Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

State of Illinois Environmental Protection Agency 208 water quality management planning program.

Cover and spine title: Water quality management plan.

TDQAS : Training Development Quality Assurance System : clients.

"September 1989."

Who's really hypertensive? - Quality control issues in the assessment of blood pressure for randomized trials

The characterization of blood pressure in treatment trials assessing the benefits of blood pressure lowering regimens is a critical factor for the appropriate interpretation of study results. With numerous operators involved in the measurement of blood pressure in many thousands of patients being screened for entry into clinical trials, it is essential that operators follow pre-defined measurement protocols involving multiple measurements and standardized techniques. Blood pressure measurement protocols have been developed by international societies and emphasize the importance of appropriate choice of cuff size, identification of Korotkoff sounds, and digit preference. Training of operators and auditing of blood pressure measurement may assist in reducing the operator-related errors in measurement. This paper describes the quality control activities adopted for the screening stage of the 2nd Australian National Blood Pressure Study (ANBP2). ANBP2 is cardiovascular outcome trial of the treatment of hypertension in the elderly that was conducted entirely in general practices in Australia. A total of 54 288 subjects were screened; 3688 previously untreated subjects were identified as having blood pressure >140/90 mmHg at the initial screening visit, 898 (24%) were not eligible for study entry after two further visits due to the elevated reading not being sustained. For both systolic and diastolic blood pressure recording, observed digit preference fell within 7 percentage points of the expected frequency. Protocol adherence, in terms of the required minimum blood pressure difference between the last two successive recordings, was 99.8%. These data suggest that adherence to blood pressure recording protocols and elimination of digit preferences can be achieved through appropriate training programs and quality control activities in large multi-centre community-based trials in general practice. Repeated blood pressure measurement prior to initial diagnosis and study entry is essential to appropriately characterize hypertension in these elderly patients.

Through the lenses of organizational culture: A comparison of state-owned enterprises and joint ventures in China

This study compared state-owned enterprises (SOEs) and joint ventures (JVs) in light of organizational culture practices. Data were obtained via a survey participated by 781 respondents from five enterprises. Factoring identified four cultural dimensions: Participation, Teamwork, Supervision, and Meetings. All four dimensions, except Participation, were rated significantly higher by respondents from SOEs as compared to the ratings in JVs. Based on the findings, this study concluded that culture practices valued in one type of enterprise might be liability in another. The implication for management is to gear culture practices to the characteristics of the organization to make it successful.

Development of a web-service-agents-based family wealth management system

The roiling financial markets, constantly changing tax law and increasing complexity of planning transaction increase the demand of aggregated family wealth management (FWM) services. However, current trend of developing such advisory systems is mainly focusing on financial or investment side. In addition, these existing systems lack of flexibility and are hard to be integrated with other organizational information systems, such as CRM systems. In this paper, a novel architecture of Web-service-agents-based FWM systems has been proposed. Multiple intelligent agents are wrapped as Web services and can communicate with each other via Web service protocols. On the one hand, these agents can collaborate with each other and provide comprehensive FWM advices. On the other hand, each service can work independently to achieve its own tasks. A prototype system for supporting financial advice is also presented to demonstrate the advances of the proposed Webservice- agents-based FWM system architecture.

Human resource management and organizational performance:evidence from the retail banking sector

Underpinned by the resource-based view (RBV), social exchange theory (SET), and a theory of intrinsic motivation (empowerment), I proposed and tested a multi-level model that simultaneously examines the intermediate linkages or mechanisms through which HPWS impact individual and organizational performance. First and underpinned by RBV, I examined at the unit level, collective human capital and competitive advantage as path-ways through which the use of HPWS influences – branch market performance. Second and-, underpinned by social exchange (perceived organizational support) and intrinsic motivation (psychological empowerment) theories, I examined cross and individual level mechanisms through which experienced HPWS may influence employee performance. I tested the propositions of this study with multisource data obtained from junior and senior customer contact employees, and managers of 37 branches of two banks in Ghana. Results of the Structural Equation Modeling (SEM) analysis revealed that (i) collective human capital partially mediated the relationship between management-rated HPWS and competitive advantage, while competitive advantage completely mediated the influence of human capital on branch market performance. Consequently, management-rated HPWS influenced branch market performance indirectly through collective human capital and competitive advantage. Additionally, results of hierarchical linear modeling (HLM) tests of the cross-level influences on the motivational implications of HPWS revealed that (i) management-rated HPWS influenced experienced HPWS; (ii) perceived organizational support (POS) and psychological empowerment fully mediated the influence of experienced HPWS on service-oriented organizational citizenship behaviour (OCB), and; (iii) service-oriented OCB mediated the influence of psychological empowerment and POS on service quality and task performance. I discuss the theoretical and practical implications of these findings.

