Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management

Objectives: To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners. Methods: An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements. Results: Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users. Conclusion: The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance. Practice Implications: The GRiST web-based DSS (www.egrist.org) links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.

A review of non-pharmacological and pharmacological management of seasonal and perennial allergic conjunctivitis

Allergic eye disease encompasses a group of hypersensitivity disorders which primarily affect the conjunctiva and its prevalence is increasing. It is estimated to affect 8% of patients attending optometric practice but is poorly managed and rarely involves ophthalmic assessment. Seasonal allergic conjunctivitis (SAC) is the most common form of allergic eye disease (90%), followed by perennial allergic conjunctivitis (PAC; 5%). Both are type 1 IgE mediated hypersensitivity reactions where mast cells play an important role in pathophysiology. The signs and symptoms are similar but SAC occurs periodically whereas PAC occurs year round. Despite being a relatively mild condition, the effects on the quality of life can be profound and therefore they demand attention. Primary management of SAC and PAC involves avoidance strategies depending on the responsible allergen(s) to prevent the hypersensitivity reaction. Cooled tear supplements and cold compresses may help bring relief. Pharmacological agents may become necessary as it is not possible to completely avoid the allergen(s). There are a wide range of anti-allergic medications available, such as mast cell stabilisers, antihistamines and dual-action agents. Severe cases refractory to conventional treatment require anti-inflammatories, immunomodulators or immunotherapy. Additional qualifications are required to gain access to these medications, but entry-level optometrists must offer advice and supportive therapy. Based on current evidence, the efficacy of anti-allergic medications appears equivocal so prescribing should relate to patient preference, dosing and cost. More studies with standardised methodologies are necessary elicit the most effective anti-allergic medications but those with dual-actions are likely to be first line agents.

Integrated approach to healthcare quality management:a case study

Purpose - The purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically. Design/methodology/approach - This paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare services (Operating room utilization, Accident and emergency, and Intensive care) in order to demonstrate its effectiveness. Findings - The paper finds that LFA is an effective method of quality management of hospital-based healthcare services. Research limitations/implications - This paper shows LFA application in three service processes in one hospital. However, ideally this is required to be tested in several hospitals and other services as well. Practical implications - In the paper the proposed model can be practised in hospital-based healthcare services for improving performance. Originality/value - The paper shows that quality improvement in healthcare services is a complex and multi-dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in health care delivery and corrective measures are taken for superior performance, there is an absence of an integrated approach, which can identify and analyze issues, provide solutions to resolve those issues, develop a project management framework (planning, monitoring, and evaluating) to implement those solutions in order to improve process performance. This study introduces an integrated and uniform quality management tool. It integrates operations with organizational strategies. © Emerald Group Publishing Limited.

Managing healthcare technology in quality management framework

Healthcare services available these days deploy high technology to satisfy both internal and external customers by continuously improving various quality parameters. Quality improvement in healthcare services is a complex and multidimensional task. Although various quality management tools are routinely deployed for identifying quality issues in healthcare delivery, there is absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues and develop a project management framework to implement and evaluate those solutions. This study introduces an integrated and uniform quality management framework for healthcare services. This study uses the Logical Framework Analysis (LFA) to improve the performance of healthcare services. LFA has three major steps - problem identification, solution derivation and formation of a planning matrix for implementation and evaluation. LFA has been applied in a case study environment to three acute healthcare services (Operating Room (OR) utilisation, Accident and Emergency (A&E) and intensive care) in order to demonstrate its effectiveness. Copyright © 2007 Inderscience Enterprises Ltd.

Insights into factors affecting production and operations management (POM) journal evaluation

The paper extends the current literature on peer review journal evaluations by providing a number of insights based on the diversity of Production and Operations Management (POM) research. We provide peer review evaluations for POM research outlets, based on a sampling frame that includes a large number of POM researchers worldwide. More specifically, the paper develops and tests various hypotheses as to whether the perceived quality and relevance of a journal is affected by such factors as: (i) nature of research work (empiricists versus modelers), (ii) society membership, (iii) research productivity, (iv) geographical location, and (v) seniority. Our findings suggest that caution must be exercised when utilizing existing POM journal rankings, as some factors, particularly the difference between empiricists and modelers, may influence journal evaluation. These must be considered when addressing issues such as faculty promotions, tenure, and salary. © 2006 Elsevier B.V. All rights reserved.

International insights into twenty-first century quality management:facts or fashion?

Invited editorial - Papers from the 3rd World Conference on Productions and Operations Management (POM) Tokyo 2008.

