Raising the voice of dissatisfaction : a qualitative study of the Queensland acute health care consumer and the experience of complaining

Research into complaints handling in the health care system has predominately focused on examining the processes that underpin the organisational systems. An understanding of the cognitive decisions made by patients that influence whether they are satisfied or dissatisfied with the care they are receiving has had limited attention thus far. This study explored the lived experiences of Queensland acute care patients who complained about some aspect of their inpatient stay. A purposive sample of sixteen participants was recruited and interviewed about their experience of making a complaint. The qualitative data gathered through the interview process was subjected to an Interpretative Phenomenological Analysis (IPA) approach, guided by the philosophical influences of Heidegger (1889-1976). As part of the interpretive endeavour of this study, Lazarus’ cognitive emotive model with situational challenge was drawn on to provide a contextual understanding of the emotions experienced by the study participants. Analysis of the research data, aided by Leximancer™ software, revealed a series of relational themes that supported the interpretative data analysis process undertaken. The superordinate thematic statements that emerged from the narratives via the hermeneutic process were ineffective communication, standards of care were not consistent, being treated with disrespect, information on how to complain was not clear, and perceptions of negligence. This study’s goal was to provide health services with information about complaints handling that can help them develop service improvements. The study patients articulated the need for health care system reform; they want to be listened to, to be acknowledged, to be believed, for people to take ownership if they had made a mistake, for mistakes not to occur again, and to receive an apology. For these initiatives to be fully realised, the paradigm shift must go beyond regurgitating complaints data metrics in percentages per patient contact, towards a concerted effort to evaluate what the qualitative complaints data is really saying. An opportunity to identify a more positive and proactive approach in encouraging our patients to complain when they are dissatisfied has the potential to influence improvements.

Closing the loop of design and analysis : Parametric modelling tools for early decision support

There is a growing need for parametric design software that communicates building performance feedback in early architectural exploration to support decision-making. This paper examines how the circuit of design and analysis process can be closed to provide active and concurrent feedback between architecture and services engineering domains. It presents the structure for an openly customisable design system that couples parametric modelling and energy analysis software to allow designers to assess the performance of early design iterations quickly. Finally, it discusses how user interactions with the system foster information exchanges that facilitate the sharing of design intelligence across disciplines.

Analysis for the use of cumulative plots for travel time estimation on signalized network

This paper provides fundamental understanding for the use of cumulative plots for travel time estimation on signalized urban networks. Analytical modeling is performed to generate cumulative plots based on the availability of data: a) Case-D, for detector data only; b) Case-DS, for detector data and signal timings; and c) Case-DSS, for detector data, signal timings and saturation flow rate. The empirical study and sensitivity analysis based on simulation experiments have observed the consistency in performance for Case-DS and Case-DSS, whereas, for Case-D the performance is inconsistent. Case-D is sensitive to detection interval and signal timings within the interval. When detection interval is integral multiple of signal cycle then it has low accuracy and low reliability. Whereas, for detection interval around 1.5 times signal cycle both accuracy and reliability are high.

Quantitative approaches to content analysis : identifying conceptual drift across publication outlets

Unstructured text data, such as emails, blogs, contracts, academic publications, organizational documents, transcribed interviews, and even tweets, are important sources of data in Information Systems research. Various forms of qualitative analysis of the content of these data exist and have revealed important insights. Yet, to date, these analyses have been hampered by limitations of human coding of large data sets, and by bias due to human interpretation. In this paper, we compare and combine two quantitative analysis techniques to demonstrate the capabilities of computational analysis for content analysis of unstructured text. Specifically, we seek to demonstrate how two quantitative analytic methods, viz., Latent Semantic Analysis and data mining, can aid researchers in revealing core content topic areas in large (or small) data sets, and in visualizing how these concepts evolve, migrate, converge or diverge over time. We exemplify the complementary application of these techniques through an examination of a 25-year sample of abstracts from selected journals in Information Systems, Management, and Accounting disciplines. Through this work, we explore the capabilities of two computational techniques, and show how these techniques can be used to gather insights from a large corpus of unstructured text.

