Managing people and performance:An evidence based framework applied to health service organizations

People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1. Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2. People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3. Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4. Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5. Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid.

A methodology for the generation and evaluation of biorefinery process chains, in order to identify the most promising biorefineries for the EU

The topic of bioenergy, biofuels and bioproducts remains at the top of the current political and research agenda. Identification of the optimum processing routes for biomass, in terms of efficiency, cost, environment and socio-economics is vital as concern grows over the remaining fossil fuel resources, climate change and energy security. It is known that the only renewable way of producing conventional hydrocarbon fuels and organic chemicals is from biomass, but the problem remains of identifying the best product mix and the most efficient way of processing biomass to products. The aim is to move Europe towards a biobased economy and it is widely accepted that biorefineries are key to this development. A methodology was required for the generation and evaluation of biorefinery process chains for converting biomass into one or more valuable products that properly considers performance, cost, environment, socio-economics and other factors that influence the commercial viability of a process. In this thesis a methodology to achieve this objective is described. The completed methodology includes process chain generation, process modelling and subsequent analysis and comparison of results in order to evaluate alternative process routes. A modular structure was chosen to allow greater flexibility and allowing the user to generate a large number of different biorefinery configurations The significance of the approach is that the methodology is defined and is thus rigorous and consistent and may be readily re-examined if circumstances change. There was the requirement for consistency in structure and use, particularly for multiple analyses. It was important that analyses could be quickly and easily carried out to consider, for example, different scales, configurations and product portfolios and so that previous outcomes could be readily reconsidered. The result of the completed methodology is the identification of the most promising biorefinery chains from those considered as part of the European Biosynergy Project.

Aspects of the design and control of manufacturing systems subject to demand uncertainty

The recent explosive growth in advanced manufacturing technology (AMT) and continued development of sophisticated information technologies (IT) is expected to have a profound effect on the way we design and operate manufacturing businesses. Furthermore, the escalating capital requirements associated with these developments have significantly increased the level of risk associated with initial design, ongoing development and operation. This dissertation has examined the integration of two key sub-elements of the Computer Integrated Manufacturing (CIM) system, namely the manufacturing facility and the production control system. This research has concentrated on the interactions between production control (MRP) and an AMT based production facility. The disappointing performance of such systems has been discussed in the context of a number of potential technological and performance incompatibilities between these two elements. It was argued that the design and selection of operating policies for both is the key to successful integration. Furthermore, policy decisions are shown to play an important role in matching the performance of the total system to the demands of the marketplace. It is demonstrated that a holistic approach to policy design must be adopted if successful integration is to be achieved. It is shown that the complexity of the issues resulting from such an approach required the formulation of a structured design methodology. Such a methodology was subsequently developed and discussed. This combined a first principles approach to the behaviour of system elements with the specification of a detailed holistic model for use in the policy design environment. The methodology aimed to make full use of the `low inertia' characteristics of AMT, whilst adopting a JIT configuration of MRP and re-coupling the total system to the market demands. This dissertation discussed the application of the methodology to an industrial case study and the subsequent design of operational policies. Consequently a novel approach to production control resulted. A central feature of which was a move toward reduced manual intervention in the MRP processing and scheduling logic with increased human involvement and motivation in the management of work-flow on the shopfloor. Experimental results indicated that significant performance advantages would result from the adoption of the recommended policy set.

Chemistry of phospholipid oxidation

The oxidation of lipids has long been a topic of interest in biological and food sciences, and the fundamental principles of non-enzymatic free radical attack on phospholipids are well established, although questions about detail of the mechanisms remain. The number of end products that are formed following the initiation of phospholipid peroxidation is large, and is continually growing as new structures of oxidized phospholipids are elucidated. Common products are phospholipids with esterified isoprostane-like structures and chain-shortened products containing hydroxy, carbonyl or carboxylic acid groups; the carbonyl-containing compounds are reactive and readily form adducts with proteins and other biomolecules. Phospholipids can also be attacked by reactive nitrogen and chlorine species, further expanding the range of products to nitrated and chlorinated phospholipids. Key to understanding the mechanisms of oxidation is the development of advanced and sensitive technologies that enable structural elucidation. Tandem mass spectrometry has proved invaluable in this respect and is generally the method of choice for structural work. A number of studies have investigated whether individual oxidized phospholipid products occur in vivo, and mass spectrometry techniques have been instrumental in detecting a variety of oxidation products in biological samples such as atherosclerotic plaque material, brain tissue, intestinal tissue and plasma, although relatively few have achieved an absolute quantitative analysis. The levels of oxidized phospholipids in vivo is a critical question, as there is now substantial evidence that many of these compounds are bioactive and could contribute to pathology. The challenges for the future will be to adopt lipidomic approaches to map the profile of oxidized phospholipid formation in different biological conditions, and relate this to their effects in vivo. This article is part of a Special Issue entitled: Oxidized phospholipids-their properties and interactions with proteins.

