"Customer" knowledge management in healthcare

This paper reports on a work-in-progress project on the management of patient knowledge in a UK general hospital. Greater involvement of patients is generally seen as crucial to the effective provision of healthcare in the future. However, this presents many challenges, especially in the light of the ageing population in most developed countries and the consequent increasing demand for healthcare. In the UK, there have been many attempts to increase patient involvement by the systematisation of patient feedback, but typically they have not been open to academic scrutiny or formal evaluation, nor have they used any knowledge management principles. The theoretical foundations for this project come first from service management and thence from customer knowledge management. Service management stresses the importance of the customer perspective. Healthcare clearly meets the definitions of a service even though it may also include some tangible elements such as surgery and provision of medication. Although regarding hospital patients purely as "customers" is a viewpoint that needs to be used with care, application of the theory offers potential benefits in healthcare. The two main elements we propose to use from the theory are the type of customer knowledge and its relationship to attributes of the quality of the service provided. The project is concerned with investigating various knowledge management systems (KMS) that are currently in use (or proposed) to systematise patient feedback in an NHS Trust hospital, to manage knowledge from and to a lesser extent about patients. The study is a mixed methods (quantitative and qualitative) action research investigation intended to answer the following three research questions: • How can a KMS be used as a mechanism to capture and evaluate patient experiences to provoke patient service change • How can the KMS assist in providing a mechanism for systematising patient engagement? • How can patient feedback be used to stimulate improvements in care, quality and safety?

Description and preliminary results from a structured specialist behavioural weight management group intervention:Specialist Lifestyle Management (SLiM) programme

Background -  Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods - The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results - Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions - The SLiM programme is an effective group intervention for the management of severe and complex obesity.

Dissidents with an innovation cause? Non-institutionalized actors’ online social knowledge sharing, solution-finding tensions and technology management innovation

Purpose – Traditionally, most studies focus on institutionalized management-driven actors to understand technology management innovation. The purpose of this paper is to argue that there is a need for research to study the nature and role of dissident non-institutionalized actors’ (i.e. outsourced web designers and rapid application software developers). The authors propose that through online social knowledge sharing, non-institutionalized actors’ solution-finding tensions enable technology management innovation. Design/methodology/approach – A synthesis of the literature and an analysis of the data (21 interviews) provided insights in three areas of solution-finding tensions enabling management innovation. The authors frame the analysis on the peripherally deviant work and the nature of the ways that dissident non-institutionalized actors deviate from their clients (understood as the firm) original contracted objectives. Findings – The findings provide insights into the productive role of solution-finding tensions in enabling opportunities for management service innovation. Furthermore, deviant practices that leverage non-institutionalized actors’ online social knowledge to fulfill customers’ requirements are not interpreted negatively, but as a positive willingness to proactively explore alternative paths. Research limitations/implications – The findings demonstrate the importance of dissident non-institutionalized actors in technology management innovation. However, this work is based on a single country (USA) and additional research is needed to validate and generalize the findings in other cultural and institutional settings. Originality/value – This paper provides new insights into the perceptions of dissident non-institutionalized actors in the practice of IT managerial decision making. The work departs from, but also extends, the previous literature, demonstrating that peripherally deviant work in solution-finding practice creates tensions, enabling management innovation between IT providers and users.

Stratégiai paradigmaváltás szervezeti verseny(képesség) és az Operations management központi szerepe (Central role of strategic paradigm change, corporate competitiveness and operations management)

