From Quality Management to Socially Responsible Organisations: the Case for CSR

Purpose – The purpose of this paper is to focus on the growing interest of the role of business in society, commonly referred to as CSR. Historically CSR can be traced back to the 1950s, although in very recent times there has been a virtual explosion of interest in its use and applicability in organisations. However, there are many unresolved issues, most notably in terms of how CSR should or can be implemented and embedded in an organisation. This paper therefore seeks to explore the relationship and potential synergies between quality management and CSR. Design/methodology/approach – The qualitative exploratory study in this paper represents the first stage of an ongoing research programme, and is based on an in-depth analysis of quality award submission documentation from six case organisations that have recently been recognised as winners in relation to their quest for business improvement. Findings – The paper finds that substantial evidence from each of the case organisations demonstrates the breadth and depth of activities in which they are engaging under the broad headings of workplace, environment, social impact, and economic impact. However, whilst there is no doubting the sincerity of the actions, the approaches and activities, a strategic focus on CSR is still very much in its infancy. Research limitations/implications – In this paper there is a paucity of empirical research examining how existing management tools, techniques and methodologies can be used to further the CSR debate. This paper represents an important first step in redressing this imbalance. Practical implications – The paper suggests that the quality management and business excellence frameworks can offer a strong foundation from which to develop CSR strategies, behaviours and activities in an organisation. Originality/value – This paper represents an important first step in understanding how and where CSR “fits” into an organisation and potentially how existing quality methodologies, tools and frameworks can be used to aid the implementation of CSR.

Legitimising Quality Principles through Critical Incidents in Organisational Development

Purpose – The aim of this paper is to analyse how critical incidents or organisational crises can be used to check and legitimise quality management change efforts in relation to the fundamental principles of quality. Design/methodology/approach – Multiple case studies analyse critical incidents that demonstrate the importance of legitimisation, normative evaluation and conflict constructs in this process. A theoretical framework composed of these constructs is used to guide the analysis. Findings – The cases show that the critical incidents leading to the legitimisation of continuous improvement (CI) were diverse. However all resulted in the need for significant ongoing cost reduction to achieve or retain competitiveness. In addition, attempts at legitimising CI were coupled with attempts at destabilising the existing normative practice. This destabilisation process, in some cases, advocated supplementing the existing approaches and in others replacing them. In all cases, significant conflict arose in these legitimising and normative evaluation processes. Research limitations/implications – It is suggested that further research could involve a critical analysis of existing quality models, tools and techniques in relation to how they incorporate, and are built upon, fundamental quality management principles. Furthermore, such studies could probe the dangers of quality curriculum becoming divorced from business and market reality and thus creating a parallel existence. Practical implications – As demonstrated by the case studies, models, tools and techniques are not valued for their intrinsic value but rather for what they will contribute to addressing the business needs. Thus, in addition to being an opportunity for quality management, critical incidents present a challenge to the field. Quality management must be shown to make a contribution in these circumstances. Originality/value – This paper is of value to both academics and practitioners.

An Investigation of Fuzzy Multiple Heuristic Orderings in the Construction of University Examination Timetables

In this paper, we present an investigation into using fuzzy methodologies to guide the construction of high quality feasible examination timetabling solutions. The provision of automated solutions to the examination timetabling problem is achieved through a combination of construction and improvement. The enhancement of solutions through the use of techniques such as metaheuristics is, in some cases, dependent on the quality of the solution obtained during the construction process. With a few notable exceptions, recent research has concentrated on the improvement of solutions as opposed to focusing on investigating the ‘best’ approaches to the construction phase. Addressing this issue, our approach is based on combining multiple criteria in deciding on how the construction phase should proceed. Fuzzy methods were used to combine three single construction heuristics into three different pair wise combinations of heuristics in order to guide the order in which exams were selected to be inserted into the timetable solution. In order to investigate the approach, we compared the performance of the various heuristic approaches with respect to a number of important criteria (overall cost penalty, number of skipped exams, number of iterations of a rescheduling procedure required and computational time) on twelve well-known benchmark problems. We demonstrate that the fuzzy combination of heuristics allows high quality solutions to be constructed. On one of the twelve problems we obtained lower penalty than any previously published constructive method and for all twelve we obtained lower penalty than when any of the single heuristics were used alone. Furthermore, we demonstrate that the fuzzy approach used less backtracking when constructing solutions than any of the single heuristics. We conclude that this novel fuzzy approach is a highly effective method for heuristically constructing solutions and, as such, has particular relevance to real-world situations in which the construction of feasible solutions is often a difficult task in its own right.

Quality of life and inflammation in exacerbations of bronchiectasis.

