Managing healthcare quality using combined SWOT and the analytic process

Improving healthcare quality is a growing need of any society. Although various quality improvement projects are routinely deployed by the healthcare professional, they are characterised by a fragmented approach, i.e. they are not linked with the strategic intent of the organisation. This study introduces a framework which integrates all quality improvement projects with the strategic intent of the organisation. It first derives the strengths, weaknesses, opportunities and threats (SWOT) matrix of the system with the involvement of the concerned stakeholders (clinical professional), which helps identify a few projects, the implementation of which ensures achievement of desired quality. The projects are then prioritised using the analytic hierarchy process with the involvement of the concerned stakeholders (clinical professionals) and implemented in order to improve system performance. The effectiveness of the method has been demonstrated using a case study in the intensive care unit of Queen Elizabeth Hospital in Bridgetown, Barbados.

Life with sheepdogs:alternative metaphorical models of the doctoral research process revisited

The doctoral research process is the entry path for the academic profession. Traditionally it is explained by reference to another professional entry path, the industrial apprenticeship. Revisiting a paper and discussion originally held at the Marketing Education Group conference in 1991, we explore the implications and limitations of this metaphorical model, suggest alternatives and consider the interaction between student characteristics and supervisory approach. Through this process we offer marketing academics a vast range of unflattering metaphors to employ in describing themselves, their students, their supervisors and their colleagues.

The management of stress amongst professional carers within a social services department

This thesis considers four broad areas:(i) ANALYSIS OF THE STRESS FIELD.(a) research studies, relevant to the British Social Services considering the cultural setting, and the rigor with which they were conducted; (b) models of stress, specifically examining the theoretical soundness and practical application of the Medical, Engineering and Transactional models;(c) organisational models of stress relating specifically to human service organisations.(ii) QUALITATIVE AND QUANTITATIVE RESEARCH METHODOLOGIES.(a) the appropriate application of each respective methodology and the particular usefulness of qualitative research designs; (b) the relevance of understanding the language and terminology associated with the subject area prior to the implementation of survey methods; (iii) FIELDWORK.(a) Phase 1. By use of focus groups, in-depth interviews and diary keeping amongst a small range of teams and managers, the Researcher develops a basic conceptual framework of stress within a Social Services context. In addition a small scale personality inventory was administered to participants.(b) Phase 2. This consisted of three key elements: 6 case studies in which the Researcher implements and appraises the impact of a range of intervention strategies designed to assist teams and their managers in dealing more effectively with stress; the administration of a large scale survey to all the field social work teams within the Social Services Department; an analysis of the user role within the stress process by way of two focus groups.(iv) THEORETICAL DEVELOPMENT.

Doctoral work in translation studies as an interdisciplinary mutual learning process:how a translator, teacher educator and linguistic typologist worked together

The focus of this paper is on the doctoral research training experienced by one of the authors and the ways in which the diverse linguistic and disciplinary perspectives of her two supervisors (co-authors of this paper) mediated the completion of her study. The doctoral candidate is a professional translator/interpreter and translation teacher. The paper describes why and how she identified her research area and then focused on the major research questions in collaboration with her two supervisors, who brought their differing perspectives from the field of linguistics to this translation research, even though they are not translators by profession or disciplinary background and do not speak Korean. In addition, the discussion considers the focus, purpose and theoretical orientation of the research itself (which addressed questions of readability in translated English-Korean texts through detailed analysis of a corpus and implications for professional translator training) as well as the supervisory and conceptual processes and practices involved. The authors contend that doctoral research of this kind can be seen as a mutual learning process and that inter-disciplinary research can make a contribution not only to the development of rigorous research in the field of translation studies but also to the other disciplinary fields involved.

When does food refusal require professional intervention?

