The roles of community pharmacists and other pharmacy staff:public perceptions

Introduction: The focus of the community pharmacist’s (CP’s) activities continues to move away from traditional dispensing activities towards the provision of health services. Current functions of CPs cover a combination of roles including prescription matters, counselling and service provision. These expanding roles, along with raised prescription volume, have increased CP workload. Therefore, it has become commonplace to delegate certain activities to other pharmacy staff (PS). This research aimed to examine public perceptions of CPs and other PS functions. Methodology: A self-completion postal questionnaire was sent to a random sample of 9769 members of the general public in England. Participants were asked to indicate which functions they believed CPs and other PS perform. Data were imported into SPSS 22 for analysis. Results: A response rate of 15.7% (n = 1537) was achieved. The roles most commonly attributed to CPs were monitoring prescription appropriateness (90.4%, n = 1390) and counselling patients on prescribed medicines (90.4%, n = 1389). The role most commonly attributed to other PS was sales transactions (92.4%, n = 1420). Similar numbers of responders agreed that the delivery of health services was the role of both CPs and other PS (58.9%, n = 906; 57.0%, n = 876). Conclusion: Despite a move towards more service based practice, the public still primarily associate the CP’s role with activities centred on dispensing. The provision of health services was seen to be equally carried out by CPs and other PS. As the CP’s service-based activities continue to develop, promotional activities may be required to ensure developments in CP functions are recognised by the public

Managing people and performance:An evidence based framework applied to health service organizations

People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1. Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2. People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3. Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4. Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5. Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid.

Computer based monitoring in U.K. service organizations : a comparative study

The majority of the literature about CBM is American in origin, and (inter alia) notes that there were differing uses of similar technology, indicating that context has an important role to play in the use of CBM. The literature maps the psychological effects of CBM in considerable detail, but only two published studies examine the context of CBM. These grounded results provide scant support for any systematic, quantitative, large scale analysis of computer based monitoring in the UK context. This thesis thus aims to systemically examine the context of CBM using discourse analysis. Forty four interviewees were theoretically sampled using a structured sample technique in four organizations. All were national or multinational enterprises. The interviews were semi structured in nature and divided into three sections. The first addressed the respondents' thoughts and perceptions about CBM, the second elicited talk about the departmental context (focusing the management - worker relationship), and the final section addressed the organizational context. The cases demonstrated variation in the use of CBM, measured according to the criteria of Westin (1987, 1988) and according to the interpretive repertoires used by the respondents in each case. Seven analytical categories of talk emerged from the data: three at the organizational level and four at the departmental level of analysis. Discourse analysis revealed two discrete interpretive repertories - the procedural and the substantive repertoires - in respondents' talk whose main variation occurred at the departmental level of analysis. Furthermore, patterns were found in the use of these repertories within cases and between categories. Between the cases, variation in the use of the repertories matched the between case variation according to the criteria of Westin. It would thus appear that the source of variation in the use of CBM lies in its context, more specifically in the relative emphasis of humanistic, interpersonal and idiosyncratic values within the management worker relationship.

Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Service differentiation in OFDM-Based IEEE 802.16 networks

IEEE 802.16 network is widely viewed as a strong candidate solution for broadband wireless access systems. Various flexible mechanisms related to QoS provisioning have been specified for uplink traffic at the medium access control (MAC) layer in the standards. Among the mechanisms, bandwidth request scheme can be used to indicate and request bandwidth demands to the base station for different services. Due to the diverse QoS requirements of the applications, service differentiation (SD) is desirable for the bandwidth request scheme. In this paper, we propose several SD approaches. The approaches are based on the contention-based bandwidth request scheme and achieved by the means of assigning different channel access parameters and/or bandwidth allocation priorities to different services. Additionally, we propose effective analytical model to study the impacts of the SD approaches, which can be used for the configuration and optimization of the SD services. It is observed from simulations that the analytical model has high accuracy. Service can be efficiently differentiated with initial backoff window in terms of throughput and channel access delay. Moreover, the service differentiation can be improved if combined with the bandwidth allocation priority approach without adverse impacts on the overall system throughput.

