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.

Proposing a systems vision of knowledge management in emergency care

This paper makes a case for taking a systems view of knowledge management within health-care provision, concentrating on the emergency care process in the UK National Health Service. It draws upon research in two casestudy organizations (a hospital and an ambulance service). The case-study organizations appear to be approaching knowledge (and information) management in a somewhat fragmented way. They are trying to think more holistically, but (perhaps) because of the ways their organizations and their work are structured, they cannot ‘see’ the whole of the care process. The paper explores the complexity of knowledge management in emergency health care and draws the distinction for knowledge management between managing local and operational knowledge, and global and clinical knowledge.

The UK productivity gap in the service sector: do management practices matter?

Purpose – This paper aims to contribute to the debate on the drivers of the productivity gap that exists between the UK and its major international competitors. Design/methodology/approach – From the macro perspective the paper explores the quantitative evidence on the productivity differentials and how they are measured. From the micro perspective, the article explores the quantitative evidence on the role of management practices claimed to be a key determinant in promoting firm competitiveness and in bridging the UK gap. Findings – This study suggests that management practices are an ambiguous driver of firm productivity and higher firm performance. On the methodological side, qualitative and subjective measures of either management practices or firm performance are often used. This makes the results not comparable across studies, across firms or even within firms over time. Productivity and profitability are often and erroneously interchangeably used while productivity is only one element of firm performance. On the other hand, management practices are multi-dimensional constructs that generally do not demonstrate a straightforward relationship with productivity variables. To assume that they are the only driver of higher productivity may be misleading. Moreover, there is evidence of an inverse causal relationship between management practices and firm performance. This calls into question most empirical results of the extant literature based on the unidirectional assumption of direct causality between management practices and firm performance. Research limitations/implications – These and other issues suggest that more research is needed to deepen the understanding of the UK productivity gap and more quantitative evidence should be provided on the way in which management practices contribute to the UK competitiveness. Their impact is not easily measurable due to their complexity and their complementary nature and this is a fertile ground for further research. Originality/value – This paper brings together the evidence on the UK productivity gap and its main drivers, provided by the economics, management and performance measurement literature. This issue scores very highly in the agenda of policy makers and academics and has important implications for practitioners interested in evaluating the impact of managerial best practices.

Using grounded theory for theory building in operations management research:a study on inter-firm relationship governance

Purpose – Qualitative theory building approaches, such as grounded theory method (GTM), are still not very widespread and rigorously applied in operations management (OM) research. Yet it is agreed that more systematic observation of current industrial phenomena is necessary to help managers deal with their problems. The purpose of this paper is to provide an example to help guide other researchers on using GTM for theory building in OM research. Design/methodology/approach – A GTM study in the German automotive industry consisting of 31 interviews is followed by a validation stage comprising a survey (110 responses) and a focus group. Findings – The result is an example of conducting GTM research in OM, illustrated by the development of the novel collaborative enterprise governance framework for inter-firm relationship governance in the German automotive industry. Research limitations/implications – GTM is appropriate for qualitative theory building research, but the resultant theories need further testing. Research is necessary to identify the transferability of the collaborative enterprise governance concept to other industries than automotive, to other organisational areas than R&D and to product and service settings that are less complex and innovative. Practical implications – The paper helps researchers make more informed use of GTM when engaging in qualitative theory building research in OM. Originality/value – There is a lack of explicit and well-informed use of GTM in OM research because of poor understanding. This paper addresses this deficiency. The collaborative enterprise governance framework is a significant contribution in an area of growing importance within OM.

'Girls who do Boys like they’re girls'? Exploring the role of gender in the junior management of contemporary service work

This article attempts to explain the clustering of women managers at junior managerial grades in the service sector by focusing on the structuring and organization of work in a call centre. The article is based on an ethnography of an organization and seeks to contribute to the ongoing debate in gender research by exploring and documenting the requirement for the enactment of masculinities at work for successful managers. Central to our account is the role of team leader which, as a junior management position, occupies a key role in understanding and accounting for the gendered hierarchical terrain of contemporary service-based organizations. In exploring the role of team leader, a position that tends overwhelmingly to be held by female staff, we draw attention to the perception of the gendered nature of the role by subordinate members of the organization, the team-leaders themselves and more senior managers. The position is also brought into sharp relief in comparison with the subordinate role of the ‘problem manager’, a position overwhelmingly held by men.