The move to servitization (from a product service system point of view)

Product Service Systems (PSSs) emphasize the substitution of products with services. The term “Servitisation” was introduced by Sandra Vendermerwe in the 80s to represent the addition of services to increase a company’s competitive edge. Key to PSS, and Servitisation more generally, is the “informated product”. The informated product enables health monitoring of the product in use and can be key to a workable PSS. This paper reviews the evolution of servitisation and the associated business benefit. It also then reviews the concept of informated product reconfiguration techniques and remote services that enables PSS to be delivered.

Key success factors when implementing strategic manufacturing initiatives

Purpose – This paper reports the study of key success factors (KSFs) in the project management of the implementation of strategic manufacturing initiatives (SMIs). Design/methodology/approach – In order to gather the experience and knowledge of many industries, from different geographic locations, in a broad range of types and sizes of SMIs, a questionnaire-based survey of practitioners worldwide was selected as the most appropriate research method among those available. Findings – The identification of those tasks and activities that must be done well in order to succeed in the implementation of a SMI in practice. Practical implications – Practitioners focusing their attention on the KSFs identified are more likely to succeed. Once these factors have been identified, the value of benchmarking project management methodologies then comes from drawing attention to those tasks that are key to the success of the implementation of SMIs. Originality/value – The paper presents new thinking by bringing project management into the operations strategy implementation literature as an important mediating factor for success. In this context the factors that are required for successful implementation are identified.

From words to action:visibility of management in supporting interdisciplinary team working in an acute rehabilitative geriatric hospital

Purpose: The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. Design/methodology/approach: A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Findings: Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. Research limitations/implications: The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. Practical implications: The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Social implications: Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. Originality/value: The authors draw on solid theoretical frameworks - the complexity theory, team effectiveness model and the social identity theory - to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level. © Emerald Group Publishing Limited.

Developing an intervention to equip nurses for acute life threatening events (ALTEs) in hospital:a phenomenological approach to healthcare research

Objectives: To understand staff's experiences of acute life threatening events (ALTEs) in a pediatric hospital setting. These data will inform an intervention to equip nurses with clinical and emotional skills for dealing with ALTEs. Method: A mixed design was used in the broader research program; this paper focuses on phenomenon-focused interviews analyzed using interpretative phenomenological analysis (IPA). Results: Emerging themes included staff's relationships with patients and the impact of personhood on their ability to perform competently in an emergency. More experienced nurses described "automatic" competence generated through increased exposure to ALTEs and were able to recognize "fumbling and shaking" as a normal stress response. Designating a role was significant to staff experience of effectiveness. Key to nurses' learning experience was reflection and identifying experiences as "teachable moments." Findings were considered alongside existing theories of self-efficacy, reflective thought, and advocacy inquiry to create an experiential learning intervention involving a series of clinical and role-related scenarios. Conclusion: The phenomenological work facilitated an in-depth reading of experience. It accentuated the importance of exposure to ALTEs giving nurses experiential knowledge to prepare them for the impact of these events. Challenges included bracketing the personhood of child patients, shifting focus to clinical tasks during the pressured demands of managing an ALTE, normalizing the physiological stress response, and the need for a forum and structure for reflection and learning. An intervention will be designed to provide experiential learning and encourage nurses to realize and benefit from their embodied knowledge.

