Managing healthcare technology in quality management framework

Healthcare services available these days deploy high technology to satisfy both internal and external customers by continuously improving various quality parameters. Quality improvement in healthcare services is a complex and multidimensional task. Although various quality management tools are routinely deployed for identifying quality issues in healthcare delivery, there is absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues and develop a project management framework to implement and evaluate those solutions. This study introduces an integrated and uniform quality management framework for healthcare services. This study uses the Logical Framework Analysis (LFA) to improve the performance of healthcare services. LFA has three major steps - problem identification, solution derivation and formation of a planning matrix for implementation and evaluation. LFA has been applied in a case study environment to three acute healthcare services (Operating Room (OR) utilisation, Accident and Emergency (A&E) and intensive care) in order to demonstrate its effectiveness. Copyright © 2007 Inderscience Enterprises Ltd.

An exploratory study of the utilisation of the UK's Prudential Borrowing Framework

This article considers the utilisation of the UK’s Prudential Borrowing Framework (PBF) and the associated Prudential Code for local government capital finance. It finds that the increased flexibility and local freedom are at the cost of less financial certainty in terms of the risks borne by local authorities and local tax payers. The PBF seems to encourage a less formal approach to risk, being considered inevitable and handled if and when adverse risk outcomes occur. Consequently capital projects may lack affordability, sustainability and prudence. The Prudential Indicators required by the Code are not easily understood by non-specialists and their calculation cannot be used to replace sound judgement or to identify the best financing option.

Assessing pupil and school performance by non-parametric and parametric techniques

This paper discusses the use of the non-parametric free disposal hull (FDH) and the parametric multi-level model (MLM) as alternative methods for measuring pupil and school attainment where hierarchical structured data are available. Using robust FDH estimates, we show how to decompose the overall inefficiency of a unit (a pupil) into a unit specific and a higher level (a school) component. By a sample of entry and exit attainments of 3017 girls in British ordinary single sex schools, we test the robustness of the non-parametric and parametric estimates. Finally, the paper uses the traditional MLM model in a best practice framework so that pupil and school efficiencies can be computed.

Performance measurement based co-ordination of enterprise resource planning systems in a virtual enterprise

As the backbone of e-business, Enterprise Resource Planning (ERP)system plays an important role in today's competitive business environment. Few publications discuss the application of ERP systems in a virtual enterprise (VE). A VE is defined as a dynamic partnership among enterprises that can bring together complementary core competencies needed to achieve a business task. Since VE strongly emphasises partner cooperation, specific issues exist relative to the implementation of ERP systems in a VE. This paper discusses the use of VE Performance Measurement System(VEPMS) to coordinate ERP systems of VE partners. It also defines the framework of a `Virtual Enterprise Resource Planning (VERP) system', and identifies research avenues in this field.

Shareholder or stakeholder management:strategies for performance optimisation

This paper is based upon the findings of a CIMA research project into the way which corporate performance is affected by the performance measurement system adopted. It compares and contrasts the techniques in use in a sample of large companies that use a variety of techniques. We have classified these techniques into 3 types: • Value based management techniques • Stakeholder management techniques • Traditional accounting techniques. The analysis traces the interactions between corporate objectives, decision making criteria, performance measurement systems, and executive incentive schemes in order to develop an understanding of the effects of such techniques upon corporate performance. This paper seeks to provide some answers to the following two questions: • What approach leads to superior performance for a firm? • What is different between these approaches when they are used in practice, as distinct from theory? In doing so we have drawn upon both contingency theory and sociobiology theory to develop a framework for understanding the relationship between the choke of performance measurement system and the resulting performance.

Performance data indicate summation for pictorial depth-cues in slanted surfaces

Over recent years much has been learned about the way in which depth cues are combined (e.g. Landy et al., 1995). The majority of this work has used subjective measures, a rating scale or a point of subjective equality, to deduce the relative contributions of different cues to perception. We have adopted a very different approach by using two interval forced-choice (2IFC) performance measures and a signal processing framework. We performed summation experiments for depth cue increment thresholds between pairs of pictorial depth cues in displays depicting slanted planar surfaces made from arrays of circular 'contrast' elements. Summation was found to be ideal when size-gradient was paired with contrast-gradient for a wide range of depth-gradient magnitudes in the null stimulus. For a pairing of size-gradient and linear perspective, substantial summation (> 1.5 dB) was found only when the null stimulus had intermediate depth gradients; when flat or steeply inclined surfaces were depicted, summation was diminished or abolished. Summation was also abolished when one of the target cues was (i) not a depth cue, or (ii) added in conflict. We conclude that vision has a depth mechanism for the constructive combination of pictorial depth cues and suggest two generic models of summation to describe the results. Using similar psychophysical methods, Bradshaw and Rogers (1996) revealed a mechanism for the depth cues of motion parallax and binocular disparity. Whether this is the same or a different mechanism from the one reported here awaits elaboration.

