Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

Employer evasion of workers’ entitlements 1968 – 1995: why, what and whose?

Employer non-compliance with workers’ entitlements has been largely ignored in Australian industrial relations. The legal and regulatory literature however, identifies arguments relating to employer propensity to evade regulatory requirements, as well as highlighting environmental factors that may influence such behaviour. This article explores these issues in the Australian federal industrial relations jurisdiction, as well as providing a picture of employer evasion of minimum labour standards between 1986 and 1995: who is exploited and in respect of what entitlements. Industry contexts and common characteristics of non-compliance are outlined by exploration of 30 awards ranked by the extent of underpayments recovered by the federal inspectorate during the period. Employer evasion of workers’ entitlements is arguably a calculated business decision, prompted or facilitated by intense competition, precarious employment (particularly female and youth), non-unionized workplaces and under-resourced enforcement agencies.

Rock pools of critical thought : finding a place to think through my higher degree and what a PhD was all about

The rock pools, salt pans, cliffs and bluffs, and the banks of the Coorooman and Pumpkin Creeks within Darumbal and Woppaburra Country are used as a backdrop in this paper, which offers an exploration of one woman’s quest to undertake her PhD and develop as an Indigenous scholar. The paper describes this Country and the use of Country to nourish, develop, stimulate and support the intellect. It draws on Australian and international literature to demonstrate the intellectual growth and development of Indigenous scholars. The paper offers a highly personal narrative of intellectual journeying which shows how we can be agents of change and power in our individual lives, even while power is being exercised over us and we are being oppressed and marginalised as Indigenous peoples.

A model of organisational leadership development informing succession development : elements and practices

It is noted from observations of Compton (2009), Richards (2008), Taylor and Bennett (2002), and others that succession leadership planning and development fails to receive adequate attention in the corporate sector (see Byham 2002; Richards 2008; Wellins and Byham 2001). This paper acknowledges a marked paucity of systematic succession leadership development in education organisations. The need would seem to be compounded at a time when substantial attrition in the leadership ranks is expected over the next five years, reflecting widespread workforce demographics (Busine and Watt 2005; Jacobzone, Cambois, Chaplain, and Robine 1998; Taylor and Bennett 2002). The Lantern model has been developed in response to a perceived need to offer an integrated, systematic approach to organisational and succession leadership development. The model offers an organising framework for considering succession leadership development in a strategic, integrated way. The concept is based on organisational development and leadership literature which sees leadership development not as a series of 'tacked on' activities but as an organic 'whole of organisation' approach fostering the relevant knowledge, skills and understandings which support and 'grow' leaders as the organisation goes about its business. This paper explores how such an ideal might happen, and it suggests that pursuing such an ideal is timely. The leadership baton is set to shift at an accelerated rate in universities, as for organisations broadly, owing to age-related attrition. Moreover, given the increased complexity and demands of the leadership remit in the education leadership environment, it would seem particularly opportune to explore a framework concentrating on engendering a positive, connected organisational climate capable of growing strategic leadership strength from within. Eight core elements of the model, derived from the literature and practice research, are explored. The Lantern model purports to 'cover the bases' of succession leadership development, with particular reference to the education environment. The model is next described

Financial planning and well-being

The aim of this paper is to provide a review of the theoretical and research literature on the ways in which financial planning can enhance well-being. In reviewing the literature, the paper develops a conceptual framework for thinking about the extended value of financial planning, beyond financial outcomes, by examining the process of planning in the financial domain and its relationship to life satisfaction, living an intentional life, attainment of life goals, and the development of a sense of mastery. An essential element of psychological well-being is engagement in life tasks and roles. Planning can be considered a life management strategy that enables individuals to control and structure their lives. Having meaningful goals and the plans to achieve those goals enable individuals to experience higher levels of life engagement and well-being (MacLeod et al., 2008). Recent research on well-being suggests that domain-specific behaviours contribute to domain-specific satisfactions, which in turn contribute to an individual’s overall satisfaction with life (Easterlin, 2003; 2006). Thus changes in domain satisfaction, such as financial satisfaction, are likely to effect changes in life satisfaction.