Food refusal can have the potential to lead to nutritional deficiencies, which increases the risk of a variety of communicable and non-communicable diseases. Deciding when food refusal requires professional intervention is complicated by the fact that there is a natural and appropriate stage in a child's development that is characterised by increased levels of rejection of both previously accepted and novel food items. Therefore, choosing to intervene is difficult, which if handled badly can lead to further food refusal and an even more limited diet. Food refusal is often based on individual preferences; however, it can also be defined through pathological behaviours that require psychological intervention. This paper presents and discusses several different types of food refusal behaviours; these are learningdependent, those that are related to a medical complication, selective food refusal, fear-based food refusal and appetiteawareness-autonomy-based food refusal. This paper describes the behaviours and characteristics that are often associated with each; however, emphasis is placed on the possibility that these different types of food refusal can often be co-morbid. The decision to offer professional intervention to the child and their family should be a holistic process based on the level of medical or psychological distress resulting from the food refusal. © 2009 Bentham Science Publishers Ltd.

"I'm a better manager":A biographic narrative study of the impact of personal trauma on the professional lives of managers in the UK

This doctoral study aims to understand how experiences of critical illness or bereavement affect the way managers view and approach their work and their relationships at work. This is an interpretative phenomenological study examining the subjective meanings of personal experience and is underpinned by biographic narratives from four participants and interviews with their nominated workplace witnesses (i.e. colleagues who worked alongside the individual at the time of their trauma). As a consequence of the findings that have emerged across this study, three contributions to theory are presented. All four participants described their traumas as a professional growth experience for themselves as managers, which resulted in self-reported and observed behaviour change at work. Consequently, the first area of theoretical contribution is a suggested extension to the post-traumatic growth (PTG) framework (Calhoun & Tedeschi, 2006) with the addition of a new behavioural dimension called ‘managerial growth’, when applied to the context of ‘ordinary’ organizations. The second area of theoretical contribution arose through the reflexive process that was created during data collection where participants and their witnesses remembered episodes of compassion interaction at work. The second area of contribution thus seeks to extend the existing model of compassion at work (Dutton, Worline, Frost and Lilius, 2006), by conceptualising compassion as a dyadic process between a compassion ‘giver’ and a compassion ‘receiver’ in which the compassion receiver ‘trusts or ‘mistrusts’; ‘discloses’ or ‘withholds’; ‘connects’ or ‘disconnects’ with the compassion giver. The third area of contribution is a new conceptualisation of reflexivity, ‘three-dimensional reflexivity’ (3DR) (Armstrong, Butler and Shaw, 2013). 3DR brings together three of the elements that have been missing from critically reflexive management research; by working with multiple variants of reflexivity in the same study; surfacing different reflexive voices to guard against the researcher’s (potentially) solipsistic own; and remaining sensitive to the concept of reflexive time. In doing so, 3DR not only provides a deeper understanding of individual lived experience; it is also a vehicle in which self-insight is gained. Furthermore, by engaging in its practice, those involved in this study have developed both personally and professionally as a result.

An Open Virtual World for Professional Development

The paper presents a study that focuses on the issue of sup-porting educational experts to choose the right combination of educational methodology and technology tools when designing training and learning programs. It is based on research in the field of adaptive intelligent e-learning systems. The object of study is the professional growth of teachers in technology and in particular that part of their qualification which is achieved by organizing targeted training of teachers. The article presents the process of creating and testing a system to support the decision on the design of training for teachers, leading to more effective implementation of technology in education and integration in diverse educational contexts. ACM Computing Classification System (1998): H.4.2, I.2.1, I.2, I.2.4, F.4.1.