Whole life performance assessment: critical success factors

Whole life costing (WLC) has become the best practice in construction procurement and it is likely to be a major issue in predicting whole life costs of a construction project accurately. However, different expectations from different organizations throughout a project's life and the lack of data, monitoring targets, and long-term interest for many key players are obstacles to be overcome if WLC is to be implemented. A questionnaire survey was undertaken to investigate a set of ten common factors and 188 individual factors. These were grouped into eight critical categories (project scope, time, cost, quality, contract/administration, human resource, risk, and health and safety) by project phase, as perceived by the clients, contractors and subcontractors in order to identify critical success factors for whole life performance assessment (WLPA). Using a relative importance index, the top ten critical factors for each category, from the perspective of project participants, were analyzed and ranked. Their agreement on those categories and factors were analyzed using Spearman's rank correlation. All participants identify “Type of Project” as the most common critical factor in the eight categories for WLPA. Using the relative index ranking technique and weighted average methods, it was found that the most critical individual factors in each category were: “clarity of contract” (scope); “fixed construction period” (time); “precise project budget estimate” (cost); “material quality” (quality); “mutual/trusting relationships” (contract/administration); “leadership/team management” (human resource); and “management of work safety on site” (health and safety). There was relatively a high agreement on these categories among all participants. Obviously, with 80 critical factors of WLPA, there is a stronger positive relationship between client and contactor rather than contractor and subcontractor, client and subcontractor. Putting these critical factors into a criteria matrix can facilitate an initial framework of WLPA in order to aid decision making in the public sector in South Korea for evaluation/selection process of a construction project at the bid stage.

A configuration framework of manufacturing strategy paradigm in state owned enterprises within China's petrochemical industry:building context-embedded configurations for the paradigm of strategic manufacturing management from exploratory case studies

