The information specialist in the clinical team: Building expertise in evidence-based healthcare

The Clinician Development Program (CDP) is an initiative of Queensland Health’s Quality Improvement and Enhancement Program. At the Royal Brisbane & Royal Women's Hospital Health Service Districts, evidence-base practice (EBP) is an important CDP area in which several projects were carried out in 2002. This paper describes one such project. A medical librarian was invited to accompany the clinical team on morning rounds in the Medical Assessment & Planning Unit (MAPU). The librarian conducted information skills training in the ward and helped clinicians to answer questions directly related to patient care. Questions not answered during the round were followed-up, usually within 48 hours, and responses emailed to the consultant who led the rounds. At the project’s conclusion the librarian was invited to continue as a member of the MAPU clinical team, thus acknowledging the valuable role an information specialist can play in incorporating research evidence into patient care. Clinical librarianship (CL) creates a space, albeit a contentious one, for the health librarian at the bedside. This paper describes an Australian CL project and attempts to demystify the role of an information specialist in EBP. It also highlights some of the challenges facing librarians and clinicians attempting to embed EBP in clinical settings.

Assessing service satisfaction between a 3PL provider and a vehicle manufacturer using the SERVQUAL technique

This paper reports on a new study conducted within a leading UK based (and US owned) car manufacturing company looking at the satisfaction between parties within a newly formed third party logistics (3PL) relationship. The study contains a two-way assessment of the relationship (i.e. the vehicle manufacturer’s Parts Supply and Logistics Operation’s assessment of the 3PL’s service and the 3PL’s assessment of the vehicle manufacturer’s relationship management ability). The study principally used an online SERVQUAL survey, (backed up with an on-line questionnaire, and face to face interviews) for data collection. The paper discusses the background and problems that have arisen in the relationship, the analysis of how each of the parties sees one other in terms of the service provided. Also, the findings and recommendations presented to management are outlined: these include factors such as the need for information sharing, reliability, flexibility, role specificity, trust and effective requirements management.

Innovation management using logical framework in hospital-based healthcare units

Innovation is part and parcel of any service in today's environment, so as to remain competitive. Quality improvement in healthcare services is a complex, multi-dimensional task. This study proposes innovation management in healthcare services using a logical framework. A problem tree and an objective tree are developed to identify and mitigate issues and concerns. A logical framework is formulated to develop a plan for implementation and monitoring strategies, potentially creating an environment for continuous quality improvement in a specific unit. We recommend logical framework as a valuable model for innovation management in healthcare services. Copyright © 2006 Inderscience Enterprises Ltd.

Service encounter conceptualisation:employees' service behaviours and customers' service quality perceptions

The enhancement of service quality is an area of optimal managerial relevance that has, to date, received minimal attention in the literature. Because customers' service quality evaluations are based almost entirely upon the behaviours of frontline employees, organisations rely heavily upon these employees to improve overall service quality provision. However, much of the literature looking at service quality enhancement lacks detail when examining the impact of employee service-related behaviours on customers' service quality perceptions. As a result, this paper comprehensively conceptualises those front-line employee behaviours which are the most likely to enhance customers' service quality perceptions. This conceptualisation is grounded in an extensive review of the services marketing literature, pooling together previously disparate research strands. Formal hypotheses are presented. Implications and future research directions are also discussed.

Market orientation in the service sector of the transition economies of central Europe

The Narver and Slater market orientation scale is tested in the context of service firms in the transition economies of central Europe and found to be both valid and reliable. The survey examined levels of market orientation in 205 business to business services companies and 141 consumer services companies in Hungary, Poland and Slovenia. As predicted by the predominantly western marketing literature, those service firms with higher levels of market orientation; were more often found in turbulent, rapidly changing markets; were more likely to pursue longer term market building goals rather than short term efficiency objectives; more likely to pursue differentiated positioning through offering superior levels of service compared to competitors; and also performed better on both financial and market based criteria. A number of different business approaches, however, are evident in the transition economies suggesting that other business orientations may co-exist with a market orientation creating a richer and more complex set of organizational drivers.

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.

