bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doctor‐managers as decision makers in hospitals and health centres
Authors: Elina Viitanen , Juhani Lehto , Tiina Tampsi‐Jarvala , Kari Mattila , Irma Virjo , Mauri Isokoski , Harri Hyppölä , Esko Kumpusalo , Hannu Halila , Santero Kujala , Jukka Vänskä 
Published: July 2006

PurposeThis paper describes factors influencing doctor‐managers' decision making in specialised health care, health centres and at different levels of management.Design/methodology/approachData were collected as part of a survey on physicians graduating in 1977‐1991 as drawn from the register of the Finnish Medical Association. The study sample was formed by selecting all physicians born on odd days (n=4,144) from the baseline group (n=8,232). The category of doctor‐managers comprised physicians reporting as their main occupation: principal or assistant principal physician of hospital, medical director or principal physician of health centre, senior ward physician of hospital, and health centre physician in charge of a population area.FindingsIndependent of gender, all doctor‐managers responding to the survey reported that the most important base for decision making was personal professional experience. Position in organisation (first‐line manager, principal physician) had no impact on the base of decision making. Doctor‐managers in primary health care utilised knowledge on norms and knowledge available from their organisation in support of their decision making to a greater degree compared with doctor‐managers in specialised health care.Research implicationsEvolution discourse from public administration is not yet receiving much response in Finnish doctor‐managers' activities, instead, they still act as clinicians.Originality/valueFacing the growing challenges of the future, the paper shows that doctor‐managers should reconstruct their orientation and to act more like managers.
Management of stigma and disclosure of HIV/AIDS status in healthcare settings
Authors: Wong Victor , Wong Loretta 
Published: July 2006

PurposeThis paper aims to examine the management strategies adopted by older people living with HIV/AIDS (PHAs) to conceal their positive status in healthcare settings, and their responses taken and means used to cope with the stigmatizing and exclusionary effects as a result of the disclosure of their status by/to healthcare workers.Design/methodology/approachUnder the auspices of a local NGO in Hong Kong, a total of seven male older PHAs aged 55 or above from pre‐existing HIV/AIDS self‐help groups were recruited for two separate focus groups. A thematic approach was adopted for data analysis and specific themes identification.FindingsAn analysis of the data revealed that older PHAs did exercise their own agency in preventing against and managing stigma in their access to and use of health care services. Two more specific themes around “sign of disapproval” and “discriminatory practice” as barriers to access were also identified.Research limitations/implicationsBecause of the small sample size, the pattern of stigmatization experiences and coping strategies cannot claim to be representative of the complete picture of the stigma associated with HIV/AIDS.Originality/valueThis is the first exploratory study of the stigmatization and devaluation suffered by older PHAs in healthcare settings in the context of Hong Kong. It also explored in details the pros and cons of the stigma management strategies employed by this vulnerable group of patients. The implications for practice both on the side of healthcare workers and policy makers and that of PHAs were discussed.
Managing hospital supplies: process reengineering at Gujarat Cancer Research Institute, India
Authors: Ramani K.V. 
Published: July 2006

PurposeAims to give an overview of the re‐engineering of processes and structures at Gujarat Cancer Research Institute (GCRI), Ahmedabad.Design/methodology/approachA general review of the design, development and implementation of reengineered systems in order to address concerns about the existing systems.FindingsGCRI is a comprehensive cancer care center with 550 beds and well equipped with modern diagnostic and treatment facilities. It serves about 200,000 outpatients and 16,000 inpatients annually. The approach to a better management of hospital supplies led to the design, development, and implementation of an IT‐based reengineered and integrated purchase and inventory management system. The new system has given GCRI a saving of about 8 percent of its annual costs of purchases, and improved the availability of materials to the user departments.Originality/valueShows that the savings obtained are used not only for buying more hospital supplies, but also to buy better quality of hospital supplies, and thereby satisfactorily address the GCRI responsibility towards meeting its social obligations for cancer care.
Differentiating between research, audit and quality improvement: governance implications
Authors: Hill Sarah L. , Small Neil 
Published: July 2006