The role of the production system as a key determinant of competitive performance of business operations- has long been the subject of industrial organization research, even predating the .explicit conceptua1isation of manufacturing, strategy in the literature. Particular emergent production issues such as the globalisation of production, global supply chain management, management of integrated manufacturing and a growing e~busjness environment are expected to critically influence the overall competitive performance and therefore the strategic success of the organization. More than ever, there is a critical need to configure and improve production system and operations competence in a strategic way so as to contribute to the long-term competitiveness of the organization. In order to operate competitively and profitably, manufacturing companies, no matter how well managed, all need a long-term 'strategic direction' for the development of operations competence in order to consistently produce more market value with less cost towards a leadership position. As to the long-term competitiveness, it is more important to establish a dynamic 'strategic perspective' for continuous operational improvements in pursuit of this direction, as well as ongoing reviews of the direction in relation to the overall operating context. However, it also clear that the 'existing paradigm of manufacturing strategy development' is incapable of adequately responding to the increasing complexities and variations of contemporary business operations. This has been factually reflected as many manufacturing companies are finding that methodologies advocated in the existing paradigm for developing manufacturing strategy have very limited scale and scope for contextual contingency in empirical application. More importantly, there has also emerged a deficiency in the multidimensional and integrative profile from a theoretical perspective when operationalising the underlying concept of strategic manufacturing management established in the literature. The point of departure for this study was a recognition of such contextual and unitary limitations in the existing paradigm of manufacturing strategy development when applied to contemporary industrial organizations in general, and Chinese State Owned Enterprises (SOEs) in particular. As China gradually becomes integrated into the world economy, the relevance of Western management theory and its paradigm becomes a practical matter as much as a theoretical issue. Since China markedly differs from Western countries in terms of culture, society, and political and economic systems, it presents promising grounds to test and refine existing management theories and paradigms with greater contextual contingency and wider theoretical perspective. Under China's ongoing programmes of SOE reform, there has been an increased recognition that strategy development is the very essence of the management task for managers of manufacturing companies in the same way as it is for their counterparts in Western economies. However, the Western paradigm often displays a rather naive and unitary perspective of the nature of strategic management decision-making, one which largely overlooks context-embedded factors and social/political influences on the development of manufacturing strategy. This thesis studies the successful experiences of developing manufacturing strategy from five high-performing large-scale SOEs within China’s petrochemical industry. China’s petrochemical industry constitutes a basic heavy industrial sector, which has always been a strategic focus for reform and development by the Chinese government. Using a confirmation approach, the study has focused on exploring and conceptualising the empirical paradigm of manufacturing strategy development practiced by management. That is examining the ‘empirical specifics’ and surfacing the ‘managerial perceptions’ of content configuration, context of consideration, and process organization for developing a manufacturing strategy during the practice. The research investigation adopts a qualitative exploratory case study methodology with a semi-structural front-end research design. Data collection follows a longitudinal and multiple-case design and triangulates case evidence from sources including qualitative interviews, direct observation, and a search of documentations and archival records. Data analysis follows an investigative progression from a within-case preliminary interpretation of facts to a cross-case search for patterns through theoretical comparison and analytical generalization. The underlying conceptions in both the literature of manufacturing strategy and related studies in business strategy were used to develop theoretical framework and analytical templates applied during data collection and analysis. The thesis makes both empirical and theoretical contributions to our understanding of 'contemporary management paradigm of manufacturing strategy development'. First, it provides a valuable contextual contingency of the 'subject' using the business setting of China's SOEs in petrochemical industry. This has been unpacked into empirical configurations developed for its context of consideration, its content and process respectively. Of special note, a lean paradigm of business operations and production management discovered at case companies has significant implications as an emerging alternative for high-volume capital intensive state manufacturing in China. Second, it provides a multidimensional and integrative theoretical profile of the 'subject' based upon managerial perspectives conceptualised at case companies when operationalising manufacturing strategy. This has been unpacked into conceptual frameworks developed for its context of consideration, its content constructs, and its process patterns respectively. Notably, a synergies perspective towards the operating context, competitive priorities and competence development of business operations and production management has significant implications for implementing a lean manufacturing paradigm. As a whole, in so doing, the thesis established a theoretical platform for future refinement and development of context-specific methodologies for developing manufacturing strategy.

A comparative and longitudinal analysis of the evolving relationship between the environment and the strategy, structure and performance of selected organisations in the British carpet industry 1959-1986:a firms in sector perspective of organisational adaptation

Orthodox contingency theory links effective organisational performance to compatible relationships between the environment and organisation strategy and structure and assumes that organisations have the capacity to adapt as the environment changes. Recent contributions to the literature on organisation theory claim that the key to effective performance is effective adaptation which in turn requires the simultaneous reconciliation of efficiency and innovation which is afforded by an unique environment-organisation configuration. The literature on organisation theory recognises the continuing confusion caused by the fragmented and often conflicting results from cross-sectional studies. Although the case is made for longitudinal studies which comprehensively describe the evolving relationship between the environment and the organisation there is little to suggest how such studies should be executed in practice. Typically the choice is between the approaches of the historicised case study and statistical analysis of large populations which examine the relationship between environment and organisation strategy and/or structure and ignore the product-process relationship. This study combines the historicised case study and the multi-variable and ordinal scale approach of statistical analysis to construct an analytical framework which tracks and exposes the environment-organisation-performance relationship over time. The framework examines changes in the environment, strategy and structure and uniquely includes an assessment of the organisation's product-process relationship and its contribution to organisational efficiency and innovation. The analytical framework is applied to examine the evolving environment-organisation relationship of two organisations in the same industry over the same twenty-five year period to provide a sector perspective of organisational adaptation. The findings demonstrate the significance of the environment-organisation configuration to the scope and frequency of adaptation and suggest that the level of sector homogeneity may be linked to the level of product-process standardisation.