Professionalism within pharmacy – the thoughts of Professional Leaders

To ascertain the thoughts of selected professional leaders on matters relating to pharmacist professionalism. These views will help build a picture of the professional status of pharmacy. Methods - Semi-structured interviews were conducted between July and November 2013 with representatives from eight UK pharmacy leadership bodies. The bodies were selected for their roles in pharmacy policy development, regulation and professional representation. The interviews were recorded and transcribed verbatim. Analysis by constant comparison identified a number of emerging themes. Results - The following emerging themes were identified from the interview data: Influence of the Pharmacy Landscape: Participants highlighted the role that pharmacy plays within the National Health Service and wider society and how future developments may affect the professional status currently afforded to pharmacists. Vocalising Pharmacy: Communication within the profession and also with those external to the profession, including other healthcare professionals and the general public, is important to ensure a high professional standing. The Impact of Commercialism: Professionalism and commercialism were generally seen to be antithetical and a rise in commercialism may adversely impact on external perceptions of the professionalism of pharmacy. Responsibility for Professionalism: The professional image of pharmacy is maintained by the individuals operating within it regardless of their scope of practice. It is the responsibility of all those individuals to ensure that they actively demonstrate ‘professional’ behaviours. The Journey to Professionalism: Acquiring a professional ethos is a continual process but there are stages in a pharmacist’s development that are considered particularly important. These include upbringing, undergraduate education and pre-registration training. Conclusions - Pharmacy’s professional status in the UK remains open to challenge and vital to retaining that status is the public perception of pharmacists. Future research examining pharmacy’s claims to professional status should focus on exploring the attitudes of the general public in addition to the views of pharmacists.

The risk of adverse selection and its management in the process of venture capital investment (The experience of Hungarian investors)

Venture capitalists can be regarded as financers of young, high-risk enterprises, seeking investments with a high growth potential and offering professional support above and beyond their capital investment. The aim of this study is to analyse the occurrence of information asymmetry between venture capital investors and entrepreneurs, with special regard to the problem of adverse selection. In the course of my empirical research, I conducted in-depth interviews with 10 venture capital investors. The aim of the research was to elicit their opinions about the situation regarding information asymmetry, how they deal with problems arising from adverse selection, and what measures they take to manage these within the investment process. In the interviews we also touched upon how investors evaluate state intervention, and how much they believe company managers are influenced by state support.

Facing a paradigm shift in professional credentialing: Preparedness of registered dietitians for Professional Development 2001

In the year 2001, the Commission on Dietetic Registration (CDR) will begin a new process of recertifying Registered Dietitians (RD) using a self-directed lifelong learning portfolio model. The model, entitled Professional Development 2001 (PD 2001), is designed to increase competency through targeted learning. This portfolio consists of five steps: reflection, learning needs assessment, formulation of a learning plan, maintenance of a learning log, and evaluation of the learning plan. By targeting learning, PD 2001 is predicted to foster more up-to-date practitioners than the current method that requires only a quantity of continuing education hours. This is the first major change in the credentialing system since 1975. The success or failure of the new system will impact the future of approximately 60,000 practitioners. The purpose of this study was to determine the readiness of RDs to change to the new system. Since the model is dependent on setting goals and developing learning plans, this study examined the methods dietitians use to determine their five-year goals and direction in practice. It also determined RD's attitudes towards PD 2001 and identified some of the factors that influenced their beliefs. A dual methodological design using focus groups and questionnaires was utilized. Sixteen focus groups were held during state dietetic association meetings. Demographic data was collected on the 132 registered dietitians who participated in the focus groups using a self-administered questionnaire. The audiotaped sessions were transcribed into 643 pages of text and analyzed using Non-numerical Unstructured Data - Indexing Searching and Theorizing (NUD*IST version 4). Thirty-four of the 132 participants (26%) had formal five-year goals. Fifty-four participants (41%) performed annual self-assessments. In general, dietitians did not currently have professional goals nor conduct self-assessments and they claimed they did not have the skills or confidence to perform these tasks. Major barriers to successful implementation of PD 2001 are uncertainty, misinterpretation, and misinformation about the process and purpose, which in turn contribute to negative impressions. Renewed vigor to provide a positive, accurate message along with presenting goal-setting strategies will be necessary for better acceptance of this professional development process. ^

Parent involvement on school advisory councils: A process evaluation at the middle school level