Az elmúlt két évtized folyamán a menedzserek megtanultak a megújult szabályok szerint játszani. Tudatosították, hogy a vállalatuk eredményes navigálásához folyamatosan figyelniük és adaptálniuk kell a legújabb módszereket, elméleteket. Jelen tanulmányával a szerző ezt a folyamatot kívánja segíteni, valamint arra az alapvető kérdésre keresi a választ, hogy érdemes-e a rendkívül gyorsan változó világban hosszabb távú célok meghatározásával foglalkozni, és ha igen, akkor mire összpontosítsák a vállalatok erőfeszítéseiket. Milyen részletezettséggel, milyen módon határozzák meg az elképzeléseiket úgy, hogy közben megőrizzék a vállalat flexibilitását, a változások idején nélkülözhetetlen agilitást. A szerző arra vállalkozik, hogy feltárja a stratégiai paradigmaváltás fejlődését, a termelési stratégia, az operations management központi meghatározó szereppé válását, valamint áttekintse a termelési és szolgáltatási rendszervezetés (OM) elveinek, eszközeinek, módszereinek fejlődését, kölcsönhatását, összefüggéseit. _______ Change of paradigm has taken place in strategic planning. Fight for position turned into a fight of movement. Companies strive to achieve individual, not copyable organizational performance, as well as to realize their business strategies by means of value generating, proactive approach. Operative management now placed in the focus of production strategy is becoming the compass, the driving force of leadership. The management of production and service systems has grown into independent scientific disciplines. It yielded such principles, tools and methods which are present as world-renowned blueprints (scientific tools) in the field of maintaining and developing corporate performance. In the present study the author specifies and discusses the tools of operative management as criteria of value generation aiming at quality and cost efficiency. He analyses the backto- back character, interrelationship of quality, TQM (Total Quality Management), TPS (Toyota Production System) and JIT (Just in Time). He examines the effects thereof on corporate performance where significant and strong relationship can be demonstrated in case there is an ability to plan and develop new products. The current new OM (Operations Management) techniques increasingly rely upon the quality of human resources, the permanent improvement of procedures as well as focusing on tight cooperation with suppliers/customers. Supply chain management, core competence management, service management now represent a “new generation” of the OM methods, processes, serving at the same time as basis and starting point for expectable future techniques as well.

Best practices in exemplary service delivery: A multiple case study of service quality

The purpose of this study was to explain how exemplary service providers in luxury hotels provide consistently excellent service. Using a case study framework, the study investigated the service provider's strategies and concepts of service delivery, the importance and implementation of organizational and individual controls, and the role of training and learning. The study identified barriers to service provision and characteristics of the exemplary individuals that affect their ability to deliver luxury service. This study sought to better understand how exemplary service providers learn, think about, and do their work. The sample population of three Five-Diamond-Award winning resorts was selected for their potential for learning about the phenomenon of interest. The results demonstrate that exemplary service providers possess individual characteristics that are enhanced by the organizations for which they work. Exemplary service providers are often exemplary communicators who are emotionally generous and genuinely enjoy helping and serving others. Exemplary service organizations treat their employees as they treat their customers, as suggested by the Service-Profit Chain (Heskett, Sasser & Schlesinger, 1997). Further, they have systems and standards to guarantee satisfactory service experiences for every guest. They also encourage their service providers to personalize their service delivery and to seek opportunities to delight their guests, using a combination of controls, traditions and cultural values. Several customer service theories are discussed in relationship to whether they were or were not supported by the data. The study concluded that the delivery of exemplary service is a complex phenomenon that requires successful interactions between guests, service providers and the organization. A Model of Exemplary Service Delivery is presented and discussed that demonstrates the components of service quality as shown in the data. The model can be used by practitioners seeking to create, enhance, or evaluate their service quality, and by researchers seeking insights into the complex concepts in service quality research. Implications for future research are discussed.

Service Quality and Black Customer Satisfaction - A Perspective on the United States Restaurant Industry

This paper examines the issue of racial discrimination of Black United States (U.S.) restaurant patrons from a service quality and customer satisfaction perspective. In spite of the progress the industry has made in recent years to alleviate this problem, many contemporary examples clearly demonstrate that racial discrimination is still of great concern. The articles stresses the importance of an ethical approach in human resource management-intensive and offers suggestions for reducing discriminatory practices in U.S. restaurant service delivery.

Measuring Brand Equity of Restaurant Chains

Little research has been done to measure brand equity of hospitality companies. It is important for food service organizations to measure accurately their brand equity in order to manage and leverage it properly. This study attempts to measure the brand equity of casual dining restaurant chains in monetary terms using conjoint analysis.