Traffic based energy consumption optimisation to improve the lifetime and performance of ad hoc wireless sensor networks

Ad hoc wireless sensor networks (WSNs) are formed from self-organising configurations of distributed, energy constrained, autonomous sensor nodes. The service lifetime of such sensor nodes depends on the power supply and the energy consumption, which is typically dominated by the communication subsystem. One of the key challenges in unlocking the potential of such data gathering sensor networks is conserving energy so as to maximize their post deployment active lifetime. This thesis described the research carried on the continual development of the novel energy efficient Optimised grids algorithm that increases the WSNs lifetime and improves on the QoS parameters yielding higher throughput, lower latency and jitter for next generation of WSNs. Based on the range and traffic relationship the novel Optimised grids algorithm provides a robust traffic dependent energy efficient grid size that minimises the cluster head energy consumption in each grid and balances the energy use throughout the network. Efficient spatial reusability allows the novel Optimised grids algorithm improves on network QoS parameters. The most important advantage of this model is that it can be applied to all one and two dimensional traffic scenarios where the traffic load may fluctuate due to sensor activities. During traffic fluctuations the novel Optimised grids algorithm can be used to re-optimise the wireless sensor network to bring further benefits in energy reduction and improvement in QoS parameters. As the idle energy becomes dominant at lower traffic loads, the new Sleep Optimised grids model incorporates the sleep energy and idle energy duty cycles that can be implemented to achieve further network lifetime gains in all wireless sensor network models. Another key advantage of the novel Optimised grids algorithm is that it can be implemented with existing energy saving protocols like GAF, LEACH, SMAC and TMAC to further enhance the network lifetimes and improve on QoS parameters. The novel Optimised grids algorithm does not interfere with these protocols, but creates an overlay to optimise the grids sizes and hence transmission range of wireless sensor nodes.

Does role clarity explain employee-perceived service quality? A study of antecedents and consequences in call centres

Purpose – Role clarity of frontline staff is critical to their perceptions of service quality in call centres. The purpose of this study is to examine the effects of role clarity and its antecedents and consequences on employee-perceived service quality. Design/methodology/approach – A conceptual model, based on the job characteristics model and cognitive theories, is proposed. Key antecedents of role clarity considered here are feedback, autonomy, participation, supervisory consideration, and team support; while key consequences are organizational commitment, job satisfaction and service quality. An internal marketing approach is adopted and all variables are measured from the frontline employee's perspective. A structural equation model is developed and tested on a sample of 342 call centre representatives of a major commercial bank in the UK. Findings – The research reveals that role clarity plays a critical role in explaining employee perceptions of service quality. Further, the research findings indicate that feedback, participation and team support significantly influence role clarity, which in turn influences job satisfaction and organizational commitment. Research limitations/implications – The research suggests that boundary personnel in service firms should strive for more clarity in perceived role for delivering better service quality. The limitations are in sample availability from in-house transaction call centres of a single bank. Originality/value – The contributions of this study are untangling the confusing research evidence on the effect of role clarity on service quality, using service quality as a performance variable as opposed to productivity estimates, adopting an internal marketing approach to understanding the phenomenon, and introducing teamwork along with job-design and supervisory factors as antecedent to role clarity.

Antecedents and consequences of service quality in consumer evaluation of self-service internet technologies

Advances in technology coupled with increasing labour costs have caused service firms to explore self-service delivery options. Although some studies have focused on self-service and use of technology in service delivery, few have explored the role of service quality in consumer evaluation of technology-based self-service options. By integrating and extending the self-service quality framework the service evaluation model and the Technology Acceptance Model the authors address this emerging issue by empirically testing a comprehensive model that captures the antecedents and consequences of perceived service quality to predict continued customer interaction in the technology-based self-service context of Internet banking. Important service evaluation constructs like perceived risk, perceived value and perceived satisfaction are modelled in this framework. The results show that perceived control has the strongest influence on service quality evaluations. Perceived speed of delivery, reliability and enjoyment also have a significant impact on service quality perceptions. The study also found that even though perceived service quality, perceived risk and satisfaction are important predictors of continued interaction, perceived customer value plays a pivotal role in influencing continued interaction.

