Which components of heart failure programs are effective? A meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of heart failure management in 9,560 patients (Abridged Cochrane Review)

Aims--Telemonitoring (TM) and structured telephone support (STS) have the potential to deliver specialised management to more patients with chronic heart failure (CHF), but their efficacy is still to be proven. Objectives To review randomised controlled trials (RCTs) of TM or STS on all- cause mortality and all-cause and CHF-related hospitalisations in patients with CHF, as a non-invasive remote model of specialised disease-management intervention.--Methods and Results--Data sources:We searched 15 electronic databases and hand-searched bibliographies of relevant studies, systematic reviews, and meeting abstracts. Two reviewers independently extracted all data. Study eligibility and participants: We included any randomised controlled trials (RCT) comparing TM or STS to usual care of patients with CHF. Studies that included intensified management with additional home or clinic visits were excluded. Synthesis: Primary outcomes (mortality and hospitalisations) were analysed; secondary outcomes (cost, length of stay, quality of life) were tabulated.--Results: Thirty RCTs of STS and TM were identified (25 peer-reviewed publications (n=8,323) and five abstracts (n=1,482)). Of the 25 peer-reviewed studies, 11 evaluated TM (2,710 participants), 16 evaluated STS (5,613 participants) and two tested both interventions. TM reduced all-cause mortality (risk ratio (RR 0•66 [95% CI 0•54-0•81], p<0•0001) and STS showed similar trends (RR 0•88 [95% CI 0•76-1•01], p=0•08). Both TM (RR 0•79 [95% CI 0•67-0•94], p=0•008) and STS (RR 0•77 [95% CI 0•68-0•87], p<0•0001) reduced CHF-related hospitalisations. Both interventions improved quality of life, reduced costs, and were acceptable to patients. Improvements in prescribing, patient-knowledge and self-care, and functional class were observed.--Conclusion: TM and STS both appear effective interventions to improve outcomes in patients with CHF.

Lean project management in large scale industrial project via standardization

Lean project management is the comprehensive adaption of other lean concept like lean construction, lean manufacturing and lean thinking into project management context. Execution of many similar industrial projects creates the idea of lean project management in companies and rapidly growing in industries. This paper offers the standardization method in order to achieve Lean project management in large scale industrial project. Standardization refers to all activity which makes two projects most identical and unify to each other like standardization of design, reducing output variability, value analysis and strategic management. Although standard project may have minor effi ciency decrease, compare to custom built project; but great advantage of standard project like cost saving, time reduction and quality improvement justify standardization methodology. This paper based on empirical experience in industrial project and theoretical analysis of benefi ts of project standardization.

The democratic deficit and school-based management in Australia

Purpose: The paper seeks to apply the theory of the democratic deficit to school-based management with an emphasis on Australia. This theory was developed to examine managerial restructuring of the Australian Public Service in the 1990s. Given similarities between the use of managerial practices in the public service and government schools, the authors draw on recent literature about school-based management in Australia and apply the democratic deficit theory to it. ----- ----- Design/methodology/approach: This paper is conceptual in focus. The authors analyse literature in terms of the three components of the democratic deficit – i.e. the weakening of accountability, the denial of the roles and values of public employees, and the emergence of a “hollow state” – and in relation to the application of this theory to the Australian Public Service.----- ----- Findings: A trend towards the three components of the democratic deficit is evident in Australia although, to date, its emergence has not been as extensive as in the UK. The authors argue that the democratic principles on which public schooling in Australia was founded are being eroded by managerial and market practices.----- ----- Practical implications: These findings provide policy makers and practitioners with another way of examining managerial and market understandings of school-based management and its impact on teachers and on students. It offers suggestions to reorient practices away from those that are exclusively managerial-based towards those that are public-sector based.----- ----- Originality/value: The value of this paper is that it applies the theory of the democratic deficit to current understandings of school-based management.