Work stressors, strains and hospital unit performance

Hospital employees who work in an environment with zero tolerance to error, face several stressors that may result in psychological, physiological, and behavioural strains, and subsequently, in suboptimal performance. This thesis includes two studies which investigate the stressor-to-strain-to-performance relationships in hospitals. The first study is a cross-sectional, multi-group investigation based on secondary data from 65,142 respondents in 172 acute/specialist UK NHS trusts. This model proposes that senior management leadership predicts social support and job design which, in turn, moderate stressors-to-strains across team structure. The results confirm the model's robustness. Regression analysis provides support for main effects and minimal support for moderation hypotheses. Therefore, based on its conclusions and inherent limitations, study one lays the framework for study two. The second study is a cross-sectional, multilevel investigation of the strain-reducing effects of social environment on externally-rated unit-level performance based on primary data from 1,137 employees in 136 units, in a hospital in Malta. The term "social environment" refers to the prediction of the moderator variables, which is to say, social support and decision latitude/control, by transformational leadership and team climate across hospital units. This study demonstrates that transformational leadership is positively associated with social support, whereas team climate is positively associated with both moderators. At the same time, it identifies a number of moderating effects which social support and decision latitude/control, both separately and together, had on specific stressor-to-strain relationships. The results show significant mediated stressor-to-strain-to-performance relationships. Furthermore, at the higher level, unit-level performance is positively associated with shared unit-level team climate and with unit-level vision, the latter being one of the five sub-dimension of transformational leadership. At the same time, performance is also positively related to both transformational leadership and team climate when the two constructs are tested together. Few studies have linked the buffering effects of the social environment in occupational stress with performance. Therefore, this research strives to make a significant contribution to the occupational stress and performance literature with a focus on hospital practice. Indeed, the study highlights the wide-ranging and far-reaching implications that these findings provide for theory, management, and practice.

Real options and multinational investments : an empirical study of risk, performance and organisational awareness

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT This thesis is a cross-disciplinary study of the empirical impact of real options theory in the fields of decision sciences and performance management. Borrowing from the economics, strategy and operations research literature, the research examines the risk and performance implications of real options in firms’ strategic investments and multinational operations. An emphasis is placed on the flexibility potential and competitive advantage of multinational corporations to explore the extent to which real options analysis can be classified as best practice in management research. Using a combination of qualitative and quantitative techniques the evidence suggests that, if real options are explored and exploited appropriately, real options management can result in superior performance for multinational companies. The qualitative findings give an overview of the practical advantages and disadvantages of real options and the statistical results reveal that firms which have developed a high awareness of their real options are, as predicted by the theory, able to reduce their downside risk and increase profits through flexibility, organisational slack and multinationality. Although real options awareness does not systematically guarantee higher returns from operations, supplementary findings indicate that firms with evidence of significant investments in the acquisition of real options knowledge tend to outperform competitors which are unaware of their real options. There are three contributions of this research. First, it extends the real options and capacity planning literature to path-dependent contingent-claims analysis to underline the benefits of average type options in capacity allocation. Second, it is thought to be the first to explicitly examine the performance effects of real options on a sample of firms which have developed partial capabilities in real options analysis suggesting that real options diffusion can be key to value creation. Third, it builds a new decision-aiding framework to facilitate the use of real options in projects appraisal and strategic planning.

Customer-driven innovation within U.S. business services and its impact on firm performance

This thesis examines the innovative performance of 206 U.S. business service firms. Undeniably, a need exists for better comprehension of the service sector of developed economies. This research takes a unique view by applying a synthesis approach to studying innovation and attempts to build under a proposed strategic innovation paradigm. A quantitative method is utilised via questionnaire in which all major types of innovation are under examination including: product and service, organisational, and technology-driven innovations. Essential ideas for this conceptual framework encapsulate a new mode of understanding service innovation. Basically, the structure of this analysis encompasses the likelihood of innovation and determining the extent of innovation, while also attempting to shed light on the factors which determine the impact of innovation on performance among service firms. What differentiates this research is its focus on customer-driven service firms in addition to other external linkages. A synopsis of the findings suggest that external linkages, particularly with customers, suppliers and strategic alliances or joint ventures, significantly affect innovation performance with regard to the introduction of new services. Service firms which incorporate formal and informal R&D experience significant increases in the extent of new-to-market and new-to-firm innovations. Additionally, the results show that customer-driven service firms experience greater productivity and growth. Furthermore, the findings suggest that external linkages assist service firm performance.

