bluuebunny/crossref_metadata_2025 huggingface dataset:
Deterring sustainability in higher education institutions
Authors: Velazquez Luis , Munguia Nora , Sanchez Margarita
Published: January 2007

Purpose

To explore some of the factors that could obstruct the implementation of the sustainability initiatives in higher education institutions as a way for assisting key players to improve the effectiveness of their potential or current sustainability initiatives and being ready for the United Nations Decade of Education for Sustainable Development.

Design/methodology/approach

It was conducted a literature review of published and unpublished articles, conference proceedings, university reports, books, and website documents. It was not target any specific discipline. However, most of the material was from engineering, economics, sociology, and related sciences. The time frame of the literature review was from 1990 to 2002. Important references prior to 1990 were also analyzed.

Findings

The adequate conditions for the successful implementation of sustainability programs do not exist. There are many obstacles preventing the success of sustainability initiatives on campuses around the world. However, sustainability initiatives on campuses are flourishing despite these difficulties.

Originality/value

Usually, literature about sustainability on campus is focused most on good experiences, paying little or no attention to describe the issues hampering their evolution. What went wrong is mentioned without sufficient consideration or given a secondary status making it impossible to learn from bad experiences. This paper reveals several failures as a way to anticipate solutions for overcoming institutional barriers confronted in particular situations.
LibQUAL+™ as transformative experience
Authors: Wall Tom B.
Published: January 2007

Opportunities for meaningful change exist with any new experience. Occasionally, these opportunities can have a significant effect, either as a catalyst for change, or via the process of experience itself. The most powerful experiences are those that generate new ideas, and possibly new behaviors or approaches to service. LibQUAL+™ is unique in that it provides both the opportunity to rethink a library’s service program, as well as a process that compels library staff to consider the importance of, and respond to, user perceptions in the improvement of library services. This paper suggests that when libraries decide to participate in LibQUAL+™, they should use the experience as a critical first step in a longitudinal analysis of library collections and services. With the commitment to listening to users and rethinking the service program, the LibQUAL+™ process is inherently transformative.
Extracting meaningful measures of user satisfaction from LibQUAL+™ for the University Libraries at Virginia Tech
Authors: Hitchingham Eileen E. , Kenney Donald
Published: January 2007

The University Libraries at Virginia Tech have participated in each iteration of LibQUAL+™ beginning in 1999. This report focuses on the Virginia Tech experience, the results from the 2001 survey, and what was done with the findings. While most examinations of the survey data centered on determining results associated with feedback from three major constituent groups – undergraduates, graduate students, and faculty – an interesting gender difference across all types of users in the assignment of satisfaction scores was discernible.
Making decisions using the balanced scorecard and the simple multi‐attribute rating technique
Authors: Valiris George , Chytas Panagiotis , Glykas Michael
Published: January 2007

Purpose

The purpose of this article is to address the measure selection problem and to propose the use of a multi‐criteria approach to address the problem more effectively. The main objective of this research is to propose a methodology (not a new performance measurement framework) that will support existing measurement framework(s) during the process of performance measurement systems' design, implementation and use, and to advance the decision‐making process.

Design/methodology/approach

Conforming to the most favoured approach, the balanced scorecard is adopted to illustrate the proposed methodology. This paper briefly illustrates the application of the proposed methodology. This illustration is based on a real case study from a Greek financial institution, which has considered the proposed methodology in order to select appropriate measures. The paper begins with a brief literature review on the balanced scorecard, the theory of MCDM and smart technique. In section three the proposed methodology is presented and each of the stages involved. The paper then illustrates the proposed methodology.

Findings

The greatest significance of the methodology suggested here is that it provides a structure to guide decision makers through the process of measure selection. Criteria must be identified and considered systematically, as must alternatives (i.e. measures).

