757 resultados para service delivery models


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A model is presented that captures the complex nature of the service experience in an attempt to aid in the design, development and evaluation of service delivery personnel and systems.

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Postprint

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Thesis (Ph.D.)--University of Washington, 2016-08

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Social-scientific analysis of public-participation initiatives has proliferated in recent years. This review article discusses some key aspects of recent work. Firstly, it analyses some of the justifications put forward for public participation, drawing attention to differences and overlaps between rationales premised on democratic representation/representativeness and those based on more technocratic ideas about the knowledge that the public can offer. Secondly, it considers certain tensions in policy discourses on participation, focusing in particular on policy relating to the National Health Service and other British public services. Thirdly, it examines the challenges of putting a coherent vision for public participation into practice, noting the impediments that derive from the often-competing ideas about the remit of participation held by different groups of stakeholders. Finally, it analyses the gap between policy and practice, and the consequences of this for the prospects for the enactment of active citizenship through participation initiatives.

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Academic libraries are faced with a daunting series of challenges brought on by the digital revolution. In an era when millions of books, articles, images, and videos available instantaneously via the web, libraries across all institutional types are experiencing declining demand for their traditional services, built around the storage and dissemination of physical resources. At the same time, new demand for digital information services and collaborative learning spaces promise new areas of opportunity and engagement with patrons. A rapid and orderly transition to “the library of the future” requires difficult trade-offs, however, as no institution can afford to continue expanding both its commitment to comprehensive, local print collections as well as new investments in staff, technology, and renovations. This report illustrates how progressive academic libraries are evolving in response to these challenges, providing case studies and best practices in managing library space, staff, and resources.

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The demand for palliative care is increasing, yet there are few data on the best models of care nor well-validated interventions that translate current evidence into clinical practice. Supporting multidisciplinary patient-centered palliative care while successfully conducting a large clinical trial is a challenge. The Palliative Care Trial (PCT) is a pragmatic 2 x 2 x 2 factorial cluster randomized controlled trial that tests the ability of educational outreach visiting and case conferencing to improve patient-based outcomes such as performance status and pain intensity. Four hundred sixty-one consenting patients and their general practitioners (GPs) were randomized to the following: (1) GP educational outreach visiting versus usual care, (2) Structured patient and caregiver educational outreach visiting versus usual care and (3) A coordinated palliative care model of case conferencing versus the standard model of palliative care in Adelaide, South Australia (3:1 randomization). Main outcome measures included patient functional status over time, pain intensity, and resource utilization. Participants were followed longitudinally until death or November 30, 2004. The interventions are aimed at translating current evidence into clinical practice and there was particular attention in the trial's design to addressing common pitfalls for clinical studies in palliative care. Given the need for evidence about optimal interventions and service delivery models that improve the care of people with life-limiting illness, the results of this rigorous, high quality clinical trial will inform practice. Initial results are expected in mid 2005. (c) 2005 Elsevier Inc. All rights reserved.

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This dissertation studies refugee resettlement in the United States utilizing the Integration Indicator’s framework developed by Ager and Strang for the U.S. context. The study highlights the U.S. refugee admissions program and the policies in the states of Maryland and Massachusetts while analyzing the service delivery models and its effects on refugee integration in these locations. Though immigration policy and funding for refugee services are primarily the domain of the federal government, funds are allocated through and services are delivered at the state level. The Office of Refugee Resettlement (ORR), which operates under the Department of Health and Human Services, was established after the Refugee Act of 1980 to deliver assistance to displaced persons. The ORR provides funds to individual states primarily through The Refugee Social Service and Targeted Assistance Formula Grant programs. Since the inauguration of the ORR three primary models of refugee integration through service delivery have emerged. Two of the models include the publicly/privately administered programs, where resources are allocated to the state in conjunction with private voluntary agencies; and the Wilson/Fish Alternative programs, where states sub-contract all elements of the resettlement program to voluntary agencies and private organizations —in which they can cease all state level participation and voluntary agencies or private organizations contract directly from the ORR in order for all states to deliver refugee services where the live. The specific goals of this program are early employment and economic self-sufficiency. This project utilizes US Census, state, and ORR data in conjunction with interviews of refugee resettlement practitioners involved in the service delivery and refugees. The findings show that delivery models emphasizing job training, English instruction courses, institutional collaboration, and monetary assistance, increases refugee acclimation and adaptation, providing insight into their potential for integration into the United States.