Export memory: a preliminary investigation of its quality, its use, and its link to export performance

Exporting is one of the main ways in which organizations internationalize. With the more turbulent, heterogeneous, sophisticated and less familiar export environment, the organizational learning ability of the exporting organization may become its only source of sustainable competitive advantage. However, achieving a competitive level of learning is not easy. Companies must be able to find ways to improve their learning capability by enhancing the different aspects of the learning process. One of these is export memory. Building from an export information processing framework this research work particularly focuses on the quality of export memory, its determinants, its subsequent use in decision-making, and its ultimate relationship with export performance. Within export memory use, four export memory use dimensions have been discovered: instrumental, conceptual, legitimizing and manipulating. Results from the qualitative study based on the data from a mail survey with 354 responses reveal that the development of export memory quality is positively related with quality of export information acquisition, the quality of export information interpretation, export coordination, and integration of the information into the organizational system. Several company and environmental factors have also been examined in terms of their relationship with export memory use. The two factors found to be significantly related to the extent of export memory use are acquisition of export information quality and export memory quality. The results reveal that export memory quality is positively related to the extent of export memory use which in turn was found to be positively related to export performance. Furthermore, results of the study show that there is only one aspect of export memory use that significantly affects export performance – the extent of export memory use. This finding could mean that there is no particular type of export memory use favored since the choice of the type of use is situation specific. Additional results reveal that environmental turbulence and export memory overload have moderating effects on the relationship between export memory use and export performance.

The influence of tool geometry on the performance of drilling tools

The main objective of the work presented in this thesis is to investigate the two sides of the flute, the face and the heel of a twist drill. The flute face was designed to yield straight diametral lips which could be extended to eliminate the chisel edge, and consequently a single cutting edge will be obtained. Since drill rigidity and space for chip conveyance have to be a compromise a theoretical expression is deduced which enables optimum chip disposal capacity to be described in terms of drill parameters. This expression is used to describe the flute heel side. Another main objective is to study the effect on drill performance of changing the conventional drill flute. Drills were manufactured according to the new flute design. Tests were run in order to compare the performance of a conventional flute drill and non conventional design put forward. The results showed that 50% reduction in thrust force and approximately 18% reduction in torque were attained for the new design. The flank wear was measured at the outer corner and found to be less for the new design drill than for the conventional one in the majority of cases. Hole quality, roundness, size and roughness were also considered as a further aspect of drill performance. Improvement in hole quality is shown to arise under certain cutting conditions. Accordingly it might be possible to use a hole which is produced in one pass of the new drill which previously would have required a drilled and reamed hole. A subsidiary objective is to design the form milling cutter that should be employed for milling the foregoing special flute from drill blank allowing for the interference effect. A mathematical analysis in conjunction with computing technique and computers is used. To control the grinding parameter, a prototype drill grinder was designed and built upon the framework of an existing cincinnati cutter grinder. The design and build of the new grinder is based on a computer aided drill point geometry analysis. In addition to the conical grinding concept, the new grinder is also used to produce spherical point utilizing a computer aided drill point geometry analysis.

An advanced real-time predictive maintenance framework for large scale machine systems

This thesis introduces and develops a novel real-time predictive maintenance system to estimate the machine system parameters using the motion current signature. Recently, motion current signature analysis has been addressed as an alternative to the use of sensors for monitoring internal faults of a motor. A maintenance system based upon the analysis of motion current signature avoids the need for the implementation and maintenance of expensive motion sensing technology. By developing nonlinear dynamical analysis for motion current signature, the research described in this thesis implements a novel real-time predictive maintenance system for current and future manufacturing machine systems. A crucial concept underpinning this project is that the motion current signature contains infor­mation relating to the machine system parameters and that this information can be extracted using nonlinear mapping techniques, such as neural networks. Towards this end, a proof of con­cept procedure is performed, which substantiates this concept. A simulation model, TuneLearn, is developed to simulate the large amount of training data required by the neural network ap­proach. Statistical validation and verification of the model is performed to ascertain confidence in the simulated motion current signature. Validation experiment concludes that, although, the simulation model generates a good macro-dynamical mapping of the motion current signature, it fails to accurately map the micro-dynamical structure due to the lack of knowledge regarding performance of higher order and nonlinear factors, such as backlash and compliance. Failure of the simulation model to determine the micro-dynamical structure suggests the pres­ence of nonlinearity in the motion current signature. This motivated us to perform surrogate data testing for nonlinearity in the motion current signature. Results confirm the presence of nonlinearity in the motion current signature, thereby, motivating the use of nonlinear tech­niques for further analysis. Outcomes of the experiment show that nonlinear noise reduction combined with the linear reverse algorithm offers precise machine system parameter estimation using the motion current signature for the implementation of the real-time predictive maintenance system. Finally, a linear reverse algorithm, BJEST, is developed and applied to the motion current signature to estimate the machine system parameters.