Medicines reconciliation at the point of hospital discharge for children

Objectives: Hospital discharge is a transition of care, where medication discrepancies are likely to occur and potentially cause patient harm. The purpose of our study was to assess the prescribing accuracy of hospital discharge medication orders at a London, UK teaching hospital. The timeliness of the discharge summary reaching the general practitioner (GP, family physician) was also assessed based on the 72 h target referenced in the Care Quality Commission report.1 Method: 501 consecutive discharge medication orders from 142 patients were examined and the following records were compared (1) the final inpatient drug chart at the point of discharge, (2) printed signed copy of the initial to take away (TTA) discharge summary produced electronically by the physician, (3) the pharmacist's amendments on the initial TTA that were hand written, (4) the final electronic patient discharge summary record, (5) the patients final take home medication from the hospital. Discrepancies between the physician's order (6) and pharmacist's change(s) (7) were compared with two types of failures – ‘failure to make a required change’ and ‘change where none was required’. Once the patient was discharged, the patient's GP, was contacted 72 h after discharge to see if the patient discharge summary, sent by post or via email, was received. Results: Over half the patients seen (73 out of 142) patients had at least one discrepancy that was made on the initial TTA by the doctor and amended by the pharmacist. Out of the 501 drugs, there were 140 discrepancies, 108 were ‘failures to make a required change’ (77%) and 32 were ‘changes where none were required’ (23%). The types of ‘failures to make required changes’ discrepancies that were found between the initial TTA and pharmacist's amendments were paracetamol and ibuprofen changes (dose banding) 38 (27%), directions of use 34 (24%), incorrect formulation of medication 28 (20%) and incorrect strength 8 (6%). The types of ‘changes where none were required discrepancies’ were omitted medication 15 (11%), unnecessary drug 14 (10%) and incorrect medicine including spelling mistakes 3 (2%). After contacting the GPs of the discharged patients 72 h postdischarge; 49% had received the discharge summary and 45% had not, the remaining 6% were patients who were discharged without a GP. Conclusion: This study shows that doctor prescribing at discharge is often not accurate, and interventions made by pharmacist to reconcile are important at this point of care. It was also found that half the discharge summaries had not reached the patient's family physician (according to the GP) within 72 h.

The evaluation of marketing strategies for the sale of sports goods in Europe

The objectives of this thesis are to examine and evaluate the process of marketing as practiced by an established and successful company in the sports trade, Dunlop Sports Company Ltd. (D.S.C.). In particular the field of strategy formulation for exporting is considered in an operational context, and compared with existing literature and theory on the subject. Market intelligence has been gathered by visiting European territories and pursuing available sources in the United Kingdom. The data now available is intended to act as a base for developing a more effective market research function within D.S.C. At various stages reports have been submitted on specific topics to the Company and this thesis represents the culmination of these reports and an outline for future policies which are open to D.S.C. The thesis chooses certain aspects of marketing and examines the way in which the marketing strategy of the Company appears to act upon these. In particular the topics of Pricing, Distribution and Market Research are considered. Initially a series of alternative market postures are postulated and assessed within the European strategy of D.S.C. Where no explicit strategy is available an implied strategy is identified and evaluated. In chapters on Pricing and Distribution some of the problems being encountered are given detailed consideration and preferred policies arc suggested. In the final chapter the major strengths and weaknesses of of the Company are brought together and the various recommendations summarised in the context of a marketing strategy which would meet some o:f the current difficulties. The emphasis tliroughout is on the effect of strategy formulation, whether or not this appears adequate, and how each of the various operational elements of the marketing mix depend upon this.

Its in her eyes? A barometer for EU accession through female perceptions of role portrayals in advertising:a cross-cultural study of Ukraine and Turkey?

This article examines female response to gender role portrayals in advertising for Ukraine and Turkey. Being both new potential EU candidates, we argue that gender stereotype could also be used as a \u2018barometer\u2019 of progress and closure towards a more generally accepted EU behaviour against women. While their history remains different, both from a political and society values point of views, constraints are currently being faced that require convergence or justification of practices and understanding. Principal components analysis is employed over 290 questionnaires to identify the underlying dimensions. Results indicate overall similarities in perceptions, fragmentation within groups, but seem to provide divergence regarding thresholds.

