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.

Accountability, organisational learning and risks to patient safety in England: conflict or compromise?

This article examines the current risk regulation regime, within the English National Health Service (NHS), by investigating the two, sometimes conflicting, approaches to risk embodied within the field of policies towards patient safety. The first approach focuses on promoting accountability and is built on legal principles surrounding negligence and competence. The second approach focuses on promoting learning from previous mistakes and near-misses, and is built on the development of a ‘safety culture’. Previous work has drawn attention to problems associated with risk-based regulation when faced with the dual imperatives of accountability and organisational learning. The article develops this by considering whether the NHS patient safety regime demonstrates the coexistence of two different risk regulation regimes, or merely one regime with contradictory elements. It uses the heuristic device of ‘institutional logics’ to examine the coexistence of and interrelationship between ‘organisational learning’ and ‘accountability’ logics driving risk regulation in health care.

Understanding the role of self-identity in habitual risky behaviours: pedestrian road-crossing decisions across the lifespan

Self-identity as a careful pedestrian has not been fully considered in previous work on predicting intention to cross the road, or actual crossing behaviour, in non-optimal situations. Evidence suggests that self-identity may be a better predictor than attitudes in situations where decision-making styles have become habitual ways to respond. This study compared contributions of self-identity and attitudes to the prediction of intentions in two situations differing in level of habitual crossing expectation, and to crossing behaviour. Three hundred and sixty-two adults (17–92 years) completed a questionnaire measuring self-identity, attitudes, intentions, experience, social identity variables (e.g. age, gender) and personal limitations (mobility). Two hundred and five participants also completed a road-crossing simulation. Self-identity and attitude were both shown as significant independent predictors of intention in both situations. However, self-identity was less effective as a predictor in the higher risk scenario, where intention to perform the behaviour was lower, and for participants aged >75 years who had lower intention across scenarios. Self-identity strongly predicted intention to cross, which in turn predicted behaviour, but self-identity did not directly predict behaviour. Self-identity was strongly predicted by age. Implications for theories of compensation in older age and for design and targeting of pedestrian safety education are discussed.

An investigation into the relationship between pupil and accommodation responses during near vision

A Hamamatsu Video Area Analyser has been coupled with a modified Canon IR automatic optometer. This has allowed simultaneous recording of pupil diameter and accommodation response to be made both statically and continuously, a feature not common in previous studies. Experimental work concerned pupil and accommodation responses during near vision tasks under a variety of conditions. The effects of sustained near vision tasks on accommodation have usually been demonstrated by taking post-task measures under darkroom conditions. The possibility of similar effects on pupil diameter was assessed using static and continuous recordings following a near vision task. Results showed that is luminance levels remained unchanged by using a pre-and post-task bright-empty field then, although accommodation regressed to pre-task levels,pupil diameter remained for several minutes at the contstricted level induced by the task. An investigation into the effect of a sinusoidally-modulated blur-only accommodative stimulus on pupil response demonstrated that response may be reduced or absent despite robust accommodation responses. This suggests that blur-driven acommodation alone may not be sufficient to produce a pupil near response and that the presence of other cues may be necessary. Pupil response was investigated using a looming stimulus which produced an inferred-proximity cue. It was found that a pupil response could be induced which was in synchrony with the stimulus while closed-loop accommodation response was kept constant by the constraints of optical blur. The pupil diameter of young and elderly subjects undertaking a 5 minute reading task was measured to assess the contribution of pupil constriction to near vision function in terms of depth-of-focus. Results showed that in the young subjects pupil diameter was too large to have a significant effect on depth-of-focus although it may be increased in the elderly subjects. Pupil and accommodation reponses to a temporally-modulated stimulus containing all cues present in a normal visual environment was assessed and results showed that as stimulus temporal frequency increased, pupil response showed increasing phase lag relative to closed-loop accommodation. The results of this study suggest that it may be necessary to change the accepted view of the function of pupil response as part of the near vision triad and that further study would be of benefit in particular to designers of vision aids such as, for example, bifocal contact lenses.

Low level feature detection in human vision

Influential models of edge detection have generally supposed that an edge is detected at peaks in the 1st derivative of the luminance profile, or at zero-crossings in the 2nd derivative. However, when presented with blurred triangle-wave images, observers consistently marked edges not at these locations, but at peaks in the 3rd derivative. This new phenomenon, termed ‘Mach edges’ persisted when a luminance ramp was added to the blurred triangle-wave. Modelling of these Mach edge detection data required the addition of a physiologically plausible filter, prior to the 3rd derivative computation. A viable alternative model was examined, on the basis of data obtained with short-duration, high spatial-frequency stimuli. Detection and feature-making methods were used to examine the perception of Mach bands in an image set that spanned a range of Mach band detectabilities. A scale-space model that computed edge and bar features in parallel provided a better fit to the data than 4 competing models that combined information across scale in a different manner, or computed edge or bar features at a single scale. The perception of luminance bars was examined in 2 experiments. Data for one image-set suggested a simple rule for perception of a small Gaussian bar on a larger inverted Gaussian bar background. In previous research, discriminability (d’) has typically been reported to be a power function of contrast, where the exponent (p) is 2 to 3. However, using bar, grating, and Gaussian edge stimuli, with several methodologies, values of p were obtained that ranged from 1 to 1.7 across 6 experiments. This novel finding was explained by appealing to low stimulus uncertainty, or a near-linear transducer.

Influence of the generated power, measurement bandwidth, and noise level on intensity statistics of a quasi-CW Raman fiber laser

In the present paper we numerically study instrumental impact on statistical properties of quasi-CW Raman fiber laser using a simple model of multimode laser radiation. Effects, that have the most influence, are limited electrical bandwidth of measurement equipment and noise. To check this influence, we developed a simple model of the multimode quasi- CW generation with exponential statistics (i.e. uncorrelated modes). We found that the area near zero intensity in probability density function (PDF) is strongly affected by both factors, for example both lead to formation of a negative wing of intensity distribution. But far wing slope of PDF is not affected by noise and, for moderate mismatch between optical and electrical bandwidth, is only slightly affected by bandwidth limitation. The generation spectrum often becomes broader at higher power in experiments, so the spectral/electrical bandwidth mismatch factor increases over the power that can lead to artificial dependence of the PDF slope over the power. It was also found that both effects influence the ACF background level: noise impact decreases it, while limited bandwidth leads to its increase. © (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

Multi-level genetic algorithm for the resource-constrained re-entrant scheduling problem in the flow shop

The re-entrant flow shop scheduling problem (RFSP) is regarded as a NP-hard problem and attracted the attention of both researchers and industry. Current approach attempts to minimize the makespan of RFSP without considering the interdependency between the resource constraints and the re-entrant probability. This paper proposed Multi-level genetic algorithm (GA) by including the co-related re-entrant possibility and production mode in multi-level chromosome encoding. Repair operator is incorporated in the Multi-level genetic algorithm so as to revise the infeasible solution by resolving the resource conflict. With the objective of minimizing the makespan, Multi-level genetic algorithm (GA) is proposed and ANOVA is used to fine tune the parameter setting of GA. The experiment shows that the proposed approach is more effective to find the near-optimal schedule than the simulated annealing algorithm for both small-size problem and large-size problem. © 2013 Published by Elsevier Ltd.