Originality/value

While the smart was chosen to select appropriate measures for the balanced scorecard, the basic approach used in formulating the problem serves also as a framework for the application of other multi‐criteria approaches to this problem as well as to other performance measurement frameworks. Ultimately, better quality decisions will result; both as a consequence of the support provided by the multi‐criteria tools and as a result of a structure that will help the decision makers to better understand the issues associated with the problem involved.
Think local, search global? Comparing search engines for searching geographically specific information
Authors: Smith Alastair G.
Published: January 2007

This study evaluates the retrieval of New Zealand information using three local New Zealand search engines, four major global search engines and three metasearch engines. Searches for NZ topics were carried out on all the search engines, and the relative recall calculated. The local search engines did not achieve higher recall than the global search engines or metasearch engines, but no search engine achieved more than 45 percent recall. Despite the theoretical advantage of searching the databases of several individual search engines, metasearch engines did not achieve higher recall. Of relevant pages for the queries, 36 percent were outside the .nz domain. Implications for searching for geographically specific information, and for evaluation of search engines, are discussed.
Changes in the value chain of scientific information: economic consequences for academic institutions
Authors: Roosendaal Hans E. , Huibers Theo W.C. , Geurts Peter A.Th. M. , van der Vet Paul E.
Published: January 2007

The economic impact of information and communication technology (ICT) on the academic library and on the academic institution are discussed in terms of changes in the value chain of scientific information induced by the use of ICT. Argues that ICT is a very strong engine for change as it has the potential not only to transform the research information system, but also the educational information system or even the education system at large. Academic institutions will have to create their own publishing and archiving environments using the same technology as in research publishing. These developments will have a profound impact on the value chain of scientific information as it leads academic institutions to assume entirely new roles in this chain and to develop new capabilities. As well as a digital collection strategy, academic libraries will develop strategies for supporting e‐learning and e‐publishing. This leads to changes in the economic conditions at the institutional and also industrial level. The developments will be discussed in general.
Revolutionising the voting process through online strategies
Authors: Smith Alan D. , Clark John S.
Published: January 2007

Purpose

To provide practitioners of information management with an overview and framework to explore the various controversies associated with the methods of traditional methods of voting with electronically enhanced voting via the internet (I‐voting). The current paper is centered on the assumption that I‐voting is the next logical step in applying online information‐gathering and retrieval technologies to the field of e‐government.

Design/methodology/approach

A review of the applied literature on electronically enhanced voting methods with potentials associated with internet voting, as well as from practical experience, resulted in a basic model for discussion of the emergent nature of I‐voting.

Findings

I‐voting would reduce the cost for staffing polling stations, and also the funds needed to pay for voting machines. I‐voting could also reduce the number of errors made by both the voters and the electoral administrators, and allow for easier adoption of uniform standards in the ballot format, since it could be transmitted via the internet from a central election agency to all local and regional polling places. Bridging the digital divide and internet security issues may be the most important barriers that must be overcome if I‐voting becomes a viable option in the USA.

Research limitations/implications

It may be years, if ever, before a truly secure, relatively risk‐free internet service, such as I‐voting, is developed. However, despite the controversies associated with election fraud, the numerous current voting systems that are in place suffer from the same problems associated with online informational exchanges; but, for the most part, nations still conduct their businesses and the political systems are still relatively stable.

Practical implications

Owing to recent voting débâcles in the USA, the public is demanding a more reliable and secure method of voting. Currently, many nations are moving more toward electronically enhanced voting methods with the long‐term goal being internet voting. Unfortunately, there are heated debates about the pros and cons of handing over the right to vote, using a system that is prone to security risks from outside sources.

Originality/value

In the short term, there should be increased interest in establishing national and international standards for testing and certification of electronic and I‐voting systems and their IT‐infrastructure. It is a basic premise of the present study that voting online increases voter participation, which can only be viewed in a positive light.
E‐government and the transformation of public administrations in EU countries
Authors: Torres Lourdes , Pina Vicente , Royo Sonia
Published: January 2007

Purpose

The objective of this paper is to study the development of e‐government initiatives at the regional and local level in the EU through the opinion of those agents directly involved in the projects.

Design/methodology/approach

The authors wrote a questionnaire that was sent to the regions and the largest cities of EU countries, in order to find out their degree of involvement in e‐government initiatives. Responses were received from 47 regional and local governments.

Findings

At present, most regional and local governments have a web site, although in most cases it is little more than a governmental billboard. E‐government is not likely to remodel governance in the short term, since democracy initiatives are not on the present agenda of most EU countries. The survey findings show that e‐government initiatives are still predominantly non‐interactive and non‐deliberative. They tend to reflect present service delivery patterns, not transform them.

Research limitations/implications

The construction and management of web sites is becoming an essential element of modern public administration, but little is known about how these initiatives are being implemented. Given the substantial investment in time and other resources for governmental online initiatives, it is essential to begin to evaluate governmental web site initiatives in terms of quality and effectiveness.

