What is shared services?

Purpose This chapter discusses the constitution of Shared Services and the value of a consensual agreement of a definition for academe and practice. It explores the operating principles and services, the concepts of internal customer and internal service, and their importance for the practitioner and research communities. Methodology/approach This chapter employed a broad review of the literature to examine Shared Services. The research team used NVivo as a tool to create a database of key articles and books to analyze the key concepts and topics. Findings There is a lack of consensus on the definition of Shared Services in the research and practitioner community. Additionally, the concept of internal customer requires greater exploration and understanding within the context of Shared Services. How Shared Services provides competitive advantage to organizations is also not well understood. Research limitations/implications This discussion provides a challenge to the research community to focus on the contributions of shared services to business management theory. This requires a consensus that is currently nonexistent, to ensure the correct use of the terminology and model. Practical implications By establishing a clearer understanding of what is Shared Services, the academic and the practitioner community, in particular, will gain greater competencies on Shared Services to support change management programs during the implementation phases and minimize implementation costs by lowering organizational and people resistance. The variants in shared services terminology create confusion which is likely to result in ambiguity during implementation and have practical implications on governance, customers and service, benefits realization and performance. Originality/value of chapter This chapter addresses the lack of agreed definition of the term Shared Services and the role of the internal customer and consequent internal service delivery.

Spatially explicit perceptions of ecosystem services and land cover change in forested regions of Borneo

Spatially explicit information on local perceptions of ecosystem services is needed to inform land use planning within rapidly changing landscapes. In this paper we spatially modelled local people's use and perceptions of benefits from forest ecosystem services in Borneo, from interviews of 1837 people in 185 villages. Questions related to provisioning, cultural/spiritual, regulating and supporting ecosystem services derived from forest, and attitudes towards forest conversion. We used boosted regression trees (BRTs) to combine interview data with social and environmental predictors to understand spatial variation of perceptions across Borneo. Our results show that people use a variety of products from intact and highly degraded forests. Perceptions of benefits from forests were strongest: in human-altered forest landscapes for cultural and spiritual benefits; in human-altered and intact forests landscapes for health benefits; intact forest for direct health benefits, such as medicinal plants; and in regions with little forest and extensive plantations, for environmental benefits, such as climatic impacts from deforestation. Forest clearing for small scale agriculture was predicted to be widely supported yet less so for large-scale agriculture. Understanding perceptions of rural communities in dynamic, multi-use landscapes is important where people are often directly affected by the decline in ecosystem services.

Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

Australian paramedic graduates transitioning into UK NHS ambulance services: what are the potential challenges?

With United Kingdom (UK) Ambulance National Health Service (NHS) Trusts and Foundation Trusts actively recruiting Australian paramedic graduates, this article seeks to stimulate discussion by identifying differences existing between the two ambulance systems, as well as highlighting potential challenges that Australian graduates may face when transitioning to the UK ambulance service. It also identifies similarities between Australian and UK ambulance systems, which may assist new graduates to overcome the transition shock. This article suggests that transition shock is not solely related to Australian graduates moving to the UK, and may well be present for graduates moving to comparable international ambulance services in Canada, the Middle East, Ireland and South Africa.

Identifying relevant information for emergency services from twitter in response to natural disaster

This project proposes a framework that identifies high‐value disaster-based information from social media to facilitate key decision-making processes during natural disasters. At present it is very difficult to differentiate between information that has a high degree of disaster relevance and information that has a low degree of disaster relevance. By digitally harvesting and categorising social media conversation streams automatically, this framework identifies highly disaster-relevant information that can be used by emergency services for intelligence gathering and decision-making.

