bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why is your patient sedated?
Authors: Murphy Olwen , King Graham , Callanan Ian , W. Butler Marcus 
Published: June 2014

Purpose
– The purpose of this paper is to examine the recording of clinical indication for prescribed sedative/hypnotic (SH) medications in a large, acute tertiary referral hospital.

Design/methodology/approach
– All hospital inpatients’ medications (n=367) were audited for prescription details regarding SH medications. Medical notes were then examined for evidence of a recorded indication for such medications.

Findings
– SH medications were prescribed to many hospital inpatients (42.5 per cent) during admission. An indication was documented in the nursing or medical records for 24.4 per cent of patients who were prescribed such medications. Nurses rather than by doctors prescribed most SH medications (74 vs 26 per cent, respectively, p=0.003). Some patients receiving SH medications were both over 65 and impaired in their mobility (19.2 per cent). The treatment indication was documented in 47 per cent.

Practical implications
– Most patients prescribed SH medications have nothing in their medical record explaining why these drugs are being used, including half of the elderly, less mobile patients. All health professionals dealing with SH medications and doctors in particular need to justify the use of such medications in the medical record. For the particularly high-risk groups where SH medications are potentially more dangerous, explicit guidance on why and how such medications are to be used must be provided by prescribers.

Originality/value
– For the first time, data are presented on documentation rates for clinical indication of prescribed SH medications across a large acute hospital, and highlights significant shortcomings in practice. This study should inform other organisations of the need to be mindful of facilitating greater compliance with good prescribing practice.
Quality of care and health professional burnout: narrative literature review
Authors: Humphries Niamh , Morgan Karen , Catherine Conry Mary , McGowan Yvonne , Montgomery Anthony , McGee Hannah 
Published: June 2014

Purpose
– Quality of care and health professional burnout are important issues in their own right, however, relatively few studies have examined both. The purpose of this paper is to explore quality of care and health professional burnout in hospital settings.

Design/methodology/approach
– The paper is a narrative literature review of quality of care and health professional burnout in hospital settings published in peer-reviewed journals between January 2000 and March 2013. Papers were identified via a search of PsychInfo, PubMed, Embase and CINNAHL electronic databases. In total, 30 papers which measured and/or discussed both quality of care and health professional burnout were identified.

Findings
– The paper provides insight into the key health workforce-planning issues, specifically staffing levels and workloads, which impact upon health professional burnout and quality of care. The evidence from the review literature suggests that health professionals face heavier and increasingly complex workloads, even when staffing levels and/or patient-staff ratios remain unchanged.

Originality/value
– The narrative literature review suggests that weak retention rates, high turnover, heavy workloads, low staffing levels and/or staffing shortages conspire to create a difficult working environment for health professionals, one in which they may struggle to provide high-quality care and which may also contribute to health professional burnout. The review demonstrates that health workforce planning concerns, such as these, impact on health professional burnout and on the ability of health professionals to deliver quality care. The review also demonstrates that most of the published papers published between 2000 and 2013 addressing health professional burnout and quality of care were nursing focused.
Improving process quality for pediatric emergency department
Authors: B.J. Kim Byungjoon , R. Delbridge Theodore , B. Kendrick Dawn 
Published: June 2014

Purpose
– Overcrowding in emergency departments (EDs) leads to longer waiting times and results in higher number of patients leaving the ED without being seen by a physician. EDs need to improve quality for patients’ waiting time and length of stay (LoS) from the perspective of process and flow control management. The paper aims to discuss these issues.

Design/methodology/approach
– The retrospective case study was performed using the computerized ED patient time logs from arrival to discharge between July 1, 2009 and June 30, 2010. Patients were divided into two groups either adult or pediatric with a cutoff age of 18. Patients’ characteristics were measured by arrival time periods, waiting times before being seen by a physician, total LoS and acuity levels. A discrete event simulation was applied to the comparison of quality performance measures.

Findings
– Statistically significant differences were found between the two groups in terms of arrival times, acuity levels, waiting time stratified for various arrival times and acuity levels. The process quality for pediatric patients could be improved by redesign of patient flow management and medical resource.

Research limitations/implications
– The results are limited to a case of one community and ED. This study did not analyze the characteristic of leaving the ED without being seen by a physician.

