Managing healthcare quality using logical framework analysis

Purpose - The purpose of this paper is to develop an integrated quality management model that identifies problems, suggests solutions, develops a framework for implementation and helps to evaluate dynamically healthcare service performance. Design/methodology/approach - This study used the logical framework analysis (LFA) to improve the performance of healthcare service processes. LFA has three major steps - problems identification, solution derivation, and formation of a planning matrix for implementation. LFA has been applied in a case-study environment to three acute healthcare services (Operating Room utilisation, 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 study shows LFA application in three service processes in one hospital. This very limited population sample needs to be extended. Practical implications - The proposed model can be implemented in hospital-based healthcare services in order to improve performance. It may also be applied to other services. Originality/value - 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 healthcare delivery, they are not without flaws. There is an absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues, develop a project management framework to implement those solutions. This study introduces an integrated and uniform quality management tool for healthcare services. © Emerald Group Publishing Limited.

Optimization of facility location-allocation problem in customer-driven supply chain

This paper develops and applies an integrated multiple criteria decision making approach to optimize the facility location-allocation problem in the contemporary customer-driven supply chain. Unlike the traditional optimization techniques, the proposed approach, combining the analytic hierarchy process (AHP) and the goal programming (GP) model, considers both quantitative and qualitative factors, and also aims at maximizing the benefits of deliverer and customers. In the integrated approach, the AHP is used first to determine the relative importance weightings or priorities of alternative locations with respect to both deliverer oriented and customer oriented criteria. Then, the GP model, incorporating the constraints of system, resource, and AHP priority is formulated to select the best locations for setting up the warehouses without exceeding the limited available resources. In this paper, a real case study is used to demonstrate how the integrated approach can be applied to deal with the facility location-allocation problem, and it is proved that the integrated approach outperforms the traditional costbased approach.

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.

Manufacturing knowledge management strategy

The study sought to understand the components of knowledge management strategy from the perspective of staff in UK manufacturing organizations. To analyse this topic, we took an empirical approach and collaborated with two manufacturing organizations. Our main finding centres on the key components of a knowledge management strategy, and the relationships between it and manufacturing strategy and corporate strategy. Other findings include: the nature of knowledge in manufacturing organizations; the relevance of (in)formal processes; top-down and bottom-up communication; taking ownership for information processes. We also make comments on the development of action plans for better knowledge management. The implications are that, for an integrated approach to knowledge management strategy in manufacturing organizations, involvement across the organization and at all levels is necessary.

The European Community and innovation policy : reorienting towards diffusion

This study aims to explore the position of diffusion oriented support mechanisms in European Community (EC) innovation policy. With the shift from the traditional linear model towards an integrative approach to innovation, the role of diffusion of technologies and knowledge, achieved greater weight. This shift in both the thinking of academic experts, and of national policy makers, induced EC policy makers to appeal for similar changes in Community innovation policy. From the mid-1980s, the Commission of the European Communities, the key actor in EC policy making, thought to move its innovation policy away from the traditional science push approach. This study shows that in the implementation of programmes for research, technology and innovation, the traditional linear model is still dominant. The core research and technological development programmes still operate from a science push concept of innovation, mainly due to their pre-competitive nature. The case of SPRINT illustrates that policy programmes with an integrated innovation perspective can be successful at Community level. However the programme operates in a relatively isolated position from overall research and technological development policy. The case of BRITE-EURAM illustrates the difficulties of collaborative research programmes, the bulk of EC support mechanisms, to move away from the traditional model. The study shows how conflicting policy objectives arising from the different policy networks that shape EC policy making, in combination with a lack of co-ordination in those policy domains, hinder the emergence of the integrated approach. Consequently EC diffusion policy, implemented from the perspective of the linear model, will have a sub-optimal impact on the competitiveness of European industries.

