bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing large‐scale quality improvement
Authors: Morrow Elizabeth , Robert Glenn , Maben Jill , Griffiths Peter 
Published: April 2012

PurposeThis paper aims to focus on facilitating large‐scale quality improvement in health care, and specifically understanding more about the known challenges associated with implementation of lean innovations: receptivity, the complexity of adoption processes, evidence of the innovation, and embedding change. Lessons are drawn from the implementation of The Productive Ward: Releasing Time to Care™ programme in English hospitals.Design/methodology/approachThe study upon which the paper draws was a mixed‐method evaluation that aimed to capture the perceptions of three main stakeholder groups: national‐level policymakers (15 semi‐structured interviews); senior hospital managers (a national web‐based survey of 150 staff); and healthcare practitioners (case studies within five hospitals involving 58 members of staff). The views of these stakeholder groups were analysed using a diffusion of innovations theoretical framework to examine aspects of the innovation, the organisation, the wider context and linkages.FindingsAlthough The Productive Ward was widely supported, stakeholders at different levels identified varying facilitators and challenges to implementation. Key issues for all stakeholders were staff time to work on the programme and showing evidence of the impact on staff, patients and ward environments.Research limitations/implicationsTo support implementation, policymakers should focus on expressing what can be gained locally using success stories and guidance from “early adopters”. Service managers, clinical educators and professional bodies can help to spread good practice and encourage professional leadership and support. Further research could help to secure support for the programme by generating evidence about the innovation, and specifically its clinical effectiveness and broader links to public expectations and experiences of healthcare.Originality/valueThis paper draws lessons from the implementation of The Productive Ward programme in England, which can inform the implementation of other large‐scale programmes of quality improvement in health care.
Linking Six Sigma to simulation: a new roadmap to improve the quality of patient care
Authors: Celano Giovanni , Costa Antonio , Fichera Sergio , Tringali Giuseppe 
Published: April 2012

PurposeImproving the quality of patient care is a challenge that calls for a multidisciplinary approach, embedding a broad spectrum of knowledge and involving healthcare professionals from diverse backgrounds. The purpose of this paper is to present an innovative approach that implements discrete‐event simulation (DES) as a decision‐supporting tool in the management of Six Sigma quality improvement projects.Design/methodology/approachA roadmap is designed to assist quality practitioners and health care professionals in the design and successful implementation of simulation models within the define‐measure‐analyse‐design‐verify (DMADV) or define‐measure‐analyse‐improve‐control (DMAIC) Six Sigma procedures.FindingsA case regarding the reorganisation of the flow of emergency patients affected by vertigo symptoms was developed in a large town hospital as a preliminary test of the roadmap. The positive feedback from professionals carrying out the project looks promising and encourages further roadmap testing in other clinical settings.Practical implicationsThe roadmap is a structured procedure that people involved in quality improvement can implement to manage projects based on the analysis and comparison of alternative scenarios.Originality/valueThe role of Six Sigma philosophy in improvement of the quality of healthcare services is recognised both by researchers and by quality practitioners; discrete‐event simulation models are commonly used to improve the key performance measures of patient care delivery. The two approaches are seldom referenced and implemented together; however, they could be successfully integrated to carry out quality improvement programs. This paper proposes an innovative approach to bridge the gap and enrich the Six Sigma toolbox of quality improvement procedures with DES.
On the day of surgery: how long does preventable disruption prolong the patient journey?
Authors: Al‐Hakim Latif , Yan Gong Xiao 
Published: April 2012

PurposeDisruption considerably prolongs session times for surgery, affects the quality of patient care, and prolongs waiting lists. In addition, there is a strong relationship between disruption and surgical error. This research aims to provide a platform for healthcare services to identify the sources of preventable disruption affecting operative time within the perioperative process and to effectively reduce it.Design/methodology/approachEvents inside and outside operating rooms that disturb the operative time were recorded for 31 elective surgeries over the period of five months. Disruption events were classified according to the hospital's requirements and the findings were reviewed by the surgical teams. Lean thinking approaches were used to achieve the purpose of this study.FindingsPreventable disruption caused an increase in surgical time of approximately 25 per cent. Preventable disruption consisted of poor information flow, failure to follow concepts of methods study, lack of communication and lack of coordination. Coordination failures were the main reason for disruption followed by the lack of following the principles of motion economy.Originality/valueSurgical disruption has substantial financial implications for hospitals. This research indicates that it is possible to reduce operative time considerably by eliminating preventable disruption. Such additional time could be utilised to deal with the pressure of emergency cases, reduce the waiting lists for elective surgery, increase operating room utilisation, and reduce medical errors.
Significant components of service brand equity in healthcare sector
Authors: Chahal Hardeep , Bala Madhu 
Published: April 2012