The evolution of logistics service providers and the role of Internet-based applications in facilitating global operations

The need for global logistics services has increased dramatically and become extremely complex and dynamic as a result of a number of changes in manufacturing and in industrial production. In response, the logistics industry is changing in a variety of ways, including mergers to form integrated transportation service providers, outsourcing and increased use of information technology. The aim of this chapter is to provide an overview of the evolution and the most important trends in the logistics services provider (LSP) industry. Specific emphasis will be given to the role of Internet-based applications. Within this context, the chapter will also present the role of logistics e-marketplaces. In particular, based on the secondary research of currently existing logistics on-line marketplaces, an analysis and classification of them is provided with the aim of identifying service gaps. The analysis reveals that logistics electronic marketplaces, despite the increased range of services currently offered, still face limitations with reference to integrated customs links or translation services, which both reduce the efficiency of global operations.

The development and evaluation of an evidence-based drug information service

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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.

Architecture of remote monitoring and diagnosis system based on service-oriented architecture(SOA)

In view of the increasingly complexity of services logic and functional requirements, a new system architecture based on SOA was proposed for the equipment remote monitoring and diagnosis system. According to the design principles of SOA, different levels and different granularities of services logic and functional requirements for remote monitoring and diagnosis system were divided, and a loosely coupled web services system was built. The design and implementation schedule of core function modules for the proposed architecture were presented. A demo system was used to validate the feasibility of the proposed architecture.

Assessing service satisfaction between a 3PL provider and a vehicle manufacturer using the SERVQUAL technique

This paper reports on a new study conducted within a leading UK based (and US owned) car manufacturing company looking at the satisfaction between parties within a newly formed third party logistics (3PL) relationship. The study contains a two-way assessment of the relationship (i.e. the vehicle manufacturer’s Parts Supply and Logistics Operation’s assessment of the 3PL’s service and the 3PL’s assessment of the vehicle manufacturer’s relationship management ability). The study principally used an online SERVQUAL survey, (backed up with an on-line questionnaire, and face to face interviews) for data collection. The paper discusses the background and problems that have arisen in the relationship, the analysis of how each of the parties sees one other in terms of the service provided. Also, the findings and recommendations presented to management are outlined: these include factors such as the need for information sharing, reliability, flexibility, role specificity, trust and effective requirements management.

Innovation management using logical framework in hospital-based healthcare units

Innovation is part and parcel of any service in today's environment, so as to remain competitive. Quality improvement in healthcare services is a complex, multi-dimensional task. This study proposes innovation management in healthcare services using a logical framework. A problem tree and an objective tree are developed to identify and mitigate issues and concerns. A logical framework is formulated to develop a plan for implementation and monitoring strategies, potentially creating an environment for continuous quality improvement in a specific unit. We recommend logical framework as a valuable model for innovation management in healthcare services. Copyright © 2006 Inderscience Enterprises Ltd.

Service encounter conceptualisation:employees' service behaviours and customers' service quality perceptions

The enhancement of service quality is an area of optimal managerial relevance that has, to date, received minimal attention in the literature. Because customers' service quality evaluations are based almost entirely upon the behaviours of frontline employees, organisations rely heavily upon these employees to improve overall service quality provision. However, much of the literature looking at service quality enhancement lacks detail when examining the impact of employee service-related behaviours on customers' service quality perceptions. As a result, this paper comprehensively conceptualises those front-line employee behaviours which are the most likely to enhance customers' service quality perceptions. This conceptualisation is grounded in an extensive review of the services marketing literature, pooling together previously disparate research strands. Formal hypotheses are presented. Implications and future research directions are also discussed.

Market orientation in the service sector of the transition economies of central Europe

The Narver and Slater market orientation scale is tested in the context of service firms in the transition economies of central Europe and found to be both valid and reliable. The survey examined levels of market orientation in 205 business to business services companies and 141 consumer services companies in Hungary, Poland and Slovenia. As predicted by the predominantly western marketing literature, those service firms with higher levels of market orientation; were more often found in turbulent, rapidly changing markets; were more likely to pursue longer term market building goals rather than short term efficiency objectives; more likely to pursue differentiated positioning through offering superior levels of service compared to competitors; and also performed better on both financial and market based criteria. A number of different business approaches, however, are evident in the transition economies suggesting that other business orientations may co-exist with a market orientation creating a richer and more complex set of organizational drivers.