PurposeIn the context of changes in the priority given to ensuring that health care is evidence‐based, and that service quality should be maximised, there is a new emphasis on quality improvement programmes in the UK National Health Service (NHS). It is not clear how far these programmes can be categorised using the paradigms of research and audit. Making a distinction between what constitutes audit, quality improvement and research is important in the context of enhanced clinical and research governance requirements and in an environment of both sensitivity in relation to the ethics of research and concern about the efficacy of ethics committees. This study aims to address this issue.Design/methodology/approachThis article reviews the literature on how quality improvement differs from audit and research. It considers different ways of considering ethics in research and questions how far one can rely on professional judgement as an alternative to formal ethics committee procedures. The factors that characterise different sorts of activity are reworked to enable a template to be devised. The template, presented in the form of a flow‐chart, enables health care workers to better categorise a variety of activities and highlights the necessary procedural requirements that follow.FindingsKey factors are identified in the existing literature that help differentiate between quality improvement, audit and research. These factors range from intent in undertaking the activity, through sample/site selection, choice of methodology, analysis, patterns and speed of dissemination.Originality/valueIf quality improvement is to continue to be a central theme in the NHS agenda, it is important that both the Central Office for Ethical Review and NHS organisations review the categorisation system to include quality improvement in their clinical effectiveness structures.
Structured clinical audits: Queen Victoria Hospital, East Grinstead, UK
Authors: Shah Manisha , Gould Gez 
Published: July 2006

PurposeTo audit all the clinical audits conducted by the anaesthetic department at the Queen Victoria Hospital, East Grinstead, from August 2004 to July 2005 against recommendations published in the paper “Improving the reporting of clinical audits in the NHS”.Design/methodology/approachThe standards used were a central system of recording ongoing and completed projects, adequate methodological details with each audit, action plan with each audit, follow‐up of action plan and closing the loop for each audit.FindingsA problem was identified regarding unfinished projects when trainees move on to other hospitals. Changes have been made to solve that problem.Research limitations/implicationsOnly audits from one department were audited. If all the audits from the whole hospital are examined, more problems with reporting audits may be found.Practical implicationsA structured audit programme driven by local issues has enabled the study department's services to improve continuously.Originality/valueThis paper tries to show the usefulness of audits in bringing improvements to the NHS.
New frontiers and approaches to clinical governance
Authors: Sheps Sam 
Published: July 2006

PurposeSeeks to explore conceptual approaches and training paradigms that are necessary to counter new challenges in the face of new concepts and tools to assess and mitigate threats to patient safety, while enhancing quality of care.Design/methodology/approachInterdisciplinary conceptual approaches and a specific strategy – that of Canada's Western Regional Training Centre for Health Services Research – are presented.FindingsA critical element in meeting the new challenges in clinical governance is significant change in both managerial and clinical culture.Originality/valueThe approach outlined directly addresses many of the tensions inherent in current clinical governance and broadens the conception of clinical governance to embrace a wider array of critical health system issues.
Developing a multifunctional tree‐structured quality index for soil management
Authors: Barbiroli Giancarlo , Casalicchio Giovanni , Raggi Andrea 
Published: July 2006

PurposeAn extensive knowledge of soil characteristics and an awareness of the type and amount of pollutants present are essential to evaluate the utilization potential of soil resources for various land uses. On the other hand, for management and decision‐making purpose, there is a need to develop concise indices in order to adequately express the overall quality of soil resources. The aim of this study was to introduce a flexible soil quality index system, mainly based on fertility and the presence of pollutants.Design/methodology/approachA tree‐structured approach was adopted, leading to a concise final index from various intermediate sub‐indices. More specifically, a number of physical‐chemical‐biological parameters lead to an agronomic quality index (AQI). Another group of parameters referring to polluting substances of various origins are combined to give a multifunctional quality index (MQI). AQI and MQI are then coupled into an overall general quality index. The proposed model was implemented by using a set of data concerning various specific sites throughout Italy.FindingsThe proposed methodology proved useful in providing valuable and quick information about the overall soil quality performance and its main sources, and in helping to balance the contrasting needs of obtaining concise quantitative information, on the one hand, and of minimizing the inevitable loss of information inherent in every process of synthesis, on the other hand.Originality/valueThis paper presents an innovative quality index structure for the environmental and multifunctional management of soil, whose main value is related to its flexibility (e.g. different number and kind of parameters, various levels of aggregation) which makes it applicable to various contexts.
An overview of sustainability practices at the maquiladora industry in Mexico
Authors: Velázquez Luis , Munguía Nora , de los Ángeles Navarrete Maria , Zavala Andrea 
Published: July 2006