Sequential Monte Carlo for Bayesian sequentially designed experiments for discrete data

In this paper we present a sequential Monte Carlo algorithm for Bayesian sequential experimental design applied to generalised non-linear models for discrete data. The approach is computationally convenient in that the information of newly observed data can be incorporated through a simple re-weighting step. We also consider a flexible parametric model for the stimulus-response relationship together with a newly developed hybrid design utility that can produce more robust estimates of the target stimulus in the presence of substantial model and parameter uncertainty. The algorithm is applied to hypothetical clinical trial or bioassay scenarios. In the discussion, potential generalisations of the algorithm are suggested to possibly extend its applicability to a wide variety of scenarios

Validating the is-impact model in the Malaysian public sector

This research is one of several ongoing studies conducted within the IT Professional Services (ITPS) research programme at Queensland University of Technology (QUT). In 2003, ITPS introduced the IS-Impact model, a measurement model for measuring information systems success from the viewpoint of multiple stakeholders. The model, along with its instrument, is robust, simple, yet generalisable, and yields results that are comparable across time, stakeholders, different systems and system contexts. The IS-Impact model is defined as “a measure at a point in time, of the stream of net benefits from the Information System (IS), to date and anticipated, as perceived by all key-user-groups”. The model represents four dimensions, which are ‘Individual Impact’, ‘Organizational Impact’, ‘Information Quality’ and ‘System Quality’. The two Impact dimensions measure the up-to-date impact of the evaluated system, while the remaining two Quality dimensions act as proxies for probable future impacts (Gable, Sedera & Chan, 2008). To fulfil the goal of ITPS, “to develop the most widely employed model” this research re-validates and extends the IS-Impact model in a new context. This method/context-extension research aims to test the generalisability of the model by addressing known limitations of the model. One of the limitations of the model relates to the extent of external validity of the model. In order to gain wide acceptance, a model should be consistent and work well in different contexts. The IS-Impact model, however, was only validated in the Australian context, and packaged software was chosen as the IS understudy. Thus, this study is concerned with whether the model can be applied in another different context. Aiming for a robust and standardised measurement model that can be used across different contexts, this research re-validates and extends the IS-Impact model and its instrument to public sector organisations in Malaysia. The overarching research question (managerial question) of this research is “How can public sector organisations in Malaysia measure the impact of information systems systematically and effectively?” With two main objectives, the managerial question is broken down into two specific research questions. The first research question addresses the applicability (relevance) of the dimensions and measures of the IS-Impact model in the Malaysian context. Moreover, this research question addresses the completeness of the model in the new context. Initially, this research assumes that the dimensions and measures of the IS-Impact model are sufficient for the new context. However, some IS researchers suggest that the selection of measures needs to be done purposely for different contextual settings (DeLone & McLean, 1992, Rai, Lang & Welker, 2002). Thus, the first research question is as follows, “Is the IS-Impact model complete for measuring the impact of IS in Malaysian public sector organisations?” [RQ1]. The IS-Impact model is a multidimensional model that consists of four dimensions or constructs. Each dimension is represented by formative measures or indicators. Formative measures are known as composite variables because these measures make up or form the construct, or, in this case, the dimension in the IS-Impact model. These formative measures define different aspects of the dimension, thus, a measurement model of this kind needs to be tested not just on the structural relationship between the constructs but also the validity of each measure. In a previous study, the IS-Impact model was validated using formative validation techniques, as proposed in the literature (i.e., Diamantopoulos and Winklhofer, 2001, Diamantopoulos and Siguaw, 2006, Petter, Straub and Rai, 2007). However, there is potential for improving the validation testing of the model by adding more criterion or dependent variables. This includes identifying a consequence of the IS-Impact construct for the purpose of validation. Moreover, a different approach is employed in this research, whereby the validity of the model is tested using the Partial Least Squares (PLS) method, a component-based structural equation modelling (SEM) technique. Thus, the second research question addresses the construct validation of the IS-Impact model; “Is the IS-Impact model valid as a multidimensional formative construct?” [RQ2]. This study employs two rounds of surveys, each having a different and specific aim. The first is qualitative and exploratory, aiming to investigate the applicability and sufficiency of the IS-Impact dimensions and measures in the new context. This survey was conducted in a state government in Malaysia. A total of 77 valid responses were received, yielding 278 impact statements. The results from the qualitative analysis demonstrate the applicability of most of the IS-Impact measures. The analysis also shows a significant new measure having emerged from the context. This new measure was added as one of the System Quality measures. The second survey is a quantitative survey that aims to operationalise the measures identified from the qualitative analysis and rigorously validate the model. This survey was conducted in four state governments (including the state government that was involved in the first survey). A total of 254 valid responses were used in the data analysis. Data was analysed using structural equation modelling techniques, following the guidelines for formative construct validation, to test the validity and reliability of the constructs in the model. This study is the first research that extends the complete IS-Impact model in a new context that is different in terms of nationality, language and the type of information system (IS). The main contribution of this research is to present a comprehensive, up-to-date IS-Impact model, which has been validated in the new context. The study has accomplished its purpose of testing the generalisability of the IS-Impact model and continuing the IS evaluation research by extending it in the Malaysian context. A further contribution is a validated Malaysian language IS-Impact measurement instrument. It is hoped that the validated Malaysian IS-Impact instrument will encourage related IS research in Malaysia, and that the demonstrated model validity and generalisability will encourage a cumulative tradition of research previously not possible. The study entailed several methodological improvements on prior work, including: (1) new criterion measures for the overall IS-Impact construct employed in ‘identification through measurement relations’; (2) a stronger, multi-item ‘Satisfaction’ construct, employed in ‘identification through structural relations’; (3) an alternative version of the main survey instrument in which items are randomized (rather than blocked) for comparison with the main survey data, in attention to possible common method variance (no significant differences between these two survey instruments were observed); (4) demonstrates a validation process of formative indexes of a multidimensional, second-order construct (existing examples mostly involved unidimensional constructs); (5) testing the presence of suppressor effects that influence the significance of some measures and dimensions in the model; and (6) demonstrates the effect of an imbalanced number of measures within a construct to the contribution power of each dimension in a multidimensional model.