A probability-based approach for assessing the relationship between crash accidents and pavement properties

Skid resistance is a condition parameter characterising the contribution that a road makes to the friction between a road surface and a vehicle tyre. Studies of traffic crash histories around the world have consistently found that a disproportionate number of crashes occur where the road surface has a low level of surface friction and/or surface texture, particularly when the road surface is wet. Various research results have been published over many years and have tried to quantify the influence of skid resistance on accident occurrence and to characterise a correlation between skid resistance and accident frequency. Most of the research studies used simple statistical correlation methods in analysing skid resistance and crash data.----- ------ Preliminary findings of a systematic and extensive literature search conclude that there is rarely a single causation factor in a crash. Findings from research projects do affirm various levels of correlation between skid resistance and accident occurrence. Studies indicate that the level of skid resistance at critical places such as intersections, curves, roundabouts, ramps and approaches to pedestrian crossings needs to be well maintained.----- ----- Management of risk is an integral aspect of the Queensland Department of Main Roads (QDMR) strategy for managing its infrastructure assets. The risk-based approach has been used in many areas of infrastructure engineering. However, very limited information is reported on using risk-based approach to mitigate crash rates related to road surface. Low skid resistance and surface texture may increase the risk of traffic crashes.----- ----- The objectives of this paper are to explore current issues of skid resistance in relation to crashes, to provide a framework of probability-based approach to be adopted by QDMR in assessing the relationship between crash accidents and pavement properties, and to explain why the probability-based approach is a suitable tool for QDMR in order to reduce accident rates due to skid resistance.

Subtropical design in South East Queensland : a handbook for planners, developers and decision makers

Subtropical Design in South East Queensland provides a direct link between climatic design, applied urban design and sustainable planning policy. The role that character and identity of a place plays in achieving environmental sustainability is explained. Values of local distinctiveness to do with climate, landscape and culture are identified and the environmental, social and economic benefits of applying subtropical design principles to planning are described. The handbook provides planners and urban designers with an understanding of how subtropical design principles apply within the different contexts of urban planning including the entire spectrum of urban scales from the regional scale, to the city, neighbourhood, street, individual building or site. Twelve interactive principles, and interrelated strategies, drawn predominantly from the body of knowledge of landscape architecture, architectural science and urban design are described in detail in text, and richly illustrated with diagrams and photographs.

Aurora : an illustrated novella

Aurora, an illustrated novella, is a retelling of the classic fairytale Sleeping Beauty, set on the Australian coast around the grounds of the family lighthouse. Instead of following in the footsteps of tradition, this tale focuses on the long time Aurora is cursed to sleep by the malevolent Minerva; we follow Aurora as she voyages into the unconscious. Hunted by Minerva through the shifting landscape of her dreams, Aurora is dogged by a nagging pull towards the light—there is something she has left behind. Eventually, realising she must face Minerva to break the curse, they stage a battle of the minds in which Aurora triumphs, having grasped the power of her thoughts, her words. Aurora, an Australian fairytale, is a story of self-empowerment, the ability to shape destiny and the power of the mind. The exegesis examines a two-pronged question: is the illustrated book for young adults—graphic novel—relevant to a contemporary readership, and, is the graphic novel, where text and image intersect, a suitably specular genre in which to explore the unconscious? It establishes the language of the unconscious and the meaning of the term ‘graphic novel’, before investigating the place of the illustrated book for an older readership in a contemporary market, particularly exploring visual literacy and the way text and image—a hybrid narrative—work together. It then studies the aptitude of graphic literature to representing the unconscious and looks at two pioneers of the form: Audrey Niffenegger, specifically her visual novel The Three Incestuous Sisters, and Shaun Tan, and his graphic novel The Arrival. Finally, it reflects upon the creative work, Aurora, in light of three concerns: how best to develop a narrative able to relay the dreaming story; how to bestow a certain ‘Australianess’ upon the text and images; and the dilemma of designing an illustrated book for an older readership.

