Problems with a great idea : referral by prehospital emergency services to a community-based falls-prevention service

Background and aim Falls are the leading cause of injury in older adults. Identifying people at risk before they experience a serious fall requiring hospitalisation allows an opportunity to intervene earlier and potentially reduce further falls and subsequent healthcare costs. The purpose of this project was to develop a referral pathway to a community falls-prevention team for older people who had experienced a fall attended by a paramedic service and who were not transported to hospital. It was also hypothesised that providing intervention to this group of clients would reduce future falls-related ambulance call-outs, emergency department presentations and hospital admissions. Methods An education package, referral pathway and follow-up procedures were developed. Both services had regular meetings, and work shadowing with the paramedics was also trialled to encourage more referrals. A range of demographic and other outcome measures were collected to compare people referred through the paramedic pathway and through traditional pathways. Results Internal data from the Queensland Ambulance Service indicated that there were approximately six falls per week by community-dwelling older persons in the eligible service catchment area (south west Brisbane metropolitan area) who were attended to by Queensland Ambulance Service paramedics, but not transported to hospital during the 2-year study period (2008–2009). Of the potential 638 eligible patients, only 17 (2.6%) were referred for a falls assessment. Conclusion Although this pilot programme had support from all levels of management as well as from the service providers, it did not translate into actual referrals. Several explanations are provided for these preliminary findings.

Where do we find services in enterprise architectures? A comparative approach

In recent years, enterprise architecture (EA) has captured growing attention as a means to systematically consolidate and interrelate diverse IT artefacts in order to provide holistic decision support. Since the emergence of Service-Oriented Architecture (SOA), many attempts have been made to incorporate SOA artefacts in existing EA frameworks. Yet the approaches taken to achieve this goal differ substantially for the most commonly used EA frameworks to date. This paper investigates and compares five widely used EA frameworks in the way they embrace the SOA paradigm. It identifies what SOA artefacts are considered to be in the respective EA frameworks and their relative position in the overall structure. The results show that services and related artefacts are far from being well-integrated constructs in current EA frameworks. The comparison presented in this paper will support practitioners in identifying an EA framework that provides SOA support in a way that matches their requirements and will hopefully inspire the academic EA and SOA communities to work on a closer integration of these architectures.

Collaboration : developing integration in multi-purpose services in rural New South Wales, Australia

Introduction: The Multi-purpose Service (MPS) Program was introduced to rural Australia in 1991 as a solution to poor health outcomes in rural compared with metropolitan populations, difficulty in attracting healthcare staff and a lack of viability and range of health services in rural areas. The aim of this study was to describe the main concerns of participants involved in the development of multi-purpose services in rural New South Wales (NSW). This article is abstracted from a larger study and discusses the extent to which collaboration occurred within the new multi-purpose service. Methods: A constructivist grounded theory methodology was used. Participants were from 13 multi-purpose services in rural NSW and 30 in-depth interviews were conducted with 6 community members, 11 managers and 13 staff members who had been involved in the process of developing a multi-purpose service. Results: The main concern of all participants was their anticipation of risk. This anticipation of risk manifested itself in either trust or suspicion and explained their progression through a phase of collaborating. Participants who had trust in other stakeholders were more likely to embrace an integrated health service identity. Those participants, who were suspicious that they would lose status or power, maintained that the previous hospital services provided a better health service and described a coexistence of services within the multi-purpose service. Conclusions: This study provided an insight into the perceptions of community members, staff members and managers involved in the process of developing a multi-purpose service. It revealed that the anticipation of risk was intrinsic to a process of changing from a traditional hospital service to collaborating in a new model of health care provided at a multi-purpose service.

Inward internationalization of services : Exploring satisfaction and dissatisfaction of overseas students in Australia

Most research has assessed the outward internationalization process of service firms and less is known in the literature about the inward internationalization of services, or companies that provide the service to overseas customers in the domestic market (i.e., tourism, education, healthcare). Specifically, there is scant research looking at the overseas customer perspective. This study attempts to identify the main drivers of satisfaction and dissatisfaction for overseas customers. The critical incident technique (CIT) method was used to collect and analyse the data. A total of 107 critical incidents regarding drivers of satisfaction and dissatisfaction for overseas customers in a higher educational service context were collected. Findings of this study show that drivers of service satisfaction and dissatisfaction for overseas customers derive from elements of the core service and peripheral service. However, the findings show that elements of the peripheral service (living environment, socialization and interaction with others, and personal performance) are more important for international students.

Demand for public hospital emergency department services in Australia : 2000–2001 to 2009–2010

Objective: Hospital EDs are a significant and high-profile component of Australia’s health-care system, which in recent years have experienced considerable crowding. This crowding is caused by the combination of increasing demand, throughput and output factors. The aim of the present article is to clarify trends in the use of public ED services across Australia with a view to providing an evidence basis for future policy analysis and discussion. Methods: The data for the present article have been extracted, compiled and analysed from publicly available sources for a 10 year period between 2000–2001 and 2009–2010. Results: Demand for public ED care increased by 37% over the decade, an average annual increase of 1.8% in the utilization rate per 1000 persons. There were significant differences in utilization rates and in trends in growth among states and territories that do not easily relate to general population trends alone. Conclusions: This growth in demand exceeds general population growth, and the variability between states both in utilization rates and overall trends defies immediate explanation. The growth in demand for ED services is a partial contributor to the crowding being experienced in EDs across Australia. There is a need for more detailed study, including qualitative analysis of patient motivations in order to identify the factors driving this growth in demand.

