The use of email in a child and adolescent mental health service: are staff ready?

All staff members of a child and adolescent mental health service were invited to participate in a survey about the use of email. Sixty-two of the 105 staff members responded to the survey, a participation rate of 59%. Of the respondents, 32 were allied health staff, 10 were nurses, seven were administrative staff, six were medical staff, three were operational staff and four were acting in a combination of these roles. The respondents reported extensive work-related email usage and considered that they were confident in using email despite low levels of training. However, they did not feel that they understood the legal and ethical issues involved. Furthermore, there was limited incorporation of email into standard record keeping. The majority of respondents thought that increased use of email would lead to a greater workload, a consequence they considered would probably increase over time. Many commented on the quick and practical use of this medium, but were wary about using email with individuals outside the service organization, especially if it were to contain clinical material. There was low use of email directly with clients, and clinicians were ambivalent about incorporating email into therapy. The results suggest that it is timely to consider the utility and appropriateness of email communication with clients and external service providers, and to formulate guidelines and procedures to ensure the confidentiality of client information and the safety of clients and staff.

Quality of service in flexible workflows through process constraints

Workflow technology has delivered effectively for a large class of business processes, providing the requisite control and monitoring functions. At the same time, this technology has been the target of much criticism due to its limited ability to cope with dynamically changing business conditions which require business processes to be adapted frequently, and/or its limited ability to model business processes which cannot be entirely predefined. Requirements indicate the need for generic solutions where a balance between process control and flexibility may be achieved. In this paper we present a framework that allows the workflow to execute on the basis of a partially specified model where the full specification of the model is made at runtime, and may be unique to each instance. This framework is based on the notion of process constraints. Where as process constraints may be specified for any aspect of the workflow, such as structural, temporal, etc. our focus in this paper is on a constraint which allows dynamic selection of activities for inclusion in a given instance. We call these cardinality constraints, and this paper will discuss their specification and validation requirements.

Managing service productivity using data envelopment analysis

This chapter provides the theoretical foundation and background on data envelopment analysis (DEA) method. We first introduce the basic DEA models. The balance of this chapter focuses on evidences showing DEA has been extensively applied for measuring efficiency and productivity of services including financial services (banking, insurance, securities, and fund management), professional services, health services, education services, environmental and public services, energy services, logistics, tourism, information technology, telecommunications, transport, distribution, audio-visual, media, entertainment, cultural and other business services. Finally, we provide information on the use of Performance Improvement Management Software (PIM-DEA). A free limited version of this software and downloading procedure is also included in this chapter.

Reconfigurable service-oriented architecture for autonomic computing

Almost a decade has passed since the objectives and benefits of autonomic computing were stated, yet even the latest system designs and deployments exhibit only limited and isolated elements of autonomic functionality. In previous work, we identified several of the key challenges behind this delay in the adoption of autonomic solutions, and proposed a generic framework for the development of autonomic computing systems that overcomes these challenges. In this article, we describe how existing technologies and standards can be used to realise our autonomic computing framework, and present its implementation as a service-oriented architecture. We show how this implementation employs a combination of automated code generation, model-based and object-oriented development techniques to ensure that the framework can be used to add autonomic capabilities to systems whose characteristics are unknown until runtime. We then use our framework to develop two autonomic solutions for the allocation of server capacity to services of different priorities and variable workloads, thus illustrating its application in the context of a typical data-centre resource management problem.

PSS as a service based strategy for western manufacturers

A product-service system (PSS) is a subtle blend of products and services that are offered as an integrated solution to customers. Much existing work on PSS has originated from Scandinavia and has been motivated by a sustainability agenda. Although valuable, this form has limited appeal to western manufacturers. However, by expanding the concepts of PSS to also embrace leading thinking on large scale complex service systems and informated products and services, it is possible to put forward the basis of a service business model that offers the means to differentiate from competitors who simply offer lower priced products. This paper aims to build this case. It reports the state-of-the-art of PSS, defines the concept, reports on its origin and features, discusses examples of applications, and finally proposes a research strategy for future work on this topic.

Does internal marketing improve service quality in call centres?