Practical implications
– Separation of pediatric patients from adult patients in an ED can reduce the waiting time before being seen by a physician and the total staying time in the ED for pediatric patients. It can also lessen the chances for pediatric patients to leave the ED without being seen by a physician.

Originality/value
– A process and flow control management scheme based on patient group characteristics may improve service quality and lead to a better patient satisfaction in ED.
Lean Six Sigma and marketing: a missed opportunity
Authors: Chaplin Lara , T.J. O’Rourke Simon 
Published: June 2014

Purpose
– The purpose of this paper is to assess the current use being made of the sustainability message within business improvement activity and project justification within individual businesses.

Design/methodology/approach
– This is a reflective paper that looks at an illustrative case study against the wider perspectives of Lean Six Sigma (LSS) implementation, market orientation and business improvement initiatives in general.

Findings
– The piece discusses the gains derived from the LSS projects and identifies gaps in potential benefits in particular the paper questions how well any potential marketing messages were exploited by the organisation. The findings critically evaluates the impact that marketing function involvement could have in helping to promote the wider productivity message and its contribution to the wider corporate social responsibility (CSR) strategy for the organisation. The document also suggests how the company could leverage internally focused projects to adopt a companywide marketing orientation and use such leverage to support future LSS project selection and justification.

Research limitations/implications
– The observations are limited to a single case study, although tempered by the authors’ wider experience. Further empirical research is required to validate the observations and conclusions.

Practical implications
– The proposed approach to future improvement initiatives can help to increase the wider productivity message and assist organisations to exploit their internal projects in external communications and wider CSR strategy.

Originality/value
– The paper proposes an approach that can be used to widen organisational involvement in improvement initiatives allowing future project justification to be less internally cost focused, more holistic with a focus on customer voice.
The tragedy of the private: transaction cost considerations
Authors: Peneva Todorova Tamara 
Published: June 2014

Purpose
– The purpose of this paper is to weigh the benefits and costs of public property, as opposed to private, from the transaction cost perspective. In the absence of transaction costs, private property has clear advantages over public. However, when the true costs of running an economic system are taken into account, the advantages of private property are not so evident and public property may turn out to be the preferred form of ownership. The paper shows that in high-transaction cost sectors and economies such as the newly emerging markets in Eastern Europe, public property is a cheaper way of organizing economic activities, as it can save on transaction costs. The paper demonstrates these virtues of public ownership in relation to market failure, the provision of public goods, natural monopolies and competitive industries with a high degree of market uncertainty, opportunism and asset specificity.

Design/methodology/approach
– A qualitative paper discussing the advantages of public over private property in the presence of high-transaction costs.

Findings
– Studying different types of market failure the paper finds that public property is advantageous to private in high-transaction cost systems.

Originality/value
– Since most of the standard literature emphasizes the advantages of private property, the paper gives an economic explanation to those of public property taking on a new institutional approach and conducting a transaction cost analysis.
Income inequality in the EU: how do member states contribute?
Authors: Papatheodorou Christos , Pavlopoulos Dimitris 
Published: June 2014

Purpose– The purpose of this paper is to analyse the structure of overall inequality in the EU-15 by investigating the extent to which total inequality is attributed to inequality between or within the individual countries. Also, the paper examines whether the contribution of between-country and within-country components changed in the period between 1996 to 2008, before the outbreak of the economic crisis.Design/methodology/approach– The paper applies a decomposition analysis by population subgroup utilizing micro-data from the ECHP and EU-SILC surveys. A number of inequality indices are employed to capture the different aspects of inequality and test the robustness of the results.Findings– The analysis shows that the between-countries differences account only for a small part of overall inequality in the EU-15. Furthermore, the contribution of the between county component to total inequality has shrunk dramatically during the examined period. The overall EU inequality has been affected disproportionally by income disparities at the various parts of the income distribution in different countries.Practical implications– Policies aiming to reduce inequality within each country would be far more effective in reducing overall inequality in the EU than policies targeting to reduce only disparities between member states.Originality/value– The findings question the effectiveness of EU policy priorities to decrease inequality that have mainly focused on reducing cross-country and/or regions differences regarding certain macroeconomic indicators such as per-capita income (or GDP). The evidence suggests that the social protection system provides a useful tool in explaining the differences in inequality between countries and their contribution to overall EU inequality.
Financial development and economic growth in GCC countries
Authors: Grassa Rihab , Gazdar Kaouthar 
Published: June 2014

