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.

Global HR roles and factors influencing their development:evidence from emerging Indian IT services multinationals

The rapid growth of emerging markets’ multinational companies (MNCs) is a recent phenomenon and, as such, their nature and structure of key management processes, functions, and roles need further examination. While an abundance of low-cost labor is often the starting point of competitive advantage for many of the emerging markets’ MNCs, it is the optimum configuration of people, processes, and technology that defines how they leverage their intangible resources. Based on case studies of four Indian IT services MNCs, involving 51 in-depth interviews of business and human resource (HR) leaders at the corporate and subsidiary levels, we identify five key HR roles—namely, strategic business partner, guardian of culture, builder of global workforce and capabilities, champion of processes, and facilitator of employee development. The analysis also highlights that the HR function in Indian IT service MNCs faces several challenges in consolidating the early gains of internationalization, such as lack of decentralized decision making, developing a global mind-set, localization of the workforce, and developing a global leadership pipeline. Based on our exploratory findings, we propose a framework outlining the global HR roles pursued by emerging IT services MNCs, the factors influencing them, and the challenges facing their HR function for future research.

B2B service brand identity and brand performance:an empirical investigation in the UK’s B2B IT services sector

Purpose – This paper aims to apply the business-to-business (B2B) Service Brand Identity (SBI) scale to empirically assess the influence of service brand identity on brand performance for the first time. Design/methodology/approach – Based on data collected from 421 senior marketing executives, this paper applies the B2B SBI and structural equation modeling to fulfill the above purpose. Findings – Brand personality and human resource initiatives have a positive and significant influence on brand performance. Corporate visual identity, in addition to an employee and client focus, has an insignificant impact on performance. Consistent communications have a negative and significant influence on brand performance. Research limitations/implications – Data were only collected from executives in the UK. This research would benefit from replicative studies. Practical implications – This research empirically establishes the brand management activities that drive brand performance. Originality/value – This is the first empirical study to assess the influence service brand identity has on brand performance.

CloudMPL:a domain specific language for describing management policies for an autonomic cloud infrastructure

To benefit from the advantages that Cloud Computing brings to the IT industry, management policies must be implemented as a part of the operation of the Cloud. Among others, for example, the specification of policies can be used for the management of energy to reduce the cost of running the IT system or also for security policies while handling privacy issues of users. As cloud platforms are large, manual enforcement of policies is not scalable. Hence, autonomic approaches for management policies have recently received a considerable attention. These approaches allow specification of rules that are executed via rule-engines. The process of rules creation starts by the interpretation of the policies drafted by high-rank managers. Then, technical IT staff translate such policies to operational activities to implement them. Such process can start from a textual declarative description and after numerous steps terminates in a set of rules to be executed on a rule engine. To simplify the steps and to bridge the considerable gap between the declarative policies and executable rules, we propose a domain-specific language called CloudMPL. We also design a method of automated transformation of the rules captured in CloudMPL to the popular rule-engine Drools. As the policies are changed over time, code generation will reduce the time required for the implementation of the policies. In addition, using a declarative language for writing the specifications is expected to make the authoring of rules easier. We demonstrate the use of the CloudMPL language into a running example extracted from a management energy consumption case study.

It takes an institution's village to retain a student: A comprehensive look at two early warning system undergraduate retention programs and administrators' perceptions of students' experiences and the retention services they provide students in the early warning system retention programs

Institutions have implemented many campus interventions to address student persistence/retention, one of which is Early Warning Systems (EWS). However, few research studies show evidence of interventions that incorporate noncognitive factors/skills, and psychotherapy/psycho-educational processes in the EWS. A qualitative study (phenomenological interview and document analysis) of EWS at both a public and private 4-year Florida university was conducted to explore EWS through the eyes of the administrators of the ways administrators make sense of students' experiences and the services they provide and do not provide to assist students. Administrators' understanding of noncognitive factors and the executive skills subset and their contribution to retention and the executive skills development of at-risk students were also explored. Hossler and Bean's multiple retention lenses theory/paradigms and Perez's retention strategies were used to guide the study. Six administrators from each institution who oversee and/or assist with EWS for first time in college undergraduate students considered academically at-risk for attrition were interviewed. Among numerous findings, at Institution X: EWS was infrequently identified as a service, EWS training was not conducted, numerous cognitive and noncognitive issues/deficits were identified for students, and services/critical departments such as EWS did not work together to share students' information to benefit students. Assessment measures were used to identify students' issues/deficits; however, they were not used to assess, track, and monitor students' issues/deficits. Additionally, the institution's EWS did address students' executive skills function beyond time management and organizational skills, but did not address students' psychotherapy/psycho-educational processes. Among numerous findings, at Institution Y: EWS was frequently identified as a service, EWS training was not conducted, numerous cognitive and noncognitive issues/deficits were identified for students, and services/critical departments such as EWS worked together to share students' information to benefit students. Assessment measures were used to identify, track, and monitor students' issues/deficits; however, they were not used to assess students' issues/deficits. Additionally, the institution's EWS addressed students' executive skills function beyond time management and organizational skills, and psychotherapy/psycho-educational processes. Based on the findings, Perez's retention strategies were not utilized in EWS at Institution X, yet were collectively utilized in EWS at Institution Y, to achieve Hossler and Bean's retention paradigms. Future research could be designed to test the link between engaging in the specific promising activities identified in this research (one-to-one coaching, participation in student success workshops, academic contracts, and tutoring) and student success (e.g., higher GPA, retention). Further, because this research uncovered some concern with how to best handle students with physical and psychological disabilities, future research could link these same promising strategies for improving student performance for example among ADHD students or those with clinical depression.

