bluuebunny/crossref_metadata_2025_split huggingface dataset:
The actual implementation of accruals accounting
Authors: Connolly Ciaran , Hyndman Noel 
Published: July 2006

PurposeTo ascertain the principal benefits and drawbacks that have been experienced in implementing accruals‐based resource accounting in the UK public sector.Design/methodology/approachIn a unique study, which presents case research of the Northern Ireland experience within the wider UK context, semi‐structured interviews were held with key actors involved in the implementation, maintenance or oversight of resource accounting in Northern Ireland. This paper looks at the operation of a newly introduced system through the eyes of those who are in a position to understand and evaluate the impacts (accountants).FindingsIt finds that the actual implementation of accruals accounting is very different, in effect, in cost and in terms of timing, to that presented in pre‐implementation government publications. The result is a complex, expensive system that has provided few benefits to date. What is found is a story of overoptimistic claims and obfuscation of costs. The very best that could be suggested from this research is that a lengthy continuum of accounting change is underway.Research limitations/implicationsThis research is a case study within the wider UK public sector and therefore any generalizing of the conclusions beyond the Northern Ireland context should be undertaken with care. However, although Northern Ireland departments are relatively small compared with Westminster departments, there are significant similarities between the modes of operation of all departments within the UK (whether in Westminster, Scotland or Wales). Furthermore, both the implementation of resource accounting and the challenges that it presents are common to all public sector bodies in the UK.Originality/valueGives some thought‐provoking arguments into the benefits and drawbacks of implementing accruals‐based resource accounting in the UK public sector which will provide interest to those in the field.
On James Bond and the importance of NGO accountability
Authors: Unerman Jeffrey , O'Dwyer Brendan 
Published: July 2006

PurposeThe purpose of this paper is to set out key issues in the academic study of non‐governmental organisation (NGO) accountability, and to introduce papers appearing in this special issue on NGO accountability.Design/methodology/approachThis is a discussion paper exploring key issues theoretically.FindingsThe paper finds that there are many aspects of NGO accountability which should be explored in greater depth in future studies. Several other issues have been examined in the papers in this special issue of Accounting, Auditing & Accountability Journal.Research limitations/implicationsThere is a possibility that the issues explored in this paper, and the other papers in this special issue, will lead to a considerable growth in academic studies in this area.Practical implicationsThe paper is a contribution to the growing debate on NGO accountability.Originality/valueThe paper sets an agenda for research into NGO accountability.
Microfinance: accountability from the grassroots
Authors: Dixon Rob , Ritchie John , Siwale Juliana 
Published: July 2006

PurposeThe purpose of this research is to use an accountability framework to explain the emerging tensions in accountability and how an intended bottom‐up approach became progressively supplanted. This paper is set within an emerging Zambian microfinance organisation moving into crisis.Design/methodology/approachA series of semi‐structured interviews were conducted with key local microfinance specialists, managers and accountants, clients and past and current loan officers. Live observation of the client‐loan officer interface and internal meetings provided triangulation on accountability relationships in the midst of crisis. Data were analysed using NVIVO, a qualitative computer software package.FindingsThe findings show that tensions between vertical and horizontal accountability in practice can be directly translated into heightened pressure and stresses on both the non‐governmental organisation (NGO) and its loan officers, which constrain overall accountabilities to other stakeholders and disguise other potential dysfunctions.Research limitations/implicationsThis study focussed on accountability at the grassroots in microfinance NGOs with a social mission. It reveals potential for further personal, community and socially constituted accounting research within microfinance in particular.Originality/valueThe paper adds to the literature on NGO accountability. It will be of value to researchers and practitioners seeking to gain a better understanding of not‐for‐profit organisations whose goals are not primarily wealth creation. It also gives details on under‐researched areas in accounting, namely NGOs and poverty reduction, and practices in Sub‐Saharan Africa.
Research, audit and quality improvement
Authors: Paxton Roger , Whitty Paula , Zaatar Ali , Fairbairn Andrew , Lothian Jane 
Published: July 2006

PurposeThe purpose of this article is to clarify the distinction between research and audit, and propose appropriate regulatory arrangements for audit and related activities.Design/methodology/approachThe methods used were literature reviews and conceptual analysis.FindingsResearch and audit overlap in various ways, but differ in terms of their purposes and the risks likely to be encountered and distinguished, along with a third related category of activities called quality improvement.Practical implicationsAppropriate regulatory arrangements are proposed for audit and quality improvement activities. Using these should ensure appropriate ethical standards and risk management, while avoiding the time‐consuming over‐regulation that occurs when projects are unnecessarily submitted to the ethical scrutiny appropriate for research projects.Originality/valueGives suggestions and information that could be of great value in spreading service improvement.
Conceptual design of an e‐health strategy for the Spanish health care system
Authors: González Marvin E. , Quesada Gioconda , Urrutia Ignacio , Gavidia José V. 
Published: July 2006