GIS linked environmental process models

In recent years there has been a great effort to combine the technologies and techniques of GIS and process models. This project examines the issues of linking a standard current generation 2½d GIS with several existing model codes. The focus for the project has been the Shropshire Groundwater Scheme, which is being developed to augment flow in the River Severn during drought periods by pumping water from the Shropshire Aquifer. Previous authors have demonstrated that under certain circumstances pumping could reduce the soil moisture available for crops. This project follows earlier work at Aston in which the effects of drawdown were delineated and quantified through the development of a software package that implemented a technique which brought together the significant spatially varying parameters. This technique is repeated here, but using a standard GIS called GRASS. The GIS proved adequate for the task and the added functionality provided by the general purpose GIS - the data capture, manipulation and visualisation facilities - were of great benefit. The bulk of the project is concerned with examining the issues of the linkage of GIS and environmental process models. To this end a groundwater model (Modflow) and a soil moisture model (SWMS2D) were linked to the GIS and a crop model was implemented within the GIS. A loose-linked approach was adopted and secondary and surrogate data were used wherever possible. The implications of which relate to; justification of a loose-linked versus a closely integrated approach; how, technically, to achieve the linkage; how to reconcile the different data models used by the GIS and the process models; control of the movement of data between models of environmental subsystems, to model the total system; the advantages and disadvantages of using a current generation GIS as a medium for linking environmental process models; generation of input data, including the use of geostatistic, stochastic simulation, remote sensing, regression equations and mapped data; issues of accuracy, uncertainty and simply providing adequate data for the complex models; how such a modelling system fits into an organisational framework.

Planning for cycling in the West Midlands

The issues involved in planning for pedal cyclists are examined with reference to the West Midlands County. Working with a local cycling campaign group, the researcher uses action research methods to investigate and influence the campaign. Development of cycle planning is traced through the literature, focusing on bicycle ownership, bicycle use and cycling policy. UK practice is contrasted with the integrated approach of other countries. An extensive bibliography is provided. Local authority cycle planning through the TPP process is systematically assessed over three years. This provides a context for the information regarding cycling in the West Midlands. Existing data is presented from the 1981 Census and local police road accident and bicycle theft records. The developing relationship between the local authority and the cycle campaign group is narrated in detail, explaining the problems that can beset efforts to improve conditions for cyclists. The researcher was closely involved in this interaction, particularly with policy and a major public inquiry. A survey of the Cycle Campaign Network indicates that the local group was not atypical. To provide information relevant to the local campaign and for effective local planning, a survey of 3,500 West Midlands residents was conducted using a novel combination of questionnaires and interviews. It shows that 1) Bicycle ownership and use is considerably higher than indicated by the 1978/9 National Travel Survey 2) Cycling is most import to certain disadvantaged sections of the community, particularly the young, those without access to a car and in the lower SEGs. The broader issues of transport policy are discussed, concluding that cycling is regarded as a marginal activity and that changes in general transport policy, land use planning and fiscal arrangements are necessary conditions for cycle planning to succeed. An integrated package of cycling measures involving engineering, education, enforcement and encouragement is also required. Recommendations are made concerning central government, local authorities and cycle campaign groups. Subjects for further research are identified.

Multi-criteria logistics distribution network design using SAS/OR

This paper explores the use of the optimization procedures in SAS/OR software with application to the contemporary logistics distribution network design using an integrated multiple criteria decision making approach. Unlike the traditional optimization techniques, the proposed approach, combining analytic hierarchy process (AHP) and goal programming (GP), considers both quantitative and qualitative factors. In the integrated approach, AHP is used to determine the relative importance weightings or priorities of alternative warehouses with respect to both deliverer oriented and customer oriented criteria. Then, a GP model incorporating the constraints of system, resource, and AHP priority is formulated to select the best set of warehouses without exceeding the limited available resources. To facilitate the use of integrated multiple criteria decision making approach by SAS users, an ORMCDM code was implemented in the SAS programming language. The SAS macro developed in this paper selects the chosen variables from a SAS data file and constructs sets of linear programming models based on the selected GP model. An example is given to illustrate how one could use the code to design the logistics distribution network.

