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.

Building engaged, sustainable online communities : a case study of an adventure travel website

This paper will provide an overview of a join research initiative being developed by the Queensland University of Technology in conjunction with the Australian Smart Services Cooperative Research Centre in relation to the development and analysis of online communities. The intention of this project is to initially create an exciting and innovative web space around the concept of adventure travel and then to analyse the level of user engagement to uncover possible patterns and processes that could be used in the future development of other virtual online communities. Travel websites are not a new concept and there are many successful examples currently operating and generating profit. The intention of the QUT/Smart Services CRC project is to analyse the site metrics to determine the following: what specific conditions/parameters are required to foster a growing and engaged virtual community; when does the shift occur from external moderation to a more sustainable system of self-moderation within the online community; when do users begin to take ownership of a site and take an invested interested in the content and growth of an online community; and how to retain active contributors and high-impact power users on a long-term basis. With the travel website rapidly approaching release, this paper begins the process of reflection, outlining the process undertaken and the findings so far aggregated whilst also positioning the project within the greater context of current online user participation and user generated content research.

Value management : an extension of quantity surveying services in Malaysia

Value Management (VM) initially started in early 1940s in the US manufacturing industry has increasingly becoming popular within the construction industry community internationally. It has been widely accepted as an important tool in the management of projects. The structured, systematic and multi-disciplinary approach in decision making process is a niche for VM in delivering better value for money project to the client investment. It would appear to be gaining some momentum as an essential management tool in the Malaysian construction sector especially in the quantity surveying practice. Quantity surveyors increasing involvement in VM provides an opportunity for the profession to re-model some of its traditional services in a more positive light and develop leading-edge skills and promote the profession. International practice has associated VM to be part of services offered in the quantity surveying practice; especially in UK has proven to be a natural progression of QS profession. The introduction of VM as early 1980’s in Malaysia combined with increasing demand for construction project to facilitate nation progress is shedding a positive light for quantity surveying profession to take lead in developing VM as one of their niche area. Therefore, the quantity surveying profession having the opportunity to take lead of this service which reflect their traditional attributes for providing the best value-for-money advise to the client. This paper shall discuss on the development of VM in Malaysia and the challenges VM face services in QS firm to remain ahead of their competitors.

The extent of six sigma methodologies usage in services

The last two decades have seen the application of six sigma methodologies in many manufacturing and also some service industries. Six sigma’s success in manufacturing is well published. But the same cannot be said about its implementation in services. Applying six sigma to services is still limited to only a small number of services. This paper reviews the application of six sigma in service industries. Emphasis is given to application issues such as what are necessary critical success factors and key performance indicators in order for a project to be successful. A pilot study was carried out in order to highlight the issues discussed. Regardless of the service that is provided, a number of guidelines can be commonly applied to varying types of services. The aim of this paper is to help widen the scope of six sigma application in services.

Applying six-sigma in the service industry: a review and case study in call center services

This paper presents an extensive review on the services, six-sigma, and application of six-sigma in services. In order to improve service quality focus on service process is necessary. Six-sigma is a philosophy which also concentrates on the improvement of process. So, six-sigma if properly applied can be useful for services. This study focuses on the application aspect of six-sigma to wider range of services. The wider applicability of six-sigma depends on identification of key performance indicators(KPIs) for different types of service processes. A case study is conducted in call center services to identify, analyze and compare critical to quality characteristics (CTQs) and KPIs with other types of services available in literature. This study will be helpful to both practitioners and researchers.

Problems with a great idea : referral by prehospital emergency services to a community-based falls-prevention service

Background and aim Falls are the leading cause of injury in older adults. Identifying people at risk before they experience a serious fall requiring hospitalisation allows an opportunity to intervene earlier and potentially reduce further falls and subsequent healthcare costs. The purpose of this project was to develop a referral pathway to a community falls-prevention team for older people who had experienced a fall attended by a paramedic service and who were not transported to hospital. It was also hypothesised that providing intervention to this group of clients would reduce future falls-related ambulance call-outs, emergency department presentations and hospital admissions. Methods An education package, referral pathway and follow-up procedures were developed. Both services had regular meetings, and work shadowing with the paramedics was also trialled to encourage more referrals. A range of demographic and other outcome measures were collected to compare people referred through the paramedic pathway and through traditional pathways. Results Internal data from the Queensland Ambulance Service indicated that there were approximately six falls per week by community-dwelling older persons in the eligible service catchment area (south west Brisbane metropolitan area) who were attended to by Queensland Ambulance Service paramedics, but not transported to hospital during the 2-year study period (2008–2009). Of the potential 638 eligible patients, only 17 (2.6%) were referred for a falls assessment. Conclusion Although this pilot programme had support from all levels of management as well as from the service providers, it did not translate into actual referrals. Several explanations are provided for these preliminary findings.