Support services for higher degree research students: A survey of three Australian universities

A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

Assistance arrangements and use of services among persons with multiple sclerosis and their caregivers

A large population-based survey of persons with multiple sclerosis (MS) and their caregivers was conducted in Ontario using self-completed mailed questionnaires. The objectives included describing assistance arrangements, needs, and use of and satisfaction with services, and comparing perceptions of persons with MS and their caregivers. Response rates were 83% and 72% for those with MS and caregivers, respectively. Based on 697 respondents with MS whose mean age is 48 years, 70% are female, and 75% are married. While 24% experience no mobility restrictions, the majority require some type of aid or a wheelchair for getting around. Among 345 caregivers, who have been providing care for 9 years on average, the majority are spouses. Caregivers report providing more frequent care than do persons with MS report receiving it, particularly for the following activities of daily living: eating, meal preparation, and help with personal finances. Caregivers also report assistance of longer duration per day than do care recipients with MS. Frequency and duration of assistance are positively associated with increased MS symptom severity and reduced mobility. Generally there is no rural-urban disparity in service provision, utilization or satisfaction, and although there is a wide range of service utilization, satisfaction is consistently high. Respite care is rarely used by caregivers. Use of several services is positively associated with increased severity of MS symptoms and reduced mobility. Assistance arrangements and use of services, each from the point of view of persons with MS and their caregivers, must be taken into account in efforts to prolong home care and to postpone early institutionalization of persons with MS.

“I have to rest all the time because you are not allowed to play”: Exploring children’s perceptions of autonomy during sleep-time in long day care services

Daytime sleep is a significant part of the daily routine for children attending early childhood education and care (ECEC) services in Australia and many other countries. The practice of sleep-time can account for a substantial portion of the day in ECEC and often involves a mandated sleep/rest period for all children, including older preschool-aged children. Yet, there is evidence that children have a reduced need for daytime sleep as they approach school entry age and that continuation of mandated sleep-time in ECEC for preschool-aged children may have a negative impact on their health, development, learning and well-being. Mandated sleep-time practices also go against current quality expectations for services to support children’s agency and autonomy in ECEC. This study documents children’s reports of their experiences of sleep-time in ECEC. Semi-structured interviews were conducted with 54 preschool-aged children (44–63 months) across four long day ECEC services that employed a range of sleep-time practices. Findings provide a snapshot of children’s views and experiences of sleep-time and perceptions of autonomy-supportive practices. These provide a unique platform to support critical reflection on sleep-time policies and practices, with a view to continuous quality improvement in ECEC. This study forms part of a programme of work from the Sleep in Early Childhood research group. Our work examines sleep practices in ECEC, the subsequent staff, parent and child experiences and impacts on family and child learning and development outcomes.

Factors influencing sustainability of health service innovation: Emergency nurse practitioner services

Introduction: Emergency department nurse practitioner services are one of the most frequently implemented service delivery models in Australian hospitals. This research examined factors influencing sustainability of this innovative service delivery model and offers some recommendations for future service integration. Background Many health service innovations have been implemented in an attempt to meet the growing demand for efficient, cost effective health care however, sustainability of many of these innovations has not been evaluated and is poorly understood. Aim The aim of the research was to identify factors that influence sustainability of emergency department nurse practitioner services and to operationalise a theoretical framework for evaluating innovation sustainability. Methodology The research used case study methodology. The case was emergency nurse practitioner services, and units of analysis were emergency department staff, emergency nurse practitioners and documents relating to nurse practitioner services. The data collection methods included, survey, one-on-one interviews, document analysis and telephone survey. Results This research shows that emergency nurse practitioner services partially comply with the factors of sustainability as described in the Sustainability of Innovation theoretical framework: Political, Organisational, Workforce, Financial and Innovation specific factors. Where services do not entirely meet the factors the existing benefits of the service may outweigh the barriers and other means of working around shortfalls are also implemented by staff to ensure patient safety. Conclusion The rapidly expanding emergency nurse practitioner service has been examined using case study methodology to find that certain factors may be threatening the sustainability of this health service innovation. Potentially an innovation may be sustained when only some factors are met in the short term, however, long term sustainability may be challenged if factors are not addressed and supported.