Information and communication technology for E-regions

Information and communication technologies (ICTs) are essential components of the knowledge economy, and have an immense complementary role in innovation, education, knowledge creation, and relations with government, civil society, and business within city regions. The ability to create, distribute, and exploit knowledge has become a major source of competitive advantage, wealth creation, and improvements in the new regional policies. Growing impact of ICTs on the economy and society, rapid application of recent scientific advances in new products and processes, shifting to more knowledge-intensive industry and services, and rising skill requirements have become crucial concepts for urban and regional competitiveness. Therefore, harnessing ICTs for knowledge-based urban development (KBUD) has a significant impact on urban and regional growth (Yigitcanlar, 2005). In this sense, e-region is a novel concept utilizing ICTs for regional development. Since the Helsinki European Council announced Turkey as a candidate for European Union (EU) membership in 1999, the candidacy has accelerated the speed of regional policy enhancements and adoption of the European regional policy standards. These enhancements and adoption include the generation of a new regional spatial division, NUTS-II statistical regions; a new legislation on the establishment of regional development agencies (RDAs); and new orientations in the field of high education, science, and technology within the framework of the EU’s Lisbon Strategy and the Bologna Process. The European standards posed an ambitious new agenda in the development and application of contemporary regional policy in Turkey (Bilen, 2005). In this sense, novel regional policies in Turkey necessarily endeavor to include information society objectives through efficient use of new technologies such as ICTs. Such a development seeks to be based on tangible assets of the region (Friedmann, 2006) as well as the best practices deriving from grounding initiatives on urban and local levels. These assets provide the foundation of an e-region that harnesses regional development in an information society context. With successful implementations, the Marmara region’s local governments in Turkey are setting the benchmark for the country in the implementation of spatial information systems and e-governance, and moving toward an e-region. Therefore, this article aims to shed light on organizational and regional realities of recent practices of ICT applications and their supply instruments based on evidence from selected local government organizations in the Marmara region. This article also exemplifies challenges and opportunities of the region in moving toward an e-region and provides a concise review of different ICT applications and strategies in a broader urban and regional context. The article is organized in three parts. The following section scrutinizes the e-region framework and the role of ICTs in regional development. Then, Marmara’s opportunities and challenges in moving toward an e-region are discussed in the context of ICT applications and their supply instruments based on public-sector projects, policies, and initiatives. Subsequently, the last section discusses conclusions and prospective research.

Power through influence : the evolution of arts management in Australia

The purpose of this paper is to frame effective models of arts management for Australia in the nineties and beyond based on an analysis of historical practices. The evolutionary process of government subvention of the arts through non-profit arts organisations provides a clear statement of the role of power and influence. In particular the ascendancy of arts organisations and their management constitute a background against which to study other non-profit corporations.

Using reputation management in participatory sensing for data classification

Participatory sensing enables collection, processing, dissemination and analysis of environmental sensory data by ordinary citizens, through mobile devices. Researchers have recognized the potential of participatory sensing and attempted applying it to many areas. However, participants may submit low quality, misleading, inaccurate, or even malicious data. Therefore, finding a way to improve the data quality has become a significant issue. This study proposes using reputation management to classify the gathered data and provide useful information for campaign organizers and data analysts to facilitate their decisions.

Examination of process to develop a framework for better implementation of quality practices in building projects

Quality, as well as project success, in construction projects should be capable of being regarded as the fulfillment of expectation of those contributors and stakeholders involved in such projects. Although a significant amount of quality practices have been introduced within the industry, establishment and attainment of reasonable levels of quality internationally in construction projects continues to be an ongoing problem. To date, some investigation into the introduction and improvement of quality practices and stakeholder management in the construction industry has been accomplished independently, but so far no major studies have been completed that examine comprehensively how quality management practices that particularly concentrate on the stakeholders’ perspective of quality can be used to contribute to final project quality outcomes. This paper aims to examine the process for development of a framework for better involvement of stakeholders in quality planning and practices and subsequently to contribute to higher quality outcomes within construction projects. Through extensive literature review it highlights various perceptions of quality, categorizes quality issues with particular focus on benefits and shortcomings and also examines stakeholders’ viewpoint of project quality in order to promote the improvement of outcomes throughout a project’s lifecycle. It proposes a set of arranged information as a basis for development of prospective framework which ultimately aims to improve project quality outcomes. The subsequent framework that will be developed from this research will provide project managers and owners with the required information and strategic direction to achieve their own and their stakeholders’ targets for implementation of quality practices and achievement of high quality outcomes on their future projects.