Increasing parental involvement was made an important goal for all Florida schools in educational reform legislation in the 1990's. A forum for this input was established and became known as the School Advisory Council (SAC). To demonstrate the importance of process and inclusion, a south Florida school district and its local teacher's union agreed on the following five goals for SACs: (a) to foster an environment of professional collaboration among all stakeholders, (b) to assist in the preparation and evaluation of the school improvement plan, (c) to address all state and district goals, (d) to serve as the avenue for authentic and representative input from all stakeholders, and (e) to ensure the continued existence of the consensus-building process on all issues related to the school's instructional program. ^ The purpose of this study was to determine to what extent and in what ways the parent members of one south Florida middle school's SAC achieved the five district goals during its first three years of implementation. The primary participants were 16 parents who served as members of the SAC, while 16 non-parent members provided perspective on parent involvement as “outside sources.” Being qualitative by design, factors such as school climate, leadership styles, and the quality of parental input were described from data collected from four sources: parent interviews, a questionnaire of non-parents, researcher observations, and relevant documents. A cross-case analysis of all data informed a process evaluation that described the similarities and differences of intended and observed outcomes of parent involvement from each source using Stake's descriptive matrix model. A formative evaluation of the process compared the observed outcomes with standards set for successful SACs, such as the district's five goals. ^ The findings indicated that parents elected to the SACs did not meet the intended goals set by the state and district. The school leadership did not foster an environment of professional collaboration and authentic decision-making for parents and other stakeholders. The overall process did not include consensus-building, and there was little if any input by parents on school improvement and other important issues relating to the instructional program. Only two parents gave the SAC a successful rating for involving parents in the decision-making process. Although compliance was met in many of the procedural transactions of the SAC, the reactions of parents to their perceived role and influence often reflected feelings of powerlessness and frustration with a process that many thought lacked meaningfulness and productivity. Two conclusions made from this study are as follows: (a) that the role of the principal in the collaborative process is pivotal, and (b) that the normative-re-educative approach to change would be most appropriate for SACs. ^

The politics of professional sports facility subsidies in Florida

Political leaders in urban settings regularly confront difficult decisions over how to distribute public funds. Those decisions may be even more controversial when they involve public subsidies of professional sports facilities. Yet, state and local governments in the United States have granted billions of dollars in financial and land-based subsidies for professional sports facilities over the past two decades, raising questions about how these types of corporate welfare decisions are made by local leaders. Scholarship on urban politics and community power suggests a number of theories to explain political influence. They include elitism, pluralism, political economy and growth machines, urban regimes, coalition theory, and minority empowerment. My hypothesis is that coalition theory, a theory that argues that public policy decisions are made by shifting, ad hoc alliances within a community, best describes these subsidy decisions. ^ To test this hypothesis I employ a public policy process model and develop a framework of variables that is used to methodically examine four sports facilities funding decisions in two Florida counties between 1977 and 1998: Joe Robbie Stadium and the American Airlines Arena in Miami-Dade, and the Ice Palace Arena and the Raymond James Stadium in Hillsborough County. The framework includes six variables that permit a rigorous examination of the actors involved in the decision, their interactions, and the political environment within which they operate. The variables are formal political structure, informal sector, subsidy proponents, subsidy opponents, public policy options, and public opinion. ^ This research rests on qualitative data gathered from interviews of public and private officials involved in subsidy decisions, public records, and media reports Employing a case study analysis, I offer a rich description of the decision making process to publicly fund sports stadiums and arenas in Florida. My findings confirm that the best theory to explain decisions to subsidize sports facilities is one in which short-term, temporary coalitions are formed to accomplish policy goals. ^

The effects of a professional development course on the teaching practices of P--12 classroom teachers