Organizational resources enabling service responsiveness:evidence from Greece

This article examines the implementation of relationship marketing strategy based on a sample of business-to-business firms operating in Greece. Organizational resources, including a focus on learning and flexibility/adaptation in strategic planning, are demonstrated to be antecedents of effective relationship marketing strategies. The possession of these resources lead to superior customer performance (as measured by customer satisfaction and loyalty) and, ultimately, superior financial performance (as measured by profit levels, profit margin, and ROI). Our results provide support for the development of organizational resources that foster and enable relationship marketing in business-to-business environments since such resources are linked with improved firm performance. © 2003 Elsevier Inc. All rights reserved.

Building team-based working:a practical guide to organizational transformation

Building Team-based Working is designed for use by managers and consultants who are introducing team-based working into organizations. The book synthesizes knowledge about how to build team-based organizations, focusing particularly on the psychological and social processes that can facilitate or obstruct successful teamwork. Rather than advise managers on how to build effective teams, as most books in this area tend to do, this book instead focuses on how to build organizations structured around teams. The text is divided into six sections describing the six main stages of developing team-based working in an organization. The chapters follow a common structure. Each one opens with a summary of the aims and activities relevant to that stage and concludes with a selection of appropriate support materials and tools. These materials can also be downloaded from the CD accompanying the text. The advice given is based on evidence gathered by the authors over 20 years of practical management experience, research work in organizations, and consultancy across the public, manufacturing and service sectors.

Diabetes service provision:a qualitative study of newly diagnosed Type 2 diabetes patients' experiences and views

Aims: To explore newly diagnosed Type 2 diabetes patients' views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings. Methods: Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results: Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they dis-liked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals. Conclusions: Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run 'one-stop' diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK. © 2005 Diabetes UK.

A corpus-based investigation of junk emails

Almost everyone who has an email account receives from time to time unwanted emails. These emails can be jokes from friends or commercial product offers from unknown people. In this paper we focus on these unwanted messages which try to promote a product or service, or to offer some “hot” business opportunities. These messages are called junk emails. Several methods to filter junk emails were proposed, but none considers the linguistic characteristics of junk emails. In this paper, we investigate the linguistic features of a corpus of junk emails, and try to decide if they constitute a distinct genre. Our corpus of junk emails was build from the messages received by the authors over a period of time. Initially, the corpus consisted of 1563, but after eliminating the duplications automatically we kept only 673 files, totalising just over 373,000 tokens. In order to decide if the junk emails constitute a different genre, a comparison with a corpus of leaflets extracted from BNC and with the whole BNC corpus is carried out. Several characteristics at the lexical and grammatical levels were identified.

Service innovation, embeddedness and business performance:evidence from Northern Ireland

This paper explores the factors that determine innovation by service firms, and in particular the contribution of intra- and extra-regional connectivity. Subsequently, it is examined how service firms' innovation activity relates to productivity and export behaviour. The empirical analysis is based on matched data from the 2005 UK Innovation Survey - the UK component of the 4th Community Innovation Survey (CIS) - and the Annual Business Inquiry for Northern Ireland. Evidence is found of negative intra-regional embeddedness effects, but there is a positive contribution to innovation from extra-regional connectivity, particularly links to customers. Relationships between innovation, exporting, and productivity prove complex, but suggest that innovation itself is not sufficient to generate productivity improvements. Only when innovation is combined with increased export activity are productivity gains evident.

Determining inventory service support levels in multi-national companies

Multi-national manufacturing companies are often faced with very difficult decisions regarding where and how to cost effectively manufacture products in a global setting. Clearly, they must utilize efficient and responsive manufacturing strategies to reach low cost solutions, but they must also consider the impact of manufacturing and transportation solutions upon their ability to support sales. One important sales consideration is determining how much work in process, in-transit stock, and finished goods to have on hand to support sales at a desired service level. This paper addresses this important consideration through a comprehensive scenario-based simulation approach, including sensitivity analysis on key study parameters. Results indicate that the inventory needs vary considerably for different manufacturing and delivery methods in ways that may not be obvious when using common evaluative tools.