Value co-creation in social marketing wellness services

Customer perceived value is concerned with the experiences of consumers when using a service and is often referred to in the context of service provision or on the basis of service quality (Auh, et al., 2007; Chang, 2008; Jackson, 2007; Laukkanen, 2007; Padgett & Mulvey, 2007; Shamdasani, Mukherjee & Malhotra, 2008). Understanding customer perceived value has benefits for social marketing and allows scholars and practitioners alike to identify why consumers engage in positive social behaviours through the use of services. Understanding consumers’ use of wellness services in particular is important, because the use of wellness services demonstrates the fulfilment of social marketing aims; performing pro-active, positive social behaviours that are of benefit to the individual and to society (Andreasen, 1994). As consumers typically act out of self-interest (Rothschild, 1999), this research posits that a value proposition must be made to consumers in order to encourage behavioural change. Thus, this research seeks to identify how value is created for consumers of wellness services in social marketing. This results in the overall research question of this research: How is value created in social marketing wellness services? A traditional method towards understanding value has been the adoption of an economic approach, which considers the utility gained and where value is a direct outcome of a cost-benefit analysis (Payne & Holt, 1999). However, there has since been a shift towards the adoption of an experiential approach in understanding value. This experiential approach considers the consumption experience of the consumer which extends beyond the service exchange and includes pre- and post-consumption stages (Russell-Bennett, Previte & Zainuddin, 2009). As such, this research uses an experiential approach to identify the value that exists in social marketing wellness services. Four dimensions of value have been commonly conceptualised and identified in the commercial marketing literature; functional, emotional, social, and altruistic value (Holbrook, 1994; Sheth, Newman & Gross, 1991; Sweeney & Soutar, 2001). It is not known if these value dimensions also exist in social marketing. In addition, sources of value said to influence value dimensions have been conceptualised in the literature. Sources of value such as information, interaction, environment, service, customer co-creation, and social mandate have been conceptually identified both in the commercial and social marketing literature (Russell-Bennet, Previte & Zainuddin, 2009; Smith & Colgate, 2007). However, it is not clear which sources of value contribute to the creation of value for users of wellness services. Thus, this research seeks to explore these relationships. This research was conducted using a wellness service context, specifically breast cancer screening services. The primary target consumer of these services is women aged 50 to 69 years old (inclusive) who have never been diagnosed with breast cancer. It is recommended that women in this target group have a breast screen every 2 years in order to achieve the most effective medical outcomes from screening. A two-study mixed method approach was utilised. Study 1 was a qualitative exploratory study that analysed individual-depth interviews with 25 information-rich respondents. The interviews were transcribed verbatim and analysed using NVivo 8 software. The qualitative results provided evidence of the existence of the four value dimensions in social marketing. The results also allowed for the development of a typology of experiential value by synthesising current understanding of the value dimensions, with the activity aspects of experiential value identified by Holbrook (1994) and Mathwick, Malhotra and Rigdon (2001). The qualitative results also provided evidence for the existence of sources of value in social marketing, namely information, interaction, environment and consumer participation. In particular, a categorisation of sources of value was developed as a result of the findings from Study 1, which identify organisational, consumer, and third party sources of value. A proposed model of value co-creation and a set of hypotheses were developed based on the results of Study 1 for further testing in Study 2. Study 2 was a large-scale quantitative confirmatory study that sought to test the proposed model of value co-creation and the hypotheses developed. An online-survey was administered Australia-wide to women in the target audience. A response rate of 20.1% was achieved, resulting in a final sample of 797 useable responses after removing ineligible respondents. Reliability and validity analyses were conducted on the data, followed by Exploratory Factor Analysis (EFA) in PASW18, followed by Confirmatory Factor Analysis (CFA) in AMOS18. Following the preliminary analyses, the data was subject to Structural Equation Modelling (SEM) in AMOS18 to test the path relationships hypothesised in the proposed model of value creation. The SEM output revealed that all hypotheses were supported, with the exception of one relationship which was non-significant. In addition, post hoc tests revealed seven further significant non-hypothesised relationships in the model. The quantitative results show that organisational sources of value as well as consumer participation sources of value influence both functional and emotional dimensions of value. The experience of both functional and emotional value in wellness services leads to satisfaction with the experience, followed by behavioural intentions to perform the behaviour and use the service again. One of the significant non-hypothesised relationships revealed that emotional value leads to functional value in wellness services, providing further empirical evidence that emotional value features more prominently than functional value for users of wellness services. This research offers several contributions to theory and practice. Theoretically, this research addresses a gap in the literature by using social marketing theory to provide an alternative method of understanding individual behaviour in a domain that has been predominantly investigated in public health. This research also clarifies the concept of value and offers empirical evidence to show that value is a multi-dimensional construct with separate and distinct dimensions. Empirical evidence for a typology of experiential value, as well as a categorisation of sources of value is also provided. In its practical contributions, this research identifies a framework that is the value creation process and offers health services organisations a diagnostic tool to identify aspects of the service process that facilitate the value creation process.