Originality/value

This work is of value as, to date, there are very few studies that benchmark local government web sites across the EU.
Visualizing overlap and rank differences among web‐wide search engines
Authors: Jacsó Péter
Published: January 2007

Purpose

To compare the performance of different search engines, highlighting the overlap and rank differences.

Design/methodology/approach

Presents results of an overlap test search series among traditional CD‐ROM indexing/abstracting databases since the mid‐1980s, web databases, and authors' own polysearch engine, and reviews Google Scholar.

Findings

Finds that overlap is minimal among web‐wide search engines which crawl and index the mostly unstructured open web; and that overlap among Google Scholar and the native search engines is far less than the ideal 100 per cent in the optimal context of crawling and indexing highly‐structured and metadata‐rich collections.

Originality/value

Reinforces the existing view that for comprehensive searches one must search more than one database. Highlights and recommends several very good search engine sites.
Interfaces to knowledge organization systems in Canadian digital library collections
Authors: Shiri Ali , Molberg Keri
Published: January 2007

Purpose

The purpose of this paper is to report an investigation into the ways in which Canadian digital library collections have incorporated knowledge organization systems into their search interfaces.

Design/methodology/approach

A combination of data‐gathering techniques was used. These were as follows: a review of the literature related to the application of knowledge organization systems, deep scanning of Canadian governmental and academic institutions web sites on the web, identify and contact researchers in the area of knowledge organization, and identify and contact people in the governmental organizations who are involved in knowledge organization and information management.

Findings

A total of 33 digital collections were identified that have made use of some type of knowledge organization system. Thesauri, subject heading lists and classification schemes were the widely used knowledge organization systems in the surveyed Canadian digital library collections.

Research limitations/implications

The target population for this research was limited to governmental and academic digital library collections.

Practical implications

An evaluation of the knowledge organization systems interfaces showed that searching, browsing and navigation facilities as well as bilingual features call for improvements.

Originality/value

This research contributes to the following areas: digital libraries, knowledge organization systems and services and search interface design.
Performance of question‐based vs keyword‐based search engines and effect of web user characteristics on search engine performance
Authors: Ozmutlu Seda
Published: January 2007

Purpose

The purpose of this study is to investigate whether question and keyword‐format queries are more successfully processed by search engines encouraging answers to searching and keyword‐format querying, respectively. This study aims to investigate whether web user characteristics and choice of search engine affects the relevancy scores and precision of the results.

Design/methodology/approach

The results of two search engines, Google and AskJeeves, were compared for question and keyword‐format queries. It was observed that AskJeeves was slightly more successful in processing question‐format queries, but this finding was not statistically supported. However, Google provided results on keyword‐format queries and the entire set of queries, which were statistically superior to those of AskJeeves.

Findings

Analysis of variance (ANOVA) showed that the age of web user is not as affective on the relevancy score and precision of results as other factors. Interactions of the main factors were also affective on the relevancy scores and precision, meaning that the different combinations of various factors cause a synergy in terms of relevancy scores and precision.

Research limitations/implications

This was a preliminary work on the effect of user characteristics on comprehension and evaluation of search query results. Future work includes expanding this study to include more web user characteristics, more levels of the web user characteristics, and inclusion of more search engines.

Originality/value

The findings of this study provide statistical proof for the relationship between the characteristics of web users, choice of search engine and the relevancy scores and precision of search results.
Implementing the KPMG Value Explorer
Authors: Andriesson Daniel
Published: January 2007

Purpose

The purpose of this paper is to describe the results of an empirical study into the critical success factors for implementing an intellectual capital valuation method, the KPMG Value Explorer.

Design/methodology/approach

For this study the design approach was used as research methodology.

Findings

The research shows the strengths and weaknesses of the method and identifies four general critical success factors for the implementation of intellectual capital valuation and measurement tools.

Research limitations/implications

The research was based on six case studies. Application of the method with other companies may provide further grounding of the conclusions.

Practical implications

The research shows that practitioners who want to implement an intellectual capital valuation or measurement method must: perform a proper diagnosis of the problem at hand; have knowledge of the strengths and weaknesses of the method they want to use; understand the application domain of the method – the class of problems and the class of contexts for which the method needs to provide a solution; and possess the necessary skills to implement the method.

