Performance measurement of intensive care services in hospitals:The case of Barbados

The Intensive Care Unit (ICU) being one of those vital areas of a hospital providing clinical care, the quality of service rendered must be monitored and measured quantitatively. It is, therefore, essential to know the performance of an ICU, in order to identify any deficits and enable the service providers to improve the quality of service. Although there have been many attempts to do this with the help of illness severity scoring systems, the relative lack of success using these methods has led to the search for a form of measurement, which would encompass all the different aspects of an ICU in a holistic manner. The Analytic Hierarchy Process (AHP), a multiple-attribute, decision-making technique is utilised in this study to evolve a system to measure the performance of ICU services reliably. This tool has been applied to a surgical ICU in Barbados; we recommend AHP as a valuable tool to quantify the performance of an ICU. Copyright © 2004 Inderscience Enterprises Ltd.

Assessing the effectiveness of business support services in England:evidence from a theory based evaluation

In England, publicly supported advice to small firms is organized primarily through the Business Link (BL) network. Using the programme theory underlying this business support, we develop four propositions and test these empirically using data from a new survey of over 3000 English SMEs. We find strong support for the value to BL operators of a high profile to boost take-up. We find support for the BL’s market segmentation that targets intensive assistance to younger firms and those with limited liability. Allowing for sample selection, we find no significant effects on growth from ‘other’ assistance but find a significant employment boost from intensive assistance. This partially supports the programme theory assertion that BL improves business growth and strongly supports the proposition that there are differential outcomes from intensive and other assistance. This suggests an improvement in the BL network, compared with earlier studies, notably Roper et al. (2001), Roper and Hart (2005).

A profile of low vision services in England the Low Vision Service Model Evaluation (LOVSME) project

In the UK, low vision rehabilitation is delivered by a wide variety of providers with different strategies being used to integrate services from health, social care and the voluntary sector. In order to capture the current diversity of service provision the Low vision Service Model Evaluation (LOVSME) project aimed to profile selected low vision services using published standards for service delivery as a guide. Seven geographically and organizationally varied low-vision services across England were chosen for their diversity and all agreed to participate. A series of questionnaires and follow-up visits were undertaken to obtain a comprehensive description of each service, including the staff workloads and the cost of providing the service. In this paper the strengths of each model of delivery are discussed, and examples of good practice identified. As a result of the project, an Assessment Framework tool has been developed that aims to help other service providers evaluate different aspects of their own service to identify any gaps in existing service provision, and will act as a benchmark for future service development.

Effect of disability glare on visual performance

The object of the study was to investigate, establish and quantify the relationship between contrast sensitivity, intraocular light scatter and glare. The aim was to establish the effects on vision, in an effort to provide a more comprehensive understanding of the visual world of subjects prone to increased light scatter in the eye. Disability glare refers to the reduction in visual performance produced by a glare source. The reduction in visual performance can be explained by intraocular scattered light producing a veiling luminance which is superimposed upon the retinal image. This veiling luminance lowers contrast thus sensitivity to the stimulus declines. The effect of glare of luminance and colour contrast sensitivity for young and elderly subjects was examined. For both age groups, disability glare was greatest for the red-green stimulus and least for the blue-yellow. The precise effect of a glare source on colour discrimination depends upon the interaction between the chromaticity of the glare source and that of the stimulus. The effect of a long wavelength pass (red) and a short wavelength pass filter (blue) on disability glare was examined. Disability glare was not significantly different with the red and blue filters, even in the presence of wavelength dependent scatter. An equation was derived which allowed an intrinsic Light Scatter Factor (LSF) to be determined for any given glare angle (Paulsson and Sjöstrand, 1980). Corrections to the formula to account for factors such as pupil size changes are unnecessary. The results confirm the suitability of measuring the LSF using contrast threshold with and without glare, provided that appropriate methods are used. Using this formula an investigation into the amount of wavelength dependent scatter indicated that wavelength dependent scatter in normal young, elderly or cataractous eyes is of little or no significance. Finally, it seemed desirable to investigate the effect ultraviolet (UV) radiation has on intraocular light scatter and subsequently visual performance. Overall the results indicated that the presence or absence of UV radiation has relatively little effect on visual function for the young, elderly or cataract patient.

Towards an operations strategy for the infusion of product-centric services into manufacturing:service systems implementation

The work in this chapter is concerned with product-centric servitization. This is where a portfolio of services are formed and integrated to support product availability and use. Such servitization can be a valuable source of revenue for a manufacturer, yet little attention has been given to the configuration of the wider operations strategy that needs to be in place to deliver integrated products and services successfully. Therefore, the purpose of this chapter is to put forward a generic set of characteristics for such operations. Our intention is that these characteristics will be valuable to practitioners contemplating sophisticated forms of servitization, as they suggest the likely and significant changes that will be needed to the operations strategy of a conventional manufacturing organisation.

The link between HR practices, psychological contract fulfillment, and organizational performance:the case of the Greek services sector

The purpose of this study is to investigate the impact of human resource (HR) practices on organizational performance through the mediating role of psychological contract (expressed by the influence of employer on employee promises fulfillment through employee attitudes). The study is based on a national sample of 78 organizations from the public and private services sector in Greece, including education, health, and banking, and on data obtained from 348 employees. The statistical method employed is structural equation modeling, via LISREL and bootstrapping estimation. The findings of the study suggest that employee incentives, performance appraisal, and employee promotion are three major HR practices that must be extensively employed. Furthermore, the study suggests that the organization must primarily keep its promises about a pleasant and safe working environment, respectful treatment, and feedback for performance, in order for employees to largely keep their own promises about showing loyalty to the organization, maintaining high levels of attendance, and upholding company reputation. Additionally, the study argues that the employee attitudes of motivation, satisfaction, and commitment constitute the nested epicenter mediating construct in both the HR practices–performance and employer–employee promise fulfillment relationships, resulting in superior organizational performance. © 2012 Wiley Periodicals, Inc.