Although internal marketing has been conceptually argued to improve service quality, empirical evidence in this respect has been limited. This research investigates the relationship between rewards, which are a key component of internal marketing paradigm, and service quality of frontline employees in banking call centres. In this context, the authors develop hypotheses with the help of literature review, and empirically examine the effects of various extrinsic and intrinsic rewards on service quality. The results indicate that intrinsic rewards have greater effect on service quality than extrinsic rewards, which offer managerial implications and directions for future research.

Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Service employee clusters in banking:exploring Ind's typology considering behaviour, commitment and attitude about leadership

Purpose: Ind suggests front line employees can be segmented according to their level of brand-supporting performance. His employee typology has not been empirically tested. The paper aims to explore front line employee performance in retail banking, and profile employee types. Design/methodology/approach: Attitudinal and demographic data from a sample of 404 front line service employees in a leading Irish bank informs a typology of service employees. Findings: Champions, Outsiders and Disruptors exist within retail banking. The authors provide an employee profile for each employee type. They found Champions amongst males, and older employees. The highest proportion of female employees surveyed were Outsiders. Disruptors were more likely to complain, and rated their performance lower than any other employee type. Contrary to extant literature, Disruptors were more likely to hold a permanent contract than other employee types. Originality/value: The authors augment the literature by providing insights about the profile of three employee types: Brand Champions, Outsiders and Disruptors. Moreover, the authors postulate the influence of leadership and commitment on each employee type. The cluster profiles raise important questions for hiring, training and rewarding front line banking employees. The authors also provide guidelines for managers to encourage Champions, and curtail Disruptors. © Emerald Group Publishing Limited.

Bilateral visual outcomes and service utilization of patients treated for 3 years with ranibizumab for neovascular age-related macular degeneration

Background: The aim of this study was to describe bilateral visual outcomes and the effect of incomplete follow-up after 3 years of ranibizumab therapy for neovascular age-related macular degeneration. Secondarily, the demands on service provision over a 3-year period were described. Methods: Data on visual acuity, hospital visits, and injections were collected over 36 months on consecutive patients commencing treatment over a 9-month period. Visual outcome was determined for 1) all patients, using last observation carried forward for missed visits due to early discontinuation and 2) only those patients completing full 36-month follow-up. Results: Over 3 years, 120 patients cumulatively attended hospital for 1,823 noninjection visits and 1,365 injection visits. A visual acuity loss of <15 letters (L) was experienced by 78.2% of patients. For all patients (n=120), there was a mean loss of 1.68 L using last observation carried forward for missing values. Excluding five patients who died and 30 who discontinued follow-up, mean gain was 1.47 L. In bilateral cases, final acuity was on average 9 L better in second eyes compared to first eyes. Also, 91% of better-seeing eyes continued to be the better-seeing eye. Conclusion: We have demonstrated our approach to describing the long-term service provision and visual outcomes of ranibizumab therapy for neovascular age-related macular degeneration in a consecutive cohort of patients. Although there was a heavy burden with very frequent injections and clinic visits, patients can expect a good level of visual stability and a very high chance of maintaining their better-seeing eye for up to 3 years. © 2014 Chavan et al. This work is published by Dove Medical Press Limited.

A Conceptual Foresight Model to Investigate the Adoption of Radio Frequency Identification Technology in the English National Health Service