"How prepared are engineering educators to implement active learning?" - The emerging findings

This paper discusses the question of how well prepared Engineering Educators are to implement Active Learning approaches within Higher Education undergraduate Engineering Programmes in Malaysia. As the role of Higher Education has shifted from being that of a 'knowledge provider' to become primarily focused upon 'learning facilitation', so the role of teachers or academic staff has changed in that they have become the key to implementing successful Active Learning. Based upon the emergent findings from a case study conducted at a Malaysian institution of higher education, the paper reveals that the engineering educators within the institution concerned were neither prepared nor ready to implement Active Learning. Indeed, it is evident from the study findings that a huge effort is needed in terms of educational policy and practice to ensure that Malaysian institutions offering engineering education should move efficiently and effectively towards the unilateral adoption of Active Learning approaches.

Cut mowing and grazing effects with grey cattle on plant species composition in case of Pannon wet grasslands

Examined area can be found at Balaton Uplands National Park (Hungary). 5 sample areas were examined in Badacsonytördemic: 1: 32 hectare under-grazed pasture, 2: 38 hectare overgrazed pasture, 3: 34 hectare hayfield, 4: trampled area, 5: beaten track. Livestock population was 118 in the monitored pastures. Sampling was executed along five 52m long circular transects, within 5cm × 5cm interlocking quadrates. Based on the data we can state that the curve of the drinking area was the highest of speciesarea examinations however weed appeared because of degradation which provided more species. According to species-area examinations overgrazed areas were richer in species then other examined areas. Based on diversity data drinking area considered degraded, while meadow and overgrazed areas was considered as proper state. Diversity of meadow was larger, but dominance of economically useful species was smaller. The amount of less valuable species – Carex hirta – increased.

Arctic ecosystem responses to changes in water availability and warming: Short and long-term responses

Arctic soils store close to 14% of the global soil carbon. Most of arctic carbon is stored below ground in the permafrost. With climate warming the decomposition of the soil carbon could represent a significant positive feedback to global greenhouse warming. Recent evidence has shown that the temperature of the Arctic is already increasing, and this change is associated mostly with anthropogenic activities. Warmer soils will contribute to permafrost degradation and accelerate organic matter decay and thus increase the flux of carbon dioxide and methane into the atmosphere. Temperature and water availability are also important drivers of ecosystem performance, but effects can be complex and in opposition. Temperature and moisture changes can affect ecosystem respiration (ER) and gross primary productivity (GPP) independently; an increase in the net ecosystem exchange can be a result of either a decrease in ER or an increase in GPP. Therefore, understanding the effects of changes in ecosystem water and temperature on the carbon flux components becomes key to predicting the responses of the Arctic to climate change. The overall goal of this work was to determine the response of arctic systems to simulated climate change scenarios with simultaneous changes in temperature and moisture. A temperature and hydrological manipulation in a naturally-drained lakebed was used to assess the short-term effect of changes in water and temperature on the carbon cycle. Also, as part of International Tundra Experiment Network (ITEX), I determined the long-term effect of warming on the carbon cycle in a natural hydrological gradient established in the mid 90's. I found that the carbon balance is highly sensitive to short-term changes in water table and warming. However, over longer time periods, hydrological and temperature changed soil biophysical properties, nutrient cycles, and other ecosystem structural and functional components that down regulated GPP and ER, especially in wet areas.

The Theory of Planned Behavior and Ethnically Diverse Community College Students and Their Intentions to Exercise: A Preliminary Analysis

Although regular exercise is the key to a healthy lifestyle, college students are insufficiently active to maintain good health. Motivations to exercise may vary among different ethnic groups. The results of a pilot study using the Theory of Planned Behavior (Gordon, 2008) showed that ethnically diverse college students can rate their beliefs (behavioral, social, and cognitive) pertaining to physical activity.

Roseate spoonbill reproduction as an indicator for restoration of the Everglades and the Everglades estuaries

Ecological monitoring is key to successful ecosystem restoration. Because all components within an ecosystem cannot be monitored, it is important to select indicators that are representative of the system, integrate system responses, clearly respond to system change, can be effectively and efficiently monitored, and are easily communicated. The roseate spoonbill is one ecological indicator species that meets these criteria within the Everglades ecosystem. Monitoring of roseate spoonbills in Florida Bay over the past 70 years has shown that aspects of this species’ reproduction respond to changes in hydrology and corresponding changes in prey abundance and availability. This indicator uses nesting location, nest numbers and nesting success in response to food abundance and availability. In turn, prey abundance is a function of hydrological conditions (especially water depth) and salinity. Metrics and targets for these performance measures were established based on previous findings. Values of each metric were translated into indices and identified as stoplight colors with green indicating that a given target has been met, yellow indicating that conditions are below the target, but within an acceptable range of it, and red indicating the measure is performing poorly in relation to the target.