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Globaalin talouden rakenteet muuttuvat jatkuvasti. Yritykset toimivat kansainvälisillä markkinoilla aiempaa enemmän. Tuotannon lisäämiseksi monet yritykset ovat ulkoistaneet tuotteidensa tuki- ja ylläpitotoiminnot halvan työvoiman maihin. Yritykset voivat tällöin keskittää toimintansa ydinosamiseensa. Vapautuneita resursseja voidaan käyttää yrityksen sisäisessä tuotekehityksessä ja panostaa seuraavan sukupolven tuotteiden ja teknologioiden kehittämiseen. Diplomityö esittelee Globaalisti hajautetun toimitusmallin Internet-palveluntarjoajalle jossa tuotteiden tuki- ja ylläpito on ulkoistettu Intiaan. Teoriaosassa esitellään erilaisia toimitusmalleja ja keskitytään erityisesti hajautettuun toimitusmalliin. Tämän lisäksi luetellaan valintakriteerejä joilla voidaan arvioida projektin soveltuvuutta ulkoistettavaksi sekä esitellään mahdollisuuksia ja uhkia jotka sisältyvät globaaliin ulkoistusprosessiin. Käytäntöosassa esitellään globaali palvelun toimittamisprosessi joka on kehitetty Internet-palveluntarjoajan tarpeisiin.

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The Access to Allied Psychological Services component of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; Allied health professionals were providing services from GPs' rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

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Many public organisations have been under great pressure in recent years to increase the efficiency and transparency of outputs, to rationalise the use of public resources, and to increase the quality of service delivery. In this context, public organisations were encouraged to introduce the New Public Management reforms with the goal of improving the efficiency and effectiveness of the performance organisation through a new public management model. This new public management model is based on measurement by outputs and outcomes, a clear definition of responsibilities, the transparency and accountability of governmental activities, and on a greater value for citizens. What type of performance measurement systems are used in police services? Based on the literature, we see that multidimensional models, such as the Balanced Scorecard, are important in many public organisations, like municipalities, universities, and hospitals. Police services are characterised by complex, diverse objectives and stakeholders. Therefore, performance measurement of these public services calls for a specific analysis. Based on a nationwide survey of all police chiefs of the Portuguese police force, we find that employee performance measurement is the main form of measurement. Also, we propose a strategic map for the Portuguese police service.

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The purpose of this paper is to describe the development and to test the reliability of a new method called INTERMED, for health service needs assessment. The INTERMED integrates the biopsychosocial aspects of disease and the relationship between patient and health care system in a comprehensive scheme and reflects an operationalized conceptual approach to case mix or case complexity. The method is developed to enhance interdisciplinary communication between (para-) medical specialists and to provide a method to describe case complexity for clinical, scientific, and educational purposes. First, a feasibility study (N = 21 patients) was conducted which included double scoring and discussion of the results. This led to a version of the instrument on which two interrater reliability studies were performed. In study 1, the INTERMED was double scored for 14 patients admitted to an internal ward by a psychiatrist and an internist on the basis of a joint interview conducted by both. In study 2, on the basis of medical charts, two clinicians separately double scored the INTERMED in 16 patients referred to the outpatient psychiatric consultation service. Averaged over both studies, in 94.2% of all ratings there was no important difference between the raters (more than 1 point difference). As a research interview, it takes about 20 minutes; as part of the whole process of history taking it takes about 15 minutes. In both studies, improvements were suggested by the results. Analyses of study 1 revealed that on most items there was considerable agreement; some items were improved. Also, the reference point for the prognoses was changed so that it reflected both short- and long-term prognoses. Analyses of study 2 showed that in this setting, less agreement between the raters was obtained due to the fact that the raters were less experienced and the scoring procedure was more susceptible to differences. Some improvements--mainly of the anchor points--were specified which may further enhance interrater reliability. The INTERMED proves to be a reliable method for classifying patients' care needs, especially when used by experienced raters scoring by patient interview. It can be a useful tool in assessing patients' care needs, as well as the level of needed adjustment between general and mental health service delivery. The INTERMED is easily applicable in the clinical setting at low time-costs.