Sharpening the edge of market driven intangibles and innovations

A review of the extant literature concludes that market-driven intangibles and innovations are increasingly considered to be the most critical firm-specific resources, but also finds a lack of elaboration of which types of these resources are most important. In this paper, we incorporate these observations into a conceptual model and link it to highly developed institutional settings for the model evaluation. From the point of view of firm revenue management, we can anticipate that performance advantages created through deployment of intellectual and relational capital in marketing and innovation are more likely to be superior. In essence, they constitute the integration of organisational intangibles both in cognitive and behavioural level to create an idiosyncratic combination for each firm. Our research findings show feasible paths for sharpening the edge of market-driven intangibles and innovations. We discuss the key results for research and practice.

Effects of relational policies in export channels

Two key causes of failure for exporters are (1) the availability of adequate resources at the point of entry, and, (2) the quality of the exporter-foreign distributor relationship. Generally, export research has found that, as foreign distributor relationship-specific investments increase and as relational bonds are established, performance improves (e.g., Bello and Gilliland 1997). However, investments and the quality of the relationship are challenged by the foreign distributor’s motivation to participate in the relationship. One way exporters deal with this issue is by developing trade policies, which we refer to as “relational policies,” that are intended to motivate relational behaviors on the part of the foreign distributor.

A soft-computing-based method for the automatic discovery of fuzzy rules in databases:uses for academic research and management support in marketing

The study here highlights the potential that analytical methods based on Knowledge Discovery in Databases (KDD) methodologies have to aid both the resolution of unstructured marketing/business problems and the process of scholarly knowledge discovery. The authors present and discuss the application of KDD in these situations prior to the presentation of an analytical method based on fuzzy logic and evolutionary algorithms, developed to analyze marketing databases and uncover relationships among variables. A detailed implementation on a pre-existing data set illustrates the method. © 2012 Published by Elsevier Inc.

The definition, theoretical modelling and empirical research of front-line service employee corporate identity within a UK national grocery retailer:determining the FLE corporate brand identification construct

Over the past forty years the corporate identity literature has developed to a point of maturity where it currently contains many definitions and models of the corporate identity construct at the organisational level. The literature has evolved by developing models of corporate identity or in considering corporate identity in relation to new and developing themes, e.g. corporate social responsibility. It has evolved into a multidisciplinary domain recently incorporating constructs from other literature to further its development. However, the literature has a number of limitations. It remains that an overarching and universally accepted definition of corporate identity is elusive, potentially leaving the construct with a lack of clear definition. Only a few corporate identity definitions and models, at the corporate level, have been empirically tested. The corporate identity construct is overwhelmingly defined and theoretically constructed at the corporate level, leaving the literature without a detailed understanding of its influence at an individual stakeholder level. Front-line service employees (FLEs), form a component in a number of corporate identity models developed at the organisational level. FLEs deliver the services of an organisation to its customers, as well as represent the organisation by communicating and transporting its core defining characteristics to customers through continual customer contact and interaction. This person-to-person contact between an FLE and the customer is termed a service encounter, where service encounters influence a customer’s perception of both the service delivered and the associated level of service quality. Therefore this study for the first time defines, theoretically models and empirically tests corporate identity at the individual FLE level, termed FLE corporate identity. The study uses the services marketing literature to characterise an FLE’s operating environment, arriving at five potential dimensions to the FLE corporate identity construct. These are scrutinised against existing corporate identity definitions and models to arrive at a definition for the construct. In reviewing the corporate identity, services marketing, branding and organisational psychology literature, a theoretical model is developed for FLE corporate identity, which is empirically and quantitatively tested, with FLEs in seven stores of a major national retailer. Following rigorous construct reliability and validity testing, the 601 usable responses are used to estimate a confirmatory factor analysis and structural equation model for the study. The results for the individual hypotheses and the structural model are very encouraging, as they fit the data well and support a definition of FLE corporate identity. This study makes contributions to the branding, services marketing and organisational psychology literature, but its principal contribution is to extend the corporate identity literature into a new area of discourse and research, that of FLE corporate identity