Use of public oral health services by the adult population: a multilevel analysis

Background It is important to assess context to explain inequalities in oral health, particularly with regard to the type of service used; thus, this study aimed to identify the social determinants of public dental service use by adults and to assess whether, beyond the level individual, existing inequalities are also expressed in the context in which individuals are embedded. Methods A multilevel analysis with three levels of aggregation of variables was performed. The individual variables were derived from the database of the SB Minas Gerais project—a survey of oral health status of the population of Minas Gerais, a state of the Brazilian Southeast region. The variable at the neighborhood level came from the Census of 2010. The variables at the municipal level were obtained from available public databases relating to oral health services. At the municipal level, the Human Development Index (HDI) variable was chosen to represent quality of life in the municipalities. Results In the final model, the following individual variables were associated with greater use of public dental services: lower income (PR = 1.98, 95% CI = 1.53; 2.58), higher number of residents at home (PR = 1.37, 95% CI = 1.11; 1.68) and higher number of teeth requiring treatment (PR = 1.49, 95% CI = 1.20; 1.84). With regard to context variables, a poorer infrastructure (PR = 0.62, 95% CI = 0.40; 0.96) leads to a lower use of public services. Conclusion The use of public services is associated with family income, how this income is divided in households, the need for treatment presented by the individual and the organization of the existing oral health service infrastructure in the municipality.

Design and Implementation of a Cloud Infrastructure for Distributed Scientific Calculation

Cloud computing enables independent end users and applications to share data and pooled resources, possibly located in geographically distributed Data Centers, in a fully transparent way. This need is particularly felt by scientific applications to exploit distributed resources in efficient and scalable way for the processing of big amount of data. This paper proposes an open so- lution to deploy a Platform as a service (PaaS) over a set of multi- site data centers by applying open source virtualization tools to facilitate operation among virtual machines while optimizing the usage of distributed resources. An experimental testbed is set up in Openstack environment to obtain evaluations with different types of TCP sample connections to demonstrate the functionality of the proposed solution and to obtain throughput measurements in relation to relevant design parameters.

Revealing Cultural Ecosystem Services through Instagram Images : The Potential of Social Media Volunteered Geographic Information for Urban Green Infrastructure Planning and Governance

With the prevalence of smartphones, new ways of engaging citizens and stakeholders in urban planning and govern-ance are emerging. The technologies in smartphones allow citizens to act as sensors of their environment, producing and sharing rich spatial data useful for new types of collaborative governance set-ups. Data derived from Volunteered Geographic Information (VGI) can support accessible, transparent, democratic, inclusive, and locally-based governance situations of interest to planners, citizens, politicians, and scientists. However, there are still uncertainties about how to actually conduct this in practice. This study explores how social media VGI can be used to document spatial tendencies regarding citizens’ uses and perceptions of urban nature with relevance for urban green space governance. Via the hashtag #sharingcph, created by the City of Copenhagen in 2014, VGI data consisting of geo-referenced images were collected from Instagram, categorised according to their content and analysed according to their spatial distribution patterns. The results show specific spatial distributions of the images and main hotspots. Many possibilities and much potential of using VGI for generating, sharing, visualising and communicating knowledge about citizens’ spatial uses and preferences exist, but as a tool to support scientific and democratic interaction, VGI data is challenged by practical, technical and ethical concerns. More research is needed in order to better understand the usefulness and application of this rich data source to governance.

Sustainability of Open Access Services: Phase 4 Workshop report

Phase 4: Review of the conditions under which individual services and platforms can be sustained On Tuesday 1 October 2013, in Bristol, United Kingdom, Knowledge Exchange brought together a group of international Open Access Service providers to discuss the sustainability of their services. A number of recurring lessons learned were mentioned; Though project funding can be used to start up a service, it does not guarantee the continuation of a service and it can be hard to establish the service as a viable entity, standing on its own feet. Research funders should be aware that if they have policies or mandates for making research outputs available they will eventually also be responsible for on-going support for the underlying infrastructure. At present some services are used globally but the costs are only covered by a limited geographic spread, sometimes only a number of institutions or only one country. Finding other funding sources can be challenging. Various routes were mentioned including commercial partnerships, memberships, offering additional paid services or using a Freemium model. There is not one model that will fit all. As more services turn to library sponsorship to sustain them, one strategy might be to bundle the requests and approach a group of research and infrastructure funders or institutions (and others) with a package rather than each service going through the same resource consuming process of soliciting funding. This will also allow the community to identify gaps, dependencies and overlap in the services. The possibility of setting up an organisation to bundle the services was discussed and a number of risks were identified.

