint where they deliver value, and identify the knowledge, skills and abilities required by the optimum number of people to deliver the vision.
Sparking worker creativity: cultures where garden variety creativity can flourish
Authors: Mayfield Milton
Published: October 2009

Purpose

This article discusses how managers can increase creativity from all workers, and how this increase will improve organizational outcomes at all levels.

Design/methodology/approach

Paper recommendations are based on existing conceptual and data based garden variety creativity studies. From these studies, a practical, management oriented implementation model is developed.

Findings

Managers can substantially improve worker creativity by removing creativity blocks, providing creativity support, and structuring work to promote creativity.

Originality/value

The provided recommendations will improve worker creativity, and this increased creativity will aid companies to better cope with unexpected changes in the business environment.
Intergenerational differences in values and dioxin risk perceptions in South Korea
Authors: Park Seohyun , Smardon Richard C.
Published: October 2009

Purpose

The objectives of the research are to examine the differences among generations in South Korea in values or worldview (measured by the feeling of Connectedness‐to‐Nature Scale (CNS)) and the intervening effects of the worldview on perceptions and behaviors in relation to and in response to the complex risk of dioxins – the unpleasant by‐products of the modern wasteful cultures.

Design/methodology/approach

A quasi‐experimental survey method was designed based on the content analysis of the media coverage on dioxin risk in Korea. The variables examined for this research include awareness, risk knowledge, the affective connectedness to nature worldview, opinion of management methods, and willingness‐to‐act (WTA) behaviors. An in‐person‐type survey administration was conducted on individuals from different social backgrounds in the city of Jeonju, Korea.

Findings

The findings show that there are no significant effects of age on one's awareness and knowledge of dioxin risk. However, the older respondents show significantly higher CNS, societal‐level WTA, and recycling behaviors.

Research limitations/implications

The implications include that the traditional Korean worldview, which emphasizes oneness or connectedness between humans and nature, does not disappear and infact significantly influences the perceptions and behaviors of the older Koreans. It is possible to assume that the younger Koreans are relatively less influenced by this worldview. However, additional tests across society are necessary for obtaining some generalization.

Originality/value

The originality or value of the study is that it systematically produces a social psychological analysis of the long‐term complex risk for individuals other than North Americans.
Impact of abattoir wastes based on some physicochemical parameters on Woji Creek, Port Harcourt, Nigeria
Authors: Johnbosco Emeka Umunnakwe , Braide Solomon A. , Chindah Alex C.
Published: October 2009

Purpose

The purpose of this paper is to examine the environmental and health impacts of abattoir wastes due to unhygienic disposal methods and inadequate slaughtering facilities as it affects some physicochemical and bacteriological parameters of Woji Creek and its environs.

Design/methodology/approach

The study involved the choice of five sampling stations for two different seasons: wet and dry. Standard methods were adopted for field and laboratory studies.

Findings

Water samples from station 2 (discharge point station) showed higher concentrations of turbidity, phosphate, biochemical oxygen demand, faecal coliform count for both dry and wet seasons, while dissolved oxygen values were lower at this station than in the other study stations. Water samples were slightly acidic (6.49‐6.70) for the five stations sampled during the study period. At the upstream station, the water had lower levels of turbidity, temperature, phosphate, nitrate, biochemical oxygen demand, faecal coliform count, but the values increased downstream after the discharge point station showing the impact of the abattoir effluents. The results further revealed seasonal influence on the parameters with higher values recorded during the dry season for conductivity, salinity, turbidity, phosphate, dissolved oxygen, biochemical oxygen demand, faecal coliform counts, temperature, total dissolved solids. This is because during the wet season the increased volume of water apparently diluted the concentration of abattoir wastes.

Practical implications

The work was carried out in order to establish the existing levels of the measured parameters and assess the pollution profile of the Creek as a result of abattoir operations.

Originality/value

This is the first time a holistic research has been conducted on Woji Creek. The paper has provided data and knowledge on which further research can be carried out to monitor changes in water quality caused by the activities of the abattoir operators.