PurposeThe purpose of this article is to describe the design and development of an e‐health strategy for the Spanish health care system. Using quality function deployment and benchmarking analysis as an analytical model, a strategy in e‐health care is proposed.Design/methodology/approachThis article uses the case of a Spanish community to build a general framework for e‐health system development. Based on a multi‐disciplinary literature, and the specific needs of a community, the process of e‐health system development is analyzed and reduced into a series of phases that form an integrated method. Best practice managerial techniques are adapted to the healthcare industry and the inter‐relationships between them are mapped in a theoretical model that results in the desired outcomes.FindingsThis analysis produces a road‐map to e‐health system development consisting of several phases: analysis of the current situation of the system and determination of objectives; collection and analysis of customer expectations; development of an action plan through cross‐evaluation of customer and system needs; cost and strategic analyses; and evaluation and control systems. Managerial implications are provided.Originality/valueThe strategy proposed in this article is a prototype and an ongoing study in the Castilla‐La Mancha community.
Barriers to accepting e‐prescribing in the USA
Authors: Smith Alan D. 
Published: July 2006

PurposeWith the number of prescriptions rising nationally each year, it is surprising that web‐based technology is not fully embraced in the pharmacy industry as an aid to quality‐assuring prescribing processes. Traditional prescription handling is done in a manual fashion with physicians hand‐writing prescriptions for the patients during an office visit, giving the patient the responsibility of taking the prescription to a pharmacy or mailing the prescription to a mail order company for fulfillment. Electronic prescribing (e‐prescribing) has the ability not only to streamline the prescription writing process, but also to reduce the number of errors that may be incurred with hand‐written prescriptions. The purpose of this paper is to investigate these phenomena in the USA. Design/methodology/approach – A number of hypotheses were tested using principal‐components analysis (PCA) and factor analyses. As a result, a total of 55 fully employed, professional and semi‐professional service management and internet users, representing a college‐educated and knowledge‐based sample derived from the metropolitan section of Pittsburgh, was selected. Findings – The six major constructs generated from the factor loadings in descending order of importance were: profit and risk factors, shipping and handling, saving, customer relationship management (CRM) and ethics, age, and awareness. The dependent variable chosen to be regressed against these major independent factor‐based constructs was willingness to purchase prescriptions online. The overall relationship was found to be statistically significant (F=2.971, p=0.015) in predicting willingness to use e‐prescribing options based on the various independent constructs. However, when testing the various standardized beta coefficients in the linear model, only the factor score‐based construct CRM and ethics was found to significantly contribute to predicting the willingness to purchase prescriptions online (t=−3.074, p=0.003). Research limitations/implications – Although this study appears to represent the e‐prescribing process in the USA, the sample size and region studied are only one slice of the general population. Practical implications – Unfortunately, the adoption of e‐prescribing has been difficult to attain owing to numerous barriers throughout the industry. Such acceptance barriers include lack of technology trust, associated system costs, and risk of un‐securing patient health and medical information. Originality/value – This article documents that increasing numbers of pharmacies today are building their IT‐infrastructures to accept electronic prescriptions and it may soon be the preferred method for physicians to write prescriptions. It is with great anticipation that this technology will also enhance the prescription‐writing abilities of prescribing physicians globally, giving them electronic access to patient medical records and resources that will assist them in prescribing the correct drug for the patient.
Consumer evaluation of hospital foodservice quality: an empirical investigation
Authors: Wright Olivia R.L. , Connelly Luke B. , Capra Sandra 
Published: July 2006