This follow-up study examined the long term effects of a staff development model on P–12 classroom teachers' instructional practices and dispositions regarding a curricular innovation. The sample, 44 private school practitioners who participated in the staff development program that used the model, was administered a survey at three checkpoints over a three year period to gather quantitative data regarding the participants' concerns about the curricular innovation. A comparison group of 19 practitioners also completed the survey. Qualitative data, gathered through interviews conducted with ten of the 44 participants, contributed to understanding the participants' perspectives on changes they perceived in their teaching practices as a result of the staff development. Elements of the model that were most instrumental in effecting those changes were identified. ^ The findings indicated that the participants demonstrated changes in the quality of their concerns, moving from self concerns and task concerns to impact concerns immediately following the training. The decrease in self concerns was sustained three years after the staff development, while task concerns increased and impact concerns returned to pre staff development levels. A significant difference in stages of concern between the participant and the comparison groups was noted at self and impact stages. ^ Findings revealed that participants changed their teaching practices and beliefs about instructional processes as a result of the staff development, becoming more collaborative and confident in implementing innovative approaches; they were perceived as leaders among their peers. Elements of the staff development model that participants identified as being influential in the change process included the opportunity for collaboration, authenticity of the training activities, and ongoing and comprehensive nature of the training. ^

Teachers' perceptions of the national board certification process: Developing a sense of professionalism

This study describes and explains the experiences and perceptions of six public school teachers who had undergone the National Board for Professional Teaching Standards national certification process as a vehicle for promoting a teacher's sense of professionalism. Of these six participants, two achieved National Board certification, two did not achieve National Board certification, and two are awaiting results of their certification status. The study took place over a period of eleven months and focused on the participants' perceptions regarding the National Board certification process as it affected their sense of (a) efficacy and (b) professionalism. Data for this collective case study were gathered from interviews, portfolios and videotapes, and artifacts. Using case analysis, this study's participants' responses gathered through the interview process were examined. ^ The findings indicated that participants had concerns about the National Board certification process in the following areas: process, sense of efficacy, and sense of professionalism. All participants reported the process to be overwhelmingly demanding. Analysis of the data also reveals that those who were successful in achieving National Board certification had a greater sense of efficacy than those who did not. A disappointing finding was that the National Board process impacting participants' sense of professionalism could not be sustained; however, the participants in this study suggested the process was a step towards providing opportunities for collaboration, collegiality, and reflective practice. This study raises the question as to whether or not the espoused purposes of National Board certification are achieved via the certification process. ^

A case study: Perceptions of the induction process of intern principals in Broward County Public Schools

The case study is a qualitative study of the perceptions of a purposeful sample of intern principal participants in Broward County Public School's 2001-2003 principal leadership induction program through survey, interview and document analysis of their experiences concerning their success or failure in achieving the position of principal. The study focused on constructs of professional and organizational socialization and instructional leadership that research suggests are vital and integrated components of the effective development of aspiring instructional leaders. ^ The findings revealed that purposeful mentoring, a variety of site placement, hands on practical experiences, in addition to the quality of experience measured by the number of years prior experience are positively reported to affect the degrees of success perceived by intern principals. The study validated the interrelatedness of the three constructs professional and organizational socialization and instructional leadership as components that are realized in the development process through formal and informal characteristics of socialization. The data gathered would be of benefit to principal leadership program designers to assist in their understanding of participants' successes and failures that influence individual needs based on their experience as perceived by this group. ^ Implications for further study are the need for better understanding of leadership development, continued reinforcement of best practices such as mentoring, site shadowing and coaching, clarification of the administrator's role, data analysis, curriculum implementation and student achievement. Organizations need to implement a common set of expectations, reasoning, attitudes, and understanding of purpose that guide behaviors. Recommendations are to design leadership induction programs to meet individual strengths and weaknesses not a one-size-fits-all program including a constructive and prescriptive two-way feedback system, select and assign mentors based on their expertise and candidate needs, varied site placements, develop skills to build collaborative relationships, and a standards based monitoring and assessment system to document program mastery and completion. ^