On selecting an optimal wavelet for detecting singularities in traffic and vehicular data

Serving as a powerful tool for extracting localized variations in non-stationary signals, applications of wavelet transforms (WTs) in traffic engineering have been introduced; however, lacking in some important theoretical fundamentals. In particular, there is little guidance provided on selecting an appropriate WT across potential transport applications. This research described in this paper contributes uniquely to the literature by first describing a numerical experiment to demonstrate the shortcomings of commonly-used data processing techniques in traffic engineering (i.e., averaging, moving averaging, second-order difference, oblique cumulative curve, and short-time Fourier transform). It then mathematically describes WT’s ability to detect singularities in traffic data. Next, selecting a suitable WT for a particular research topic in traffic engineering is discussed in detail by objectively and quantitatively comparing candidate wavelets’ performances using a numerical experiment. Finally, based on several case studies using both loop detector data and vehicle trajectories, it is shown that selecting a suitable wavelet largely depends on the specific research topic, and that the Mexican hat wavelet generally gives a satisfactory performance in detecting singularities in traffic and vehicular data.

Analysing environmental acoustic data through collaboration and automation

Monitoring environmental health is becoming increasingly important as human activity and climate change place greater pressure on global biodiversity. Acoustic sensors provide the ability to collect data passively, objectively and continuously across large areas for extended periods. While these factors make acoustic sensors attractive as autonomous data collectors, there are significant issues associated with large-scale data manipulation and analysis. We present our current research into techniques for analysing large volumes of acoustic data efficiently. We provide an overview of a novel online acoustic environmental workbench and discuss a number of approaches to scaling analysis of acoustic data; online collaboration, manual, automatic and human-in-the loop analysis.