Originality/value

Successfully implementing a method for the valuation or measurement of intellectual capital is not an easy task. Practitioners yet receive little support from the intellectual capital research community. Little research has been done into the factors that influence the success of a method. This paper is a first attempt at systematically identifying some of the factors for the successful implementation of an intellectual capital valuation or measurement method.
The art of space management
Authors: Steiner Jon
Published: January 2007

Purpose

Technological innovations and IT developments have been hailed as the key influence on changing work‐styles. However, the workplace is being shaped more and more by people and their needs. Supported by industry research, this paper aims to identify and explore some of the various elements and forces that have an impact on the space planning process.

Design/methodology/approach

The paper gathers current thought leadership, trends and external research together with the author's research, comments and opinions on optimizing space management. Global workplace trends are compared to author's observations in Dubai.

Findings

Real estate costs, building attributes, space planning concepts, technology and product innovations for the workplace are examined, as they have an influence on the role of people in the workplace. A case study provides the background and details of a revolutionary work‐style – iWork, developed by Sun Microsystems, and shows how it was adapted to meet the requirements of their regional headquarters in Dubai.

Research limitations/implications

The current phenomenal growth of Dubai could impact some cited statistics over a short period of time.

Practical implications

The paper offers guidelines and ideas for facilities managers to assess the possibility of adopting similar space planning and work‐style programmes within their own organisations.

Originality/value

Aside from the practical space planning guidelines, the paper also offers facility managers an introductory insight the challenges of establishing an office in Dubai – one of the fastest growing economies and cities in the world.
Soft landings
Authors: Way Mark
Published: January 2007

Purpose

To disseminate information on a new scope of Service for building projects that embodies post occupancy evaluation.

Design/methodology/approach

The paper draws upon recent practical experience in the field by the author and examples the background and detail of the new scope of service.

Findings

The results of field experience are exampled. Topical research is used to underpin the recommendations.

Originality/value

This paper contains the justification for a novel method of delivering new buildings and the detail of the methodology. It will be of practical value to project managers, estates directors and facilities managers.
Optimising supplier management and why co‐dependency equals mutual success
Authors: Rogers Paul A.
Published: January 2007

Purpose

To provide a reference paper for managers responsible for procuring services, advocating the use of strong relationship models, based on co‐dependency and collaboration between the supplier and purchaser of services.

Design/methodology/approach

Based on a combination of research into this topic coupled with the authors empirical knowledge through consulting case studies. The theory, as derived from the research supports, reinforces the authors' findings from dealing with client projects.

Findings

Acknowledges that the burden of transaction cost economics encourages aggregation of the services supply chain which in turn, when managed carefully facilitates an improved working/partnering opportunity with a few select suppliers. The suppliers benefit in turn by increasing volumes, allowing them to protect margins and the purchasers benefit through overall lower total cost of service, more attentive suppliers and potentially a much enhanced working relationship.

Practical implications

Practical guide for both practitioners (facilities/property/technology managers) as well students involved in procurement/logistics, supply chain studies.

Originality/value

This paper fulfils an identified area of research and offers practical guidance on how to implement a programme that achieves enhanced service supplier relationships.
Perception of risk: a study of A&E nurses and NHS managers
Authors: Dickson Gordon C.A. , Price Lesley , Maclaren William M. , Stein William M.
Published: January 2007

This exploratory study investigates perceptions of two groups of NHS staff, of a range of risks, topical and relevant to accident and emergency (A&E). Literature suggests that the effectiveness of a risk management strategy is lessened if staff exposed to risk, and managers, have different perceptions of the nature and severity of the risk. A self‐administered questionnaire was distributed to registered A&E nurses and to Trust managers at directorate level and above, working in five large inner‐city NHS Trusts. Managers and nurses were asked to quantify their perceptions of nine defined adverse events. They were also asked to identify the jobholder with day‐to‐day responsibility for managing four specific risks. Completed forms were obtained from 38 per cent of managers and nurses. Results showed broadly that managers tended to quantify risks of violence and stress to A&E nurses less highly than did nurses. By contrast, they tended to quantify risks to patients more highly than did nurses. Overall, a coherent pattern of difference in risk perception between the two groups was identified. It is argued that identification of differences of perception is an essential part of the risk management process. Illustrations are given of ways in which these differences can undermine the effectiveness of a risk management strategy.
Ways to reduce patient turnaround time and improve service quality in emergency departments
Authors: Sinreich David , Marmor Yariv
Published: January 2007

Purpose

Recent years have witnessed a fundamental change in the function of emergency departments (EDs). The emphasis of the ED shifts from triage to saving the lives of shock‐trauma rooms equipped with state‐of‐the‐art equipment. At the same time walk‐in clinics are being set up to treat ambulatory type patients. Simultaneously ED overcrowding has become a common sight in many large urban hospitals. This paper recognises that in order to provide quality treatment to all these patient types, ED process operations have to be flexible and efficient. The paper aims to examine one major benchmark for measuring service quality – patient turnaround time, claiming that in order to provide the quality treatment to which EDs aspire, this time needs to be reduced.

