To err is human to forgive divine: spotlight on complaints in the NHS, the crusade for perceived justice

The Healthcare Commission’s recently published report ‘Spotlight on Complaints’ highlights a general state of malaise with the NHS’ approach to complaint management. The conclusion of this the second report by the Commission is clear, NHS Trusts still have much to do to improve the principle antecedents, which collectively construct complainants’ attainment of perceived justice.

"Well did you feel jealous?" Control and ideology in police interviews with rape complainants

The methods used by the UK Police to investigate complaints of rape have unsurprisingly come under much scrutiny in recent times, with a 2007 joint report on behalf of HM Crown Prosecution Service Inspectorate and HM Inspectorate of Constabulary concluding that there were many areas where improvements should be made. The research reported here forms part of a larger project which draws on various discourse analytical tools to identify the processes at work during police interviews with women reporting rape. Drawing on a corpus of video recorded police interviews with women reporting rape, this study applies a two pronged analysis to reveal the presence of these ideologies. Firstly, an analysis of the discourse markers ‘well’ and ‘so’ demonstrates the control exerted on the interaction by interviewing officers, as they attach importance to certain facts while omitting much of the information provided by the victim. Secondly, the interpretative repertoires relied upon by officers to ‘make sense’ of victim’s accounts are subject to scrutiny. As well as providing micro-level analyses which demonstrate processes of interactional control at the local level, the findings of these analyses can be shown to relate to a wider context – specifically prevailing ideologies about sexual violence in society as a whole.

A test of basic assumptions of Affective Events Theory (AET) in call centre work

Based on data from 2091 call centre representatives working in 85 call centres in the UK, central assumptions of affective events theory (AET) are tested. AET predicts that specific features of work (e.g. autonomy) have an impact on the arousal of emotions and moods at work that, in turn, co-determine job satisfaction of employees. AET further proposes that job satisfaction is an evaluative judgement that mainly explains cognitive-based behaviour, whereas emotions and moods better predict affective-based behaviour. The results support these assumptions. A clear separation of key constructs (job satisfaction, positive and negative emotions) was possible. Moreover, correlations between several work features (e.g. supervisory support) and job satisfaction were, in part, mediated by work emotions, even when controlling for gender, age, call centre type (in-house versus outsourced centres) and call centre size. Predictions regarding consequences of satisfaction and affect were partly corroborated as continuance commitment was more strongly related to job satisfaction than to positive emotions. In addition, affective commitment and health complaints were related to both emotions and job satisfaction to the same extent. Thus, AET is a fruitful framework for explaining why and how specific management strategies used for designing work features influence important organizational attitudes and well-being of employees. © 2006 British Academy of Management.

The impact of leadership and quality climate on hospital performance

Objective. To explore the relationship between leadership effectiveness and health-care trust performance, taking into account external quality measures and the number of patient complaints; also, to examine the role of care quality climate as a mediator. Design. We developed scales for rating leadership effectiveness and care quality climate. We then drew upon UK national indices of health-care trust performance—Commission for Health Improvement star ratings, Clinical Governance Review ratings and the number of patient complaints per thousand. We conducted statistical analysis to examine any significant relationships between predictor and outcome variables. Setting. The study is based on 86 hospital trusts run by the National Health Service (NHS) in the UK. The data collection is part of an annual staff survey commissioned by the NHS to explore the quality of working life. Participants. A total of 17 949 employees were randomly surveyed (41% of the total sample). Results. Leadership effectiveness is associated with higher Clinical Governance Review ratings and Commission for Health Improvement star ratings for our sample (ß = 0.42, P < 0.05; ß = 0.37, P < 0.05, respectively), and lower patient complaints (ß = –0.57, P < 0.05). In addition, 98% of the relationship between leadership and patient complaints is explained by care quality climate. Conclusions. Results offer insight into how non-clinical leadership may foster performance outcomes for health-care organizations. A frequently neglected area—patient complaints—may be a valid measure to consider when assessing leadership and quality in a health-care context.