PurposeThe purpose of this article is to estimate the relationship between acute care consumers' satisfaction with hospital foodservices, foodservice characteristics, demographic and contextual variables.Design/methodology/approachThe acute care hospital foodservice patient satisfaction questionnaire was administered to 2,347 patients from 1996‐2001. Regression analysis was conducted to measure the influence of 21 foodservice attributes and seven contextual/demographic items on overall foodservice satisfaction.FindingsFoodservice satisfaction was strongly associated with variety, flavour, meat texture, temperature, meal taste, and menu staff (p<0.01). Consumers aged 70 years or more rated their overall satisfaction significantly lower than younger consumers (p<0.01), but no statistically significant differences in overall ratings existed for other contextual or demographic groups.Research limitations/implicationsThis new foodservice instrument and the methods of analysis may be generalisable, but application is likely to be context‐specific. Further applications of the instrument are required to produce greater confidence in its validity and reliability across different foodservice settings.Practical implicationsGlobal statements often used in health service satisfaction surveys (e.g. a single rating of “food quality”) provide insufficient information to allow managers to adapt foodservices to suit consumers' preferences.Originality/valueDetailed information of the kind produced here is required for the formulation of managerial and sectoral policies to improve the quality of health and consumer nutrition care. The findings are noteworthy and, as far as the literature review showed, no previously published study has produced this level of detail on consumer preferences across foodservice attributes or their relationship to overall foodservice satisfaction.
Casting light on the concept of patient satisfaction by studying the construct validity and the sensitivity of a questionnaire
Authors: Biering Páll , Becker Heather , Calvin Amy , Grobe Susan J. 
Published: July 2006

PurposeThis study aims to explore the construct validity and the sensitivity of a patient satisfaction questionnaire for the purpose of gaining a better understanding of the concept, and of issues surrounding its measurements.Design/methodology/approachSeveral statistical analyses were used to study the reliability, construct validity, and the sensitivity of a patient satisfaction questionnaire.FindingsThe study supported the construct validity, high internal consistency, and homogeneity of the instrument. Two factors were found; one consisted of negatively worded items and the other of positively worded items. The negatively worded items contributed more than the positively worded items to the sensitivity of the instrument. Items were identified that contribute little or nothing to the construct validity and/or the sensitivity of the questionnaire.Research limitations/implicationsThe effect of wording on the variability and sensitivity of the instrument can be explained both as a consequence of response set bias and with regard to the theories against which two phenomena were being measured – patient satisfaction and patient dissatisfaction. The development of two kinds of instruments is proposed: those that measure patient dissatisfaction and are sensitive to minute changes in nursing care and those that measure both concepts and capture what patients find important in their care.Originality/valueThe paper demonstrates how an analysis of the construct validity and the sensitivity of patient satisfaction instrument, can enhance understanding of the concept. It contributes to the debate about whether patient satisfaction and dissatisfaction are opposite ends of the same continuum or two different phenomena that require two different definitions.
Assessing doctors' compliance with guidelines on diabetes management
Authors: Boon Harold Tan Keng 
Published: July 2006

PurposeIn 2002 the Singapore Ministry of Health (MOH) audited doctors' compliance with diabetes clinical practice guidelines in public healthcare institutions and attempted to postulate factors that influenced the degree of conformity. This study aims to address this issueDesign/methodology/approachA retrospective cross‐sectional chart review of diabetes patient records sampled from hospital specialist outpatient clinics (SOCs) and polyclinics was performed. Childhood, gestational and secondary diabetes cases were excluded. The nine audit parameters used were process measures concerning the assessment of HbA1c, weight, blood pressure, urinary protein, serum creatinine, serum lipids, electrocardiography, retina and feet. Age‐standardised prevalence rate ratios of parameter adherence were calculated. Of the SOC cases, 89 per cent were analysed. Of the polyclinic cases, 94 per cent were analysed.FindingsAdherence to ECG and foot assessment parameters was poor among SOC cases, while poor adherence to weight and foot assessment parameters was seen in the polyclinics. There was poorer adherence to blood pressure and ECG parameters in the SOCs, but better adherence was seen for weight assessment. Among the SOC cases, Cluster A fared better than Cluster B in ECG monitoring. In the polyclinics, better adherence was seen in Cluster A for urinary protein, serum creatinine, lipids, ECG, retinal and foot assessment parameters.Originality/valueBased on pre‐existing information on local diabetes care, certain system, physician, patient and guideline factors are postulated to explain clinical practice guideline non‐compliance among doctors.
Pathways, networks and choice in health care
Authors: Keen Justin , Moore Jeanette , West Robert 
Published: July 2006