Design/methodology/approach

This study starts by separating the process each patient type goes through when treated at the ED into unique components. Next, using a simple model, the impact each of these components has on the total patient turnaround time is determined. This in turn, identifies the components that need to be addressed if patient turnaround time is to be streamlined.

Findings

The model was tested using data that were gathered through a comprehensive time study in six major hospitals. The analysis reveals that waiting time comprises 51‐63 per cent of total patient turnaround time in the ED. Its major components are: time away for an x‐ray examination; waiting time for the first physician's examination; and waiting time for blood work.

Originality/value

The study covers several hospitals and analyses over 20,000 process components; as such the common findings may serve as guidelines to other hospitals when addressing this issue.
Emotional structure and commitment: implications for health care management
Authors: Humphreys John , Brunsen Bill , Davis Dale
Published: January 2007

Purpose

This paper aims to determine if the emotional structure of direct healthcare workers was related to their commitment to the organization.

Design/methodology/approach

A total of 105 direct healthcare workers completed self‐report surveys to determine their emotional intelligence, emotional coping ability, and affective organizational commitment. Pearson Product Moment Correlation and independent samplettests were used to analyze the data.

Findings

A significant correlation was found between emotional intelligence, emotional coping ability, and organizational commitment. In addition, emotional intellect served as a moderating variable between coping ability and commitment such that those direct care workers who exhibited higher emotional coping abilities were more committed when emotional intelligence was high rather than low.

Research limitations/implications

This was an exploratory study. Larger sample sizes across multiple healthcare settings should be examined before definitive inferences should be drawn. Future studies should likely introduce other variables such as satisfaction, effort, and even performance appraisals to delineate causal relationships.

Practical implications

It appears that personality constructs such as emotional intelligence and coping ability could possibly be used as predictive instruments to determine who might be most successful in operating in the highly emotionally charged environment of healthcare.

Originality/value

This is the first study that examined the constructs of emotional intellect and coping ability and organizational commitment using a direct healthcare worker sample. It provides support for the conjecture that interpersonal emotional dynamics are critical in emotionally charged environments. This knowledge could assist healthcare managers in addressing the shortage and attrition rates associated with many direct healthcare fields.
Appreciating change in cancer services – an evaluation of service development strategies
Authors: Reed Jan , Turner Jill
Published: January 2007

Purpose

The purpose of this paper is to report on an evaluative study which used appreciative inquiry (AI) to explore the processes of change during the Cancer Services Collaborative Improvement programme instituted by the Department of Health in the UK. This was a three‐stage programme which expanded from nine pilot projects to a national service change, focussing on improving the patient's experience throughout the journey from diagnosis to treatment.

Design/methodology/approach

The paper uses AI questions in interviews with a range of CSC staff who had had different roles and length of involvement.

Findings

The study identified a range of strategies and skills that participants had developed in order to support and facilitate service change.

Practical implications

The paper offers a discussion of skills and strategies that can facilitate change in health care across clinical areas, and a discussion of the use of AI as a method of evaluation.

Originality/value

This study is one of the first to use AI in health care evaluation in the UK, and thus makes a contribution to understanding change from an AI perspective.
Tales of the unexpected?
Authors: Learmonth Mark
Published: January 2007

Purpose

Received wisdom about management and leadership in health care takes it for granted that better management is, by definition, a good thing. Aims to raise some doubts about this received wisdom and suggest that perhaps better management may be unconditionally “better” for only a few people.

Design/methodology/approach

These doubts are raised mainly via accounts of the author's personal experiences of being a manager in the UK National Health Service.

Findings

Author's attraction to some parts of a body of literature called critical management studies is discussed that was subsequently used to make sense of these experiences.