Assessment of requirements for establishment of a framework to enhance implementation of quality practices in building projects

Quality, in construction projects should be regarded as the fulfillment of expectation of those contributors involved in such projects. Although a significant amount of quality practices have been introduced within the industry, attainment of reasonable levels of quality in construction projects continues to be an ongoing problem. To date, some research into the introduction and improvement of quality practices and stakeholder management has been undertaken, but so far no major studies have been completed that comprehensively examine how greater consideration of stakeholders’ perspectives of quality can be used to contribute to final project quality outcomes. This paper aims to examine the requirements for development of a framework leading to more effective involvement of stakeholders in quality planning and practices thus ultimately contributing to higher quality outcomes for construction projects. Through an extensive literature review it highlights various perceptions of quality, categorizes quality issues with particular focus on benefits and shortcomings and also examines the viewpoints of major stakeholders on project quality. It proposes a set of criteria to be used as a basis for a quality practice improvement framework, which will provide project managers and owners with the required information and strategic direction to achieve their own and their stakeholders’ targets for implementation of quality practices leading to the achievement of improved quality outcomes on future projects.

Quality management system and construction performance

This paper discusses the level of effectiveness of quality principles and quality management system implementation and the relationship with performance of ISO9000 certified Indonesian contractors. It also discusses the statistical relationship between quality management systems (QMSs) and key performance indicators (KPIs) amongst a large sample of Indonesian construction companies. Data collected is from questionnaire surveys involving Quality Managers, Managers, and Project and Site Engineers representing 77 different companies. Results indicate that even though some contractors have not yet effectively implemented an effective QMS, most of the KPIs of respondent companies are still at the level of high performance. The statistical results show that the relationship between variables of ISO9000 QMS principles and contractors’ KPIs is significant. These results suggest that an increment in the implementation level of QMS principles can increase KPIs, however that much effort is still required for Indonesian contractors to fully effectively implement QMS principles and thus substantially improve performance against KPIs.

Corporate profit and impression management in developing markets

In this study, we examine how organisations in Fiji communicate or legitimise their profit. We base the need for understanding this phenomenon on the following premise. Organisations are part of a wider society, and in competition for scarce resources. Organisations obtain the rights to consume resources upon conception, but must continually legitimise their rights of existence and the need to access the resources. Legitimacy is the ability to continue to justify one’s authority to exist in a society. Organisations rights to resources are contractual, and have a moral obligation to act in a responsible manner and justify their outcomes, actions, and activities to external stakeholders. Such justifications would be an attempt at legitimizing their existence by some form of impression management. Impression management refers to the process by which individuals attempt to influence the impression of others (Melo et al. 2009). In corporate reporting, impression management occurs when management selects, display, and presents that information in a manner that distorts readers’ perceptions of corporate achievements (Neu 1991; Patten 2002), and is managed best through disclosures (O’Donovan 2002). In developing economies, there is significant Government protection that creates near-monopoly sectors and industries. The rendered protection permits organisations to provide essential services to the community at reasonable costs. Organisations in these sectors and industries have an ominous need to legitimise their position and actions. The bond between the organisations and the society is much stronger, making organisations devote more effort in communicating their activities. Protection permits organisations to make reasonable profits to sustain their operations. Society may not accept abnormal profits from operational efficiencies. Profit is fundamental to the society’s perception of an organisation, amplifying the need for the firm to justify a level of profit. Abnormal profit for organisations construes bad news, and organisations would make relevant disclosures to manage stakeholder impressions on profit (Patten 2002). Organisations can manage impressions by disclosing information in a particular way. That is, organisations would want to put the impression that the abnormal profit is justified and the society will obtain its benefits in future. Such form of impression management requires unambiguous disclosure of information. The readability of corporate disclosures is an important indicator of organisational abnormal profit-related legitimacy efforts in developing economies.