PurposeThe purpose of the study is to examine three significant components of service brand equity – i.e. perceived service quality, brand loyalty, and brand image – and analyze relationships among the components of brand equity and also their relationship with brand equity, which is still to be theorized and developed in the healthcare literature.Design/methodology/approachEffective responses were received from 206 respondents, selected conveniently from the localities of Jammu city. After scale item analysis, the data were analyzed using factor analysis, correlations, t‐tests, multiple regression analysis and path modeling using SEM.FindingsThe findings of the study support that service brand equity in the healthcare sector is greatly influenced by brand loyalty and perceived quality. However, brand image has an indirect effect on service brand equity through brand loyalty (mediating variable).Research limitations/implicationsThe research can be criticized on the ground that data were selected conveniently from respondents residing in the city of Jammu, India. But at the same time the respondents were appropriate for the study as they have adequate knowledge about the hospitals, and were associated with the selected hospital for more than four years. Furthermore, the validity and reliability of the data are strong enough to take care of the limitations of the convenience sampling selection method.Originality/valueThe study has unique value addition to the service marketing vis‐à‐vis healthcare literature, from both theoretical and managerial perspectives. The study establishes a direct and significant relationship between service brand equity and its two components, i.e. perceived service quality and brand loyalty in the healthcare sector. It also provides directions to healthcare service providers in creating, enhancing, and maintaining service brand equity through service quality and brand loyalty, to sustain competitive advantage.
Dark marketing: ghost in the machine or skeleton in the cupboard?
Authors: Brown Stephen , McDonagh Pierre , Shultz Clifford 
Published: April 2012

PurposeDark marketing is the “the application or adaptation of marketing principles and practices to domains of death, destruction and the ostensibly reprehensible”. This paper examines the nature, character and extent of dark marketing, noting that it is made manifest in manifold shapes and forms.Design/methodology/approachPrimarily a conceptual paper, this article includes several mini case studies – exemplars, rather – of dark marketing's many and varied expressions.FindingsThe paper considers the scale and scope of dark marketing, and endeavours to classify both. Dark marketing is discernible at micro, meso and macro scales. Its scope consists of four shades or degrees of darkness, entitled light dark marketing, slight dark marketing, quite dark marketing and night dark marketing. An evolutionary trend in the direction of darkness is also noted.Research limitations/implicationsThe paper is a think piece, not an empirical analysis. It is, therefore, a first step rather than a definitive statement.Practical implicationsPractitioners and academics are inclined to regard marketing in a positive light, as a force for the good. Crusading journalists and certain social scientists see it as the spawn of the devil. This article argues that the dark and light aspects of marketing are inextricably intertwined.Originality/valueThe paper provides food for thought, a markedly different way of thinking about marketing and its place in the world.
The key to effective organizational development in times of socioeconomic stress
Authors: Darling John R. , Heller Victor L. , Wilson Bennie J. 
Published: April 2012

PurposeSocioeconomic stress has been a major influence on organizational development during the past decade, and will continue for the foreseeable future. This treatise aims to focus on The Key and its importance for effective organizational development via leadership responses to communication challenges during the present era. It is a conceptual paper based on an actual case.Design/methodology/approachThe Key is a concept that refers to the thoughts and feelings (based on attitudes) that a leader reflects in communications and interactions with his/her universe, a universe that exists both internally within an organization as well as externally to it. The case focuses on communication challenges encountered by Judith Campbell, executive vice president of Creative Innovations, Ltd, and her interaction with Jonathan Bryant, president of Bryant and Associates, Ltd, an organizational development firm. Communication challenges that had arisen primarily due to socioeconomic stress, were seven in number: tendency to rely on only logical thinking; negative responses to external influences; lack of expectations for positive results; tendency toward reliance on sensory input; actions that ignore an inclusive perspective; failure to value and trust in change; and lack of commitment to interactive relations.FindingsFollowing Bryant's counsel, Campbell chose to address these communication challenges with a training seminar that focused on a paradigm of seven leadership responses related to The Key. These were: Paradoxical thinking; Controlled reflecting; Intentional focusing; Instinctive responding; Inclusive behaving; Purposeful trusting; and Relational being. The training program, as described herein, proved to be very enlightening to the participants and quite effective for the continued organizational development of the firm.Originality/valueThe paper reveals the results of a training program based on seven communication challenges the results of which can be used to aid in continued organizational development of a firm.
Internationalization modes other than exporting
Authors: Grandinetti Roberto , Mason Michela C. 
Published: April 2012