Originality/value

The accounts are offered in the belief that they will be of interest to other people who are wrestling with their own ways of making sense of personal experiences in and around better management in health care.
Shifting the balance of power?
Authors: McDonald Ruth
Published: January 2007

Purpose

A recurring theme in Government policy documents has been the need to change the culture of the NHS in order to deliver a service “fit for the twenty‐first century”. However, very little is said about what constitutes “culture” or how this culture change is to be brought about. This paper seeks to focus on an initiative aimed ostensibly at “empowering” staff in an English Primary Care Trust as a means of changing organisational culture.

Design/methodology/approach

It presents findings from an ethnographic study which suggests that this attempt at “culture change” is aimed at manipulating the behaviour and values of individual employees and may be interpreted as a process of changing employee identity.

Findings

Employees reacted in different ways to the empowerment initiative, with some resisting attempts to shape their identity and others actively engaging in projects to bring their unruly self into line with the ideal self to which they were encouraged to aspire.

Originality/value

The challenges presented by the need to respond to conflicting Government policies created tensions between individuals and conflicts of allegiance and identity within individual members of staff. Alternative forms of selfhood did not merely replace existing identities, but interacted with them, often uncomfortably. The irony is that, whilst Government seeks to promote culture change, the frustrations created by its top‐down target‐driven regime acted to mitigate the transformational and reconstitutive effects of a discourse of empowerment aimed at achieving this change.
Exhausting management work: conflicting identities
Authors: Mischenko Jane
Published: January 2007

Purpose

The primary purpose of this paper is to critically explore managers' experience of work identity in the National Health Service (NHS).

Design/methodology/approach

This paper is unconventional in that it uses an auto‐ethnographic approach and poetry as the empirical data from which the conceptual framework evolves. The concepts of identity, power and self are analysed in relation to the narrative utilising a post‐structuralist, critical management lens, particularly drawing from Foucault.

Findings

The paper reflects and critiques the challenges of undertaking auto‐ethnography, not least the publication and exposure of a “vulnerable aspect” of the author but also identifies this as a powerful method to explore how one uses narrative to create meaning and constitute oneself; the challenges of such textual representation and the various ways one adapts, resists and survives the challenge of the “multiphrenic” world.

Originality/value

The contribution this paper makes is an “outing” of the dynamics of being a manager in the NHS and an opening of a debate on current management discourse and practice. The further value of this paper is the experimentation of critically evaluating an auto‐ethnographic approach to researching management identity work.
MMR – public policy in crisis: whose tragedy?
Authors: Stroud Laura
Published: January 2007

Purpose

To explore the issues surrounding the falling rates of MMR vaccination following the publication of a controversial study by Wakefieldet al.

Design/methodology/approach

In order to take a fresh look at the MMR crisis, the Greek tragedy,Antigone, was used as a “strong plot” to de‐contextualise the underlying social and political issues. In this short paper, two themes are explored that emerge from readingAntigonewith respect to the unfolding crisis of public confidence in the MMR vaccine: first, the challenge to government in the form of a decrease in public trust in government and government policies; and second, how such a challenge assumes significance and, arising from that, the question of how one might respond to the challenge.

Findings

The MMR debate throws issues of importance to society into relief – for example, public trust in government and science; and notions of public good versus rational choice in public policy on vaccination, However, much of the debate has been polarised into good versus evil – good and evil being subjective positions that are interchangeable, depending on the side one favours. It is argued that the issues are more complex than this, and are as much to do with political consent and the bargain between citizen and state.

Originality/value

Using “strong plots” to theorise about current issues is powerful because it allows one to explore them from different angles and challenge one's understanding.Antigoneprovides us with a way of standing back from the MMR crisis and re‐conceptualising the issues to capture the essence of the underlying debate.
Organizing emotions in health care
Authors: Mark Annabelle
Published: January 2007

Purpose

To introduce the articles in this special issue, discussing emotion in the in health‐care organisations.

Design/methodology/approach

Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff.

Findings

Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent.

Originality/value

The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.
Cultural characteristics of “high” and “low” performing hospitals
Authors: Mannion R. , Davies H.T.O. , Marshall M.N.
Published: January 2007

Purpose

To compare and contrast the cultural characteristics of “high” and “low” performing hospitals in the UK National Health Service (NHS).

Design/methodology/approach

A multiple case study design incorporating a purposeful sample of “low” and “high” performing acute hospital Trusts, as assessed by the star performance rating system.

Findings

These case studies suggest that “high” and “low” performing acute hospital organisations may be very different environments in which to work. Although each case possessed its own unique character, significant patternings were observed within cases grouped by performance to suggest considerable cultural divergence. The key points of divergence can be grouped under four main headings: leadership and management orientation; accountability and information systems; human resources policies; and relationships within the local health economy.

