bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

PurposeThis 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/approachDetails 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.FindingsThe 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/valueThe 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

PurposeThe 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/approachPair‐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).FindingsThe 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/implicationsThe 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 implicationsThe 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/valueThe 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

PurposeAuthentic 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/approachThe 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.FindingsThe 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/valueA 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

PurposeThis 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/approachA 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.FindingsThe 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/implicationsAlthough 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 implicationsThe 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/valueThe 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

PurposeThe 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/approachThis 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.FindingsA 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/implicationsThe 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 implicationsIntegrating 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/valueThis 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

PurposeThis 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/approachThe 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.FindingsLessons 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/implicationsThe 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 implicationsIn 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/valueClinical 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

PurposeThe 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/approachCoding 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.FindingsZoning according to the traffic lights system could complement the CPA system and support a clinical governance structure utilising a whole team response.Research limitations/implicationsThe 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/valueThis 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

PurposeVarious 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/approachA cross‐sectional survey of the UK paediatricians was conducted online.FindingsA 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/valueThe 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

PurposeThis 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/approachThe paper takes the form of a narrative review starting from public records of events which the author attended.FindingsIn 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/implicationsThe impact and effectiveness of pay‐for‐performance initiatives need to be monitored as new initiatives become operationalPractical implicationsUntil 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/valueHistorically, 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

PurposeThe 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/approachApproached 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.FindingsHR 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/valueApproached 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

PurposeThis article discusses how managers can increase creativity from all workers, and how this increase will improve organizational outcomes at all levels.Design/methodology/approachPaper recommendations are based on existing conceptual and data based garden variety creativity studies. From these studies, a practical, management oriented implementation model is developed.FindingsManagers can substantially improve worker creativity by removing creativity blocks, providing creativity support, and structuring work to promote creativity.Originality/valueThe 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

PurposeThe 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/approachA 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.FindingsThe 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/implicationsThe 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/valueThe 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

PurposeThe 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/approachThe study involved the choice of five sampling stations for two different seasons: wet and dry. Standard methods were adopted for field and laboratory studies.FindingsWater 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 implicationsThe 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/valueThis 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.