Radio Frequency Identification Technology (RFID) adoption in healthcare settings has the potential to reduce errors, improve patient safety, streamline operational processes and enable the sharing of information throughout supply chains. RFID adoption in the English NHS is limited to isolated pilot studies. Firstly, this study investigates the drivers and inhibitors to RFID adoption in the English NHS from the perspective of the GS1 Healthcare User Group (HUG) tasked with coordinating adoption across private and public sectors. Secondly a conceptual model has been developed and deployed, combining two of foresight’s most popular methods; scenario planning and technology roadmapping. The model addresses the weaknesses of each foresight technique as well as capitalizing on their individual, inherent strengths. Semi structured interviews, scenario planning workshops and a technology roadmapping exercise were conducted with the members of the HUG over an 18-month period. An action research mode of enquiry was utilized with a thematic analysis approach for the identification and discussion of the drivers and inhibitors of RFID adoption. The results of the conceptual model are analysed in comparison to other similar models. There are implications for managers responsible for RFID adoption in both the NHS and its commercial partners, and for foresight practitioners. Managers can leverage the insights gained from identifying the drivers and inhibitors to RFID adoption by making efforts to influence the removal of inhibitors and supporting the continuation of the drivers. The academic contribution of this aspect of the thesis is in the field of RFID adoption in healthcare settings. Drivers and inhibitors to RFID adoption in the English NHS are compared to those found in other settings. The implication for technology foresight practitioners is a proof of concept of a model combining scenario planning and technology roadmapping using a novel process. The academic contribution to the field of technology foresight is the conceptual development of foresight model that combines two popular techniques and then a deployment of the conceptual foresight model in a healthcare setting exploring the future of RFID technology.

Szolgáltatások ellátási láncának speciális menedzsment jellemzői = Specialties in managing service supply chains

Az elmúlt évtizedekben a gazdálkodástudomány kitüntetett figyelemmel kísért két - mind a makrogazdaság, mind az egyes vállalatok működésének sikere szempontjából meghatározó fontosságú - jelenséget, egyrészt a szolgáltatásoknak a hagyományos termeléssel szembeni egyre erőteljesebb térnyerését, másrészt a fogyasztói érték teremtése szempontjából növekvő jelentőségű ellátási láncoknak, illetve azok menedzsmentjének kérdéskörét. Ugyanakkor igen kevés elemzés, de kevés leíró jellegű munka is született a két jelenséget és menedzsment problémát összekapcsoló területről, azaz a szolgáltatások ellátási láncáról, ezen ellátási láncok kezelésének speciális problémáiról. Jelen műhelytanulmányban a szolgáltatások ellátási láncának és menedzsmentjének jellegzetességeit, a klasszikus terméket előállító ellátási láncokhoz viszonyított sajátosságait foglaltuk össze a nemzetközi szakirodalom alapján. Ennek során bemutattuk, hogy az ún. tiszta szolgáltatások széles körben ismert jellemzői hatással vannak a szolgáltatások előállítását és értékesítését végző ellátási láncok működésére is. Ezek a hatások és a specialitások megjelennek az ellátási lánc menedzsment irodalomban megjelenő mindhárom problémakörre, rányomják tehát bélyegüket mind az ellátási lánc felépítésére, struktúrájára, mind az ellátási láncban együttműködő partnerek kapcsolatának = In the last decades scholars have paid a lot of attention to both service operation and supply chain management. There is still limited research on the overlapping field of theses two management areas, on service supply chain specialties. This working paper gives a structured overview on the latest research results published in English. Doing so the paper would like to draw attention of the Hungarian researchers to this field and facilitate these empirical researches. As described in the paper traditional service specialties (intangibility, perishability, inseparability, heterogeneity and the importance of human capital) create special management problems concerning (i) the structure of these supply chains, (ii) their relationship management and (iii) the management of supply chain processes.

3D TerraFly: Quality of service management for online interactive 3D geographic information system

3D geographic information system (GIS) is data and computation intensive in nature. Internet users are usually equipped with low-end personal computers and network connections of limited bandwidth. Data reduction and performance optimization techniques are of critical importance in quality of service (QoS) management for online 3D GIS. In this research, QoS management issues regarding distributed 3D GIS presentation were studied to develop 3D TerraFly, an interactive 3D GIS that supports high quality online terrain visualization and navigation. ^ To tackle the QoS management challenges, multi-resolution rendering model, adaptive level of detail (LOD) control and mesh simplification algorithms were proposed to effectively reduce the terrain model complexity. The rendering model is adaptively decomposed into sub-regions of up-to-three detail levels according to viewing distance and other dynamic quality measurements. The mesh simplification algorithm was designed as a hybrid algorithm that combines edge straightening and quad-tree compression to reduce the mesh complexity by removing geometrically redundant vertices. The main advantage of this mesh simplification algorithm is that grid mesh can be directly processed in parallel without triangulation overhead. Algorithms facilitating remote accessing and distributed processing of volumetric GIS data, such as data replication, directory service, request scheduling, predictive data retrieving and caching were also proposed. ^ A prototype of the proposed 3D TerraFly implemented in this research demonstrates the effectiveness of our proposed QoS management framework in handling interactive online 3D GIS. The system implementation details and future directions of this research are also addressed in this thesis. ^