Practical implications

As with any study, interpretation of findings should be tempered with a degree of caution because of methodological considerations. First, there are the limitations of case study which proceeds on the basis of theoretical rather than quantitative generalisation. Second, organisational culture was assessed by exploring the views of middle and senior managers. While one should in no way suggest that such an approach can capture all important cultural characteristics of organisations, it is believed that it may be at least partially justified, given the agenda‐setting powers and influence of the senior management team. Finally “star” performance measures are far from a perfect measure of organisational performance. Despite such reservations, the findings indicate that organisational culture is associated in a variety of non‐trivial ways with the measured performance of hospital organisations.

Originality/value

Highlights considerable cultural divergence within UK NHS hospitals.
Network structure and attitudes toward collaboration in a community partnership for diabetes control on the US‐Mexican border
Authors: Provan Keith G. , Harvey Jennel , Guernsey de Zapien Jill
Published: January 2007

Purpose

This study seeks to provide an examination of a health policy network operating in a single, small community along the US‐Mexican border. The purpose of the paper is to discuss why and how this network evolved, and then to present findings on how the network was structured. Analysis will focus especially on agency involvement, or “embeddedness” in the network, and its relationship to attitudes held by network members regarding trust, reputation, and perceived benefit.

Design/methodology/approach

Data were collected from 15 public and nonprofit agencies trying to work collaboratively to influence local policy and services regarding the prevention of obesity‐related chronic disease, especially diabetes. Embeddedness was measured in three different ways and both confirmed and unconfirmed networks were assessed. Network analysis methods were utilized as well as nonparametric correlation statistics.

Findings

The network was found to be densely connected through unconfirmed linkages, but much less so when these links were confirmed. Strongest findings were found for shared information. Measures of agency embeddedness in the network were strong predictors of agency reputation, but findings for trust and perceived benefit were generally weak.

Originality/value

From a practice perspective, the study points to the problems in building and sustaining community‐based chronic disease health networks, especially in a small community with substantial health needs. The research also contributes to theory on embeddedness and to methodology for collecting and analyzing data on community health networks.
Clinical effectiveness: a structured teaching approach for junior doctors
Authors: Bashir G.M. , Henderson R. , Henderson K.
Published: January 2007

Purpose

To formulate an effective teaching prog ramme in the principles of clinical effectiveness for junior doctors, with simultaneous participation in a clinical audit project during their six‐month period of employment.

Design/methodology/approach

Accident and Emergency (A&E) Senior House Officers (SHOs) were educated in the principles of clinical effectiveness through a structured five‐session approach whilst they concurrently performed their clinical audit project. Throughout the process the A&E SHOs were supported by the Clinical Effectiveness Unit and the A&E Consultant overseeing departmental audit.

Findings

The structured teaching programme resulted in a good understanding of the clinical effectiveness process amongst the A&E SHOs, as demonstrated by their ability to perform a clinical audit project which ultimately improved practice.

Research limitations/implications

This study has involved the construction and assessment of a teaching framework for junior doctors. The conclusions have been drawn on the basis of objective measures such as the completion of a clinical audit project which successfully improved practice. Thus, the publications of the findings may be considered in the category of a research paper. However, the authors accept that the assessment of a teaching programme's success and its portability to other departments or institutions can be highly subjective.

Practical implications

With appropriate guidance and support, junior doctors are able to perform meaningful clinical effectiveness exercises at an early stage in their careers and within the constraints of short periods of employment. The structured teaching approach could be considered as a template which other institutions may wish to adopt to educate their own juniors.

Originality/value

Despite the increasing importance of clinical audit in modern practice, the authors are not aware of any published teaching programmes which provide junior doctors with the necessary understanding of and skills required to take part in the clinical effectiveness process.
Developing surgical site infection surveillance within clinical governance
Authors: Hogg Samantha , Baird Nicola , Richards Judith , Hughes Sean , Nolan John , Jones Adrian , Holmes Alison
Published: January 2007

Purpose

To describe orthopaedic surgical site infection (SSI) surveillance models at two English pilot sites, and to review their effectiveness and integration into clinical governance.

Design/methodology/approach

The different organisational models for orthopaedic SSI at two Trusts were examined and assessed.