Rethinking regulatory design : The Australian National Classification Scheme review

This paper considers issues of methodological innovation in communication, media and cultural studies, that arise out of the extent to which we now live in a media environment characterised by an digital media abundance, the convergence of media platforms, content and services, and the globalisation of media content through ubiquitous computing and high-speed broadband networks. These developments have also entailed a shift in the producer-consumer relationships that characterised the 20th century mass communications paradigm, with the rapid proliferation of user-created content, accelerated innovation, the growing empowerment of media users themselves, and the blurring of distinctions between public and private, as well as age-based distinctions in terms of what media can be accessed by whom and for what purpose. It considers these issues through a case study of the Australian Law Reform Commission's National Classification Scheme Review.

Apps and attitudes : towards an understanding of the m-librarian’s professional make-up

This chapter will discuss a research project that identifies the skills, knowledge and attitudes of the m-librarian. Six library and information professionals engaged in the provision of m-library services throughout Australia were interviewed. Six themes emerged as being critical for the m-librarian: technology, personal traits, user focus, communication, collaboration, research and development. The research is significant because it establishes an open dialogue between current industry professionals, library science educators and the professional association on the evolving skills and knowledge required by information professional in a world of rapidly changing technology. This dialogue will guide the development of current and future education of library and information professionals.

Where do we find services in enterprise architectures? A comparative approach

In recent years, enterprise architecture (EA) has captured growing attention as a means to systematically consolidate and interrelate diverse IT artefacts in order to provide holistic decision support. Since the emergence of Service-Oriented Architecture (SOA), many attempts have been made to incorporate SOA artefacts in existing EA frameworks. Yet the approaches taken to achieve this goal differ substantially for the most commonly used EA frameworks to date. This paper investigates and compares five widely used EA frameworks in the way they embrace the SOA paradigm. It identifies what SOA artefacts are considered to be in the respective EA frameworks and their relative position in the overall structure. The results show that services and related artefacts are far from being well-integrated constructs in current EA frameworks. The comparison presented in this paper will support practitioners in identifying an EA framework that provides SOA support in a way that matches their requirements and will hopefully inspire the academic EA and SOA communities to work on a closer integration of these architectures.

Conversation, community and kids: blogging for youth at Gold Coast City Council libraries

In late 2007, Gold Coast City Council libraries embarked on an online library project, designed to ramp up libraries’ online services to customers. As part of this project, the Young People’s team identified a need to connect with youth aged 12 to 16 in the online environment, in order to create a direct channel of communication with this market segment and encourage them to engage with the library. Blogging was identified as an appropriate means of communicating with both current and potential library customers from this age group. The Young People’s team consequently prepared a concept plan for a youth blog for launch in Children’s Book Week 2008 and are working towards development of management and administrative models and documentation and implementation of the blog itself. While many libraries have been quick to take up Web 2.0-style services, there has been little formal publication about the successes (or failures) of this type of project. Likewise, few libraries have published about the planning, management, and administration of such services. The youth blog currently in development at Gold Coast City Council libraries will be supported by a robust planning phase and will be rigorously evaluated as part of the project. This paper will report on the project (its aims, objectives and outputs), the planning process, and the evaluation activities and outcomes.

Collaboration : developing integration in multi-purpose services in rural New South Wales, Australia

Introduction: The Multi-purpose Service (MPS) Program was introduced to rural Australia in 1991 as a solution to poor health outcomes in rural compared with metropolitan populations, difficulty in attracting healthcare staff and a lack of viability and range of health services in rural areas. The aim of this study was to describe the main concerns of participants involved in the development of multi-purpose services in rural New South Wales (NSW). This article is abstracted from a larger study and discusses the extent to which collaboration occurred within the new multi-purpose service. Methods: A constructivist grounded theory methodology was used. Participants were from 13 multi-purpose services in rural NSW and 30 in-depth interviews were conducted with 6 community members, 11 managers and 13 staff members who had been involved in the process of developing a multi-purpose service. Results: The main concern of all participants was their anticipation of risk. This anticipation of risk manifested itself in either trust or suspicion and explained their progression through a phase of collaborating. Participants who had trust in other stakeholders were more likely to embrace an integrated health service identity. Those participants, who were suspicious that they would lose status or power, maintained that the previous hospital services provided a better health service and described a coexistence of services within the multi-purpose service. Conclusions: This study provided an insight into the perceptions of community members, staff members and managers involved in the process of developing a multi-purpose service. It revealed that the anticipation of risk was intrinsic to a process of changing from a traditional hospital service to collaborating in a new model of health care provided at a multi-purpose service.