PurposeThe goal of this study is to further the existing understanding of the diverging pollution prevention and occupational and safety practices undertaken in the Mexican maquiladora industry in order to promote the creation of a sustainable production system.Design/methodology/approachThis study explores in detail the occupational health, safety and environmental practices performed by six electronic maquiladoras located in the State of Sonora, Mexico. The OSHA's program evaluation profile (PEP) and cleaner production and pollution prevention and worker surveys were the instruments used for collecting information. All instruments were complemented with short interviews and walkthroughs in the production lines.FindingsEvidences from this study suggest that today's trends in maquiladoras production patterns continue to go in an unsustainable direction because of the lack of good environmental and occupational and safety practices.Practical implicationsThis study reveals the most telling and significant sustainability themes associated to the maquiladora industry that holds the exciting potential of protecting the environment and labor and strengthening economic growth through more efficient and sustainable production.Originality/valueSustainability production is an issue that is often neglected into the actual stock of published material about maquiladoras. This study fills this gap through a broad structural approach that takes into account economic, social, and environment aspects as a way to helping the adoption of sustainability practices in the maquiladora industry.
Effects of maturity choices on loan‐guarantee portfolios1
Authors: Gendron Michel , Son Lai Van , Soumaré Issouf 
Published: July 2006

PurposeThe purpose of this paper is to analyse the effects of the maturities of credit‐enhanced debt contracts on the value of an insurer's loan‐guarantee portfolios.Design/methodology/approachThe paper proposes a contingent‐claims model and uses as measure of credit insurance risk, the market value of the private guarantee, which accounts for projects' and guarantor's specific risks, correlations as well as financial leverage.FindingsThe results indicate that in the case of insuring the debts of two parallel projects with different specific risks, one high‐risk and the other low‐risk, the tradeoff between maturities of the guarantees increases with the projects' expected losses, hence the maturity choice decision is crucial for portfolios subject to high expected losses. For a two sequential projects loan‐guarantee portfolio, the paper finds that, regardless of the order of execution of the projects, it is the maturity of the debt supporting the high‐risk project that drives the risk exposure of the portfolio.Practical implicationsSince the management of portfolios of guarantees is of significant importance to many organizations both domestically and internationally, this paper proposes a simple and tractable model to gauge the impact of maturity choices for loan‐guarantee portfolios.Originality/valueThis is a first attempt at modeling multiple maturities in the context of portfolios of vulnerable loan guarantees.
Variant simulation in design and risk estimation of manufacturing system
Authors: Burduk Anna , Chlebus Edward 
Published: July 2006

PurposeTo show necessity of risk evaluation during modelling and simulation of production systems. To show an approach to risk evaluation of manufacturing system which has serial reliability structure.Design/methodology/approachModelling and simulation of a manufacturing system allows one to conduct verification of different solutions in the area of production planning, before they are started. This is impossible with traditional methods.FindingsReliable results of simulation research can be obtained only if they are based on an integrated model of the company, that covers all components of the manufacturing process including also its organization and risk in production processes.Practical implicationsThe paper describes the stages and results of a project carried out in 2002 in an international company. The proposed method of risk evaluation may be helpful to determine the risk level in the chosen production line and eventually for the whole enterprise manufacturing systems.Originality/valueThe risk concept was treated as a synonym of unreliability. This kind of approach enabled decomposition of the production system into several areas and determination of the reliability structure.
Translating knowledge of supply chain uncertainty into business strategy and actions
Authors: Koh S.C.L. , Tan K.H. 
Published: July 2006

PurposeThis paper seeks to present the process and results of the application of a decision‐making tool, namely TAPS, which enables translation of knowledge of supply chain uncertainty into business strategy and actions.Design/methodology/approachThe knowledge of supply chain uncertainty is collected from previous research performed under enterprise resource planning (ERP)‐controlled manufacturing environments. The knowledge is used as the input for TAPS and is mapped to investigate and formulate appropriate business strategy and action plan to manage supply chain uncertainty in such environments.FindingsThe results of knowledge translation provide a set of guidelines to academics and practitioners, which indicates the underlying causes of supply chain uncertainty in ERP‐controlled manufacturing environments in a priority order, and the suitable business strategy and actions that could potentially be adopted to manage the uncertainty.Practical implicationsOwing to the increasing level of complexity and uncertainty intoday's enterprises, translating knowledge is suggested to be useful in assisting decision making and business strategy formulation.Originality/valueThis research provides a successful case example of knowledge translation process of supply chain uncertainty into business strategy and actions, which enables creation of sustainable strategies to manage uncertainty based on the concept of knowledge management and learning.
Simulation for product life cycle management
Authors: Xie Xiaoling , Simon Matthew 
Published: July 2006