Uses of frontier efficiency methodologies and multi-criteria decision making for performance measurement in the energy sector

Guest editorial Ali Emrouznejad is a Senior Lecturer at the Aston Business School in Birmingham, UK. His areas of research interest include performance measurement and management, efficiency and productivity analysis as well as data mining. He has published widely in various international journals. He is an Associate Editor of IMA Journal of Management Mathematics and Guest Editor to several special issues of journals including Journal of Operational Research Society, Annals of Operations Research, Journal of Medical Systems, and International Journal of Energy Management Sector. He is in the editorial board of several international journals and co-founder of Performance Improvement Management Software. William Ho is a Senior Lecturer at the Aston University Business School. Before joining Aston in 2005, he had worked as a Research Associate in the Department of Industrial and Systems Engineering at the Hong Kong Polytechnic University. His research interests include supply chain management, production and operations management, and operations research. He has published extensively in various international journals like Computers & Operations Research, Engineering Applications of Artificial Intelligence, European Journal of Operational Research, Expert Systems with Applications, International Journal of Production Economics, International Journal of Production Research, Supply Chain Management: An International Journal, and so on. His first authored book was published in 2006. He is an Editorial Board member of the International Journal of Advanced Manufacturing Technology and an Associate Editor of the OR Insight Journal. Currently, he is a Scholar of the Advanced Institute of Management Research. Uses of frontier efficiency methodologies and multi-criteria decision making for performance measurement in the energy sector This special issue aims to focus on holistic, applied research on performance measurement in energy sector management and for publication of relevant applied research to bridge the gap between industry and academia. After a rigorous refereeing process, seven papers were included in this special issue. The volume opens with five data envelopment analysis (DEA)-based papers. Wu et al. apply the DEA-based Malmquist index to evaluate the changes in relative efficiency and the total factor productivity of coal-fired electricity generation of 30 Chinese administrative regions from 1999 to 2007. Factors considered in the model include fuel consumption, labor, capital, sulphur dioxide emissions, and electricity generated. The authors reveal that the east provinces were relatively and technically more efficient, whereas the west provinces had the highest growth rate in the period studied. Ioannis E. Tsolas applies the DEA approach to assess the performance of Greek fossil fuel-fired power stations taking undesirable outputs into consideration, such as carbon dioxide and sulphur dioxide emissions. In addition, the bootstrapping approach is deployed to address the uncertainty surrounding DEA point estimates, and provide bias-corrected estimations and confidence intervals for the point estimates. The author revealed from the sample that the non-lignite-fired stations are on an average more efficient than the lignite-fired stations. Maethee Mekaroonreung and Andrew L. Johnson compare the relative performance of three DEA-based measures, which estimate production frontiers and evaluate the relative efficiency of 113 US petroleum refineries while considering undesirable outputs. Three inputs (capital, energy consumption, and crude oil consumption), two desirable outputs (gasoline and distillate generation), and an undesirable output (toxic release) are considered in the DEA models. The authors discover that refineries in the Rocky Mountain region performed the best, and about 60 percent of oil refineries in the sample could improve their efficiencies further. H. Omrani, A. Azadeh, S. F. Ghaderi, and S. Abdollahzadeh presented an integrated approach, combining DEA, corrected ordinary least squares (COLS), and principal component analysis (PCA) methods, to calculate the relative efficiency scores of 26 Iranian electricity distribution units from 2003 to 2006. Specifically, both DEA and COLS are used to check three internal consistency conditions, whereas PCA is used to verify and validate the final ranking results of either DEA (consistency) or DEA-COLS (non-consistency). Three inputs (network length, transformer capacity, and number of employees) and two outputs (number of customers and total electricity sales) are considered in the model. Virendra Ajodhia applied three DEA-based models to evaluate the relative performance of 20 electricity distribution firms from the UK and the Netherlands. The first model is a traditional DEA model for analyzing cost-only efficiency. The second model includes (inverse) quality by modelling total customer minutes lost as an input data. The third model is based on the idea of using total social costs, including the firm’s private costs and the interruption costs incurred by consumers, as an input. Both energy-delivered and number of consumers are treated as the outputs in the models. After five DEA papers, Stelios Grafakos, Alexandros Flamos, Vlasis Oikonomou, and D. Zevgolis presented a multiple criteria analysis weighting approach to evaluate the energy and climate policy. The proposed approach is akin to the analytic hierarchy process, which consists of pairwise comparisons, consistency verification, and criteria prioritization. In the approach, stakeholders and experts in the energy policy field are incorporated in the evaluation process by providing an interactive mean with verbal, numerical, and visual representation of their preferences. A total of 14 evaluation criteria were considered and classified into four objectives, such as climate change mitigation, energy effectiveness, socioeconomic, and competitiveness and technology. Finally, Borge Hess applied the stochastic frontier analysis approach to analyze the impact of various business strategies, including acquisition, holding structures, and joint ventures, on a firm’s efficiency within a sample of 47 natural gas transmission pipelines in the USA from 1996 to 2005. The author finds that there were no significant changes in the firm’s efficiency by an acquisition, and there is a weak evidence for efficiency improvements caused by the new shareholder. Besides, the author discovers that parent companies appear not to influence a subsidiary’s efficiency positively. In addition, the analysis shows a negative impact of a joint venture on technical efficiency of the pipeline company. To conclude, we are grateful to all the authors for their contribution, and all the reviewers for their constructive comments, which made this special issue possible. We hope that this issue would contribute significantly to performance improvement of the energy sector.