Information interventions for orienting patients and their carers to cancer care facilities

Background: Cancer patients experience distress and anxiety related to their diagnosis, treatment and the unfamiliar cancer centre. Strategies with the aim of orienting patients to a cancer care facility may improve patient outcomes. Although meeting patients' information needs at different stages is important, there is little agreement about the type of information and the timing for information to be given. Orientation interventions aim to address information needs at the start of a person's experience with a cancer care facility. The extent of any benefit of these interventions is unknown. Objectives: To assess the effects of information interventions which orient patients and their carers/family to a cancer care facility, and to the services available in the facility. Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2); MEDLINE (OvidSP) (1966 to Jun 2011), EMBASE (Ovid SP) (1966 to Jun 2011), CINAHL (EBSCO) (1982 to Jun 2011), PsycINFO (OvidSP) (1966 to Jun 2011), review articles and reference lists of relevant articles. We contacted principal investigators and experts in the field. Selection Criteria: Randomised controlled trials (RCTs), cluster RCTs and quasi-RCTs evaluating the effects of information interventions that orient patients and their carers/family to a cancer care facility. Data collection and analysis: Results of searches were reviewed against the pre-determined criteria for inclusion by two review authors. The primary outcomes were knowledge and understanding; health status and wellbeing, evaluation of care, and harms. Secondary outcomes were communication, skills acquisition, behavioural outcomes, service delivery, and health professional outcomes. We pooled results of RCTs using mean differences (MD) and 95% confidence intervals (CI). Main results: We included four RCTs involving 610 participants. All four trials aimed to investigate the effects of orientation programs for cancer patients to a cancer facility. There was high risk of bias across studies. Findings from two of the RCTs demonstrated significant benefits of the orientation intervention in relation to levels of distress (mean difference (MD) -8.96 (95% confidence interval (CI) -11.79 to -6.13), but non-significant benefits in relation to state anxiety levels (MD -9.77 (95% CI -24.96 to 5.41). Other outcomes for participants were generally positive (e.g. more knowledgeable about the cancer centre and cancer therapy, better coping abilities). No harms or adverse effects were measured or reported by any of the included studies. There were insufficient data on the other outcomes of interest. Authors conclusion: This review has demonstrated the feasibility and some potential benefits of orientation interventions. There was a low level of evidence suggesting that orientation interventions can reduce distress in patients. However, most of the other outcomes remain inconclusive (patient knowledge recall/ satisfaction). The majority of studies were subject to high risk of bias, and were likely to be insufficiently powered. Further well conducted and powered RCTs are required to provide evidence for determining the most appropriate intensity, nature, mode and resources for such interventions. Patient and carer-focused outcomes should be included.

ThinkLifecycle

Exhibited at The Fashioning the Future Awards Showcase exhibition Fashioning the Future Awards is the leading international cross-disciplinary platform for celebrating innovative initiatives towards fashion design for sustainability, its development and communication. The 2011 awards are a showcase for exceptional work that celebrates ‘Unique’ ways to create our futures. Fashioning the Future is designed and coordinated by the Centre for Sustainable Fashion at London College of Fashion. Unique Enterprise Award The Unique Enterprise Award was offered for the consideration of the opportunities that arise from the necessity to solve the issues around water, waste, wellbeing, energy, equality and biodiversity. Winner Alice Payne According to Alice Payne there is no one-size-fits-all approach to creating a sustainable fashion system. Existing companies will need to evolve, change the way they design and produce garments, offer services rather than products, and engage with the end user to consider the end of life and future lives of their garments. The ThinkLifecycle content management system (CMS) acts as a bridge between existing industry practices and new, redirected practice in which sustainability is at the forefront of commercial thinking. Its chief aim is to embed lifecycle thinking within a company at a daily, operational level.

Community planning : integrating social and physical environments

This key planning textbook on designing healthy and sustainable communities informs planners about community life and the processes of planning and equips them with the essential knowledge and skills they need to organise change and improve the quality of urban living. The author examines the impacts of social and economic change on community life and organization and explores ways in which these changes can be planned and managed. Community planning is presented as a means to balance and integrate beneficial change with the maintenance of valued cultural traditions and life styles. This involves bringing together fields of study and practice including urban and regional planning, design, communication, housing, community organization, employment, transport, and governance. Links drawn between personal values, human activities, physical spaces and societal governance assist this process of synthesis. Establishing a common vocabulary to discuss planning - for urban and regional planners, including health planners; and open space planners - enables both students and practitioners to work with each other and with those for whom they provide services to create stronger, healthier and more sustainable communities. The aims and roles of community planning are explored and the key planning operations are explained, including the phases and applications of community planning method; the planning and location of community facilities; the roles of design in shaping responsive community spaces; and the capacity of different types of community governance to improve the relations between citizens and societies. The book is organized into two main parts: after the first three chapters have established the interests and scope of community planning, the next six each moves from an account of issues and theoretical concerns, through a review of case studies, to summaries of leading practice. This positive approach is intended to encourage readers to develop their own capacities for effective participation and action. The concluding chapter draws together the contributions of preceding ones to demonstrate the integrity of the community planning process