Medicines information sources and services for consumers : A special focus on the Internet and people with depression

The range of consumer health and medicines information sources has diversified along with the increased use of the Internet. This has led to a drive to develop medicines information services and to better incorporate the Internet and e-mail into routine practice in health care and in community pharmacies. To support the development of such services more information is needed about the use of online information by consumers, particularly of those who may be the most likely to use and to benefit from the new sources and modes of medicines communication. This study explored the role and utilization of the Internet-based medicines information and information services in the context of a wider network of information sources accessible to the public in Finland. The overall aim was to gather information to develop better and more accessible sources of information for consumers and services to better meet the needs of consumers. Special focus was on the needs and information behavior among people with depression and using antidepressant medicines. This study applied both qualitative and quantitative methods. Consumer medicines information needs and sources were identified by analyzing the utilization of the University Pharmacy operated national drug information call center (Study I) and surveying Finnish adults (n=2348) use of the different medicines information sources (Study II). The utilization of the Internet as a source of antidepressant information among people with depression was explored by focus group discussions among people with depression and with current or past use of the antidepressant(s) (n=29, Studies III & IV). Pharmacy response to the needs of consumers in term of providing e-mail counseling was assessed by conducting a virtual pseudo customer study among the Finnish community pharmacies (n=161, Study V). Physicians and pharmacists were the primary sources of medicines information. People with mental disorders were more frequent users of telephone- and Internet-based medicines information sources and patient information leaflets than people without mental disorders. These sources were used to complement rather than replace information provided face-to-face by health professionals. People with depression used the Internet to seek facts about antidepressants, to share experiences with peers, and for the curiosity. They described that the access to online drug information was empowering. Some people reported lacking the skills necessary to assess the quality of online information. E-mail medication counseling services provided by community pharmacies were rare and varied in quality. Study results suggest that rather than discouraging the use of the Internet, health professionals should direct patients to use accurate and reliable sources of online medicines information. Health care providers, including community pharmacies should also seek to develop new ways of communicating information about medicines with consumers. This study determined that people with depression and using antidepressants need services enabling interactive communication not only with health care professionals, but also with peers. Further research should be focused on developing medicines information service facilitating communication among different patient and consumer groups.

Understanding consumers' decisions to adopt technology-enabled transformative services

This study extends understanding of consumers' decisions to adopt transformative services delivered via technology. It incorporates competitive effects into the model of goal-directed behavior which, in keeping with the majority of consumer decision making models, neglects to explicitly account for competition. A goal-level operationalization of competition, incorporating both direct and indirect competition, is proposed. A national web-based survey collected data from 431 respondents about their decisions to adopt mental health services delivered via mobile phone. The findings show that the extent to which consumers perceived using these transformative services to be more instrumental to achieving their goals than competition had the greatest impact on their adoption decisions. This finding builds on the limited empirical evidence for the inclusion of competitive effects to more fully explain consumers' decisions to adopt technology-based and other services. It also provides support for a broader operationalization of competition with respect to consumers' personal goals.

Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: findings from a mixed-methods study

Background Motivation is an important driver for health professionals to maintain professional competencies, continue in a workforce and contribute to work tasks. While there is some research about motivation in health workers in low to middle income countries, maternal morbidity and mortality remains high in many low and middle income countries and this can be improved by improving the quality of maternal services and the training and skills maintenance of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods. Methods The study consisted of a survey using a self-administered questionnaire of 240 health workers in 5 districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23 item motivation instrument based on Kenyan health context, modified for Vietnamese language and culture. Results The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = -0.14, p=0.03), ability to perform key tasks (β = 0.22, p=0.001), and shift schedule (β = -0.13, p=0.05). Motivation was higher in health workers self-identifying as competent or enabled to provide more care activities. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to motivation. Conclusions The study demonstrates the importance of understanding the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low and middle income countries.

How Jung's concept of the wounded healer can guide learning and teaching in social work and human services

The concept of the “wounded healer” has been used to explain why those with adverse childhood histories often enter helping professions such as social work and human services (SWHS). Psychotherapist Carl Jung (1875–1961) believed wounded healers developed insight and resilience from their own experiences, enabling transformative interventions to occur with clients. Concerns exist that students with adverse childhood histories in SWHS may display unresolved emotional issues. This journal article explores how Jung’s interpretation of the wounded healer can be critically applied to understanding the learning needs of SWHS students with histories of abuse, neglect or other childhood adversity. The relevance of the wounded healer to SWHS education is explored in three key areas: - 1) the increased possibility of the occurrence of countertransference; - 2) the potential for vicarious traumatisation and burnout, and; - 3) personal and professional resilience displayed by SWHS students with a history of childhood adversity. The wounded healer metaphor allows for a more nuanced understanding of SWHS students with these histories. It also provides insight into the pedagogical considerations associated with teaching this student cohort.