Achieving quality improvement in the mask manufacturing industry by using Six Sigma technique

The Six Sigma technique is one of the quality management strategies and is utilised for improving the quality and productivity in the manufacturing process. It is inspired by the two major project methodologies of Deming’s "Plan – Do – Check – Act (PDCA)" Cycle which consists of DMAIC and DMADV. Those two methodologies are comprised of five phases. The DMAIC project methodology will be comprehensively used in this research. In brief, DMAIC is utilised for improving the existing manufacturing process and it involves the phases Define, Measure, Analyse, Improve, and Control. Mask industry has become a significant industry in today’s society since the outbreak of some serious diseases such as the Severe Acute Respiratory Syndrome (SARS), bird flu, influenza, swine flu and hay fever. Protecting the respiratory system, then, has become the fundamental requirement for preventing respiratory deceases. Mask is the most appropriate and protective product inasmuch as it is effective in protecting the respiratory tract and resisting the virus infection through air. In order to satisfy various customers’ requirements, thousands of mask products are designed in the market. Moreover, masks are also widely used in industries including medical industries, semi-conductor industries, food industries, traditional manufacturing, and metal industries. Notwithstanding the quality of masks have become the prioritisations since they are used to prevent dangerous diseases and safeguard people, the quality improvement technique are of very high significance in mask industry. The purpose of this research project is firstly to investigate the current quality control practices in a mask industry, then, to explore the feasibility of using Six Sigma technique in that industry, and finally, to implement the Six Sigma technique in the case company to develop and evaluate the product quality process. This research mainly investigates the quality problems of musk industry and effectiveness of six sigma technique in musk industry with the United Excel Enterprise Corporation (UEE) Company as a case company. The DMAIC project methodology in the Six Sigma technique is adopted and developed in this research. This research makes significant contribution to knowledge. The main results contribute to the discovering the root causes of quality problems in a mask industry. Secondly, the company was able to increase not only acceptance rate but quality level by utilising the Six Sigma technique. Hence, utilising the Six Sigma technique could increase the production capacity of the company. Third, the Six Sigma technique is necessary to be extensively modified to improve the quality control in the mask industry. The impact of the Six Sigma technique on the overall performance in the business organisation should be further explored in future research.

Is language a barrier for quality care in hospitals? A case series from an Emergency Department of a teaching hospital in Brisbane

Aim: The aim of this pilot study is to describe the use of an Emergency Department (ED) at a large metropolitan teaching hospital by patients who speak English or other languages at home. Methods: All data were retrieved from the Emergency Department Information System (EDIS) of this tertiary teaching hospital in Brisbane. Patients were divided into two groups based on the language spoken at home: patients who speak English only at home (SEO) and patients who do not speak English only or speak other language at home (NSEO). Modes of arrival, length of ED stay and the proportion of hospital admission were compared among the two groups of patients by using SPSS V18 software. Results: A total of 69,494 patients visited this hospital ED in 2009 with 67,727 (97.5%) being in the SEO group and 1,281 (1.80%) in the NSEO group. The proportion of ambulance utilisation in arrival mode was significantly higher among SEO 23,172 (34.2%) than NSEO 397 (31.0%), p <0.05. The NSEO patients had longer length of stay in the ED (M = 337.21, SD = 285.9) compared to SEO patients (M= 290.9, SD = 266.8), with 46.3 minutes (95%CI 62.1, 30.5, p <0.001) difference. The admission to the hospital among NSEO was 402 (31.9%) higher than SEO 17,652 (26.6%), p <0.001. Conclusion: The lower utilisation rates of ambulance services, longer length of ED stay and higher hospital admission rates in NSEO patients compared to SEO patients are consistent with other international studies and may be due to the language barriers.