The impact of the introduction of visual display terminals on the job characteristics, job satisfaction and well-being of users in government offices

The proliferation of visual display terminals (VDTs) in offices is an international phenomenon. Numerous studies have investigated the health implications which can be categorised into visual problems, symptoms of musculo-skelctal discomfort, or psychosocial effects. The psychosocial effects are broader and there is mixed evidence in this area. The inconsistent results from the studies of VDT work so far undertaken may reflect several methodological shortcomings. In an attempt to overcome these deficiencies and to broaden the model of inter-relationships a model was developed to investigate their interactions and Ihc outputs of job satisfaction, stress and ill health. The study was a two-stage, long-term investigation with measures taken before the VDTs were introduced and the same measures taken 12 months after the 'go-live' date. The research was conducted in four offices of the Department of Social Security. The data were analysed for each individual site and in addition the total data were used in a path analysis model. Significant positive relationships were found at the pre-implementation stage between the musculo-skeletal discomfort, psychosomatic ailments, visual complaints and stress. Job satisfaction was negatively related to visual complaints and musculo-skeletal discomfort. Direct paths were found for age and job level with variety found in the job and age with job satisfaction and a negative relationship with the office environment. The only job characteristic which had a direct path to stress was 'dealing with others'. Similar inter-relationships were found in the post-implementation data. However, in addition attributes of the computer system, such as screen brightness and glare, were related positively with stress and negatively with job satisfaction. The comparison of the data at the two stages found that there had been no significant changes in the users' perceptions of their job characteristics and job satisfaction but there was a small and significant reduction in the stress measure.

Methodology of photic stimulation revisited:updated European algorithm for visual stimulation in the EEG laboratory

Intermittent photic stimulation (IPS) is a common procedure performed in the electroencephalography (EEG) laboratory in children and adults to detect abnormal epileptogenic sensitivity to flickering light (i.e., photosensitivity). In practice, substantial variability in outcome is anecdotally found due to the many different methods used per laboratory and country. We believe that standardization of procedure, based on scientific and clinical data, should permit reproducible identification and quantification of photosensitivity. We hope that the use of our new algorithm will help in standardizing the IPS procedure, which in turn may more clearly identify and assist monitoring of patients with epilepsy and photosensitivity. Our algorithm goes far beyond that published in 1999 (Epilepsia, 1999a, 40, 75; Neurophysiol Clin, 1999b, 29, 318): it has substantially increased content, detailing technical and logistical aspects of IPS testing and the rationale for many of the steps in the IPS procedure. Furthermore, our latest algorithm incorporates the consensus of repeated scientific meetings of European experts in this field over a period of 6 years with feedback from general neurologists and epileptologists to improve its validity and utility. Accordingly, our European group has provided herein updated algorithms for two different levels of methodology: (1) requirements for defining photosensitivity in patients and in family members of known photosensitive patients and (2) requirements for tailored studies in patients with a clear history of visually induced seizures or complaints, and in those already known to be photosensitive.

Will you tolerate this? The impact of affective commitment on complaint intention and postrecovery behavior

Successful complaint management primarily depends on customers' willingness to voice their complaints and on companies' ability to adequately deal with these complaints. This article investigates the impact of one relationship characteristic in the complaint management process: affective commitment. Based on two studies, the authors investigate whether affective commitment moderates the impact of complaint barriers on complaint intention (a) and whether it moderates the link between complaint satisfaction and purchase behavior after the complaint (b). Results show that affectively committed customers exhibit higher complaint intention irrespective of the level of complaint barriers. Furthermore, affectively committed customers display little change in their postrecovery behavior, even after a service failure followed by an unsatisfactory recovery attempt. It seems that these customers are tolerant and want to help the provider improve their business. Affective commitment seems to amplify willingness to help the company by means of voicing dissatisfaction despite considerable efforts in doing so. Moreover, affective commitment buffers the negative effects of service failures on postrecovery behavior. Findings have important implications for managers. They highlight the necessity to measure customers' affective commitment. Based on that, tailored complaint systems can be designed, which help in achieving a more effective allocation of resources for customer recovery.

Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens

Purpose - To assess clinical outcomes and subjective experience after bilateral implantation of a diffractive trifocal intraocular lens (IOL). Setting - Midland Eye Institute, Solihull, United Kingdom. Design - Cohort study. Methods - Patients had bilateral implantation of Finevision trifocal IOLs. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), and manifest refraction were measured 2 months postoperatively. Defocus curves were assessed under photopic and mesopic conditions over a range of +1.50 to -4.00 diopters (D) in 0.50 D steps. Contrast sensitivity function was assessed under photopic conditions. Halometry was used to measure the angular size of monocular and binocular photopic scotomas arising from a glare source. Patient satisfaction with uncorrected near vision was assessed using the Near Activity Visual Questionnaire (NAVQ). Results - The mean monocular CDVA was 0.08 logMAR ± 0.08 (SD) and the mean binocular CDVA, 0.06 ± 0.08 logMAR. Defocus curve testing showed an extended range of clear vision from +1.00 to -2.50 D defocus, with a significant difference in acuity between photopic conditions and mesopic conditions at -1.50 D defocus only. Photopic contrast sensitivity was significantly better binocularly than monocularly at all spatial frequencies. Halometry showed a glare scotoma of a mean size similar to that in previous studies of multifocal and accommodating IOLs; there were no subjective complaints of dysphotopsia. The mean NAVQ Rasch score for satisfaction with near vision was 15.9 ± 10.7 logits. Conclusions - The trifocal IOL implanted binocularly produced good distance visual acuity and near and intermediate visual function. Patients were very satisfied with their uncorrected near vision.

Tracing social influence in responses to strategy change in an online community

Interest into the effects of social influence on members of online communities is growing but there is a lack of knowledge about the impact of influential members in online communities on responses to strategy change within the wider community. We explore social influence in responses to strategy change through content analysis of forum posts before and after a change in strategy. Acceptance or non-acceptance of strategy change and subsequent positive and negative behavioural responses online are dependent on individual factors. The details of these behavioural responses to a change in strategy are tabulated and included in a conceptual model to inform decision-makers. Strategy change precipitates a reduction in social influence effects. Non-acceptance of strategy change is associated with competitor advertisement, inflammatory behaviour, offensive behaviour and complaints. This negative behaviour has important ramifications for acceptance of strategy change within the wider community and impacts on the viability of setting up online forums. © 2014 © 2014 Taylor & Francis.

Cyberstalking:a new challenge for criminal law

Cyberstalking has recently emerged as a new and growing problem and is an area that will probably receive a higher profile within criminal law as more cases reach court (see Griffiths, 1999; Griffiths, Rogers and Sparrow, 1998; Bojic and McFarlane, 2002a; 2002b). For the purposes of this article we define cyberstalking as the use of information and communications technology (in particular the Internet) in order to harass individuals. Such harassment may include actions such as the transmission of offensive e-mail messages, identity theft and damage to data or equipment. Whilst a more comprehensive definition has been presented elsewhere (Bocij and McFarlane, 2002), it is hoped that the definition here is sufficient for those unfamiliar with this field. The stereotypical stalker conjures up images of someone harassing a victim who is the object of their affection. However, not all stalking incidents are motivated by unrequited love. Stalking can also be motivated by hate, a need for revenge, a need for power and/or racism. Similarly, cyberstalking can involve acts that begin with the issuing of threats and end in physical assault. We also make distinctions between conventional stalking and cyberstalking. Whilst some may view cyberstalking as an extension of conventional stalking, we believe cyberstalking should be regarded as an entirely new form of deviant behaviour. It is not surprising that cyberstalking is sometimes thought of as a trivial problem. A number of writers and researchers have suggested that cyberstalking and associated activities are of little genuine concern. Koch (2000), for example, goes as far as accusing those interested in cyberstalking as promoting hysteria over a problem that may be minuscule or even imaginary. The impression gained is that cyberstalking represents a relatively small problem where victims seldom suffer any real harm. Whilst there are no genuinely reliable statistics that can be used to determine how common cyberstalking incidents are, a great deal of evidence is available to show that cyberstalking is a significant and growing problem (Griffiths et al, 1998). For instance, CyberAngels (a well-known Internet safety organization) receives some 500 complaints of cyberstalking each day, of which up to 100 represent legitimate cases (Dean, 2000). Another Internet safety organization (Working to Halt Online Abuse) reports receiving an average of 100 cases per week (WHOA, 2001). To highlight the types of cyberstalking behaviours that take place and some of the major issues facing criminal law, we briefly examine four high profile cases of cyberstalking (adapted from Bocij and MacFarlane, 2002b).