What is social innovation? The paradigm shift and its relationship with Social Work

Innovation is a fundamental part of social work. In recent years there has been a shift in the innovation paradigm, making it easier to accept this relationship. National and supranational policies aimed at promoting innovation appear to be specifically guided by this idea. To be able to affirm this hypothesis, it is necessary to review the perception that social workers have of their duties. It is also useful to examine particular cases that show how such social innovation arises.

Innovations in Hospitality Human Resources: Cases from the U.S. Lodging Industry

[Excerpt] Today’s hospitality and tourism companies face complex, dramatically shifting challenges, most notably the need to compete for increasingly sophisticated customers in a global, fluid marketplace. To attract and retain the loyal cadre of customers that will ensure the organization’s success, service companies such as hospitality organizations must employ technologically advanced, yet margin sensitive, product and pricing strategies and practices that will differentiate themselves to their intended market. Even more importantly, these service organizations need to devise strategies that will capture and retain the most important yet, from a financial perspective, unrecognized asset on the balance sheet: the employees that design and deliver the service to the customer base. Human resource strategists (i.e. Becker & Gerhart, 1996; Cappelli & Crocker-Hefter, 1996; O’Reilly & Pfeffer, 2000; Pfeffer, 1998; Ulrich, 1997), including those who take a hospitality perspective (i.e. Baumann, 2000; Hume, 2000; Worcester, 1999) advocate a renewed attention to the investment in employees or “human capital” as a source of strategic competitive advantage.

Knowledge management capabilities and organizational performance: an investigation into the effects of knowledge infrastructure and processes on organizational performance

Knowledge is one of the most important assets for surviving in the modern business environment. The effective management of that asset mandates continuous adaptation by organizations, and requires employees to strive to improve the company's work processes. Organizations attempt to coordinate their unique knowledge with traditional means as well as in new and distinct ways, and to transform them into innovative resources better than those of their competitors. As a result, how to manage the knowledge asset has become a critical issue for modern organizations, and knowledge management is considered the most feasible solution. Knowledge management is a multidimensional process that identifies, acquires, develops, distributes, utilizes, and stores knowledge. However, many related studies focus only on fragmented or limited knowledge-management perspectives. In order to make knowledge management more effective, it is important to identify the qualitative and quantitative issues that are the foundation of the challenge of effective knowledge management in organizations. The main purpose of this study was to integrate the fragmented knowledge management perspectives into the holistic framework, which includes knowledge infrastructure capability (technology, structure, and culture) and knowledge process capability (acquisition, conversion, application, and protection), based on Gold's (2001) study. Additionally, because the effect of incentives ̶̶ which is widely acknowledged as a prime motivator in facilitating the knowledge management process ̶̶ was missing in the original framework, this study included the importance of incentives in the knowledge management framework. This study also identified the relationship of organizational performance from the standpoint of the Balanced Scorecard, which includes the customer-related, internal business process, learning & growth, and perceptual financial aspects of organizational performance in the Korean business context. Moreover, this study identified the relationship with the objective financial performance by calculating the Tobin's q ratio. Lastly, this study compared the group differences between larger and smaller organizations, and manufacturing and nonmanufacturing firms in the study of knowledge management. Since this study was conducted in Korea, the original instrument was translated into Korean through the back translation technique. A confirmatory factor analysis (CFA) was used to examine the validity and reliability of the instrument. To identify the relationship between knowledge management capabilities and organizational performance, structural equation modeling (SEM) and multiple regression analysis were conducted. A Student's t test was conducted to examine the mean differences. The results of this study indicated that there is a positive relationship between effective knowledge management and organizational performance. However, no empirical evidence was found to suggest that knowledge management capabilities are linked to the objective financial performance, which remains a topic for future review. Additionally, findings showed that knowledge management is affected by organization's size, but not by type of organization. The results of this study are valuable in establishing a valid and reliable survey instrument, as well as in providing strong evidence that knowledge management capabilities are essential to improving organizational performance currently and making important recommendations for future research.