PurposeEffective product life cycle management will save costs and resources and improve customer service. Seeks to present a simulation model of the complete life cycle of a batch of products undergoing breakdown and repair and to show the ability of the model to predict future waste arisings and cost savings.Design/methodology/approachARENA system simulation software is used for a novel application – a full life cycle of manufacture, use, repair and ultimate disposal. Two batches of products are compared: products with and without features which improve reliability. The number of replications for the Monte Carlo process can be calculated from the statistics of the model data.FindingsThe model demonstrates the predicted flows of products through their life cycle. The software has in‐built probability distributions that are not fully suitable for the problem modelled, requiring some artificial treatment, especially when using the delay function. The number of replications should be increased, requiring additional computer time.Practical implicationsThe model is potentially valuable for producers wishing to predict the effect on future costs or the risk of modifying designs. The method can also be used to assist waste management using the output graphs of disposed components or products; hence the economics of component remanufacture or reuse can be modelled.Originality/valueThe paper presents the first known application of manufacturing system simulation software for modelling product life cycles.
Taboo search vs genetic algorithms in solving and optimising PCB problems
Authors: Saad Sameh , Khalil Eaid , Fowkes Cliff , Basarab‐Horwath Ivan , Perera Terrence 
Published: July 2006

PurposeTo highlight the differences and common features of taboo search (TS) and genetic algorithms (GA) in solving the problem of board‐type sequencing on the assembly line simultaneously with the combined problem of feeder assignment and component placement sequencing in the printed circuit board (PCB) industry.Design/methodology/approachTwo metaheuristics (search techniques) are used to solve three problems associated with the PCB assembly line: TS and GA. The implemented approach is used to solve the three problems on a single pick‐and‐place sequential machine with a stationary board table and stationary feeders, and with the use of the Euclidean metric.FindingsThe achieved results show a satisfactory reduction in assembly time, when TS and GA are compared with a random solution, with a slight superiority of TS over GA. However, the program running time is longer for TS.Practical implicationsThe hypothetical case study used shows that in real life the savings could reach an average of 6 per cent when TS is used. Slightly lower savings are possible when GA is used.Originality/valueThis paper provides a clear insight into how some of the problems associated with the production of PCBs can be solved simultaneously using metaheuristics such as TS and GA.
Global supply chain strategy: a Chinese market perspective
Authors: Hong Paul , Noh Jungbae , Hwang Woosang 
Published: July 2006

PurposeThe purpose of this paper is to develop an understanding of changing business control patterns that may be critical for firms, in order to manage effective enterprise information infrastructures in and through the Chinese market.Design/methodology/approachThis paper presents a typology that shows four types of Chinese market penetration and development, in terms of level of foreign management control and level of foreign ownership control. The model is illustrated through case examples of US, Korean, and Chinese firms.FindingsThe paper shows that sustainable design and management of enterprise information infrastructures require continuous awareness of changes in corporate management and ownership control.Research limitations/implicationsThe transition paths among the four different types of global operations provide a rich basis for further theory development in the areas of the global supply chain practices beyond the Chinese market. Future research is needed to identify key variables that define the level of management and ownership control.Practical implicationsThe typology and transitions paths presented in this paper may be a valuable road‐map for firms that are considering the Chinese market. In the course of implementing global supply chain strategies, foreign firms operating in China face complex business challenges, including multiple performance requirements, environmental regulations and cultural differences. In designing and managing effective enterprise information infrastructures, firms need to be conscious of both internal and external changes related to their management and ownership control. An understanding of changing business control patterns is critical if firms are to sustain effective enterprise information infrastructures in and through the Chinese market.Originality/valueChina is a potential global supply chain base. Global firms must consider carefully the extent of foreign management and ownership control with which they enter the Chinese market. These two dimensions are useful in analyzing the behavior and strategic options of global firms in this market.