A comprehensive approach to quality management of intensive care services

Purpose – The purpose of this paper is to develop a comprehensive framework for improving intensive care unit performance. Design/methodology/approach – The study introduces a quality management framework by combining cause and effect diagram and logical framework. An intensive care unit was identified for the study on the basis of its performance. The reasons for not achieving the desired performance were identified using a cause and effect diagram with the stakeholder involvement. A logical framework was developed using information from the cause and effect diagram and a detailed project plan was developed. The improvement projects were implemented and evaluated. Findings – Stakeholders identified various intensive care unit issues. Managerial performance, organizational processes and insufficient staff were considered major issues. A logical framework was developed to plan an improvement project to resolve issues raised by clinicians and patients. Improved infrastructure, state-of-the-art equipment, well maintained facilities, IT-based communication, motivated doctors, nurses and support staff, improved patient care and improved drug availability were considered the main project outputs for improving performance. The proposed framework is currently being used as a continuous quality improvement tool, providing a planning, implementing, monitoring and evaluating framework for the quality improvement measures on a sustainable basis. Practical implications – The combined cause and effect diagram and logical framework analysis is a novel and effective approach to improving intensive care performance. Similar approaches could be adopted in any intensive care unit. Originality/value – The paper focuses on a uniform model that can be applied to most intensive care units.

A survey of semantic web services formalisms

The field of Semantic Web Services (SWS) has been recognized as one of the most promising areas of emergent research within the Semantic Web initiative, exhibiting an extensive commercial potential and attracting significant attention from both industry and the research community. Currently, there exist several different frameworks and languages for formally describing a Web Service: Web Ontology Language for Services (OWL-S), Web Service Modelling Ontology (WSMO) and Semantic Annotations for the Web Services Description Language (SAWSDL) are the most important approaches. To the inexperienced user, choosing the appropriate platform for a specific SWS application may prove to be challenging, given a lack of clear separation between the ideas promoted by the associated research communities. In this paper, we systematically compare OWL-S, WSMO and SAWSDL from various standpoints, namely, that of the service requester and provider as well as the broker-based view. The comparison is meant to help users to better understand the strengths and limitations of these different approaches to formalizing SWS, and to choose the most suitable solution for a given application. Copyright © 2015 John Wiley & Sons, Ltd.

A survey of semantic web services formalisms

The field of Semantic Web Services (SWS) has been recognized as one of the most promising areas of emergent research within the Semantic Web (SW) initiative, exhibiting an extensive commercial potential, and attracting significant attention from both industry and the research community. Currently, there exist several different frameworks and languages for formally describing a Web Service: OWL-S (Web Ontology Language for Services), WSMO (Web Service Modeling Ontology) and SAWSDL (Semantic Annotations for the Web Services Description Language) are the most important approaches. To the inexperienced user, choosing the appropriate paradigm for a specific SWS application may prove to be challenging, given a lack of clear separation between the ideas promoted by the associated research communities. In this paper, we systematically compare OWL-S, WSMO and SAWSDL from various standpoints, namely that of the service requester and provider as well as the broker based view. The comparison is meant to help users to better understand the strengths and limitations of these different approaches to formalising SWS, and to choose the most suitable solution for a given use case. © 2013 IEEE.

Evaluation of low vision services on the quality of life of individuals with age-related macular degeneration

Background: Age-related macular degeneration (ARMD) is a major cause of irreversible visual loss in the elderly and a significant threat to their quality of life. Although low vision services often improve the functional outcomes of individuals with macular disease, it remains unclear whether or not they have any impact on quality of life. The principal aim of this study was to determine the effect of a hospital-based low vision clinic on the quality of life of individuals with ARMD. Methods: Forty patients with ARMD attended the low vision clinic at Milton Keynes University Hospital. Quality of life was measured with the vision-specific Low Vision Quality of Life (LVQOL) questionnaire and the general health EuroQol (EQ-5D-5L) questionnaire. Measures were completed at baseline (time zero, T0), and at three- (T3) and six-month (T6) follow-up visits. Results: The near visual acuity of individuals attending the low vision clinic for the first time improved significantly between visits T0 and T3 (p=0.005), reflecting the practiced use of their newly-dispensed low vision aids. As expected, there was no significant change in near acuity over this time period for existing patients. For both new and existing patients, a significant increase in LVQOL score was evident between visits T0 and T3, with a further significant improvement between T3 and T6. Similarly, there was a significant decrease in EQ-5D-5L questionnaire scores between visits T0 and T6. Conclusions: The higher LVQOL scores obtained at the end of the study period (T6) provide evidence that low vision services at Milton Keynes University Hospital served to improve patient quality of life. The reduction in EQ-5D-5L scores over the same time period suggests that low vision services also provide for an improvement in general health-related quality of life. Impact: The findings support the cause of low vision services to improve not only the vision and functional outcomes of individuals with macular disease but also their quality of life. Moreover, the findings suggest that a more efficient allocation of resources at low vision clinics may be possible through the standardisation of patient follow-up frequency.