Findings

Both sites recognised that regular feedback to clinical staff and clinical ownership are important determinants of success, and this was addressed by both models. Each site appointed a surveillance coordinator within the infection control service to oversee the programme, but tasked data collection to different staff groups directly involved with the care of orthopaedic patients. Feedback programmes to Clinical Governance Committees, clinical staff and managers were developed, reinforcing surveillance of SSI as a core component of surgical risk management and quality assurance, and an integral part of clinical governance. The pilots demonstrated the importance of a dedicated surveillance coordinator.

Practical implications

Infection following joint replacement surgery is associated with high morbidity and financial costs. In 2004 surveillance of orthopaedic SSI became mandatory in England. A description and assessment of these pilot sites will be of practical value to Trusts that must now implement SSI surveillance.

Originality/value

SSI surveillance is a corner‐stone of risk management and quality clinical care, yet little has been published on organisational frameworks needed for implementation, particularly in the context of clinical governance. This paper addresses these issues in describing and assessing the models at two English pilot sites.
Audit: efficiency of fast‐tracking hip fractures from accident and emergency
Authors: Syed Mujahid Ali , Mahmood Faisal , Ramesh Palanisamy
Published: January 2007

Purpose

To analyse the implementation of fast‐tracking pathway of hip fractures from accident and emergency to the orthopaedic wards.

Design/methodology/approach

A retrospective audit analysing 100 case notes of fast‐tracked hip fractures selected at random for the period of one year was undertaken.

Findings

Several deficiencies were identified in the implementation of the pathway.

Practical implications

Recommendations have been made for correction of the inadequacies identified.

Originality/value

This paper aims to increase the efficiency and safety of fast‐tracking system for hip fractures, which is being deployed by many hospitals throughout the UK.
Clinical audit and the implementation of the Ottawa Ankle Rules
Authors: Jennings V. , Newton C. , Bonner K. , Hancock R.
Published: January 2007

Purpose

To implement the research‐based Ottawa Ankle Rules in a district hospital and audit their impact on the number and appropriateness of X‐rays for ankle injuries in A&E.

Design/methodology/approach

The method used was retrospective data collection, followed by education and prospective data collection on the management of subsequent ankle injuries. The computer records of the first 150 people presenting to A&E with ankle/foot injuries in one month were reviewed to determine whether the patient underwent an X‐ray, and what the results were. Every doctor working in A&E was then educated using a hand‐out giving the Ottawa Ankle Rules. The management of 150 people presenting with ankle/foot injuries in the month after this intervention was assessed.

Findings

There was a reduction in the number of patients receiving X‐rays (83/150 or 55 per cent versus 128/150 or 85 per cent pre‐intervention; p<<0.001). There was also an increase in the proportion of X‐rays showing fractures (17/83 or 20 per cent versus 16/128 or 12.5 per cent; difference not statistically significant).

Research limitations/implications

Possible to stimulate good practice with audit.

Practical implications

Improvement in practice stimulated by a motivated trainee doctor with appropriate support. Factors contributing to success discussed.

Originality/value

Encouraging example of successful audit, of interest to those interested in using clinical audit to improve care.
The Patients Accelerating Change Project: does it make any difference?
Authors: Sweeney Grace , O'Hagan Bridget , Squire Sarah , Powell Caroline
Published: January 2007

Purpose

The purpose of this survey was to evaluate the impact and experience of the Patients Accelerating Change (PAC) project from the perspective of 28 people who were closely involved in the project.

Design/methodology/approach

Data were collected by telephone interview with 28 individuals from nine acute NHS Trusts which piloted the PAC project.

Findings

PAC was seen to make a positive impact in terms of improving communication and information, helping patients feel valued and listened to, providing real direction as a result of listening to feedback from patients, and improving processes and procedures in the participating Trusts. The PAC project raised the profile of the Patient and Public Involvement Agenda within the NHS Trust organisations that participated in the project.

Research limitations/implications

The PAC project was still in its infancy at the time of data collection for this study, and over half of the sample was likely to have been composed of enthusiasts for the process: this may have contributed to a positive bias.

Practical implications

The PAC project works on a “staggered approach” in terms of realising short‐ and then long‐term improvements in the patient's experience. By the end of the project it was expected that some “quick wins” could be identified and the PAC organisers acknowledged that more time is needed in order to realise longer‐term improvements.

Originality/value

This survey provides useful information to patients and staff at NHS Trusts who may be considering how best to involve patients in planning and improving the quality of care that they receive.