Operations management

Operations management deals with the management of the creation of goods and the delivery of services to the customer. It plays an essential role in the success of any organization. In this book, Andrew Greasley provides a clear and accessible introduction to this important area of study, focusing on all key areas of operations in both manufacturing and service industries. Operations Management, Second Edition covers the main areas of operations strategy, the design of the operations system and the management of operations over time. Yet, its concise nature of the text means students are not overwhelmed by the amount of material presented. This new edition also features: New content in such areas such as the quality gap model, enterprise systems and business process management. Expanded case studies, to include more global and European cases and longer cases at the end of each chapter. Greater clarity in chapter material organization. Worked Examples providing a step–by–step guide to the procedure to solve quantitative problems. Visual redesign in full colour. More support material for students and lecturers, including an interactive WileyPLUS course. All lecturers can access supporting resources on the companion website at www.wiley.com/college/greasley including an Instructor’s Manual with suggested solutions for all case study questions and end of chapter exercises, a Test Bank and PowerPoint slides for each chapter. Students will find multiple–choice test quizzes, web–links and an online glossary. Operations Management is essential reading for all students studying operations management, whether on undergraduate, postgraduate or continuing professional development courses.

Computer based monitoring in U.K. service organizations : a comparative study

The majority of the literature about CBM is American in origin, and (inter alia) notes that there were differing uses of similar technology, indicating that context has an important role to play in the use of CBM. The literature maps the psychological effects of CBM in considerable detail, but only two published studies examine the context of CBM. These grounded results provide scant support for any systematic, quantitative, large scale analysis of computer based monitoring in the UK context. This thesis thus aims to systemically examine the context of CBM using discourse analysis. Forty four interviewees were theoretically sampled using a structured sample technique in four organizations. All were national or multinational enterprises. The interviews were semi structured in nature and divided into three sections. The first addressed the respondents' thoughts and perceptions about CBM, the second elicited talk about the departmental context (focusing the management - worker relationship), and the final section addressed the organizational context. The cases demonstrated variation in the use of CBM, measured according to the criteria of Westin (1987, 1988) and according to the interpretive repertoires used by the respondents in each case. Seven analytical categories of talk emerged from the data: three at the organizational level and four at the departmental level of analysis. Discourse analysis revealed two discrete interpretive repertories - the procedural and the substantive repertoires - in respondents' talk whose main variation occurred at the departmental level of analysis. Furthermore, patterns were found in the use of these repertories within cases and between categories. Between the cases, variation in the use of the repertories matched the between case variation according to the criteria of Westin. It would thus appear that the source of variation in the use of CBM lies in its context, more specifically in the relative emphasis of humanistic, interpersonal and idiosyncratic values within the management worker relationship.

An investigation into the nature, determinants, and dynamics of service quality expectations

On the basis of a review of the substantive quality and service marketing literature current knowledge regarding service quality expectations was found either absent or deficient. The phenomenon is of increasing importance to both marketing researchers and management and was therefore judged worthy of scholarly consideration. Because the service quality literature was insufficiently rich when embarking on the thesis three basic research issues were considered namely the nature, determinants, and dynamics of service quality expectations. These issues were first conceptually and then qualitatively explored. This process generated research hypotheses mainly relating to a model which were subsequently tested through a series of empirical investigations using questionnaire data from field studies in a single context. The results were internally consistent and strongly supported the main research hypotheses. It was found that service quality expectations can be meaningfully described in terms of generic/service-specific, intangible/tangible, and process/outcome categories. Service-specific quality expectations were also shown to be determined by generic service quality expectations, demographic variables, personal values, psychological needs, general service sophistication, service-specific sophistication, purchase motives, and service-specific information when treating service class involvement as an exogenous variable. Subjects who had previously not directly experienced a particular service were additionally found to revise their expectations of quality when exposed to the service with change being driven by a sub-set of identified determinants.