From Clerk and Cashier to Guest Service Agent

In their study - From Clerk and Cashier to Guest Service Agent - by Nancy J. Allin, Director of Quality Assurance and Training and Kelly Halpine, Assistant Director of Quality Assurance and Training, The Waldorf-Astoria, New York, the authors state at the outset: “The Waldorf-Astoria has taken the positions of registration clerk and cashier and combined them to provide excellent guest service and efficient systems operation. The authors tell how and why the combination works. That thesis statement defines the article, and puts it squarely in the crosshairs of the service category. Allin and Halpine use their positions at the Waldorf-Astoria in New York City to frame their observations “The allocation of staff hours has been a challenge to many front office managers who try their hardest to schedule for the norm but provide excellent, efficient service throughout the peaks,” Allin and Halpine allude. “…the decision [to combine the positions of registration clerk and cashier] was driven by a desire to improve guest service where its impact is most obvious, at the front desk. Cross-trained employees speed the check-in and check-out process by performing both functions, as the traffic at the desk dictates,” the authors say. Making such a move has resulted in positive benefits for both the guests and the hotel. “Benefits to the hotel, in addition to those brought to bear by increased guest satisfaction, include greater flexibility in weekly scheduling and in granting vacations while maintaining adequate staffing at the desk,” say Allin and Halpine . “Another expected outcome, net payroll savings, should also be realized as a consequence of the ability to schedule more efficiently.” The authors point to communication as the key to designing a successful combination such as this, with the least amount of service disruption. They bullet-point what that communication should entail. Issues of seniority, wage and salary rates, organizational charting, filing, scheduling, possible probationary periods, position titles, and physical layouts are all discussed. “It is critical that each of the management issues be addressed and resolved before any training is begun,” Allin and Halpine suggest. “Unresolved issues project confusion and lack of conviction to line employees and the result is frustration and a lack of commitment to the combination process,” they push the thought Allin and Halpine insist: “Once begun, training must be ongoing and consistent.” In the practical sense, the authors provide that authorizing overtime is helpful in accomplishing training. “Training must address the fact that employees will be faced with guest situations which are new to them, for example: an employee previously functioning as a cashier will be faced with walking guests. Specific exercises should be included to address these needs,” say the authors.

Perceived Risk of Predation Affects Reproductive Life - History Traits in Gambusia holbrooki, but Not in Heterandria formosa

Key to predicting impacts of predation is understanding the mechanisms through which predators impact prey populations. While consumptive effects are well-known, non-consumptive predator effects (risk effects) are increasingly being recognized as important. Studies of risk effects, however, have focused largely on how trade-offs between food and safety affect fitness. Less documented, and appreciated, is the potential for predator presence to directly suppress prey reproduction and affect life-history characteristics. For the first time, we tested the effects of visual predator cues on reproduction of two prey species with different reproductive modes, lecithotrophy (i.e. embryonic development primarily fueled by yolk) and matrotrophy (i.e. energy for embryonic development directly supplied by the mother to the embryo through a vascular connection). Predation risk suppressed reproduction in the lecithotrophic prey (Gambusia holbrokii) but not the matrotroph (Heterandria formosa). Predator stress caused G. holbrooki to reduce clutch size by 43%, and to produce larger and heavier offspring compared to control females. H. formosa, however, did not show any such difference. In G. holbrooki we also found a significantly high percentage (14%) of stillbirths in predator-exposed treatments compared to controls (2%). To the best of our knowledge, this is the first direct empirical evidence of predation stress affecting stillbirths in prey. Our results suggest that matrotrophy, superfetation (clutch overlap), or both decrease the sensitivity of mothers to environmental fluctuation in resource (food) and stress (predation risk) levels compared to lecithotrophy. These mechanisms should be considered both when modeling consequences of perceived risk of predation on prey-predator population dynamics and when seeking to understand the evolution of reproductive modes.