A theory of constraints service systems improvement method: Case of the airline turnaround problem

This dissertation develops a process improvement method for service operations based on the Theory of Constraints (TOC), a management philosophy that has been shown to be effective in manufacturing for decreasing WIP and improving throughput. While TOC has enjoyed much attention and success in the manufacturing arena, its application to services in general has been limited. The contribution to industry and knowledge is a method for improving global performance measures based on TOC principles. The method proposed in this dissertation will be tested using discrete event simulation based on the scenario of the service factory of airline turnaround operations. To evaluate the method, a simulation model of aircraft turn operations of a U.S. based carrier was made and validated using actual data from airline operations. The model was then adjusted to reflect an application of the Theory of Constraints for determining how to deploy the scarce resource of ramp workers. The results indicate that, given slight modifications to TOC terminology and the development of a method for constraint identification, the Theory of Constraints can be applied with success to services. Bottlenecks in services must be defined as those processes for which the process rates and amount of work remaining are such that completing the process will not be possible without an increase in the process rate. The bottleneck ratio is used to determine to what degree a process is a constraint. Simulation results also suggest that redefining performance measures to reflect a global business perspective of reducing costs related to specific flights versus the operational local optimum approach of turning all aircraft quickly results in significant savings to the company. Savings to the annual operating costs of the airline were simulated to equal 30% of possible current expenses for misconnecting passengers with a modest increase in utilization of the workers through a more efficient heuristic of deploying them to the highest priority tasks. This dissertation contributes to the literature on service operations by describing a dynamic, adaptive dispatch approach to manage service factory operations similar to airline turnaround operations using the management philosophy of the Theory of Constraints.

The Food Service Industry: Beliefs Held by Academics

In his study - The Food Service Industry: Beliefs Held by Academics - by Jack Ninemeier, Associate Professor, School of Hotel, Restaurant and Institutional Management at Michigan State University, Associate Professor Ninemeier initially describes his study this way: “Those in the academic sector exert a great deal of influence on those they are training to enter the food service industry. One author surveyed educational institutions across the country to ascertain attitudes of teachers toward various segments of the industry.” Those essential segments of the industry serve as the underpinnings of this discussion and are four-fold. They are lodging, institutional, multi-unit, and single-unit properties. For each segment the analysis addressed factors relating to Marketing, management and operating concerns: Marketing, operations, fiscal management, innovation, future of the segment Employee-related concerns: quality of work life, training/education opportunities, career opportunities The study uses a survey of academicians as a guide; they point to segments of the food service industry students might be inclined to enter, or even ignore. The survey was done via a questionnaire sent from the campus of the School of Hotel, Restaurant and Institutional Management at Michigan State University to 1850 full-time faculty members in two and four-year hospitality programs in the United States. Through the survey, Ninemeier wishes to reasonably address specific problems now confronting the food service industry. Those problems include but are not limited to: reducing employee turnover, retaining staff, increasing productivity and revenue, and attracting new staff. “Teachers in these programs are, therefore, an important plank in industry's platform designed to recruit students with appropriate background knowledge and interest in their operations,” Ninemeier says. Your author actually illustrates the survey results, in table form. The importance to an employee, of tangibles and intangibles such as morale, ego/esteem, wages, and benefits are each explored through the survey. According to the study, an interesting dichotomy exists in the institutional property element. Although, beliefs the academics hold about the institutional element suggest that it offers low job stress, attractive working conditions, and non-demanding competitive pressures, the survey and Ninemeier also observe: “Academics do not believe that many of their graduates will enter the institutional segment.” “If academic beliefs are incorrect, an educational program to educate academics about management and employee opportunities in the segment may be in order,” Ninemeier waxes philosophically.

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL™ Generic Core Module for child health and functioning, PedsQL™ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.