Impact of diet composition on blood glucose regulation

Abstract Nutritional management of blood glucose levels is a strategic target in the prevention and management of type 2 diabetes mellitus (T2DM). To implement such an approach it is essential to understand the effect of food on glycaemic regulation and on the underlying metabolic derangements. This comprehensive review summarises the results from human dietary interventions exploring the impact of dietary components on blood glucose levels. Included are the major macronutrients; carbohydrate, protein and fat, micronutrient vitamins and minerals, non-nutrient phytochemicals and additional foods including low-calorie sweeteners, vinegar and alcohol. Based on the evidence presented in this review, it is clear that dietary components have significant and clinically relevant effects on blood glucose modulation. An integrated approach that includes reducing excess body weight, increased physical activity along with a dietary regime to regulate blood glucose levels will not only be advantages in T2DM management, but will benefit the health of the population and limit the increasing worldwide incidence of T2DM.

Institutional change and the challenge of policy coordination in the English regions

By contrast to major constitutional reforms elsewhere in the UK, in England's eight regions beyond London New Labour has favoured administrative decentralisation. This paper examines these institutional arrangements and assesses their capacity to develop a more integrated approach to territorial development. It confirms a growing awareness of the need to ensure greater coherence between policies to promote economic, social and environmental wellbeing. Nonetheless, a complex regional institutional architecture, inconsistent sector-based strategies, a lack of strategic leadership and blurred accountabilities hamper moves towards policy integration and the delivery of joint outcomes. Moreover, despite ongoing reforms, the absence of a clear regional agenda in a functionally designed Whitehall raises fundamental questions about the ability of sub-national bodies to work collectively to develop and implement a more coherent approach to regional policy.

Supply chain integration framework using literature review

Definitions and measures of supply chain integration (SCI) are diverse. More empirical research, with clear definition and appropriate measures are needed. The purpose of this article is to identify dimensions and variables for SCI and develop an integrated framework to facilitate this. A literature review of the relevant academic papers in international journals in Logistics, Supply Chain Management and Operations Management for the period 1995-2009 has been undertaken. This study reveals that information integration, coordination and resource sharing and organisational relationship linkage are three major dimensions for SCI. The proposed framework helps integrate both upstream suppliers and downstream customers with the focal organisation. It also allows measuring SCI using both qualitative and quantitative approach. This study encourages researchers and practitioners to identify dimensions and variables for SCI and analyses how it affects the overall supply chain (SC) performance in terms of efficiency and responsiveness. Although there is extensive research in the area of SCI, a comprehensive and integrated approach is missing. This study bridges the gap by developing a framework for measuring SCI, which enables any organisation to identify critical success factors for integrating their SC, measures the degree of integration qualitatively and quantitatively and suggest improvement measures. © 2013 Copyright Taylor and Francis Group, LLC.