A literature review on research methodologies of gross pollutant traps

This paper presents a comprehensive review of scientific and grey literature on gross pollutant traps (GPTs). GPTs are designed with internal screens to capture gross pollutants—organic matter and anthropogenic litter. Their application involves professional societies, research organisations, local city councils, government agencies and the stormwater industry—often in partnership. In view of this, the 113 references include unpublished manuscripts from these bodies along with scientific peer-reviewed conference papers and journal articles. The literature reviewed was organised into a matrix of six main devices and nine research areas (testing methodologies) which include: design appraisal study, field monitoring/testing, experimental flow fields, gross pollutant capture/retention characteristics, residence time calculations, hydraulic head loss, screen blockages, flow visualisations and computational fluid dynamics (CFD). When the fifty-four item matrix was analysed, twenty-eight research gaps were found in the tabulated literature. It was also found that the number of research gaps increased if only the scientific literature was considered. It is hoped, that in addition to informing the research community at QUT, this literature review will also be of use to other researchers in this field.

Using text-spotting to query the world

The world we live in is well labeled for the benefit of humans but to date robots have made little use of this resource. In this paper we describe a system that allows robots to read and interpret visible text and use it to understand the content of the scene. We use a generative probabilistic model that explains spotted text in terms of arbitrary search terms. This allows the robot to understand the underlying function of the scene it is looking at, such as whether it is a bank or a restaurant. We describe the text spotting engine at the heart of our system that is able to detect and parse wild text in images, and the generative model, and present results from images obtained with a robot in a busy city setting.

Playing with picturebooks : postmodernism and the postmodernesque

This thesis traces the influence of postmodernism on picturebooks. Through a review of current scholarship on both postmodernism and postmodern literature it examines the multiple ways in which picturebooks have responded to the influence of postmodernism. The thesis is predominantly located in the field of Cultural and Literary Studies, which informs the ways in which children’s literature is positioned within contemporary culture and how it responds to the influences which shape its production and reception. Cultural and Literary Studies also offers a useful theoretical frame for analysing issues of textuality, ideology, and originality, as well as social and political comment in the focus texts. The thesis utilises the theoretical contributions by, in particular, Linda Hutcheon, Brian McHale, and Fredric Jameson as well as reference to children’s literature studies. This thesis makes a significant contribution to the development of an understanding of the place of the postmodern picturebook within the cultural context of postmodernism. It adds to the field of children’s literature research through an awareness of the (continuing) evolution of the postmodern picturebook particularly as the current scholarship on the postmodernism picturebook does not engage with the changing form and significance of the postmodern picturebook to the same extent as this thesis. This study is significant from a methodological perspective as it draws on a wide range of theoretical perspectives across literary studies, visual semiotics, philosophy, cultural studies, and history to develop a tripartite methodological framework that utilises the methods of postclassical narratology, semiotics, and metafictive strategies to carry out the textual analysis of the focus texts. The three analysis chapters examine twenty-two picturebooks in detail with respect to the ways in which the conventions of narrative are subverted and how dominant discourses are interrogated. Chapter 4: Subverting Narrative Processes includes analysis of narrative point of view, modes of representation, and characters and the problems of identity and subjectivity. Chapter 5: Challenging Truth, History, and Unity examines questions of ontology, the difficulties of representing history, and addresses issues of difference and ‘otherness’. The final textual analysis chapter, Chapter 6: Engaging with Postmodernity, critiques texts which engage with issues of globalisation, mass media, and consumerism. Brief discussion of a further fifteen picturebooks throughout the thesis provides additional support. Children’s texts have a tradition of being both resistant and compliant. Its resistance has made a space for the development of the postmodern picturebook; its compliance is evident in its tendency to take a route around a truly radical or iconoclastic position. This thesis posits that children’s postmodern picturebooks adopt what suits their form and purposes by drawing from and reflecting on some influences of postmodernism while disregarding those that seem irrelevant to its direction. Furthermore, the thesis identifies a shift in the focus of a number of postmodern picturebooks produced since the turn of the twenty-first century. This trend has seen a shift from texts which interrogate discourses of liberal humanism to those that engage with aspects of postmodernity. These texts, postmodernesque picturebooks, offer contradictory perspectives on aspects of society emanating from the rise in global trends mentioned above.