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VVALOSADE is a research project of professor Anita Lukka's VALORE research team in the Lappeenranta University of Technology. The VALOSADE includes the ELO technology program of Tekes. SMILE is one of four subprojects of the VALOSADE. The SMILE study focuses on the case of the company network that is composed of small and micro-sized mechanical maintenance service providers and forest industry as large-scale customers. The basic principle of the SMILE study is the communication and ebusiness in supply and demand networks. The aim of the study is to develop ebusiness strategy, ebusiness model and e-processes among the SME local service providers, and onthe other hand, between the local service provider network and the forest industry customers in a maintenance and operations service business. A literature review, interviews and benchmarking are used as research methods in this qualitative case study. The first SMILE report, 'Ebusiness between Global Company and Its Local SME Supplier Network', concentrated on creating background for the SMILE study by studying general trends of ebusiness in supply chains and networks of different industries. This second phase of the study concentrates on case network background, such as business relationships, information systems and business objectives; core processes in maintenance and operations service network; development needs in communication among the network participants; and ICT solutions to respond needs in changing environment. In the theory part of the report, different ebusiness models and frameworks are introduced. Those models and frameworks are compared to empirical case data. From that analysis of the empirical data, therecommendations for the development of the network information system are derived. In process industry such as the forest industry, it is crucial to achieve a high level of operational efficiency and reliability, which sets up great requirements for maintenance and operations. Therefore, partnerships or strategic alliances are needed between the network participants. In partnerships and alliances, deep communication is important, and therefore the information systems in the network also are critical. Communication, coordination and collaboration will increase in the case network in the future, because network resources must be optimised to improve competitive capability of the forest industry customers and theefficiency of their service providers. At present, ebusiness systems are not usual in this maintenance network. A network information system among the forest industry customers and their local service providers actually is the only genuinenetwork information system in this total network. However, the utilisation of that system has been quite insignificant. The current system does not add value enough either to the customers or to the local service providers. At present, thenetwork information system is the infomediary that share static information forthe network partners. The network information system should be the transaction intermediary, which integrates internal processes of the network companies; the network information system, which provides common standardised processes for thelocal service providers; and the infomediary, which share static and dynamic information on right time, on right partner, on right costs, on right format and on right quality. This study provides recommendations how to develop this system in the future to add value to the network companies. Ebusiness scenarios, vision, objectives, strategies, application architecture, ebusiness model, core processes and development strategy must be considered when the network information system will be developed in the next development step. The core processes in the case network are demand/capacity management, customer/supplier relationship management, service delivery management, knowledge management and cash flow management. Most benefits from ebusiness solutions come from the electrifying of operational level processes, such as service delivery management and cash flow management.

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Tässä työssä tutkittiin sähköisen liiketoiminnan palveluiden tarvetta kartonkiteollisuudessa. Palveluiden tarvetta ja sisältöä tutkittiin suomalaisessa metsäteollisuusyrityksessä. Tutkimus suoritettiin teemahaastatteluin ja sitä täydennettiin tekemällä yritys case. Tutkimuksen pohjana toimi esiselvitys, jossa muutamia sähköisen liiketoiminnan palveluita oli tunnistettu. Sähköisen liiketoiminnan palveluiden on havaittu lisääntyneen merkittävästi yritystenvälisessä liiketoiminnassa. Kuluttajakaupassa sähköisen liiketoiminnan palvelut ovat olleet jo pitkään käytössä. Sähköisen kaupankäynnin lisääntyminen on ajanut yrityksiä perustamaan sähköisiä kauppapaikkoja, modernisoimaan toimitusmallejaan tai palvelukonseptejaan sekä huomioimaan sähköisen tiedonvaihdon vaikutuksia liiketoimissaan. Tutkimuksen tulokset johtivat kolmeen johtopäätökseen. Tutkimus osoitti, että sähköisen liiketoiminnan palvelut ovat osa nykyaikaista yritystenvälistä liiketoimintaa. Palveluita on olemassa ja niitä on tarjolla yrityksen kilpailijoiden toimesta maailmanlaajuisesti. Toiseksi tutkimus osoitti, että toimitusketjun tulevaisuus on palveluiden kehittämisessä ja niiden rakentamisessa. Kartonkituotteet lähenevät toisiaan laadullisesti kokoajan, sähköiset palvelut voivat tuoda kilpailuetua ja niiden avulla voidaan erottua markkinoilla. Kolmanneksi, sähköiseen liiketoimintaan on panostettava ja palveluita on rakennettava toimitusmalleja tukevaksi. Palveluiden sisällön on huomioitava asiakastarpeet.

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As marketers and researchers we understand quality from the consumer's perspective, and throughout contemporary service quality literature there is an emphasis on what the consumer is looking for, or at least that is the intention. Through examining the underlying assumptions of dominant service quality theories, an implicit dualistic ontology is highlighted (where subject and object are considered independent) and argued to effectively negate the said necessary consumer orientation. This fundamental assumption is discussed, as are the implications, following a critical review of dominant service quality models. Consequently, we propose an alternative approach to service quality research that aims towards a more genuine understanding of the consumer's perspective on quality experienced within a service context. Essentially, contemporary service quality research is suggested to be limited in its inherent third-person perspective and the interpretive, specifically phenomenographic, approach put forward here is suggested as a means of achieving a first-person perspective on service quality.