Purpose– The purpose of this paper is to compare the effects of Islamic financial development and conventional financial development on the economic growth for five GCC countries (Bahrain, Kuwait, Qatar Saudi Arabia and UAE).Design/methodology/approach– Using generalized least squares, OLS and panel data frameworks, this paper employs different measures of financial development for the period (1996-2011).Findings– Empirical results strongly support the hypothesis that Islamic finance leads to growth in the five GCC countries, however, no significant relationship observed between conventional financial development and growth.Practical implications– The findings of this paper suggest the need to accelerate the financial reforms for Islamic finance that have been launched in the region since the last decade and to improve the efficiency of these countries’ Islamic financial systems to stimulate saving/investment and, consequently, long-term economic growth.Originality/value– This study has several contributions to the existing literature. To the best of the authors’ knowledge, this paper is the first study that examines empirically the effect of Islamic finance on economic growth in GCC countries. As well, this paper is the first to compare the different effects of Islamic finance and conventional finance on economic growth on a context of countries having the most developed Islamic financial system in the world operating side-by-side with a conventional financial system.
Customer relationship mining system for effective strategies formulation
Authors: Lam H.Y. , Ho G.T.S. , Wu C.H. , Choy K.L. 
Published: June 2014

Purpose
– The purpose of this paper is to propose a customer relationship mining system (CRMS) to analyze the data collected from franchisees and formulates a marketing strategy based on customer demand and behavior.

Design/methodology/approach
– The system makes use of cloud technology to collect and manage data among the franchisees. An integrated approach of association rule mining and the neural network technique is adopted to investigate customer behavioral patterns and to forecast sales demand, respectively.

Findings
– The significance and contribution of this paper are demonstrated by adopting the CRMS in the education industry in Hong Kong. The findings led to the identification of student learning intentions such as course preferences, and the forecasting of enrolment demand in terms of demand forecast. It is believed that better resources allocation can be achieved and an increase in customer satisfaction is foreseeable.

Research limitations/implications
– The proposed CRMS could be applied to various franchising industries for effective marketing strategy formulation. However, since the data in this study are extracted from a specific industry, modifications may be required before the CRMS can be applied to other franchising industries.

Originality/value
– This study presents a new application to convert data into useful knowledge, and provides useful insights for delivering strategic promotional plans under a franchising business model. Through the pilot study conducted in a franchising education center, the results demonstrate that the proposed CRMS is valuable in providing effective promotion to attract more customers, better preparation in resources allocation and more standardized methods to formulate marketing strategies in the franchising industry.
Supply chain design through QFD-based optimization
Authors: Durga Prasad K.G. , Venkata Subbaiah K. , Narayana Rao K. 
Published: June 2014

Purpose– The purpose of this paper is to demonstrate a methodology to design a supply chain with a view to achieve a strategic fit between competitive and supply chain strategies.Design/methodology/approach– Quality function deployment (QFD)-based optimization methodology is employed to design a supply chain for a product through aligning the competitive and supply chain strategies. Normal boundary intersection (NBI) method is adopted to obtain optimal weights of the supply chain design objectives. Weighted additive model is developed for multi-objective optimization. Utility-based attribute function, which structure the relationship between the elements of competitive and supply chain strategies is established. The utility functions and the information contained in the House of Quality (HOQ) of QFD are used to define the supply chain performance (SCP).Findings– SCP index is computed using the set of supply chain design objectives obtained by solving the weighted additive model. On the basis of SCP index, the supply chain activities are planned accordingly. An illustrative example is presented in this paper to describe the QFD-based optimization methodology for designing a supply chain.Originality/value– QFD-based optimization is a novel approach to design a supply chain with a focus on aligning competitive and supply chain strategies.
The Six Sigma program: an empirical study of Brazilian companies
Authors: Monteiro de Carvalho Marly , Lee Ho Linda , Helena Boarin Pinto Silvia 
Published: June 2014