PurposeThe purpose of this paper is to develop and empirically evaluate a model of the firm‐level determinants of export performance that includes the firm's internationalization modes other than exporting.Design/methodology/approachThe paper uses information gathered on 147 Italian manufacturing small to medium‐sized enterprises (SMEs) and applies a structural equation modeling procedure to evaluate determinants included in the model, which are: the firm's commitment to developing an international marketing strategy, the organizational structure for exports, international modes other than exporting (foreign direct investment, international alliances, global sourcing), and some characteristics of the firm already extensively explored in other studies (size, age, international experience).FindingsThe above‐mentioned firm internationalization methods are shown, as a whole, to have a statistically significant, positive and direct influence on export performance. The same can be said of the strategic variable and the organizational variable, whereas the firm characteristics have only an indirect effect on export performance, mediated by the previous three determinants.Research limitations/implicationsThe study presents some limitations. In particular, it was limited to manufacturing SMEs in a particular geographical area (North‐East Italy). Replications in other territories are needed to validate the current findings. Moreover, the results of the statistical analysis reveal a moderate support to the research model with regard to some fit indices. These issues could be addressed in future research.Originality/valueThe most important outcome of the study refers to the influence of the internationalization modes other than exporting. Although a great deal of theoretical and empirical literature analyzed the determinants of export performance, this relationship has been largely neglected.
Strategic flexibility and the emergence of virtual global strategies
Authors: Turner Colin 
Published: April 2012

PurposeThe aim of this article is to explore the rise of firms making a strategic virtue of virtuality. This trend underlines the increased diversity of internationalisation trajectories within the modern international economy where multinational companies (MNCs) use third parties in a “strategic” manner to support a stated value proposition. To highlight this diversity, the article identifies a particular strategic type: virtual global strategy.Design/methodology/approachThe article uses configural analysis to identify the particular strategic type of virtual global strategy. Based on the identification of this type, the article offers evidence from the corporate telecommunications market where this strategy has emerged.FindingsThe evidence offered suggests there are limits to the strategic value of a virtual global strategy. Not only are the conditions for its existence rare, but also even in those sectors where it is feasible many firms will seek a degree of hybridity as there is still value in some degree of physical presence either at the regional or local level.Practical implicationsThe emergence of these innovative strategies challenges the understanding of the form and nature of internationalisation. Not only does it highlight that there is value in virtuality, but also challenges conventional understanding of the nature of commitment within host markets.Originality/valueThe value of the article lies in understanding the increasingly diverse set of trajectories linked to internationalisation and the ability of firms to make a strategic virtue of virtuality within international markets.
Consideration of selflessness and self‐interest in outsourcing decisions
Authors: Zutshi Ambika , Creed Andrew , Sohal Amrik S. , Wood Greg 
Published: April 2012

PurposeThe paper aims to discuss the need to balance selflessness and self‐interest issues in outsourcing decisions. This discussion is timely given the tensions that currently exist between those who want off‐shore outsourcing to continue as a means for increasing international trade, and those who only want to conduct business on‐shore.Design/methodology/approachA conceptual approach has been taken in this paper in order to highlight key considerations for ethical decision‐making with respect to off‐shore outsourcing.FindingsConsiderations of selflessness and self‐interest are embedded in outsourcing decisions. It is recommended that a balance between making profits and fulfilling social responsibilities is required, ideally, at each stage of decision‐making. Hence, managers should think critically about the reasons behind off‐shore outsourcing decisions, the process of arriving at decisions, and the impact of their decisions on stakeholders.Research limitations/implicationsThis is a conceptual paper and further empirical data to validate the stages of decision‐making framework are required.Practical implicationsFailure to take into account the selflessness and self‐interest outcomes of off‐shore outsourcing could potentially off‐set strategic gains by leading to negative media publicity for a company.Social implicationsEthical considerations as part of outsourcing decisions should result in a transparent, fair and more humane working environment for both the host and the home country representatives involved in the process.Originality/valueThis paper presents an original framework of selflessness and self‐interest considerations when making off‐shore outsourcing decisions. Both Eastern and Western business perspectives have been incorporated as part of the decision‐making framework.
Client learning for successful architect‐client relationships
Authors: Siva Jessica , London Kerry 
Published: April 2012