Analysis of marine conflicts

The traffic conflict technique (TCT) is a powerful technique applied in road traffic safety assessment as a surrogate of the traditional accident data analysis. It has subdued the conceptual and implemental weaknesses of the accident statistics. Although this technique has been applied effectively in road traffic, it has not been practised well in marine traffic even though this traffic system has some distinct advantages in terms of having a monitoring system. This monitoring system can provide navigational information as well as other geometric information of the ships for a larger study area over a longer time period. However, for implementing the TCT in the marine traffic system, it should be examined critically to suit the complex nature of the traffic system. This paper examines the suitability of the TCT to be applied to marine traffic and proposes a framework for a follow up comprehensive conflict study.

The emerging role of private health care provision in China : a critical analysis of the current health system

China continues to face great challenges in meeting the health needs of its large population. The challenges are not just lack of resources, but also how to use existing resources more efficiently, more effectively, and more equitably. Now a major unaddressed challenge facing China is how to reform an inefficient, poorly organized health care delivery system. The objective of this study is to analyze the role of private health care provision in China and discuss the implications of increasing private-sector development for improving health system performance. This study is based on an extensive literature review, the purpose of which was to identify, summarize, and evaluate ideas and information on private health care provision in China. In addition, the study uses secondary data analysis and the results of previous study by the authors to highlight the current situation of private health care provision in one province of China. This study found that government-owned hospitals form the backbone of the health care system and also account for most health care service provision. However, even though the public health care system is constantly trying to adapt to population needs and improve its performance, there are many problems in the system, such as limited access, low efficiency, poor quality, cost inflation, and low patient satisfaction. Currently, private hospitals are relatively rare, and private health care as an important component of the health care system in China has received little policy attention. It is argued that policymakers in China should recognize the role of private health care provision for health system performance, and then define and achieve an appropriate role for private health care provision in helping to respond to the many challenges facing the health system in present-day China.

Observational research and verbal protocol methods

This paper describes observational research and verbal protocols methods, how these methods are applied and integrated within different contexts, and how they complement each other. The first case study focuses on nurses’ interaction during bandaging of patients’ lower legs. To maintain research rigor a triangulation approach was applied that links observations of current procedures, ‘talk-aloud’ protocol during interaction and retrospective protocol. Maps of interactions demonstrated that some nurses bandage more intuitively than others. Nurses who bandage intuitively assemble long sequences of bandaging actions while nurses who bandage less intuitively ‘focus-shift’ in between bandaging actions. Thus different levels of expertise have been identified. The second case study consists of two laboratory experiments. It focuses on analysing and comparing software and product design teams and how they approached a design problem. It is based on the observational and verbal data analysis. The coding scheme applied evolved during the analysis of the activity of each team and is identical for all teams. The structure of knowledge captured from the analysis of the design team maps of interaction is identified. The significance of this work is within its methodological approach. The maps of interaction are instrumental for understanding the activities and interactions of the people observed. By examining the maps of interaction, it is possible to draw conclusions about interactions, structure of knowledge captured and level of expertise. This research approach is transferable to other design domains. Designers will be able to transfer the interaction maps outcomes to systems and services they design.

Ensemble-based DDoS detection and mitigation model

This work-in-progress paper presents an ensemble-based model for detecting and mitigating Distributed Denial-of-Service (DDoS) attacks, and its partial implementation. The model utilises network traffic analysis and MIB (Management Information Base) server load analysis features for detecting a wide range of network and application layer DDoS attacks and distinguishing them from Flash Events. The proposed model will be evaluated against realistic synthetic network traffic generated using a software-based traffic generator that we have developed as part of this research. In this paper, we summarise our previous work, highlight the current work being undertaken along with preliminary results obtained and outline the future directions of our work.