Purpose– The purpose of this paper is to assess the status of Six Sigma's status in Brazilian companies and understand the integration of this program with other quality management approaches. Additionally, the critical success factors (CSFs) for Six Sigma implementation and primary Six Sigma program characteristics were identified. Finally, the results of the used of Six Sigma were analysed.Design/methodology/approach– An extensive literature review illustrates the primary Six Sigma characteristics and its relationship with other quality approaches. The research methodology encompasses survey development and statistical analyses. Questionnaires are distributed to 1,000 large firms in the manufacturing and service industries in Brazil. Altogether, a total of 198 firms, of which 46 companies adopted the Six Sigma program, participated in this study.Findings– The results suggest a synergic and incremental pattern of quality model implementation. The study reveals that companies that have adopted Six Sigma have a long history of implementing quality programs, which suggests a certain level of quality maturity. The studied companies perceive in Six Sigma an incremental evolution, which can be combined with earlier initiatives and provides strong synergy with ISO 9000. The findings of this study confirm the distinctive Six Sigma role structure suggested by several authors. However, three possible configurations of the role structure were found that differ in terms of training and the dedication of human resources involved in the Six Sigma program.Research limitations/implications– This study demonstrates the inherent limits of the research method adopted, the use of a non-probabilistic sample and a reliance on self-reported perceptions, which introduces bias to the analysis.Practical implications– Important managerial implications of this study are related to the Six Sigma structure adopted. The capillarity of the program in the organisation as a whole can be related to the type of role structure configuration adopted. This structure can have an impact in terms of both numbers and employees’ and managers’ degree of involvement, as well as the type of training and resources provided.Originality/value– The diffusion of Six Sigma in Brazilian companies is less widespread than in other countries. Three possible configurations of the role structure were found that differ in terms of the training and dedication of human resources entailed by the Six Sigma program. Three CSFs factors were identified: organisation, infrastructure and human resources.
Status of lean manufacturing practices in Indian industries and government initiatives
Authors: Thanki S.J. , Thakkar Jitesh 
Published: June 2014

Purpose– The purpose of this paper is to report a pilot study on lean awareness and implementation using the survey data collected from about 32 industries situated in western and eastern region of India.Design/methodology/approach– A survey instrument containing 45 statements was designed to assess respondents’ attitude and awareness toward lean practices and to explore the level of lean implementation in the organization. The instrument was distributed personally or through mail to the employees of 32 industries and they were supported for any query about the questions. Descriptive statistical analysis, hierarchical cluster analysis and ANOVA were used to analyze the data with SPSS statistical software.Findings– The research uncovers the fact that the current status of lean implementation and awareness in Indian industries is not so encouraging and the reason for that is, the human-related issues are not tackled properly. Quality and process technology, are the two key areas where industries are indicating inadequate efforts and poor insight.Research limitations/implications– The study conducted was limited to 32 industries situated in the eastern and western region of India. The data collected for few industries rely on only one respondent.Practical implications– The study identifies the lean implementation status based on nine lean assessment key areas and uncovers the major roadblocks for lean practices in Indian industries. It provides key insights to lean practicing industries and lean practitioner about the major barriers and key areas for the improvement.Originality/value– The paper reports comprehensive insights on current awareness and implementation of lean manufacturing (LM) in India. It also highlights the initiatives taken by Government of India to increase the competitiveness of the Indian industries, specifically of manufacturing sector, through the adoption of LM techniques. This would provide a platform for carrying out a detailed research in LM in Indian context.
Lean “Leadership People Process Outcome” (LPPO) implementation model
Authors: K. Dibia Ifechukwude , Nath Dhakal Hom , Onuh Spencer 
Published: June 2014

Purpose
– The purpose of this paper is to present the Lean “Leadership People Process Outcome” (LPPO) implementation model.

Design/methodology/approach
– The model is developed from existing models through literature review and its success from use in lean implementation is reported in case studies.

Findings
– The LPPO model is a Lean implementation model that is flexible and easily adaptable. It is system based, people driven, customer centred, with measurable outcome and a drive for continuous improvement.

Research limitations/implications
– This work is based on existing literature and case studies.

Practical implications
– The paper would be of interest to Lean practitioners as the model developed is system generic and easily adaptable.

Originality/value
– The LPPO model presented in this paper has been newly developed and the successful application is seen in the case studies.