Success and failure factors of shared services : an IS literature analysis

Organizations seeking improvements in their performance are increasingly exploring alternative models and approaches for providing support services; one such approach being Shared Services. Because of the possible consequential impact of Shared Services on organizations, and given that information systems (IS) is both an enabler of Shared Services (for other functional areas) as well as a promising area for Shared Services application, Shared Services is an important area for research in the IS field. Though Shared Services has been extensively adopted on the promise of economies of scale and scope, factors of Shared Services success (or failure) have received little research attention. This paper reports the distillation of success and failure factors of Shared Services from an IS perspective. Employing NVIVO and content analysis of 158 selected articles, 9 key success factors and 5 failure factors are identified, suggesting important implications for practice and further research.

Identifying the extent, motivations and barriers to outsourcing of accounting services.

In this paper we analyse the oursourcing of accounting services. The extent to which firms are currently outsourcing, or considering outsourcing such services, and the motivations and barriers associated with outsourcing are identified. Empirical data from a random sample of accounting firms are used in this analysis. Data indicate that the majority of accounting firms are either currently outsourcing or considering outsourcing and that they exopect the volume of oursourced services to increase. In contrast to the scholarly literature advocating labor arbitrage as the primary driver for organizations choosing to outsource, in this study it was found that the main factors underpinning the decision to outsource were the expediting of service delivary to clients, and to enable the firm to focus on its core competencies.

Why perform pro-social behaviours? Understanding the key sources of perceived value in preventative health services

In maintaining quality of life, preventative health is an important area in which the performance of pro-social behaviours provides benefits to individuals who perform them as well as society. The establishment of the Preventative Health Taskforce in Australia demonstrates the significance of preventative health and aims to provide governments and health providers with evidence-based advice on preventative health issues (Preventative Health Taskforce, 2009). As preventative health behaviours are voluntary, for consumers to sustain this behaviour there needs to be a value proposition (Dann, 2008; Kotler and Lee, 2008). Customer value has been shown to influence repeat behaviour (McDougall and Levesque, 2000), word-of-mouth (Hartline and Jones, 1999), and attitudes (Dick and Basu, 2008). However to date there is little research that investigates the source of value for preventative health services. This qualitative study explores and identifies three categories of sources that influence four dimensions of value – functional, emotional, social and altruistic (Holbrook 2006). A conceptual model containing five propositions outlining these relationships is presented. This study provides evidence-based research that reveals sources of value that influence individuals’ decisions to perform pro-social behaviours in the long-term through their use of preventative health services. This research uses BreastScreen Queensland (BSQ), a cancer screening service, as the service context.

Opportunities of public transport experience enhancements with mobile services and urban screens

Public transportation is an environment with great potential for applying innovative ubiquitous computing services to enhance user experiences. This paper provides the underpinning rationale for research that will be looking at how real-time passenger information system deployed by transit authorities can provide a core platform to improve commuters’ user experiences during all stages of their journey. The proposal builds on this platform to inform the design and development of innovative social media, mobile computing and geospatial information applications, with the hope to create fun and meaningful experiences for passengers during their everyday travel. Furthermore, we present the findings of our pilot study that aims to offer a better understanding of passengers’ activities and social interactions during their daily commute.

Towards a unified service description language for the internet of services : requirements and first developments

Service-oriented Architectures (SOA) and Web services leverage the technical value of solutions in the areas of distributed systems and cross-enterprise integration. The emergence of Internet marketplaces for business services is driving the need to describe services, not only from a technical level, but also from a business and operational perspective. While, SOA and Web services reside in an IT layer, organizations owing Internet marketplaces are requiring advertising and trading business services which reside in a business layer. As a result, the gap between business and IT needs to be closed. This paper presents USDL (Unified Service Description Language), a specification language to describe services from a business, operational and technical perspective. USDL plays a major role in the Internet of Services to describe tradable services which are advertised in electronic marketplaces. The language has been tested using two service marketplaces as use cases.

Composing services for third-party service delivery

This paper proposes a model-based technique for lowering the entrance barrier for service providers to register services with a marketplace broker, such that the service is rapidly configured to utilize the brokerpsilas local service delivery management components. Specifically, it uses process modeling for supporting the execution steps of a service and shows how service delivery functions (e.g. payment points) ldquolocalrdquo to a service broker can be correctly configured into the process model. By formalizing the different operations in a service delivery function (like payment or settlement) and their allowable execution sequences (full payments must follow partial payments), including cross-function dependencies, it shows how through tool support, the non-technical user can quickly configure service delivery functions in a consistent and complete way.