International differences in management of physical activity data: Can they explain some of the difference in prevalence estimates?

Background: National physical activity data suggest that there is a considerable difference in physical activity levels of US and Australian adults. Although different surveys (Active Australia and BRFSS) are used, the questions are similar. Different protocols, however, are used to estimate “activity” from the data collected. The primary aim of this study was to assess whether the 2 approaches to the management of PA data could explain some of the difference in prevalence estimates derived from the two national surveys. Methods: Secondary data analysis of the most recent AA survey (N = 2987). Results: 15% of the sample was defined as “active” using Australian criteria but as “inactive” using the BRFSS protocol, even though weekly energy expenditure was commensurate with meeting current guidelines. Younger respondents (age < 45 y) were more likely to be “misclassified” using the BRFSS criteria. Conclusions: The prevalence of activity in Australia and the US appears to be more similar than we had previously thought.

The relationship between fundamental movement skills and self-reported physical activity during Finnish junior high school

Background: Previous studies have shown that fundamental movement skills (FMS) and physical activity are related. Specifically, earlier studies have demonstrated that the ability to perform a variety of FMS increases the likelihood of children participating in a range of physical activities throughout their lives. To date, however, there have not been studies focused on the development of, or the relationship between, these variables through junior high school (that is, between the ages of 13 and 15). Such studies might provide important insights into the relationships between FMS and physical activity during adolescence, and suggest ways to design more effective physical education programmes for adolescents. Purpose: The main purposes of the study are: (1) to investigate the development of the students' self-reported physical activity and FMS from Grade 7 to Grade 9, (2) to analyse the associations among the students' FMS and self-reported physical activity through junior high school, (3) to analyse whether there are gender differences in research tasks one and/or two. Participants and setting: The participants in the study were 152 Finnish students, aged 13 and enrolled in Grade 7 at the commencement of the study. The sample included 66 girls and 86 boys who were drawn from three junior high schools in Middle Finland. Research design and data collection: Both the FMS tests and questionnaires pertaining to self-reported physical activity were completed annually during a 3 year period: in August (when the participants were in Grade 7), January (Grade 8), and in May (Grade 9). Data analysis: Repeated measures multivariate analysis of variances (MANOVAs) were used to analyse the interaction between gender and time (three measurement points) in FMS test sumscores and self-reported physical activity scores. The relationships between self-reported physical activity scores and fundamental movement skill sumscores through junior high school were analysed using Structural Equation Modelling (SEM) with LISREL 8.80 software. Findings: The MANOVA for self-reported physical activity demonstrated that both genders' physical activity decreased through junior high school. The MANOVA for the FMS revealed that the boys' FMS sumscore increased whereas the girls' skills decreased through junior high school. The SEM and squared multiple correlations revealed FMS in Grades 7 and 8 as well as physical activity in Grade 9 explained FMS in Grade 9. The portion of prediction was 69% for the girls and 55% for the boys. Additionally, physical activity measured in Grade 7 and FMS measured in Grade 9 explained physical activity in Grade 9. The portion of prediction was 12% for the girls and 29% for the boys. In the boys' group, three additional paths were found; FMS in Grade 7 explained physical activity in Grade 9, physical activity in Grade 7 explained FMS in Grade 8, and physical activity in Grade 7 explained physical activity in Grade 8. Conclusions: The study suggests that supporting and encouraging FMS and physical activity are co-related and when considering combined scores there is a greater likelihood of healthy lifelong outcomes. Therefore, the conclusion can be drawn that FMS curriculum in school-based PE is a plausible way to ensure good lifelong outcomes. Earlier studies support that school physical education plays an important role in developing students FMS and is in a position to thwart the typical decline of physical activity in adolescence. These concepts are particularly important for adolescent girls as this group reflects the greatest decline in physical activity during the adolescent period.