Patients with bronchiectasis often have impaired quality of life (QoL), which deteriorates with exacerbations. The aim of this study was to investigate changes in QoL and how these were influenced by changes in airway physiology and inflammation in patients with bronchiectasis before and after resolution of an exacerbation. Sputum induction and a QoL questionnaire were undertaken on the first day, day 14, and 4 weeks after completion of intravenous antibiotics (day 42). Eighteen patients (12 female) were recruited, median (IQ range) age of 54 (47–60) years. There was a trend towards an improvement in lung function from visit 1 to visit 2, but this was not statistically significant. C-reactive protein (CRP) [mean (SEM)] reduced between visit 1 and visit 2 [55.4 (21.5) vs 9.4 (3.1) mg/L, P = 0.03] but did not increase significantly on visit 3 [44.4 (32.9) mg/L, P = 0.27]. The median (interquartile range) sputum cell count (×106 cells/g of sputum) decreased from visit 1 to visit 2 [21.6 (11.8–37.6)–13.3 (6.7–22.9) × 106 cells/g, respectively, P = 0.008] and increased from visit 2 to visit 3 [26.3 (14.1–33.6) × 106 cells/g, P = 0.03]. All soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-a. Regarding QoL, three of the four domains (dyspnoea, emotional, mastery) significantly improved from visit 1 to visit 2 but did not change between visit 2 and visit 3. The improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers.

Limitations of instantaneous water quality sampling in surface-water catchments: Comparison with near-continuous phosphorus time-series data.

The validity of load estimates from intermittent, instantaneous grab sampling is dependent on adequate spatial coverage by monitoring networks and a sampling frequency that re?ects the variability in the system under study. Catchments with a ?ashy hydrology due to surface runoff pose a particular challenge as intense short duration rainfall events may account for a signi?cant portion of the total diffuse transfer of pollution from soil to water in any hydrological year. This can also be exacerbated by the presence of strong background pollution signals from point sources during low flows. In this paper, a range of sampling methodologies and load estimation techniques are applied to phosphorus data from such a surface water dominated river system, instrumented at three sub-catchments (ranging from 3 to 5 km2 in area) with near-continuous monitoring stations. Systematic and Monte Carlo approaches were applied to simulate grab sampling using multiple strategies and to calculate an estimated load, Le based on established load estimation methods. Comparison with the actual load, Lt, revealed signi?cant average underestimation, of up to 60%, and high variability for all feasible sampling approaches. Further analysis of the time series provides an insight into these observations; revealing peak frequencies and power-law scaling in the distributions of P concentration, discharge and load associated with surface runoff and background transfers. Results indicate that only near-continuous monitoring that re?ects the rapid temporal changes in these river systems is adequate for comparative monitoring and evaluation purposes. While the implications of this analysis may be more tenable to small scale ?ashy systems, this represents an appropriate scale in terms of evaluating catchment mitigation strategies such as agri-environmental policies for managing diffuse P transfers in complex landscapes.

Quality of life in men receiving radiotherapy and neo-adjuvant androgen deprivation for prostate cancer:Results from a prospective longitudinal study

Aim. To report a study measuring the quality of life and side effects in men receiving radiotherapy and hormone ablation for prostate cancer up to 1year after treatment. Background. Prostate cancer incidence is increasing with the result that more men are living longer with the disease and the side effects of treatment. It is important to know the effects this has on their quality of life. Design. Survey. Method. Between September 2006-September 2007, all men who were about to undergo radical conformal radiotherapy ± neo-adjuvant androgen deprivation for localized prostate cancer were invited to participate in the study; 149 men were recruited. They completed the European Organization on Research and Treatment of Cancer quality of life questionnaire C-30 and Prostate Cancer module PR25 at four time-points. Results. At 4-6weeks after radiotherapy, participants experienced the biggest relative decline in global quality of life, social, physical, and role functioning and an increase in treatment side effects. At 6months postradiotherapy the majority of men experienced an improvement in their side effects. However, a minority of men were experiencing severe side effects of radiotherapy at 1year post-treatment. Single men and men who had a low quality of life prior to radiotherapy, reported a lower quality of life at 1year after treatment in comparison to married men. Conclusion. Men with prostate cancer suffer limitations due to the symptoms they experience and disruption to their quality of life. It is essential that nurses develop and deliver follow-up care which is flexible and appropriate to the individual needs of these men. © 2012 Blackwell Publishing Ltd.