Planning and implementing safety management systems

This thesis describes a study of the content and applicability of BS8800:1996 Guide to occupational health and safety management systems. The research is presented chronologically, with literature review and content analysis of SMS related guides and standards interwoven with two elements of qualitative empirical work. The first of these was carried out shortly after publication of BS8800 in 1996, a 'before-the-event' investigation of how organisations were intending to approach SMS implementation. The challenges faced by these organisations are reviewed against standard management theory, suggesting that the initial motivation for SMS implementation governs the approach organisations will adopt to guidance such as BS8800. The second phase of empirical work was undertaken in the context of OHSAS 18001, an auditable protocol based on BS8800, which allows organisations to certify their safety management systems. A discussion of the evolution of certifiable safety management system is presented, highlighting the similarities and differences between this, BS8800, SMS and wider management system standards. A case study then reviews the experiences of a catering company that implemented 18001, motivated by the opportunity for certification as a business benefit. The empirical work is used to comment on the guidance provided by BS8800, within its evolved role as guidance organisations may use for implementation of a SMS to be certified according to the specifications of OHSAS 18001. It is suggested that optimal implementation is facilitated by initial status review, continual improvement and the use of annexes, where there are used to make changes to the existing safety management system. This thesis concludes with a discussion of these elements, highlighting pertinent areas within BS8800 where revision or amendment may be appropriate.

A comparison of U.S. and Japanese management systems and their transferability to Singapore industry

This research compares U.S. and Japanese management systems and evaluates their transferability to the Singaporean manufacturing industry. The objectives were:- a) To determine the effectiveness of U.S. and Japanese management systems when applied to Singapore. b) Determine the extent of transferability of U.S. and Japanese management systems to Singapore. c) Survey general problems ecountered in the application of U.S. and Japanese management systems to the Singapore industry. The study using questionnaire survey and interviews covered a total of eighty companies from four groups of firms in four industrial sectors comprising of U.S. and Japanese subsidiaries based in Singapore and their respective parent companies. Data from the questionnaires and interviews were used to investigate environmental conditions, management philosophy, management functions/practices, management effectiveness, and firm productivity. Two-way analysis of variance was used to analyse the questionnaire data. The analysis of the perceptual data from the questionnaire survey and interviews suggested that both U.S. and Japanese parent companies performed better in almost all the management variables studied when compared to their subsidiaries in Singapore. U.S. subsidiaries have less difficulty in adjusting to the Singapore environmental conditions and obtained better results than the Japanese subsidiaries in management functions/practices and management philosophy than the U.S. subsidiaries. In addition, the firm productivity (in terms of labour and capital productivity) of U.S. subsidiaries in Singapore was found to be higher than those of the Japanese subsidiaries. It was found that the Japanese parent companies returned the highest score among the four groups of firms in all the four industrial sectors for all the four management variables (i.e. environmental conditions, management philosophy, management functions/practices, and management effectiveness) surveyed using questionnaires. In contrast, the average score for Japanese subsidiaries in Singapore was generally the lowest among the four groups of firms. Thus the results of this study suggest that the transfer of U.S. management system into the Singapore industry is more successful than the Japanese management system. The problems encountered in the application of U.S. and Japanese management in Singapore were identified and discussed by the study. General recommendations for the Singaporean manufacturing industry were then made based on the findings of the questionnaire survey and interview analysis.

River basin surveillance using remotely sensed data: a water resources information management system

This thesis describes the development of an operational river basin water resources information management system. The river or drainage basin is the fundamental unit of the system; in both the modelling and prediction of hydrological processes, and in the monitoring of the effect of catchment management policies. A primary concern of the study is the collection of sufficient and sufficiently accurate information to model hydrological processes. Remote sensing, in combination with conventional point source measurement, can be a valuable source of information, but is often overlooked by hydrologists, due to the cost of acquisition and processing. This thesis describes a number of cost effective methods of acquiring remotely sensed imagery, from airborne video survey to real time ingestion of meteorological satellite data. Inexpensive micro-computer systems and peripherals are used throughout to process and manipulate the data. Spatial information systems provide a means of integrating these data with topographic and thematic cartographic data, and historical records. For the system to have any real potential the data must be stored in a readily accessible format and be easily manipulated within the database. The design of efficient man-machine interfaces and the use of software enginering methodologies are therefore included in this thesis as a major part of the design of the system. The use of low cost technologies, from micro-computers to video cameras, enables the introduction of water resources information management systems into developing countries where the potential benefits are greatest.