A qualidade dos cuidados de enfermagem e a Norma ISO 9001 : Aplicação empírica no Hospital CUF Infante Santo

A preocupação com a qualidade e normalização dos serviços de saúde é cada vez maior, verificando-se que, para responder às progressivas exigências dos utentes, aparecem entidades que criam normas universais, as quais pretendem a garantia da qualidade nos serviços de saúde. Contudo, a implementação de um sistema de gestão da qualidade, através da norma ISO 9001, nestas organizações, é um desafio pela dificuldade de avaliação da qualidade dos serviços prestados- cuidados de saúde. Estando presente num hospital profissional como médicos, enfermeiros e gestores, com características culturais que influenciam a forma de encarar a qualidade e a sua monitorização para a existência de uma mudança profunda, quando se implementa uma política de qualidade, é fundamental conhecer a definição da qualidade de cada profissional, membro de uma cultura e, deste modo, a sua postura perante o fenómeno. O presente trabalho tem como objectivos identificar a percepção dos enfermeiros do Hospital Cuf Infante-Santo, relativamente ao sistema de gestão da qualidade, segundo a norma ISO, e, consequentemente, investigar pontos fortes, pontos fracos, ameaças e oportunidades da implementação dessa norma nessa organização hospitalar. Para atingir os objectivos, foi desenvolvido um modelo de análise, onde se considera o relacionamento entre as características da qualidade em saúde, cultura organizacional hospitalar e do sistema da norma ISO, para o desenvolvimento da melhoria contínua na organização. Os dados, para a elaboração desta dissertação, foram recolhidos através de inquérito por questionários aos enfermeiros do Hospital Cuf Infante-Santo, que se encontravam a laborar na organização aquando da implementação da norma ISO, sendo utilizado o método quantitativo e técnicas do estudo qualitativo na análise de dados orientados para o significado das acções. Do trabalho desenvolvido, conclui-se que a percepção relativamente às alterações na qualidade dos cuidados está limitada pelo facto de a maioria dos respondentes não conhecer o sistema de qualidade (Norma ISO 9001), sendo este um dos pontos fracos para a implementação da norma ISO na organização. Deste modo, a situação diagnosticada constitui um alerta para as organizações de saúde, ao implementarem sistemas de gestão da qualidade, potencializarem os pontos fortes identificados, como a orientação dos enfermeiros para o cuidar e para o cliente e, por outro lado, evitar repetir pontos fracos, como o identificado anteriormente, através do envolvimento e formação dos seus colaboradores nas políticas da qualidade. Os enfermeiros preocupam-se com a qualidade, mas referem que não a monitorizam regularmente. Pelo que, esta necessidade com a implementação do sistema de gestão da qualidade, deverá ser corrigida, de modo a que a organização de saúde em estudo caminhe para a excelência. ABSTRACT: The concern with the quality and standardization of health services is increasing, verifying that to respond to the progressiva demands of the users, there appear entities wishing to create universal standards to ensure the quality in health services. However, implementing a quality management service, through ISO 9001 standard, in these organizations, it is a challenge by the difficulties of evaluation in the quality of the provided services - health care. Being present in a hospital professionals such as doctors, nurses and managers, with cultural characteristics that influence the way and method of facing the quality and its monitoring for the existence of a profound change, when a quality policy is implemented, it is fundamental to know the definition of the quality of each and ever professional, member of a culture, and in this way, their posture towards the phenomenon. This present study aims to identify the perceptions of nurses at the Infante-Santo CUF Hospital, relatively to the quality management system, according to the ISO standard, and consequently, investigating strengths, weaknesses, threats and opportunities of the implementation of this standard in that hospital organization. To achieve these aims or objectives, an analysis model was developed, which considers the relationship between the characteristics of the quality of health, hospital organizational culture and the ISO standard system, for the further development of the continuous improvement in the organization. The data for the elaboration of this dissertation was collected through questionnaire surveys done to the nurses at Infante-Santo CUF Hospital, who were working in the organization during the ISO standard implementation, being used the quantity method and techniques of the quality study in the analysis of data orientated to the meaning of actions. The developed research concluded that the perception related to the alterations in the quality of the care is limited by the majority of respondents not knowing the quality system (ISO 9001 standard), being this one of the weaknesses to the implementation of the ISO standard in the organization. Therefore, the diagnosed situation constituted a warning to the health organizations, to implement quality management systems, potentially the identified strengths, such as the orientation of the nurses to the care and to the client, and on the other hand, avoiding the repetition of weaknesses, as previously identified, through the involvement and training of its employees in the quality policies. The nurses are concerned about the quality but they refer that there is no regular monitoring. Thus, this necessity of the implementation of the quality and management system should be corrected, so that the health organization being studied should proceed to excellence.