A fuzzy AHP based integer linear programming model for the multi-criteria transshipment problem

Purpose – The purpose of this research is to develop a holistic approach to maximize the customer service level while minimizing the logistics cost by using an integrated multiple criteria decision making (MCDM) method for the contemporary transshipment problem. Unlike the prevalent optimization techniques, this paper proposes an integrated approach which considers both quantitative and qualitative factors in order to maximize the benefits of service deliverers and customers under uncertain environments. Design/methodology/approach – This paper proposes a fuzzy-based integer linear programming model, based on the existing literature and validated with an example case. The model integrates the developed fuzzy modification of the analytic hierarchy process (FAHP), and solves the multi-criteria transshipment problem. Findings – This paper provides several novel insights about how to transform a company from a cost-based model to a service-dominated model by using an integrated MCDM method. It suggests that the contemporary customer-driven supply chain remains and increases its competitiveness from two aspects: optimizing the cost and providing the best service simultaneously. Research limitations/implications – This research used one illustrative industry case to exemplify the developed method. Considering the generalization of the research findings and the complexity of the transshipment service network, more cases across multiple industries are necessary to further enhance the validity of the research output. Practical implications – The paper includes implications for the evaluation and selection of transshipment service suppliers, the construction of optimal transshipment network as well as managing the network. Originality/value – The major advantages of this generic approach are that both quantitative and qualitative factors under fuzzy environment are considered simultaneously and also the viewpoints of service deliverers and customers are focused. Therefore, it is believed that it is useful and applicable for the transshipment service network design.

Linking risk management to strategic controls:a case study of Tesco plc

Definitions and perceptions of the role and styles of risk management, and performance management/strategic control systems have evolved over time, but it can be argued that risk management is primarily concerned with ensuring the achievement of strategic objectives. This paper shows the extent of overlap between a broad-based view of risk management, namely Enterprise Risk Management (ERM), and the balanced scorecard, which is a widely used strategic control system. A case study of one of the UK's largest retailers, Tesco plc, is used to show how ERM can be introduced as part of an existing strategic control system. The case demonstrates that, despite some differences in lines of communications, the strategic controls and risk controls can be used to achieve a common objective. Adoption of such an integrated approach, however, has implications for the profile of risk and the overall risk culture within an organisation.

Examining the relationship between risk assessment and risk management in mental health

Risk assessment is crucial for developing risk management plans to prevent or minimize mental health patients' risks that will impede their recovery. Risk assessments and risk management plans should be closely linked. Their content and the extent to which they are linked within one Trust is explored. There is a great deal of variability in the amount and detail of risk information collected by nurses and how this is used to develop risk management plans. Keeping risk assessment information in one place rather than scattered throughout patient records is important for ensuring it can be accessed easily and linked properly to risk management plans. Strengthening the link between risk assessment and management will help ensure interventions and care is tailored to the specific needs of individual patients, thus promoting their safety and well-being. Thorough risk assessment helps in developing risk management plans that minimize risks that can impede mental health patients' recovery. Department of Health policy states that risk assessments and risk management plans should be inextricably linked. This paper examines their content and linkage within one Trust. Four inpatient wards for working age adults (18-65 years) in a large mental health Trust in England were included in the study. Completed risk assessment forms, for all patients in each inpatient ward were examined (n= 43), followed by an examination of notes for the same patients. Semi-structured interviews took place with ward nurses (n= 17). Findings show much variability in the amount and detail of risk information collected by nurses, which may be distributed in several places. Gaps in the risk assessment and risk management process are evident, and a disassociation between risk information and risk management plans is often present. Risk information should have a single location so that it can be easily found and updated. Overall, a more integrated approach to risk assessment and management is required, to help patients receive timely and appropriate interventions that can reduce risks such as suicide or harm to others. © 2011 Blackwell Publishing.