Enjoying the third age! Discourse, identity and liminality in extra-care communities

Extra-care housing has been an important and growing element of housing and care for older people in the United Kingdom since the 1990s. Previous studies have examined specific features and programmes within extra-care locations, but few have studied how residents negotiate social life and identity. Those that have, have noted that while extra care brings many health-related and social benefits, extra-care communities can also be difficult affective terrain. Given that many residents are now ‘ageing in place’ in extra care, it is timely to revisit these questions of identity and affect. Here we draw on the qualitative element of a three-year, mixed-method study of 14 extra-care villages and schemes run by the ExtraCare Charitable Trust. We follow Alemàn in regarding residents' ambivalent accounts of life in ExtraCare as important windows on the way in which liminal residents negotiate the dialectics of dependence and independence. However, we suggest that the dialectic of interest here is that of the third and fourth age, as described by Gilleard and Higgs. We set that dialectic within a post-structuralist/Lacanian framework in order to examine the different modes of enjoyment that liminal residents procure in ExtraCare's third age public spaces and ideals, and suggest that their complaints can be read in three ways: as statements about altered material conditions; as inter-subjective bolstering of group identity; and as fantasmatic support for liminal identities. Finally, we examine the implications that this latter psycho-social reading of residents' complaints has for enhancing and supporting residents' wellbeing.

From ‘poor parenting’ to micro-management:coalition governance and the sponsorship of arm’s-length bodies in the United Kingdom, 2010–13

The delegation of public tasks to arm’s-length bodies remains a central feature of contemporary reform agendas within both developed and developing countries. The role and capacity of political and administrative principals (i.e. ministers and departments of state) to control the vast network of arm’s-length bodies for which they are formally responsible is therefore a critical issue within and beyond academe. In the run-up to the 2010 General Election in the United Kingdom, the ‘quango conundrum’ emerged as an important theme and all three major parties committed themselves to shift the balance of power back towards ministers and sponsor departments. This article presents the results of the first major research project to track and examine the subsequent reform process. It reveals a stark shift in internal control relationships from the pre-election ‘poor parenting’ model to a far tighter internal situation that is now the focus of complaints by arm’s-length bodies of micro-management. This shift in the balance of power and how it was achieved offers new insights into the interplay between different forms of governance and has significant theoretical and comparative relevance. Points for practitioners: For professionals working in the field of arm’s-length governance, the article offers three key insights. First, that a well-resourced core executive is critical to directing reform given the challenges of implementing reform in a context of austerity. Second, that those implementing reform will also need to take into account the diverse consequences of centrally imposed reform likely to result in different departments with different approaches to arm’s-length governance. Third, that reforming arm’s-length governance can affect the quality of relationships, and those working in the field will need to mitigate these less tangible challenges to ensure success.

»The German likes quarrelling.« Conflict and belonging in German diasporic communities around 1900

Discourses of inclusion and exclusion were an integral part of German nation building after 1871. The paper shows that they were not confined to the metropole but were, in fact, reciprocated abroad. Selected instances of conflict within German migrant communities around the world are taken as a springboard to analyze public contestations of (trans-)national belonging. The sources abound with gossip, aggressive bickering, and official complaints to authorities. Contentious issues cover the areas of politics, religion, class, and language. The case studies engage critically with a number of wider issues. First, they question contemporaneous interpretations of an Imperial diaspora as a unified and Heimat-oriented block. Second, on a theoretical level the article argues that internal ruptures are constitutive elements of diaspora construction and should be considered in concomitant theorizations. Third, the case studies highlight the close connection between diaspora and nation building. Fourth, the discourses studied did not only take place within communities, but also between them, as well as with the metropole, all in multi-directional ways. Questions of belonging were discussed around the world with strikingly similar arguments and terminology. Globalization was at work at the discourse level.