Integrated approach to healthcare quality management:a case study

Purpose - The purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically. Design/methodology/approach - This paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare services (Operating room utilization, 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 paper shows LFA application in three service processes in one hospital. However, ideally this is required to be tested in several hospitals and other services as well. Practical implications - In the paper the proposed model can be practised in hospital-based healthcare services for improving performance. Originality/value - The paper shows that 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 health care delivery and corrective measures are taken for superior performance, there is an absence of an integrated approach, which can identify and analyze issues, provide solutions to resolve those issues, develop a project management framework (planning, monitoring, and evaluating) to implement those solutions in order to improve process performance. This study introduces an integrated and uniform quality management tool. It integrates operations with organizational strategies. © Emerald Group Publishing Limited.

A simulation of a workflow management system

Suggests that simulation of the workflow component of a computer supported co-operative work (CSCW) system has the potential to reduce the costs of system implementation, while at the same time improving the quality of the delivered system. Demonstrates the value of being able to assess the frequency and volume of workflow transactions using a case study of CSCW software developed for estate agency co-workers in which a model was produced based on a discrete-event simulation approach with implementation on a spreadsheet platform.

Knowledge management in a New Zealand tree farming company:Ambiguity and resistance to the "technology solution"

Purpose - Managers at the company attempt to implement a knowledge management information system in an attempt to avoid loss of expertise while improving control and efficiency. The paper seeks to explore the implications of the technological solution to employees within the company. Design/methodology/approach - The paper reports qualitative research conducted in a single organization. Evidence is presented in the form of interview extracts. Findings - The case section of the paper presents the accounts of organizational participants. The accounts reveal the workers' reactions to the technology-based system and something of their strategies of resistance to the system. These accounts also provide glimpses of the identity construction engaged in by these knowledge workers. The setting for the research is in a knowledge-intensive primary industry. Research was conducted through observation and interviews. Research limitations/implications - The issues identified are explored in a single case-study setting. Future research could look at the relevance of the findings to other settings. Practical implications - The case evidence presented indicates some of the complexity of implementation of information systems in organizations. This could certainly be seen as more evidence of the uncertainty associated with organizational change and of the need for managers not to expect an easy adoption of intrusive IT solutions. Originality/value - This paper adds empirical insight to a largely conceptual literature. © Emerald Group Publishing Limited.

Quality management (QM) implementation in the Kuwaiti Oil Industry:An empirical study and a proposed generic framework

In an Arab oil producing country in the Middle East such as Kuwait, Oil industry is considered as the main and most important industry of the country. This industry’s importance emerged from the significant role it plays in both country’s national economy and also global economy. Moreover, Oil industry’s criticality comes from its interconnectivity with national security and power in the Middle East region. Hence, conducting this research in this crucial industry had certainly added values to companies in this industry as it investigated thoroughly the main components of the TQM implementation process and identified which components affects significantly TQM’s implementation and its gained business results. In addition, as the Oil sector is a large sector that is known for its richness of employees with different national cultures and backgrounds. Thus, this culture-heterogeneous industry seems to be the most appropriate environment to address and satisfy a need in the literature to investigate the national culture values’ effects on TQM implementation process. Furthermore, this research has developed a new conceptual model of TQM implementation process in the Kuwaiti Oil industry that applies in general to operations and productions organizations at the Kuwaiti business environment and in specific to organizations in the Oil industry, as well it serves as a good theoretical model for improving operations and production level of the oil industry in other developing and developed countries. Thus, such research findings minimized the literature’s gap found the limited amount of empirical research of TQM implementation in well-developed industries existing in an Arab, developing countries and specifically in Kuwait, where there was no coherent national model for a universal TQM implementation in the Kuwaiti Oil industry in specific and Kuwaiti business environment in general. Finally, this newly developed research framework, which emerged from the literature search, was validated by rigorous quantitative analysis tools including SPSS and Structural Equation Modeling. The quantitative findings of questionnaires collected were supported by the qualitative findings of interviews conducted.