Sourcing business and software services

With the advancement of Service-Oriented Architecture in the technical and business domain, the management & engineering of services requires a thorough and systematic understanding of the service lifecycle for both business and software services. However, while service-oriented approaches acknowledge the importance of the service ecosystem, service lifecycle models are typically internally focused, paying limited attention to processes related to offering services to or using services from other actors. In this paper, we address this need by discussing the relations between a comprehensive service lifecycle approach for service management & engineering and the sourcing & purchasing of services. In particular we pay attention to the similarities and differences between sourcing business and software services, the alignment between service management & engineering and sourcing & purchasing, the role of sourcing in the transformation of an organization towards a service-oriented paradigm, the role of architectural approaches to sourcing in this transformation, and the sourcing of specific services at different levels of granularity.

Getting research data ‘out there’ : collaborative solutions to identifying, describing and making research data more visible

At QUT research data refers to information that is generated or collected to be used as primary sources in the production of original research results, and which would be required to validate or replicate research findings (Callan, De Vine, & Baker, 2010). Making publicly funded research data discoverable by the broader research community and the public is a key aim of the Australian National Data Service (ANDS). Queensland University of Technology (QUT) has been innovating in this space by undertaking mutually dependant technical and content (metadata) focused projects funded by ANDS. Research Data Librarians identified and described datasets generated from Category 1 funded research at QUT, by interviewing researchers, collecting metadata and fashioning metadata records for upload to the Australian Research Data commons (ARDC) and exposure through the Research Data Australia interface. In parallel to this project, a Research Data Management Service and Metadata hub project were being undertaken by QUT High Performance Computing & Research Support specialists. These projects will collectively store and aggregate QUT’s metadata and research data from multiple repositories and administration systems and contribute metadata directly by OAI-PMH compliant feed to RDA. The pioneering nature of the work has resulted in a collaborative project dynamic where good data management practices and the discoverability and sharing of research data were the shared drivers for all activity. Each project’s development and progress was dependent on feedback from the other. The metadata structure evolved in tandem with the development of the repository and the development of the repository interface responded to meet the needs of the data interview process. The project environment was one of bottom-up collaborative approaches to process and system development which matched top-down strategic alliances crossing organisational boundaries in order to provide the deliverables required by ANDS. This paper showcases the work undertaken at QUT, focusing on the Seeding the Commons project as a case study, and illustrates how the data management projects are interconnected. It describes the processes and systems being established to make QUT research data more visible and the nature of the collaborations between organisational areas required to achieve this. The paper concludes with the Seeding the Commons project outcomes and the contribution this project made to getting more research data ‘out there’.

Whole life cycle costing for Malaysia residential property development : the cultural environment

As knowledge of the residential development costing impact on resource and budgeting use increase, developers are moving towards more sustainable solution by implementing whole life cycle costing. Property management requires an understanding of infrastructure management, service life planning and quality management. Today, people are beginning to realize that effective property management in high-rise residential property can sustain the property value and maintain high returns on their investment. The continuous growth of high-rise residential properties indicates that there is a need for an effective property management system to provide a sustainable high-rise residential property development. For such reasons, this paper attempts to study the culture that have been applied due the residential property development in Malaysia as to improve to the best and sustainable practice in providing the best cost effectiveness management system in residential property development.