A systematic, tool-supported method for conducting literature reviews in information systems

While the importance of literature studies in the IS discipline is well recognized, little attention has been paid to the underlying structure and method of conducting effective literature reviews. Despite the fact that literature is often used to refine the research context and direct the pathways for successful research outcomes, there is very little evidence of the use of resource management tools to support the literature review process. In this paper we want to contribute to advancing the way in which literature studies in Information Systems are conducted, by proposing a systematic, pre-defined and tool-supported method to extract, analyse and report literature. This paper presents how to best identify relevant IS papers to review within a feasible and justifiable scope, how to extract relevant content from identified papers, how to synthesise and analyse the findings of a literature review and what are ways to effectively write and present the results of a literature review. The paper is specifically targeted towards novice IS researchers, who would seek to conduct a systematic detailed literature review in a focused domain. Specific contributions of our method are extensive tool support, the identification of appropriate papers including primary and secondary paper sets and a pre-codification scheme. We use a literature study on shared services as an illustrative example to present the proposed approach.

Development sites in the empty city : from picture book to performance

Picturebooks invite performance every time they are read. What happens to them when they’re adapted for live performance? This ongoing practice led research project (2008-) regenerates and transforms picturebook The Empty City (Hachette/Livre 2007) by David Megarrity and Jonathon Oxlade into a live experience. In this rebuilding, interanimation of text and illustration on the picturebook page suddenly open up into a new and complex structure incorporating composition of music, animation, live action, projected image and performing objects. The presenter is the creator of both the source text and writer/composer of the adaptation, providing a unique vantage point that draws on sources from both within and without the creative process up to and including audience reception. From the foundations up, this paper’s focus is on deep, muddy sites of development in the adaptation process, unearthed treasures, and how perceptions of fear and safety push, sway and stress the building of a new performance work for children in content, form and process.

A sustainable approach to community based rehabilitation in rural and remote Australia

This paper presents a summary of an extensive review of the health, disability and rehabilitation literature conducted for the purposes of informing the formulation of a sustainable approach to community based rehabilitation in rural and remote Australia. It begins with a review of definitions of disability and rehabilitation, which is followed by differentiating 'rehabilitation in the community' and 'community based rehabilitation'. Finally, a network of community based rehabilitation coalitions is proposed as a sustainable approach to community based rehabilitation in rural and remote Australia. Each coalition would have a community rehabilitation facilitator and community specific database of resources, as well as a register of local community rehabilitation assistants who can support the work of health professionals by providing rehabilitation interventions under the latter's direction. In this approach, rehabilitation is conceptualised as being about people's lives rather than only a series of interventions provided by health care professionals. As such, rehabilitation becomes everybody's business.

Gender, sexuality and the challenge of seeing in Orlando

Orlando (Sally Potter, 1992) is a significant filmic achievement: in only ninety minutes it offers a rich, layered, and challenging account of a life lived across four hundred years, across two sexes and genders, and across multiple countries and cultures. Already established as a feminist artist, Potter aligns herself with a genealogy of feminist art by adapting Virginia Woolf’s Orlando: A Biography (1928) to tell the story of Orlando: a British subject who must negotiate their “identity” while living a strangely long time and, also somewhat strangely, changing biological sex from male to female. Both novel and film interrogate norms of gender and culture. They each take up issues of sex, gender, and sexuality as socially-constructed phenomena rather than as “essential truths”, and Orlando’s attempts to tell his/her story and make sense of his/her life mirror readers’ attempts to understand and interpret Orlando’s journey within inherited artistic traditions.