Reaching common ground:A patient-family-based conceptual framework of quality EOL care

Improvement in the quality of end-of-life (EOL) care is a priority health care issue since serious deficiencies in quality of care have been reported across care settings. Increasing pressure is now focused on Canadian health care organizations to be accountable for the quality of palliative and EOL care delivered. Numerous domains of quality EOL care upon which to create accountability frameworks are now published, with some derived from the patient/family perspective. There is a need to reach common ground on the domains of quality EOL care valued by patients and families in order to develop consistent performance measures and set priorities for health care improvement. This paper describes a meta-synthesis study to develop a common conceptual framework of quality EOL care integrating attributes of quality valued by patients and their families. © 2005 Centre for Bioethics, IRCM.

Evaluation of quality of life and priorities of patients with glaucoma

PURPOSE: To investigate the quality of life and priorities of patients with glaucoma.

METHODS: Patients diagnosed with glaucoma and no other ocular comorbidity were consecutively recruited. Clinical information was collected. Participants were asked to complete three questionnaires: EuroQuol (EQ-5D), time tradeoff (TTO), and choice-based conjoint analysis. The latter used five-attribute outcomes: (1) reading and seeing detail, (2) peripheral vision, (3) darkness and glare, (4) household chores, and (5) outdoor mobility. Visual field loss was estimated by using binocular integrated visual fields (IVFs).

RESULTS: Of 84 patients invited to participate, 72 were enrolled in the study. The conjoint utilities showed that the two main priorities were "reading and seeing detail" and "outdoor mobility." This rank order was stable across all segmentations of the data by demographic or visual state. However, the relative emphasis of these priorities changed with increasing visual field loss, with concerns for central vision increasing, whereas those for outdoor mobility decreased. Two subgroups of patients with differing priorities on the two main attributes were identified. Only 17% of patients (those with poorer visual acuity) were prepared to consider TTO. A principal component analysis revealed relatively independent components (i.e., low correlations) between the three different methodologies for assessing quality of life.

CONCLUSIONS: Assessments of quality of life using different methodologies have been shown to produce different outcomes with low intercorrelations between them. Only a minority of patients were prepared to trade time for a return to normal vision. Conjoint analysis showed two subgroups with different priorities. Severity of glaucoma influenced the relative importance of priorities.

The Quality of Reporting of Diagnostic Accuracy Studies of Optical Coherence Tomography in Glaucoma

Objective: To evaluate the quality of reporting of diagnostic accuracy studies using optical coherence tomography (OCT) in glaucoma. Design: Descriptive series of published studies. Participants: Published studies reporting a measure of the diagnostic accuracy of OCT for glaucoma. Methods: Review of English language papers reporting measures of diagnostic accuracy of OCT for glaucoma. Papers were identified from a Medline literature search performed in June 2006. Articles were appraised using the 25 items provided by the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. Each item was recorded as full, partially, or not reported. Main Outcome Measures: Degree of compliance with the STARD guidelines. Results: Thirty papers were appraised. Eight papers (26.7%) fully reported more than half of the STARD items. The lowest number of fully reported items in a study was 5 and the highest was 17. Descriptions of key aspects of methodology frequently were missing. For example, details of participant sampling (e.g., consecutive or random selection) were described in only 8 (26.7%) of 30 publications. Measures of statistical uncertainty were reported in 18 (60%) of 30 publications. No single STARD item was fully reported by all the papers. Conclusions: The standard of reporting of diagnostic accuracy studies in glaucoma using OCT was suboptimal. It is hoped that adoption of the STARD guidelines will lead to an improvement in reporting of diagnostic accuracy studies, enabling clearer evidence to be produced for the usefulness of OCT for the diagnosis of glaucoma. © 2007 American Academy of Ophthalmology.

Impact of counselling on quality of life and sleep in cancer patients

It has been acknowledged that poor quality of sleep significantly correlates with poor quality of life; evidence suggests that counselling has a positive impact not only on the cancer patient's quality of life, but also on family members and friends. The aim of this service evaluation was to determine if there was an improvement in clients’ quality of life and sleep patterns following counselling as offered by a local cancer charity. A total of 60 matched pre- and post-counselling questionnaires were completed and subjected to statistical analysis. When considering quality of life, in the domains of Role Emotional, Mental Health and Mental Component Summary Score, it can be concluded that counselling has a positive effect on emotional health and mental wellbeing. The mean total number of hours sleep per night significantly increased from 6 hours sleep per night at baseline to 6.8 hours sleep per night at the completion of counselling (p=0.005) showing clients gained an extra 48 minutes sleep per night. The improved emotional and mental wellbeing alongside the extra 48 minutes sleep per night provides evidence that there is a positive outcome for those patients and families who use counselling services. Nurses and other members of the multidisciplinary team should be encouraged to discuss supportive therapies with patients and those affected by cancer at all stages of the cancer trajectory, regardless of social status, gender or cancer type.