The effects of perceived business uncertainty, external consultants and risk management on organisational outcomes

Purpose: The purpose of this paper is to investigate the relations between perceived business uncertainty (PBU), use of external risk management (RM) consultants, formalisation of RM, magnitude of RM methods and perceived organisational outcomes. Design/methodology/approach: This paper is based on a questionnaire survey of members of the Chartered Institute of Management Accountants in the UK. Using AMOS 17.0, the paper tests the strength of the direct and indirect effects among the variables and explores the fit of the overall path model. Findings: The results indicate significant and positive associations exist between the extent of PBU and the level ofRMformalisation, as well as between the level ofRMformalisation and the magnitude of RMmethods adopted. The use of externalRMconsultants is also found to have a significant and positive impact on the magnitude of RM methods adopted. Finally, both the extent of RM formalisation and the magnitude of RM methods adopted are seen to be significantly associated with overall improvement in organisational outcomes. Research limitations/implications: The study uses perceptual measures of the level of business uncertainty, usage of RM and organisational outcomes. Further, the respondents are members of a management accounting professional body and the views of other managers, such as risk managers, who are also important to the governance process are not incorporated. Originality/value: This study provides empirical evidence on the impact ofRMdesign and usage on improvements in organisational outcomes. It contributes to the RM literature where empirical research is needed in order to be comparable with the traditional management control system literature.

Accounting students' perceptions of a Learning Management System:an international comparison

Purpose - The purpose of this study is to investigate student perceptions of the design features included in an off the shelf Learning Management System (LMS) in teaching undergraduate accounting students. Design/methodology/approach - Questionnaire responses from 846 accounting students studying in the UK, Australia and New Zealand provide international data to develop a model to explain student perception of the LMS. Findings - The final model shows student satisfaction with the use of a LMS is positively associated with three variables: usefulness of lecture notes, bulletin boards and discussion forums, and other LMS tools. Further, the comparison of cultural differences of the three countries shows all students treat the provision of notes as a desirable attribute on a LMS. Findings also suggest that although students find the provision of materials over the LMS does not enhance student engagement in class, overall a comparison of the three countries shows all students treat the provision of notes as a desirable attribute of a LMS. Research limitations/implications - Future research should collect ethnicity data to enable an analysis of cultural influence on student perceptions of the LMS. Practical implications - As increased motivation to learn is found to contribute to improved achievement of learning outcomes, the study's findings have implications for faculty contemplating the adoption of a LMS in their courses. The findings specifically confirm that usefulness of lecture notes, use of bulletin/discussion boards, and other LMS tools are positively endorsed by students and hence increase their motivation to learn. Originality/value - The current paper adds to the literature as the motivation to use and engage with LMSs by accounting students is not well understood. © Emerald Group Publishing Limited.

Loan loss provisions, earnings management and capital management under IFRS:the case of EU commercial banks

Prior research has shown that loan loss provisions are primarily used as a tool for earnings management and capital management by listed banks. Effective 2005 all listed companies in the European Union (EU) are required to comply with International Financial Reporting Standards (IFRS). Adherence to IFRS, it is claimed, should enhance transparency of reporting practices relative to local General Accepted Accounting Principles (GAAP). The overall objective of this paper is to examine the impact of the implementation of IFRS on the use of loan loss provisions (LLPs) to manage earnings and capital. We use a sample of 91 EU listed commercial banks covering a period of 10 years (before and after implementation of IFRS). Since early adopters may have different incentives and motivations relative to those who adopt mandatorily, we dichotomize our sample into early and late adopters. Overall, we find that earnings management (using loan loss provisions) for both early and late adopters while significant over the estimation window is significantly reduced after implementation of IFRS. We also find that, for risky banks, earnings management behavior is more pronounced when compared to the less risky banks, but is significantly reduced in the post IFRS period. Capital management behavior by bank managers is not significant in both pre and post IFRS regimes. Overall, we conclude that the implementation of IFRS in the EU appears to have improved earnings quality by mitigating the tendency of bank managers of listed commercial banks to engage in earnings management using loan loss provisions.

Efficiency and the trading system:The case of SETSmm

This paper studies the impact that a change from a dealer system to a market-maker supported auction system has on market quality. We study the impact that the introduction of SETSmm at the London Stock Exchange had on firm value, price efficiency and liquidity. We discover a small SETSmm return premium associated with the announcement that securities are to migrate to the new trading system. Moreover, securities that migrate to SETSmm are characterized by improvements to liquidity and pricing efficiency. We find that these changes are related to the return premium.