The effects of new technology on employment structures in the service sector

This thesis explores the interrelationships between the labour process, the development of technology and patterns of gender differentiation. The introduction of front office terminals into building society branches forms the focus of the research. Case studies were carried out in nine branches, three each from three building societies. Statistical data for the whole movement and a survey of ten of the top thirty societies provided the context for the studies. In the process of the research it became clear that it was not technology itself but the way that it was used, that was the main factor in determining outcomes. The introduction of new technologies is occurring at a rapid pace, facilitated by continuing high growth rates, although front office technology could seldom be cost justified. There was great variety between societies in their operating philosophies and their reasons for and approach to computerisation, but all societies foresaw an ultimate saving in staff. Computerisation has resulted in the deskilling of the cashiering role and increased control over work at all stages. Some branch managers experienced a decrease in autonomy and an increase in control over their work. Subsequent to this deskilling there has been a greatly increased use of part time staff which has enabled costs to be reduced. There has also been a polarisation between career and non-career staff which, like the use of part time staff, has occurred along gender lines. There is considerable evidence that societies' policies, structures and managerial attitudes continue to directly and indirectly discriminate against women. It is these practices which confine women to lower grades and ensure their dependence on the family and which create the pool of cheap skilled labour that societies so willingly exploit by increasing part time work. Gender strategies enter management strategies throughout the operations of the organisation.

A process view of knowledge management:it ain't want you do, it's the way that you do it

Knowledge management needs to consider the three related elements of people, processes and technology. Much existing work has concentrated on either people or technology, often to the exclusion of the other two elements. Yet without thinking about process ? the way people, organisations and even technology actually do things ? any implementation of a knowledge management initiative is at best risky, and at worst doomed to failure. This paper looks at various ways in which a process view has appeared, expl icitly or implicitly, in knowledge management research and practice so far, and reflects on how more 'thinking about process' might improve knowledge management in the future. Consistent with this overall viewpoint, the issues generally centre less on wha t a process view would suggest should be done, but rather on the way that it would be implemented in practice.

The appraisal and management of multi-storey dwelling blocks using large concrete panel systems

This exploratory study is concerned with the integrated appraisal of multi-storey dwelling blocks which incorporate large concrete panel systems (LPS). The first step was to look at U.K. multi-storey dwelling stock in general, and under the management of Birmingham City Council in particular. The information has been taken from the databases of three departments in the City of Birmingham, and rearranged in a new database using a suite of PC software called `PROXIMA' for clarity and analysis. One hundred of their stock were built large concrete panel system. Thirteen LPS blocks were chosen for the purpose of this study as case-studies depending mainly on the height and age factors of the block. A new integrated appraisal technique has been created for the LPS dwelling blocks, which takes into account the most physical and social factors affecting the condition and acceptability of these blocks. This appraisal technique is built up in a hierarchical form moving from the general approach to particular elements (a tree model). It comprises two main approaches; physical and social. In the physical approach, the building is viewed as a series of manageable elements and sub-elements to cover every single physical or environmental factor of the block, in which the condition of the block is analysed. A quality score system has been developed which depends mainly on the qualitative and quantitative conditions of each category in the appraisal tree model, and leads to physical ranking order of the study blocks. In the social appraisal approach, the residents' satisfaction and attitude toward their multi-storey dwelling block was analysed in relation to: a. biographical and housing related characteristics; and b. social, physical and environmental factors associated with this sort of dwelling, block and estate in general.The random sample consisted of 268 residents living in the 13 case study blocks. Data collected was analysed using frequency counts, percentages, means, standard deviations, Kendall's tue, r-correlation coefficients, t-test, analysis of variance (ANOVA) and multiple regression analysis. The analysis showed a marginally positive satisfaction and attitude towards living in the block. The five most significant factors associated with the residents' satisfaction and attitude in descending order were: the estate, in general; the service categories in the block, including heating system and lift services; vandalism; the neighbours; and the security system of the block. An important attribute of this method, is that it is relatively inexpensive to implement, especially when compared to alternatives adopted by some local authorities and the BRE. It is designed to save time, money and effort, to aid decision making, and to provide ranked priority to the multi-storey dwelling stock, in addition to many other advantages. A series of solution options to the problems of the block was sought for selection and testing before implementation. The traditional solutions have usually resulted in either demolition or costly physical maintenance and social improvement of the blocks. However, a new solution has now emerged, which is particularly suited to structurally sound units. The solution of `re-cycling' might incorporate the reuse of an entire block or part of it, by removing panels, slabs and so forth from the upper floors in order to reconstruct them as low-rise accommodations.