PurposeThe purpose of the paper is to present an alternative to the supply chain model of health care delivery that currently informs most thinking about the design of care processes.Design/methodology/approachThe paper draws on arguments from systems theories and public administration, to generate an analysis of the nature of health care processes. It sets out a model of services characterised by treatment and care needs that vary over time, that are inherently uncertain, involve frequent assessment and re‐assessment, and provide patients and service providers with choices about treatment and care. Evidence from an evaluation of intermediate care is used to illustrate the analysis.FindingsThe analysis suggests that both the supply chain and a more network‐like model of health care processes can help us to understand health care processes. The two are complementary.Research limitations/implicationsLargely conceptual in nature. The empirical evidence is taken from one study. The ideas are presented to stimulate thinking rather than to prove an argument.Practical implicationsThe conceptualisation of care processes as network‐like has implications for the way in which we think about the design and performance of health care systems.Originality/valueThere have been few publications that seek to use both systems and network approaches to understand health care processes.
Using the balanced scorecard to measure Chinese and Japanese hospital performance
Authors: Chen Xiao‐yun , Yamauchi Kazunobu , Kato Ken , Nishimura Akio , Ito Katuski 
Published: July 2006

PurposeThe objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.Design/methodology/approachOne hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries.FindingsThe BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system.Research limitations/implicationsHospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems.Originality/valueThe first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.
HACCP and the management of healthcare associated infections
Authors: Griffith Chris 
Published: July 2006

PurposeHospital cleaning and healthcare associated infections (HCAIs) continue to attract adverse media attention and consumer concern. Parallels exist with similar publicity relating to cleaning and food safety in the food industry almost 13 years earlier. This paper examines some of the management solutions developed in the food industry, and discusses their application to healthcare delivery.Design/methodology/approachThe food industry is managing food safety by adopting a dual approach based on pre‐requisite programmes and Hazard Analysis Critical Control Points (HACCP). How these differ is described and how the approaches and terminology can be adapted for use in healthcare is discussed.FindingsThe food industry is moving towards external certification of safety using national and international standards. The HACCP approach, a management tool and a central requirement of these standards, is evolving and there is interest worldwide from the healthcare community. Its application to the decontamination of endoscopes, using conventional HACCP, is presented, as well as suggestions for a simplified format for managing patient‐related procedures. Taking this type of approach to the management of HCAIs could provide greater transparency, reduce infection rates and increase consumer confidence.Practical implicationsPotential problems in adopting HACCP, including cost and human resource, are discussed.Originality/valueThe HACCP method/approach has previously been mentioned in the medical literature but this paper is one of the few to examine, from basic principles, its infection control application within a broader approach to quality assurance.
Getting value from knowledge management
Authors: Spender J‐C. 
Published: July 2006

PurposeGetting value from knowledge management (KM) means managing the way new knowledge is brought to bear on the business's practices, for value is added only through practice – not through talk. Though there are relationships between knowledge and practice, and the purpose of KM is to get more value from the firm's knowledge, knowledge is too loose and slippery a term to afford us a good handle on these matters. The paper proposes a novel typology that distinguishes data, meaning, and skilled practice. Each must be managed differently, though management must integrate all into the business model.Design/methodology/approachA non‐empirical theoretical paper clarifying the interaction of different epistemologies or ways of knowing within the business. Different epistemologies are illustrated and discussed at a managerial level, the formal and academic philosophizing is left out.FindingsThe paper shows that KM are not all alike.Originality/valueHighly original, given very few KM writers address multiple epistemologies and then propose a practice‐based approach to their integration. Despite its theoretical language the paper actually proposes a severely practical approach to real‐world KM.
Similarities and differences between TQM, six sigma and lean
Authors: Andersson Roy , Eriksson Henrik , Torstensson Håkan 
Published: July 2006

PurposeDuring the last decades, different quality management concepts, including total quality management (TQM), six sigma and lean, have been applied by many different organisations. Although much important work has been documented regarding TQM, six sigma and lean, a number of questions remain concerning the applicability of these concepts in various organisations and contexts. Hence, the purpose of this paper is to describe the similarities and differences between the concepts, including an evaluation and criticism of each concept.Design/methodology/approachWithin a case study, a literature review and face‐to‐face interviews in typical TQM, six sigma and lean organisations have been carried out.FindingsWhile TQM, six sigma and lean have many similarities, especially concerning origin, methodologies, tools and effects, they differ in some areas, in particular concerning the main theory, approach and the main criticism. The lean concept is slightly different from TQM and six sigma. However, there is a lot to gain if organisations are able to combine these three concepts, as they are complementary. Six sigma and lean are excellent road‐maps, which could be used one by one or combined, together with the values in TQM.Originality/valueThe paper provides guidance to organisations regarding the applicability and properties of quality concepts. Organisations need to work continuously with customer‐orientated activities in order to survive; irrespective of how these activities are labelled. The paper will also serve as a basis for further research in this area, focusing on practical experience of these concepts.