Evaluating green infrastructure in urban environments using a multi-taxa and functional diversity approach

Forested areas within cities host a large number of species, responsible for many ecosystem services in urban areas. The biodiversity in these areas is influenced by human disturbances such as atmospheric pollution and urban heat island effect. To ameliorate the effects of these factors, an increase in urban green areas is often considered sufficient. However, this approach assumes that all types of green cover have the same importance for species. Our aim was to show that not all forested green areas are equal in importance for species, but that based on a multi-taxa and functional diversity approach it is possible to value green infrastructure in urban environments. After evaluating the diversity of lichens, butterflies and other-arthropods, birds and mammals in 31 Mediterranean urban forests in south-west Europe (Almada, Portugal), bird and lichen functional groups responsive to urbanization were found. A community shift (tolerant species replacing sensitive ones) along the urbanization gradient was found, and this must be considered when using these groups as indicators of the effect of urbanization. Bird and lichen functional groups were then analyzed together with the characteristics of the forests and their surroundings. Our results showed that, contrary to previous assumptions, vegetation density and more importantly the amount of urban areas around the forest (matrix), are more important for biodiversity than forest quantity alone. This indicated that not all types of forested green areas have the same importance for biodiversity. An index of forest functional diversity was then calculated for all sampled forests of the area. This could help decision-makers to improve the management of urban green infrastructures with the goal of increasing functionality and ultimately ecosystem services in urban areas.

How do customers of a financial services institution judge its communications

Communications are important for relationships within a marketing channel from both a theoretical and managerial perspective. Yet it is a problematic area for scholars. Thus, this research addresses the problem of how do customers of a financial services institution perceive communications with an ideal institution? This study's case research methodology used in-depth interviews with 34 carefully selected customers of a building society. The factors that make up customers' attitudes about corporate communications for an ideal financial services institution were identified and actual perceptions were compared against that ideal. The findings confirmed the importance of communications for customers in a relationship with a financial services provider and suggested communication priorities for customers in this context. In addition, the findings suggested sources of communication dissatisfaction for customers. These findings build upon the literature that speculates about customer perceptions of communications with organizations but provides little evidence to support hypotheses. The contributions arose from the emphasis on the customers' own attitudes and the patterns found within them.

Improving the Flexibility of Active Grids through Web Services

Active Grids are a form of grid infrastructure where the grid network is active and programmable. These grids directly support applications with value added services such as data migration, compression, adaptation and monitoring. Services such as these are particularly important for eResearch applications which by their very nature are performance critical and data intensive. We propose an architecture for improving the flexibility of Active Grids through web services. These enable Active Grid services to be easily and flexibly configured, monitored and deployed from practically any platform or application. The architecture is called WeSPNI ('Web Services based on Programmable Networks Infrastructure'). We present the architecture together with some early experimental results on using web services to monitor data movement in an active grid.

IT service desk process improvement : a narrative style case study

This paper is a detailed case narrative on how a Faculty of a leading Australian University conducted a rigorous process improvement project, applying fundamental Business Process Management (BPM) concepts. The key goal was to increase the efficiency of the faculty’s service desk. The decrease of available funds due to reducing student numbers and the ever increasing costs associated with service desk prompted this project. The outcomes of the project presented a set of recommendations which leads to organizational innovation having information technology as an enabler for change. The target audience includes general BPM practitioners or academics who are interested in BPM related case studies, and specific organisations who might be interested in conducting BPM within their service desk processes.

Exchange relationships in building services maintenance activity : a test of transaction cost economics and the resource dependency view

The firm is faced with a decision concerning the nature of intra-organizational exchange relationships with internal human resources and the nature or inter-organizational exchange relationships with market firms. In both situations, the firm can develop an exchange that ranges from a discrete exchange to a relational exchange. Transaction Cost Economics (TCE) and the Resource Dependency View (RDV) represent alternative efficiency-based explanations fo the nature of the exchange relationship. The aim of the paper is to test these two theories in respect of air conditioning maintenance in retail centres. Multiple sources of information are genereated from case studies of Australian retail centres to test these theories in respoect of internalized operations management (concerning strategic aspects of air conditioning maintenance) and externalized planned routine air conditioning maintenance. The analysis of the data centres on pattern matching. It is concluded that the data supports TCE - on the basis of a development in TCE's contractual schema. Further research is suggested towards taking a pluralistic stance and developing a combined efficiency and power hypothesis - upon which Williamson has speculated. For practice, the conclusions also offer a timely cautionary note concerning the adoption of one approach in all exchange relationships.