PurposeThis paper seeks to explain how clients deal effectively with challenges on private single dwelling projects by achieving learning.Design/methodology/approachEight in‐depth interviews were conducted across five case studies of successful architect‐client relationships. The narrative inquiry approach was used to establish the extent to which clients achieved learning and to describe the ways clients effectively dealt with project challenges.FindingsThe findings indicate that clients achieved learning on all five case studies, enabling them to function with increasing competency over the course of projects. Client learning is a characteristic of successful relationships and is demonstrated through the following indicators: learning about the nature of the design/construction process, learning to take enjoyment in the new environment, and learning about the architectural milieu.Research limitations/implicationsThis research is limited to the investigation of the simplified architect‐client relationship on private single dwelling projects. However, the conceptual model developed can be used to investigate relationships associated with other project types as they may offer different circumstances and challenges to the management of project relationships.Practical implicationsA total of 69 per cent of architects in Australia spend some of their work time on residential projects, and therefore improvements in this area can have significant impact on a considerably large portion of the profession.Social implicationsProblematic architect‐client relationships resulting in the marginalisation of the profession can be detrimental to the quality of the environment. An understanding of characteristics underpinning successful architect‐client relationships can thus contribute to the quality of the built environment.Originality/valueThis research identified ways in which clients effectively dealt with difficulties on projects by achieving learning to achieve successful architect‐client relationships.
Trust and the Project Management Body of Knowledge
Authors: Brewer Graham , Strahorn Scott 
Published: April 2012

PurposeThis paper aims to identify the extent to which dimensions of trust are reflected in the functional description of the role of a project manager as outlined in the Project Management Body of Knowledge (PMBOK).Design/methodology/approachThe literature is used to identify trust dimensions that have the potential to impact on the conduct of a project. These are then assembled into a theoretical framework, which is then used to drive a thematic analysis of the project manager's role as described in PMBOK. Similarities are confirmed, and absences identified and explained in the context of the literature.FindingsThe fourth edition of PMBOK is the first to make overt reference to the concept of trust. Detailed analysis of the text reveals that although certain trust dimensions are recognised they are dealt with in general terms, as desirable characteristics within the project environment rather than specific facilitators or actions in relation to the conduct of project.Practical implicationsPMBOK is the most widely recognised standard for the conduct of project management, and as such has achieved wide acceptance as defining the project manager's role. It recognises trust as playing a part in the successful management of projects. However, fostering trust is central to the art of project management, and requires greater consideration than indicated by PMBOK.Originality/valueThis is the first critical analysis of PMBOK in relation to trust.
Is incentivisation significant in ensuring successful partnered projects?
Authors: Hughes Deborah , Williams Trefor , Ren Zhaomin 
Published: April 2012

PurposeThis research aimed to test the hypothesis “The use of incentivisation with a gain/pain share of about 15 per cent is a precursor to the achievement of successful infrastructure partnering projects in South Wales”. This hypothesis arose from Egan's speech in 2008 discussing the success of partnering.Design/methodology/approachTwo infrastructure projects in South Wales were chosen for the study. This research demonstrates that partnering is not suitable for all projects. Incentivisation places a focus on cost that can have a detrimental effect on the other aspects that exist within the oft quoted triangle of time, cost and quality.FindingsNeither of the two case projects can be judged a success from the perspective of both parties. What represents success to one client would not equal success to the other. Overall it must be concluded that the hypothesis was not proven. Egan's view appears to be too simplistic to apply in all situations and is not always the key to success as he suggests.Originality/valueThis paper makes an original contribution by exploring if incentivisation can provide success within infrastructure projects in South Wales. The content of the paper will be of interest to clients, contractors and consultants engaged in formulating partnering contracts.